PWS_Waste_Disposal_23_Oct_14.pdf

AIR FORCE MEDICAL OPERATIONS AGENCY

PERFORMANCE WORK STATEMENT

FOR

AIR FORCE DRUG TESTING LABORATORY WASTE DISPOSAL SERVICES

23 October 2014

TABLE OF CONTENTS

Page

1.0 DESCRIPTION OF SERVICES 3

1.1 Background 3

1.2 Scope 3

1.3 Acronyms 3

2.0 SUMMARY OF REQUIREMENTS 4

2.1 Description of Service 4

2.2 General Contract Personnel Requirements 5

2.3 Services Summary 7

2.4 Government Furnished Support 8

2.5 Deliverables 8

3.0 QUALITY CONTROL PLAN 10

4.0 NON PERSONAL SERVICES 10

5.0 CONTRACTOR IDENTIFICATION 10

6.0 HOURS OF OPERATION 10

7.0 APPENDICES 10

7.1 APPENDIX A: Health Insurance Portability & Accountability Act (HIPAA)11 of 1996

7.2 APPENDIX B: HQ USAF/SGR Organizational Conflict of Interest (COI) 16

7.3 APPENDIX C: HQ USAF/SG Non-Disclosure Agreement 19

7.4 APPENDIX D: Customer Complaint Record 22

1.0 DESCRIPTION OF SERVICES

1.1 Background: The Air Force Medical Operations Agency (AFMOA) is responsible for optimizing the health, safety, and performance of the U.S. Air Force Medical Services (AFMS).

Its mission covers a broad range of programs including medical operations support to include forensic drug testing. Contract service is required to properly remove and destroy medical waste accrued to the normal course of drug testing operations.

1.2 Scope: The Air Force Drug Testing Lab (AFDTL) disposes of approximately 1,000,000 urinalysis samples annually. A sample consists of a 105 mL round capped bottle, 15 to 90 mL of urine, and less than 5 grams of labels and seals. The labels contain social security numbers.

This may add up to 270,000 pounds of medical waste annually. The AFDTL is able to handle medical waste containers of 96 gallon capacity. These containers contain a maximum of 500 lbs of waste, but on average contain only 320 lbs of waste. The AFDTL expects to dispose of 1100 containers of such waste per year. On site disposal and destruction of excess sample collection bottles is not feasible due to manpower requirements and facility limitations. The AFDTL requires services for this medical and personally identifiable information (PII) waste disposal.

1.3 Acronyms

ACRONYMS

ACRONYM DEFINITIONS

AF Air Force AFDTL Air Force Drug Testing Laboratory AFMS Air Force Medical Service AFMOA Air Force Medical Operations Agency CFR Code of Federal Regulations CO Contracting Officer COR Contracting Officer Representative DoD Department of Defense DoDD Department of Defense Directive FAR Federal Acquisition Regulation HIPAA Health Insurance Portability and Accountability Act of 1996 HQ USAF/SG Headquarters United States Air Force Surgeon General IAW In Accordance With NAC National Agency Check NDA Non-Disclosure Agreement OCI Organizational Conflict of Interest PA Privacy Act PII Personally Identifiable Information POC Point of Contact PWS Performance Work Statement

2.0 SUMMARY OF REQUIREMENTS:

2.1 Description of Service—Medical Waste Disposal Services. The Contractor shall provide competent personnel for the completion of the tasks below:

2.1.1 Provide reusable containers (96 gallon) for disposal of sample collection bottles

2.1.1.1 Containers shall be marked with biohazard identification markings to comply with local, federal and other governing laws, regulations, policies and directives.

2.1.1.2 A minimum of 20 containers will reside at the AFDTL at any given time.

2.1.1.3 No more than 20 empty containers shall be left at the AFDTL at any given time.

2.1.1.4 Clean and sanitize containers upon issue and re-issue.

2.1.2 Contractor shall remove up to 20 containers with discarded sample collection bottles up to 3 times per week. Containers will contain, on average, 320 lbs of waste.

Containers will not contain more than 500 pounds of waste. The contractor and AFDTL will agree on the number of containers of waste removed when the service is performed.

2.1.2.1 Provide a sufficient number of containers within 1 business day of notification to collect all discarded sample collection bottles should more than 20 containers be required.

