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This is a Request for Quote (RFQ) issued by the Great Plains Area Indian Health Service (IHS) Pine Ridge Service Unit for Medical Physicist Services. The RFQ (RFQ-PR25-029) is a 100% Small Business Set-aside contract with NAICS Code 541690 and a $19.0 million size standard. The contract will provide medical physics services for Pine Ridge Hospital, Kyle Health Center, and Wanblee Health Center, including equipment inspections, physicist surveys, and radiation safety audits across radiology and dental departments.

The one-year contract requires medical physicist services including: 1 inspection at Pine Ridge Hospital's Radiology Department, 1 inspection at Pine Ridge Hospital's Dental Department, 1 inspection at Kyle Health Center's Radiology and Dental Departments, 1 inspection at Wanblee Health Center's Radiology and Dental Department, and radiation safety audits at three locations. Quotes are due by August 27, 2025 at 12:00 pm MST, with pricing to be all-inclusive and covering travel, lodging, per diem, fringe benefits, and taxes. The contract will be awarded on a Lowest Price Technically Acceptable (LPTA) basis, evaluating factors such as delivery schedule, past performance, price reasonableness, and responsiveness to requirements.

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A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994) (Public Law 103-355). This announcement constitutes the only solicitation; quotes are being requested, and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) Pine Ridge Service Unit intends to award a Firm-Fixed Price, Non-Personal

Service, Commercial Item, contract in response to Request for Quote (RFQ) RFQ-PR25-029.

C. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular (FAC) 2025-05 dated 08/07/2025.

D. This RFQ is issued as 100% Small Business Set-aside, and the associated NAICS Code is 541690 which has a size standard of $19.0.

E. The quoted unit pricing must be all inclusive (to include but not be limited to travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

Medical Physicist Services:

1. Pine Ridge Hospital - Radiology Department -Equipment Inspection -Physicist Survey:

1 Inspection @ $ _________________ per inspection = $ _________________

2. Pine Ridge Hospital - Dental Department - Equipment Inspection -Physicist Survey:

3. Kyle Health Center - Radiology and Dental Departments -Equipment Inspection -Physicist Survey:

4. Wanblee Health Center - Radiology and Dental Department - Equipment Inspection -Physicist Survey:

5. Radiation Safety Audits for Pine Ridge, Kyle Health Center and Wanblee Health Center

3 locations @ $ _________________ per location = $ __________________

TOTAL: $ ________________________

The period of performance will be for one (1) year from date of award.

F. The primary objective of this contract is to establish a 1-year contract to provide Medical Physicist Services for the IHS Pine Ridge Service Unit, Kyle Health Center and Wanblee Health Center.

G. FAR 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (Sep 2023).

NOTE: Quotes shall be submitted on company letterhead stationery, signed, dated and it shall include:

1. Solicitation number RFQ-PR25-029.

2. Closing Date: August 27, 2025 at 12:00 pm MST.

3. Name, address and telephone number of company and email address of contact person.

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents, if necessary.

5. Terms of any express warranty.

6. Price and any discount terms.

7. “Remit to” address, if different than mailing address.

8. A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically).

9. Acknowledgment of Solicitation Amendments (if any issued)

10. Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information).

11. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation.

Offerors that fail to furnish required representations or information or reject the terms and conditions of the solicitation may be excluded from consideration.

Basis of award is Lowest Price Technically Acceptable “LPTA” factors in determining the successful contractor.

▪ Ability to meet the Delivery Schedule

▪ Past Performance.

▪ Reasonableness of Price.

▪ Responsiveness to requirements.

H. FAR 52.212-3 Offer Representations and Certifications-Commercial Products and Commercial Services (May 2024) – See attachment for full text.

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v)) of this provision.

I. FAR 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023) – See attachment; in by reference.

J. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial

Products and Commercial Services (Jan 2025) - See attachment for full text.

