Complete AG-82A7-S-12-0060.rtf

SOLICITA TION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

1. REQUISITION NUMBER

PAGE IOF47

OFFEROR TO COMPLETE BLOCKS 12,17,23,24, & 30

580395

2. CONTRACT NO.

3.A W ARDIEFFECTIVI; DATE

4. ORDER NUMBER

S. SOLICITATION NUMBER

6. SOLICITATION ISSUE

AG-82A7-S-12-0060

DATE

7. FOR SOLICITATION

a. NAME

b. TELEPHONE NUMBER (No collect

S. OFFER DUE DATE/

INFORMA TlON CALL: 0 Shirlee Harrison calls)

LOCAL TIME

303-275-5305

5/25/20123:00 PM

Mountain Time

9. ISSUEDBY

CODE I

10. THIS ACQUISITION IS

11. DELIVERY FOR

12. DISCOUNT TERMS

[ ] UNRESTRICTED

FOB DESTINATION

UNLESS BLOCK IS

USDA Forest Service

[X] SET ASIDE 100 % FOR

MARKED

[ ] EMERGING SMALL BUSINESS

r ] SEE SCHEDULE

WO AQM Job Corps Support Branch

[ X ] SMALL BUSINESS

I 13A. THIS CONTRACT IS RATED

ORDER UNDER DP AS (15 CFR 700

740 Simms Street

[ ] HUBZONE SMALL BUSINESS

13B. RATING

Golden, CO 80401

[ ] SERVlCE DISABLED

VETERAN-OWNED SMALL BUSINESS

[ ]S(A)

NAICS: 621210

14. METHOD OF SOLICATION

SIZE STANDARD: $7.0 million r lRFQ r lIFB r X 1 RFP

IS. DELIVER TO

16. ADMINISTERED BY

CODE

I 82A7 Pine Ridge Job Corps Center

WO AQM Job Corps Support Branch

17a. CONTRACTOR! OFFERER

1~CILITYI

ISa. PAYMENT WILL. BE MADE BY

ODE

TELEPHONE NO.

DUNS #

Pine Ridge Job Corps Center

FAX NO.

E-Mail Address:

D 17b CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ISb. SUMBIT INVOICES TO ADDRESS SHOWN IN BLOCK ISA UNLESS

ADDRESS IN OFFER

BLOCK BELOW IS CHECKED

D SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNlT

UNIT PRICE

AMOUNT

Dental Services, Pine Ridge Job Corp Center

YR

Chadron NE 69337

See attached Schedule to submit pricing.

25.

ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) I X I 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5. [XI ARE I I ARE NOT ATIACHED.

r J 27b. CONTRACTIPURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATIACHED. ADDENDA [IARE [ IARE NOT ATTACHED

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFlED HEREIN

30a. SIGNATURE OF OFFEROR!CONTRACTOR

31a. UNITED STATES OF AMERICA (Signature Of Contracting Officer) 30b. NAME AND TITLE OF SIGNER

/30C. DATE SIGNED

3Ib. NAME OF CONTRACTING OFFICER 31c. DATE SIGNED 32a. QUANTITY IN COLUMN 21 HAS BEEN

32b. SIGNATURE OF AUTHORIZED GOVT.

32c. DATE r .JRECEIVED I I INSPECTED r I ACCEPTED, AND CONFORMS TO THE

!REPRESENTATIVE

CONTRACT, EXCEPT AS NOTED

32d. PRINTED NAME AND TITLE OF AUTHORIZED

F' TELEPHONE NUMBER OF AUTHORIZED

F~G. E-MAIL OF AUTHORIZED

GOVERNMENT REPRESENTATIVE

VERNMENT REPRESENT A TIVE

OVERNMENT REPRESENTATIVE

33. SHIP NUMBER

34. VOUCHER NUMBER

I 35. AMOUNT VERIFIED CORRECT

~6. PAYMENT

II .lCOMPLETE [ I PARTIAL I J FfNAL I .lPARTIAL [ I FINAL

FOR

37. CHECK NUMBER

3S. SIR ACCOUNT NUMBER / 39. SIR VOUCHER NUMBER

40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 41b. SIGNATURE AND TITLE OF CERTIFYING

4Ic. DATE

OFFICER

42a. RECEIVED BY (print) / 42b. RECEIVED AT (Location) / 42c.DATE REC'D

42d. TOTAL

(YYMMDD)

CONTAINERS

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (Rev. 312005) Prescribed by GSA-FAR (48CFR 53.212

PART

II

III

IV

Dental Services Pine Ridge Job Corp Center

TABLE OF CONTENTS

CONTENTS

STANDARD FORM (SF) 1449

Continuation of SF 1449

CONTRACT CLAUSES

FAR 52.212-4, Contract Terms and Conditions- Commercial Items Addendum to FAR 52.212-4 FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes and Executive Orders

CONTRACT DOCUMENTS, EXHIBITS, AND ATTACHMENTS

Scope of Work Special Contract Requirements Exhibit 1 -- U.S. Dept of Labor Wage Determination Exhibit 2 -- Quality Assurance Surveillance Plan

SOLICITATION PROVISIONS

FAR 52.212-1, Instructions to Offerors - Commercial Items FAR 52.212-2, Evaluation - Commercial Items FAR 52.212-3, Offerors Representations & Certifications-- Commercial Items Addendum to FAR 52.212-3 (includes proposal submission instructions) SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

