DRAFT PWS - Temporary Shuttle Service - VAPHS.docx
DOCX document 47 KB Posted
- Attached to
- V212--VAPHS Shuttle Services Federal contract opportunity
- Solicitation number
- 36C24420Q0845
About this file
This performance work statement and related federal contract opportunity describe requirements for shuttle bus services at the VA Pittsburgh Healthcare System. The VA seeks a contractor to provide three shuttle buses during peak times and one during off-peak to transport approximately 200 employees daily between the medical center and a parking facility within three miles. The base period of performance is one year starting in September 2020 with two option years. Interested parties must respond by July 23 with company information, a service plan and costs, and COVID safety procedures to be considered for the single award SDVOSB, VOSB, SB, or unrestricted LB set-aside contract. The NAICS code is 485113 with a $16.5 million size standard.
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Performance Work Statement (PWS): Temporary Shuttle Bus Service
GENERAL INFORMATION
Requirement Description:
The VA Pittsburgh Healthcare System (VAPHS) is seeking a qualified contractor to provide all necessary resources required to provide a temporary shuttle service to transport Government employees to and from the Medical Center at 4100 Allequippa St, Pittsburgh PA. 15219.
Type of Contract:
The Government intends, but is not obligated, to award a single Firm-Fixed Price contract.
Period of Performance (POP):
The period of performance shall include a 12-month base period of performance.
TASK ORDER REQUIREMENTS
Scope:
The Contractor provide a shuttle service to a parking facility located within a 2-mile radius of the Medical Center.
The contractor shall provide continuous shuttle bus transportation service during parking hours of operation. This service shall include all resources necessary to successfully staff, operate, maintain, and support the routes required. VA will not be responsible for providing any equipment, staff, or items necessary to fulfill this service; the contractor is responsible for providing all the elements of this service that are identified as the commercial standard.
This service shall be for all authorized Government personnel (Federal employees and PIV badge holding contractors) and their accompanied guests. If the shuttle driver suspects an individual who is not a Government employee or an escorted guest is trying to access the shuttle, they shall ask to see the individual’s Federal credentials or guest badge. Appropriate employee credentials include: VA Photo ID; State / USAID Photo ID card; U.S. Diplomatic Passport; Other Federal Agency Photo ID; Military Photo ID (Active Duty Only).
Contractor provided Shuttle Service Shuttles shall operate Monday through Friday between the hours of 5:00am and 5:30pm, excluding Federal Holidays. Service shall begin the first pick-up promptly at 5:00am, and have pick-up and departure occur from each designated stop every 15 minutes during the period of highest demand. After the periods of highest demand, the pick-up and departure would occur every 30 minutes. It is the contractor’s responsibility to provide a schedule for each stop throughout the day. Highest demand is anticipated from 5:00am-8:00am and 3:00pm-5:30pm, during these hours 200 employees would need to be transported between stops.
Due to current guidelines on the capacity of buses for COVID-19 the Contractor shall provide 3 shuttle buses during times of high demand (5:00am-8:00am and 3:00pm-5:30pm) that can accommodate a minimum of 25 people, during the time of low demand (8:00am to 3:00pm) the contractor shall provide a shuttle that can accommodate a minimum of 12 people for transportation to and from the designated stop at:
VA Pittsburgh Healthcare System: 4100 Allequippa St, Pittsburgh PA. 15219
The Contractor shall not leave shuttles on VA premises; except for during pick-up or drop-off at the Medical Center.
Passengers shall only be picked-up and discharged at the designated stops.
Federal Holidays:
The Contractor shall not provide service on the following federal holidays:
· New Year’s Day
· Martin Luther King Jr. Birthday
· Presidents’ Day
· Memorial Day
· Independence Day
· Labor Day
· Columbus Day
· Veterans Day
· Thanksgiving Day
· Christmas Day
The Contractor shall supply a plan on the sanitation of shuttles between trips to ensure the safety of passengers and reducing the spread of COVID 19.
Compliance, Permits, Certifications, & Insurance:
Through-out the duration of this service the contractor shall be in compliance with the Performance Work Statement and all applicable federal, state, and local laws. The contractor shall be responsible for determining the latest applicable editions of all relevant federal, state and local regulations.
