RFQ 36C26222Q0266 HME 1-5-22.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

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

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

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

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 166

36C26222Q0266 1-5-2022

Singletary, Ryan 562-766-2272 1-20-2022

3 PM PST

36C262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815

X 100

X

621610

$16.5 Million

N/A

X

Department of Veterans Affairs 4811 Airport Plaza Drive Suite 600

Long Beach CA 90815

36C262

Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815

Government Purchase Card

See CONTINUATION Page

See CONTINUATION Page x X x 6

Singletary, Ryan

Home Medical Equipment Services RFQ

Quotes are due Thursday, January 20, 2022.

See details below.

36C26222Q0266

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 NOTIFICATION TO OFFERORS

B.3 INTRODUCTION AND PERFORMANCE WORK STATEMENT (PWS)

B.4 SUPPLIES OR SERVICES AND PRICES/COSTS

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

C.2 52.216-18 ORDERING (AUG 2020)

C.3 52.219-14 LIMITATIONS ON SUBCONTRACTING (SEP 2021)

C.4 52.219-13 NOTICE OF SET-ASIDE OF ORDERS (MAR 2020)

C.5 52.245-2 GOVERNMENT PROPERTY INSTALLATION OPERATION SERVICES

(APR 2012)

C.6 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.7 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.8 52.216-32 TASK-ORDER AND DELIVERY-ORDER OMBUDSMAN (SEP 2019) .. 47

C.9 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.10 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) . 48

C.11 52.223-18 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT

MESSAGING WHILE DRIVING (JUN 2020)

C.12 52.225-13 RESTRICTIONS ON CERTAIN FOREIGN PURCHASES (FEB 2021)

C.13 52.227-14 RIGHTS IN DATA—GENERAL (MAY 2014) ALTERNATE V (DEC

2007)

C.14 52.232-39 UNENFORCEABILITY OF UNAUTHORIZED OBLIGATIONS (JUN

2013)

C.15 52.233-3 PROTEST AFTER AWARD (AUG 1996) ALTERNATE I (JUN 1985)

C.16 52.244-6 SUBCONTRACTS FOR COMMERCIAL ITEMS (JUL 2021)

C.17 52.245-1 GOVERNMENT PROPERTY (SEP 2021) ALTERNATE II (APR 2012)

C.18 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.19 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING

AND COMPLIANCE (JUL 2018)

C.20 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.21 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.22 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2021) (JUL

2020) (DEVIATION)

36C26222Q0266

C.23 52.223-99 ENSURING ADEQUATE COVID-19 SAFETY PROTOCOLS FOR

FEDERAL CONTRACTORS (OCT 2021) (DEVIATION)

C.24 VHA SUPPLEMENTAL CONTRACT REQUIREMENTS FOR ENSURING

ADEQUATE COVID-19 SAFETY PROTOCOLS FOR FEDERAL CONTRACTORS

(AMENDED OCTOBER 25, 2021)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVEILLANCE PLAN

HOME MEDICAL EQUIPMENT (HME) SERVICE

D.2 PAST PERFORMANCE QUESTIONNAIRE

D.3 WAGE DETERMINATIONS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (SEP 2021)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN

TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT

(OCT 2020)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.4 52.216-1 TYPE OF CONTRACT (APR 1984)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

E.7 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.8 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (FEB 2021) (JUL 2020) (DEVIATION)

36C26222Q0108

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT:

Contracting Officer 36C262 Ryan Singletary

Department of Veterans Affairs

Network Contracting Office 22

4811 Airport Plaza Drive

Suite 600

Long Beach CA 90815

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or [X] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [x] Monthly with COR Approved Invoice

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Government Purchase Card

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 NOTIFICATION TO OFFERORS

1. Authority: Home Medical Equipment (HME) Services are being procured in accordance with Public Law (PL) 38 United States Code (USC) 8153. This procurement shall be conducted in accordance with Federal Acquisition Regulation (FAR) Part 12 and FAR Part 13. This requirement may result in multiple awards with 100% of the awarded contract’s going to verified small business.

2. Offerors should reference enclosed FAR clause 52.212-2, Evaluation – Commercial Items for further information of requirements for the submission of quotes. Failure to do so may preclude the offeror from further consideration.

3. Offerors should thoroughly review the specifications and be familiar with the requirements of the solicitation prior to submitting quotes in order to be fully aware of the scope of services required. Failure to do so will not relieve the successful offeror from performing in accordance with the strict intent and meaning of the specifications without additional cost to the Government.