PAGE

'1-10 11-16 16-19 20-24 25-47

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A 7 -S-12-0060

I PAGE OF PAGES

2 47

CONTINlJATI0N OF STANDARD FORM 144-9 NOTE: This acquisition utilizes Simplified Acquisition procedures. (insert if SAP)

1. Continuation of Block 17b:

Remittance Address: When the Contractor wishes payments to be mailed to an address other than that shown in block 17a of the Standard Form 1449, the Contractor shall insert the remittance address below:

2. Continuation of Blocks 19 through 24 (Schedule of Services):

BASIC SERVICES - See Special Contract Requirements, and Exhibits 2. Provide all management, supervision, labor, supplies, materials, and equipment (except as otherwise specified herein); and plan, schedule, and coordinate as necessary to ensure effective performance of all services as specified herein. The Contractor shall be fully responsible for providing Dental Services as indicated herein for the location listed below:

Pine Ridge Job Corp Center 15710 Hwy 385 Chadron NE Prices for all years shall be based on the Wage Determination in Exhibit 1. Offerors shall not include any contingencies for increased labor costs for which adjustments are provided through FAR 52.222-43, Fair Labor Standards Act and Service Contract Act -- Price Adjustment clause.

Contractor personnel will perform all work required in the Performance Work Statement (PWS) for the amounts agreed to below, working Monday - Friday, excluding Federal holidays. Specific hours of duty must comply with PWS requirements and shall be agreed to through coordination with Center personnel.

When Contractor personnel are on vacation, sick leave, or any other leave, a qualified substitute shall be provided by the Contractor in accordance with the PWS.

Dental Services Pine Ridge Job Corp Center

SOLJRCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A7-S-12-0060

I PAGE OF PAGES

3 47

19.

20.

21.

22.

23.

24.

ITEM

SCHEDULE OF SERVICES

QUANTITY

UNIT

UNIT PRICE

TOTALAMT

NO.

(Estimated)

BASE YEAR SERVICES - July 01 2012 through June 30 2013

Periodic Oral Evaluation

EA

Limited Oral

EA

Evaluation/problem

Intraoral-periapical First

EA

Film

Intraoral-periapical Each

EA

Additional Film

Bitewings-two films

EA

Panoramic Film

EA

Prophylaxis adult

EA

Amalgam-one surface

EA

Amalgam-two surface

EA

Amalgam-three surface

EA

Amalgam-four or more

EA

surface

Resin-one surface, EA anterior

Resin-two surface

EA

Resin-three surface

EA

Resin-four or more

EA

surface anterior

EA

posterior

Resin-two surface, EA

Resin-three surface, EA

EA

surface, posterior

Re-cement crown

EA

Pre-fab stainless steel

EA

crown

Dental Services Pine Ridge Job Corp Center

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A7-S-12-0060

I PAGE OF PAGES

4 47

Coronal Remnants-

EA

deciduous tooth

Extraction-erupted tooth

EA

Surgical removal of

EA

erupted tooth

Removal of impacted

EA

tooth-soft

EA

tooth-part

EA

tooth-complete

Surgical removal of

EA

residual tooth

Palliative (emergency)

EA

. treatment

Application of

EA

desensitizing medication

Treatment of

EA

complication

TOTAL

20.

21.

22.

23.

24.

ITEM

SCHEDULE OF SERVICES

QUANTITY

UNIT

UNIT PRICE

TOTALAMT

OPTION YEAR I SERVICES - July 01, 2013 through June 30,2014

EA

Limited Oral

EA

EA

EA

EA

Panoramic Film

EA

Prophylaxis adult

EA

Amalgam-one surface

EA

Amalgam-two surface

EA

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A 7 -S-12-0060

I PAGE OF PAGES

5 47

Amalgam-three surface

EA

Amalgam-four or more

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

Pre-fab stainless steel

EA

Coronal Remnants-

EA

EA

Surgical removal of

EA

EA

EA

EA

EA

EA

treatment

EA

EA

Dental Services Pine Ridge Job Corp Center

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A7-S-12-0060

I PAGE OF PAGES

6 47

19.

20.

21.

22.

23.

24.

ITEM

SCHEDULE OF SERVICES

QUANTITY

UNIT

UNIT PRICE

TOTAL AMT

OPTION YEAR II SERVICES - July 01, 2014 through June 30, 2015

EA

Limited Oral

EA

I ntraoral-periapical First

EA

EA

EA

Panoramic Film

EA

Prophylaxis adult

EA

Amalgam-one surface

EA

Amalgam-two surface

EA

Amalgam-three surface

EA

Amalgam-four or more

EA

EA

EA

EA

EA

EA

EA

EA

EA

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A7-S-12-0060

I PAGE OF PAGES

7 47

Re-cement crown

EA

Pre-fab stainless steel

EA

EA

EA

Surgical removal of

EA

EA

EA

EA

EA

EA

EA

EA

19.

20.

21.

22.

23.

24.

