AG-82A7-S-13-0001_Attachment_to_SF1449.pdf

TABLE OF CONTENTS

PART CONTENTS PAGE

I STANDARD FORM (SF) 1449 1-11

Continuation of SF 1449

II CONTRACT CLAUSES 12-16

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

III CONTRACT DOCUMENTS, EXHIBITS, AND ATTACHMENTS 17-26

Scope of Work Special Contract Requirements

Exhibit 1 -- U.S. Dept of Labor Wage Determination 25 Exhibit 2 -- QASP-Matrix 26

IV SOLICITATION PROVISIONS 27-39

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 52.212-1 & 52.212-2 (includes proposal submission instructions)

ATTACHMENT TO SF 1449 - SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL | PAGE OF PAGES ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Terms and Conditions | 5 | 39

Dental Services Harpers Ferry Job Corp

CONTINUATION OF STANDARD FORM 1449

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 and 3 (if applicable). 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:

Harpers Ferry Job Corps Civilian Conservation Center 146 Buffalo Drive Harpers Ferry, WV 25425

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.

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Terms and Conditions | 6 | 39

Dental Services Harpers Ferry Job Corp

SCHEDULE OF SERVICES

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

Provide Dental Services to the students of Harpers Ferry Job Corps Civilian Conservation Center, 146 Buffalo Drive, Harpers Ferry, West Virginia, for the period beginning December 1, 2012 through November 30, 2013 and any subsequent option periods (maximum of 60 months) in accordance with the Terms of the Contract.

Personnel performing the services must be certified and/or licensed in the state of West Virginia.

The Government shall furnish:

1. All equipment, supplies and materials necessary to perform the services will be provided by the center.

The Contractor shall furnish:

1. Dentist, licensed in the state of West Virginia

2. Dental Hygienist, licensed in the state of West Virginia

3. Dental Assistant

ESTIMATED QUANTITIES

The quantities listed for each item are the governments best estimates based upon past experience. The list of services below is a guide for you to compile your fixed price total cost for each year. The Government will award a Fixed Price contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government. The contractor will be paid based upon the actual work performed pursuant to the Performance Work Statement. No mileage or compensation will be allowed for travel to and from the Harpers Ferry Job Corps Center.

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Terms and Conditions | 7 | 39

PLEASE COMPLETE THE UNIT PRICE COLUMN; THE ESTIMATED TOTAL AMOUNT WILL BE ENTERED AT TIME

OF AWARD.

19.

ITEM

NO.

20.

SCHEDULE OF SERVICES

21.

ESTIMATE

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

ESTIMATED

TOTAL AMT

BASE YEAR SERVICES: December 01 , 2012 – November 30, 2013

001 Dental Services - ADA Code for Services EST DO NA

Period Oral Evaluation – D0120 250

Limited Oral Evaluation/Problem – D0140 75

Intraoral-Periapical First Film – D0220 55

Intraoral-Periapical Each Additional Film-D0230 25

Bitewings-two Films - D0272 1000

Panoramic Film – D0330 75

Prophylaxis Adult - D1110 75

Amalgam-one Surface - D2140 125

Amalgam-two Surface - D2150 65

Amalgam-three Surface – D2160 25

Amalgam-Four or more Surface – D2161 25

Resin-one Surface, Anterior – D2330 125

Resin-two Surface, Anterior – D2331 65

Resin-three Surface, Anterior – D2332 25

Resin-four Surface, Anterior – D2335 25

Resin-one Surface, Posterior – D2391 125

Resin-two Surface, Posterior – D2392 65

Resin-three Surface, Posterior – D2393 25

Resin-four Surface, Posterior - D2394 25

Re-cement Crown – D2920 5

Pre-fab Stainless Steel Crown – D2931 5

Coronal Remnants – Deciduous Tooth – D7111 5

Extraction – Erupted Tooth – D7140 25

Surgical Removal of Erupted Tooth – D7210 30

Removal of Impacted Tooth-Soft – D7220 10

Removal of Impacted Tooth-Part – D7230 10

Removal of Impacted Tooth-Complete – D7240 10

Surgical Removal of Residual Tooth – D7250 10

Palliative (Emergency) Treatment – D9110 10

Application of Desensitizing Medication - D9910 175

Treatment of Complication 10

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Terms and Conditions | 8 | 39

19.