The contractor shall, without additional expense to the Government, be responsible for obtaining any necessary licenses, permits, and insurance to comply with any applicable federal and municipal laws, codes, and regulations in connection with the performance of this service.
The contractor shall furnish the Contracting Officer (CO) with their Certificate of Insurance (see clause 52.228-10), containing an endorsement to the effect that cancellation or any material change in the policies which adversely affect the interest of the Government, shall not be effective unless a thirty (30) day written notice of cancellation or change is furnished to the Contracting Officer’s Representative (COR). The term “will endeavor” is not acceptable as issued by an insurance carrier.
Driver Requirements:
Drivers shall perform the required service in such a manner as to cause the least possible interference with the Government’s activities. They are responsible for ensuring rider eligibility. If a passenger is not eligible, the driver is to deny them access to the shuttle.
The driver shall not leave, at any time, the shuttle with the key in the ignition.
The driver’s name shall be displayed within the bus so that it is visible for all passengers.
Additionally, drivers may be required to successfully complete any applicable government training.
Employment:
The contractor shall not employ any person who is an employee of the U.S. Government, if the employment of that person would create an appearance of a conflict of interest.
The contractor shall ensure all drivers operating under this contract possess a valid operator’s license required to operate the type of vehicle necessary to perform the shuttle bus service, as required by the State of Delaware. A copy of these licenses must be provided to the COR or CO prior to the start of the contract.
In addition, the drivers must be able to meet the minimum government security clearance requirements. The contractor shall ensure all drivers providing service under this contract have less than five (5) points on their current license, none of which may be assessed for reckless driving.
Any change in an employee’s driving status shall be reported to the COR immediately upon discovery.
By submitting a quote in response to this solicitation, the contractor is certifying their drivers do not have a serious health condition which could impair their driving skills and place passengers at risk.
All contractor drivers must understand and speak fluent English.
The Government reserves the right to order the removal from service under this contract any drivers who violate these requirements.
Breaks:
All employee breaks must be covered. The contractor shall provide sufficient staff to allow drivers designated breaks and lunch without affecting continuous shuttle operations.
Appearance:
Drivers shall be clean, well-groomed, and professional appearance at all times.
The contractor shall provide uniforms to all personnel working under this contract. Uniforms shall facilitate easy identification of contractor staff by employee name and company name. Uniform type will be agreed upon with VA and contractor at the pre-work meeting. Uniforms shall be worn at all times during performance of contract duties.
Safety:
Drivers shall not knowingly operate an unsafe vehicle nor operate it in an unsafe manner.
Conduct:
Drivers shall display professional manners at all times. The following acts are not permissible by drivers who provide services under this requirement:
· Use of intoxicating liquors, narcotics or controlled substances of any kind (excluding doctor’s prescriptions which do not impair driver’s driving ability) while on duty or reporting for duty while under the influence of these substances.
· Smoking and other uses of tobacco while on duty. All passengers and contractor staff are prohibited from smoking on shuttles.
· Carrying of pistols, firearms or concealed weapons.
· Resorting to physical violence while on duty.
· Spitting in prohibited places or any other unsanitary, offensive or insensitive practices or behavior.
· Use of loud, indecent or profane language and/or making threatening or obscene gestures toward customers or other employees.
· Text messaging while driving in accordance with FAR 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving.
· Stopping for personal business, including excessive use of restroom facilities, while shuttle is occupied by a passenger.
· Engaging customers in a verbal confrontation in an attempt to settle a disagreement. Should a disagreement arise, the driver is to contact his dispatcher/supervisor via the radio system. The contractor shall then contact the COR.
· Soliciting or accepting tips from customers, companions or others at any time.
· Loitering in or around Government facilities during off duty hours.
DELIVERABLES
Contingency Service: The contractor shall provide contingency shuttles and drivers to prevent a lapse in service due to shuttle and/or employee availability. In order to keep the employee wait time at an absolute minimum, the contractor shall immediately notify the COR when a mode of transportation is not in service and would result in schedule delays. The contingency shuttles shall be in the same condition as those regularly offered, and drivers shall possess the same qualifications and perform the schedule of those regularly scheduled.
