HT940624Q0043.pdf

SEE ADDENDUM

(No Collect Calls)

HT940624Q0043 09-Apr-2024

b. TELEPHONE NUMBER

(757)953-5740

8. OFFER DUE DATE/LOCAL TIME

09:00 AM 16 Apr 2024

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

HT94069. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

KIMBERLY BUNN

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

0011971289

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

DHA CONTRACTING OFFICE TIDEWATER HT9406

7700 ARLINGTON BLVD

FALLS CHURCH VA 22042

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE HT0242 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

NAV MED CNT PORTSMOUTH VA - MM

SHERRON PURYEAR

ATTN SUPPLY OFFICER BLDG 250

54 LEWIS MINOR STREET

PORTSMOUTH VA 23708-2297

TEL: 757-953-7461 FAX:

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$34,000,000

NAICS:

811210

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF41

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

Section A - Solicitation/Contract Form

POINTS OF CONTACT

VENDOR TO COMPLETE THE FOLLOWING:

COMPANY NAME: ______________________

CAGE: ___________________

DUNS: ___________________

Vendor POC: ____________________ Phone: ____________________ Fax: ____________________ Vendor email: _________________________________

Defense Health Agency Contracting Activity (DHACA) POC: Kimberly Bunn Phone: 757-953-5740 Email: kimberly.p.bunn.civ@health.mil

Product/Services for: Naval Medical Center Portsmouth VA 620 John Paul Jones Circle Portsmouth VA 23708-2297 Phone: 757-953-1494

Vendor to reference RFQ Number: HT940624Q0043 on all inquiries.

PAYMENT INFORMATION

Payment in Arrears (Check One): Monthly Quarterly Semi-Annually Annually *Please ensure that quoted price matches the choice above and is evenly divisible depending on the selection

PROMPT PAYMENT

For Prompt Payment Act Purposes, this contract is:

Subject to the 7-calender day constructive acceptance period.

Note: Vendor will be required to provide billing electronically via the WAWF Electronic Invoicing Method. For additional information, a review of the following web sites may be required: websites: https://wawf.eb.mil or http://wawftraining Email: usn.detrick.nmrlc-detftdmd.list.nmlc-wawf@health.mill

EMAIL QUOTES/PROPOSALS TO: kimberly.p.bunn.civ@health.mil DO NOT forward via U.S. Mail service. It is the Contractor’s responsibility to confirm receipt of quote/proposal.

Section B - Supplies or Services and Prices

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Years FY24 Calibration and maintenance

FFP

FY24 Maintenance & Calibration of Rad Safety and Rad Oncology Equipment.

See section C for equipment list.

FOB: Destination

PURCHASE REQUEST NUMBER: 0011971289

NET AMT

0002 1 Years FY25 Calibration and maintenance

FFP

FY25 Maintenance & Calibration of Rad Safety and Rad Oncology Equipment.

See section C for equipment list FOB: Destination

0003 1 Years FY26 Calibration and maintenance

FFP

FY26 Maintenance & Calibration of Rad Safety and Rad Oncology Equipment.

See section C for equipment list

0004 1 Years FY27 Calibration and maintenance

FFP

FY27 Maintenance & Calibration of Rad Safety and Rad Oncology Equipment.

See section C for equipment list

Section C - Descriptions and Specifications

PERFORMANCE WORK STATEMENT

Department of Defense Defense Health Agency

Performance Work Statement

NMCP-DCSS-RADIOLOGY

1.0 GENERAL INFORMATION

1.1 This is a non-personal services contract to provide Equipment Calibration and Maintenance

1.1.1 Description of services/introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform Equipment Calibration and Maintenance from as defined in this Performance Work Statement (PWS).

1.1.2 Background:

1.1.3 Scope:

This contract shall provide full calibration and maintenance services for the listed equipment to include any accessories. This contract shall provide for on-site corrective repairs and preventive maintenance. It shall include systems, system components, and their assembly parts (i.e.: contractor responsible for total maintenance of entire system). All maintenance provisions shall apply to hardware, firmware, and software, as appropriate, unless otherwise stated.

SEE Quote that includes: EQUIPMENT LIST AND PRICES

1. General a.The Contractor shall comply with HIPAA and DoD Business Associate Agreement as applicable to the performance of this contract.

b.The Contractor shall be fully qualified / authorized by the Original Equipment Manufacturer (OEM) in the calibration and repair of all equipment listed within this contract. Contractor shall maintain current qualifications throughout entire contract period. Qualification includes but not limited to the certification of all repair persons and repair facilities by the OEM as being trained / qualified to perform required repairs.

2. Scope of Work a.The Contractor shall provide trained, experienced, English speaking personnel, labor, tools, diagnostic equipment, software, test phantoms, material, supplies, transportation, parts and equipment necessary to perform Preventive Maintenance (PM), Calibration (CAL), Safety testing (ST) and corrective maintenance.

b.The Contractor shall provide telephonic communications with the Government to discuss technical matters relating to the performance of this contract. The Contractor will provide the name and phone number of a Government point of contact within 5 business days after receipt of award. A Contractor’s systems operator will be made available to answer technical questions regarding system operations and applications.

c.Equipment listed in this contract will be maintained to meet the original equipment manufacturers (OEM’s) specifications.

