Combined_Synopsis_&_Solicitation_18QMG10_RMC.pdf

RFQ No: FA520518QMG10

35th Contracting Squadron Bldg. 656, USAF Misawa Air Base, Japan

Unit 5201, APO AP 96319-5201 FA520518QMG10, RMC Nurse

26 Jul 18 Notice to Offeror:

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 the only solicitation; quotes are being requested and a written solicitation will not be issued. The solicitation number is FA520518QMG10 and the solicitation is issued as request for quotation (RFQ). The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular FAC 2005-99. Associated NAICS is 621399. Place of Performance for this service is TOPA - TRICARE Operations and Patient Administration, Bldg. 99, Misawa Air Base, Japan. Special attention shall be made to FAR 52.212- 1 and 52.212-2.

Please send any response NO LATER THAN 1600 hrs on 9 Aug 18 (JST) or 0300 hrs on 9 Aug 18 (EST)

Point of Contact: Michiko Yoshizawa, Contract Specialist, Email michiko.yoshizawa.jp@us.af.mil.

Alternate POC: Mutsuo Shibasaki, Contracting Officer, Email michiko.yoshizawa.jp@us.af.mil.

Lack of registration in the SAM database will make an offeror ineligible for award. The Contractor is required to confirm on an annual basis that its information in the SAM database is accurate and complete at https://www.sam.gov/. (IAW FAR 52.232-33)

Please provide the following information:

Company Name:

POC (Name and Title):

Address:

Email: Phone No.:

CAGE Code: DUNS No.: TIN No.:

Prompt payment discount terms: Quote Expiration:

Item No.

Description Qty Unit Unit Price Extended Price

RMC Nurse Service, in accordance with (IAW) the attached Performance-based Work Statement (PWS) Base Year Period of Performance (POP):

1 Oct 18 thru 30 Sep 19

12 Mo

RMC Nurse Service, IAW PWS Option Year One POP: 1 Oct 19 thru 30 Sep 20

12 Mo

RMC Nurse Service, IAW PWS Option Year Two POP: 1 Oct 20 thru 30 Sep 21

12 Mo

RMC Nurse Service, IAW PWS Option Year Three POP: 1 Oct 21 thru 30 Sep 22

12 Mo

RMC Nurse Service, IAW PWS Option Year Four POP: 1 Oct 22 thru 30 Sep 23

12 Mo

Total Amount

Provisions and clauses incorporated by reference:

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

52.203-3 Gratuities 52.203-6 Alt I Restrictions On Subcontractor Sales To The Government (Sep 2006) -- Alternate I 52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements 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 52.209-9 Updates of Publicly Available Information Regarding Responsibility Matters 52.209-10 Prohibition on Contracting With Inverted Domestic Corporations 52.212-1 Instructions to Offerors--Commercial Items 52.212-3 Alt I Offeror Representations and Certifications--Commercial Items (JAN 2017) Alternate I 52.212-4 Contract Terms and Conditions--Commercial Items 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 Worker's Compensation Insurance (Defense Base Act) 52.228-4 Workers' Compensation and War-Hazard Insurance Overseas 52.232-18 Availability Of Funds 52.232-33 Payment by Electronic Funds Transfer--System for Award Management 52.233-3 Protest After Award 52.233-4 Applicable Law for Breach of Contract Claim 252.203-7000 Requirements Relating to Compensation of Former DoD Officials 252.204-7008 Compliance With Safeguarding Covered Defense Information Controls 252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting 252.204-7015 Notice of Authorized Disclosure of Information for Litigation Support 252.225-7050 Disclosure of Ownership or Control by the Government of a Country that is a State Sponsor of Terrorism 252.232-7003 Electronic Submission of Payment Requests and Receiving Reports 252.232-7010 Levies on Contract Payments 252.243-7002 Requests for Equitable Adjustment 252.244-7000 Subcontracts for Commercial Items

Provisions/Clause incorporated by full text:

ADDENDUM TO FAR 52.212-4

FAR 52.212-4 is tailored as follows:

Paragraph (k), Taxes, is changed to read "Exemption from Japanese customs duties and taxes. Resulting contract shall be exempt from customs duties and taxes of Japan, in accordance with article XI and XII of the status of Forces Agreement between Japan and the United States.

This is applicable to Japanese contractors only.

(End of Addendum)

FAR 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR

EXECUTIVE ORDERS--COMMERCIAL ITEMS (DEVIATION 2013-O0019) (NOV 2017)

(a) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (a) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records -- Negotiation.

(1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor’s directly pertinent records involving transactions related to this contract.

(2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved.

(3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law.

