14-t-0210.doc

Section A - Solicitation/Contract Form

CLAUSES INCORPORATED BY FULL TEXT

Fill in Blanks:

TIN (tax ID): ________________

CAGE: ________________

DUNS: __________________

Vendor Point of Contact: ______________________Phone: ____________________

Vendor email: ______________________

Naval Medical Center Portsmouth POC: Biomedical Engineering Dept

Vendors quoted price shall be inclusive of all cost including material, labor & travel.

Payment Monthly, Quarterly, Annually (circle one) in Arrears 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: https://wawf.eb.mil http://wawftraining (email) wawf@nmlc.med.navy.mil Vendor to reference N00183-14-T-0210 on all Inquires.

Government reserves the right to:

(1) award based on an "All or Nothing Evaluation".

(2) award a “Best Value” requirement. Vendors with superior past performance histories may be given 1st consideration.

PROMPT PAYMENT

For Prompt Payment Act Purposes, this contract is:

Subject to the 7-calender day constructive acceptance period.

EVALUATION FACTORS

(1) Qualification (of vendor and service techs) by OEM in the repair and maintenance of all listed items

(2) Experience in the repair and maintenance of all listed items

(3) Access to proprietary / OEM replacement parts to include software updates

(4) Access to proprietary support items such as tooling, service manuals

(5) Ability to provide timely support

Section B - Supplies or Services and Prices

Maintenance in Accordance with Section C

FFP

for the period 1 Oct 14 - 30 Sep 15

FOB: Destination

MILSTRIP: N0018315RQPE003

PURCHASE REQUEST NUMBER: N0018315RQPE003

NET AMT

0001AA

Maintenance in Accordance with Section C on 1 ea. Medical Video Monitor

Model: OEV191H

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AB

Maintenance in Accordance with Section C on 1 ea. Rhinolaryngoscope

Model: ENF-XP

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AC

Maintenance in Accordance with Section C on 1 ea. Light Source, Fiberoptic, Flexible Endoscopic

Model: CLV180

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AD

Maintenance in Accordance with Section C on 1 ea. Gastroscope

Model: GIFH190

Man: Olympus America

Location: Gastro Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

MILSTRIP: N0018315RQGS005

PURCHASE REQUEST NUMBER: N0018315RQGS005

NET AMT

0001AE

Maintenance in Accordance with Section C on 2 ea. Gastroscope

Model: GIFH190 / GIFH191

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AF

Maintenance in Accordance with Section C on 2 ea. Bronchoscope, Flexible, Video

Model: BFMP160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AG

Maintenance in Accordance with Section C on 2 ea. Bronchoscope, Flexible, Video

Model: BFXP160f / BFXF160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AH

Maintenance in Accordance with Section C on 2 ea. Bronchoscope, Flexible, Video

Model: BF3C160

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AJ

Maintenance in Accordance with Section C on 1 ea. Gastroscope, Flexible, Video

Model: XP160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AK

Maintenance in Accordance with Section C on 1 ea. Video Image Processor, Endoscopic

Model: XP160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AL

Maintenance in Accordance with Section C on 2 ea. Video Image Processor

Model: GIFH180

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AM

Maintenance in Accordance with Section C on 1 ea. Colonoscope, Video

Model: Q180AL

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AN

Maintenance in Accordance with Section C on 1 ea. Video Image Processor

Model: H180AL

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AP

Maintenance in Accordance with Section C on 1 ea. Bronchoscope, Flexible Video

Model: H180AL

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0001AQ

Maintenance in Accordance with Section C on 2 ea. Bronchoscope, Flexible Video

Model: BF240

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

FFP

for the period 1 Oct 15 - 30 Sep 16

FOB: Destination

NET AMT

0002AA

FFP

on 1 ea. Medical Video Monitor

Model: OEV191H

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AB

FFP

on 1 ea. Rhinolaryngoscope

Model: ENF-XP

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AC

FFP

on 1 ea. Light Source, Fiberoptic, Flexible Endoscopic

Model: CLV180

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AD

FFP

on 1 ea. Gastroscope

Model: GIFH190

Man: Olympus America

Location: Gastro Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

MILSTRIP: N0018315RQGS005

NET AMT

0002AE

FFP

on 2 ea. Gastroscope

Model: GIFH190 / GIFH191

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AF

FFP

on 2 ea. Bronchoscope, Flexible, Video

Model: BFMP160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AG

FFP

on 2 ea. Bronchoscope, Flexible, Video

Model: BFXP160f / BFXF160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AH

FFP

on 2 ea. Bronchoscope, Flexible, Video

Model: BF3C160

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AJ

FFP

on 1 ea. Gastroscope, Flexible, Video

Model: XP160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AK

FFP

on 1 ea. Video Image Processor, Endoscopic

Model: XP160F

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AL

FFP

on 2 ea. Video Image Processor

Model: GIFH180

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AM

FFP

on 1 ea. Colonoscope, Video

Model: Q180AL

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AN

FFP

on 1 ea. Video Image Processor

Model: H180AL

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AP

FFP

on 1 ea. Bronchoscope, Flexible Video

Model: H180AL

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

0002AQ

FFP

on 2 ea. Bronchoscope, Flexible Video

Model: BF240

Man: Olympus America

Location: Pediatric Clinic

See Section C for additional details

Unit Price: $________________________(vendor fill in)