ITEM

NO.

20.

SCHEDULE OF SERVICES

21.

ESTIMATE

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

OPTION YEAR ONE SERVICES: December 01 , 2013 – November 30, 2014

101 Dental Services – ADA Code for Services EST DO NA

Period Oral Evaluation – D0120 250

Limited Oral Evaluation/Problem – D0140 75

Intraoral-Periapical First Film – D0220 55

Intraoral-Periapical Each Additional Film-D0230 25

Bitewings-two Films - D0272 1000

Panoramic Film - D0330 75

Prophylaxis Adult - D1110 75

Amalgam-one Surface – D2140 125

Amalgam-two Surface - D2150 65

Amalgam-three Surface - D2160 25

Amalgam-Four or more Surface – D2161 25

Resin-one Surface, Anterior – D2330 125

Resin-two Surface, Anterior - D2331 65

Resin-three Surface, Anterior – D2332 25

Resin-four Surface, Anterior – D2335 25

Resin-one Surface, Posterior – D2391 125

Resin-two Surface, Posterior – D2392 65

Resin-three Surface, Posterior – D2393 25

Resin-four Surface, Posterior – D2394 25

Re-cement Crown – D2920 5

Pre-fab Stainless Steel Crown – D2931 5

Coronal Remnants – Deciduous Tooth – D7111 5

Extraction – Erupted Tooth – D7140 25

Surgical Removal of Erupted Tooth – D7210 30

Removal of Impacted Tooth-Soft – D7220 10

Removal of Impacted Tooth-Part – D7230 10

Removal of Impacted Tooth-Complete – D7240 10

Surgical Removal of Residual Tooth – D7250 10

Palliative (Emergency) Treatment – D9110 10

Application of Desensitizing Medication – D9110 175

Treatment of Complication – D9910 10

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Terms and Conditions | 9 | 39

NO.

20.

SCHEDULE OF SERVICES

21.

ESTIMATE

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

OPTION YEAR TWO SERVICES: December 01 , 2014 – November 30, 2015

201 Dental Services – ADA Code for Services EST DO NA

Period Oral Evaluation – D0120 250

Limited Oral Evaluation/Problem – D0140 75

Intraoral-Periapical First Film – D0220 55

Intraoral-Periapical Each Additional Film- D0230 25

Bitewings-two Films - D0272 1000

Panoramic Film – D0330 75

Prophylaxis Adult – D1110 75

Amalgam-one Surface – D2140 125

Amalgam-two Surface - D2150 65

Amalgam-three Surface - D2160 25

Amalgam-Four or more Surface – D2161 25

Resin-one Surface, Anterior – D2330 125

Resin-two Surface, Anterior – D2331 65

Resin-three Surface, Anterior – D2332 25

Resin-four Surface, Anterior – D2335 25

Resin-one Surface, Posterior – D2391 125

Resin-two Surface, Posterior – D2392 65

Resin-three Surface, Posterior – D2393 25

Resin-four Surface, Posterior – D2394 25

Re-cement Crown – D2920 5

Pre-fab Stainless Steel Crown – D2931 5

Coronal Remnants – Deciduous Tooth – D7111 5

Extraction – Erupted Tooth – D7140 25

Surgical Removal of Erupted Tooth – D7210 30

Removal of Impacted Tooth-Soft – D7220 10

Removal of Impacted Tooth-Part – D7230 10

Removal of Impacted Tooth-Complete – D7240 10

Surgical Removal of Residual Tooth – D7250 10

Palliative (Emergency) Treatment – D9110 10

Treatment of Complication - D9930 10

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Terms and Conditions | 10 | 39

NO.

20.

SCHEDULE OF SERVICES

21.

ESTIMATE

QUANTITY

22.

UNIT

23.

UNIT

PRICE

24.