The contractor shall provide contact information within 5 business days after contract award. In the event a replacement is made, the contractor shall provide the replacement’s contact information within 5 business days.

3. Government furnished property, Materials and Services.

a.The Contractor representative(s) at each site is encouraged to request a pre-maintenance inspection prior to the award of the contract. As all apparent discrepancies must be identified upon submittal of quote, any and all claims must be received within 30 days of contract award or prior to contract start whichever occurs first. All non-apparent / hidden discrepancies must be identified no later than the first scheduled preventative maintenance. Any claims resulting from hidden defects must be received within 30 days of first scheduled preventative maintenance. Any equipment found to be inoperable during this pre-maintenance inspection would be repaired using a separate purchase order. The cost of repairs shall not exceed contractor’s normal retail rate for required repairs. The government certifies that the equipment to be maintained under this contract will be in good operating condition on the effective date of this contract. For the purpose of this contract, the clause, “good operating condition” means the conditions necessary for the equipment to function as intended without corrective maintenance. The Contractor agrees to leave the equipment in good operating condition at the expiration of this contract. During the final week of this contract, the Government will make final inspection of the equipment. Any correction of deficiencies noted during this inspection shall be resolved prior to contract end. The Government reserves the right to request the repair (at no additional cost to the Government) of items identified with latten defects after contract termination, when it has been determined that defects either are a result of contractor’s performance or should have been discovered during normal performance of work under this contract.

b.The government will be responsible for maintaining the proper environment, including utilities and site requirements necessary for the system to function properly as specified by the OEM.

c.The Government will operate the system in accordance with the instruction manual provided by the OEM.

d.The Government will not be responsible for the damage or loss due to fire, theft, accident, or other disaster of Contractor supplies, materials, or for the personal belongings brought onto Government property by Contractor’s personnel.

4. Contractor Furnished Property and Material.

a.The Contractor shall provide all service literature, reference publications, laptop computers and diagnostic software to be used by the contractor service technicians and as required for the completion of the services in accordance with this contract.

5. Replacement Parts.

a.The Contractor shall have ready access to unique and/or high mortality replacement parts. All parts supplied shall be compatible with the existing system. In the event that replacements parts are required to be shipped. Shipping shall be performed with Next Day Air at no additional cost to the Government. If Next Day is not available, then contractor shall ship by the next fastest means.

b.The Contractor shall, at their expense, replace all worn or defective parts necessary to restore the equipment to 100% operational condition as specified by the OEM.

c.Contractor installed replacement parts shall become the property of the Government and the replaced malfunctioning part shall become the property of the Contractor. Replaced items shall be properly disposed of at no additional cost to the Government (contractor to pay all “environmental fees” where required).

d.Freight, postage, and storage charges associated with shipment and receipt of replacement parts, and the return of parts shall be the responsibility of the Contractor.

e.All replacement parts shall be new and certified as OEM replacement parts. In the event that new parts are not available, the COR must approve the use of rebuilt parts and sub-assemblies prior to ordering and installing. The use of rebuilt parts is allowed provided that they are warranted to be free of defects for a period of time that meets or exceeds warranties of similar replacement parts. The contractor shall specifically annotate on the final Field Service Report the use and identification of rebuilt parts and the period of warranty. When discrepancies occur, the Government will make the final determination on whether a replacement part is of equal or better quality.

f.The Contractor must include software revisions and updates (field service changes), which are required due to FDA, or manufacturer announced safety-hazard recall, to include FDA Year 2000 Compliance Directive, as part of the contract at no additional cost to the Government. Updates shall be performed as soon as possible after release, but no later than the first scheduled Preventative Maintenance Inspection after release. For any updates that have been identified as critical, or required for the proper operation of equipment by the OEM, contractor shall provide installation within 30 days of release regardless of Preventative Maintenance Schedules.

6. Contractor Report Requirements.

a.During normal duty hours, Contracted Field Service Engineer (FSE) personnel shall check-in with the Radiology Department upon arrival at the Government site and again prior to departure. (Radiology Department /Ph: 757-953-1242). The Contractor FSEs shall personally notify Radiology Department of problems that result in the equipment being left disabled upon their departure. After normal duty hours, Contractor FSE’s shall notify / leave message on Ph: 757-953-1242 to provide status of service performed, including PMs and corrective maintenance.

b.The Contractor shall provide to Radiology Department a full service report within two (2) days after completion of all service performed. The service report shall include, but not be limited to: contract number, equipment description (model, serial number, equipment control number) contractor’s log number, detailed description of the service(s) performed, HT940623P0061 Page replacement part(s) information (part number, value, nomenclature, unit price, manufacturer, if not OEM, and whether the part is new/used/reconditioned), the completion date and time, man-hours expended and the hourly rate normally charged for the type of service performed, model and serial numbers, and the name of the FSE performing the service. In the event that agents / sub-contractor’s are used in the performance of repairs, said agent shall be identified on the service report by company name and contact information (i.e., telephone number). Additionally contractor will be required to affix a tag on equipment upon the completion of a preventative maintenance inspection. Tag may either be a “sticker” or “hanging tag”. As a minimum the tag shall contain: the name of the contractor, technician performing inspection and date of inspection legibly printed.