K. Attached are the Federal Acquisition Regulations (FAR) & Health & Human Services Acquisition Regulation (HHSAR) clauses that are applicable, including below.

L. Offers will be accepted electronically, Submit via e-mail to the following:

Kim Carpio, Purchasing Agent at kim.carpio@ihs.gov

Please submit any questions by August 22, 2025 by 12:00 pm MST.

Contractors must obtain a Unique Entity ID (UEI) number and Taxpayer Identifying number (TIN); and be registered with the System for Award Management (SAM) at www.sam.gov.

ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. 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.

The 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 reference in Paragraph #G-2. All required information must be submitted to be considered responsive and eligible for the award.

No contract award shall be made to any vendor listed on the OIG Exclusions List at http://exclusions.org.hhs.gov throughout the duration of the contract.

Invoice Processing Platform (IPP)

The Indian Health Services is in the process of implementing an electronic invoicing system.

https://www.sam.gov/ mailto:kim.carpio@ihs.gov http://www.sam.gov/ http://exclusions.org.hhs.gov/

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 Treasury’s Bureau of the Fiscal

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

https://obamawhitehouse.archives.gov/sites/default/files/omb/memoranda/2015/m-15-19.pdf https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

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Statement of Work

Medical Physicist

Services

Pine Ridge Service Unit

Section 1: General Information

1.1 General: This is a non-personal services contract to provide medical physics services for the Pine

Ridge Comprehensive Health Care Facility (PRCHCF). This survey will also include the Kyle Health

Center and the Wanblee Health Center. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.2 Period of Performance: Physical survey must be conducted during July to August of each year and reports are due within 30 days of completion. Assistance to create corrective action plan, review plan with program director, and re-evaluate to ensure compliance is acceptable may occur within the following 11 months. The total period of performance is one year beginning from the date of the award.

1.3 Place of Performance: Pine Ridge Comprehensive Healthcare Facility

PO Box 1201

Pine Ridge, South Dakota 57770

1.4 Hours of Operation: All work shall be performed during business hours of 8:00 am to 5:00 PM. If a service has begun during regular business hours and it must be completed before any patients can be imaged according to the American College of Radiology (ACR), The Joint Commission (TJC), or the

Mammography Quality Standards Act (MQSA), then the physicist must complete the service.

1.5 Location of Services:

• Pine Ridge Hospital 607 Indian Health Rd Pine Ridge, SD 57770

• Kyle Health Center 1000 Health Center Rd Kyle, SD 57752

• Wanblee Health Center 210 1st ST Wanblee, SD 57577

(These 3 locations are all more than 90 miles separation)

1.6 Type of Contract: The government will award a Firm Fixed Price One Year Contract

1.7 Invoice Submission:

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 Treasury’s https://obamawhitehouse.archives.gov/sites/default/files/omb/memoranda/2015/m-15-19.pdf

Page | 2

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

Section 2: Definitions & Acronyms

2.1 Definitions:

Contractor. A supplier or vendor awarded a contract to provide specific supplies or service to the government.

Work Day. The number of hours per day the Contractor provides services in accordance with the contract is an 8-hour day.

2.2 Acronyms:

AAPM

ACR

CBCT

CFR

COR-NA

CT

FOV

HVL

IEC

MQSA

MRI

NCRP

PET

QA

RSO

SMPTE

SOW

SPECT

TJC

American Association of Physicist in Medicine

American College of Radiology

Cone Beam Computed Tomography

Code of Federal Regulations

Contracting Officer Representative-Non-Applicable

Computed Tomography

Field of View

Half Value Layer

International Electrotechnical Commission

Mammography Quality Standards Act

Magnetic Resonance Imaging

National Council for Radiation Protection

Positron Emission Tomography

Quality Assurance

Radiation Safety Officer

Society of Motion Picture and Television Engineers

Statement of Work

Single-Photon Emission Computed Tomography

The Joint Commission https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

Page | 3

Section 3: Government Furnished Property, Equipment, and Services

None

Section 4: Contractor Furnished Items and Services

The Contractor shall provide all equipment, supplies, management, supervision, personnel, and transportation necessary to assure that all services are in accordance with the contract and all applicable laws and regulations. The contractor shall ensure all work meets performance standards specified in this Statement of

Work (SOW).