4. TECHNICAL INQUIRES: Direct all technical inquiries via email to the Contracting Officer, Ryan Singletary at Ryan.Singletary@va.gov no later than Thursday, January 13, 2022. Questions will only be answered by email.

5. DUNS NUMBER: Provide the Dun and Bradstreet Number assigned to your firm in the space provided below: (refer to FAR Provision 52.212-1, Instructions to Offerors – Commercial Items):

6. The FAR requires all contractors conducting business with the Government to be registered in three (3) separate and individual online databases:

a. The Federal Awardee Performance and Integrity Information System (FAPIIS) found at https://fapiis.ppirs.gov/, a subcomponent of the Past Performance and Information Retrieval System (PPIRS). As prescribed in FAR Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed $100,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor is provided an opportunity to comment on past performance evaluations prior to each report closing. The PPIRS database, which is available to all Federal agencies, is used to capture this information. Further, your registered representative data, as well as any other information in your registration data, must be kept current. Performance evaluations entered into PPIRS by the contracting officer will be assigned to the contractor’s registered representative for comment. Failure to comment and reassign the report back to the contracting officer, or to maintain current registration, will result in the Government’s evaluation being entered in the database with a statement that you have failed to respond.

b. Contractor Performance Assessment Reporting System (CPARS): As prescribed in FAR Part 42.15, the VA evaluates contractor past performance on all contracts that exceed $100,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that that the contractor is provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement, VA uses an online database, the CPARS, which is maintained by the National Institutes of Health (NIH). The CPARS database information is shared with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. You are required to register with the CPARS database at the following web address: https://cpars.gov/. Further, your registered representative data, as well as any other information in your registration data, must be kept current. Performance evaluations entered into CPARS by the contracting officer will be assigned to the contractor’s registered representative for comment. Failure to comment and reassign the report back to the contracting officer, or to maintain current registration, will result in the Government’s evaluation being entered in the database with a statement that you have failed to respond. Help in registering can be obtained by contacting CPARS Support by calling (207) 438-1690.

c. The System for Award Management (SAM) for the provision of basic information relative to contract awards found at https://www.sam.gov/. After initial registration, the contractor is required to update registration data as changes occur and must re-register annually to ensure all data remains current. Noncompliance with this requirement will preclude the exercising of any option periods that may be included herein and will be cause for termination of the contract at such time noncompliance is discovered. Refer to FAR Clause 52.212-4, para (t) for more details. IT IS IMPERATIVE THAT ALL OFFERORS COMPLETE THESE REGISTRATIONS IN ORDER TO BE CONSIDERED FOR CONTRACT AWARD. Award cannot be made to a contractor without current registration in each of these database systems.

B.3 INTRODUCTION AND PERFORMANCE WORK STATEMENT (PWS)

INTRODUCTION: The Service Area Office (SAO)-West, Network Contracting Office-22 (NCO-22), Long Beach, CA, will solicit and award a contract in accordance with FAR Part 12, Acquisition of Commercial Items and FAR Part 13. Award shall be based on the offeror’s ability to provide those specific services listed in the section entitled Supplies or Services and Prices/Costs. Award will be made to the responsible Offeror(s), who in the conforming to this solicitation, is determined most advantageous to the Government, cost and other factors considered, of which Technical and Past Performance are required to be submitted (see Addendum 52.212-2 Evaluation – Commercial Items). The NCO anticipates award of a Firm-Fixed Price, Indefinite Delivery Indefinite Quantity (IDIQ) Contract. The number of quantities specified in the schedule are estimates only and are subject to change. The Government is not obligated to purchase any specified amount of supplies or services under resulting contracts, but shall be obligated to make payment for all supplies and services mailto:Ryan.Singletary@va.gov https://fapiis.ppirs.gov/ https://cpars.gov/ https://www.sam.gov/ requested and received in the quantities and of the quality requested. The NAICS Code for this procurement is 621610. All responses/or questions must be in writing via mail, email, or fax (no telephone inquiries will be accepted). Respond to:

Department of Veterans Affairs VHA Regional Procurement Office – West (RPOW) Network Contracting Office-22 Attention: Ryan Singletary 4811 Airport Plaza Dr. Suite 600 Long Beach, CA 90815 Fax: 562-766-2272 Email: Ryan.Singletary@va.gov

PERFORMANCE WORK STATMENT:

HOME MEDICAL EQUIPMENT SERVICES

1. SCOPE OF WORK

1.1 The contractor shall provide all the necessary labor, facilities, transportation and management to perform delivery and pick-up services, set-up and disassembly, minor repair and storage of government-owned Home Medical Equipment (HME). Services will be provided to VA beneficiaries as directed by the Veterans Integrated Service Network (VISN) 22 Prosthetic and Sensory Aids Services Departments listed herein. The use of the terms “Veteran”, “beneficiaries” and “patient” are used interchangeably and refer to the recipient of required equipment and incidental services required under the contract.