7. Contractor Responsibility.

a.The Contractor shall be responsible for the repair/replacement of damaged Government owned equipment and property due to the negligence of the Contractor or his representatives. All such replacement or repair shall be at the Contractor’s expense and shall be inspected to the satisfaction of the KO or appointed representative.

8. Preventive Maintenance Services.

a.In accordance with Naval Medical Logistics Command (NAVMEDLOGCOM) Risk Assessment Criteria, preventive maintenance shall be performed one (1) time per year, in accordance with the Original Equipment Manufacturer’s (OEM) recommendations.

b.The Calibration and Preventive Maintenance visits shall be performed at a mutually agreed upon time between the end user and contractor.

The Contractor shall schedule and complete Calibration and Preventive Maintenance services prior to the 15th of the selected month.

c.During each scheduled preventive maintenance visit performed during the Base and each Option Year, the Contractor shall replace all worn or defective parts as required to complete the preventive maintenance.

d.All test equipment used in the performance of this contract must be Calibrated (if required / as required by manufacture of test equipment) and shall be in compliance with Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Original Equipment Manufacturer (OEM) and Federal Drug Administration (FDA) standards as required by Bureau of Medicine and Surgery (BUMED) Equipment Management Manual NAVMED P-5132 (CH-1, rev.1-2008).

9. Corrective Maintenance a.Normal Working Hour Maintenance Coverage Maintenance Coverage will be Monday through Friday, between 8:00 A.M. to 4:00 P.M. A contractor Service Tech shall respond via telephone within 2 hours after receipt of trouble call, and provide on-site service no later than the close of business (4:00 pm) on the next business day. Equipment shall be operational within 48 hours.

b.Government request for corrective maintenance will be placed by Radiology Department, to the Contractor’s POC. Corrective Maintenance shall be completed during the hours specified in the contract.

c.The Contractor shall assign a unique Log/Reference Number to each Government request for Corrective Maintenance.

d.Contractor’s response to requests for service may include telephone consultation with the equipment user/operator and a Contractor FSE. Telephone consultation shall: 1) provide instruction in determining operator error; 2) determine the most likely cause of the problem; 3) determine if resolution of the problem requires the dispatch of a FSE; and 4) identify replacement parts likely to be required in order to return the equipment to 100% operational condition as specified by the OEM.

e.Contractor’s pricing shall be inclusive of all cost including parts, labor, travel and shipping.

f.The Contractor shall have his/her own service manuals, specifications, schematic diagrams, and parts lists to assist in the evaluation/repair of all equipment included in this contract.

10. Removal of Government Property a.Whenever the repair of equipment cannot be performed at the Government site as determined by the Contractor, the Contractor shall notify Radiology Department who will make arrangements for the Contractor to remove the item to the Contractor’s designated site. The Contractor will be required to sign a Government form accepting responsibility for the Government equipment. The Contractor shall provide a detailed description and quantities of items to be removed. Description shall include manufacturer’s serial numbers and equipment control number (ECN). In the event that items / sub-assemblies / accessories are repaired via “Repair by Replacement” a detailed description of replaced items is to be included upon return of repaired components.

b.In the event that that contractor determines the equipment must be moved to an alternate location for repair, the Contractor is responsible for transporting the equipment to the alternate location and returning the repair equipment back to the Government site.

c.Contractor shall notify the Government as soon as possible if any repairs / calibration will exceed a 14 day turnaround time.

d. Vendor’s price shall be inclusive of all cost including, parts, labor and return shipping.

11. Equipment Modification Upgrades a.The Contractor shall only incorporate OEM specified modifications, alterations and upgrades. Approval shall be obtained from Radiology POC prior to the Contractor installation of any modification, alteration, or upgrades.

b.The Contractor shall maintain contact with the OEM to determine the requirement for field modifications and to ensure accomplishment of these modifications in accordance with the time schedule set forth by the OEM. HT940623P0061 c.The Government shall not alter the system without prior notification to the Contractor.

d.The contractor shall provide software updates to the Government. Installation of updates will be left to the discretion of the Government. All supplied software is to be warranted current and free of defects such as viruses.

12. Service beyond the Scope of the Contract a.The Contractor shall immediately, but not later than 24 consecutive hours after discovery, notify Radiology Department, in writing, of the existence or the development of any defects in, or repair required to the scheduled equipment, which the Contractor considers they are not responsible for under the terms of this contract. The Contractor shall state why this existence or development is not within scope.

1.2 Administrative specifications

1.2.1 Place of performance: The work shall be performed at Radiation Safety and Rad Oncology – Radiology – NMCP

1.2.2 Recognized Federal holidays: is not required to perform services on holidays New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Juneteenth Day Christmas Day Independence Day

1.2.3 Hours of operation: The contractor is responsible for conducting business Monday thru Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. The contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons.

1.2.4 Emergency Services:. On occasion, services may be required to support an activation or exercise of contingency plans outside the normal duty hours.

1.3 Contractor Identification

1.3.1 Contractor personnel performing services in a contractor capacity in a Government facility are required to possess and wear an identification badge that displays his or her name and the name of their company. Ensure all those with whom the person interacts in any face-to-face dealings while supporting the Governemnt understands that the person is contractor support personnel.