(b)

(1) Notwithstanding the requirements of any other clause in this contract, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (b)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause—

(i) 52.203-13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

(ii) 52.219-8, Utilization of Small Business Concerns (Oct 2014) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $650,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities.

(iii) 52.222-17, Nondisplacement of Qualified Workers (May 2014) (E.O. 13495). Flow down required in accordance with paragraph (1) of FAR clause 52.222-17.

(iv) 52.222-21, Prohibition of Segregated Facilities (Apr 2015).

(v) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246).

(vi) 52.222-35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212).

(vii) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793).

(viii) 52.222-62 Paid Sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706).

(ix) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212).

(x) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496).

Flow down required in accordance with paragraph (f) of FAR clause 52.222-40.

(xi) 52.222-41, Service Contract Labor Standards (May 2014), (41 U.S.C. chapter 67).

(xii) ____ (A) 52.222-50, Combating Trafficking in Persons (Mar 2015) (22 U.S.C. chapter 78 and E.O. 13627).

___ (B) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 E.O. 13627).

(xiii) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67.)

(xiv) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67)

(xv) 52.222-54, Employment Eligibility Verification (Oct 2015).

(xvi) 52.222-55, Minimum Wages Under Executive Order 13658 (Dec 2015) (E.O. 13658).

(xvii) 52.222-62, Paid sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706).

(xviii) (A) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

(B) Alternate I (Jan 2017) of 52.224-3.

(xix) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).

(xx) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6.

(xxi) 52.247-64, Preference for Privately-Owned U.S. Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64.

(2) While not required, the contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.

(End of Clause)

52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor no later than 30 calendar days.

Note: Since these services will be performed strictly in the country of Japan, the contractor is required to follow the labor standard of Japan. The rate will be adjusted as a result of revisions to prevailing labor rates provided by the Secretary of Labor, as applicable to contracts performed in the United States. Therefore, payment shall be made at the rates specified for the period of performance immediately preceding the period of extended services.

(End of clause)

52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor no later than 30 calendar days; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 calendar days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed five

(5) years and six (6) months.

DFARS 252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013)

(a) Definitions. As used in this clause--

Department of Defense Activity Address Code (DoDAAC) is a six position code that uniquely identifies a unit, activity, or organization.

Document type means the type of payment request or receiving report available for creation in Wide Area WorkFlow (WAWF).

Local processing office (LPO) is the office responsible for payment certification when payment certification is done external to the entitlement system.

(b) Electronic invoicing. The WAWF system is the method to electronically process vendor payment requests and receiving reports, as authorized by DFARS 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) WAWF access. To access WAWF, the Contractor shall--

(1) Have a designated electronic business point of contact in the System for Award Management at https://www.acquisition.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this Web site.

(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the “Web Based Training” link on the WAWF home page at https://wawf.eb.mil/.

(e) WAWF methods of document submission. Document submissions may be via Web entry, Electronic Data Interchange, or File Transfer Protocol.

(f) WAWF payment instructions. The Contractor must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order:

(1) Document type. The Contractor shall use the following document type(s).

Invoice 2-in-1 DO NOT SUBMIT STAND-ALONE OR OTHER INVOICE TYPE

(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WAWF, as specified by the contracting officer.

N/A

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table* Field Name in WAWF Data to be entered in WAWF Pay Official DoDAAC F87700 Issue By DoDAAC FA5205 Admin DoDAAC FA5205 Inspect By DoDAAC FA5205 / F3D4A1 Ship To Code FA5205 / F3D4A1 Ship From Code N/A Mark For Code N/A Service Approver (DoDAAC) N/A Service Acceptor (DoDAAC) N/A Accept at Other DoDAAC N/A LPO DoDAAC N/A DCAA Auditor DoDAAC N/A Other DoDAAC(s) N/A

(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request.

(5) WAWF email notifications. The Contractor shall enter the email address identified below in the “Send Additional Email Notifications” field of WAWF once a document is submitted in the system.

miyabi.wada@us.af.mil michiko.yoshizawa.jp@us.af.mil

(g) WAWF point of contact. (1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact.

35th Contracting Squadron, Misawa Air Base, Japan Email: michiko.yoshizawa.jp@us.af.mil Contracting Officer: Mr. Mutsuo Shibasaki Contract Administrator: Michiko Yoshizawa

(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

AFFARS 5352.201-9101 OMBUDSMAN (JUN 2016)

(a) An ombudsman has been appointed to hear and facilitate the resolution of concerns from offerors, potential offerors, and others for this acquisition. When requested, the ombudsman will maintain strict confidentiality as to the source of the concern. The existence of the ombudsman does not affect the authority of the program manager, contracting officer, or source selection official. Further, the ombudsman does not participate in the evaluation of proposals, the source selection process, or the adjudication of protests or formal contract disputes. The ombudsman may refer the interested party to another official who can resolve the concern.