OPTION YEAR THREE SERVICES: December 01 , 2015 – November 30, 2016

301 Dental Services – ADA Code for Services EST DO NA

Period Oral Evaluation – D0120 250

Limited Oral Evaluation/Problem – D0140 75

Intraoral-Periapical First Film – D0220 55

Intraoral-Periapical Each Additional Film- D0230 25

Bitewings-two Films – D0272 1000

Panoramic Film - D0330 75

Prophylaxis Adult - D1110 75

Amalgam-one Surface - D2140 125

Amalgam-two Surface - D2150 65

Amalgam-three Surface - D2160 25

Amalgam-Four or more Surface – D2161 25

Resin-one Surface, Anterior – D2330 125

Resin-two Surface, Anterior – D2331 65

Resin-three Surface, Anterior – D2332 25

Resin-four Surface, Anterior – D2335 25

Resin-one Surface, Posterior – D2391 125

Resin-two Surface, Posterior – D2392 65

Resin-three Surface, Posterior – D2393 25

Resin-four Surface, Posterior – D2394 25

Re-cement Crown – D2920 5

Pre-fab Stainless Steel Crown – D2931 5

Coronal Remnants – Deciduous Tooth – D7111 5

Extraction – Erupted Tooth – D7140 25

Surgical Removal of Erupted Tooth – D7210 30

Removal of Impacted Tooth-Soft – D7220 10

Removal of Impacted Tooth-Part – D7230 10

Removal of Impacted Tooth-Complete – D7240 10

Surgical Removal of Residual Tooth – D7250 10

Palliative (Emergency) Treatment – D9110 10

Treatment of Complication – D9930 10

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Terms and Conditions | 11 | 39

NO.

20.

SCHEDULE OF SERVICES

21.

ESTIMATE

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

OPTION YEAR FOUR SERVICES: December 01 , 2016 – November 30, 2017

401 Dental Services – ADA Code for Services EST DO NA

Period Oral Evaluation – D0120 250

Limited Oral Evaluation/Problem – D0140 75

Intraoral-Periapical First Film – D0220 55

Intraoral-Periapical Each Additional Film- D0230 25

Bitewings-two Films - D0272 1000

Panoramic Film – D0330 75

Prophylaxis Adult - D1110 75

Amalgam-one Surface - D2140 125

Amalgam-two Surface - D2150 65

Amalgam-three Surface – D2160 25

Amalgam-Four or more Surface – D2161 25

Resin-one Surface, Anterior – D2330 125

Resin-two Surface, Anterior – D2331 65

Resin-three Surface, Anterior – D2332 25

Resin-four Surface, Anterior – D2335 25

Resin-one Surface, Posterior – D2391 125

Resin-two Surface, Posterior – D2392 65

Resin-three Surface, Posterior – D2393 25

Resin-four Surface, Posterior – D2394 25

Re-cement Crown – D2920 5

Pre-fab Stainless Steel Crown – D2931 5

Coronal Remnants – Deciduous Tooth – D7111 5

Extraction – Erupted Tooth – D7140 25

Surgical Removal of Erupted Tooth – D7210 30

Removal of Impacted Tooth-Soft – D7220 10

Removal of Impacted Tooth-Part – D7230 10

Removal of Impacted Tooth-Complete – D7240 10

Surgical Removal of Residual Tooth – D7250 10

Palliative (Emergency) Treatment – D9110 10

Treatment of Complication – D9930 10

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Clauses | 12 | 39

PART II -- CONTRACT CLAUSES

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

(TAILORED)

(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.)

(c) Changes (tailored). Changes in the terms and conditions of this contract may be made only by written agreement of the parties. NOTE: Modifications to exercise option years are issued unilaterally, as it’s at the Government’s sole discretion to invoke additional performance periods.

