HEVAS6-12-T-0003-0001.pdf

HA603312RCPD002

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions ofthe document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

1. This amendment is issued to incorporate the follow ing changes/updates:

a. To provide a list of consolidated Questions and Answ ers (Q&A) in response to w ritten questions submitted in reference to this solicitation.

b. To add Past Performance Questionnaire as an attachment to be used as formor example.

c. To change the brief description of requirement to "Psychological Evaluations for Severe Emotional Disorders (SED)" for line item numbers 0002, 1002, 2002, the Statement of Work and throughout the solicitation.

2. All others information remain unchanged.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 7

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 09-Nov-2011

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X HEVAS6-12-T-0003

X 9B. DATED (SEE ITEM 11)

31-Oct-2011

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt ofOffer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one ofthe following methods:

(a) By completing Items 8 and 15, and returning 1 copies ofthe amendment; (b) By acknowledging receipt ofthis amendment on each copy of the offer submitted;

or (c) By separate letter or telegramwhich includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. Ifby virtue of this amendment you desire to change an offer already submitted, such change may be made by telegramor letter, provided each telegramor letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(Ifapplicable)

6. ISSUED BY

3. EFFECTIVE DATE

07-Nov-2011

CODE

DDESS AREA SERVICE CENTER

ATTN: PROCUREMENT DIVISION

700 WESTPARK DRIVE

PEACHTREE CITY GA 30269-1498

HEVAS6 7. ADMINISTERED BY (Ifother than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

HEVAS6-12-T-0003

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 0002

The CLIN description has changed from Psychological Evaluation to Psychological Evaluation for SED.

CLIN 1002

The CLIN description has changed from Psychological Evaluation to Psychological Evaluation for SED.

CLIN 2002

The CLIN description has changed from Psychological Evaluation to Psychological Evaluation for SED.

The following have been added by full text:

ATTACHMENT 2

PAST PERFORMANCE QUESTIONNAIRE

NOTE: Offerors are responsible for requesting that their 3 references complete this past performance questionnaire. References shall return the completed questionnaire directly to the Domestic Dependent Elementary and Secondary Schools (DDDESS) Procurement Office, Not Later Than 16:00 PM (EST), 18 Nov 2011. References shall not return the completed questionnaires to the requestors.

You have been identified as having been a customer of the following company for providing Education Programs or similar services:

Requesting Company Name: ________________________________________________.

The Dept. of Defense Education Activity (DoDEA)/DDESS is conducting an evaluation of this company’s previous record of performance as part of a source selection process to award a contract for similar services. We cordially request you complete and forward this questionnaire:

To Arrive at DDESS Not Later Than: 16:00 PM (EST), 18 Nov 2011 to the DDESSPROC@am.dodea.edu, attention Michael J. Eadon. For questions related to this form, please contact Mr. Michael J. Eadon, Contract Specialist, at (678) 364-8061.

1. Company Information Name

Street Address

City State Zip Code

2. Point Of Contact (POC):

Name / Title

Ph No. Fax No.

Email Address

3. Services Received:

Briefly Describe Services Received: ___________________________________________________ Country Where Services Performed: ______________ Approx. Value of Services: $____________ Date You Began Using This Firm’s Services: ______________

4. Rate the degree of service confidence received:

(Please rate services received by entering and “X” in the applicable rating block below)

1st Column = Subtstantial Confidence 2nd Column = Satisfactory Confidence 3rd Column = Limited Confidence 4th Column = No Confidence 5th Column = Neutral/Unknown

Su bs ta nt ia l

S at is fa ct or y

L im i te d

N o

N eu tr al

/ U nk no w n

Effectiveness at providing Educational and Clinical assessments.

Responsiveness to the requirement and commitment to customer satisfaction.

Quality of workmanship

Experience, training and skill level of personnel accomplishing work.

Overall satisfaction with service/performance.

5. Please Provide Written Comments To Explain Your Ratings (Use Additional Sheets If Necessary):

6. Rated By:

Signature Printed Name & Title Date

Domestic Dependent Elementary and Secondary Schools (DDESS), Procurement Division 700 Westpark Drive, Peachtree City GA 30269-3554

QUESTIONS AND ANSWERS

QUESTIONS AND ANSWERS

Consolidation as of: 8 Nov 2011, 3:00 p.m. EST

Solicitation #: HEVAS6-12-T-0003, (Psychological Evaluations for Suspected Emotional Disorders (SED))

Question/Concern #1: Who is responsible for obtaining the past performance references?

