Contract - W81K0425PA028.pdf

WOMEN-OWNED SMALL

BUSINESS (WOSB)

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

1. REQUISITION NUMBER PAGE 1 OF

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME b. TELEPHONE NUMBER (No collect 8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NUMBER

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

OFFER

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

BELOW IS CHECKED

REQUEST

FOR QUOTE

(RFQ)

INVITATION

FOR BID

(IFB)

REQUEST

FOR

PROPOSAL

(RFP)

SEE ADDENDUM

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Government Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH

AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND

ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS

SPECIFIED

29. AWARD OF CONTRACT: REFERENCE OFFER

DATED . . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

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

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

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

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS UNRESTRICTED OR

NORTH AMERICAN

INDUSTRY CLASSIFICATION

STANDARD (NAICS):

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

THE DEFENSE PRIORITIES

AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

SET ASIDE: % FOR:

11. DELIVERY FOR FREE ON

BOARD (FOB) DESTINATION

UNLESS BLOCK IS MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

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

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

8(A)

ECONOMICALLY

DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30.

calls)

Solicitation/Contract Form Continuation

MEDICAL RECORDS STORAGE

North American Industry Classification System (NAICS): 484110

W81K0425PA028

Continuation of Supplies or Services and Prices/Costs

Additional Information/Notes

PERFORMANCE WORK STATEMENT

1. Scope of Work. The contractor shall furnish all labor, material, and equipment necessary to store, pick up, deliver, and destroy (when authorized by Womack Army Medical Center (WAMC) representative) medical records to ensure privacy standards are adhered to.

2. Contractor agrees to pick up and deliver (when requested by WAMC representative) boxes of medical records at WAMC and five outlying medical clinics. All clinics are located on Fort Bragg, NC 28310.

3. Contractor facility must be able to store at least 5,358 boxes of medical records. Quantity of boxes may increase or decrease during the term of the contract.

4. Contractor must allow WAMC representative to do announced and unannounced visits to the Contractor's facility.

5. Contractor facility must have authorization to store Personal Health Information (PHI) and Personal Identifiable Information (PII).

6. Contractor facility must be compliant with Health Insurance Portability Accountability Act (HIPAA).

7. Contractor shall index every chart within the boxes for all inpatient and outpatient charts. Will annotate on the excel spreadsheet the following naming convention to include the file/Paper Record Tracking (PRT) number, box number, last name, first name, Department of Defense (DOD) ID number (if applicable), Family Member Prefix (FMP), and all PII.

8. Contractor shall complete a DA 200 Form for each box in accordance with PII located on each chart (see exhibit D). The DA Form 200 will be placed inside each box.

9. Contractor shall retrieve record storage boxes from warehouse and transport to the facilities designated for delivery.

10. Contractor shall refile boxes to the warehouse for storage on shelving/pallets.

11. Contractor shall pick up all WAMC files from existing storage facility and relocate the files to the designated storage facility.

12. Authorized WAMC representatives will be making numerous trips to the Contractor's facility for record pulls and other interactions throughout the term of the contract. Therefore, the Contractor facility must be within a ten-mile radius of Fort Bragg, NC 28310.

13. Contractor must store records in ventilated area. Boxes of records must be stored on shelves individually, not palletized.

14. Contractor agrees that WAMC shall provide its own boxes. Box sizes range in the following dimensions in inches; 15x12x10; 15.9x25.4x10.3; 16 1/2 x13x10 3/8; 24x12x10. During the term of the contract, manufacturers may change box sizes. However, it is unlikely that there will be a major change in the size of the boxes. If there is a major change in size of the boxes, WAMC will immediately notify the Contractor to resolve any storage issues.

15. The contractor shall provide services during the normal working hours from 9:00 AM Eastern Standard Time, to 4 PM Eastern Standard Time, Monday through Friday. When Contractor is notified by authorized WAMC representative, Contractor must make pick-up and delivery within four hours of initial notification by WAMC authorized representative.

16. When WAMC require an immediate pick up of records, WAMC will notify Contractor no less than one hour before picking up. For other pick-ups WAMC will notify Contractor no less than 24 hours before picking up. Notification will include the specific box/ record for the Contractor to pull.

17. The contractor shall ensure its drivers are able to speak, read, and write in English in order to effectively communicate with government personnel.

18. On 6 April 2007, Fort Bragg began using RAPIDGate. The RAPIDGate Program is voluntary and uses innovative technology to provide a complete identification and access management solution for contractors, vendors, suppliers, and service providers who require routine access to the installation. For more information about Eid Passport, the RAPIDGate Program or to enroll your company, please go to www.RAPIDGate.com or call

(877) 727-4342.

PERFORMANCE WORK STATEMENT - ADDENDUM FOR ANTI- TERRORISM/OPERATIONS SECURITY

Access and general protection/security policy and procedures. This standard language is for Contractor employees with an area of performance within Army controlled installation, facility, or area. Contractor and all associated sub-contractors' employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office.

Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in Contractor security matters or processes.

For Contractors requiring Common Access Card (CAC). Before CAC issuance, the Contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The Contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or

(3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management.

For Contractors that do not require CAC but require access to a DoD facility or installation. Contractor and all associated sub-contractors' employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate

Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative), or, at OCONUS locations, in accordance with status of forces agreements and other theater regulations.

Threat Awareness Reporting Program. For all Contractors with security clearances. Per AR 381- 12 Threat Awareness and Reporting Program (TARP), Contractor employees must receive annual TARP training by a CI agent or other trainer as specified in 2-4b.

20. Quality Assurance Surveillance Plan (QASP). The following minimum Quality Assurance Plan applies. The Government may modify inspection methods in accordance with site specific requirements.

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

REFERENCE

PWS

STANDARD

MAXIMUM

ALLOWABLE

DEGREE OF

DEVIATION FROM

REQUIREMENT (AOL)

METHOD OF

SURVEILLANCE

CONTRACTOR

CORRECTIVE ACTIONS

Para 1 100% compliance

No deviation from requirement.

Periodic Surveillance by the COR

Contractor immediately corrects at no additional cost to the Government

Para 3 100% compliance

No deviation from requirement.

COR will monitor initial storage of 5,358 boxes of records

Contractor immediately corrects at no additional cost to the Government

Para 4 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS.

Contractor immediately corrects action

Para 5 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS

Contractor immediately corrects at no additional cost to the Government

Para 6 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS

Contractor immediately corrects at no additional cost to the Government

Para 7 100% compliance

No deviation from requirement.

COR will check the location of the Contractor's facility.

Contractor immediately corrects at no additional cost to the Government

Para 8 100% compliance

No deviation from requirement.

COR will check location of Contractor facility for ventilation.

Contractor immediately corrects at no additional cost to the Government

Para 9 100% compliance

No deviation from requirement.

COR will check location of Contractor facility for ventilation.

Contractor immediately corrects at no additional cost to the Government

Para 16 99%

One percent deviation allowable. Contractor allowed only two instances per year in which records are not ready for pick up.

COR will be notified if record not available for pick up.

Contractor immediately corrects at no additional cost to the Government

QASP RATING

Standard Measurement

99%to 100% Excellent

96%to 98% Very Good

95% Satisfactory

92%to 94% Marginal

91% or Less Unsatisfactory

PERFORMANCE REQUIREMENT SUMMARY (PRS)

REFERENCE PWS

STANDARD

MAXIMUM

ALLOWABLE DEGREE

OF DEVIATION FROM

REQUIREMENT (AOL)

METHOD OF

SURVEILLANCE

Para 1 100% compliance

No deviation from requirement.

Periodic Surveillance by the COR

Para 3 100% compliance

No deviation from requirement.

COR will monitor initial storage of 5,358 boxes of records

Para 4 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS.

Para 5 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS

Para 6 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS

Para 7 100% compliance

No deviation from requirement.

COR will check the location of the Contractor's facility.

Para 8 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS

Para 9 100% compliance

No deviation from requirement.

COR will monitor compliance with PWS

Para 16 99%

One percent deviation allowable. Contractor allowed only two instances per year in which records are not ready for pick up.

COR will be notified if record not available for pick up.

Department of Defense (DoD) Business Associate Agreement (BAA)

Introduction

In accordance with 45 CFR (S)(S)164.502(e)(2), 164.504(e); the Health Information Technology for Economic and Clinical Health (HITECH) Act;

and paragraph 3.3.c. of Department of Defense Manual (DoDM) 6025.18, "Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule in DoD Health Care Programs," March 13, 2019, and Chapter 1, Section 5 of the TRICARE Operations Manual, this document serves as a Business Associate Agreement (BAA) between the executing parties for purposes of the Health Insurance Portability and Accountability Act (HIPAA) as implemented by the HIPAA Rules and Department of Defense (DoD) HIPAA Issuances (as defined below). The parties are a DoD Component, acting as a HIPAA Covered Entity, and a Business Associate (i.e., a DoD Contractor creates, receives, maintains, and /or transmits protected health information (PHI) for the purpose of performing covered functions on behalf of the DoD Component). The HIPAA Rules (as defined below) require BAAs between covered entities and business associates. As such, this BAA implements and incorporates the applicable DoD HIPAA Issuances (including DoDI 6025.18 and the authorities incorporated therein) and provides the Business Associate requirements which apply to the relevant Business Associates contract or other agreement between the parties.

(a) Catchall Definition:: Except as otherwise provided in this BAA, the following terms used in this BAA shall have the same meaning as those terms in the DoD HIPAA Issuances : Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices (NoPP), PHI,, Required by Law, Secretary of HHS, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use.