FOB: Destination

NET AMT

Section C - Descriptions and Specifications

DESCRIPTION/SPECIFICATION/WORK STATEMENT

Statement of Work

Selected vendor must be able to provide full contract support immediately upon award of a resulting order. Vendor will provide full maintenance support for the items listed in Section B and all support items / components. This contract shall provide for maintenance services which include on-site corrective repairs, normal working hour coverage (8:00 A.M. to 4:30 P.M. Monday through Friday excluding Federal holidays) and 24-hour emergency service and routine preventive maintenance services to Department of Defense owned equipment, as listed on the: DD Form 1155 “Order for Supplies or Services”. It shall include all systems, subsystem components, and assemblies, (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.

1. General

a. The Contractor shall comply with Federal, State, and Local Laws, plus any Federal Regulations as applicable to the performance of this contract. To include but not limited to HIPAA and DoD Business Associate Agreement as they apply.

b. The Contractor shall not accept any instructions issued by any person employed by the U. S. Government, other than: the Contracting Officer (KO), or Biomedical Engineering Division (BME), all acting within the limits of their authority.

c. The Contractor shall be qualified / authorized by the Original Equipment Manufacturer (OEM) in the repair of all equipment listed within this contract. Contractor shall maintain qualifications throughout entire contract period. Contractor and all repair technicians must have current (within 2 years) certification for the maintenance of all covered equipment. 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. The Government shall maintain the right to seek proof of qualification prior to award and anytime during contract period of performance.

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. A 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 manufacturer’s (OEM’s) specifications.

d. Equipment and associated components shall be serviced as listed on: DD Form 1155, “Order for Supplies or Services”.

e. The Contractor Point of Contact (POC). The Contractor shall provide in writing the name and telephone number of a primary and alternate English-speaking individual to act as their representative for the scheduling and coordination of service calls, and to be responsible for the coordination of the contract with the Government.

f. The contractor will be allowed to make repairs either on-site or off-site. For off-site repairs the Government will agree to ship equipment to contactor for repairs. The contractor will be required to pay shipping cost for both out-bound and in-bound items. The contractor will be required to provide any required shipping boxes / materials.

g. All repairs are to be completed and ready for use within 10 business days of notice of repair need. Ready for use includes returned to NMCP for use. In the event that repairs are not completed within the requested 10 days the contractor is to provide a “loner item” of equivalent technical capacity at no additional cost. The contractor will be required to maintain an inventory of loner equipment equivalent to total number of items required to be maintained.

h. The intent of this requirement is to provide direct repair of all items listed in Section B. In the event of a “major repair / extensive” repair, a “repair by exchange” shall be allowed after approval by the Government. All items repaired by exchange must be exchanged with equipment that is equal or better technical capabilities and financial value. The Government shall retain the sole right to determine “equal or better”.

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 onset 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.

b. The contractor is required to have ready access to any required proprietary tooling, software and support literature to include access to proprietary technical support manuals / information.

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 in the fastest reasonable means possible (i.e., next day air) at no additional cost to the Government.

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, rebuilt parts and sub-assemblies must be approved in advance by the COR (Contracting Officers Representative). All rebuilt parts must be warranted 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. Where applicable, 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.

Specific Tasks.

6. Contractor Report Requirements.

a. During normal duty hours, Contracted Field Service Engineer (FSE) personnel shall check-in with the Biomedical Engineering Division upon arrival at the Government site and again prior to departure. (Biomedical Engineering located in Build-250 1st floor; 757-953-5336). The Contractor FSEs shall personally notify Biomedical Engineering (BME) of problems that result in the equipment being left disabled upon their departure. After normal duty hours, Contractor FSE’s shall notify the Officer of the Day Desk (Bldg 2, 2nd Floor) and the systems operator designated by BME.

b. The Contractor shall provide to BME 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, replacement part(s) information (part number, part 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-contractors 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 Manufactures (OEM) recommendations.

b. The Government shall select the months in which preventive maintenance services are to be performed. The preventive maintenance visits shall be performed during the following months. Base Year: within 90 days of award date; Option Years: March of each contract year.