2.1.2.2 Provide drivers possessing qualifications to enter onto Lackland AFB

2.1.2.3 Contact the AFDTL point of contact (POC) if a regularly scheduled pick up occurs on a national holiday to determine if a pickup will be changed to an alternate day mutually agreed upon by the contractor and AFDTL or if the scheduled shipment will be skipped.

2.1.2.4 Respond to AFDTL request for no service for a time designated by the

AFDTL if lab or base access is suspended for work, safety or security reasons beyond the control of the AFDTL. Contractor shall be prepared to respond to

QC Quality Control SAF Secretary of the Air Force SG Surgeon General SI Sensitive Information no-notice base closures and contact AFDTL POC for alternate pick-up arrangements.

2.1.3 Properly and sufficiently destroy all data on discarded sample collection bottles.

2.1.3.1 Data on the discarded sample collection bottles is on the top of the collection bottle cap and around the sides of the collection bottle. These data include service member social security number and other identifying information.

2.1.3.2 Contractor shall comply with all local, federal and other laws, regulations, policies and directives concerning the destruction and disposition of Privacy Act (PA) data and PII.

2.1.3.2.1 Contractor shall provide, in writing, the method and process for destruction of this data and information at the beginning of the base year and each option year of the contract.

2.1.3.2.2 Contractor shall certify, in writing, compliance with their proposed destruction method and process at the beginning of the base year and each option year of the contract..

2.1.3.2.3 Contractor shall maintain records of this destruction in accordance with governing laws, regulations, policies and directives.

2.1.4 Properly and sufficiently destroy all data on discarded sample collection bottles.

2.1.4.1 Do not use urine for any purpose other than disposal.

2.1.4.2 Contractor shall provide, in writing, the method and process for disposal of urine at the beginning of the base year and each option year of the contract..

2.1.4.3 Contractor shall certify, in writing, compliance with their proposed disposal method and process at the beginning of the base year and each option year of the contract.

2.1.5 Contractor shall be prepared to provide service within 1 business day of contract award.

2.2 GENERAL CONTRACTOR PERSONNEL REQUIREMENTS. The contractor shall provide personnel that meet the following requirements:

2.2.1 Contractor personnel shall know how to read, understand, speak, and write the English language.

2.2.2 Contractor shall not employ persons for work on this contract if identified to the contractor as a potential threat to health, safety, security, general well-being or operational mission of the installation and its population.

2.2.3 Contractor shall be responsible for Personnel Security. Documentation required for security certification shall be the responsibility of the contract and the client organization.

Data items will not contain classified data. However, proper disposal of PA information will be required.

2.2.4 Work performed under this contract is unclassified. However, the technical and medical privacy data used within the scope of this contract requires adherence to security/privacy requirements imposed by the Government, DoD, AF and other applicable security clearance requirements as applicable to this contract. The contractor shall handle and protect all data as directed and implemented by the AFMSA enterprise and its implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

(Appendix A)

2.2.5 Contractor personnel shall not release any personal or medical/patient information to include patient personal health information, during the course of this contract. Handle information in accordance with (IAW) the following items that the Government will provide upon request:

2.2.5.1 The Privacy Act of 1974 (5 U.S.C. § 552a), which includes Public Law 100- 503, Department of Defense Directive (DoDD) 5400.11, and DoDD 5400.11-R and must be treated as FOR OFFICIAL USE ONLY.

2.2.5.2 The Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), which includes DoD 6025.18-R and is FOR OFFICIAL USE ONLY.

(Appendix A)

2.2.5.3 Other Military Health Services, AFMOA, Federal and State laws may also be applicable.

2.2.5.4 Contractor shall provide signed Non-disclosure agreements to the Contracting Officer’s Representative (COR) for each contractor personnel. (Appendix C)

2.2.5.5 Contractor shall provide patient information only to Government employees, Government Contractor, and subcontractors having a need-to-know such information in performance of their duties for this project as approved by the COR or Contracting Officer (CO).

2.2.5.6 Contractor shall keep the COR informed of issues dealing with the security clearances and/or other certifications. No foreign national candidates shall be utilized within the scope of this contract without prior approval of the Government.

2.2.6 Contractor shall be responsible for ensuring personnel security to include, but not limited to, meeting the following requirements:

2.2.6.1 Initiate, maintain, and document minimum personnel security investigations appropriate to the individual’s responsibilities and access to DoD Sensitive Information

(SI).