ADDENDUM TO FAR 52.212-4

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

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at these addresses:

https://www.acquisition.gov/far & http://www.dm.usda.gov/procurement/policy/agar.html

52.204-9 Personal Identity Verification of Contractor Personnel Jan 2011 52.217-8 Option to Extend Services 15 calendar days prior to contract expiration date Nov 1999

52.228-5 Insurance -- Work on a Government Installation Jan 1997 52.237-7 Indemnification and Medical Liability Insurance Jan 1997

AGAR 452.204-71 Personal Identity Verification of Contractor Personnel Oct 2007 452.215-73 Post Award Conference Nov 1996 452.224-70 Confidentiality of Information Feb 1988

2. FAR 52.216-1 TYPE OF CONTRACT (APR 1984)

The Government contemplates award of a fixed-price contract resulting from this solicitation.

3. FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within 15 days of expiration of the current contract; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 30 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed

5 years and 6 months.

4. KEY PERSONNEL (FEB 1988)

(a) The Contractor shall assign to this contract the following key personnel: Dentist

(b) During the first ninety (90) days of performance, the Contractor shall make no substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the Contracting Officer within 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (c) below. After the initial 90-day period, the Contractor shall submit the information required by paragraph (c) to the Contracting Officer at least 15 days prior to making any permanent substitutions.

(c) The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the Contracting Officer.

Proposed substitutes should have comparable qualifications to those of the persons being replaced. The Contracting Officer will notify the Contractor within 15 calendar days after receipt of all required information of the decision on substitutions. The contract will be modified to reflect any approved changes of key personnel.

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Clauses | 13 | 39

5. RESTRICTIONS AGAINST DISCLOSURE (FEB 1988)

(a) The Contractor agrees, in the performance of this contract, to keep all information contained in source documents or other media furnished by the Government in the strictest confidence. The Contractor also agrees not to publish or otherwise divulge such information in whole or in part in any manner or form, or to authorize or permit others to do so, taking such reasonable measures as are necessary to restrict access to such information while in the Contractor's possession, to those employees needing such information to perform the work provided herein, i.e., on a "need to know" basis. The Contractor agrees to immediately notify in writing, the Contracting Officer, named herein, in the event that the Contractor determines or has reason to suspect a breach of this requirement.

(b) The Contractor agrees not to disclose any information concerning the work under this contract to any persons or individual unless prior written approval is obtained from the Contracting Officer. The Contractor agrees to insert the substance of this clause in any consultant agreement or subcontract hereunder.

6. TERM OF CONTRACT: Performance of the work requirements under this contract is expected to begin on December 1, 2012, and continue through November, 2013, with four (4) 12-month option periods.

7. 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 another person; shall make a report of the suspected abuse to the Contracting Officer’s Representative within 24 hours. The initial report shall be made by phone and shall be followed-up in writing, providing salient points of the allegations.

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, an offense involving a child victim or drug felony, will be grounds for denying employment or for dismissal of an 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 (AUG

2012)

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which 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(g)).

(2) 52.233-3, Protest After Award (Aug 1996) (31 U.S.C. 3553).

(3) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004) (Pub. L. 108-77, 108-78).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated into this contract by reference to implement provisions of law or Executive Orders applicable to acquisitions of commercial items:

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Clauses | 14 | 39

Dental Services Harpers Ferry Job Corp

X (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 253g and 10 U.S.C. 2402).

(2) 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)).

(3) 52.203-13, Contractor Code of Business Ethics and Conduct (Apr 2010) (Pub. L. 110-252,

(4) 52.203-15, Whistleblower Protections under the American Recovery & Investment Act of 2009

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

X (5) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (AUG 2012) (Pub. L. 109-282) (31 U.S.C. 6101 note).

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

(7) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Feb 2012) (41 U.S.C. 2313).

X (8) 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 Division D of Pub. L. 110-161).

(9) 52.219-3, Notice of HUBZone Set-Aside or Sole-Source Award (Nov 2011) (15 U.S.C. 657a).

(10) 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 U.S.C. 657a).

(11) [Reserved] (12)(i) 52.219-6, Notice of Total Small Business Set-Aside (Nov 2011) (15 U.S.C. 644).

(ii) Alternate I (Nov 2011) of 52.219-6.

(iii) Alternate II (Nov 2011) of 52.219-6.

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

(ii) Alternate I (Oct 1995) of 52.219-7.

(iii) Alternate II (Mar 2004) of 52.219-7.