(b) Specific definitions:

Agreement means this BAA together with the documents and/or other arrangements under which the Business Associate signatory performs services involving access to PHI on behalf of the DoD component signatory.

Breach means the loss of control, compromise, unauthorized disclosure, unauthorized acquisition, or any similar occurrence where: (1) a person other than an authorized user accesses or potentially accesses personally identifiable information; or (2) an authorized user accesses or potentially accesses Personally Identifiable Information (PII) for an other than authorized purpose. The foregoing definition is based on the definition of breach in Office of Management and Budget (0MB) Memorandum M-17-12.

Business Associate shall generally have the same meaning as the term "Business Associate" in the DoD HIPAA Issuances, and in reference to this BAA, shall mean [insert name of the non-federal Business Associate entity/signatory to this BAA].

Covered Entity shall generally have the same meaning as the term "covered entity" in the DoD HIPAA Issuances, and in reference to this BAA, shall mean [insert name of the DoD Component entity/DoD signatory to this BAA}.

Covered Functions are functions of a covered entity, the performance of which makes the entity a health plan or health care provider as outlined in DoDM 6025.18.

Defense Health Agency (DHA) Privacy Office means the DHA Privacy and Civil Liberties Office, with the responsibilities and authorities as outlined in DoDM 6025.18. The Chief of the DHA Privacy Office is the HIPAA Privacy and Security Officer for DHA.

DoD HIPAA Issuances means all DoD issuances implementing the HIPAA Rules in the DoD Military Health System (MHS). These issuances include DoDM 6025.18 (2019), Department of Defense Instruction (DoDI) 6025.18, "Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule Compliance in DoD Health Care Programs," March 13, 2019; and DoDI 8580.02, "Security of individually Identifiable Health Information in DoD Health Care Programs," August 12, 2015.

DoD Privacy Program Issuances means the current DoD issuances implementing within DoD the Privacy Act and certain privacy-related authorities, as identified by DHA Privacy Office Guidance. These issuances are DoDI 5400.11, "DoD Privacy and Civil Liberties Programs," January 29, 2019, DoDM 5400.11, Volume 2 "DoD Privacy and Civil Liberties Programs: Breach Preparedness and Response Plan," May 6, 2021, and DoD 5400.11-R, "Department of Defense Privacy Program," May 14, 2007. These issuances are available on the Washington Headquarters Services DoD Directives website ://www.esd.whs.mil/D or upon request.

Department of Health and Human Services (HHS) Breach means a breach that satisfies the HIPAA Breach Rule definition of breach found in 45 CFR (S)164.402.

HIPAA Rules means the regulations issued by HHS pursuant to its authority to issue regulations on health information privacy, as provided by Section 264(c) of HIPAA. The HIPAA Rules, as amended by the Omnibus Final Rule, include the HIPAA Privacy Rule, the HIPAA Breach Rule, the HIPAA Security Rule, and the HIPAA Enforcement Rule.

I. Obligations and Activities of the Business Associate

(a) The Business Associate shall not use or disclose PHI other than as permitted or required by the Agreement or as required by law.

(b) The Business Associate shall use appropriate safeguards, and comply with the HIPAA Rules and DoD HIPAA Issuances incorporated by reference in this document Issuances with respect to PHI, to prevent use or disclosure of PHI other than as provided for by the Agreement.

(c) The Business Associate shall report to the Covered Entity any breach of which it becomes aware, and shall proceed with breach response steps as required by Part V of this agreement. With respect to electronic PHI, the Business Associate shall also respond to any security incident of which it becomes aware in accordance with any cybersecurity provisions of the Agreement. If at any point the Business Associate becomes aware that a security incident involves a breach, the Business Associate shall immediately initiate breach response as required by Part V of this BAA.

(d) In accordance with DoDM 6025.18, paragraph 3.3.c.(3)(b)4, 45 CFR

(S)164.502(e)(l)(ii)) and (S)164.308(b)(2),the Business Associate shall ensure that any (and all) subcontractors that create, receive, maintain, or transmit PHI on behalf of the Business Associate agree to the same restrictions, conditions, and requirements that apply to the Business Associate with respect to PHI, specifically the responsibilities laid out in the DoD HIPAA Issuances incorporated by reference in this agreement. PHI.

(e) The business associate may disclose PHI to a business associate that is a subcontractor and may allow the subcontractor to create, receive, maintain, or transmit PHI on its behalf, if the business associate obtains satisfactory assurances, in accordance with DoDM 6025.18, paragraph 4.5.e.

(1), that the subcontractor will appropriately safeguard the information.

(f) The Business Associate shall make available PHI in a Designated Record Set, to the Covered Entity or, as directed by the Covered Entity, to an Individual, as necessary to satisfy the Covered Entity obligations under 45 CFR (S)164.524 and DoDM 6025.18, paragraph 5.3.c.