ITEM

SCHEDULE OF SERVICES

QUANTITY

UNIT

UNIT PRICE

TOTALAMT

OPTION YEAR III SERVICES - July 31, 2015 through June 30, 2016

EA

Limited Oral

EA

I ntraoral-periapical First

EA

EA

EA

Panoramic Film

EA

Prophylaxis adult

EA

Dental Services Pine Ridge Job Corp Center

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A7-S-12-0060

I PAGE OF PAGES

8 47

Amalgam-one surface

EA

Amalgam-two surface

EA

Amalgam-three surface

EA

Amalgam-four or more

EA

EA

EA

EA

EA

EA

EA

EA

EA

EA

Pre-fab stainless steel

EA

EA

EA

Surgical removal of

EA

EA

EA

EA

EA

EA

EA

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A7-S-12-0060

I PAGE OF PAGES

9 47

Treatment of

EA

19.

20.

21.

22.

23.

24.

ITEM

SCHEDULE OF SERVICES

QUANTITY

UNIT

UNIT PRICE

TOTAL AMT

OPTION YEAR IV SERVICES - July 31, 2016 through June 30, 2017

EA

Limited Oral

EA

EA

EA

EA

Panoramic Film

EA

Prophylaxis adult

EA

Amalgam-one surface

EA

Amalgam-two surface

EA

Amalgam-three surface

EA

Amalgam-four or more

EA

EA

EA

EA

EA

EA

EA

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

SF 1449 - SOLICITATION FOR COMMERCIAL ITEMS

Solicitation # AG-82A 7 -S-12-0060

I PAGE OF PAGES

10 47

Resin-three surface, EA

EA

EA

Pre-fab stainless steel

EA

EA

EA

Surgical removal of

EA

EA

EA

EA

EA

EA

EA

EA

Dental Services Pine Ridge Job Corp Center

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

file_0.jpg file_1.wmf

CONTRACT CLAUSES

FAR 52.212-4 CONTRACT TERMS AND CONDITIONS -- COMMERCIAL ITEMS (FEB 2012)

(TAILORED) I

(As stated in Block 27 of the SF 1449, this clause is Incorporated By Reference; however, in accordance with FAR 12.302, the following paragraphs of this clause have been tailored, all other paragraphs remain unchanged.)

(a) lnsoection/Acceptence (tailored). The Government shall only tender for acceptance those items that conform to the requirementslof this contract. The Government reserves the right to inspect any services that have been tendered for acceptance. The Government may require re-performance of nonconforming services, or performance of omitted services, lat no increase in contract price. If the contractor fails to promptly perform the services again or to take the necessary action to ensure future performance in conformity with contract requirements, the Government may (1) take deductions from the contract price based on the Government's estimated value of the services not received, (2) by contract or otherwise, perform the services and deduct from a subsequent monthly payment any cost incurred by the Government that is directly related to the performance of such services or (3) terminate the contract for cause.

I

shall be submitted as a Single billing on a monthly basis, no later than ten days following the period invoiced. The billings shall be for the services rendered within the billing period.

(4) Contracto~ Personnel, including substitute personnel, are responsible for keeping track of hours wor~ed daily and shall maintain a record of hours worked daily, which shall be submitted rith the Contractor's invoice.

(5) See samp1e invoice at Exhibit 3.

(6) Invoices shall be mailed to:

Pine Ridge Job Corp Center 15710 Hwy 385 Chadron NE 69337 ADDENDUM TO FAR 52.2l2-4

1. FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one o~ more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Cont~acting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at thij address: https:/lwww.acquisition.gov/far

(a) ... 30 calendar days of the contract expiration date (c), .. five (5) years and 6 months Mar 2000

52.237-7

Indemnification and Medical Liability Insurance

Jan 1997

AGAR 452.204-71

Dental Services Pine Ridge Job Corp Center rersonal Identity Verification of Contractor Personnel Oct 2007 SiURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

452.215-73 452.237-74 452.237-75 rost Award Conference \<ey Personnel restrictions Against Disclosure

Nov 1996 Feb 1988 Feb 1988

2.

FAR 52.216-1 TYPE OF CONTRACT (APR1984)

I

(2) (3) The Government contemplates award of a fixed-price contract resulting from this solicitation.

3. TERM OF CONTRACT: Performance of the work requirements under this contract is expected to begin on July 01,2012 and contitue through June 30,2013, with four (4) 12-month option periods.

4. REPORTING ALLEGED CHILD ABUSE:

Pursuant to the spirit and requirements of P.L. 101-647, Section 225 and 226, the following applies:

Any employee or representative of the Contractor who becomes aware of allegations that a child in the program covered by this contract is (a) a victim of a crime of physical abuse, sex abuse, or exploitation; or (b) a witness to a crime committed against anotherperson; shall make a report of the suspected abuse to the Contracting Officer's Representative within 24 hours. fhe initial report shall be made by phone and shall be followed-up in writing, providing salient points of the alle1gations.

When such allegations about a contractor employee occur as covered by this clause, the Contractor employee who is the subject of the allegations will immediately be required to vacate the work site and will be replaced by another contactor employee. The subject employee will remain away from the work site until an investigation is completed.

The Government will not incur additional costs by the Contractor who must provide a replacement employee.

The Contractor shall limit disclosure of documents concerning alleged child abuse to the persons who by reason of their participation in the proceeding have reason to know such information.

Any conviction of a sex crime, anioffense involving a child victim or drug felony, will be grounds for denying employment or for dismissal of a1 employee in any position-serving children. Conviction of a crime other than a sex crime may be considered if it bears on an individual's fitness to have responsibility for the safety and well being of children. The consideration of another crime bearing on an individual's fitness will be mutually agreed upon between the NTC and agency involved.

