HHSM-500-2016-RFP-0012_Amendment_000002.pdf

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Part A/B Medicare Administrative Contractor, Jurisdiction J
Solicitation number
HHSM-500-2016-RFP-0012
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HHSM-500-2016-RFP-0012 Amendment 000002

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HHSM-500-2016-RFP-0012

x x copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted ; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT 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. If by virtue of this amendment you desire to change an offer already submitted , such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

x

AGG/PS

Contract Specialist Phillip Smith

MACG - DSMAC

BALTIMORE MD 21244-1850

7500 SECURITY BLVD., MS: B3-30-03

CMS,OAGM,MACG,DSMAC

05/13/2016000002

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended , by one of the following methods: (a) By completing

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6)CODE 6. ISSUED BY

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

04/14/2016

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

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

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

ORDER NO. IN ITEM 10A.

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

The purpose of this amendment is to

1. Delete G.27 CONTRACT WORK PERFORMED OUTSIDE THE UNITED STATES (APR 2016)

2. Delete H.26 CMS SECURITY CLAUSE (APR 2016)

3. Correct administrative errors to the following RFP Sections

• L.10.a, Delivery Instructions, total number of volumes

• L.13.4, Volume III, Tab C, Past Performance Evaluation Factor, Proposal Instructions, page limits

• L.15. Proposal Instructions: Volume V, Conflict of Interest, Section M.6(1), Business

Continued ...

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 15B. CONTRACTOR/OFFEROR 16C. DATE SIGNED

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

Bridget Rineker

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

NSN 7540-01-152-8070

Previous edition unusable

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

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 4

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

HHSM-500-2016-RFP-0012/000002

Ethics, Conflict of Interest and Compliance, Evaluation Criteria, RFP reference.

4. Delete and replace the following RFP

Attachments:

• Attachment J.01, Statement of Work

• Attachment J.12, Cost Template Summary Sheet

• Attachment J.13, CLIN 0001 Cost Proposal

Template - Implementation

• Attachment J.14, CLIN 0002 Cost Proposal

Template – Base Year

• Attachment J.15, CLIN 0003 Cost Proposal

Template – Option Year 1

• Attachment J.16, CLIN 0004 Cost Proposal

Template – Option Year 2

• Attachment J.17, CLIN 0005 Cost Proposal

Template – Option Year 3

• Attachment J.18, CLIN 0006 Cost Proposal

Template – Option Year 4

• Attachment J.19, CLIN 0007 Cost Proposal

Template – Closeout

• Attachment J.20, Basis of Estimate

5. Answer Offeror’s questions in response to the solicitation.

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

HHSM-500-2016-RFP-0012 A/B MAC Jurisdiction J Amendment 000002

A. Delete in its entirety Subsection G.27, CONTRACT WORK PERFORMED OUTSIDE THE

UNITED STATES (APR 2016), which was incorporated in Amendment 000001.

B. Delete in its entirety Subsection H.26, CMS SECURITY CLAUSE, which was incorporated in Amendment 000001.

C. RFP Section L.10.a, Delivery Instructions, is hereby amended to correct an administrative error to the total number of volumes:

FROM: The Offeror shall submit one original of each proposal volume (5 total) listed in the table above and three copies (13 total) and CD-ROMs (5 total) as stated above (Volume V only needs to be submitted as an Original copy), in Microsoft Office Word or Excel, version 2010.

TO: The Offeror shall submit one original of each proposal volume (5 total) listed in the table above and three copies (12 total) and CD-ROMs (5 total) as stated above (Volume V only needs to be submitted as an Original copy), in Microsoft Office Word or Excel, version 2010.

D. RFP Section L Section L.13.4, Volume III, Tab C, Past Performance Evaluation Factor, Proposal Instructions, is hereby amended to correct an administrative error to the page limits:

FROM: VOLUME III, TAB C, Past Performance Evaluation Factor, Proposal Instructions

(Included in the 100-page limit)

TO: VOLUME III, TAB C, Past Performance Evaluation Factor, Proposal Instructions

(NOT Included in the 100-page limit)

E. RFP Section L.15, Proposal Instructions: Volume V, Conflict of Interest, Section M.6(1), Business Ethics, Conflict of Interest and Compliance, Evaluation Criteria, is hereby amended to correct and administrative error to a contract section reference:

FROM: 1. In the event that Business Ethics, Organizational and Personal Conflicts of Interest (hereinafter collectively or individually referred to as COI) and/or Compliance information is required and/or submitted, it will be reviewed for the apparent successful Offeror, but not receive a score/rating. The Business Ethics, Conflict of Interest and Compliance Submission by Offeror/Contractor, Attachment J.10 (and J.11. as applicable), and the information contained therein, HHSM-500-2016-RFP-0012 A/B MAC Jurisdiction J Amendment 000002 will be reviewed by the Contracting Officer, in accordance with contract section H.3 and Section L.15 of this solicitation, in order to make a determination whether the Offeror meets the COI requirements. Additionally, the Contracting Officer may use other information, besides that disclosed by the Offeror, in the Contracting Officer’s evaluation of conflicts of interest.\

TO: 1. In the event that Business Ethics, Organizational and Personal Conflicts of

Interest (hereinafter collectively or individually referred to as COI) and/or Compliance information is required and/or submitted, it will be reviewed for the apparent successful Offeror, but not receive a score/rating. The Business Ethics, Conflict of Interest and Compliance Submission by Offeror/Contractor, Attachment J.10 (and J.11. as applicable), and the information contained therein, will be reviewed by the Contracting Officer, in accordance with contract section H.1 and Section L.15 of this solicitation, in order to make a determination whether the Offeror meets the COI requirements. Additionally, the Contracting Officer may use other information, besides that disclosed by the Offeror, in the Contracting Officer’s evaluation of conflicts of interest.

F. The following RFP attachments are hereby deleted and replaced in entirety:

• Attachment J.01, Statement of Work

• Attachment J.12, Cost Template Summary Sheet

• Attachment J.13, CLIN 0001 Cost Proposal Template - Implementation

• Attachment J.14, CLIN 0002 Cost Proposal Template – Base Year

• Attachment J.15, CLIN 0003 Cost Proposal Template – Option Year 1

• Attachment J.16, CLIN 0004 Cost Proposal Template – Option Year 2

• Attachment J.17, CLIN 0005 Cost Proposal Template – Option Year 3

• Attachment J.18, CLIN 0006 Cost Proposal Template – Option Year 4

• Attachment J.19, CLIN 0007 Cost Proposal Template – Closeout

• Attachment J.20, Basis of Estimate

G. Answers in response to Offeror’s questions submitted pursuant to RFP, Section L.8, Solicitation Questions, are provided as an attachment to this amendment.

END OF MODIFICATION

SF-30
HHSM-500-2016-RFP-0012 Amendment 2
2016-05-13T13:50:19-0400
Bridget R. Rineker -S

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