B_SF-18_75H70626R00004_Only_01_06_2026.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

See Schedule

CODE 16. ADMINISTERED BYCODE

X

X

561320

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR167

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

02/05/2026 1200 MT

01/06/2026

ASHLEIGH YAZZIE

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70626R00004

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 12 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Multiple Destinations

15. DELIVER TO

Pine Ridge SD 57770 Pine Ridge PHS Indian Hospital

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$34

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Pine Ridge Service Unit

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

ADMINISTERED BY:

Pine Ridge Service Unit Pine Ridge PHS Indian Hospital 607 Indian Health Road E. Hwy 18 Pine Ridge SD 57770

NOTICE TO QUOTER

100% Small Business Buy Indian Set-Aside

REQUEST FOR QUOTES: RFQ 75H70626R00004

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

NICHOLE R. LEREW

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

RETURN RFQ TO: DHHS - Great Plains Area Indian

Health Service Department of Acquisition

Management Fed. Bldg. Room 309; 115 4th Ave SE;

Aberdeen, SD 57401

Email: ashleigh.yazzie@ihs.gov

GENERAL DESCRIPTION: Labor Hour Type Commercial

Item Purchase Order to provide a Non-Personal

Registered Nurse/License Practical Nurse Services to the Outpatient Departments according to the attached Performance Work Statement (PWS) for the

Great Plains Area - Indian Health Service - Pine

Ridge Service Unit, Pine Ridge, South Dakota

57770, and other health care centers including

Martin District Clinic, Kyle Health Center, Wanblee Health Center. The quoted unit price is an all-inclusive cost.

All-inclusive unit price is defined to include travel, lodging, per diem, fringe benefits, federal, state and local taxes, plus all other costs pertinent to the performance of this purchase order.

NAICS Code: 561320 Temporary Help Services. The

SBA set the size standard in millions of dollars

$34.0

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

12 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004

Base Period with Eight (8) Option periods extending multiple years. Base Period shall be three (3) months, and each option period shall be three (3) months.

Work Schedule: Please refer to the Performance

Work Statement C.3.5. Tour of Duties.

Period of Performance: Base Award with option periods. Options periods shall be in quarterly arrears.

Base: 3/1/2026 5/31/2026

1st Option Period: 6/1/2026 8/31/2026

2nd Option Period: 9/1/2026 11/30/2026

3rd Option Period: 12/1/2026 2/28/2027

4th Option Period: 3/1/2027 5/31/2027

5th Option Period: 6/1/2027 8/31/2027

6th Option Period: 9/1/2027 11/30/2027

7th Option Period: 12/1/2027 2/29/2028

8th Option Period: 3/1/2028 5/31/2028

EVALUATION AND SUBMITTAL:

52.212-1 INSTRUCTIONS TO OFFERORS - COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES NOV 2025

(DEVIATION)

Sub-paragraph (b) is replaced in its entirety by the following:

(b) Submission of quotes. All quotes must include the following information and submitted via email to ashleigh.yazzie@ihs.gov.

(1) Volume 1 - Label "Administrative Documents."

Signed and dated SF-1449 and all associated SF-30 amendments, if any. A completed copy of the representations and certifications at Federal

Acquisition Regulation (FAR) 52.212-3 (see FAR

52.212-3(b) for those representations and certifications that the quoter shall complete electronically).

(2) Volume 2 - Label " Technical Capability and

Approach." The offeror shall demonstrate its ability to meet or exceed the requirements outlined in the Performance Work Statement (PWS).

The offeror shall provide the following information: - A clear, detailed approach that

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

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CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004 outlines how the requirements of the PWS will be met. - Identify key personnel and demonstrate how they meet the qualifications stated in the PWS. -

Resumes, certifications, and any other relevant documentation for all proposed key personnel. -

Submit a proposed project schedule, ensuring alignment with the government's required Period of Performance. The schedule must include tasks, milestones, and lead times, presented in a both narrative and chart formats. NO PRICING

INFORMATION SHALL BE INCLUDED IN VOLUMES 1, 2,

and 3. Submit three (3) copies.

(3) Volume 3 - Label "Past Performance." Include a minimum of 3 but no more than 5 Non-Personal

Service Contracts in Outpatient Continence

Department of similar or same scope and magnitude within the past five (5) years. Past performance information should include award information including modifications, fully-executed past performance reviews, and other information that demonstrate compliance to price, and technical capability. If available, include past performance evaluations from the Contractor

Performance Assessment Reporting System (CPARS).