(b) Before consulting with an ombudsman, interested parties must first address their concerns, issues, disagreements, and/or recommendations to the contracting officer for resolution. Consulting an ombudsman does not alter or postpone the timelines for any other processes (e.g., agency level bid protests, GAO bid protests, requests for debriefings, employee-employer actions, contests of OMB Circular A-76 competition performance decisions).

(c) If resolution cannot be made by the contracting officer, the interested party may contact the ombudsman, Air Force Installation Contracting Agency (AFICA)/KP Director, 1940 Allbrook Drive, Building 1, Write- Patterson AFB OH 45433, Phone: (937)257-5529, Fax: (937)656-0919. Concerns, issues, disagreements, and recommendations that cannot be resolved at the Center/MAJCOM/DRU/SMC ombudsman level, may be brought by the interested party for further consideration to the Air Force ombudsman, Associate Deputy Assistant Secretary (ADAS) (Contracting), SAF/AQC, 1060 Air Force Pentagon, Washington DC 20330-1060, phone number (571) 256-2395, facsimile number (571) 256-2431.

(d) The ombudsman has no authority to render a decision that binds the agency.

(e) Do not contact the ombudsman to request copies of the solicitation, verify offer due date, or clarify technical requirements. Such inquiries shall be directed to the Contracting Officer.

AFFARS 5352.242-9000 CONTRACTOR ACCESS TO AIR FORCE INSTALLATIONS (NOV 2012)

(a) The contractor shall obtain base identification and vehicle passes, if required, for all contractor personnel who make frequent visits to or perform work on the Air Force installation(s) cited in the contract. Contractor personnel are required to wear or prominently display installation identification badges or contractor-furnished, contractor identification badges while visiting or performing work on the installation.

(b) The contractor shall submit a written request on company letterhead to the contracting officer listing the following: contract number, location of work site, start and stop dates, and names of employees and subcontractor employees needing access to the base. The letter will also specify the individual(s) authorized to sign for a request for base identification credentials or vehicle passes. The contracting officer will endorse the request and forward it to the issuing base pass and registration office or Security Forces for processing. When reporting to the registration office, the authorized contractor individual(s) should provide a valid driver’s license, current vehicle registration, valid vehicle insurance certificate, and 35FW Form 54, Application for Vehicle Registration to obtain a vehicle pass.

(c) During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel and for prompt return of credentials and vehicle passes for any employee who no longer requires access to the work site.

(d) When work under this contract requires unescorted entry to controlled or restricted areas, the contractor shall comply with AFI 31-101, Integrated Defense, and AFI 31-501, Personnel Security Program Management.

(e) Upon completion or termination of the contract or expiration of the identification passes, the prime contractor shall ensure that all base identification passes issued to employees and subcontractor employees are returned to the issuing office.

(f) Failure to comply with these requirements may result in withholding of final payment.

AFFARS 5352.242-9001 COMMON ACCESS CARDS (CAC) FOR CONTRACTOR PERSONNEL (NOV

2012)

(a) For installation(s)/location(s) cited in the contract, contractors shall ensure Common Access Cards (CACs) are obtained by all contract or subcontract personnel who meet one or both of the following criteria:

(1) Require logical access to Department of Defense computer networks and systems in either:

(i) the unclassified environment; or

(ii) the classified environment where authorized by governing security directives.

(2) Perform work, which requires the use of a CAC for installation entry control or physical access to facilities and buildings.

(b) Contractors and their personnel shall use the following procedures to obtain CACs:

(1) Contractors shall provide a listing of personnel who require a CAC to the contracting officer. The government will provide the contractor instruction on how to complete the Contractor Verification System (CVS) application and then notify the contractor when approved.

(2) Contractor personnel shall obtain a CAC from the nearest Real Time Automated Personnel Identification Documentation System (RAPIDS) Issuing Facility (typically the local Military Personnel Flight (MPF)).

(c) While visiting or performing work on installation(s)/location(s), contractor personnel shall wear or prominently display the CAC as required by the governing local policy.

(d) During the performance period of the contract, the contractor shall:

(1) Within 7 working days of any changes to the listing of the contract personnel authorized a CAC, provide an updated listing to the contracting officer who will provide the updated listing to the authorizing government official; (2) Return CACs in accordance with local policy/directives within 7 working days of a change in status for contractor personnel who no longer require logical or physical access;

(3) Return CACs in accordance with local policy/directives within 7 working days following a CACs expiration date; and

(4) Report lost or stolen CACs in accordance with local policy/directives.