X (14) 52.219-8, Utilization of Small Business Concerns (Jan 2011) (15 U.S.C. 637(d)(2) and (3)).

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

(ii) Alternate I (Oct 2001) of 52.219-9.

(iii) Alternate II (Oct 2001) of 52.219-9.

(iv) Alternate III (Jul 2010) of 52.219-9.

(16) 52.219-13, Notice of Set-Aside of Orders (Nov 2011)(15 U.S.C. 644(r)).

X (17) 52.219-14, Limitations on Subcontracting (Nov 2011)(15 U.S.C. 637(a)(14)).

(18) 52.219-16, 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 Concerns

(Oct 2008)(10 U.S.C. 2323) (if offeror elects to waive the adjustment, it shall so indicate in its offer).

(ii) Alternate I (June 2003) to 52.219-23.

(20) 52.219-25, Small Disadvantaged Business Participation Program – Disadvantaged Status and

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

(21) 52.219-26, Small Disadvantaged Business Participation Program – Incentive Subcontracting (Oct

2000)(Pub. L. 103-355, section 7102, and 10 U.S.C. 2323).

(22) 52.219-27, Notice of Service-Disabled Verteran-Owned Small Business Set-Aside (Nov 2011)(15

U.S.C. 657(f)).

X (23) 52.219-28, Post Award Small Business Program Rerepresentation (Apr 2012)(15 U.S.C.

632(a)(2)).

(24) 52.219-29, Notice of Set-Aside for Economically Disadvantaged Women-Owned Small Business

(EDWOSB) Concerns (Apr 2012)(15 U.S.C. 637(m)).

(25) 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)).

X (26) 52.222-3, Convict Labor (June 2003)(E.O. 11755).

(27) 52.222-19, Child Labor – Cooperation with Authorities and Remedies (Mar 2012)(E.O. 13126).

X (28) 52.222-21, Prohibition of Segregated Facilities (Feb 1999).

X (29) 52.222-26, Equal Opportunity (Mar 2007)(E.O. 11246).

X (30) 52.222-35, Equal Opportunity for Veterans (Sep 2010) (38 U.S.C. 4212).

X (31) 52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010)(29 U.S.C. 793).

X (32) 52.222.37, Employment Reports on Veterans (Sep 2010) (38 U.S.C. 4212).

X (33) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010)

(E.O. 13496).

X (34) 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).

ITEMS Solicitation No. AG-82A7-S-13-0001 | | IN REFERENCE TO Contract Clauses | 15 | 39

Dental Services Harpers Ferry Job Corp

(35)(i) 52.223-9, 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).

(36) 52.223-15, Energy Efficiency in Energy-Consuming Products (Dec 2007) (42 U.S.C. 8259b).

(37)(i) 52.223-16, IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products

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

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

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

13513).

(39) 52.225-1, Buy American Act – Supplies (Feb 2009)(41 U.S.C. 10a – 10d).

(40)(i) 52.225-3, Buy American Act – Free Trade Agreement – Israeli Trade Act (May 2012)(41 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 112-41).

(ii) Alternate I (Mar 2012) of 52.225-3.

(iii) Alternate II (Mar 2012) of 52.225-3.

(iv) Alternate III (Mar 2012) of 52.225-3.

(41) 52.225-5, Trade Agreements (May 2012)(19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note).

(42) 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).

(43) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007)(42.U.S.C. 5150).

(44) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov

2007)(42.U.S.C. 5150).

(45) 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)).

(46) 52.232-30, Installment Payments for Commercial Items (Oct 1995)(41 U.S.C. 255(f), 10 U.S.C.

2307(f)).

X (47) 52.232-33, Payment by Electronic Funds Transfer – Central Contractor Registration (Oct 2003)(31

U.S.C. 3332).

(48) 52.232-34, Payment by Electronic Funds Transfer – Other than Central Contractor Registration

(May 1999) (31 U.S.C. 3332).

(49) 52.232-36, Payment by Third Party (Feb 2010)(31 U.S.C. 3332).

(50) 52.239-1, Privacy or Security Safeguards (Aug 1996)(5 U.S.C. 552a).