FAR 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO

IMPLEMENT STATUTES OR EXECUTIVE ORDERS -- COMMERCIAL ITEMS

are incorporated in this contract by reference, to implement provisions of law or executive orders applicable to acquisitions of commercial items:

(1) 52.222-50, Combating Trafficking in Persons (Feb 2009) (22 U.S.C. 7104(g).

__ Alternate I (Aug 2007) of 52.222-50 (22 U.S.C. 7104(9)).

52.233-3, Protest After Award (Aug 1996) (31 U.S.C. 3553).

52.233-4, fPPlicable Law for Breach of Contract Claim (Oct 2004) (Pub. L. 108-77, 108-78).

Dental Services Pine Ridge Job Corp Center

SOiRCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

has indicated as being incorpora~ed into this contract by reference to implement provisions of law or Executive

title VI, Chapter 1 (41 U.S.C. 251 note».

2009 (June 2010) (Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the ~merican Recovery & Reinvestment Act of 2009).

52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Feb 2012) (Pub. L. 109-282) (31 U.S.C. 6101 note).

52.209-6, Protecting the Government's Interest When Subcontracting with Contractors bebarred, Suspended, or Proposed for Debarment. (Dec 2010) (31 U.S.C. 6101 note).

52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Feb 2012) (41 U.S.C. 2313).

52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (section 740 of Division C of Pub. L. 111-117, section 743 of Division D of Pub. L. 111-8, and section 745 of I Division D of Pub. L. 110-161).

52.219-3, Notice of HUBZone Set-Aside or Sole-Source Award (Nov 2011) (15 U.S.C.

657a).

52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Jan 2011) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 ~.S.C. 657a).

[Reserved] 52.219-6, Notice ofTotal Small Business Set-Aside (Nov 2011) (15 U.S.C. 644).

~Iternate I (Nov 2011) of 52.219-6.

Alternate II (Nov 2011) of 52.219-6.

52.219-7, Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644).

!4lternate I (Oct 1995) of 52.219-7.

~Iternate II (Mar 2004) of 52.219-7.

52.219-8, Utilization of Small Business Concerns (Jan 2011) (15 U.S.C. 637(d)(2) and (3».

52.219-9, Small Business Subcontracting Plan (Jan 2011) (15 U.S.C. 637(d)(4).

~Iternate I (Oct 2001) of 52.219-9.

Alternate II (Oct 2001) of 52.219-9.

~Iternate III (Jul 2010) of 52.219-9.

52.219-13, Notice of Set-Aside of Orders (Nov 2011)(15 U.S.C. 644(r».

52.219-14, Limitations on Subcontracting (Nov 2011 )(15 U.S.C. 637(a)(14».

~2.219-16, Liquidated Damages - Subcontracting Plan (Jan 1999)(15 U.S.C.

637(d)(4)(F)(i».

(19)(i) 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business ~oncerns (Oct 2008)(10 U.S.C. 2323) (if offeror elects to waive the adjustment, it shall so indicate in its offer).

~nd Reporting (Dec 2010)(Pub. L. 103-355, section 7102, and 10 U.S.C. 2323).

52.219-26, Small Disadvantaged Business Participation Program - Incentive ~ubcontracting (Oct 2000)(Pub. L. 103-355, section 7102, and 10 U.S.C. 2323).

52.219-27, Notice of Service-Disabled Verteran-Owned Small Business Set-Aside (Nov 2011 )(15 U.S.C. 657(f».

52.219-28, Post Award Small Business Program Rerepresentation (Apr 2012)(15 U.S.C.

632(a)(2)).

52.219-29, Notice of Set-Aside for Economically Disadvantaged Women-Owned Small ~usiness (EDWOSB) Concerns (Apr 2012)(15 U.S.C. 637(m».

52.219-30, Notice of Set-Aside for Women-Owned Small Business (WOSB) Concerns Eligible Under the WOSB Program (Apr 2012)(15 U.S.C. 637(m».

52.222-3, Convict Labor (June 2003)(E.O. 11755).

I (5) _X_ (6) (7) (8) (9) (10) _X_ (11 ) (12)(i) (ii) (iii) (13)(i) (ii) (iii) (14) (15)(i) (ii) (iii) (iv) (16) (17) (18) _X_ _X_ _X_ (21) (22) _X_ (23) (24) (25) _X_ (26) SdURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

Dental Services Pine Ridge Job Corp Center

I -AT--T--A-C-H-M-E-N-T-T---O--S--F -14-4-9-~-:s~olL-:IC--IT=-A--T=-IO---N--I=C-=-O-:-:N=TRA=-:-C::-:T=-IO-=-=RD=-E=-R=-. =FO-=-=R-::C:-::O:-:-M:-:M-:-:E:::R:-::C:-:-IA:-:L----:-I-::p:-::A-::G:-::E:-:O:::-:F~P=-A:-:G:::-:E=::S~

52.222-19, Child Labor - Cooperation with Authorities and Remedies (Mar 2012)(E.O.

13126).

52.222-21, Prohibition of Segregated Facilities (Feb 1999).

52.222-26, Equal Opportunity (Mar 2007)(E.O. 11246).