(The Government Fiscal Year runs: October through September). The Contractor shall schedule and complete preventive maintenance services prior to the 15th of the selected month.

c. 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.

9. Corrective Maintenance

a. Normal Working Hour Maintenance Coverage

Maintenance Coverage will be Monday through Friday, between 8:00 A.M. to 4:30 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 (4:30 pm) on the next business day. Equipment shall be operational within 48 hours. The Government reserves the right to deduct from the Contractor’s payment an amount not to exceed the hourly rate of $50.00 per hour for each hour the Contractor fails to respond, as specified in the contract.

a. In the event that emergency service outside the normal working hours are required by the Government, additional work shall be billable to the Government at published commercial rates, and negotiated and approved by a Contracting Officer prior to services rendered.

b. Government request for corrective maintenance will be placed by BME, 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) to determine the most likely cause of the problem; 3) to determine if resolution of the problem requires the dispatch of a FSE; and 4) to 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, unless otherwise indicated. Any/all exclusions are listed as follows:

No Exclusions

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 BME who will make arrangements for the Contractor to remove the item to the Contractor’s designated site. The Contractor may be required to sign a Government form accepting responsibility for the Government equipment. The Contractor shall provide a detailed description of removed items. For associated items / accessories, contractor to provide a detailed description and quantities of items to be removed. Description to include as a minimum manufacturers serial numbers and equipment control number (ECN) of all equipment / items removed. 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. All charges resulting from a Contractor determined requirement to transport Government owned property, covered by this contract, to and from an alternate repair location shall be the responsibility of the Contractor.

11. Equipment Modification Upgrades

a. The Contractor shall only incorporate OEM specified modifications, alterations and upgrades. Approval shall be obtained from BME 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.

c. The Government shall not alter the system without prior notification to the Contractor.

d. The contractor at no additional cost 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 BME, 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.

b. At the same time of the notification, the Contractor shall furnish BME with written estimate of the cost to make the necessary repairs. Repairs considered by the Contracting Officer to be outside the scope of this contract shall not be covered under this contract, but shall be ordered under a separate purchase order.

CURRENT INVENTORY

Section E - Inspection and Acceptance

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

Section F - Deliveries or Performance

DELIVERY INFORMATION

30-SEP-2015

FOB: Destination

30-SEP-2015

PEDIATRIC DEPARTMENT

620 JOHN PAUL JONES CIRCLE

BLDG 3

PORTSMOUTH VA 23708-2297

757-953-6853

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

GASTROENTEROLOGY CLINIC 2K

BLDG 2

620 JOHN PAUL JONES CIRCLE

PORTSMOUTH VA 23708

757-953-2033

N00183

30-SEP-2015

PEDIATRIC DEPARTMENT

620 JOHN PAUL JONES CIRCLE

BLDG 3

PORTSMOUTH VA 23708-2297

757-953-6853

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2015

N00183

30-SEP-2016

30-SEP-2016

PEDIATRIC DEPARTMENT

620 JOHN PAUL JONES CIRCLE

BLDG 3

PORTSMOUTH VA 23708-2297

757-953-6853

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

GASTROENTEROLOGY CLINIC 2K

BLDG 2

620 JOHN PAUL JONES CIRCLE

PORTSMOUTH VA 23708

757-953-2033

N00183

30-SEP-2016

PEDIATRIC DEPARTMENT

620 JOHN PAUL JONES CIRCLE

BLDG 3

PORTSMOUTH VA 23708-2297

757-953-6853

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

30-SEP-2016

N00183

CLAUSES INCORPORATED BY REFERENCE

Section G - Contract Administration Data

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

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

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

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

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

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

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

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

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

(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site before submitting payment requests through

WAWF. Both can be accessed by selecting the “Web Based Training” link on the WAWF home page at https://wawf.eb.mil/.

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

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

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

(Contracting Officer: Insert applicable document type(s). Note: If a “Combo” document type is identified but not supportable by the Contractor's business systems, an “Invoice” (stand-alone) and

“Receiving Report” (stand-alone) document type may be used instead.)

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

(Contracting Officer: Insert inspection and acceptance locations or “Not applicable”.)

(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 or “See schedule” if multiple ship to/acceptance locations apply, or “Not applicable.”)

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

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

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

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

(End of clause)

Section H - Special Contract Requirements

CLAUSES INCORPORATED BY FULL TEXT

N00183-0002 Authorized Callers (Medical) Only persons authorized by the Division Officer or his designated representative from Materiel Management department located in/at the Biomedical Engineering Division, Naval Medical Center, Portsmouth, VA, telephone (757) 953-5764, are to place trouble or repair calls against this maintenance agreement. Calls placed by unauthorized personnel may result in non-payment of services. In each instance that the contractor or his agent reports to Biomedical Engineering Division, Naval Medical Center, Portsmouth, VA, in response to the terms of this order, he shall log in an out with the Biomedical Engineering Division. When inspections and/or repairs have been completed, the contractor or his agent shall obtain the signature of the Department Head or his representative as applicable, on a detailed service ticket and shall leave the customer copy of the service ticket when checking out with the Biomedical Engineering Division. A copy of the service ticket shall be submitted with invoice for payment. In case of inquiries, call Biomedical Engineering Division, Naval Medical Center, telephone (757) 953-5764.

