Combined Synopsis Solicitation Commercial Services_Music Therapy.pdf

Combined Synopsis-Solicitation for Commercial Services for Lexington VA Healthcare System for Lexington, KY

36C24924Q0150

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Description

This is a combined synopsis/solicitation for commercial products and commercial services prepared in accordance with the format in Federal Acquisition Regulation (FAR) subpart 12.6, “Streamlined Procedures for Evaluation and Solicitation for Commercial Products and Commercial Services,” as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested, and a written solicitation document will not be issued.

This solicitation is issued as an RFQ. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2023-06.

The associated North American Industrial Classification System (NAICS) code for this procurement is 541990, with a small business size standard of $19.5 million.

The FSC/PSC is R499.

The Network Contracting Office 9, Department of Veteran Affairs, 1639 Medical Center Parkway Suite 204, Murfreesboro, TN 37129 is seeking to purchase music therapy services for the Lexington VA Medical Center in Lexington, KY.

All interested companies shall provide quotations for the following:

Schedule of Services

Line Item Description Quantity Unit of Measure

Unit Price

Total Price

0001 Licensed Music Therapist. Contract Period: Base Year. PoP: 02-05-2024 through 02-04-2025

218 HR

Unit Price

Total Price

0002 Licensed Music Therapist. Contract Period: Option Year One. PoP: 02-05- 2025 through 02-04-2026

Unit Price

Total Price

0003 Licensed Music Therapist. Contract Period: Option Year Two. PoP: 02-05- 2026 through 02-04-2027

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Unit Price

Total Price

0004 Licensed Music Therapist. Contract Period: Option Year Three. PoP: 02- 05-2027 through 02-04-2028

Unit Price

Total Price

0005 Licensed Music Therapist. Contract Period: Option Year Four. PoP: 02- 05-2028 through 02-04-2029.

STATEMENT OF WORK

1. Scope

The Lexington VA Health Care System (LVAHCS) Whole Health Program has a requirement to provide Integrative Health Services including Music Therapy to veterans. Services will be provided at the Lexington VA. Instructors offering the services will have a master’s degree in music and be a licensed music therapist. Practitioner will have a current CPR certification or will complete BLS through the VA before offering classes. Proof of training of all individual practitioners will be provided to the LVAHCS.

Services shall be provided in a safe, effective and non-judgmental manner and will take into consideration the individual needs of the recipient.

2. Purpose

The Department of Veterans Affairs is committed to providing individualized, proactive, patient-driven care that includes both conventional and integrative health (IH) approaches. The Office of Patient Centered Care and Cultural Transformation (OPCCCT) provides leadership to VHA regarding IH approaches and serves as the LVAHCS’s partner in establishing a Whole Health model of care within our facility. It is VHA’s goal to provide care in the safest and least restrictive environment, through a continuum of services. The LVAHCS’s IHP is responsible for developing, managing and providing IH services to our Veterans. By partnering with a local Practitioner qualified to offer all required services to our Veterans through vested providers, the IHP will create an avenue for Veterans to access IH services.

The primary goal of the IHP is to maintain or improve the health of Veterans served in our organization by increasing equal access to IH services.

3. Description of Service

a. The business will provide Practitioner whose training has been fully vested through the organization in a manner acceptable to the LVAHCS for the following clinical services: guitar, drumming, song writing or

P a g e 3 | 15 similar expressive music therapy (2 hours per week), to offer clinical services to veterans served by the LVAHCS, under the direction of the LVAHCS IHP.

b. Programming will run Monday through Friday, between the hours of 0700-1900, with the exception of 11 Federal Holidays (New Year’s Day, MLK Day, Presidents Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving, and Christmas Day)

c. Services will be provided in both group sessions. Group sessions will accommodate from 1-12 participants, with the ability to add/drop participants with limited notice.

d. A master schedule of program offerings will be maintained by the VA IHP staff and be made available to the contractor. Changes to the schedule will be done with a minimum of 6 weeks’ notice to the contractor.

e. Cancellations of services will be accepted with a 6-week notice, without penalty. If cancellations are made within a 6-week time frame from said appointment, full compensation will be provided to the contracting organization.