52.222-35, Equal Opportunity for Veterans (Sep 2010) (38 U.S.C. 4212).

52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010)(29 U.S.C. 793).

52.222.37, Employment Reports on Veterans (Sep 2010) (38 U.S.C. 4212).

52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496).

52.222-54, Employment Eligibility Verification (Jan 2009) (E.O. 12989) (not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803).

(35)(i) !li2.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items ~May 2008)(42 U.S.C. 6962(c)(3)(A)(ii» (not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803).

(ii) Alternate I (May 2008) of 52.223-9 (not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803).

Products (Dec 2007)(E.O. 13423).

(ii) Alternate I (Dec 2007) of 52.223-16.

(38) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (Aug 2011) (E.O. 13513).

U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.s.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, Pub. L. 108-77, 108-78, 108-286, 108-302, 109-53, 109-169,109-283,110-138, and Pub. L. 112-41).

Alternate I (Mar 2012) of 52.225-3.

Alternate II (Mar 2012) of 52.225-3.

Alternate III (Mar 2012) of 52.225-3.

52.225-5, Trade Agreements (Mar 2012)(19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note).

52.225-13, Restrictions on Certain Foreign Purchases (June 2008)(E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury). .

52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007)(42.U.S.C. 5150).

52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov ~007)(42.U.S.C. 5150).

52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002)(42 U.S.C.

255(f) , 10 U.S.C. 2307(f».

52.232-30, Installment Payments for Commercial Items (Oct 1995)(41 U.S.C. 255(1),10 U.S.C.2307(1).

52.232-33, Payment by Electronic Funds Transfer - Central Contractor Registration (Oct 2003)(31 U.S.C. 3332).

52.232-34, Payment by Electronic Funds Transfer - Other than Central Contractor Registration (May 1999) (31 U.S.C. 3332).

52.232-36, Payment by Third Party (Feb 2010)(31 U.S.C. 3332).

52.239-1, Privacy or Security Safeguards (Aug 1996)(5 U.S.C. 552a).

52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006)(46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631).

(ii) Alternate I (Apr 2003) of 52.247-64.

52.222-3, _x_ _X __ _X_ _X_ _X __ _X __ _X __ (27) (28) (29) (30) (31 ) (32) (33) _X __ (34) _X_ _X_ (ii) (iii) (iv) (41) (42) (43) (44) (45) (46) _X __ (47) (48) (49) (50) (51)(1) (1 )

(c) The contractor shall to comply with the FAR clauses in this paragraph (c), applicable to commercial services, which the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Ex~cutive Orders applicable to.acquisitions of commercial items:

_X_ (1) 51.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.).

l Pine Ridge Job Corp Center

-L (2) _X_ (3) (4) (5) (6) (7) (8)

52.222-42, Statement of Equivalent Rates for Federal Hires (May 1989)(29 U.S.C. 206 and 41 U.S.C. 351, et seq.).** 52.222-43, Fair Labor Standards Act and Service Contract Act -- Price Adjustment (Multiple Year and Option Contracts) (Sep 2009)(29 U.S.C. 206 and 41 U.S.C. 351, et seq.).

52.222-44, Fair Labor Standards Act and Service Contract Act -- Price Adjustment (Sep 2009)(29 U.S.C. 206 and 41 U.S.C. 351, et seq.).

52.222-51, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment -- Requirements (Nov 2007)(41 U.s.C. 351, et seq.). .

52.222-53, Exemption from Application of the Service Contract Act to Contracts for Certain Services -- Requirements (Feb 2009)(41 U.S.C. 351, et seq.).

52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (Mar 2009)(Pub.L.

110-247).

52.237-11; Accepting and Dispensing of $1 Coin (Sept 2008)(31 U.S.C. 5112(p)(1».

(d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records -- Negotiation.

(1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract.

(2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved.

(3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law.

(e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c), or (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clauses -

(i) (ii) (iii) (iv) (v) (vi) (vii) (viii) (ix) (x) (xi) (xii) Dental Services Pine Ridge Job Corp Center

52.203-13, Contractor Code of Business Ethics and Conduct (Apr 2010)(Pub. L. 110-252, Title VI, Chapter 1 (41 U.S.C. 251 note).

52.219-8,Utilization of Small Business Concerns (Dec 2010)(15 U.S.C. 637(d)(2) and (3», in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $650,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities.

[Reserved] 52.222-26, Equal Opportunity (Mar 2007)(E.O. 11246).

52.222-35, Equal Opportunity for Veterans (Sep 2010) (38 U.S.C. 4212).

52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010)(29 U.S.C. 793).

52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dee 2010) (E.O.

13496). I 52.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.).

52.222-50, Combating Trafficking in Persons (Feb 2009) (41 U.s.C. 351, et seq.).

_ Alternate I (Aug 2007) of 52.222-50 (22 U.s.C. 7104(g».

52.222-51, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment -- Requirements (Nov 2007)(41 U.S.C. 351, et seq.).

52.222-53, Exemption from Application of the Service Contract Act to Contracts for Certain Services -

- Requirements (Feb 2009)(41 U.S.C. 351, et seq.).

52.222-54, Employment Eligibility Verification (Jan 2009).

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

Flow doJn required in accordance with paragraph (e) of FAR clause 52.226-6.