2.2.6.2 Immediately report to the appropriate government representative contractor personnel filling a sensitive position receive an unfavorable National Agency Check (NAC) adjudication, or if information that would result in an unfavorable NAC becomes available. Notify the Privacy Office within 5 working days if at any time contractor personnel has privileges revoked to DoD data or system data because of security concerns.

2.2.7 Physical Security: The Contractor shall be accountable for control of Government property IAW AFJI 31-102. The Contractor is also responsible for the protection of any contractor-owned equipment or supplies brought onto the installation IAW AFJI31-102.

Further, the Contractor shall not remove any Government property from the installation outside the scope of the contract.

2.2.8 Installation Entry: The Contractor shall comply with established security procedures for entering the installation and its facilities to include any special security procedures established for entry to restricted areas or mission essential or vulnerable areas.

2.2.9 Denial of Entry: Government reserves the right to terminate entry of any contractor personnel upon disclosure of information that indicates the individual’s continued entry to the installation is not in the best interest of the national security. Additionally, violation of or deviation from established security procedures by contractor personnel may result in confiscation of identification media and denial of future entry to the installation.

2.2.10 Conduct of Contractor Personnel:

2.2.10.1 Contractor personnel will be required to observe all base and facility parking, safety and traffic regulation that apply to all facility employees.

2.2.10.2 Do not allow/use alcoholic beverages on the job.

2.2.10.3 There shall be no loud, profane or abusive language used on the job.

2.2.10.4 Contract personnel shall wear, clean work or business attire and present a neat well-groomed appearance.

2.3 SERVICES SUMMARY (SS). The Government will periodically evaluate the contractor’s performance by appointing a representative(s) to monitor performance to ensure services are received. The Government representative will evaluate the contractor’s performance through inspection of deliverables and receipt of all complaints from customers. The Government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints. Likewise, the Government may decrease the number of quality control inspections if performance dictates. The Quality Assurance Person shall make final determination of the validity of customer complaints.

See Table 1 – Services Summary below:

Performance Requirements

PWS

Paragraph Reference

Performance Threshold/ Standard

Surveillance Method

1 20 clean and sanitized containers with a 96 gallon capacity are on hand at the

AFDTL

2.1.1. to 2.1.1.4

No more than one (1) instance per contract year of failure to provide 20 clean- 96 Gal containers.

Periodic Inspection weekly

2 Provide disposal service sufficient to remove all discarded samples

2.1.2.1 Discarded samples are

removed as scheduled with no more than 2 late removals during a 6 month period attributable to the Contractor

Periodic Inspection weekly

3 Provide drivers possessing qualifications to enter onto Lackland AFB

2.1.2.2 No more than one (1)

deficiency per option period

Periodic Inspection Quarterly

4 Provide and certify evidence of Privacy Act data and PII destruction with on-site verification

2.1.3.2 to 2.1.3.2.3

No Deficiencies 100% Inspection Quarterly

5 Provide and certify evidence of urine disposal

2.1.4 to 2.1.4.3

No Deficiencies 100% Inspection Monthly

6 Provide report showing contract costs are being tracked and managed

2.5.2.4 No more than one late

report per year

100% Inspection monthly

Table 1 – Services Summary

2.4 GOVERNMENT FURNISHED SUPPORT. The government will provide access to medical waste requiring disposal.

2.5 DELIVERABLES. Any papers, recommendations, etc. that the contractor submits are drafts, not final copies. The Government reserves the right to make changes on delivery dates.

2.5.1 Deliverables Summary Table

DELIVERABLE PARAGRAPH DELIVERY DATE/DESCRIPTION

Disposal Containers 2.1.1 As necessary Disposal Services 2.1.2 Three times per week Destruction/disposal Procedures

2.1.3.2.1, 2.1.4.2 Upon initial award and annually thereafter

Provide Compliance with disposal documentation

2.1.3.2.2, 2.1.4.3 Upon initial award and annually thereafter

Monthly Status/Financial Report

2.5.2.2 & 2.5.2.4 The fifth calendar day of every month electronically to the COR

Table 2 – Deliverables Summary

2.5.2 Monthly Status/Financial Report.

2.5.2.1 The contractor shall prepare and submit a monthly status/ financial report identifying all tasks performed, status, issues, and anticipated actions consistent with performance work statement (PWS).