N00183-0004 PRIVACY AND SECURITY OF PROTECTED HEALTH INFORMATION

1. Introduction In accordance with DoD 6025.18-R “Department of Defense Health Information Privacy Regulation,” January 24, 2003, the Business Associate meets the definition of Business Associate. Therefore, a Business Associate Agreement is required to comply with both the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security regulations. This clause serves as that agreement whereby the Business Associate agrees to abide by all applicable HIPAA Privacy and Security requirements regarding health information as defined in this clause, and in DoD 6025.18-R and DoD 8580.02-R, as amended. Additional requirements will be addressed when implemented.

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 or DoD 8580.02-R.

(1) HITECH Act shall mean the Health Information Technology for Economic and Clinical Health Act included in the American Recovery and Reinvestment Act of 2009.

(2) Individual has the same meaning as the term “individual” in 45 CFR 160.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

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

(4) Protected Health Information has the same meaning as the term “protected health information” in 45 CFR 160.103, limited to the information created or received by the Business Associate from or on behalf of the Government pursuant to the Contract.

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

(6) Required by Law has the same meaning as the term “required by law” in 45 CFR 164.103.

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

(8) Security Incident will have the same meaning as the term “security incident” in 45 CFR 164.304, limited to the information created or received by Business Associate from or on behalf of Covered Entity.

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

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

b. The Business Associate shall not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law.

c. The Business Associate shall use appropriate safeguards to maintain the privacy of the Protected Health Information and to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

d. The HIPAA Security administrative, physical, and technical safeguards in 45 CFR 164.308, 164.310, and 164.312, and the requirements for policies and procedures and documentation in 45 CFR 164.316 shall apply to Business Associate. The additional requirements of Title XIII of the HITECH Act that relate to the security and that are made applicable with respect to covered entities shall also be applicable to Business Associate. The Business Associate 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 Business Associate shall, at their own expense, take action to mitigate, to the extent practicable, any harmful effect that is known to the Business Associate of a use or disclosure of Protected Health Information by the Business Associate in violation of the requirements of this Clause. These mitigation actions will include as a minimum those listed in the TMA Breach Notification Standard Operating Procedure (SOP), which is available at: http://www.tricare.mil/tmaprivacy/breach.cfm

f. The Business Associate shall report to the Government any security incident involving protected health information of which it becomes aware.

g. The Business Associate shall report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract of which the Business Associate becomes aware.

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

i. The Business Associate shall ensure that any agent, including a subBusiness Associate, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

j. The Business Associate shall provide access, at the request of the Government, and in the time and manner reasonably 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 Business Associate shall 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, and in the time and manner reasonably designated by the Government.

l. The Business Associate shall make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Business Associate, on behalf of the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner reasonably designated by the Government or the Secretary, for purposes of the Secretary determining the Government’s compliance with the Privacy Rule.

m. The Business Associate shall 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 Business Associate shall provide to the Government or an Individual, in time and manner reasonably 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.

2. General Use and Disclosure Provisions Except as otherwise limited in this Clause, the Business Associate 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, the HIPAA Security Rule, DoD 6025.18-R or DoD 8580.02-R if done by the Government. The additional requirements of Title XIII of the HITECH Act that relate to privacy and that are made applicable with respect to covered entities shall also be applicable to Business Associate.

3. Specific Use and Disclosure Provisions

a. Except as otherwise limited in this Clause, the Business Associate may use Protected Health Information for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate.

b. Except as otherwise limited in this Clause, the Business Associate may disclose Protected Health Information for the proper management and administration of the Business Associate, provided that disclosures are required by law, or the Business Associate 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 Business Associate 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 Clause, the Business Associate 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. Business Associate may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j)(1).

4. Obligations of the Government Provisions for the Government to Inform the Business Associate of Privacy Practices and Restrictions

a. The Government shall provide the Business Associate with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520.

b. The Government shall provide the Business Associate with any changes in, or revocation of, permission by Individual to use or disclose Protected Health

Information, if such changes affect the Business Associate’s permitted or required uses and disclosures.

c. The Government shall notify the Business Associate 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.

5. Permissible Requests by the Government The Government shall not request the Business Associate to use or disclose

Protected Health Information in any manner that…