1.2 All services will be performed in the Veteran’s place of residence. The contractor shall have a facility or resources physically located in the area of service depicted in Attachment 1, in which they will provide service. The contractor’s office location shall include the service office, warehouse, dispatch of vehicles and other functions related to the performance of services of this contract within a fifty

(50) mile radius of the VA facilities listed in Attachment 1 to facilitate periodic inspections by VA and/or other accrediting agencies. The geographical boundaries described herein (see Attachment 1) have been determined as the areas of responsibility/jurisdiction for each VA Medical Center (VAMC). The listing of counties for each VAMC does not exclude the provision of services in other counties. Some counties are served by more than one VAMC.

The participating facilities covered in this solicitation are:

VA Greater Los Angeles Healthcare System

Prosthetics (121)

11301 Wilshire Blvd.

Los Angeles, CA 90073

COR: Aryeh Lax

Phone: 310-268-3875

FAX: 310-268-4763

VA Sepulveda Ambulatory Care Clinic

Division of VA Greater LA Healthcare System

Prosthetics (121)

16111 Plummer Street, Bldg. 200 Room 1502

North Hills, CA 91343

COR: Sherita Lawrence

Phone: 818-891-7711 x32980

Fax: 818-895-5832

VA Long Beach Healthcare System

Prosthetics (121)

5901 East Seventh Street

Long Beach, California 90822-5201

COR: Vinnie Dang

Phone: 562-826-5895

Fax: 562-346-5824

VA San Diego Healthcare System

Prosthetics (121)

3350 La Jolla Village Drive

San Diego, CA 92161

COR: Francisco Pinedo

Phone: 858-642-1658

FAX: 858-552-7533

VA Loma Linda Healthcare System

Prosthetics (121)

1790 Park Avenue, Suite 100

Redlands, CA 92374

COR: Veronica Gipson

Phone: 909-801-5694

Fax: 909-801-5980

VA Phoenix Healthcare System

Prosthetics (121)

650 E. Indian School Road

Phoenix, AZ 85012

COR: Andra Batie

Phone: 602-222-6537

Fax: 602-222-2778

VA Tucson Healthcare System

Prosthetics (121)

3601 South Sixth Avenue

Tucson, AZ 85723-0001

COR: Danny Serna

Phone: 520-629-4938

Fax: 520-629-4679

VA Albuquerque Healthcare System

Prosthetics (121)

1501 San Pedro Dr. S.E.

Albuquerque, NM 87108

COR: Monica Trujillo

Phone: 505-256-5707

FAX: 505-256-2813

VA Prescott Healthcare System

Prosthetics (121)

500 Highway 89 North

Prescott, AZ 86313-5001

COR: Derrick Bayan

Phone: 928-717-7454

Fax: 928-632-6500

Period of Performance: The contract effective period shall be for a one (1) year Base period, 2/1/2022 through 1/31/2023, and four

(4) one-year Option Year renewal periods under FAR Clause 52.217-9.

2. SERVICE SPECIFICATIONS

2.1 Orders: The Contracting Officer’s Representative (COR) or designee will submit the request (via encrypted email or fax) to the contractor to initiate delivery, set-up, pick-up or repair of HME. The request may be made orally but will be confirmed in writing within one (1) working day. The contractor shall confirm receipt (via VA approved encrypted email and fax) of the request within two (2) working hours of notification.

2.2 Delivery/Set-up of HME: The contractor shall deliver HME to patients, within forty-eight (48) hours of request from the COR or designee (dependent on patient’s availability), to include after normal business hours, weekends and holidays; this response time will also apply to service calls. Upon receipt of a request, the contractor will schedule by telephone a delivery time with the patient/caregiver. If a delivery time cannot be scheduled within the time frame stated above, the contractor will document all attempts and notify the COR or designee. Retrieved/refurbished equipment will be issued before new equipment is issued - unless otherwise instructed by VA COR or designee.