2.5.2.2 One hard copy of this report shall be submitted to the CO and an electronic copy to the COR by the fifth calendar day of the month following the end of the reporting period.

2.5.2.3 Specific content of the report shall be coordinated with the COR and delivered in an electronic format mutually agreed upon by the contractor and the COR.

2.5.2.4 The report shall include the following items:

Contract number Contractor name Period covered by report Issues Summary description of activities and accomplishments during the report period Description of problems and issues encountered during the report period Status of open problems or issues identified in previous monthly report(s) Problem solutions/recommendations Trend Analysis Financial Analysis of amount charged compared to funding remaining in option period Assessment of completing option period without extra funding

2.5.2.5 This report shall also keep the COR informed of all funds expended.

3.0 QUALITY CONTROL PLAN. The Contractor is responsible for Contract Management and Quality Control (QC), not the Government.

3.1 The Contractor shall be responsible for QC for all work accomplished during the performance of this contract. All work shall be accomplished using the best commercial practices and be within the governing laws, regulations, policies and directives. The COR will regularly review the contractor personnel’s work and documentation.

4.0 NON PERSONAL SERVICES. The Government will neither supervise contractor personnel nor control the method by which the contractor performs the required tasks. Under no circumstances shall the Government assign tasks to, or prepare work schedules for, individual contractor personnel. The contractor is responsible to manage its personnel and to guard against any actions that are of the nature of personal services, or give the perception of personal services.

If the contractor feels that any actions constitute, or are perceived to constitute personal services, it shall be the contractor’s responsibility to notify the CO immediately. These services shall not be used to perform work of a policy/decision making or management nature, i.e., inherently Governmental functions. All decisions relative to programs supported by the contractor shall be the sole responsibility of the Government.

5.0 CONTRACTOR IDENTIFICATION. All contractor/subcontractor personnel shall wear a Government identification badge at all times while performing under this effort

6.0 HOURS OF OPERATION. The Contractor access to the medical waste at the AFDTL is Monday through Friday between the hours of 6:00 am and 10:00 am.

6.1 PLACE OF PERFORMANCE. Pick up the medical waste at the Air Force Drug Testing Laboratory, 2480 Ladd Street Bldg. 3750, Lackland AFB, TX 78236.

6.2 Government agencies will not be available during scheduled holidays, inclement weather, weekends, after duty hours, or AF down days. The Vendor will be called or emailed 3 business days prior to AF down days. All chargeable work will be directly attributable to the task performed by the contractor personnel.

6.3 Scheduled Holidays. New Year’s Day; Dr. Martin Luther King, Jr. Birthday; President’s Day; Memorial Day; Independence Day; Labor Day; Columbus Day; Veteran’s Day;

Thanksgiving Day; Christmas Day.

7.0 APPENDICES.

7.1 APPENDIX A. Health Insurance Portability and Accountability Act (HIPAA) of 1996

7.2 APPENDIX B. HQ AFMOA Organizational Conflict of Interest

7.3 APPENDIX C. HQ USAF/SG Non-Disclosure Agreement

7.4 APPENDIX D. Customer Complaint Record

Appendix A

HEALTH INSURANCE PORTABILITY AND

ACCOUNTABILITY ACT (HIPAA) OF 1996

HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The AFMS and its components are specifically listed as covered entities (CE) under HIPAA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all AFMS CEs. The specific implementation of HIPAA Privacy for DOD medical facilities is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for the AFMS are contained in DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. AFMS organizations are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered into or amended after the respective implementation dates.

IAW these regulations, the Contractor and its employees meet the definition of Business Associate. Therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for this contract, whereby the Contractor and its employees agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DOD 6025.18- R, DOD 8580.02-R, and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

Introduction

(a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8580.02-R or AFI 41-217.

Individual has the same meaning as the term “individual” in 45 CFR 164.50 1 and 164.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E.

Protected Health Information has the same meaning as the term “protected health information” in 45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of the Government.

Electronic Protected Health Information has the same meaning as the term “electronic protected health information” in 45 CFR 160.103.

Required by Law has the same meaning as the term “required by law” in 45 CFR 164.501 and 164.103.

Secretary means the Secretary of the Department of Health and Human Services or his/her designee.

Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 and part 164, subpart C.

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 160.502, 164.103, 164.304 and 164.501.

(b) The Contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law.

(c) The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

(d) The Contractor agrees to use administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic protected health information that it creates, receives, maintains, or transmits in the execution of this Contract.