Section 5: Specific Tasks

The Contractor shall comply with radiation protection standards in 29 CFR 1910.1096 and immediately report any unsafe conditions with the potential to adversely impact the facility radiation workers or patients to the Radiation Safety Officer (RSO).

5.1 General Requirements

A. All work shall be performed by a Qualified Medical Physicist (QMP) or the QMP must be onsite providing direct quality control supervision during measurements made by a medical physicist assistant/technician. A Qualified Medical Physicist is a person who is certified by the American

Board of Radiology, American Board of Medical Physics, or the Canadian College of Physicists in

Medicine. The contractors must submit evidence of board certification with their quote and solicitation submittal.

5.2 Required Services

A. Dosimetry Badge Program: Radiation Dosimeter services to be provided for CLIENT Radiology

Department by Vendor

1) Communicate with dosimeter provider and utilize website for tracking and data entry of CLIENT staff members

2) Maintain Account with under XX dosimeters

i. Quantities: maximum of 46 for Pine Ridge, 3 for Kyle Health Center and 1 for Wanblee

Health Center (total maximum of 30 badges per year) to be billed as requested per quarter.

ii. Departments: - add and update accounts as needed (PRSU Hospital Radiology, Kyle

Health Center Radiology, and Wanblee Health Center Radiology

iii. Participants: process paperwork and utilize provider website to add, change, and discontinue participants

iv. Badges: process paperwork and utilize website to add, change, and discontinue body and ring dosimeters. Exchange on a quarterly basis as industry standard

v. Fetal Badges: process paperwork for declaration of pregnancy and process paperwork and utilize website to coordinate monthly fetal monitoring

vi. Recalculations: communicate and process paperwork for:

a. Improper wear or handling of dosimeter

b. Lost or damaged dosimeter

c. Unworn dosimeter

d. Participants prior exposure for accurate cumulative lifetime exposure

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3) Reporting

i. Send Form 5 annual report to all badged participants

ii. Review exposure reports for wear period

iii. Notify RSO of exposures exceeding ALARA limits

iv. Provide exposure history for terminated participants

v. Provide exposure history to other employers for past participants, when requested

vi. Request and collect prior exposure history for newly badged participants

NOTE: Pine Ridge will supply the names of new hires with estimated entry on duty dates so that badges can be on hand for implementation and separation dates with end dates so that badges may be canceled for the upcoming quarter.

B. Equipment Inspections

1) All imaging equipment shall be inspected at least annually in July-August, not to exceed 14 months. Other inspections as defined below (new equipment, repairs, shielding (lead aprons), etc.) shall be completed as needed. A complete electronic report in “pdf” format shall be provided to Radiology Supervisor, Biomedical Engineering and the Radiation Safety Officer

(RSO) or a printed (hard copy) version of the report results shall be provided within 30 days after completion of the inspection.

2) Missed or errors in performance for required elements will be corrected at the expense of the contractor. If errors are found in reports, corrections in “pdf” form will be submitted expeditiously.

3) The qualified diagnostic Medical Physicist shall perform imaging equipment (X-ray equipment, CT, and Dental units) inspections to ensure compliance with the current

Regulatory agency requirements. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to Radiology Supervisor, Biomedical

Engineering and the RSO prior to the qualified diagnostic medical physicist leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients must be reported to the

RSO immediately upon discovery.

4) The qualified diagnostic medical physicist shall perform acceptance testing of all new or relocated imaging equipment prior to first clinical use. The acceptance testing shall comply with ACR and MQSA requirements. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to Biomedical Engineering and RSO prior to the qualified diagnostic medical physicist leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to Biomedical Engineering and the

RSO immediately upon discovery.