(51)(I) 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.

(1) 52.222-3,

(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 Executive Orders applicable to acquisitions of commercial items:

X (1) 52.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.).

X (2) 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.).** X (3) 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.).

_ (4) 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.).

(5) 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.).

(6) 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.).

(7) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (Mar 2009)(Pub.L. 110-

247).

(8) 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.

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Dental Services Harpers Ferry Job Corp

(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) 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).

(ii) 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.

(iii) [Reserved]

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

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

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

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

13496).

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

(ix) 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)).

(x) 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.).

(xi) 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.).

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

(xiii) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (Mar 2009)(Pub.L. 110-247). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6.

(xiv) 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). Flow down required in accordance with paragraph (d) of FAR clause 52.247- 64.

(2) While not required, the contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.

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PART III -- CONTRACT DOCUMENTS, EXHIBITS

AND ATTACHMENTS

SCOPE OF WORK

1. INTRODUCTION:

The USDA- Forest Service, Harpers Ferry Job Corps Center located at 146 Buffalo Drive, Harpers Ferry, WV, 25425, in Jefferson County, has a requirement for dental services. The Contractor’s facility is the place of performance for this contract.

Harpers Ferry Job Corp is a residential, educational, and vocational training facility for students 16 to 24 years of age. The mission of the center is to provide academic, vocational and learning skills to at-risk youth.

2. BACKGROUND:

Job Corps is a U.S. Department of Labor, Employment and Training Administration (ETA) program. Job Corps is designed 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 unique approach of competency-based and individualized instruction. Services include: basic education, High School Diploma (HSD) program, General Education Development (GED) program, vocational skills training, 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 230 students live full-time at the Harpers Ferry Job Corps Center. The students attend classes at the center. The center has classroom facilities, hands on trade education, a cafeteria, health services, recreational facilities and dormitories. Student eligibility requires that applicants must meet all of the following criteria to participate in Job Corps,

• Applicants must be at least 16 years of age and not yet 25 years of age.

• Each applicant must be a U.S. citizen, a U.S. National, a lawfully admitted permanent alien, refugee, or other alien who has been authorized by the US Attorney General to work in the United states.

Job Corps assists students in attaining and maintaining optimal health by providing basic on-Center health services to include promotion, 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.

3. CONTRACT EFFORT REQUIRED

A. General

This contract is a non-personal professional dental service contract as defined in Federal Acquisition Regulations (FAR) Part 37.101.

The purpose of the contract is to assist students in attaining and maintaining optimal health by providing basic health services to include promotion, prevention, assessment, intervention, treatment and follow up care. The contractor shall provide any and all labor, services, permits and licenses necessary to perform Dental Services to include Dental Assistant / Hygienist during the period of December 1, 2012 and ending November 30, 2013 with an option of four additional years at the Harpers Ferry Civilian Conservation Center. The contractor must be a DDS or DD with a diploma from an accredited dental school or possession of a foreign graduate licensing certificate and be licensed in the state of West Virginia. Proof of insurance will be required prior to contract award and each time an option is exercised.

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

1. New Year's Day - January I

2. Martin Luther King Jr.’s Birthday - Third Monday in January

3. Presidents Day - Third Monday in February

4. Memorial Day - Last Monday in May

5. Independence Day - July 4

6. Labor Day - First Monday in September

7. Columbus Day - Second Monday in October

8. Veteran's Day - November 11

9. Thanksgiving Day - Fourth Thursday in November

10. Christmas Day - December 25

B. Technical Requirements

The Dentist will maintain a current license to practice Dentistry in the State of West Virginia and will provide documentation of current licensure and insurance for all providers caring for Harpers Ferry Job Corps students.

The specific hours of services shall coordinated by mutual agreement between the Contractor and the Contracting Officers Representative. An estimated total of 48 weeks of services per contract period are required. Holidays and vacation periods are to be arranged by mutual agreement between the Contractor and the Contracting Officers Representative.