(e) Within 7 working days following completion/termination of the contract, the contractor shall return all CACs issued to their personnel to the issuing office or the location specified by local policy/directives.

(f) Failure to comply with these requirements may result in withholding of final payment.

ADDENDA TO FAR 52.212-1

The following is inserted as new paragraph (m) of the provision:

“(m) Proposal Preparation Instructions.

A. To assure timely and equitable evaluation of proposals, offerors must follow the instructions contained herein.

Offerors are required to meet all solicitation requirements, including terms and conditions, representations and certifications, and technical requirements, in addition to those identified as evaluation factors. Offerors must clearly identify any exception to the solicitation terms and conditions and provide complete accompanying rationale.

B. Specific Instructions: Offeror shall submit the original copy of the following:

(1) Request for Quote (RFQ) page 1:

a. Complete company information

b. Insert price information

(2) Acknowledgement of all amendments, if issued.

(3) RFQ Attachment 2, Representation and Certifications: Complete the necessary fill-ins and certifications

(4) Past Performance Information: Provide a listing of no more than three (3) of the most relevant and current contracts performed for any customer (ref. Addendum to FAR 52.212-2, paragraph (d)A).

a. Furnish the following information for each contract listed:

Block # Description 1 Name and address of Prime Contractor 2 Exact title of Contract/Service, and Contract Number 3 Name and address of contracting activity 4 Name and title of person to contact at the contracting activity 5 Phone and Email address of the POC in block 4 6 Brief service description including discussion as to its relevancy to this acquisition 7 Dollar amount of service in Block 2 (include price for base plus all options).

8 Period of performance and final contract completion date of service.

9 Place of Performance.

b. If an offeror has no past performance history of relevance, the offeror must affirmatively state it possesses no past performance histroy of relevance.

c. The evaluation of past performance information (i) will take into account past performance regarding predecessor companies, and/or (ii) will take into account past performance regarding subcontractors that will perform major aspects of the requirement identified in PWS paragraph 2, or the requirement involving referral management at medical facilities in similar magnitude of effort that this solicitation requires when such information is relevant to this acquisition.

d. If a teaming arrangement is contemplated, provide complete information as to the arrangement, including any relevant and recent past performance information on previous teaming arrangements with same partner. If this is a first time joint effort, each party to the arrangement must provide a list of past contracts of relevance. The government will evaluate not more than five (5) past performances for each party of a first time joint effort.

e. Subcontractor Consent: Past performance information pertaining to a subcontractor cannot be disclosed to the prime offeror without the subcontractor’s consent. Provide with the proposal a letter from each subcontractor that will perform major aspects of the requirement, identified in PWS para. 1, consenting to the release of its past performance information to the prime contractor.

(5) Performance Surveys: Past Performance Questionnaire (PPQ, RFQ Attachment 3) shall be used by the offerors in providing past performance quality information to the government. The government requires the offeror send out a PPQ to each Point of Contact (POC) identified in the Past Performance Information (ref.

paragraph B.(4) above).

a. The offeror shall send out the PPQ to each POC of PPI references.

b. Once the questionnaires are completed by the POCs, the information contained therein will be considered source selection sensitive and will not be released outside the government. The POCs shall forward their completed questionnaires directly to the government, not back to the offeror.

c. PPQ shall be sent directly from offeror’s reference to this office, marked to the attention of Ms. Michiko

Yoshizawa, via email to michiko.yoshizawa.jp@us.af.mil by the RFQ closing date.

(6) Qualification Requirement: The contractor shall submit documentation that demonstrates Qualification

Requirements for (an) individual(s) working under the subject contract, specified in paragraph 4 of the PWS, which is a special standard of contractor responsibility IAW FAR Part 9.104-2. Those personal qualifications are not the evaluation factor of this solicitation; however, it will be used in the determination of contractor responsibility. Please ensure that each individual working under the subject contract must have the qualifications listed in the PWS paragraph 4.

a. Personal Education. Minimum of graduation from a State Board of Nursing approved LPN/LVN training program or completion of equivalent United States military training that permits sitting for a state licensure examination. Offeror shall submit a copy of diploma.

b. Personal Licensure. A current, valid and unrestricted license in one of the 50 states and/or the District of

Columbia, the Commonwealth of Puerto Rico, or territories of the United States. All licenses must meet all state requirements, be unencumbered and remain in effect during contract employment. The contractor must be in good standing, and under no restrictions, with the state or national licensure board in any state in which a license is held or has been held within the last ten (10) years. Offeror shall submit a copy of current and valid nurse license.

c. Employment Agreement. The offeror shall have an employment agreement with the individual(s) who meet the qualification requirements mentioned in PWS paragraph 4 to support offeror’s capability to provide service beginning 1 Oct 2018. Offeror shall submit a copy of the agreement.

