RFQ_Amend_17-Q-MG05-0001_DRHA_MHA.pdf

Amendment 0001

FA5205-17-Q-MG05 DRHA/MHA Provider Svs

AMENDMENT No. 0001

To

RFQ No. FA5205-17-Q-MG05

Deployment-related Health Assessment (DRHA)

/Mental Health Assessment (MHA) Provider

25 May 17

Notice to Offeror: The purpose of this amendment to extend the RFQ closing date from “1600 hrs on 25 May

2017, Japan Standard Time” to “1600 hrs on 14 June 2017, Japan Standard Time”. Other terms and conditions remain unchanged. Please use this document for your response/quotation to acknowledge receipt of this amendment.

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in FAR

Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes only solicitation; proposals are being requested and a written solicitation will not be issued. The solicitation number is Combo FA5205-17-Q-MG05 Deployment-related Health Assessment (DRHA)/

Mental Health Assessment (MHA) Provider; this solicitation is issued as a request for quotation (RFQ). This solicitation document and incorporated provisions and clauses are those in effect through FAC 2005-95, DPN

20161222, and AFAC 2017-0127. This acquisition will be full and open competition.

Please send the response to the below POC not later than 1600 hrs on 14 June 2017, Japan Standard Time:

MSgt Tavis J. Salas, Contracting Officer, tavis.salas@us.af.mil

Michiko Yoshizawa, buyer, michiko.yoshizawa.jp@us.af.mil

Offeror Name: POC:

Address:

Email: Phone No.:

CLIN Description Units

Unit of

Issue

Unit

Price Total Price

Base Year

One (1) DRHA/MHA Family Nurse

Practitioner (FNP) In Accordance With (IAW) the attached Performance Work Statement

(PWS).

1,040 Hours

Base Year

One (1) DRHA/MHA DRHA/MHA Licensed

Practical Nurse (LPN) or Licensed Vocational

Nurse (LVN) IAW the attached PWS.

1,040 Hours mailto:tavis.salas@us.af.mil mailto:michiko.yoshizawa.jp@us.af.mil

Option Year One (1)

One (1) DRHA/MHA FNP IAW the attached

PWS.

1,560 Hours

Option Year One (1)

One (1) DRHA/MHA DRHA/MHA LPN or

LVN IAW the attached PWS.

1,560 Hours

Option Year Two (2)

One (1) DRHA/MHA FNP IAW the attached

PWS.

2,080 Hours

Option Year Two (2)

One (1) DRHA/MHA DRHA/MHA LPN or

LVN IAW the attached PWS.

2,080 Hours

Performance Period: *Please enter your first available date to begin work below, if not 1 Jul 2017

Contract Period From To

Base Year

1 Jul 2017 *Start Date

31 Dec 2017

Option Year One 1 Jan 2018 30 Sep 2018

Option Year Two 1 Oct 2018 30 Sep 2019

Performance Location: 35th Medical Group, Bldg. 99, Misawa Air Base, Japan

Prompt payment discount terms, if other than NET 30: _______________

CAGE Code: _____________ DUNS#: ________________

System for Award Management (SAM) registration valid until: ________________

In order to do business with the Government above the micro-purchase threshold ($3,500.00), vendors are required to be registered in the SAM database. Lack of registration in the SAM database will cause a vendor to be considered ineligible for a contract award. The contractor is required to confirm on an annual basis that its information in the SAM database is accurate and complete. Registration and confirmation of SAM status can be accomplished at http://www.sam.gov/ (IAW FAR 52.212-1Instructions to Offerors, Para (k)).

Evaluation Criteria: Evaluation of offers will be completed in accordance with FAR 13.106-2. The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforms to the solicitation and represents the best value to the Government. Evaluation Criteria can be found on the addendum to 52.212-1 Instructions to Offerors and addendum to 52.212-2 Evaluation of Commercial Items.

http://www.sam.gov/

Provisions and Clauses: The following provisions and/or clauses apply to this acquisition. Offerors must comply with all instructions contained herein. Clauses may be accessed electronically in full text through http://farsite.hill.af.mil.

52.203-6 Alt I Restrictions on Subcontractor Sales to the Government

52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards

52.209-6 Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment

52.209-10 Prohibition on Contracting with Inverted Domestic Corporations

52.212-1 Instructions to Offerors - Commercial Items

52.212-2 Evaluation - Commercial Items

52.212-4 Contract Terms and Conditions -- Commercial Items

52.212-5 Dev Contract Terms and Conditions Required to Implement Statues or Executive Orders –

Commercial Items (Deviation 2013-O0019)

52.233-3 Protest After Award

52.233-4 Applicable Law for Breach of Contract Claim

52.222-35 Equal Opportunity for Veterans

52.222-36 Equal Opportunity for Workers with Disabilities

52.222-37 Employment Reports on Veterans

52.222-40 Notification of Employee Rights Under the National Labor Relations Act

52.222-50 Combating Trafficking in Persons

52.223-18 Encouraging Contractor Policies to Ban Text Messaging while Driving

52.225-13 Restrictions on Certain Foreign Purchases

52.228-3 Workers Compensation Insurance (Defense Base Act).

52.228-4 Workers Compensation and War-Hazard Insurance Overseas

52.232-33 Payment by Electronic Funds Transfer - System for Award Management

52.232-40 Providing Accelerated Payments to Small Business Subcontractors.

252.203-7000 Requirements Relating to Compensation of Former DoD Officials

252.203-7003 Agency Office of the Inspector General

252.203-7005 Representation Relating to Compensation of Former DoD Officials

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting

252.204-7015 Notice of Authorized Disclosure of Information for Litigation Support

252.222-7007 Representation Regarding Combating Trafficking in Persons

252.225-7050 Disclosure of Ownership or Control by the Government of a County that is a State Sponsor of

Terrorism

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports

252.232-7006 Wide Area Work Flow Payment Instructions

252.232-7010 Levies on Contract Payments

5352.201-9101 Ombudsman

5352.242-9000 Contractor Access to Air Force Installation

Accounting and Appropriation Data

9770130.1883 2X7 7454 3H5487 010000 571MN 87900F 668800 FB5205 ESP:7C ALD: AA FSR: 001677 PSR: 005943

DSR: CIN: F3D4A17076A0010000AA

http://farsite.hill.af.mil/

9770130.1883 2X7 7454 3H5487 010000 574MD 87900F 668800 FB5205 ESP:7C ALD: AB FSR: 001677 PSR: 005946

DSR: CIN: F3D4A17076A0010000AB

Exhibit/Attachment

Atch. No. Description Pages Date

1. Performance-based Work Statement (PWS) FNP 26 21 Apr 2017

2. Performance-based Work Statement (PWS) LPN/LVN 26 21 Apr 2017

3. Addendum to 52.212-1 Instructions to Offerors 4

4. Addendum to 52.212-2 Evaluation of Commercial Items 3