5) The qualified diagnostic medical physicist shall perform a full inspection of imaging equipment after repairs or modifications that may affect the radiation output or image quality where required. In cases where the unit may not be used clinically until inspected by a physicist, the inspection must be completed within 72 hours after the facility contacts the

Page | 5 contractor. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to Biomedical Engineering and the RSO prior to the qualified diagnostic medical physicist leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to Biomedical Engineering and the RSO immediately upon discovery. Where acceptable, the physicist will review and accept the repairs report from Engineering.

6) The qualified diagnostic medical physicist shall provide consultation for additional services as needed, such as safety training, reading dosimetry badge reports, i.e.

7) The qualified diagnostic medical physicist shall review CT protocols at least annually.

C. Radiation Safety Audit

1) The qualified diagnostic medical physicist will review the program and perform a Radiation

Safety Audit for the facilities. (3 facility locations), physical cite visit to each location is required for Pine Ridge Hospital, Kyle Health Center and Wanblee Health Center.

2) The qualified diagnostic medical physicist shall provide shielding design calculations for each new, replaced, or relocated x-ray imaging system. The calculations for each shall comply with the

National Council for Radiation Protection and Measurements (NCRP) Report No. 147, and, for dental units, NCRP Report No. 145, and shall be documented in a written report which includes a diagram showing adjacent areas. The qualified diagnostic medical physicist shall perform a shielding survey to verify the structural shielding was installed per the shielding design report and complies with the design goals.

3) The qualified diagnostic medical physicist shall assist in the development of a comprehensive technical quality assurance (QA) program (e.g., technique charts, repeat/reject analysis monitoring, monitoring of exposure indices to radiographic image receptors, QA program for display monitors, QA for CT, monitoring of dose metrics from fluoroscopy studies), which complies with ACR recommendations, for all modalities. The qualified diagnostic medical physicist shall review, at least annually, the QA program.

4) The qualified diagnostic medical physicist shall review the report from Engineering to verify compliance of any necessary corrective action performed to correct deficiencies found. The contractor will perform a follow-up inspection if necessary, according to ACR, MQSA, or other relevant standards.

5.3 Equipment Inspections Descriptions

The Contractor shall conduct equipment inspections or quality control surveys of the imaging equipment listed below. The Contractor shall ensure the imaging equipment’s compliance with applicable Federal regulations and ACR recommendations and shall include, but not be limited to, monitoring the following basic performance characteristics.

Page | 6

A. Radiographic and Fluoroscopic Equipment

Physics inspections of radiographic and fluoroscopic equipment shall comply with the ACR

Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic and

Fluoroscopic Equipment. The performance of each radiographic and fluoroscopic unit must be evaluated at least annually. This evaluation should include, but not be limited to, the following tests

(as applicable):

1) Integrity of unit assembly.

2) Collimation and radiation beam alignment.

3) Fluoroscopic system spatial resolution.

4) Automatic exposure control system performance.

5) Fluoroscopic automatic brightness control performance (high-dose-rate, pulsed modes, field- of-view [FOV] variation).

6) Image artifacts.

7) Fluoroscopic phantom image quality.

8) kVp accuracy and reproducibility.

9) Linearity of exposure versus mA or mAs.

10) Exposure reproducibility.

11) Timer accuracy.

12) Beam quality assessment (half-value layer).

13) Fluoroscopic entrance exposure rate (or air kerma rate). Maximum output and output using a phantom representing a standard size patient for all clinically used settings. [The mode of operation

[e.g., magnification mode, frame rate, and any other mode selected) must be documented for each measurement.]

14) Fluorographic (image recording) entrance exposure rate (or air kerma rate) for cine imaging, if performed and entrance exposure (or air kerma) for spot images (if performed). Maximum output and output using a phantom representing a standard size patient for all clinically used settings. [The mode of operation (e.g., magnification mode, frame rate, etc.) must be documented for each measurement.]

15) Image receptor entrance exposure.