2.0 SPECIFIC TASKS

3.0 Qualifications/Considerations

3.1 Special Qualifications/Considerations:

Base Access (NMCP Commander, Navy Installations Command (CNIC), has established the Department of Navy Local Population ID Card/Base Access Pass Registration (DBID), a standardized process for granting unescorted access privileges to vendors, contractors, suppliers and service providers not otherwise entitled to the issuance of a Common Access Card (CAC) who seek access to and can provide justification to enter Navy installations and facilities. Vendors visiting Naval Medical Center Portsmouth (NMCP) may obtain daily passes directly from Naval Station Norfolk (NSN) Pass and ID office, located at NSN (Bldg CD-9), 9040 Hampton Blvd, Norfolk, Virginia, 23505, by submitting identification credentials for verification and undergoing a criminal screening/ background check. Alternatively, if the vendor so chooses, it may voluntarily elect to obtain long-term credentials through enrollment, registration, background vetting, screening, issuance of credentials, and electronic validation of credentials at its own cost through one of the designated independent contractor NCACS service providers. Credentials will be issued every five years and access privileges will be reviewed / renewed on an annual basis. The costs incurred to obtain Navy installation access of any kind are not reimbursable, and the price(s) paid for obtaining long-term NCACS credentials will not be approved as a direct cost of this contract.

Further information regarding DBID can be found at SECNAV 5512/1 (MAY 2021)

4.0 Points of Contact

4.1 Points of Contact:

Sherron Puryear – Sherron.l.puryear.civ@health.mil Susan Walden – susan.j.walden.civ@health.mil

EQUIPMENT LIST

ECN NOMENCLATURE MANUFACTURER MODEL# SERIAL#

112196 Analyzer Spectrum Unfors Instruments Inc LUXI 175924

112195 Analyzer Spectrum Unfors Instruments Inc

8121820-B UNIFOR

LUXI 175923

76915

Beta/Gamma Radia on Detector

Canberra Industries Inc

INK INSPECTOR

9078964

86580 Densitometer Victoreen 07-0443 88409 Electrometer Standard Imaging CDX2000B B153144

111240 Electrometer Standard Imaging MAX 4000 F1102025

111241 Electrometer Standard Imaging MAX 4000 F1102026

12969 Electrometer Keithley MK602 68552A

107936

Environmental Ionizing Radia on Detector

SE Interna onal

INSPECTOR+

21328

107937

Radia on Detector

SE Interna onal

INSPECTOR+

24323

75557

Radia on Detector

Ludlum Measurements

PR223591

75558

Radia on Detector

PR222635

73950

Radia on Detector

154215

74052

Radia on Detector

44-7

PR146914

74126

Radia on Detector

44-3

PR136137

Gaussmeter Alpha Lab Inc VGM 714 Gaussmeter Alpha Lab Inc VGM 715 Gauss/Telsa Meter F.W. Bell 4048 6031349 Ion Chamber PTW N31013 0240 Ion Chamber PTW N31013 0281 Ion Chamber PTW N31010 004106

Ion Chamber PTW N31010 004104 Ion Chamber Well Hoffer IC-4 2892 Ion Chamber Exradin A1SL XW141885 Ion Chamber Exradin A1SL XAH100713 ION CHAMBER - 1 Edge

Detector - Diodes

Sun Nuclear

1118000-0

71853006 ION CHAMBER - 1 Edge

Detector - Diodes

1118000-0

71853023

ION CHAMBER - CT

Diagnostic Standard Imaging A17 XAE073247

127831 Ion Chamber Survey Meter Fluke Biomedical 451P-PYR 0000006079

127832

Ion Chamber Survey Meter Fluke Biomedical 451P-PYR 0000006080

PC ELECTROMETER DUAL

CHANNEL

102147006

75556

Radia on Survey Meter, Grainger-Muller (Source Bearing Radiac)

Ludlum Measurements

14C

208902

WELL CHAMBER STANDARD IMAG HDR1000+ A153246

WELL CHAMBER STANDARD IMAG HDR1000+ A052167

WELL CHAMBER PRM WC-2 9762

86554

X-RAY FILM

DENSITOMETER Nuclear ASSOC 7443 (clamshell) 2625

109121

DETECTOR, X-RAY,

DIGITAL RADIOGRAPHY

UNFORS Instruments

8201021-H

166624

To include the following equipment:

1. Mammo

8202031-J

165361

2. CT Probe

8202041-B

167239

3. Survey Probe

8202062-C

166603

4. Light Detector

8202050-B

165901

117238

METER, X-RAY KVP, NON-

INVASIVE

RAD SAFETY LTD

8201023-D

191993 equipment:

1. Mammo RAD SAFE TD 8202031-J 183057

2. CT Probe RAD SAFE TD 8202041-C 192089

3. Light Detector RAD SAFE TD 8202050-B 190425

4. Survey Probe RAD SAFE TD 8202062-C 195028

5. Transparent Probe RAD SAFE TD 8202070-B 191136

124860

METER, X-RAY KVP,

NONINVASIVE

RTI ELECTRONICS AB

PIRANHA657

CB215050466

equipment

1. Dose Probe RTI ELECTRONICS AB RTI DOSE Probe 1411246

2. Light Probe RTI ELECTRONICS AB RTI Light Probe

MON/LUX 1312174

3. AD/DC mA Current Probe RTI ELECTRONICS AB RT MAS-2 15160777

4. RTI CT Dose Profiler RTI ELECTRONICS AB RTI CT Dose Profiler

DP2-

15060063

5. Ion Chamber Adapter RTI ELECTRONICS AB

Piranha Chamber Adapter

AC1-

15090012

6. CT Probe Adapter RTI ELECTRONICS AB DCT10 CTDI-0390

124859

CB215040388

1. Dose Probe RTI ELECTRONICS AB RTI DOSE Probe 1411253

MON/LUX 1312176

Probe RTI ELECTRONICS AB RT MAS-2 15160774

15060045

Adapter

AC1-

15090049

6. CT Probe Adapter RTI ELECTRONICS AB DCT10 CTDI-0388

124861

CB215050484

1. Dose Probe RTI ELECTRONICS AB RTI DOSE Probe 1411251

MON/LUX 1312172

Probe RTI ELECTRONICS AB RT MAS-2 15160775

15060107

Adapter

AC1-

15090058

6. CT Probe Adapter RTI ELECTRONICS AB DCT10 CTDI-0395

122310

Radiographic Quality Assurance Device

RADCAL CORP

AGDM+

48-228

1. Mammo RADCAL CORP AGDMS-DM+ 43-0241 2.. CT Probe RADCAL CORP 10x9-3ct 05-0052

3. CT Probe RADCAL CORP 10x9-180 08-0043

4. CT Probe RADCAL CORP 10x9-60e 07-0081

5. CT Probe RADCAL CORP 10-9-6 03-0097

6. CT Probe RADCAL CORP 10x9-6m 04-0071

7. Ion Chamber Adapter RADCAL CORP 10x9 to 10x6 95A96

8. Dap Check Plus RADCAL CORP DAPCKP 10-0041

144588 SNC 350P ION CHAMBER SUN NUCLEAR CORP 1045 262554001

144531

Radiographic Quality Assurance Device

RADCAL CORP

Mammo RADCAL CORP 40X9-MO 49-0168

RADCAL CORP 40X9-W 49-0222

CT Probe RADCAL CORP 10X9-3CT 05-0042

RADCAL CORP 10X9-180 08-0027

RADCAL CORP 10x9-60 07-0062

RADCAL CORP 10X9-6 03-0201

RADCAL CORP 10X9-6M 04-0052

Ion Chamber Adapter RADCAL CORP 10X5 to 9095 10A95 mAs Sensor RADCAL CORP 90M9 19-0049

143952

RAY SAFE X2

X2 BASE UNIT

283227

MAM SENSOR RAY SAFE X2 X2 MAM 290970

CT PROBE RAY SAFE X2 X2 CT 284772

SURVEY SENSOR RAY SAFE X2 X2 SURVEY 281415

LIGHT SENSOR RAY SAFE X2 LIGHT SENSOR 288876

R/F SENSOR RAY SAFE X2 X2 R/F 290016

143953

283183

MAM SENSOR RAY SAFE X2 X2 MAM 286495

CT PROBE RAY SAFE X2 X2 CT 284769

SURVEY SENSOR RAY SAFE X2 X2 SURVEY 281372

LIGHT SENSOR RAY SAFE X2 LIGHT SENSOR 288847

R/F SENSOR RAY SAFE X2 X2 R/F 289938

143954

283180

MAM SENSOR RAY SAFE X2 X2 MAM 286491

CT PROBE RAY SAFE X2 X2 CT 284761

SURVEY SENSOR RAY SAFE X2 X2 SURVEY 281363

LIGHT SENSOR RAY SAFE X2 LIGHT SENSOR 288825

R/F SENSOR RAY SAFE X2 X2 R/F 289923

143955

283171

MAM SENSOR RAY SAFE X2 X2 MAM 286351

CT PROBE RAY SAFE X2 X2 CT 274080

SURVEY SENSOR RAY SAFE X2 X2 SURVEY 281362

LIGHT SENSOR RAY SAFE X2 LIGHT SENSOR 288755

R/F SENSOR RAY SAFE X2 X2 R/F 289921

143956

283210

MAM SENSOR RAY SAFE X2 X2 MAM 286525

CT PROBE RAY SAFE X2 X2 CT 284770

SURVEY SENSOR RAY SAFE X2 X2 SURVEY 281391

LIGHT SENSOR RAY SAFE X2 LIGHT SENSOR 288875

R/F SENSOR RAY SAFE X2 X2 R/F 290007

143957

283228

MAM SENSOR RAY SAFE X2 X2 MAM 290977

CT PROBE RAY SAFE X2 X2 CT 284779

SURVEY SENSOR RAY SAFE X2 X2 SURVEY 281427

LIGHT SENSOR RAY SAFE X2 LIGHT SENSOR 288879

R/F SENSOR RAY SAFE X2 X2 R/F 290043

124862

CB215040333

1. Dose Probe RTI ELECTRONICS AB RTI DOSE Probe 1411244

MON/LUX 1312173

HT940624Q0043

Probe

RT MAS-2

15160779

4. RTI CT Dose Profiler

RTI CT Dose Profiler

15060081

5. Ion Chamber Adapter

Adapter

AC1-

15090030

6. CT Probe Adapter RTI ELECTRONICS AB DCT10 CTDI-0387

Section E - Inspection and Acceptance

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A N/A N/A Government 0002 N/A N/A N/A Government 0003 N/A N/A N/A Government 0004 N/A N/A N/A Government

CLAUSES INCORPORATED BY REFERENCE

52.246-4 Inspection Of Services--Fixed Price AUG 1996 52.246-16 Responsibility For Supplies APR 1984

Section F - Deliveries or Performance

DOCK HOURS

Naval Medical Center Portsmouth (NMCP) Receiving Dock Hours of Operation:

NMCP Receiving Dock is open Monday through Friday 0700 to 1600 (7:00 a.m. to 4:00 p.m.), excluding federal holidays. Receiving personnel may be reached at 757-953-5770.