C. Documents submitted in response to this RFQ must be consistent with the following:

(1) Requirements of the solicitation (CLINs and PWS) and government standards and regulations pertaining to the PWS.

(2) FAR 52.212-2, Evaluation – Commercial Items, of this solicitation.

D. Information regarding submission of proposals:

(1) Hand carried or mailed proposals must be delivered to the following address:

35th Contracting Squadron, Attn: Ms. Michiko Yoshizawa Bldg. 656, Misawa AB, Japan

(2) The sealed envelope or package used to submit your proposal must show the time and date specified for receipt, the solicitation number, and the name and address of the offeror.

(3) Offerors are cautioned that Misawa AB, Japan has visitor control procedures requiring individuals not affiliated with the installation to obtain a visitor pass prior to entrance. SOME DELAY SHOULD BE EXPECTED WHEN HAND-CARRYING PROPOSALS. Offerors should allow sufficient time to obtain a visitor pass and arrive at the bid depository prior to the time specified for receipt. Late proposals will be processed in accordance with FAR 52.215-1(f), “Late submission, modifications, revisions, and withdrawals of offers.”

(4) FEDERAL HOLIDAYS: The following Federal Legal Holidays are observed by this base:

New Year’s Day 1 January Birthday of Martin Luther King Third Monday in January Washington’s Birthday Third Monday in February Memorial Day Last Monday in May Independence Day 4 July Labor Day First Monday in September Columbus Day Second Monday in October Veterans Day 11 November Thanksgiving Day Fourth Thursday in November Christmas Day 25 December

(End of addenda)

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

(a) The government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the government, price and other factors considered.

The following factors will be used to evaluate offers:

(1) Past Performance, and

(2) Price

(b) Options. The government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options will not obligate the government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, will result in a binding contract without further action by either party. Before the offer's specified expiration time, the government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

ADDENDA TO FAR 52.212-2

The following is inserted as new paragraph (d) of the provision:

“(d) BASIS FOR CONTRACT AWARD: This is a best value source selection conducted in accordance with FAR 12 and 13. By submission of its offer, the offeror accedes to all solicitation requirements, including terms and conditions, representations and certifications, and technical requirements, in addition to those identified as evaluation factors. All offers will be treated equally except for their prices and performance records. Failure to meet a requirement may result in an offer being determined unacceptable. The evaluation process will include the following:

A. Past Performance Factor. The government will evaluate recent and relevant performance information on all offerors based on (i) the references provided by the offeror, and (ii) any past performance information obtained from survey/questionnaires (RFQ Attachment 3), and (iii) any data independently obtained by the government. If a reference identified by the offeror in accordance with 52.212-1(m)B.4, does not submit a survey/questionnaire, the government will follow up with the referenced POC, but it is not responsible for the failure of a reference POC to provide a survey/questionnaire.

(1) Recent past performance information includes contracts performed and/or being performed for any customer within the last five (5) years prior to the issuance date of the solicitation.

(2) Relevant contracts performance effort involved similar scope, magnitude of effort, and complexities to that required by this solicitation. The government will assess relevancy for each contract and assign a rating as described below:

Past Performance Relevancy Rating

Rating Definition

Relevant Present/past performance effort involved similar scope and magnitude of effort and complexity this solicitation requires.

Not Relevant Present/past performance effort involved some, little or none of the scope and magnitude of effort and complexities this solicitation requires.

(3) Performance Quality Assessment: For each of the recent and relevant past performance information reviewed, the performance quality of work will be assessed based on the (i) Quality Assessment Criteria evaluated under Past Performance Questionnaires (PPQs)(RFQ Attachment 3) and (ii) the evaluation rating in the Federal Past Performance Information Retrieval System (PPIRS), if available. Each recent and relevant past performance information reviewed will be assigned a rating as described below:

Quality Assessment Rating

Rating Definition

Satisfactory During the contract period, contractor performance is meeting (or met) contract requirements. For any problems encountered, contractor took effective corrective action.

Unsatisfactory

During the contract period, contractor performance is not meeting (or did not meet) contract requirements. For any problems encountered, corrective action appeared only marginally effective, not effective, or not fully implemented. Customer involvement was required.

The past performance evaluation is an assessment of the offeror’s probability of meeting the solicitation requirements. Offerors must receive a past performance rating of “Acceptable” to be eligible for award. For offerors in a teaming arrangement where two or more companies form a partnership or joint venture (JV), the following will apply: (i) for a JV at least one partner must be rated “Acceptable;” and (ii) for prime-subcontractor(s) partnerships, the prime must be rated “Acceptable” in order for the partnership to be rated “Acceptable” as a whole.