16) Equipment radiation safety functions.

17) Patient dose monitoring system calibration. This includes, for radiographic systems, the metric of dose to the image receptor (IEC Exposure Index or proprietary index) and, for fluoroscopy systems, the displays of cumulative air kerma and, if available, DAP.

18) Display monitor performance.

19) Digital image receptor performance.

20) Grids used with portable x-ray units shall be imaged for uniformity.

21) For radiographic units, measurement of entrance skin exposure (or air kerma) for a standard size patient for common radiographic projections and comparison to published diagnostic reference levels and achievable doses (e.g., ACR practice parameter.

Note: The information on entrance exposure rates (or air kerma rates) from fluoroscopy and from fluorography, in Items (13) and (14) above, for each fluoroscope, shall be in a format suitable for providing to the physicians who operate the fluoroscope.

Page | 7

B. Digital Radiography (DR)

Physics inspections of DR equipment shall comply with the American Association of Physicist in

Medicine (AAPM) Report Number 93, Acceptance Testing and Quality Control of Photostimulable

Storage Phosphor Imaging Systems. The performance of DR must be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable):

1) Component and Imaging Plate Physical Inspection and Inventory.

2) Imaging Plate Dark Noise and Uniformity.

3) Exposure Indicator Calibration.

4) Linearity and Auto-ranging Response.

5) Laser Beam Function.

6) Limiting Resolution and Resolution Uniformity.

7) Noise and Low-Contrast Resolution.

8) Spatial Accuracy.

9) Erasure Thoroughness.

10) Aliasing/Grid Response.

11) IP Throughput.

12) Positioning and Collimation Errors.

C. CT Scanners

The physics inspection shall conform to the 2012 ACR Computed Tomography Quality Control Manual or latest revision. The performance of each CT scanner shall be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable):

Review of Clinical Protocols.

1) Scout Prescription and Alignment Light Accuracy.

2) Image Thickness – Axial Mode.

3) Table Travel Accuracy.

4) Radiation Beam Width.

5) Low-Contrast Performance.

6) Spatial Resolution.

7) CT Number Accuracy.

8) Artifact Evaluation.

9) CT Number Uniformity.

10) Dosimetry (the scanner displayed CTDIvol values must be within +/- 20% of the measured

CTDIvol values).

11) Gray Level Performance of CT Acquisition Display Monitors.

D. Dental

The physics inspection shall conform to the Conference of Radiation Control Program Directors

(CRCPD), Quality Control Recommendations for Diagnostic Radiography Volume 1 Dental Facilities

July 2001. The performance of dental x-ray inspections shall be annually. This evaluation should include, but not be limited to, the following tests (as applicable).

Page | 8

1) Collimation.

2) Beam quality (half value layer).

3) Timer Accuracy and Reproducibility.

4) kVp Accuracy and Reproducibility.

5) mA or mAs Linearity.

6) Exposure Reproducibility.

7) Entrance Skin Exposure Evaluation, with comparison to published diagnostic reference levels and achievable doses (e.g., NCRP Report No. 172).

8) Technique Chart Evaluation.

9) Image uniformity (artifact evaluation).

Dental Cone Beam Computed Tomography (CBCT) Acceptance and Performance Testing

a) Acceptance Testing. Acceptance testing and measurements of air kerma at the isocenter for each kVp station for a range of clinically used mAs settings will perform initially when the CBCT unit is installed and following any move of the CBCT to another area inside or outside the initial clinical site. This testing is to ensure that the equipment performance is in agreement with the manufacturer’s technical specifications.

b) Performance Testing. Each CBCT unit shall undergo periodic quality control tests to ensure that the performance of the machine has not significantly deteriorated and is operating within the manufacturer’s technical specifications. This performance testing is performed by a qualified expert annually, at intervals not to exceed 14 months, and after repairs to the CBCT unit that may affect the radiation output or image quality.

c) Some manufacturers provide a phantom and procedures to perform machine specific quality assurance (QA) tests. In cases where the manufacturer provides a phantom and procedures to perform specific tests but the tests are not included in this SOW, then the manufacturer’s machine-specific QA tests shall be performed in addition to the QA tests in this SOW.