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 22-APR-2024 TO

21-APR-2025

N/A NAV MED CNT PORTSMOUTH VA - MM

SHERRON PURYEAR

ATTN SUPPLY OFFICER BLDG 250

54 LEWIS MINOR STREET

PORTSMOUTH VA 23708-2297

757-953-7461

HT0242

0002 POP 22-APR-2025 TO

21-APR-2026

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 22-APR-2026 TO

21-APR-2027

N/A (SAME AS PREVIOUS LOCATION)

0004 POP 22-APR-2027 TO

21-APR-2028

N/A (SAME AS PREVIOUS LOCATION)

52.246-16 Responsibility For Supplies APR 1984 52.247-34 F.O.B. Destination NOV 1991

Section G - Contract Administration Data

CLAUSES INCORPORATED BY FULL TEXT

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JAN 2023)

(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.

“Payment request” and “receiving report” are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(b) Electronic invoicing. The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (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.sam.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 shall use the following information when submitting payment requests and receiving reports in WAWF for this contract or task or delivery order:

(1) Document type. The Contractor shall submit payment requests using the following document type(s):

(i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher.

(ii) For fixed price line items—

(A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer.

(Contracting Officer: Insert applicable invoice and receiving report document type(s) for fixed price line items that require shipment of a deliverable.)

(B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer.

(Contracting Officer: Insert either “Invoice 2in1” or the applicable invoice and receiving report document type(s) for fixed price line items for services.)

(iii) For customary progress payments based on costs incurred, submit a progress payment request.

(iv) For performance based payments, submit a performance based payment request.

(v) For commercial financing, submit a commercial financing request.

(2) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract.

[Note: The Contractor may use a WAWF “combo” document type to create some combinations of invoice and receiving report in one step.]

(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 ____

Issue By DoDAAC ____

Admin DoDAAC** ____

Inspect By DoDAAC ____

Ship To Code ____

Ship From Code ____

Mark For Code ____

Service Approver (DoDAAC) ____

Service Acceptor (DoDAAC) ____

Accept at Other DoDAAC ____

LPO DoDAAC ____

DCAA Auditor DoDAAC ____

Other DoDAAC(s) ____

(*Contracting Officer: Insert applicable DoDAAC information. If multiple ship to/acceptance locations apply, insert “See Schedule” or “Not applicable.”)

(**Contracting Officer: If the contract provides for progress payments or performance-based payments, insert the DoDAAC for the contract administration office assigned the functions under FAR 42.302(a)(13).)

(4) Payment request. The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable.

(5) Receiving report. The Contractor shall ensure a receiving report meets the requirements of DFARS Appendix F.

(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.

(Contracting Officer: Insert applicable information or “Not applicable.”)

(2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed.

(End of clause)

Section H - Special Contract Requirements

PRIVACY

BUSINESS ASSOCIATE AGREEMENT

Privacy, Access, Use, and Disclosure of Protected Health Information

1. Introduction. In accordance with 45 C.F.R. §§ 164.502(e)(2) and 164.504(e), and DoDM 6025.18, “Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule in DoD Health Care Programs,” March 13, 2019, this document serves as a Business Associate Agreement (BAA) between the signatory Parties for purposes of the HIPAA and the “HITECH Act” amendments thereof, as implemented by the HIPAA Rules and DoD HIPAA issuances (both defined below). The Parties are (1) a DoD Military Health System (MHS) component command such as a Navy Medicine Medical Treatment Facility (MTF) (Naval Medical center or Naval hospital), or special mission command (research, public health, other), acting as a HIPAA covered entity, and

(2) another Federal or Government organization, civilian academic institution, or other civilian entity, acting as a HIPAA Business Associate (BA). The HIPAA Rules require BAAs between covered entities and BAs.

Implementing this BAA requirement, the applicable DoD HIPAA issuances (DoDM 6025.18) provides that requirements applicable to BAs must be incorporated (or incorporated by reference) into the contract or agreement between the Parties.