2.3 HME delivered will be clean, sanitized, and/or disinfected. HME will be packed to avoid damage during transport to the patients’ home. HME will be in operating condition. If a piece HME is delivered and is unserviceable, or the delivery is incomplete, (i.e., all components not delivered), subsequent JOBs will be made without additional cost to the Government. The scheduled time for delivery must be met, even if multiple JOBs as a result of the contractor's actions are required.

2.4 Home Assessment Requirements: The contractor will perform a home safety assessment to ensure the home environment is safe and adequate for the intended use of the HME. The assessment includes, but is not limited to the following:

a. Potential spatial and cleanliness issues, which may impede safety and/or proper usage.

b. The contractor will check the adequacy of the electrical outlet(s) in the patient’s home if applicable to the HME. When it is determined that the electrical outlet(s) are not properly grounded, but it is otherwise adequate, the contractor will provide and install a three (3) prong adapter.

c. If it is determined by the contractor, that the HME cannot be safely installed and used without creating a potential safety hazard for the patient/caregiver, the COR or designee will be notified immediately by phone. The delivery will not be completed until cleared by the COR or designee. In the event the COR advises the contractor that the delivery cannot be completed because of the safety and/or home environment related issues, the contractor will be entitled to payment for the delivery service.

2.5 Patient Education: The contractor will provide verbal and written instructions to patient and/or caregiver as part of delivery/set-up services. This will include, at a minimum, the following information:

a. Basic purpose, operating instructions, troubleshooting and correct use of HME

b. Safety precautions and warnings associated with the HME in relation to it’s in home use

c. Known safety hazards related to use with provision of a written checklist of HME information and safety checks incorporating the manufacturer’s instructions

d. When applicable, back-up HME and accessories, and emergency plans

e. Maintenance to be performed by the patient/caregiver

f. Any cleaning or disinfecting to be performed on HME or accessories and infection control procedures

g. Appropriate storage and transportation of HME

h. Demonstration of HME usage and observation of return demonstration by the patient/caregiver

2.6 The contractor will provide the Operation manual, if applicable, for all equipment to the patient and/or caregiver upon delivery of equipment.

2.7 Occasionally patients/caregivers will pick-up HME at the contractor's storage facility. The contractor will provide instruction on HME as appropriate.

2.8 Written instructions will be documented on the "Certification of Delivery" form, provided to the contractor by the VA.

2.9 The contractor will provide patients a copy of VA Patient Rights & Responsibilities. The VA Patient Rights & Responsibilities will be provided to the contractor by the COR.

2.10 The contractor will fully complete the “Certification of Delivery” form and submit it with each individualized itemized invoice.

Certification must be signed and dated by the patient/caregiver. Invoices received without or incomplete “Certification of Delivery” forms will be returned to the contractor without action.

2.11 Pick-up of equipment: The contractor will be required to pick-up HME from a patient’s home within forty-eight (48) hours of request from the COR or designee (or at the time arranged by the patient/caregiver) to include after normal business hours, weekends and holidays. The date and time of HME pick-up will be coordinated with the patient or next of kin. The contractor will make every effort to meet the patient’s or patient’s families’ requests for pick-up times. The contractor will honor patient’s or family’s requests to pick-up equipment before or after funerals or family gatherings relative to patients’ funeral. The contractor will treat such requests with the utmost courtesy and give such requests the highest priority. In the event a pick-up time cannot be scheduled with the patient/caregiver within forty-eight (48) hours, the contractor will notify the COR

2.12 All HME being picked up will be packed to avoid damage during transportation. HME returned as a unit will be packed together or marked clearly as a part of the overall unit for inventory.

2.13. Contractor may be required to perform repairs at Veteran’s place of residence. Service/repair calls may be invoiced for a minimum of one (1) hour.

Page 10 of

3. DISPOSABLE ITEMS: Retrieved or returned single use disposable items, i.e., mattresses, foam rubber cushions, pads and soft goods will NOT be stored but will be disposed of by the contractor at no additional cost to the Government. The contractor will comply with all Federal, State, and local laws and regulations governing the disposal of such items.

4. EMERGENCY SERVICE REQUEST: Emergency service requests may be for delivery or repair services and will be completed within four (4) hours after receipt of request. Cost for this service will be billed at an additional charge per JOB rate for Emergency service.

5. BILLING: Delivery/pick-up will be billed by JOB. Rates to include delivery/pick-up of HME to/from patients’ home, VA facilities and contractor's facilities, set-up/ disassembly of all government-owned HME, storage, documentation of instructions, issuance of patient's rights and responsibilities, home safety guidelines, universal precautions, removing from and placing into storage, record keeping for inventory control, testing, calibrations, and routine preventative maintenance (PM) and adjustments. Rates will also include minor repair, cleaning and disinfecting of HME.