(g) The Business Associate shall make any amendment(s) to PHI in a Designated Record Set as directed or agreed to by the Covered Entity pursuant to 45 CFR (S) and DoDM 6025.18, paragraph 5.4.

(h) The Business Associate shall maintain and make available the information required to provide an accounting of disclosures to the Covered Entity or an individual as necessary to satisfy the Covered Entity's obligations under 45 CFR (S)164.528 and DoDM 6025.18, paragraph 5.5.

(i) To the extent the Business Associate is to carry out one or more of Covered Entity's obligation(s) under the HIPAA Privacy Rule and DoDM 6025.18, the Business Associate shall comply with the requirements of the HIPAA Privacy Rule and DoDM 6025.18, that apply to the Covered Entity in the performance of such obligation(s); and

G) The Business Associate shall make its internal practices, books, and records relating to the use and disclosure of PHI from or created or received by the Business Associate on behalf of, the DoD Component available to the Secretary of HHS and to the Director, DHA, or their designee for purposes of determining compliance with the HIPAA Rules.

II. Permitted Uses and Disclosures by Business Associate

(a) The Business Associate may only use or disclose PHI as necessary to perform the services set forth in the Agreement or as required by law. The Business Associate is not permitted to de-identify PHI, nor is it permitted to use or disclose de-identified PHI, except as provided by the Agreement or directed by the Covered Entity with written approval from DHA's HIPAA Privacy Officer.

(b) The Business Associate agrees to use, disclose, and request PHI only in accordance with the HIPAA Privacy Rule "minimum necessary" standard and corresponding DHA policies and procedures as stated in the DoD HIPAA Issuances.

(c) The Business Associate shall not use or disclose PHI in a manner that would violate the DoD HIPAA Issuances if done by the Covered Entity.

(d) Except as otherwise limited in the Agreement, the Business Associate may use PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate. The foregoing authority to use PHI does not apply to disclosure of PHI, which is covered in the next paragraph.

(e) Except as otherwise limited in the Agreement, the Business Associate may disclose PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate, provided that disclosures are required by law, or the Business Associate obtains reasonable assurances from the person to whom the PHI is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached.

(f) Except as otherwise limited in the Agreement, the Business Associate may use PHI to provide Data Aggregation services relating to the Covered Entity's health care operations.

III. Provisions for Covered Entity to Inform Business Associate of Privacy Practices and Restrictions

(a) The Covered Entity shall provide the Business Associate with NoPP that the Covered Entity produces in accordance with 45 CFR (S)164.520 and DoDM 6025.18, paragraph 5.1.

(b) The Covered Entity shall notify the Business Associate of any changes m, or revocation of, the permission by an Individual to use or disclose his or her PHI, to the extent that such changes affect the Business Associate's use or disclosure of PHI.

(c) The Covered Entity shall notify the Business Associate of any restriction on the use or disclosure of PHI that the Covered Entity has agreed to or is required to abide by under 45 CFR

(S)164.522 and DoDM 6025.18, paragraph 5.2, to the extent that such changes may affect the Business Associate's use or disclosure of PHI.

IV. Permissible Requests by Covered Entity

The Covered Entity shall not request the Business Associate to use or disclose PHI in any manner that would not be permissible under the HIPAA Privacy Rule or any applicable Federal regulations (including without limitation, DoD HIPAA Issuances) if done by the Covered Entity.

V. Breach Response

(a) In general.

In the event of a breach of PII/PHI held by the Business Associate, the Business Associate shall follow the breach response requirements set forth in this Part V, which is designed to satisfy both the Privacy Act and HIPAA breach response requirements, as applicable. If a breach involves PII without PHI, then the Business Associate shall comply with DoD Privacy Program Issuances breach response requirements only. If a breach involves PHI (a subset of PII), then the Business Associate shall comply with DoD Privacy Program Issuances breach response requirements. A breach involving PHI may or may not constitute a HHS Breach. If a breach is not an HHS Breach, then the Business Associate has no HIPAA breach response obligations. In such cases, the Business Associate must still comply with breach response requirements under the DoD Privacy Program Issuances.

If the DHA Privacy Office determines that a breach is an HHS Breach, then the Business Associate shall comply with both the HIPAA Breach Rule and DoD Privacy Program Issuances, as directed by the DHA Privacy Office. If the DHA Privacy Office determines that the breach does not constitute an HHS Breach, then the Business Associate shall comply with DoD Privacy Program Issuances. The following provisions of Part V set forth the Business Associate's Privacy Act and HIPAA breach response requirements for all breaches, including but not limited to HHS breaches.