f. Contracted Practitioner will attend required team meetings at the Lexington VA Medical Center, as deemed necessary by the IHP Co-Directors. Attendance can be by phone, unless otherwise directed by the IHP Co-directors. Contracted practitioners will be expected document patient participation and outcomes in the VA Electronic Medical Record. IH practitioners are expected to share feedback and relevant experience, when appropriate, to foster the growth of the IHP. Practitioner may be asked to complete other additional, related duties by the IHP Co-Directors. Practitioners must also maintain up-to-date trainings that are required by the VHA for all personnel involved in patient care and/or research studies. Training certificates must be given to the IHP, or other appropriate staff within the IHP.

g. Practitioner will provide said therapy to Veterans seen in the IHP, unless specified as otherwise by the IHP Co-Directors or associated LVAHCS staff. The style of music therapy should be consistent with the guidelines and direction of the IHP. Sessions will be provided on a recurring, weekly basis. The date, time and location of these group sessions will be determined by the IHP. The movement practitioner is required to follow all VHA guidelines and policies surrounding patient care.

Deliverables: The Practitioner must be present no more than fifteen (15) minutes prior to the start of each session, stay forty-five (45) minutes after each session to allow for set up and clean up after class.

Each practitioner must create a safe environment of healing and restoration for Veterans. The time allotted should include preparation and introduction to the service. The practitioner should also be able to demonstrate an understanding of VHA guidelines and policies and adhere to guidelines set forth by the IHP.

Practitioner will inform VA immediately of any equipment that needs repaired or replaced. Practitioner will immediately remove any equipment that may cause a potential harm to a veteran and inform the VA. Practitioners will inform VA 30 days in advance of any supply needs.

Practitioner will access the VA through employee entrances and will only park in employee approved parking spots.

Practitioner will follow all VHA rules and regulation while on VA property.

P a g e 4 | 15 h All contracted practitioners will complete clinical notes in the Veterans Health Administration (VHA) electronic health record system, known as CPRS, utilizing templates established by IHP. These notes are to be completed at the end of each appointment, unless mitigating circumstances are present. The task much be completed in a timely fashion and should take no more than 30 minutes per group session. All required medical record documentation shall be completed within 24 hours of seeing the patient, utilizing CPRS, following sessions each day by the practitioners, adhering to VHA policies and guidelines.

In addition to required information, the practitioners should note anything of importance as it pertains to the patient's care.

4. Quality of Service The contracted Practitioner will be responsible for providing qualified, courteous and efficient services as noted above. Practitioners who are unable to keep appointments due, illness, injury or other unforeseen circumstances will inform the LVAHCS at least 2 hours prior to start of class. Contracted practitioners will inform LVAHCS at 60 days in advance of any planned vacation. Any concerns related to quality of services or practitioners will be handled between the contracting organization and the IHP staff, in a fashion acceptable to the IHP and LVAHCS staff.

5. Government-furnished Equipment.

The Government will furnish all supplies and equipment.

6. Term of Contract

Base Year: 02-05-2024 to 02-04-2025 Option Year 1: 02-05-2025 to 02-04-2026 Option Year 2: 02-05-2026 to 02-04-2027 Option Year 3: 02-05-2027 to 02-04-2028 Option Year 4: 02-05-2028 to 02-04-2029

7. Access to Services

Services will be provided as determined by the IHP and contracting organization and provisions noted above.

Per VA Acquisition Regulation (VAAR) 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED BENEFICIARIES (APR 1984): Contractor agrees to provide all services specified in this contract for any person determined eligible by the Under Secretary for Health, or designee, regardless of race, color, religion, sex, or national origin of the person for whom such services are ordered. Contractor further warrants that he/she will not resort to subcontracting as a means of circumventing this provision.

8. HIPAA Compliance

Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and Human

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Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA). The VA Central Office, Washington DC, has determined medical services provided under Veterans Benefits Administration (VBA) do not require a Business Associate Agreement (BAA) from contractors providing healthcare services on VA’s behalf.

9. Information Security

All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures. All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems: (I) Sign and acknowledge (either manually or electronical1y) understanding of and responsibilities for compliance with the “Contractor Rules of Behavior, which will be provided during the kick-off meeting; (2) Successfully complete the ‘VA Cyber Security Awareness and Rules of Behavior” training and annually complete required security training; (3) Successfully complete the appropriate VA privacy training and HIPAA training annually, TMS training 10203; and (4) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access.