Acceptance and Annual physics testing for Dental CBCT

a) Radiation output Repeatability

Make four measurements of the air kerma at the isocenter at a clinically used setting. The measurements should be less than +/-5% of the average of the five measurements and the measurements should be less than +/- 5% of the previous year’s measurement.

b) Radiation Output Reproducibility

Measure the air kerma at the isocenter for each kVp station and a range of clinically used mAs setting. Compare the results to the baseline values established at the initial acceptance testing.

The values should be +/-5% of the baseline.

c) kVp Accuracy

Measure the kVp at all clinically used settings. The measured kVp should be +/-5% of the selected kVp.

Page | 9

d) kVp Repeatability

Make five kVp measurements each for two clinically used kVp settings. All measured values should be +/-5% of the mean kVp.

e) kVp Reproducibility

Measure the kVp at all available kVp settings. The measured values should be +/-5% of the baseline.

f) Beam quality

Measure the half value layer (HVL) for aluminum. The minimum shall comply with Section

F.4.d of the Suggested State Regulations for Control of Radiation, Conference of Radiation

Control Program Directors.

g) Radiation field of view (FOV)

Measure the width of the radiation field at the isocenter. The width of the beam should be 3 mm or 30% of the total nominal collimated width.

h) Image Quality

Image the phantom provided by the manufacturer or another suitable phantom. Assess high contrast spatial resolution, uniformity of transaxial images, and image noise.

Imaging uniformity shall be assessed over the entire range of axial images.

i) Accuracy of Linear Measurements

Using images of an appropriate phantom, assess the accuracy of distance measurements.

j) Accuracy of Patient Dose Metric Indication

Assess the accuracy of the indicated dose metric (typically DAP).

k) Patient Dose Assessment

From a scan or scans using the facility’s standard techniques, record the dose metric (typically

DAP) and compare to achievable levels and diagnostic reference levels (if available)

l) Review of the technical QA program

The qualified expert shall review the technical QA program. The review shall include a trend analysis of the QA data. The results of the technical QA program review shall be included in the written report. Any trends that identify problems shall be included in the report along with recommended corrective actions.

m) Display Monitors

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Perform a visual analysis of the SMPTE test pattern.

i. Display the test pattern on the imaging console. Set the display window width/level to the manufacturer-specified values for the pattern. Do not set the window/level by eye;

doing so invalidates the procedure.

ii. Examine the pattern to confirm that the gray level display in the imaging console is subjectively correct.

1. Review the line pair patterns in the center and at each of the corners.

2. Review the black-white transition.

3. Look for any evidence of “scalloping” (loss of bit depth) or geometric distortion.

iii. Use a photometer to measure the maximum and minimum monitor brightness (0% and

100% steps)

iv. Measure additional steps within the pattern to establish a response curve.

v. Measure the brightness near the center of the monitor and near all 4 corners (or all 4 sides, depending on the test pattern used).

n) Viewing Conditions

Assess the viewing conditions for the area in which the monitor used to evaluation the CBCT studies is located.

5.4 Equipment List

Description X-ray Units Planned replacement or addition

PINE RIDGE X-RAY UNITS

CT: GE or Cannon 1

Fluoro & X-ray: GE

Portable Fluoro: OEC C-arm 1

Fixed X-ray: GE 1

DR Schimadzu Portable Rad 2

PINE RIDGE DENTAL

Progeny DC Dental

Bite wing

Sirona Orthophos XG Dental 1 Pano

Sirona Orthophos XG 3 D Ready Dental 1 Cone Beam (only if in use)