In general, for breach response, the Business Associate shall report the breach to the Covered Entity. Such breach shall be reported to the DHA Privacy Office within 24 hours at 703-275-6363 or dha.ncr.pcl.mbx.pii-breach@health.mil. If such breach is a cybersecurity incident, an incident involving damage to, protection of, and restoration of computers, electronic communications systems, electronic communications services, wire communication, electronic communication, including information contained therein, ensuring the availability, integrity, authentication, confidentiality, and nonrepudiation of data, as defined in Committee on National Security Systems Instruction (CNSSI) 4009 https://www.cnss.gov /CNSS/issuances/Instructions.cfm , the discovering party shall report the breach to the DHA NIWC CSSP Watch desk by dialing 1.866.786.4432 Cybersecurity and Infrastructure Security Agency potential-CERT) within one hour of the potential cybersecurity incident. The DHA NIWC CSSP Watch desk reports, and report to USCYBERCOM within 48 hours of being notified of the occurrence of a breach, and complete the breach response actions as required by DHA guidance https://health.mil/Military-Health-Topics/Privacy-and-Civil Liberties/Breaches-of-PII-and-PHI? Type=Policies #RefFee

The Business Associate is deemed to have discovered a breach as of the first day a breach (suspected or confirmed) is known, or by exercising reasonable diligence would have been known, to any person (other than the person committing it) who is an employee, officer or other agent of the Business Associate.

The Business Associate shall submit a report to the U.S. Computer Emergency Readiness Team (US-CERT), using the US-CERT report online form at https://us cert.cisa.gov/forms/reporthttps://us-cert.cisa.gov/forms/rep Before submission to US-CERT, the Business Associate shall save a copy of the on-line report. After submission, the Business

Associate shall record the US-CERT Reporting Number. Although only limited information about the breach may be available as of the one-hour deadline for submission, the Business Associate shall submit the US-CERT report by the deadline. The Business Associate shall e-mail updated information to the Covered Entity as it is obtained. The Business Associate shall provide a copy of the initial or updated US-CERT report to the DHA Privacy Office. Business Associate general questions about US-CERT reporting shall be directed to the DHA Privacy Office not the US-CERT office.

Additionally, the Business Associate will send to the DHA Privacy Office a completed Breach Report Form Report DD 2959 at https://www.esd.whs.

mil/Portals/54/Documents/DD/forms/dd/dd2959.p Encryption is not required, because Breach Report Forms must not contain PII/PHI.

If multiple individuals are affected by a single event or related set of events, then a single reportable breach may be deemed to have occurred, depending on the circumstances. The Business Associate shall inform the DHA Privacy Office as soon as possible if it believes that a "single event" breach response is appropriate. The DHA Privacy Office will determine how the Business Associate shall proceed and, if appropriate, consolidate separately reported breaches for purposes of Business Associate report updates, individual notification, and mitigation.

When an initially submitted Breach Report Form is incomplete or incorrect due to unavailable information, or when significant developments require an update, the Business Associate shall submit a revised form or forms, stating the updated status and previous report date(s) and showing any revisions or additions by denoting "UPDATE." Examples of updated information the Business Associate shall report include but are not limited to confirmation on the exact data elements involved, the root cause of the incident, and any mitigation actions, including sanctions, training, incident containment, follow-up, etc. The Business Associate shall submit these report updates promptly after the new information becomes available. Prompt reporting of updates is required to allow the DHA Privacy Office to make timely final determinations on any subsequent notifications or reports. The Business Associate shall provide updates to the same parties as required for the initial Breach Reporting Form. The Business Associate is responsible for reporting all information needed by the DHA Privacy Office to enable timely and accurate determinations on reports to HHS as required by the HHS Breach Rule and reports to the Defense Privacy, Civil Liberties, and Transparency Division as required by DoD Privacy Program Issuances.

(b) Individual Notification Provisions

If the DHA Privacy Office determines that individual notification is required IAW 5 CFR

(S)(S) 164.400-414, the Business Associate shall provide written notification to individuals affected by the breach as soon as possible, but no later than ten working days after the breach is discovered and the identities of the individuals are ascertained. The ten-day period begins when the Business Associate determines the identities (including addresses) of the individuals whose records were affected.

The Business Associate's proposed notification to be issued to the affected individuals shall be submitted for approval to the DHA Privacy Office.

Upon request, the Business Associate shall provide the DHA Privacy Office with the final text of the notification letter sent to the affected individuals. PII shall not be included with the text of the letter(s) provided. Copies of further correspondence with affected individuals need not be provided unless requested by the DHA Privacy Office. Pursuant to 45 CFR (S)(S) 164.400-414 and section 13407 of the HITECH Act, the Business Associate's notification to the individuals, at a minimum, shall include the following:

-The individual(s) must be advised of what specific data was involved. It is insufficient to simply state that PII has been lost. Where names, Social Security Numbers (SSNs) or truncated SSNs, and Dates of Birth (DOBs) are involved, it is critical to advise the individual of the nature and extent of any potentially PHI data elements that have been breached. In all cases, individuals should be notified as to the nature and extent of any compromised

PHI.

-The individual(s) must be informed of the facts and circumstances surrounding the breach. The description should be sufficiently detailed so that the individual clearly understands how the breach occurred.