(xiv) 52.247-6~, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006)(46 U.S.C.

Appx. 12~1 (b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64.

(2) While not re~uired, the contractor ~ay ~nclude in its subc.ont~acts for commercial items a minimal number of additional clauses necessary to satisfy ItS contractual obligations.

PART III - CONTRACT DOCUMENTS, EXHIBITS

AND ATTACHMENTS

SCOPE OF WORK

1. INTRODUCTION:

The USDA - Forest Service, Pine Ridge Job Corps Center, located at 15710 Highway 385, Chadron, Nebraska is a residential,1 educational, and vocational training facility for students 16 to 24 years of age.

The mission of the Center is to provide academic, vocational and life learning skills to at-risk youths.

2. BACKGROUND:

Pine Ridge Job Corps is J U.S. Department of Labor, Employment and Training Administration (ETA) program. Job Corps is desiqned to assist young people who need, and can benefit from, the wide range of services provided at a Job Corps Center. Through its Centers, Job Corps offers academic, vocational and life skills training using a Jnique approach of competency-based and individualized instruction. Services include basic education, High School Diploma (HSD) program; General Education Development (GED) program; vocational skills ~raining; residential living program; healthcare; and related support services. The comprehensive combination of training and support services is designed to help each student become a responsible and productive citizen. Approximately 224 students live full-time at the Pine Ridge Job Corps Center. The students atteAd classes at the Center. The Center has educational classroom facilities, hands on trade areas, a cafeteria, health services, recreational facilities, and dormitories. Because Job Corps is a self-paced program, a stu~ent's length of enrollment varies. Students may remain in the program for up to two years, but the averagJ length of enrollment is approximately nine to twelve months. An optional third year is granted to studentS who qualify for advanced training. Upon completion of tile program, students are better prepared to obt~in meaningful employment or further their education through Job Corps sponsored Advanced Career Training (ACT) or college. Career transition services are provided to all students separating from Job Corps. Student eligibility requires that applicants must meet all of the following criteria to particiPlate in Job Corps .

refugee, or other blien who has been authorized by the U.S Attorney General to work in the United States.

Job Corps assists students in attaining and maintaining optimal health by providing basic on-Center health

Dental Services Pine Ridge Job Corp Center

SOU~CE SELECTION INFORMATION - See FAR 2.101 and 3.104.

3.

services to include proJtion, prevention, assessment, intervention, and follow-up care. In addition, Job Corps strives to educate students regarding the connection between maintaining a healthy lifestyle and being employable. . \ CONTRACT EFFORT rEQUIRED:

Technical Requirements:

The Center Dentist will mlnitor the Center Oral Health and Wellness Program including:

• Advising the ceSI ter Director and Health Services Manager and Staff on all dental and oral health related matters d ring the Administrative Hours (8:00 AM to 4:30PM, Monday through Friday). This may include advi~ability of medial leaves, the utilization and cost of services, the prioritizing of patient care and 9ny other Oral Health Care areas deemed appropriate by the Center Dentist.

• Consulting, with Fenter Staff on student oral health needs and services and assistinq in the overall direction Of the dental program to include medications, supplies and equipment.

• With due regard ror Job Corps Requirements, the Center Dentist will prioritize Oral Health needs and shall promote program direction consistent with a high standard of dental care. To accomplish this, the Center Dentist may confer with the Health and Wellness Manager (HWM), Center Physician and Center Director, as needed.

• Ensuring, througp consultation with the HWM, the maintenance, confidentiality and safeguarding of all health recor9s in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA). I

• Staying current 'v\(ith Center and Job Corps policies through communication with the HWM and review of the Job qorps Health and Wellness website (http://jobcorpshealth.com).

• Issuing and mai~f.aining signed and dated standing order for dental care in accordance with Technical Assistan1ce Guide (TAG) M, available on the website under Health Program documents.

Dental Services:

Providing direct dental se"1ices to students, including:

: ~i,:::::t:~r:::::: fi:~408ryh:::~0:f ~::::' :::n:: ::::::~b:de:Yo'~:~:::r ::~~:en 45 and 75 day~, shall receive a mandatory oral exam which shall include four bite-wing x-rays,

are available o~ the website under Health Program.

• Restorative and prophylactic care will be prioritized as per TAG A, Oral Health and Wellness Program available on the website under Healthcare Program Documents. Any dental care beyond the mandatory dental exam is voluntary.

• The Center Denti~t and his/her staff will provide dental services at their office, with established days of the week a~d working hours to be agreed upon by the Contractor and Pine Ridge Job Corps Contracting Officers Representative (COR). Work will be performed between the hours of8:00 AM and 4:00\ PM. Additional days or a change in work schedule must be agreed upon by the Contractor and the £OR, with the Contactor requesting such approval 24 hours in advance for cancellation of services or changed thereof. The Contractor will also provide the services of a Dental Hygienist an~ a Dental Assistant according to the PRH Chapter 6, Exhibit 6-5 Minimum Staffing ReqUireme1ts. The Contractor will not be required to provide services during the Summer and Winter Breaks (approximately 2 weeks each).

• The Contractor willi work closely with the Health and Wellness staff to ensure that the students incur maximum benefit from their oral health and wellness program. Program productivity will be I validated by monitoring productivity and utilizing the Productivity Indi,cators as outlined in TAG Oral Health and Wellnes~ 6.3.