As a result of the recency, relevancy, and performance quality assessments, offerors will receive an integrated past performance rating as described in below table:

Past Performance Evaluation Rating

Rating Definition

Acceptable Based on the offeoror's performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offror's performance record is unknown.

Unacceptable Based on the offeror’s performance record, the Government does not have a reasonable expectation that the offeror will be able to successfully perform the required effort.

Note: In the case of an offeror without a record of relevant past performance or for whom information on past performance is not available or so sparse that no meaningful past performance rating cannot be reasonably assigned, the offeror may be evaluated “unacceptable” on past performance.

B. Price Evaluation Factor. The government will rank all offers by price, including all option prices. The price evaluation will document the fairness and reasonableness of the TEP.

Total Evaluated Price (TEP): A TEP will be computed for each offer in order to meet the requirements of FAR Parts 6 and 17. The price of a six-month extension authorized by 52.217-8, Option to Extend Services, will be added to the proposed price for each potential contract performance period.

The TEP is a two-part computation. First, the offeror’s total proposed price will be determined by multiplying the quantities identified in the Pricing Schedule by the proposed unit price, limited to two decimal places, for each Contract Line Item Number (CLIN) to confirm the extended total amount for each CLIN; the sum of all extended amounts will be the offeror’s total proposed price. Second, the total proposed price (total amount for CLINs 0001

– 4001) plus the sum of Option to Extend Services clause 52.217-8 formula will constitute the TEP.

The formula for the Option to Extend Services amount is as follows:

Base Year = CLIN Unit Amount x 6 Option Year 1 = CLIN Unit Amount x 6 Option Year 2 = CLIN Unit Amount x 6 Option Year 3 = CLIN Unit Amount x 6 Option Year 4 = CLIN Unit Amount x 6

Evaluating the Option CLINs does not obligate the government to exercise the Options

C. Offerors are cautioned to submit sufficient information and in the format specified in 52.212-1, Instructions to Offerors – Commercial Items, of this solicitation. Offerors may be asked to clarify certain aspects of their proposals. Exchanges conducted to resolve minor or clerical errors will not constitute discussions and the contracting officer reserves the rightto award a contract without the opportunity for proposal revision. The government intends to award a contract without discussions with respective offerors. The government, however, reserves the right to conduct discussions if deemed in its best interest.

1. Award will be made to the lowest priced offer, based on TEP, which meets the acceptability standards for non-price factors.”

(End of addenda)

Attachment Table of Contents

1. Performance-based Work Statement (PWS)

2. Representations and Certifications

3. Past Performance Questionnaire

Attachment 1, PWS RFQ No. FA520518QMG10

Performance-based Work Statement (PWS)

For

Referral Management Center (RMC) Nurse

Licensed Practical/Vocational Nurse (LPN/LVN) For 35th Medical Group, Misawa AB, Japan.

Non-Personal Service

35TH CONTRACTING SQUADRON

MISAWA AIR BASE, JAPAN

Date: 3 Jul 18

TABLE OF CONTENTS

Para No.

Description Page

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION……………………... 3

2. SCOPE OF WORK…………………………………………………………………… 3

3. SPECIFIC DUTIES…………………………………………………………………... 4

4. REQUIRED QUALIFICATIONS……………………………………………………. 5

5. SUPERVISION RECEIVED…………………………………………………………. 6

6. HOURS OF OPERATION…………………………………………………………… 6

7. WORK SCHEDULE…………………………………………………………………. 6

8. INSTALLATION SECURITY NOTICE TO EMPLOYEES………………………... 8

9. SECURITY REQUIREMENTS……………………………………………………… 8

10. PERFORMANCE EVALUATION MEETINGS…………………………………….. 9

11. SPECIAL REQUIREMENTS………………………………………………………... 10

12. HEALTH REQUIREMENTS………………………………………………………… 10

13. PROFESSIONAL LIABILITY RESPONSIBILITY/MEDICAL MALPRACTICE… 11

14. CONTRACTOR EMPLOYEE……………………………………………………….. 11

15. TRAINING…………………………………………………………………………… 12

16. SERVICES SUMMARY……………………………………………………………... 13

17. GOVERNMENT FURNISHED PROPERTY AND SERVICES……………………. 13

18. APPLICABLE PUBLICATIONS AND FORMS……………………………………. 15

19. DEPARTMENT OF DEFENSE (DOD) REGULATIONS/MANUALS

INSTRUCTIONS/DIRECTIVES……………………………………………………..