(e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract.

(f) The Contractor agrees to report to the Government any security incident involving protected health information of which it becomes aware.

(g) The Contractor agrees to report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract of which the Contractor becomes aware of.

(h) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor on behalf of the Government agrees to the same restrictions and conditions that apply through this Contract to the Contractor with respect to such information.

(i) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

(j) The Contractor agrees to provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The Contractor agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government.

(1) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the 'Government or the Secretary, for purposes of the Secretary determining the Government's compliance with the Privacy Rule.

(m) The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

(b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

(c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j)(1).

Obligations of the Government

Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions

(a) Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures.

(c) The Government shall notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522.

Permissible Requests by the Government

The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R, if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

Termination

(a) Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract.

(b) Effect of Termination.

(1) If this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below.

(2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health Information.

(3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in DOD 6025.18-R, HIPAA Privacy Regulation or DOD 8580.02-R, HIPAA Security Regulation or any CFR or AFI provisions means the section as currently in effect or as amended, and for which compliance is required.

(b) Survival. The respective rights and obligations of Business Associate under the "Effect of Termination" provision of this Clause shall survive the termination of this Contract.

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18-R, the CFR HIPAA Privacy Rule, DOD 8580.02-R, the CFR HIPAA Security Rule and AFI 41-217.

APPENDIX B

HQ USAF/SG ORGANIZATIONAL CONFLICT OF INTEREST

Revised: 30 Aug 2007

The purpose of this clause is to accomplish the following three objectives: (1) to inform prospective offerors that AFMOA presumes that award of this contract or task order may give rise to real or apparent OCIs with respect to other requirements or contracts within AFMOA or the AFMS; (2) to assist current contractors and prospective Offerors in developing their own business strategies regarding participation in AFMOA or AFMS requirements and in identifying and, where possible, avoiding or mitigating against OCIs; and (3) to ensure that all current contractors and prospective Offerors are afforded the maximum practicable opportunity to compete for all AFMOA and AFMS requirements consistent with the restrictions required under FAR Subpart 9.5, Government Accountability Office (GAO) or Court of Federal Claims (COFC) decisions, and sound business practices.

The Contractor and all of its agents (including officers, managers, employees, consultants, and subcontractors) will fully comply with the Special Terms and Conditions Organizational Conflict of interest (OCI) required for efforts in support of AFMOA activities. Contractor will ensure that all confidential and sensitive information will be fully protected. Such information will include, but not be limited to, all source selection sensitive information, government plans or strategies, and all proprietary information of other companies during contract performance. The disclosure of information shall not constitute a grant of any species of right, title, interest, or property in or to said information.

The Contractor understands and appreciates the absolute need to prevent conflicting roles that could or may bias its support to the AFMOA office and its AF-wide responsibilities. To ensure that any support provided by the Contractor, its personnel, or its agents, is free of any bias in judgment or objectivity and to preclude the Contractor, its personnel, or its agents, from any unfair competitive advantage in current or future acquisitions, the Contractor will implement the following:

• Organizational Isolation

• Company Wide Policy Implementation

• Non-Disclosure Agreements

Contractor participation in a requirement or contract with AFMOA programs may give rise to an unfair competitive advantage in other AFMOA procurement actions because of access to advance acquisition planning, source selection sensitive or proprietary information. Furthermore, contractor participation in one area may give rise to a real or apparent loss of contractor impartiality and objectivity where its advisory or planning assistance in one area potentially affects its present or future participation in another area.

For purposes of identifying, avoiding and/or mitigating against OCIs, AFMOA will examine all its requirements and acquisitions for potential OCI or ethical problems, regardless of the cognizant contracting activity (e.g., AFDW, VA, GSA, other agency Multiple Award Schedules, etc.) or the type of contract vehicle used (e.g., FSS order, Multiple Award ID/IQ Contracts, BPAs, FAR Part 15 competitively awards, etc.).

An Offeror/Contractor wishing to submit an offer for this procurement, or any Offeror/Contractor which provides or previously has provided support to AFMOA, must include the following as part of its offer:

• Perform a comparative analysis of the potential new work against all current and previous work performed in support of AFMOA. The comparative analysis must be included in the proposal for the new work, and must include a statement certifying whether the contractor believes that its performance of the proposed new work would create a real or apparent OCI. If the contractor believes that no real or perceived OCI will result from an award of the proposed work, no additional action by the contractor is required.