• The Center Dentistlwill provide all necessary prescriptions and referrals for care beyond what Job Corps can provide aid assist in reviewing fol/ow up information from such referrals.

Dental Services Pine Ridge Job Corp Center

SOUR<CE SELECTION INFORMATION - See FAR 2.101 and 3.104.

• Pine Ridge JOb\corps will not pay for student orthodontics. Students with orthodontic appliances . must provide documents of a treatment plan. Orthodontic care and transportation will be at the expense and responsibility of the student, parent or legal guardian.

The Dentist will not be scheduled during the period of center-wide student leave (approximately 2 weeks twice a year). Contract erriptoyees will not be scheduled to work on the following government holidays:

New Year's Day - January 1 Martin Luther King Junior's Birthday - Third Monday in January President's Day - Third Monday in February Memorial Day - Last Monday in May Independence Day - July 4th Labor Day - First Monday in September Columbus Day -Second Monday in October Veteran's Day - November 11th Thanksgiving Day - Fourth Thursday in November Christmas Day - December 25th

4. QUALIFICATIONS OF CONTRACT EMPLOYEES:

The Contracting Dentist will maintain a current license to practice Dentistry in the State of Nebraska and will provide documentation of current licensure and insurance for all providers caring for Pine Ridge Job Corps students.

Indemnification and Medical Liability Insurance (of at least $1 million) is required. Proof of insurance will be required prior to contract award and each time an option is exercised.

(1) The Pine Ridge Job Corps Center will provide transportation for all students to and from the Contractor site.

(2) The Job Corp Center will provide and furnish medications

(3) The Government will provide access to referenced TAGs and PRH B. The Contractor Shall Furnish:

(1) All other materials and equipment to provide Dental Services.

6. THE ROLE OF GOVERNMENT PERSONNEL AND RESPONSIBILITY FOR CONTRACT

ADMINISTRATION

A. Contracting Officer:The Contracting Officer (CO) has the overall responsibility for the administration of this contract. The CO alone, without delegation, is authorized to amend, modify, or deviate from the contract. Other responsibilities may be delegated to authorize representatives.

B. Contracting Officer's Representative (COR):The COR will be desiqnated in writing at the time of award to assist the CO in the day-to-day on-site administration of the contract requirements. The responsibilities of the COR iriclude, but are not limited to;

Dental Services Pine Ridge Job Corp Center

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

IN REFERENCE TO

accordance with the terms and conditions of this contract;

AJI research projects and/or publications relating to Job Corps Oral Health activities will first be cleared through the National Office of Job Corps, Washington, D.C. .

The Contract Dentist agreJs to adhere to all policies, procedures and guidelines and to make no public statements concerning Job Corps students or Job Corps activities without prior written approval of the Center Director, or their dergnated representative.

8. GOVERNING REGULATIONS, HANDBOOKS, AND REFERENCES:

FAR Part 37.101 (https:Ilw1w.acquisition.gov/far/index.html) Code of Federal Regulations (CFR), 20 CFR Section 638 and 20 CFR Section 670 -The CFR (http://www.gpoaccess.gov/cfr) states the operating requirements for Job Corpsi' The promotion and maintenance of student health and wellness is a desirable goal as well as a requireme;nt under the CFR: "A Job Corps center operator must provide medical services, through provision and coordination of a wellness program which includes access to basic medical, dental, and mental health services Itor all students, from their date of enrollment until separation from the program."

Policy and Requirements Handbook (PRH)-- The PRH expands the CFR by establishing operating policy requirements for Job Corpsi centers. Chapter 6, Sections 6.10 - 6.12, defines the required parameters and services of Center Health and Wellness Programs. The PRH is available at the following website:

http://www.jobcorps.gov/pdf/prh.pdf Technical Assistance GUid~S (TAGs)--TAGs contain technical assistance for implementing the policies and requirements set forth in the PRH. As new requirements are added to the PRH, new TAGs are developed assist in implementing the dolicy. The Oral Health and Wellness TAG and other health TAG's are available at I the following website - http://jchealth.jobcorps.gov/documents/tags/tagkju1 03. pdf Job Corps Health and Wellness WebsitelHealth Program Documents:

hUp:llwww.jobcorpshealth.comlhtmll

9. TRAVEL AND TRAINING

The Department of Labor occasionally has Health and Wellness conferences for Dental care providers.

Travel Reimbursement will be actual subsistence rates with supporting receipts, not to exceed the Federal Travel Rates and Regulatio~s. All travel costs will only be reimbursed based on the allowable Government travel rates, as defined above. Actual costs that can be reimbursed are food, lodging, and air fare. Rental vehicles must be approved on a case specific basis and only actual costs will be reimbursed. The Contractor must obtain the approval of the COR and Center Director prior to undertaking travel. All other expenses must be approvedl on a case specific basis and only actual costs will be reimbursed (i.e. rental cars, business calls, laundry1miscellaneous equipment, etc.) All travel costs and receipts will be included in invoices with receipts attached in order to be reimbursed.