Accidents:
Service shall not continue in a vehicle which has just experienced an accident, and the driver involved shall remain at the scene until the investigation is completed. The contractor shall be responsible for providing a replacement shuttle and driver within one (1) hour to continue operations. The driver shall take all reasonable steps to assure the comfort and safety of all passengers.
Delays or Disruptions in Service: The contractor shall immediately report to the COR any and all shuttle breakdowns or other problems which may affect service. When a breakdown occurs, it shall be the responsibility of the contractor to provide contingency shuttles to minimize any delay or inconvenience to the customer(s).
Weather:
The contractor shall immediately notify the COR, if road conditions exists (i.e. inclement weather) that may render shuttle vehicles unsafe to operate. However, this act of notification does not, of itself, provide authorization to discontinue services. The contractor shall receive a response from the COR within one (1) hour of notification as to whether to discontinue service.
The contractor shall monitor the Office of Personnel Management’s (OPM) official website for government closures.
Future Delays:
If the contractor foresees they will not be able to provide service on a given day, they will provide advance (as soon as applicable) written explanation of why and provide it to the COR; this documentation must be signed by the contractor’s designated responsible POC. The COR, upon conference with the CO, will determine if service from another source is required. If this occurs, the COR will immediately notify the contractor, once a decision is rendered.
The Government will issue a Bill of Collections for any costs obtained, if service is required from another source. Failure to pay as charged, within the timeframe specified in the Bill of Collections, may result in deduction of costs from the next month’s invoice.
Contractor Communication System:
The contractor shall maintain two-way communication between shuttle bus drivers and dispatcher during normal business hours. The contractor shall have telephone coverage to accept calls from the COR during the hours of 8:00am and 5:00pm.
Reporting:
Drivers List:
With the contractor’s quote submission, they shall propose drivers for the duration of the service. A copy of each driver’s valid driver’s license shall also be submitted. If a change to personnel is to be made affecting this order, the contractor shall provide the COR with an updated list, with an explanation as to why the change occurred.
Ridership:
The driver shall keep a daily log of passengers utilizing the shuttle. At each stop, the driver will report the time of day and the number of passengers boarding and departing the shuttle, also the daily bus utilization per trip (i.e. 7%). This log is to be submitted to the COR by the fifth (5) day of each month.
Accidents:
The contractor shall immediately report to the COR all accidents within one (1) hour of the occurrence. Before a vehicle can leave the scene of the accident, the operator must complete a list of all the passengers names’, telephone numbers’, and places’ of employment. The operator shall also complete all appropriate accident reports.
Vehicles:
If any equipment fails to operate at the performance standards established in this PWS, the contractor shall, within one (1) hour, provide a replacement vehicle that will enable services to continue with minimal disruption to service. Should it be necessary to remove a vehicle from service, the contractor shall immediately inform the COR. The performance standards for the shuttle vehicles are:
1. All vehicles shall meet current applicable federal, state, city, and/or county specifications and regulations including, but not limited to: licensing, registration, insurance coverage, and safety standards.
2. The contractor shall provide vehicles with a minimum capacity to accommodate 20 passengers. The shuttle vehicles shall be equipped with heating, air conditioning, and all required safety features mandated for public transportation.
3. Entry steps to the shuttle vehicles shall not require an entry step stool to enter or exit the vehicle. The interior height in the vehicles shall be sufficient to allow passengers to walk to their seats without bending.
4. The interior and exterior of the shuttle vehicles shall be kept clean and free of debris at all times (e.g., windows shall be clean and free of broken/ cracked/ scratched/ distorted glass; seats shall remain free of rips, tears, stains, and graffiti; floor shall remain free of litter or any foreign matter, etc.). Any seats cushions and/or windows that are damaged beyond repair shall be replaced immediately.
5. All components of the vehicle body, appurtenances and frames shall be maintained in a safe, sound and undamaged condition. All repairs shall be made within seven (7) days of occurrence, unless the defect would affect passenger safety or comfort, or have a significant effect on appearance. In the latter case, repairs shall be made before the vehicle is put back into service.