2. Definitions:

a. Terms. Except as provided otherwise in this BAA, the following terms used in this BAA shall have the same meaning as those terms in the DoD HIPAA Rules (DoDM6025.18-): Data aggregation, designated record set, disclosure, health care operations, individual, minimum necessary, notice of privacy practices, protected health information (PHI), required by law, secretary, security incident, subcontractor, unsecured PHI, and use.

b. Breach. means actual or possible loss of control, unauthorized disclosure of or unauthorized access to PHI or other Personally Identifiable Information (PII) (which may include, but is not limited to PHI), where persons other than authorized users gain access or potential access to such information for any purpose other than authorized purposes, where one or more individuals will be adversely affected. The foregoing definition is based on the definition of “Breach” in DoD Privacy Act issuances as defined herein.

c. BA. shall generally have the same meaning as the term “BA” in the DoD HIPAA issuances, and in reference to this BAA, shall mean the entity (another Government organization, civilian academic institution, or other civilian organization), entering into agreement with a Navy Medicine MTF or special mission command.

d. Agreement. means this BAA together with the documents or other arrangements under which the BA signatory performs services involving access to PHI on behalf of the MHS component signatory to this BAA.

e. Covered Entity. shall generally have the same meaning as the term “covered entity” in the DoD HIPAA issuances, and in reference to this BAA, shall mean a Navy Medicine MTF or special mission command under the Bureau of Medicine and Surgery.

f. DHA Privacy Office. means the Defense Health Agency (DHA) Privacy and Civil Liberties

Office. The DHA Privacy Office Director is the HIPAA Privacy and Security Officer for DHA, including the National Capital Region Medical Directorate.

g. DoD HIPAA Issuances. means the DoD issuances implementing the HIPAA Rules in the DoD MHS. These issuances are DoDM 6025.18 Implementation of the HIPAA Privacy Rule in DoD Health Care Programs,” March 13, 2019; DoD Instruction 6025.18, Privacy of Individually Identifiable Health Information in DoD Health Care Programs of December 2009, and DoD Instruction 8580.02, Security of Individually Identifiable Health Information in DoD Health Care Programs of August 2015.

h. DoD Privacy Act Issuances. means the DoD issuances implementing the Privacy Act, which are DoD Directive 5400.11, DoD Privacy Program of 29 October 2014, and DoD 5400.11-R, Department of Defense Privacy Program of 8 May 2007.

i. HIPAA Rules. means, collectively, the HIPAA privacy, security, breach and enforcement rules, issued by the United States (US) Department of Health and Human Services (HHS) and codified at 45 C.F.R. §§ 160 and 164, Subpart E (Privacy), Subpart C (Security), Subpart D (Breach) and 45 C.F.R. § 160, Subparts C-D (Enforcement), as amended by the 2013 modifications to those Rules which implemented the “HITECH Act” provisions of Publication L. 111-5. See 78 Federal Regulation 5566-5702 of 25 January 2013 (with corrections at 78 Federal Regulation 32464 of 7 June 2013. Additional HIPAA rules regarding electronic transactions and code sets (45 C.F.R. § 162) are not addressed in this BAA and are not included in the term HIPAA Rules.

j. HHS Breach. means a breach that satisfies the HIPAA Breach Rule definition of “Breach” in 45 C.F.R. § 164.402.

k. Service-Level Privacy Office. means one or more offices within the military services (Army, Navy, or Air Force) with oversight authority over Privacy Act and HIPAA privacy compliance.

3. Obligations and Activities of BA:

a. The BA shall not access, use, or disclose PHI other than as permitted or required by this Agreement, the controlling Memorandum of Understanding (MOU) or training affiliation agreement, or as required by law.

b. The BA shall use appropriate safeguards and comply with the DoD HIPAA Rules with respect to electronic PHI to prevent use or disclosure of PHI other than as provided for by this Agreement, the controlling MOU, or law.

c. The BA shall report to the covered entity any Breach of which it becomes aware and shall proceed with breach response steps required by paragraph 7 (Breach Response) of this BAA. With respect to electronic PHI, the BA shall also respond to any security incident of which it becomes aware in accordance with any information assurance provisions of the Understanding. If at any point the BA becomes aware that a security incident involves a breach, the BA shall immediately initiate breach response as required by paragraph 7 (Breach Response) of this

BAA.

d. In accordance with 45 C.F.R. §§ 164.502(e)(1)(ii)) and 164.308(b)(2), respectively, as applicable, the BA shall ensure that any entities that create, receive, maintain, or transmit PHI on behalf of the BA agree to the same restrictions, conditions, and requirements that apply to the BA with respect to such PHI.

e. The BA shall make available PHI in a designated record set, to the covered entity or, as directed by the covered entity, to an Individual, as necessary to satisfy the covered entity obligations under 45 C.F.R. § 164.524.

f. The BA shall make any amendment(s) to PHI in a designated record set as directed or agreed to by the covered entity pursuant to 45 C.F.R. § 164.526, or take other measures as necessary to satisfy covered entity’s obligations under 45 C.F.R. § 164.526.

g. The BA shall maintain and make available the information required to provide an accounting of disclosures to the covered entity or an individual as necessary to satisfy the covered entity’s obligations under 45 C.F.R. § 164.528.

h. To the extent the BA is to carry out one or more of the covered entity’s obligation(s) under the HIPAA privacy rule, the BA shall comply with the requirements of HIPAA privacy rule that apply to the covered entity in the performance of such obligation(s).

i. The BA shall make its internal practices, books, and records available to the Secretary and the covered entity for purposes of audit and in determining compliance with the HIPAA Rules.