Kavo Nomad Dental Handheld Unit 1 New 2021-22

Page | 11

KYLE X-RAY UNITS

GE Xray 1

Progeny Dental Preva (Dental) 2 Bitewing

Sirona Orthophos XG (Dental) 1 Pano

WANBLEE X-RAY UNITS

GE Proteus Xray 1

Sirona Orthophos XG 5 (Dental) 1 Pano

Progeny Dental Preva (Dental) 1 Bitewing

Dosimetry Badge Program Management (all

Sites) Radiation Safety Audit

3 Pine Ridge Hospital, Kyle Health Center and Wanblee Health Center

Contract Officer Responsibilities

The Contracting Officer (CO) is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the CO on all matters pertaining to contract administration. Only the CO is authorized to make commitments or issue any modification to include

(but not limited to) terms affecting price, quantity or quality performance of this contract.

1. Authority

1.1. No person other than the Contracting Officer has authority to bind the Government with respect to this contract.

1.2. No action or omission of any government employee or representative other than the

Contracting Officer shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

1.3. In no event shall any of the following be effective or binding on the Government or imputed to the Contracting Officer with respect to this contract:

1.3.1. An understanding or agreement between the Contractor and anyone other than the

Contracting Officer;

1.3.2. A purported modification or change order issued by anyone other than the Contracting

Officer;

1.3.3. A promise by anyone other than the Contracting Officer to provide additional funding or make payments; or

1.3.4. An order, direction, consent, or permission from anyone other than the Contracting Officer to incur costs in excess of a specified estimated cost, allotment of funds, or other ceiling;

or expend hours in excess of a specified level of effort.

CLAUSES INCORPORATED BY REFERENCE

(Firm Fixed-Price, Non-Personal Service Type, Commercial Item)

52.252-1 Solicitation Provisions Incorporated by Reference. This solicitation incorporates one or more solicitation provisions 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. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): WWW.ACQUISITION.GOV/BROWSE/INDEX/FAR (End of provision)

Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR

Citation

Clause Title Clause Date

1. 52.204-7 System for Award Management Nov 2024

2. 52.204-9 Personal Identity Verification of Contractor Personnel Jan 2011

3. 52.204-13 System for Award Management Maintenance Oct 2018

4. 52.204-16 Commercial and Government Entity Code Reporting Aug 2020

5. 52.204-17 Ownership or Control of Offeror Aug 2020

6. 52.204-18 Commercial and Government Entity Code Maintenance Aug 2020

7. 52.204-19 Incorporation by Reference of Representations and Certifications Dec 2014

8. 52.212-1 Instructions to Offerors—Commercial Products and Commercial Sep 2023

Services

9. 52.212-4 Contract Terms and Conditions—Commercial Products and Nov 2023

Commercial Services

10.

11. 52.225-25 Prohibition on Contracting with Entities Engaging in Certain Jun 2020

Activities or Transactions Relating to Iran—Representation and Certifications.

12. 52.232-39 Unenforceability of Unauthorized Obligations Jun 2013

13. 52.232-40 Providing Accelerated Payments to Small Business Subcontractors Mar 2023

14. 52.237-1 Site Visit Apr 1984

15. 52.237-2 Protecting of Government Buildings, Equipment, and Vegetation Apr 1984

16. 52.253-1 Computer Generated Forms Jan 1991

CLAUSES INCORPORATED IN FULL TEXT

Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR

Citation

Clause Title Clause Date

1. 52.204-24 Representation Regarding Certain Telecommunications and Video Nov 2021

Surveillance Services or Equipment

2. 52.212-3 Offeror Representations and Certifications—Commercial Products May 2024 and Commercial Services (see attachment)

3. 52.212-5 Contract Terms and Conditions Required to Implement Statutes Jan 2025 or Executive Orders—Commercial Products and Commercial

Services (see attachment)

4. 52.217-8 Option to Extend Services Nov 1999

5. 52.219-1 Small Business Program Representations Feb 2024 http://www.acquisition.gov/BROWSE/INDEX/FAR

6. 52.224-1 Privacy Act Notification Apr 1984

7. 52.224-2 Privacy Act Apr 1984

8. 52.252-1 Solicitation Provisions Incorporated by Reference Feb 1998

9. 52.252-2 Clauses Incorporated by Reference Feb 1998

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment.