• If the Offeror/Contractor believes that a real or apparent OCI may exist as a result of an award, the contractor shall also submit an OCI Avoidance or Mitigation Plan with its proposal.

Inclusion of the comparative analysis and OCI Avoidance or Mitigation Plan will not be counted against any offer page limitations otherwise stated in the solicitation.

The Contracting Officer (and when applicable the appropriate program office, acquisition manager, and legal counsel) will review the comparative analysis and, if provided, the Avoidance or Mitigation Plan, in accordance with the requirements of FAR Subpart 9.5 (Organizational Conflict of Interest) to make an independent determination of whether award to that Offeror would be consistent with those requirements. If it is unilaterally determined by the Contracting Officer that no OCI would arise or that the OCI Avoidance or Mitigation Plan adequately protects the interests of the government in the event of award to that Offeror, the Offeror will be determined, for purposes of this clause, to be eligible for award.

If the Offeror/Contractor knows of no OCI in accepting work under this contract, it shall certify its OCI status and submit the certification at the end of this clause with its proposal and any later award, if awarded the contract. The Contractor shall also obtain a similar certification of OCI status from all subcontractors, teaming partners or consultants prior to tasking any such party under this contract. The Contractor shall appropriately modify and include this clause, including this paragraph, in all consulting agreements and subcontracts of any tier to preserve the rights of the Government.

For breach of any of the above restrictions or for nondisclosure or misrepresentation of any relevant facts required to be disclosed concerning this contract, the Government may terminate this contract, disqualify the Contractor from subsequent related contractual efforts, and pursue any remedies as may be permitted by law or this contract.

Prior to a contract modification involving a change to the Performance Work Statement, or an increase in the level of effort or extension of the term of the contract, the Contractor shall submit any applicable organizational conflict of interest disclosure or an update of the previously submitted disclosure or representation.

The Offeror/Contractor should review the considerations below in determining whether or not a conflict of interest exists.

• Does the Offeror or any intended subcontractors, teaming partners, proposed employees, or affiliates have Unequal Access to Information? Would award to the Offeror result in the Offeror having the opportunity to access nonpublic information that may give the Offeror a competitive advantage in a later competition for a government contract?

Specifically, will the Offeror/Contractor have access to any of the following information:

o Budget(s), or Budget Information?

o Acquisition Sensitive Information related to the procurement process to include, but not limited to Acquisition Plans, Requirements, Statements of Work, or Evaluation Criteria?

• Does the Offeror or any intended subcontractors, teaming partners, proposed employees, or affiliates have “impaired objectivity” because the Offeror’s ability to render impartial judgments may be compromised because of its conflicting role(s) on this effort and other government contracts?

• Do “biased ground rules” exist? Most commonly, this would include a situation where the Offeror has, as a government contractor, written specifications or a statement of work for this effort, which could skew competition in favor of itself?

• Is the Offeror aware of any other information relating to this proposed contract/order, which could reasonably be construed as creating an OCI?

The Offeror/Contractor hereby certifies to the best of its knowledge its OCI status below:

(Offeror: Choose one of the following two statements. Delete the statement that does not apply.)

No real or perceived OCI, as defined in FAR 2.1 and discussed in FAR 9.5, will result from an award of the proposed work (there are no ‘Yes’ responses to the questions above).

A real or apparent OCI may exist as a result of an award and therefore an appropriate OCI Avoidance or Mitigation Plan is attached (Offeror shall include an appropriate OCI Avoidance or Mitigation Plan, as required by this clause, with its proposal to the Contracting Officer. [NOTE:

Either delete statement #2, or delete the last phrase allowing them to submit it, or include following statement re Mitigation Plan f related to the AFDW BAA: Mitigation Plans are not permitted in order to resolve OCI issues involving contracts awarded under the AFDW A&AS contract and the AFDW BAA.).