6. There shall be no advertisements or logos of any kind on, or in the shuttle.
7. The contractor shall not utilize a school bus body style for this shuttle service.
8. Each vehicle used to provide shuttle service shall be a conservative and uniform color that can be identified by authorized passengers as their shuttle. The contractor shall not identify the shuttle as serving government employees (i.e. Identifying the shuttle as belonging to or serving the VA).
Maintenance:
The contractor shall provide in their Quality Control Plan a plan for scheduled preventive maintenance and comply with this plan during the performance of this PWS. The plan shall include preventive maintenance and brake inspection to be performed at regularly scheduled intervals, in accordance with the manufacturer’s scheduled recommendations and timetable.
The contractor shall maintain Preventative Maintenance Inspection Reports. The reports shall include, but not be limited to: vehicle make, model, serial number, license number, vehicle identification number, fuel type, condition reports, mileage, hours in service, component change-outs, and failure call information, etc. Maintenance records shall be maintained on each vehicle and be provided to the COR or CO upon request.
The contractor shall maintain the shuttle in a clean burning state so emissions are minimized and pedestrians are not subject to exhaust fumes; therefore, the shuttle shall meet current federal and local emission standards.
Inspection:
The Government reserves the right to restrict the contractor’s use of equipment and vehicles which are in need of repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with PWS specifications. The restriction of such equipment and vehicles shall not relieve the contractor from providing all required services as defined herein.
The Government reserves the right to inspect contractor equipment and vehicles or require documentation of compliance with the PWS’s specifications. If conducted, such inspections do not constitute a warranty by the Government that the contractor’s vehicles and equipment are properly maintained.
The COR will inspect all vehicles that are to be utilized in the performance of this contract. These inspections shall be conducted:
a. Prior to start of work;
b. Before each initial use of a vehicle that is added to the routes (if necessary);
c. Whenever the COR determines an inspection is warranted.
The contractor shall not use any vehicles for this requirement that do not pass inspection.
Posted COR Information:
The contractor shall post in the front interior space of the shuttle a visible sign to passengers with the COR’s name and email address so customers may contact this individual with any questions or concerns.
A “NO TIPPING” sign will be furnished by the contractor, and this policy will be strictly enforced by the contractor. Hand-written signs are not permitted. These signs shall be submitted for approval by the COR or CO.
Posted Loop Information:
The contractor shall clearly identify on the exterior of each vehicle the loop number in which it is servicing. Signage shall be easy to read and look professional.
Invoices:
Payment to the Contractor. Payment to the Contractor shall be made monthly, in arrears, upon receipt of a properly prepared invoice. Payment for services will be at the rates specified in the Schedule of Supplies/Services. All monthly invoices from the contractor will be electronically submitted to the following through the Tungsten Network within 30 days of the end of each month’s services:
Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-8971 Customer Support Help Desk (877-353-9791)
The information page for the Financial Service Center of the Department of Veterans Affairs that includes information regarding electronic invoice submission can be referenced at:
http://www.fsc.va.gov/einvoice.asp
NOTE: Invoices for payment may be rejected if all information required by FAR Clause 52.212-4(g) is not included. Invoices without the required information will be returned.
Invoices must be approved by the Contracting Officer’s Representative prior to payment release. Invoices without the required information will be returned.
All invoices must include the assigned purchase order number and be submitted within 10 days following the month of service.
Failure to comply with all terms and conditions of this contract shall result in invoices/claims submitted for reimbursement during that period to be considered incomplete. Interest penalties imposed under the Prompt Payment Act shall not apply to incomplete invoices or invoices received after the established invoice due date.
Contractor will identify and assign personnel to be the liaison for billing purposes.
The Department of Veterans Affairs Financial Service Center (FSC) is the designated agency office for invoice receipt in accordance with the Prompt Payment Act (5 CFR Part 1315). FSC or its designated representative may contact the vendor to provide specific instructions for electronic submission of invoices. The vendor shall be responsible for any associated expenses. FSC may utilize third-party contractors to facilitate invoice processing.