-The individual(s) must be informed of any steps the individuals should take to protect themselves from potential harm resulting from the breach.

-The individual(s) must be informed of what protective actions the Business Associate is taking or the individual can take to mitigate against potential future harm. The notice must refer the individual to the current Federal Trade Commission (FTC) web site pages on identity theft and the FTC's Identity Theft Hotline, toll-free: 1-877-ID-THEFT (438-4338); Teletype (TTY):): 1- 866- 653-4261.

-The individual(s) must also be informed of any mitigation support services (e.g., one year of free credit monitoring, identification of fraud expense coverage for affected individuals, provision of credit freezes, etc.) that the Business Associate may offer affected individuals, the process to follow to obtain those services, and the period of time the services will be made available, and contact information (including a phone number, either direct or toll-free, e-mail address and postal address) for obtaining more information.

Business Associates shall ensure any envelope containing written notifications to affected individuals are clearly labeled to alert the recipient to the importance of its contents, e.g., "Data Breach Information Enclosed," and that the envelope is marked with the identity of the Business Associate and /or subcontractor organization that suffered the breach. The letter must also include contact information for a designated point of contact (POC),), phone number, email address, and postal address.

If the Business Associate determines that it cannot readily identify, or will be unable to reach, some affected individuals within the ten-day period after discovering the breach, the Business Associate shall so indicate in the initial or updated Breach Report Form. Within the 10-day period, the Business Associate shall provide the approved notification to those individuals who can be reached. Other individuals must be notified within ten days after their identities and addresses are ascertained. The Business Associate shall consult with the DHA Privacy Office, which will determine which media notice is most likely to reach the population not otherwise identified or reached. The Business Associate shall issue a generalized media notice(s) to that population in accordance with DHA Privacy Office approval.

The Business Associate shall, at no cost to the government, bear all costs associated with a breach of PH/PHI that the Business Associate has caused or is otherwise responsible for addressing.

VI. Termination

(a) Termination. Noncompliance by the Business Associate (or any of its staff, agents, or subcontractors) with any requirement addressed in this BAA may subject the Business Associate to termination under any applicable default or other termination provision of the Agreement.

(b) Effect of Termination.

(1) If the Agreement has records management requirements, the Business Associate shall handle such records in accordance with the records management requirements. If the Agreement does not have records management requirements, the records shall be handled in accordance with paragraphs (2) and (3) below, unless the Agreement has provisions for transfer of records and PII/PHI to a successor Business Associate, or if DHA gives directions for such transfer. In the case DHA or the Agreement provides for transfer of records, the Business Associate shall handle such records and information in accordance with such Agreement provisions or DHA direction.

(2) If the Agreement does not have records management requirements, except as provided in the following paragraph (3), upon termination of the Agreement, for any reason, the Business Associate shall return or destroy all PHI received from the Covered Entity, or created or received by the Business Associate on behalf of the Covered Entity that the Business Associate still maintains in any form. This provision shall apply to PHI that is in the possession of subcontractors or agents of the Business Associate. The Business Associate shall retain no copies of the PHI or its derivatives.

(3) If the Agreement does not have records management provisions and the Business Associate determines that returning or destroying the PHI is infeasible, the Business Associate shall provide to the Covered Entity notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Covered Entity and the Business Associate that return or destruction of PHI is infeasible, the Business Associate shall extend the protections of the Agreement to such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or destruction infeasible, for so long as the Business Associate maintains such PHI.

VII. Execution

(a) Survival. The obligations of Business Associate under the "Effect of Termination" provision of this BAA shall survive the termination of the Agreement or any part thereof.

(b) Interpretation. Any ambiguity in the Agreement shall be resolved in favor of a meaning that permits the DoD Component and the Business Associate to comply with the HIPAA Rules and the DoD HIPAA Rules.

[Business Associate] [DoD Covered Entity] Date Date

Item Supplies/Service Quantity Unit Unit Price Amount

Product Service Description: CLIN

0001 STORAGE OF MEDICAL RECORDS -

IPR/OPR

Project Code: S10 Pricing Arrangement: Firm Fixed Price

5,358 Each

USD 0.44

Firm Price

USD 2,357.52

Product Service Description: CLIN

0002 PICK UP AND DELIVERY OF MEDICAL

RECORDS AT WAMC AND FIVE OUTLYING

MEDICAL CLINIC- IPR/OPR

Project Code: S10 Pricing Arrangement: Firm Fixed Price

3,088 Each

USD 1.75

Firm Price

USD 5,404.00

Product Service Description: CLIN

0003 CHART INDEXING OF EVERY CHART

IN THE BOXES FOR ALL INPATIENT

PATIENT (IPR) RECORDS ( IT IS

ESTIMATED THAT WE HAVE 2448 BOXES

WITH AN ESTIMATE OF 55 CHARTS PER

BOX)