_________________________________ (Signature) ________________________ (Date) (Authorized Official / Sr. Mgr / Officer)

_________________________________(Printed Name) ________________________ (Title)

APPENDIX C

HQ USAF/SG NON-DISCLOSURE AGREEMENT

REVISED: 30 AUG 2007

Purpose: The purpose of this Non-Disclosure Agreement (NDA) is to confirm in writing that the undersigned understands his/her responsibilities regarding protection of information and/or material that he/she may come in contact with in the course of work performed under this agreement. This NDA covers all forms of information made available as Government Furnished Information (GFI) or information/material developed under this agreement, whether in the form of working materials or as deliverable product. This NDA applies to unclassified Government information/material, proprietary information/material supplied by other vendors for use by the Government, and classified Government information/material and is intended to supplement, not replace, the DD Form 254. All information/material released to the contractor remains the property of the US Government and may be withdrawn at any time.

Responsibility: As a condition of acceptability for work under this agreement with AFDW/PKM-S on behalf of AFMOA, individuals are required to complete the attached NDA:

NON-DISCLOSURE AGREEMENT

FOR

CONTRACTOR/SUBCONTRACTOR EMPLOYEES, SENIOR MANAGERS OR

CORPORATE OFFICERS

(Agreement)

I, ___________________________________________________________ (clearly print or type name), an employee, senior manager, or corporate officer of either _________________________ or a subcontractor to _____________________ under Prime Contract number ______________________; Task Order _____________________ awarded to ______________________ by the AFMOA office (Customer) agree not to disclose to any third party or anyone who is not performing work for the Customer and who does not have a need to know such information, any proprietary, source selection sensitive information, programmatic, or budgetary information (Information) contained in or accessible through the AFMOA programs and activities. Proprietary, programmatic, budgetary and source selection sensitive information and data will be handled in accordance with Government direction under the AFMOA program and applicable Government laws and regulations, including Federal Acquisition Regulation (FAR) Sections 3.104 and 9.5.

I understand that Information I may receive or possess, as a result of my assignment to work on AFMOA activities under this Contract may be considered proprietary, source selection sensitive information, and/or For Official Use Only. The responsibilities of my employer for the proper use and protection from unauthorized disclosure of proprietary or source selection sensitive information are described in FAR 3.104. Pursuant to FAR 3.104, I agree that I shall not appropriate such information for my own use or release or discuss such information with third parties unless specifically authorized by the procedures set forth in FAR 3.104.

This Agreement shall continue for a term of five (5) years from the date upon which I last have access to such information. Upon expiration of this Agreement, I have a continuing obligation not to disclose proprietary, programmatic, budgetary or source selection sensitive information to any person or legal entity unless that person or legal entity is authorized by the Government to receive such Information. I understand that any violation of my duty to protect proprietary or source selection sensitive information I was exposed to while working as an employee of _______________________ company working under the Prime Contract, subcontract, or task order as referenced above may subject me, and/or my employer, to administrative, civil and criminal sanctions.

I understand that the United States Government may seek any remedy available to it to enforce this Agreement, including, but not limited to, application for a court order prohibiting disclosure of information in breach of this agreement. Court costs and reasonable attorney fees incurred by the United States Government may be assessed against me if I lose such action. I understand that another company might file a separate claim against me if I have misused its proprietary information.

In the event that I seek other employment, I will reveal to any prospective employer the continuing obligation in this agreement prior to accepting any employment offer.

If signing as a corporate officer of either the Prime or Subcontractor, I certify that I am a duly authorized representative with legal authority to bind the Company.

Agreed and Accepted:

(Signature of Employee) (Date)

(Printed Name/Position) (Telephone Number)

(Signature of Employer Sr. Mgr/Officer) (Date)

(Printed Name/Position) (Telephone Number)

(Printed Name of Employer)

APPENDIX D

CUSTOMER COMPLAINT RECORD

DATE/TIME OF COMPLAINT

SOURCE OF COMPLAINT

ORGANIZATION

BUILDING NUMBER

INDIVIDUAL

PHONE NUMBER

NATURE OF COMPLAINT

CONTRACT REFERENCE

VALIDATION

DATE/TIME CONTRACTOR INFORMED OF COMPLAINT

ACTION TAKEN BY CONTRACTOR

RECEIVED/VALIDATED BY

Customer Complaint Record Template, Feb 05 (SAF/AQCP) COMPLAINANT -

References 63-124 (Aug2005), FAR Part 11 and 37, and DAU CLC 013)

Customer Complaint Record Template, Feb 05 (SAF/AQCP)

COR

Customer Complaint Record Template, Feb 05 (SAF/AQCP)

CONTRACTOR

Customer Complaint Record Template, Feb 05 (SAF/AQCP) Contract Administrator