Department of Labor Wage Determination Service Contract Act DOL Wage Determination No. 2015-4216 applies to the resultant Contract from this solicitation. FAR 52.222-43, Fair Labor Standards Act and Service Contract Act—Price Adjustment (Multiple Year and Option Contracts) applies to the resultant Contract; therefore, the offeror shall not include in his proposed option year prices any allowance for any contingency to cover increased costs for which adjustment is provided under FAR 52.222-43.
Contractor Personnel Security Requirements All contractor employees and subcontractor employees must complete a Special Agreement Check (SAC) investigation conducted by the FBI National Criminal History Check (NCHC).
The following forms are required for a SAC:
Fingerprints OF306 Declaration for Federal Employment.
The employee must be fingerprinted as part of the investigation. Electronic fingerprinting can be performed at the Wilmington VA Medical Center and will be coordinated through the COR and Human Resources Office.
The Contractor shall bear the expense of the background investigation(s), regardless of the final adjudication determination. A Bill of Collections shall be generated by the VA after final adjudication determination has been received.
Training:
All contractor employees and subcontractor employees who do not require access to VA Computer Systems or Direct Access to VA Sensitive Information shall complete the training below.
The contractor shall provide to the Contracting Officer’s Representative (COR) a copy of the training certification for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required.
Failure to complete the mandatory annual training annually, within the timeframe required, is grounds for suspension and removal from work on the contract until such time as the training and documents are complete.
VA Privacy Training for Personnel without Access to VA Computer Systems or Direct Access to or the Use of VA Sensitive Information
The Department of Veterans Affairs, VA must comply with all applicable privacy and confidentiality statutes and regulations. One of the requirements in VA is to have all personnel trained annually on privacy requirements. “Privacy” represents what must be protected by VA in the collection, use, and disclosure of personal information whether the medium is electronic, paper or verbal.
This document satisfies the “basic” privacy training requirement for a contractor, volunteer, or other personnel only if the individual does not use VA sensitive information or protected health information (PHI) in any form such as electronic or paper or have access to any VA computer system such as VA Time and Attendance System (VATAS), Computerized Patient Record System (CPRS), Joint Legacy Viewer (JLV), Veterans Health Information Exchange (VHIE), Compensation and Pension Record Interchange (CAPRI).
You will find this training outlines your role and responsibility for protecting VA sensitive information (medical, financial, or educational) that you may incidentally or accidentally see or overhear.
If you have direct access to VA sensitive information or access to a VA computer system where there is protected health information such as VaTAS, CPRS, JLV, VHIE or CAPRI you must take Privacy and HIPAA Focused Training (TMS 10203).
VA Privacy and Information Security Awareness and Rules of Behavior (TMS 10176) is always required to use or gain access to a VA computer system or VA sensitive information, whether or not protected health information is included. Both trainings are located within the VA Talent Management System (TMS): https://www.tms.va.gov
What is VA Sensitive Information/Data?
All Department information and/or data on any storage media or in any form or format, which requires protection due to the risk of harm that could result from inadvertent or deliberate disclosure, alteration, or destruction of the information. The term includes not only information that identifies an individual but also other information whose improper use or disclosure could adversely affect the ability of an agency to accomplish its mission, proprietary information, and records about individuals requiring protection under applicable confidentiality provisions.
What is Protected Health Information?
The HIPAA Privacy Rule defines protected health information as Individually Identifiable Health Information transmitted or maintained in any form or medium by a covered entity, such as VHA.
What is an “Incidental” Disclosure?
An incidental disclosure is one where an individual’s information may be disclosed incidentally even though appropriate safeguards are in place. Due to the nature of VA communications and practices, as well as the various environments in which Veterans receive healthcare or other services from VA, the potential exists for a Veteran’s protected health information or VA sensitive information to be disclosed incidentally.
For example:
• You overhear a healthcare provider’s conversation with another provider or patient even when the conversation is taking place appropriately.
• You may see limited Veteran information on sign-in sheets or white boards within a treating area of the facility.
• You may hear a Veteran’s name being called out for an appointment or when the Veteran is being transported/escorted to and from an appointment Safeguards You Must Follow To Secure VA Sensitive Information:
• Secure any VA sensitive information found in unsecured public areas (parking lot, trash can, or vacated area) until information can be given to your supervisor or Privacy Officer. You must report such incidents to your Privacy Officer timely.