4. Permitted Uses and Disclosures by BA:

a. The BA may only use or disclose PHI as necessary to perform the services set forth in the Understanding or as required by law. The BA is not permitted to de-identify PHI under DoD HIPAA issuances or the corresponding 45 C.F.R. § 164.514(a) through (c), nor is it permitted to use or disclose de-identified PHI except as provided by the Understanding or directed by the covered entity.

b. The BA agrees to use, disclose, and request PHI only in accordance with the HIPAA privacy rule “minimum necessary” standard and corresponding DHA policies and procedures as stated in the DoD HIPAA issuances.

c. The BA shall not use or disclose PHI in a manner that would violate the DoD HIPAA issuances or HIPAA privacy rules if done by the covered entity, except uses and disclosures for the BA’s own management and administration and legal responsibilities or for data aggregation services as set forth in the following three paragraphs:

(1) Except as otherwise limited in the understanding, the BA may use PHI for the proper management and administration of the BA or to carry out the legal responsibilities of the BA. The foregoing authority to use PHI does not apply to disclosure of PHI, which is covered in the next paragraph.

(2) Except as otherwise limited in the Understanding, the BA may disclose PHI for the proper management and administration of the BA or to carry out the legal responsibilities of the BA, provided that disclosures are required by law, or the BA obtains reasonable assurances from the person to whom the PHI is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and the person notifies the BA of any instances of which it is aware in which the confidentiality of the information has been breached.

(3) Except as otherwise limited in the Understanding, the BA may use PHI to provide Data Aggregation services relating to the covered entity’s health care operations.

5. Provisions for Covered Entity to Inform BA of Privacy Practices and Restrictions:

a. The covered entity shall provide the BA with the notice of privacy practices that the covered entity produces in accordance with 45 C.F.R.§ 164.520 and the corresponding provision of the DoD HIPAA issuances (DoDM 6025.18).

b. The covered entity shall notify the BA of any changes in, or revocation of, the permission by an Individual to use or disclose his or her PHI, to the extent that such changes affect the BA’s use or disclosure of PHI.

c. The covered entity shall notify the BA of any restriction on the use or disclosure of PHI that the covered entity has agreed to or is required to abide by under 45 C.F.R. § 164.522, to the extent that such changes may affect the BA’s use or disclosure of PHI.

6. Permissible Requests by Covered Entity. The covered entity shall not request the BA to use or disclose PHI in any manner that would not be permissible under the HIPAA privacy rule or any applicable Government regulations (including without limitation, DoD HIPAA issuances) if done by the covered entity, except for providing Data Aggregation services to the covered entity and for management and administrative activities of the BA as otherwise permitted by this BAA.

7. Breach Response:

a. General. Breach Response is designed to satisfy the DoD Privacy Act issuances and the HIPAA Breach Rule as implemented by the DoD HIPAA issuances. In general, the BA shall report the breach to the covered entity, assess the breach incident, notify affected individuals, and take mitigating actions, as applicable.

Because DoD defines “Breach” to include possible (suspected) as well as actual (confirmed) breaches, the BA shall implement these breach response requirements immediately upon the BA’s discovery of a possible breach. The following provisions set forth the BA’s Privacy Act and HIPAA breach response requirements for all breaches, including but not limited to HHS breaches (defined below). In the event of a breach of PII or PHI held by the BA, the BA shall follow the breach response requirements set forth under paragraphs 7, 8, and 9 of this BAA, which are designed to satisfy both the Privacy Act and HIPAA, as applicable.

(1) If a breach involves PII without PHI, then the BA shall comply with DoD Privacy Act issuance breach response requirements only.

(2) If a breach involves PHI (a subset of PII), then the BA shall comply with both Privacy Act and HIPAA breach response requirements.

(3) If a breach involves PHI, it may or may not constitute an HHS Breach. If a breach is not an HHS Breach, then the BA has no HIPAA breach response obligations. In such cases, the BA must still comply with breach response requirements under the DoD Privacy Act issuances.

b. HHS Breach. If the DHA Privacy Office determines that a breach is an HHS Breach, then the BA shall comply with both the HIPAA Breach Rule and DoD Privacy Act issuances, as directed by the DHA Privacy Office, regardless of where the breach occurs.

c. Non-HHS Breach. If the DHA Privacy Office determines that the breach does not constitute an HHS Breach, then the BA shall comply with DoD Privacy Act issuances, as directed by the applicable Service-Level Privacy Office.

d. Service-Level Privacy Office Point of Contact (POC). Brian Martin, who may be reached at Comm: 904-542-3559, DSN: 312-942-3559, or via E-mail: brian.k.martin4.civ@mail.mil, or usn.ncr.bumedfchava.list.bumed-pii-rpt@mail.mil.

BRIAN K. MARTIN

CODE M31 PRIVACY OFFICE

BUMED DETACHMENT JACKSONVILLE

H2005 KNIGHT LANE

PO BOX 140

NAVAL AIR STATION JACKSONVILLE FL 32212

8. Breach Reporting Provisions:

a. The BA shall report the breach within 1 business day of discovery to the US Computer Emergency Readiness Team (US-CERT) and within 24 hours of discovery to the DHA Privacy Office and the other Parties set forth below. The BA is deemed to have discovered a breach as of the time a breach (suspected or confirmed) is known, or by exercising reasonable diligence would have been known, to any person (other than the person committing it) who is an employee, officer, or other agent of the BA.

b. The BA shall submit the US-CERT report using the online form at https://forms.us-cert.gov/report. Before submission to US-CERT, the BA shall save a copy of the on-line report.