The Contractor shall provide to the contracting officer and/or the contracting officer representative (COR) a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within one (2) weeks of the initiation of the contract and annually thereafter, as required. Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete.

10. Payment of Services.

Practitioner will be paid an hourly rate. Practitioner will be paid for the 15 minutes prior to the class, the one-hour class and for the 45 minutes after the class. For a total of two (2) hours per class. There will be a total of two (2) classes per week and 5 Whole Health Events.

The period of performance is 02-05-2024 through 02-04-2025.

Place of Performance

Address: 2250 Leestown Road Postal Code: 40511-1052

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Country: UNITED STATES

Address: 1101 Veterans Drive Postal Code: 40502-2235 Country: UNITED STATES

The full text of FAR provisions or clauses may be accessed electronically at http://acquisition.gov/comp/far/index.html.

The following solicitation provisions apply to this acquisition:

1. FAR 52.212-1, “Instructions to Offerors–Commercial Products and Commercial Services”

2. FAR 52.212-3, “Offerors Representations and Certifications–Commercial Products and Commercial Services”

Offerors must complete annual representations and certifications electronically via the System for Award Management (SAM) website located at https://www.sam.gov/portal in accordance with FAR 52.212-3, “Offerors Representations and Certifications–Commercial Products and Commercial Services.” If paragraph (j) of the provision is applicable, a written submission is required.

The following contract clauses apply to this acquisition:

• FAR 52.212-4, “Contract Terms and Conditions–Commercial Products and Commercial Services” [Nov 2023]

• FAR 52.212-5, “Contract Terms and Conditions Required to Implement Statutes or Executive Orders – Commercial Products and Commercial Services” [Dec 2023]

The following subparagraphs of FAR 52.212-5 are applicable:

52.203-6 Restrictions on Subcontractor Sales to the Government (Nov 2021) 52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards (Jun 2020) 52.204-15 Service Contract Reporting Requirements for Indefinite-Delivery Contracts (Oct 2016) 52.209-6 Protecting the Government’s Interest when Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Nov 2021) 52.209-9 Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) 52.219-4 Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Oct 2022) 52.219-28 Post-Award Small Business Program Re-representation (Sep 2023) 52.222-3 Convict Labor (Jun 2003) http://acquisition.gov/comp/far/index.html https://www.sam.gov/portal

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52.222-35 Equal Opportunity for Veterans (Jun 2020) 52.222-36 Equal Opportunity for Workers with Disabilities (Jun 2020) 52.222-37 Employment Reports on Veterans (Jun 2020) 52.222-40 Notification of Employee Rights under the National Labor Relations Act (Dec 2010) 52.222-54 Employment Eligibility Verification (May 2022) 52.223-18 Encouraging Contractor Policies to Ban Text Messaging While Driving (Jun 2020) 52.232-33 Payment by Electronic Funds Transfer—System for Award Management (Oct 2018) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Mar 2023) 52.232-36 Payment by Third Party (May 2014) 52.222-41 Service Contract Labor Standards (Aug 2018) 52.222-42 Statement of Equivalent Rates for Federal Hires (May 2014) 52.222-55 Minimum Wages for Contractor Workers under Executive Order 14026 (Jan 2022) 52.222-62 Paid Sick Leave Under Executive Order 13706 (Jan 2022)

ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

Provisions that are incorporated by reference (by Citation Number, Title, and Date), have 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 version of FAR 52.212-1 in the addendum is tailored for Simplified Acquisition Procedures and supersedes the current version of FAR 52.212-1 contained in the FAR.

Additional Clauses and Provisions Applicable to Solicitation:

52.216-18 Ordering (Aug 2020) 52.217-8 Option to Extend Services (Nov 1999) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.204-27 Prohibition on a ByteDance Covered Application (June 2023) 52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber Content Paper (May 2011) 52.204-13 System for Award Management Maintenance (Oct 2018) 52.204-18 Commercial and Government Entity Code Maintenance (Aug 2020) 52.237-2 Protection of Government Buildings, Equipment, and Vegetation (Apr 1984) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) 52.204-7 System for Award Management (Oct 2018)