• Don’t take VA sensitive information off facilities grounds without VA permission unless the VA information is general public information, i.e., brochures/pamphlets.
• Don’t take pictures using a personal camera without the permission from the Medical Center Director.
• Any protected health information overheard or seen in VA should not be discussed or shared with anyone who does not have a need to know the information in the performance of their official job duties, this includes spouses, employers or colleagues.
• Do not share VA access cards, keys, or codes to enter the facility.
• Immediately report lost or stolen Personal Identity Verification (PIV) or Veteran Health Identification Cards (VHIC), VA keys or keypad lock codes to your supervisor or VA police.
• Do not use a VA computer using another VA employee’s access and password.
• Do not ask another VA employee to access your own protected health information. You must request this information in writing from the Release of Information section at your facility
What are the Six Privacy Laws and Statutes Governing VA?
1. Freedom of Information Act (FOIA) compels disclosure of reasonably described VA records or a reasonably segregated portion of the records to any person upon written request unless one or more of the nine exemptions apply.
2. Privacy Act of 1974 provides for the confidentiality of personal information about a living individual who is a United States citizen or an alien lawfully admitted to U.S. and whose information is retrieved by the individual’s name or other unique identifier, e.g. Social Security Number.
3. Health Insurance Portability and Accountability Act (HIPAA) provides for the improvement of the efficiency and effectiveness of health care systems by encouraging the development of health information systems through the establishment of standards and requirements for the electronic transmission, privacy, and security of certain health information.
4. 38 U.S.C. 5701 provides for the confidentiality of all VA patient and claimant information, with special protection for their names and home addresses.
5. 38 U.S.C. 7332 provides for the confidentiality of drug abuse, alcoholism and alcohol abuse, infection with the human immunodeficiency virus (HIV) and sickle cell anemia medical records and health information.
6. 38 U.S.C. 5705 provides for the confidentiality of designated medical-quality assurance documents.
What are the Privacy Rules Concerning Use and Disclosure?
You are not authorized to use or disclose protected health information. In general, VHA personnel may only use information for purposes of treatment, payment or healthcare operations when they have a need-to-know in the course of their official job duties. VHA may only disclose protected health information upon written request by the individual who is the subject of the information or as authorized by law.
How is Privacy Enforced?
There are both civil and criminal penalties, including monetary penalties that may be imposed if a privacy violation has taken place. Any willful negligent or intentional violation of an individual’s privacy by VA personnel, contract staff, volunteers, or others may result in such corrective action as deemed appropriate by VA including the potential loss of employment, contract, or volunteer status.
Know your VA/VHA Privacy Officer and Information Systems Security Officer. These are the individuals to whom you can report any potential violation of protected health information or VA sensitive information, or any other concerns regarding privacy of VA sensitive information.
YOU ARE RESPONSIBLE FOR PROTECTING THE CONFIDENTIAL INFORMATION OF OUR VETERANS
| __________________________________________ | ________________ | |
| Employee (Print Name) | Date |
Employee Signature Print Name of Contract Agency, if contractor Print Name of VHA Department/Supervisor/Contracting Officer
PROVIDE A COPY OF THIS FORM TO YOUR SUPERVISOR/CONTRACTING OFFICER FOR DATA ENTRY INTO TALENT MANAGEMENT SYSTEM
VHA DIRECTIVE 1192 SEASONAL INFLUENZA PREVENTION PROGRAM
VHA Directive 1192 requires all health care personnel (HCP) to participate in the seasonal influenza prevention program and outlines the key implementation steps. Health care personnel is defined in VHA Directive 1192 as all VA licensed and unlicensed, clinical and administrative, paid and unpaid, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, students, researchers, volunteers, and trainees who work in VHA locations. HCP covered by the policy are expected to receive annual influenza vaccination. Those HCP unable or unwilling to be vaccinated are required to wear a face mask throughout the influenza season. Masks are available at entrances throughout the medical center.