Answer #1: Contractors are responsible for inquiring to their customers to complete the past performance questionnaire (Attached). The contractor or the customer must submit the questionnaire to the Government Procurement Agency by email, fax or included in hardcopy proposal. See solicitation for email/delivery addresses.

Question/Concern #2: Can the past performance references be completed by handwriting?

Answer #2: Yes

Question/Concern #3: What type of information and/or format is acceptable?

Answer #3: The Past Performance Questionnaire (Attached) may be used. The Questionnaire includes the request for the following relevant information: 1) Contractor’s Name, 2) Name and Contact Information of customer to whom service was provided, 3) Description of services received, 4) Country where service was performed, 5) Approximate value of service in US$; 6) Period of performance/services; 7) Services ratings.

Send Past Performance questionnaire/references to: Email: Michael.Eadon@am.dodea.edu, or FAX:

(770) 632-8720 or mail/delivery to: DDESS ASC, 700 Westpark Drive, Attn: Procurement Division - Micheal Eadon, Peachtree City, GA 30269.

Question/Concern #4: What is the required number of past performance references?

Answer #4: Three (3) relevant past performance references of services provided within the last three (3) years will be acceptable for evaluation.

Question/Concern #5: What is the acceptable rate of reimbursement for travel costs?

Answer #5: Market research revealed that there are interested and capable vendors within the local area.

A separate line item is not established for travel reimbursement. Proposed pricings for Contract Line Item Numbers X001 and X002 should include allocated cost and profit.

The following have been modified:

STATEMENT OF WORK (SOW)

STATEMENT OF WORK (SOW)

Revision 1: 4 Nov 2011

Clinical and Psychological Evaluation Services for Suspected Emotional Disorders (SED) Students

C.1. GENERAL. The contractor shall provide clinical and psychological assessments for students with suspected emotional disorders/impairments enrolled in the Fort Bragg Schools, Fort Bragg, NC, grades preschool through grade 8. The Fort Bragg school system serves as DoDEA (Department of Defense Education Activity), DDESS (Domestic Dependent Elementary and Secondary School) District North Carolina located at Fort Bragg, North Carolina. Work will include review of referral information, provided by the Case Study Committee and or Student Support Team, observation of students, conferences with special education teachers, regular teachers, related service providers within the educational environment and parents. Individual psycho-educational assessment(s) and projective instruments required by the contractor to make diagnostic conclusions based on the referral question.

C.1.1. SCOPE OF WORK. . The contractor shall provide all required assessment tools and protocol to conduct clinical assessments which shall include but not limited to administration, scoring and interpretation of a variety of formal and informal measures to include but not limited to behavior rating scales, observations, interviews, cognitive, projective, and social emotional instruments. The contractor shall provide an individual written assessment report per clinical evaluation utilizing the prescribed format, which may include but not limited to behavioral observations during the assessment period, observations in the school environment, list of specific assessment tools and techniques utilized, dates of administration, scores, synthesis of data, statement of diagnosis, and suggestions which specifically address identified strengths and needs, appropriate for implementation within the educational environment. The contractor shall provide interpretation of assessment information which shall when deemed appropriate by the case study committee, occur within the structure of the multidisciplinary team meeting to include the parents and or/guardians.

C.1.2. BACKGROUND INFORMATION

C.1.2.1. Fort Bragg Schools provides support to the individuals classified under the Individuals with Disabilities Education Act, Part b. The schools operate under an interdisciplinary model.

The following disciplines are represented: regular education teacher, special education teacher, speech therapy, occupational therapy, physical therapy, school nursing, school psychology, adaptive physical education teacher, school administrator, school social worker, and Instructional System Specialist for Special Education Programs.

C.1.2.2. The services are to be performed in the school facilities located on the Fort Bragg, North Carolina military reservation, adjoining Pope Army Airfield and Linden Oaks, Cameron, North Carolina. Travel distance between the twelve schools varies from 1/4 to approximately 15 miles from the administrative office (see technical exhibit #1).

C.1.2.3. Additional regulations/guidance requirements: the services shall be in compliance with Public Law #101-476 and Public Law #99-457. A copy of these laws will be made available for inspection by contacting the Directorate of Contracting, building 1-1333, Fort Bragg, North Carolina. The services shall also be in compliance with the DOD implementation targets for the National Education Goals as established by the Presidential Council, and the Department of Defense Education Activity community strategic plan.

(End of Summary of Changes)