VA ACQUISITION REGULATION PROVISIONS AND CLAUSES

852.219-75 VA Notice of Limitations on Subcontracting—Certificate of Compliance for Services and Construction (Jan 2023) 852.215-72 Notice of Intent to Re-Solicit (Oct 2019) 852.232-72 Electronic Submission of Payment Requests (Nov 2018) 852.201-70 Contracting Officer’s Representative (Dec 2022) 852.239-75 Information and Communication Technology Accessibility Notice (Feb 2023)

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All quoters shall submit the following: A technical capability statement with the first page displaying name, address phone number, and the UEI number of the company, complete pages 14-15, complete pages 1-2 of this document taking all requirements stated in the SOW into consideration and sign page 12 of this document. Also, please complete and submit “Offerors Representations and Certifications-Commercial Products and Commercial Services” located at https://www.sam.gov/portal. Email all documents to the email address below.

All quotes shall be sent to the contracting officer, Angela Freel at angela.freel@va.gov.

Award will be based upon a comparative evaluation of quotes in accordance with the Simplified Acquisition Procedures of FAR 13. Comparative evaluation is the side by side pairwise comparison of quotes based on factors resulting in a Contracting Officer decision for the quote most favorable to the Government. Options are applicable.

The following are the decision factors:

Technical capability and price.

The award will be made to the response most advantageous to the Government.

Responses should contain your best terms and conditions.

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

(a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code(s) and small business size standard(s) for this acquisition appear elsewhere in the Request for Quote (RFQ). However, the small business size standard for a concern that submits a quote, other than on a construction or service acquisition, but proposes to furnish an end item that it did not itself manufacture, process, or produce is 500 employees if the acquisition—

(1) Is set aside for small business and has a value above the simplified acquisition threshold; or

(2) Uses the HUBZone price evaluation preference regardless of dollar value, unless the quoter waives the price evaluation preference; or

(3) Is an 8(a), HUBZone, service-disabled veteran-owned, economically disadvantaged women-owned, or women-owned small business set-aside or sole-source award regardless of dollar value.

https://www.sam.gov/portal

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(b) Submission of Quotes. Submit signed and dated quotes to the office specified in this Request for Quote (RFQ) at or before the exact time specified. Quotes may be submitted on letterhead stationery, or as otherwise specified in the RFQ. As a minimum, quotes must show—

(1) The solicitation number;

(2) The time specified in the solicitation for receipt of quotations;

(3) The name, address, and telephone number of the quoter;

(4) A technical description of the items being quoted in sufficient detail to evaluate compliance with the requirements in 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 Federal Acquisition Regulation (FAR) 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the quoter shall complete electronically);

(9) Acknowledgment Request for Quotation amendments;

(10) Past performance will not be considered in simplified acquisition procurements.

(11) Quote should include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Quotes that fail to furnish required representations and certifications, information requested in (1) to (9), and accept the terms and conditions of the solicitation may be excluded from consideration.

(c) Period for acceptance of Quotes. The quoter agrees to hold the prices in its quote firm for 30 calendar days from the date specified for receipt of quotes, unless another time period is specified in an addendum to the solicitation.

(d) Product samples. When required by the solicitation, product samples shall be submitted at or prior to the time specified for receipt of quotes. Unless otherwise specified in this solicitation, these samples shall be submitted at no expense to the Government, and returned at the sender’s request and expense, unless they are destroyed during testing.

https://www.acquisition.gov/far/part-52#FAR_52_212_3 https://www.acquisition.gov/far/part-52#FAR_52_212_3

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(e) Multiple Quotes. Quoters are encouraged to submit multiple quotes presenting alternative line items (provided that the alternative line items are consistent with FAR subpart 4.10), or alternative commercial products or commercial services for satisfying the requirements of this solicitation. Each quote submitted will be evaluated separately.

(f) Late submissions, revisions, and withdrawals of quotes.

(1) Quoters are responsible for submitting quotes so as to reach the Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that quotes are due.

(2) Any quotation received at the Government office designated in the solicitation after the exact time specified for receipt of quotes is "late" and may not be considered unless it is received before purchase order issuance and the Contracting Officer (CO) determines that accepting the late quotation would not unduly delay the acquisition.

(3) If an emergency or unanticipated event interrupts normal Government processes so that quotations cannot be received at the Government office designated for receipt of quotes by the exact time specified in the solicitation, and urgent Government requirements preclude a notice of an extension of the closing date, the time specified for receipt of quotes will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume.