The dental hygienist can be an independent subcontractor, or an employee of the Center Dentist. The hygienist will be under the direction of the Center Dentist

The Center Dentist will monitor the Center Oral Health and Wellness Program, to help students become and stay employed, including:

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

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

• With due regard for 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, through consultation with the HWM, the maintenance, confidentiality and safeguarding of all health records in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA).

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

The environment of the service facility shall be maintained to provide the patient with privacy as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. The Contractor will assure the maintenance, confidentiality, and safeguarding of all necessary health records.

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C. Dental Services: Scope of Work

The Contractor will provide chair side dental services to a maximum number of patients per day. In addition, the Contractor will provide an average of five cursory examinations and consultations weekly. A maximum of 15 minutes will be allowed for missed or broken appointments. The Contracting Officer’s Representative must approve procedures that require over 30 minutes. The Contractor shall maintain a patient log that reflects the patient’s name, service rendered, date, and time.

The Contractor shall issue and maintain signed and dated standing orders for dental care in accordance with Technical Assistance Guide Q.

Dental Services provided include, but are not limited to:

• All students will receive a cursory exam of the oral cavity to be performed by licensed Health and Wellness Staff within the first 48 hours on Center. Students, who have been on Center between 45 and 75 days, shall receive a mandatory oral exam which shall include four bite-wing x-rays, and will be performed by the Dentist. The exam will be documented on the SF603 and SF603A by the Dentist.

• The Contractor shall provide preventive dental health education, which will promote good oral hygiene techniques (e.g., tooth brushing, flossing, and rinsing instructions). This education can be done by a dental assistant.

• The Contractor shall provide a diagnosis and treatment plan for each student within two weeks after completion of routine dental examination. This includes a listing of the teeth involved and specific services to be rendered. The Contractor will establish priorities for the provision of comprehensive dental care, on the basis of the diagnosis and within program constraints.

• The Contractor will provide routine restorative dental care (in accordance with the Job Corps Priority Classification System).

• The Contractor shall provide assistance to the Center Director in securing appropriate referrals to ensure the receipt of special care as defined by Technical Assistance Guide 6-A.

• The Contractor shall develop and/or assure compliance with infection control policy and procedures.

• Restorative and prophylactic care will be prioritized as per TAG A, Oral Health and Wellness Program.

• The Dentist and his/her staff will provide dental services, with established days of the week and working hours to be agreed upon by the Contractor and the Contracting Officer’s Representative. Work will be performed between the hours of 8:00 AM and 4:00 PM. Additional days or a change in work schedule must be agreed upon by the Contractor and the Contracting Officer’s Representative, 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 and a Dental Assistant according to the PRH Chapter 6, Exhibit 6-5 Minimum Staffing Requirements. The Contractor will not be required to provide services during the summer and winter breaks (approximately 2 weeks each).

• The Dentist will 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 validated by monitoring productivity and utilizing the Productivity Indicators as outlined in Technical Assistance Guide (TAG) Oral Health and Wellness 6.3.

• The Dentist will provide all necessary prescriptions and referrals for care beyond what Job Corps can provide and assist in reviewing and follow up information from such referrals.

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Dental Services Harpers Ferry Job Corp

• Harpers Ferry 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.

• Ordering Prosthetics: Prosthetic devices require the advance approval of the Contracting Officer’s Representative. If approved, the Contractor will be reimbursed for cost incurred upon submission of a proper invoice.

• In order to foster a positive attitude by the students oral health services, the Dentist shall exercise good judgment concerning the amount of dental work performed at one time; in no event will the Dentist anesthetize more than one-half of the mouth at one time nor fill more than three (3) caries in one appointment without prior approval from the Contracting Officer's Representative. At all times the comfort and well-being of the students will be maintained and the Dentist must not cause any undue pain and discomfort through procedures used.

• With due regard for Job Corps Requirements, the 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, through consultation with the HWM, the maintenance, confidentiality and safeguarding of all health records in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA).

• The medical record with a dental section for each student will be provided to the contractor. Dental entries will be written directly in the dental section of the medical file. A registered nurse will meet with the contractor to discuss students seen and sign off orders for medications. The nurse will provide the medications and plan for follow-up care with the contractor.