Dental Services Pine Ridge Job Corp Center

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

12250 - Pharmacy Technilian 12280 - Phlebotomist 12305 - Radiologic Technologist 12311 Registered Nurse I 12312 - Registered NursJ II 12313 - Registered NursJ II, Specialist 12314 - Registered Nurse III 12315 - Registered Nurse III, Anesthetist 12316 - Registered Nursd IV 12317 - Scheduler (Drug land Alcohol Testing) ALL OCCUPATIONS LISTED ABdVE RECEIVE THE FOLLOWING BENEFITS:

PAGE OF PAGES

21 47 14.61 15.88 23.13 22.82 27.91 27.91 33.76 33.76 40.47 20.66

HEALTH & WELFARE: $3.59 per hour or $143.60 per week or $622.27 per month VACATION: 2 weeks paid vacation after 1 year of service with a contractor or successor; 3 weeks after 8 years, and 4 weeks after 15 years. Length of service includes the whole span of continuous service with the present contractor or successor, wherever employed, and with the predecessor contractors in the performance of similar wori at the same Federal facility. (Reg. 29 CFR 4.173) HOLIDAYS: A minimum of ten paid holidays per year: New Year's Day, Martin Luther King Jr. 's Birthday, Washington's Birthday, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans' Day, Thanksgiving Day, and Christmas Day. (A contractor may sUbstitute for any of the named holidays another day off with pay in accordance with a plan communicated to the employees involved.) (See 29 CFR 4.174) THE OCCUPATIONS WHICH HAVE NUMBERED FOOTNOTES IN PARENTHESES RECEIVE THE FOLLOWING:

1} COMPUTER EMPLOYEES: Under the SCA at section 8(b}, this wage determination does not apply to any employee who individually qualifies as a bona fide executive, administrative, or professional employee as defined in 29 C.F.R. Part 541. Because most Computer System Analysts and Computer Programmers who are compensated at a rate not less than $27.63 (or on a salary or fee basis at a rate not less than $455 per week) an hour would likely I qualify as exempt computer professionals, (29 C.F.R. 541.

400) wage rates may not be listed on this wage determination for all occupations within those job families. In addition, because this wage determination may not list a wage rate for some or all occupations within those job families if the survey data indicates that the prevailing wage rate for the occupation equals or exceeds $27.63 per hour conformances may be necessary for certain noneXempt employees. For example, if an individual employee is nonexempt but nevertheless performs duties within the scope of one of the Computer Systems Analyst or Computer Programmer occupations for which this wage determination does not specify an SCA wage rate, then the wage rate for that employee must be conformed in accordance with the conformance procedures described in the conformance note included on this wage determination.

Additionally, because job ~itles vary widely and change quickly in the computer industry, job titles are n1t determinative of the application of the computer professional exemption. THerefore, the exemption applies only to computer employees who satisfy the compensation requirements and whose primary duty consists of:

I

Dental Services Pine Ridge Job Corp Center

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104.

PAGE OF PAGES

22 47

(1) The application of systems analysis techniques and procedures, including consulting with users, to determine hardware, software or system functional specifica tions;

(2) The design, development, documentation, analysis, creation, testing or modification or computer systems or programs, including prototypes, based on and related to user or system design specifications;

(3) The design, documentation, testing, creation or modification of computer programs related to machine operating systems; or

(4) A combination of the aforementioned duties, the performance of which requires the same level of skills. (29 C.F.R. 541.400).

2) AIR TRAFFIC CONTROLLERS AND WEATHER OBSERVERS - NIGHT PAY & SUNDAY PAY: If you work at night as part of a regular tour of duty, you will earn a night differential and receive an additional 10% of basic pay for any hours worked between 6pm and 6am.

If you are a full-time employed (40 hours a week) and Sunday is part of your regularly scheduled workweek, you are paid at your rate of basic pay plus a Sunday premium of 25% of your basic rate for each hour of Sunday work which is not overtime (i.e. occasional work on Sunday outside the normal tour of duty is considered overtime work).

HAZARDOUS PAY DIFFERENTIAL: An 8 percent differential is applicable to employees employed in a position that represents a high degree of hazard when working with or in close proximity to ordinance, explosives, and incendiary materials. This includes work such as screening, blending, dying, mixing, and pressing of sensitive ordance, explosives, and pyrotechnic compositions such as lead azide, black powder and photoflash powder. All dry-house activities involving propellants or explosives.

Demilitarization, modification, renovation, demolition, and maintenance operations on sensitive ordnance, explosives and incendiary materials. All operations involving regrading and cleaning of artillery ranges.

A 4 percent differential is applicable to employees employed in a position that represents a low degree of hazard when working with, or in close proximity to ordance, (or employees possibly adjacent to) explosives and incendiary materials which involves potential injury such as laceration of hands, face, or arms of the employee engaged in the operation, irritation of the skin, minor burns and the like; minimal damage to immediate or adjacent work area or equipment being used.

All operations involving, unloading, storage, and hauling of ordance, explOSive, and incendiary ordnance material other than small arms ammunition. These differentials are only applicable to work that has been specifically designated by the agency for ordnance, explosives, and incendiary material differential pay.

** UNIFORM ALLOWANCE **

If employees are required to wear uniforms in the performance of this contract (either by the terms of the Government contract, by the employer, by the state or local law, etc.), the cost of furnishing such uniforms and maintaining (by laundering or dry cleaning) such uniforms is an expense that may not be borne by an employee where such cost reduces the hourly rate below that required by the wage determination. The Department of Labor will accept payment in accordance with the following standards' as compliance:

The…