Project Code: S10 Pricing Arrangement: Firm Fixed Price

135,000 Each

USD 0.85

Firm Price

USD 114,750.00

Product Service Description: CLIN

0004 CHART INDEXING OF EVERY CHART

IN THE BOXES FOR ALL OUTPATIENT USD 0.85

Firm Price

USD 15,994.45

PATIENT (OPR) RECORDS

Project Code: S10 Pricing Arrangement: Firm Fixed Price

18,817 Each

Product Service Description: CLIN

0005 DA 200 FORM - CCONTRACTOR WILL

FILL OUT FORM DURING INDEXING - ONE

PER BOX

Project Code: S10 Pricing Arrangement: Firm Fixed Price

5,358 Each

USD 2.00

Firm Price

USD 10,716.00

Product Service Description: CLIN

0006 TRIP FEES

Project Code: S10 Pricing Arrangement: Firm Fixed Price

50 Each

USD 30.00

Firm Price

USD 1,500.00

Continuation of Description

Requirements NEW AWARD - Base year for Medical Records Storage Contract. POC for this action is Gina Campbell 910.907.9957

Product Service Code: R612

Product Service Code: R612

Product Service Code: R612

Product Service Code: R612

Product Service Code: R612

Product Service Code: R612

Continuation of Inspection and Acceptance

Overall Contract Inspection/Acceptance Locations

Inspection and Acceptance Location

Both Destination Instructions: please invoice to wawf

DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

GINA CAMPBELL

Email: gina.r.campbell2.civ@health.mil Telephone: 910-907-9957

Inspection and Acceptance Location

Both Destination Instructions: please invoice to WAWF

DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

GINA CAMPBELL

Email: gina.r.campbell2.civ@health.mil Telephone: 910-907-9957

Inspection and Acceptance Location

Both Destination Instructions: please invoice to WAWF.

DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

GINA CAMPBELL

Email: gina.r.campbell2.civ@health.mil Telephone: 910-907-9957

Inspection and Acceptance Location

Both Destination Instructions: please invoice to WAWF.

DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

GINA CAMPBELL

Email: gina.r.campbell2.civ@health.mil Telephone: 910-907-9957

Inspection and Acceptance Location

Both Destination Instructions: please invoice to WAWF

DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

GINA CAMPBELL

Email: gina.r.campbell2.civ@health.mil Telephone: 910-907-9957

Inspection and Acceptance Location

Both Destination Instructions: please invoice to WAWF

DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

GINA CAMPBELL

Email: gina.r.campbell2.civ@health.mil Telephone: 910-907-9957

Continuation of Deliveries or Performance

From 01 Oct 2025 to 30 Sep 2026

Line Item Delivery Schedule Quantity Address and POC

Delivery Period From 01 Oct 2025 to 30 Sep 2026

Period of Performance From 01 Oct 2025 To 30 Sep 2026

5,358 Each Service Performance Site DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

Delivery Period From 01 Oct 2025 to 30 Sep 2026

Period of Performance From 01 Oct 2025 To 30 Sep 2026

3,088 Each Service Performance Site DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

Delivery Period From 01 Oct 2025 to 30 Sep 2026

Period of Performance From 01 Oct 2025 To 30 Sep 2026

135,000 Each Service Performance Site DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

Delivery Period From 01 Oct 2025 to 30 Sep 2026

Period of Performance

18,817 Each Service Performance Site DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

From 01 Oct 2025 To 30 Sep 2026

Delivery Period From 01 Oct 2025 to 30 Sep 2026

Period of Performance From 01 Oct 2025 To 30 Sep 2026

5,358 Each Service Performance Site DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

Delivery Period From 01 Oct 2025 to 30 Sep 2026

Period of Performance From 01 Oct 2025 To 30 Sep 2026

50 Each Service Performance Site DoDAAC: HT0911 CountryCode: USA

AMC BRAGG - MM

2817 REILLY ROAD, BLDG 4

FORT BRAGG, NC 28310

UNITED STATES

Contract Clauses

FAR Clauses Incorporated by Reference

Number Title Effective Date

Alternate/ Deviation

Variation Effective Date

52.204-23 Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab Covered Entities.

Dec 2023

52.204-27 Prohibition on a ByteDance Covered Application. Jun 2023 52.222-41 Service Contract Labor Standards. Aug 2018 52.222-50 Combating Trafficking in Persons. Nov 2021 52.224-3 Privacy Training. Jan 2017 52.225-13 Restrictions on Certain Foreign Purchases. Feb 2021 52.226-8 Encouraging Contractor Policies to Ban Text Messaging While Driving. May 2024 52.233-3 Protest after Award. Aug 1996 52.233-4 Applicable Law for Breach of Contract Claim. Oct 2004 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services. Nov 2023 52.222-26 Equal Opportunity. Sep 2016 52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements. Jan 2017 52.204-13 System for Award Management Maintenance. Oct 2018 52.204-18 Commercial and Government Entity Code Maintenance. Aug 2020 52.232-33 Payment by Electronic Funds Transfer-System for Award Management. Oct 2018

52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

Nov 2021

DFARS Clauses Incorporated by Reference

Number Title Effective Date

Alternate/ Deviation

Variation Effective Date

252.203-7000 Requirements Relating to Compensation of Former DoD Officials. Sep 2011 252.203-7002 Requirement to Inform Employees of Whistleblower Rights. Dec 2022 252.204-7004 Antiterrorism Awareness Training for Contractors. Jan 2023

252.204-7018 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services.

