Attachment 1.A Surveillance Checklist - Saginaw Non Emergent Transportation.pdf
PDF 117 KB Posted
- Solicitation number
- 36C25025R0013
About this file
This is a surveillance checklist for monitoring contractor performance on a non-emergent wheelchair and ambulatory patient transportation services contract at the Saginaw VA Medical Center in Michigan.
The checklist outlines five key performance objectives with associated standards and surveillance methods: 1) On-time transportation service requiring passengers to arrive 15 minutes before appointments with a 97% performance threshold measured through customer feedback, 2) Incident reporting requiring submission within 24 hours with 97% threshold monitored through random checks, 3) Monthly invoice reports requiring 95% compliance verified through 100% inspection, 4) Vehicle fleet maintenance requirements with 95% threshold checked through periodic inspections, and 5) Driver requirements and training standards with 95% compliance verified through periodic inspections. Each objective includes specific PWS paragraph references and columns to mark whether standards are met or not met.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25025R0013 0001.docx | DOCX document | |
| Attachment 3 REVISED.pdf | ||
| Solicitation Questions with Responses.pdf | ||
| Attachment 2.xlsx | XLSX spreadsheet | |
| Attachment 2.xlsx | XLSX spreadsheet | |
| 36C25025R0013.pdf | ||
| Attachment 3.pdf | ||
| Attachment 1.pdf | ||
| Attachment 2.xlsx | XLSX spreadsheet | |
| Attachment 1.A.pdf | ||
| Attachment 4.pdf | ||
| Appendix D.pdf | ||
| Attachment 4 - Service Contract Act WD 2015-4865 REF 25 Eff 7.22.2024.pdf | ||
| Attachment 2 - Price-Cost Schedule.xlsx | XLSX spreadsheet | |
| Appendix D- Rules of Behavior.pdf | ||
| Attachment 3 - Past Performance Questionnaire.pdf | ||
| 36C25025R0013.docx | DOCX document | |
| Attachment 1 - Quality Assurance Surveillance Plan.pdf |
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Text version
Surveillance Checklist
Saginaw VAMC - Non-Emergent Wheelchair and Ambulatory Patient Transportation Services
Contract: Non-Emergent Wheelchair and Ambulatory Patient Transportation
Services
Date/Time of Inspection:
Government POC Primary:
Government POC Alternate:
Organization: Saginaw VAMC Location: 1500 Weiss Street Saginaw, MI 48602
SS
Performance Objective -
Task PWS Para
Standard Performance
Threshold
Method of
Surveillance Met Not Met
Remarks
SS 1
Provide on- time transportation service to appointments
Section XII.f
Shall ensure all passengers arrive at their designated appointment location at least
15 minutes prior to the appointment time.
97% Customer
Feedback
Task PWS Para
Standard Performance
Threshold
Method of
Surveillance Met Not Met
Remarks
SS 2 Incident Reporting Section XIV.c
The Contractor shall submit all injury reports within 24 hours of incident to the VTS/COR and AOD for inclusion into the passenger’s administrative chart.
97% Random monitoring of incident reports
SS 3 Invoice Reports Section XIX
Provide a monthly invoice including secondary documentation in accordance with Section XIX of the PWS
95%
100% inspection of monthly invoices/reports
SS4 Vehicle Requirements Section VII
Contractor to maintain fleet of vehicles in accordance with paragraph VII of the PWS to include
95% Periodic
Inspection
Task PWS Para
Standard Performance
Threshold
Method of
Surveillance Met Not Met
Remarks providing reports upon request of the
COR or CO.
SS5
Driver Requirements and Training
Section V and VI
Contractor to ensure drivers meet diver requirements of section V and training standards in section VI
95% Periodic
Inspection
File details come from the government source that posted it. Updated .