It is the responsibility of the contractor to ensure that all contract staff is compliant with the requirements outlined in VHA Directive 1192. The contractor shall maintain the following documentation:
- Documentation of vaccination, e.g., signed record of immunization from a health care provider or pharmacy, or a copy of medical records documenting the vaccination.
- Completed Health Care Personnel Influenza Vaccination Form (Attachment B of VHA Directive 1192) if unwilling or unable to receive the vaccine.
The contractor is required to submit annual certification to the Contracting Officer’s Representative (COR) that all contract staff performing services at VA facilities are following VHA Directive 1192.
See HEALTH CARE PERSONNEL INFLUENZA VACCINATION FORM below.
HEALTH CARE PERSONNEL INFLUENZA VACCINATION FORM
Select the single answer that best fits your reason:
I acknowledge that VHA policy requires health care personnel to receive the influenza vaccine every year. I understand that if I decline to receive the vaccine and/or to provide proof of vaccination by November 30 or within two weeks of beginning employment if after November 30, I must wear a face mask according to requirements and guidelines within the Directive 1192, Seasonal Influenza Prevention Program.
I have read and fully understand the information on this form and have been given the opportunity to have my questions answered.
Signature: ______________________________ Date: ___________ Name (print): _____________________________ Last 4 SS# _______ Contractor Name: ____________________
QUALITY CONTROL PLAN (QCP):
The contractor shall establish and maintain a complete QCP to ensure successful service performance. The contractor’s QCP shall detail, but is not limited to: how the service will be maintained and managed; how and what corrective action will be taken, if and when it is needed; who is responsible for managing what aspects of the service; and vehicle and driver management. The contractor’s QCP, in addition to the Government’s Quality Assurance Surveillance Plan, will be used to monitor contractor performance.
When contractor performance does not meet the specifications and requirements of PWS, the COR will submit written documentation to the CO explaining how performance is considered to be unacceptable. This documentation will be provided to the CO within three (3) business days after each occurrence.
QUALITY ASSURANCE MEASURES
| QA Measure |
| Standard |
| Acceptable Quality Level |
| Method of Surveillance |
| Incentive |
| Service adheres to time schedule |
| Bus does not leave ahead of scheduled time or later than 7 minutes after scheduled departure time |
| 90% of the time |
| Customer feedback; Planned sampling |
| Exercise of option period; Performance evaluation |
| Vehicle standards – maintenance and cleanliness |
| Buses meets the requirements of the PWS |
| Less than 5 defects or infractions per month |
| Planned sampling; Customer feedback |
| Exercise of option period; Performance evaluation |
| Driver performance |
| Driver behavior and performance complies with PWS requirements |
| Less than 5 defects or infractions per month |
| Planned sampling; Customer feedback |
| Exercise of option period; Performance evaluation |
REQUIREMENT TERMINATION
The Government has the right to terminate (in whole or in part) this requirement at any time, in accordance with 52.212-4 Contract Terms and Conditions – Commercial items.
CONTRACT ADMINISTRATION
Changes:
Any changes to this PWS shall only be authorized in writing by the CO.
COR:
This requirement will designate a COR to assist the CO in monitoring all technical aspects of the contract. In no event is the COR empowered to change any of the terms and conditions of this PWS. Changes to the PWS shall be made only by the CO pursuant to a properly executed modification. The types of responsibilities within the purview of the COR’s authority will be detailed with the COR Delegation letter.
Kick-off Meeting:
The CO will coordinate and facilitate a kick-off meeting with the contractor within one week of contract award. The kick-off meeting may be held via conference call or face-to-face. The Government will provide the location and logistics of the meeting upon announcement of award.
Contractor Point-of-Contact (POC):
The contractor shall appoint an individual with the authority to resolve contractual issues related to this requirement. The contractor’s POC name, phone number, and email shall be submitted with the contractor’s quote. This individual shall be available during normal business hours, 8:00 am – 5:00 pm, Monday through Friday.
Contractor POC: _______________________________
Government POCs:
The following individuals will be the Government's points of contact during the performance of this contract:
Contracting Officer:
Contracting Officer’s Representative (COR):
File details come from the government source that posted it. Updated .