(g) Issuance of Purchase Order. The Government may issue a purchase order to one or more quoters as identified in the Request for Quote (RFQ). Therefore, the quoter’s initial quote should contain the best terms from a price and technical standpoint. However, the Government may reject any or all quotes if such action is in the public’s best interest. The Contracting Officer (CO) may issue a purchase order to other than the quoter with the lowest priced quotation.

(h) Multiple awards. The Government may issue a purchase order for any item or group of items of a quotation, unless the quoter qualifies the quotation by specific limitations. Unless otherwise provided in the Schedule, quotations may not be submitted for quantities less than those specified. The Government reserves the right to issue a purchase order for a quantity less than the quantity quoted, at the unit prices quoted, unless the quoter specifies otherwise in the quotation.

(1) Availability of requirements documents cited in the solicitation.

(i) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and https://www.acquisition.gov/far/part-4#FAR_Subpart_4_10

P a g e 11 | 15 commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to- GSA Federal Supply Service Specifications Section Suite 8100 470 East L’Enfant Plaza, SW Washington, DC 20407 Telephone (202) 619-8925, Facsimile (202) 619-8978.

(ii) If the General Services Administration, Department of Agriculture, or Department of Veterans Affairs issued this solicitation, a single copy of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained free of charge by submitting a request to the addressee in paragraph (i)(1)(i) of this provision. Additional copies will be issued for a fee.

(2) Most unclassified Defense specifications and standards may be downloaded from the following ASSIST websites:

(i) ASSIST ( https://assist.dla.mil/online/start/).

(ii) Quick Search ( http://quicksearch.dla.mil/).

(3) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point (DoDSSP) by-

(i) Using the ASSIST Shopping Wizard ( https://assist.dla.mil/wizard/index.cfm);

(ii) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or

(iii) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone (215) 697-2667/2179, Facsimile (215) 697-1462.

(4) Nongovernment (voluntary) standards must be obtained from the organization responsible for their preparation, publication, or maintenance.

(j) Unique entity identifier (UEI). Applies to all quotes that exceed the micro-purchase threshold, and quotes at or below the micro-purchase threshold if the solicitation requires the contractor to be registered in the System for Award Management (SAM).) The quoter must enter, in the block with its name and address on the cover page of its quote, the annotation "Unique Entity Identifier" followed by the unique entity identifier that identifies the quoters name and address. The quoter also must enter its Electronic Funds Transfer (EFT) indicator, if applicable.

The EFT indicator is a four-character suffix to the UEI. The suffix is assigned at the discretion of the quoter to establish additional SAM records for identifying alternative EFT accounts (see FAR subpart 32.11) for the same entity. If the quoter does not have a UEI, it should contact the entity designated at www.sam.gov for UEI establishment directly to obtain one.

http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 https://assist.dla.mil/wizard/index.cfm https://www.acquisition.gov/far/part-32#FAR_Subpart_32_11 http://www.sam.gov/

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The quoter should indicate that it is a quoter for a Government contract when contacting the entity designated at www.sam.gov for establishing the UEI.

(k) [Reserved]

(l) Requests for information. The CO will not notify unsuccessful quoters that responded to this Request for Quotation (RFQ). However, quoters may request information on purchase order(s) resulting from this solicitation with the CO.

To facilitate the award process, all quotes must include a statement regarding the terms and conditions herein as follows:

"The terms and conditions in the solicitation are acceptable to be included in the award document without modification, deletion, or addition."

Quoters shall list exception(s) and rationale for the exception(s), if any.

Submission of your response shall be received not later than February 1, 2024, at 4pm CST to angela.freel@va.gov. No hand delivery accepted.

Late submissions shall be treated in accordance with the solicitation provision at FAR 52.212- 1(f).

Point of Contact

Angela Freel at angela.freel@va.gov.