20. AIR FORCE INSTRUCTIONS………………………………………………………. 17

21. OTHER REFERENCES……………………………………………………………… 18

1. DESCRIPTION OF SERVICES/GENERAL INFORMATION. This is non-personal service contract. The Government requires one (1) Full Time Equivalent Nurse for this contract within the 35th Medical Group (MDG), Misawa Air Base, Japan. Contractor shall furnish all supervision and labor necessary to provide services in accordance with the requirements contained in this Performance Work Statement (PWS) and the professional standards, policies and guidelines of the 35 MDG, The Joint Commission (TJC), and all Air Force Instructions (AFIs) and regulations.

2. SCOPE OF WORK. Contractor employee shall competently perform all tasks IAW AFI 44- 176, Access to Care Continuum, AFI 44-173, Population Health and Medical Management, and AFI 44-170, Patient-Centered Medical Home (PCMH) Operations, ensuring all suspenses are met; documentation produced is legible, accurate, and professionally written, and all patient identifying information is protected. The contractor shall have functioning knowledge of Military Health System (MHS) Referral Management Business Rules (Air Force Medical Service RMC Guide), government appointing information systems, DoD Health Information Privacy Regulation (DoD 6025.18-R), the Privacy Act and DoD Privacy Program (DoD 5400.11-R). The general scope of work under this contract includes: Providing clerical/administrative support in the RMC for customer service, referral tracking, referral appointing, and reporting activities. This position will support the daily functions of specialty care referral appointing, referral review and coordination, beneficiary counseling and referral tracking at the Medical Treatment Facility (MTF). Ensuring Referral Management (RM) activities comply with Referral and Authorization Business rules, tracking, accounting and resulting of referrals and full use of RM information systems. Contractor employee will conduct reviews for medical necessity, pre-authorization, medical appeals, collection and recovery from insurance carries and Right of First Refusal activities. Assisting the Utilization Management activities in the RMC.

2.1. Reviews referrals for administrative, clinical completeness and appropriateness in coordination with the Chief, Medical Staff (SGH) or deputy SGH. Completes medical necessity and benefit reviews on referrals and makes recommendations to the MTF approval authority for approval/disapproval of the specialty care requested. Coordinates with the TRICARE Overseas Program contractor as needed to determine availability of local care.

2.2. Schedules referral appointments in accordance with Air Force Access to Care (ATC) standards with DoD and civilian health care providers. Ensures appointing is done within the Access to Care standards. Notifies the MTF group practice manager, TRICARE Operations and Patient Administration Flight or SGH if ATC standards are not met for referrals.

2.3. Coordinates with specialty referral clinics to obtain special patient instructions and/or tests required prior to appointment. Provides pre-appointment instructions to patients as well as the details regarding their referral appointment (i.e., date/time, provider, and location). Ensures patients receive necessary documentation appropriate for the referred medical care visit.

2.4. Interfaces with the TRICARE Overseas Program contractor, SGH and multidisciplinary personnel as needed to ensure appropriateness of referrals. Submits referrals from civilian providers to the TRICARE Service Center (TSC) for medical necessity and appropriateness review.

2.5. Locates referral requests and ensures appropriate documents are available prior to all specialty appointments. Prints diagnostic reports and/or treatment profiles as necessary.

2.6. Receives and makes patient telephone calls and computer/written correspondence regarding specialty clinic appointments and referrals. Routinely monitors referral management CHCS queue to ensure patients are being called that do not utilize the Referral Management Center (RMC) walk-in service.

2.7. Contacts patients in the event referral requests are invalid, disapproved by second level review or TRICARE Overseas Program contractor and reschedules patients as soon as possible or instructs patients of other health care options.

2.8. Answers, completes and/or appropriately forwards patient or provider telephone calls.

2.9. Coordinates with patient movement office to advise patients of their referral/health treatment options as related to their eligibility per beneficiary status and covered benefits.

2.10. Verifies eligibility of beneficiaries using Defense Eligibility Enrollment Reporting System

(DEERS).

2.11. Works in collaboration with TRICARE Operations and Patient Administration (TOPA) staff, providers, utilization manager (UM), case managers (CM), disease management (DM) nurses, special needs coordinator, health care integrator and group practice manager to determine measures to target and manage enrollees and/or processes that relate to high-cost, high-volume or problem-prone diagnoses, procedures, services and beneficiaries who have demonstrated high utilization rates. Uses the TRICARE Management Activity Medical Management Guide in performance of these duties.

3. SPECIFIC DUTIES.

3.1. Documentation. The contractor shall prepare all medical documentation to meet or exceed the standards required under applicable Air Force Instructions and the Joint Commission (TJC) guidelines. The Department of Defense’s electronic medical record system, Armed Forces Health Longitudinal Technology Application (AHLTA), shall be used for all patient encounters.

