Ambulance Matrix.log.pdf

FOR OFFICIAL USE ONLY

Ambulance Matrix

INSTRUCTIONS TO OFFERORS: Technical descriptions shall be in the form of completing the Ambulance Matrix. This Matrix will be given to the 78th Medical Group to determine whether your company is qualified to perform the duties of the resultant contract. Your response to this matrix shall include all documentation that provides evidence that meets/exceeds the qualifications and requirements as stated in this Matrix and Performance Work Statement dated 2 November 2011. In order to receive consideration in the technical evaluation process, you shall complete this Ambulance Matrix in a clear, concise and legible manner. Please describe in detail, how your company plans to execute each objective below. Merely stating the intent to comply with the objectives within the Ambulance Matrix and Performance Work Statement is insufficient and may result in the proposal being evaluated as technically unacceptable.

OBJECTIVE 1

Paragraph 1.0 of the Performance Work Statement dated 2 November 2011.

1.0 DESCRIPTION OF SERVICES. The Contractor shall provide qualified personnel, equipment, vehicles, supplies and materials (except as listed in Paragraph 3, Government Furnish Property and Services), to provide 24-hour paramedic and emergency ambulance services for patient transport at Robins AFB, GA. The responsibilities include (1) emergency paramedic response and patient transport,

(2) in-flight emergency responses, (3) participation in Robins AFB and Military Treatment Facility (MFT) exercises, and (4) third party collections forms (DD Form 2569). Transport services supports approximately 500 calls per year and average between 30 to 50 calls per month.

Please answer: How does your company plan to execute Objective 1of this Matrix?

OBJECTIVE 2

Paragraph 1.1 of the Performance Work Statement dated 2 November 2011.

1.1 EMERGENCY PARAMEDIC RESPONSE AND PATIENT TRANSPORT. The Contractor shall provide ambulance response to emergencies as requested by Houston County Fire Rescue 911/Robins AFB dispatchers or RAFB Emergency Control Center (ECC). Patients will be transferred to Houston Medical Center, Warner Robins, or if required, to other Central Georgia medical treatment facilities as directed. The contractor shall respond to primary emergencies within (not to exceed) 7 minutes. For secondary back up calls, the contractor shall respond within (not to exceed) 13 minutes when two or more calls occur at the same time. Time begins from notification to the unit to the arrival time on scene.

After the completion of the emergency ambulance run, the contractor shall complete and provide a State of Georgia run sheet to the Contracting Officer’s Representative (COR) within seven days of completion of the run.

Please answer: How does your company plan to execute Objective 2 of this Matrix?

OBJECTIVE 3

Paragraph 1.3 of the Performance Work Statement dated 2 November 2011.

1.3 Participation in Exercises and Training. The Contractor shall participate in all Robins AFB exercises as participation is a critical component to the successful execution of the MTF mission. The purpose of military exercises is to simulate real world events to prepare the medical community for potential crises or emergencies. The contractors shall prepare for the exercises and participate as if the situation was valid as deemed practicable. Example of exercises might include mid air collision of aircraft or any mass casualty exercises.

The contractor shall provide on scene ambulance coverage for 78 CES Live Pit Fire training, assistance with EMT Refresher courses, Readiness Skills Verification Programs, special events and semi-annual training with Flight Medicine/Field Response Team personnel. Once events are approved by the Government, the COR will send request to the Contractor to provide coverage.

Please answer: How does your company plan to execute Objective 3 of this Matrix?

Matrix Completed By:

Company Name:________________________________________________________

Phone:________________________ Cage Code:_______________________

Print Name:_________________________________________

Signature:__________________________________________ ` Date:_____________________