Signature of Offeror:_____________________________________________________

Name and Title of Signer:__________________________________________________

Date:__________________________________________________________________ http://www.sam.gov/

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VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—CERTIFICATE OF COMPLIANCE FOR

SERVICES AND CONSTRUCTION (JAN 2023) (DEVIATION)

(a) Pursuant to 38 U.S.C. 8127(l)(2), the offeror certifies that—

(1) If awarded a contract (see FAR 2.101 definition), it will comply with the limitations on subcontracting requirement as provided in the solicitation and the resultant contract, as follows:

(i) [X ] Services. In the case of a contract for services (except construction), the contractor will not pay more than 50% of the amount paid by the government to it to firms that are not certified SDVOSBs listed in the SBA certification database as set forth in 852.219- 73 or certified VOSBs listed in the SBA certification database as set forth in 852.219-74. Any work that a similarly situated certified SDVOSB/VOSB subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded. Other direct costs may be excluded to the extent they are not the principal purpose of the acquisition and small business concerns do not provide the service as set forth in 13 CFR 125.6.

(ii) [ ] General construction. In the case of a contract for general construction, the contractor will not pay more than 85% of the amount paid by the government to it to firms that are not certified SDVOSBs listed in the SBA certification database as set forth in 852.219- 73 or certified VOSBs listed in the SBA certification database as set forth in 852.219-74. Any work that a similarly situated certified SDBOSB/VOSB subcontractor further subcontracts will count towards the 85% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(iii) [ ] Special trade construction contractors. In the case of a contract for special trade contractors, the contractor will not pay more than 75% of the amount paid by the government to it to firms that are not certified SDVOSBs listed in the SBA certification database as set forth in 852.219-73 or certified VOSBs listed in the SBA certification database as set forth in 852.219-

74. Any work that a similarly situated certified SDBOSB/VOSB subcontractor further subcontracts will count towards the 75% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(2) The offeror acknowledges that this certification concerns a matter within the jurisdiction of an Agency of the United States. The offeror further acknowledges that this certification is subject to Title 18, United States Code, Section 1001, and, as such, a false, fictitious, or https://www.acquisition.gov/far/2.101 https://www.va.gov/oal/library/vaar/vaar852.asp#85221973 https://www.va.gov/oal/library/vaar/vaar852.asp#85221973 https://www.va.gov/oal/library/vaar/vaar852.asp#85221974 https://www.va.gov/oal/library/vaar/vaar852.asp#85221973 https://www.va.gov/oal/library/vaar/vaar852.asp#85221973 https://www.va.gov/oal/library/vaar/vaar852.asp#85221974 https://www.va.gov/oal/library/vaar/vaar852.asp#85221973 https://www.va.gov/oal/library/vaar/vaar852.asp#85221974 https://www.va.gov/oal/library/vaar/vaar852.asp#85221974

P a g e 14 | 15 fraudulent certification may render the offeror subject to criminal, civil, or administrative penalties, including prosecution.

(3) If VA determines that an SDVOSB/VOSB awarded a contract pursuant to 38 U.S.C. 8127 did not act in good faith, such SDVOSB/VOSB shall be subject to any or all of the following:

(i) Referral to the VA Suspension and Debarment Committee;

(ii) A fine under section 16(g)(1) of the Small Business Act (15 U.S.C. 645(g)(1)); and

(iii) Prosecution for violating 18 U.S.C. 1001.

(b) The offeror represents and understands that by submission of its offer and award of a contract it may be required to provide copies of documents or records to VA that VA may review to determine whether the offeror complied with the limitations on subcontracting requirement specified in the contract. Contracting officers may, at their discretion, require the contractor to demonstrate its compliance with the limitations on subcontracting at any time during performance and upon completion of a contract if the information regarding such compliance is not already available to the contracting officer. Evidence of compliance includes, but is not limited to, invoices, copies of subcontracts, or a list of the value of tasks performed.

(c) The offeror further agrees to cooperate fully and make available any documents or records as may be required to enable VA to determine compliance with the limitations on subcontracting requirement. The offeror understands that failure to provide documents as requested by VA may result in remedial action as the Government deems appropriate.

(d) Offeror completed certification/fill-in required. The formal certification must be completed, signed and returned with the offeror’s bid, quotation, or proposal. The Government will not consider offers for award from offerors that do not provide the certification, and all such responses will be deemed ineligible for evaluation and award.

Certification:

I hereby certify that if awarded the contract, [insert name of offeror] will comply with the limitations on subcontracting specified in this clause and in the resultant contract. I further certify that I am authorized to execute this certification on behalf of [insert name of offeror].

Printed Name of Signee: ________________________________________ Printed Title of Signee: _________________________________________ Signature: ___________________________________________________

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Date: _____________________ Company Name and Address: ______________________________________