The contractor shall utilize applicable adjunct local electronic systems to document non-encounter patient information, as required by applicable guidelines/processes

3.2. Work Environment/Physical Requirements. The work is primarily sedentary. However, there may be some physical demands. Requirements include standing, sitting or bending.

Individual is required to walk throughout facility to interact with staff and providers including transport of relevant documents.

3.3. Information Technology Systems (ITS). CHCS, AHLTA, CarePoint and the Integrated Clinical Database (ICDB) programs must be used for case management services. The MTF will provide system accounts/access to contractor employee after required training and security procedures have been completed by the contractor. The contractor shall comply with DoD communication and information technology security standards and policies. Initial and ongoing ITS training is necessary and provided by the Government.

3.4. Utilizes MTF performance improvement tools in data collection and identifies barriers to the achievement of improvement in multidisciplinary treatment teams and/or clinical programs.

Seeks assistance from the MTF’s Quality/Performance Improvement Manager and other case managers as needed.

3.5. Complies with requirements, and assists clinical programs and treatment teams in preparation for The Joint Commission (TJC), National Committee for Quality Assurance accreditations; the Air Force Inspection Agency Health Service Inspection; Air Force Audit Agency audits and other internal or external reviews, as applicable. Implements and monitors follow-up recommendations for corrective actions.

3.6. Must comply with Air Force Equal Opportunity and safety policies and procedures.

3.7. Additional Knowledge. The contractor must be capable of performing the full range of services commensurate with the degree and/or professional license held. The contractor must have a working knowledge of Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), International Classification of Diseases-Version 9 (ICD-9), Current Procedural Terminology-Version 4 (CPT-4) coding and InterQual or Milliman Ambulatory Care Guidelines. Working knowledge of computer applications/software to include the Windows Operating System, Microsoft Office word processing, database and spreadsheet programs and internet familiarity is required. The ability to input, extract and format data from multiple electronic sources is also required

4. REQUIRED QUALIFICATIONS:

4.1. Experience. Minimum of six (6) months of clinical nursing experience within the last 5 years is required.

4.2. Education. The minimum education requirement is graduation from a State Board of Nursing approved LPN/LVN training program or completion of equivalent United States military training that permits sitting for a state licensure examination.

4.3. Licensure. Must possess a current, valid and unrestricted license in one of the 50 states and/or the District of Columbia, the Commonwealth of Puerto Rico, or territories of the United States. All licenses must meet all state requirements, be unencumbered and remain in effect during contract employment. The contractor must be in good standing, and under no restrictions, with the state or national licensure board in any state in which a license is held or has been held within the last 10 years.

5. SUPERVISION RECEIVED:

5.1. Direct: The contractor is responsible to supervise its own employee(s). None of MDG personnel supervise the contractor.

6. HOURS OF OPERATION. The contractor’s normal duty days and hours are Monday- Friday, 0730-1630 hours, with an hour for lunch. The following is a list of legal Federal holidays and services are not provided:

- New Year's Day 1st of January

- Martin Luther King's Birthday 3rd Monday of January

- President's Day 3rd Monday of February

- Memorial Day Last Monday of May

- Independence Day 4th of July

- Labor Day 1st Monday of September

- Columbus Day 2nd Monday of October

- Veteran's Day 11th of November

- Thanksgiving Day 4th Thursday of November

- Christmas Day 25th of December

NOTE: Any of the above holidays falling on a Saturday will be observed on the preceding Friday; holidays falling on a Sunday will be observed on the following Monday. The Government may add additional family days in conjunction with these holidays which may result in MTF closures.

7. WORK SCHEDULE. The contractor will be required to perform 40 hours per week during normal clinic business hours in accordance with para. 6 above. If the contractor cannot perform in accordance with the schedule approved by COR, the contractor shall promptly report to the Contracting Officer (CO) for resolution. No shows or sudden disappearances may be cause for termination. The MTF will coordinate the appointment templates with the contractor. The contractor may be required to work more than 8 hours in a single day or 40 hours in a week, as determined by the COR based on the needs of the MTF. If additional hours are worked, the Government will reduce future scheduled hours to maintain a 40 hour work week average. All hours worked will be recorded accurately on the work schedules. Under no circumstances are the work schedules to reflect hours worked when the contractor was absent or vice versa.

7.1. Non-Duty Days. The contractor employee will not be required to perform on government non-duty days or other times when the MTF may be closed such as Pacific Air Forces (PACAF) family days.

7.2. Closures. The contractor employee shall not come in to work if the commander determines the base is closed due to snow, hurricane, or acts of God.

7.3. Performance of Services During Crisis Declared by the National Command Authority or Overseas Combatant Commander.