• Issuing and maintaining signed and dated standing orders for dental care in accordance with Technical Assistance Guide (TAG) M, available on the website under Health Program documents.

• The contractor will talk with the center registered nurse and/or the Health and Wellness Manager (HSM) registered nurse at least once a week. This is to discuss student care, schedules, cares, concerns, or any other issue.

• Student appointments will be scheduled through the wellness center. The student’s medical/dental file will accompany them to their appointment.

• All services will be provided at the contractor’s facility. The contract year will be for 48 weeks because students are gone on two separate two week breaks – one in July and one in December. If the scheduled service day is on a federal holiday or the contractor is unable to work due to illness or another issue, a mutually satisfactory alternative day will be selected.

Services of Dental Assistants

The Contractor shall furnish the services of one or more Dental Assistants to assist in the conduct of dental services. The Dental Assistants will be directly supervised by the Center Dentist and will assist the Dentist whenever the Dentist is working with the students.

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The minimum requirements for a Dental Assistance are as follows:

- Good Manual Dexterity

- Knowledge of weights and balances

- Ability to set up instrument trays and an understanding of the use of instruments

- Ability to understand oral communication

- Must have a High School Diploma

Emergency Care Requirements

The Contractor shall provide 24-hour emergency coverage for students throughout the life of the contract.

The dental provider shall be available for emergency phone consultations and provide back-up contacts with phone numbers in case of unavailability.

Phone consultations are not expected to exceed 1 hour per year. At the time of an emergency, the dentist will determine if the emergency requires immediate attention or if it can wait until the next scheduled visit.

The Contractor shall be responsible for ensuring these services are available during holiday and vacation periods.

These services shall be performed at the Contractor's facilities or other mutually acceptable location. Cost for emergency work performed away from the Center is not covered by the hourly rate specified in this contract, rather it shall be in accordance with the per call price shown in the Schedule.

MISCELLANEOUS

The Contractor shall provide dental services on a day of the week that is acceptable to the Dentist and Contracting Officer’s Representative. The Contractor and Contracting Officer’s Representative must, mutually agree upon additional days or any required changes within the scope of the contract.

The Contractor shall contact the Contracting Officer’s Representative immediately when it is necessary to cancel or change services at the Center. Rescheduling will be mutually agreed upon. The Contractor shall designate, in writing for emergency coverage, the person who will represent and act for the Contractor. In the designation, the Contractor shall specify any areas of responsibility assigned to the Contractors representative. Representative must provide appropriate credentials for DD or DDS responsibilities. Overall responsibility for the dental services program remains with the Contractor.

The Contractor shall provide priority classification based on urgency of need for dental care using the Job Corps Priority Classification System.

The contractor will also provide the following services which may aid in the development, implementation, and monitoring of the total Center health program.

- Advise the Center Director, Center physician, and health staff on all dental-related matters including staffing requirements, the advisability of student medical terminations for dental reasons, the cost of special services, and other areas deemed appropriate.

- Assist in coordinating, developing, implementing and integrating the dental health program with other health components and Center activities.

- Assure the maintenance, safeguarding, and confidentiality of all required dental records.

- Advise the Center Director regarding the specific Center Dental needs, including replacement of obsolete equipment and utilization of necessary dental supplies and medications.

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Department of Labor training for dental contractor may be required. Attendance will be approved by the Contracting Officer’s Representative and the contractor will be reimbursed at actual expenses, not to exceed the authorized rates contained in the Federal Travel Regulations. Contractor will be paid for time actually spent in training, no compensation will be provided for travel time.

The contractor will follow the policies, procedures, and guidelines established by the Job Corps. The contractor will have primary responsibility to implement the Dental program.

The Center dentist is an independent contractor and not an employee of the U.S. Forest Service or the Department of Labor, Job Corps. The contractor will exemplify and save the Harpers Ferry Job Corps Center harmless from any expenses, including attorney's fees and also claims on account of damage to property or bodily injury (including death) which may be sustained by himself/herself or his/her employees in connection with work performed.

4. QUALIFICATIONS OF CONTRACT…