As prescribed in 4.2105(a), insert the following provision:

Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services—

Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-

Commercial Products or Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision—

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition. (1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal

Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019

(Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a federal contract. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

https://www.acquisition.gov/far/part-4#FAR_4_2105 https://www.acquisition.gov/far/part-52#FAR_52_204_26 https://www.acquisition.gov/far/part-52#FAR_52_212_3 https://www.acquisition.gov/far/part-52#FAR_52_204_26 https://www.acquisition.gov/far/part-52#FAR_52_212_3 https://www.acquisition.gov/far/part-52#FAR_52_204_25

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management

(SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".

(d) Representation. The Offeror represents that—

(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds

"will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—

It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures. (1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided;

and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded

"does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

https://www.sam.gov/

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(End of provision)

52.217-8 Option to Extend Services.

As prescribed in 17.208(f), insert a clause substantially the same as the following:

Option to Extend Services (Nov 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the

Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the

Contractor within 90 days.

(End of clause)

52.219-1 Small Business Program Representations.

As prescribed in 19.309(a)(1), insert the following provision:

Small Business Program Representations (Feb 2024)

(a)Definitions. As used in this provision-

Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127, and the concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300. It automatically qualifies as a women-owned small business concern eligible under the WOSB Program.

Service-disabled veteran-owned small business (SDVOSB) concern means a small business concern-

(1)(i)Not less than 51 percent of which is owned and controlled by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and https://www.acquisition.gov/far/part-17#FAR_17_208 https://www.acquisition.gov/far/part-19#FAR_19_309 https://www.ecfr.gov/current/title-13/part-127 https://www.ecfr.gov/current/title-13/section-127.300

(ii)The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran or;

(2)A small business concern eligible under the SDVOSB Program in accordance with 13 CFR part 128 (see subpart 19.14).

(3)Service-disabled veteran, as used in this definition, means a veteran as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16), with a disability that is service-connected, as defined in 38 U.S.C. 101(16), and who is registered in the Beneficiary Identification and Records Locator

Subsystem, or successor system that is maintained by the Department of Veterans Affairs’ Veterans Benefits

Administration, as a service-disabled veteran.

Service-disabled veteran-owned small business (SDVOSB) concern eligible under the SDVOSB Program means an SDVOSB concern that—

(1) Effective January 1, 2024, is designated in the System for Award Management (SAM) as certified by the

Small Business Administration (SBA) in accordance with 13 CFR 128.300; or

(2) Has represented that it is an SDVOSB concern in SAM and submitted a complete application for certification to SBA on or before December 31, 2023.

Service-disabled veteran-owned small business (SDVOSB) Program means a program that authorizes contracting officers to limit competition, including award on a sole-source basis, to SDVOSB concerns eligible under the SDVOSB Program.

Small business concern—

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in its field of operation, and qualified as a small business under the criteria in 13 CFR part 121 and the size standard in paragraph (b) of this provision.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties’ control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13

CFR 121.103.

Small disadvantaged business concern, consistent with 13 CFR 124.1001, means a small business concern under the size standard applicable to the acquisition, that-

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by-

(i)One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged

(as defined at 13 CFR 124.104) individuals who are citizens of the United States, and

(ii)Each individual claiming economic disadvantage has a net worth not exceeding the threshold at 13

CFR 124.104(c)(2) after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13 CFR 124.106) by individuals who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

Veteran-owned small business concern means a small business concern-https://www.acquisition.gov/far/part-19#FAR_Subpart_19_14 http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section101(2)&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section101(16)&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section101(16)&num=0&edition=prelim https://www.ecfr.gov/current/title-13/part-121

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C.101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

Women-owned small business concern means a small business concern-

(1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127)…

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