Submit three (3) copies.

(4) Volume 4 - Label "Price." Offerors shall provide detailed pricing aligned with the technical approach. Include a budget narrative explaining cost assumptions and indicate any discount terms. Submit three (3) copies.

All questions must be submitted in writing via email 8 days prior to Closing Date.

52.212-2 EVALUATION - COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES NOV 2025

(DEVIATION)

(a) Evaluation factors. The Government will award a contract resulting from this solicitation to the responsible Offeror whose offer to the solicitation will be most advantageous to the

Government, price and other factors considered.

The following factors shall be used to evaluate offers:

1. Technical capability and approach in order to meet the government's requirement as defined in

Attachment A - Performance Work Statement (PWS)

Continued ...

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CONTINUATION SHEET

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(A) (B) (C) (D) (E) (F)

75H70626R00004

2. Key Personnel shall meet the requirements listed in section (0.0) of the PWS

3. Capability to meet the Period of Performance Schedule

4. Past Performance of three (3) projects providing non-personal service contract for

Outpatient Continence Department services within the past five (5) years.

5. Price

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the government to exercise the option(s).

(c) Notice of award. A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

ATTACHMENTS:

A. Notice to Quoter/Combined

Synopsis/Solicitation

B. SF18 Request for Quotations (Signature required)

C. Performance Work Statement

D. Clauses incorporated by reference and clauses in full text

E. Indian Representation Form

F. Dept. of Labor - Wage Determination

Quotation must set forth full, accurate and complete information as required by the Request for Quotation (RFQ) and be returned no later than the date referenced in Block #08 of the Request for Quotation form SF-1449. All required information must be submitted to be considered

Continued ...

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CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004 responsive and eligible for award.

ACCEPTANCE PERIOD: Your quote must stipulate that it is predicated upon all the terms and conditions of this Solicitation. In addition, it must contain a statement to the effect that it is firm for a period of at least 60 days from the date of receipt by the Government.

Period of Performance: 03/01/2026 to 05/31/2028

1 Base Period: 3 MONTHS

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

Delivery Location Code: IHSPINERIDGE

PINE RIDGE

607 Indian Health Road

E. Hwy 18

IHSPINERIDGE SD 57770 US

Period of Performance: 03/01/2026 to 05/31/2026

2 1st Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

Continued ...

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(A) (B) (C) (D) (E) (F)

75H70626R00004

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 06/01/2026 to 08/31/2026

3 2nd Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 09/01/2026 to 11/30/2026

4 3rd Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

Continued ...

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75H70626R00004

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 12/01/2026 to 02/28/2027

5 4th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance Ends: 05/31/2027

6 5th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Continued ...

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75H70626R00004

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 06/01/2027 to 08/31/2027

7 6th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 09/01/2027 to 11/30/2027

8 7th Option Period:

Ten (10) Registered Nurses/License Practical

Continued ...

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75H70626R00004

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 12/01/2027 to 02/29/2028

9 8th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 03/01/2028 to 05/31/2028

Continued ...

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75H70626R00004

The Contractor must provide only new equipment and new parts for the required products described herein; no used, refurbished, or remanufactured equipment or parts shall be provided under any circumstances. Absolutely no Gray Market Goods or

Counterfeit Electronic Parts shall be provided.

Gray Market Goods are defined as genuine branded goods intentionally or unintentionally sold outside of an authorized sales-territory or by non-authorized dealers in an authorized territory. All equipment shall be accompanied by the Original Equipment Manufacturers (OEMs) warranty. Counterfeit Electronic Parts are defined as unlawful or unauthorized reproduction, substitution, or alteration that has been knowingly mismarked, misidentified, or otherwise misrepresented to be an authentic, unmodified electronic part from the original manufacturer, or a source with the express written authority of the original manufacturer or current design activity, including an authorized aftermarket manufacturer.

Unlawful or unauthorized substitution includes used electronic parts represented as new, or the false identification of grade, serial number, lot number, date code, or performance characteristics.

Invoice Processing Platform (IPP)

The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system.

In compliance with the Office of Management and

Budget (OMB) M-15-19 memorandum, Improving

Government Efficiency and Saving Taxpayer Dollars

Through Electronic Invoicing, directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors.

Invoices submitted under any award resulting from this solicitation will be required to utilize the

Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and

Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasurys Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St.

Continued ...

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Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register- however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or

IPPCustomerSupport@fiscal.treasury.gov

Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

The Government reserves the right to accept or reject services if the level or work is unsatisfactory.

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