Jan 2023

252.204-7020 NIST SP 800-171 DoD Assessment Requirements. Nov 2023 252.225-7056 Prohibition Regarding Business Operations with the Maduro Regime. Jan 2023 252.232-7003 Electronic Submission of Payment Requests and Receiving Reports. Dec 2018 252.232-7010 Levies on Contract Payments. Dec 2006 252.244-7000 Subcontracts for Commercial Products or Commercial Services. Nov 2023

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting.

(DEVIATION 2024-O0013 REVISION 1)

May 2024 Deviation 2024-O0013 May 2024

252.247-7023 Transportation of Supplies by Sea. Oct 2024

FAR Clauses Incorporated by Full Text

52.219-28 Postaward Small Business Program Rerepresentation. (Jan 2025)

Postaward Small Business Program Rerepresentation (Jan 2025)

(a) Definitions. As used in this clause-

Long-term contract means a contract of more than five years in duration, including options. However, the term does not include contracts that exceed five years in duration because the period of performance has been extended for a cumulative period not to exceed six months under the clause at 52.217-8, Option to Extend Services, or other appropriate authority.

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 (d) of this clause.

(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.

(b) If the Contractor represented that it was any of the small business concerns identified in 19.000(a)(3) prior to award of this contract, the Contractor shall rerepresent its size and socioeconomic status according to paragraph (f) of this clause or, if applicable, paragraph (h) of this clause, upon occurrence of any of the following:

(1) Within 30 days after execution of a novation agreement or within 30 days after modification of the contract to include this clause, if the novation agreement was executed prior to inclusion of this clause in the contract.

(2) Within 30 days after a merger or acquisition that does not require a novation or within 30 days after modification of the contract to include this clause, if the merger or acquisition occurred prior to inclusion of this clause in the contract.

(3) For long-term contracts-

(i) Within 60 to 120 days prior to the end of the fifth year of the contract; and

(ii) Within 60 to 120 days prior to the date specified in the contract for exercising any option thereafter.

(c) If the Contractor represented its status as any of the small business concerns identified at 19.000(a)(3) prior to award of this contract, the Contractor shall rerepresent its size and socioeconomic status according to paragraph (f) of this clause or, if applicable, paragraph (h) of this clause, for the NAICS code assigned to an order (except that paragraphs (c)(1) through (3) of this clause do not apply to an order issued under a Federal Supply Schedule contract at subpart 8.4)-

(1) Set aside exclusively for a small business concern identified at 19.000(a)(3) that is issued under an unrestricted multiple-award contract, unless the order is issued under the reserved portion of an unrestricted multiple-award contract ( e.g., an order set aside for a woman-owned small business under a multiple-award contract that is not set-aside, unless the order is issued under the reserved portion of the multiple-award contract);

(2) Issued under a multiple-award contract set aside for small businesses that is further set aside for a specific socioeconomic category that differs from the underlying multiple-award contract ( e.g., an order set aside for a HUBZone small business concern under a multiple-award contract that is set aside for small businesses);

(3) Issued under the part of the multiple-award contract that is set aside for small businesses that is further set aside for a specific socioeconomic category that differs from the underlying set-aside part of the multiple-award contract ( e.g., an order set aside for a WOSB concern under the part of the multiple-award contract that is partially set aside for small businesses); and

(4) When the Contracting Officer explicitly requires it for an order issued under a multiple-award contract, including for an order issued under a Federal Supply Schedule contract (see 8.405-5(b) and 19.301-2(b)(2)).

(d) The Contractor shall rerepresent its size status in accordance with the size standard in effect at the time of this rerepresentation that corresponds to the North American Industry Classification System (NAICS) code(s) assigned to this contract. The small business size standard corresponding to this NAICS code(s) can be found at https://www.sba.gov/document/support--table-size-standards.

(e) The small business size standard for a Contractor providing an end item that it does not manufacture, process, or produce itself, for a contract other than a construction or service contract, is 500 employees, or 150 employees for information technology value-added resellers under NAICS code 541519, if the acquisition-

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

(2) Used the HUBZone price evaluation preference regardless of dollar value, unless the Contractor waived the price evaluation preference; or

(3) Was 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.

(f) Except as provided in…