6. LIST OF EQUIPMENT: The government-owned HME may be new or retrieved and refurbished. HME will include but not be limited to the following:

VA LONG BEACH HEALTHCARE SYSTEM

EQUIPMENT MONTHLY AVERAGE

1 Hospital beds with side rails (sets) 15

2 Hospital Bed Accessories (bed Extender, hand control pendent) 10

3 Standard mattresses 20

4 Bariatric beds 2

5 Specialty mattresses 10

6 Trapeze assemblies 10

7 Over-bed tables 10

8 Patient lifts & Accessories 5

9 Wheelchairs (manual) 2

10 Electric mobility devices (i.e., power wheelchairs & scooters) 5

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 2

12 Ambulatory aids (rollators, walkers, crutches, etc.) 5

13 Vehicle and Van lifts 2

14 Portable wheelchair ramps 2

15 Feeding Pumps & Intravenous Therapy (IV)Poles 3

16 Wheelchair batteries (repair and replace dead batteries) 5

VA LOMA LINDA HEALTHCARE SYSTEM

2 Hospital Bed Accessories (bed Extender, hand control pendent) 10

Page 11 of

3 Standard mattresses 22

4 Bariatric beds 2

5 Specialty mattresses 10

6 Trapeze assemblies 10

7 Over-bed tables 10

8 Patient lifts & Accessories 15

9 Wheelchairs (manual) 15

10 Electric mobility devices (i.e., power wheelchairs & scooters) 15

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 15

12 Ambulatory aids (rollators, walkers, crutches, etc.) 5

13 Vehicle and Van lifts 1

14 Portable wheelchair ramps 3

15 Feeding Pumps & Intravenous Therapy (IV)Poles 10

16 Wheelchair batteries (repair and replace dead batteries) 10

VA SAN DIEGO HEALTHCARE SYSTEM

2 Hospital Bed Accessories (bed Extender, hand control pendent) 10

3 Standard mattresses 20

4 Bariatric beds 2

5 Specialty mattresses 10

6 Trapeze assemblies 5

7 Over-bed tables 5

8 Patient lifts & Accessories 5

9 Wheelchairs (manual) 5

10 Electric mobility devices (i.e., power wheelchairs & scooters) 5

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 15

12 Ambulatory aids (rollators, walkers, crutches, etc.) 5

13 Vehicle and Van lifts 1

14 Portable wheelchair ramps 3

15 Feeding Pumps & Intravenous Therapy (IV)Poles 10

VA GREATER LOS ANGELES HEALTHCARE SYSTEM

Page 12 of

1 Hospital beds with side rails (sets) 15

2 Hospital Bed Accessories (bed Extender, hand control pendent) 10

3 Standard mattresses 20

4 Bariatric beds 2

5 Specialty mattresses 10

6 Trapeze assemblies 5

7 Over-bed tables 10

8 Patient lifts & Accessories 6

9 Wheelchairs (manual) 5

10 Electric mobility devices (i.e., power wheelchairs & scooters) 5

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 10

12 Ambulatory aids (rollators, walkers, crutches, etc.) 5

13 Vehicle and Van lifts 1

14 Portable wheelchair ramps 3

15 Feeding Pumps & Intravenous Therapy (IV)Poles 1

NEW MEXICO VA HEALTH CARE SYSTEM (NMVAHCS) – ALBUQUERQUE

1 Hospital beds with side rails (sets) 5

2 Hospital Bed Accessories (bed Extender, hand control pendent) 0

3 Standard mattresses 5

4 Bariatric beds 1

5 Specialty mattresses 3

6 Trapeze assemblies 3

7 Over-bed tables 5

8 Patient lifts & Accessories 3

9 Wheelchairs (manual) 5

10 Electric mobility devices (i.e., power wheelchairs & scooters) 0

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 5

12 Ambulatory aids (rollators, walkers, crutches, etc.) 0

13 Vehicle and Van lifts 0

14 Portable wheelchair ramps 0

15 Feeding Pumps & Intravenous Therapy (IV)Poles 3

16 Wheelchair batteries (repair and replace dead batteries) 0

Page 13 of

PHOENIX VA HEALTH CARE SYSTEM (PVAHCS)

NORTHERN ARIZONA HEALTH CARE SYSTEM (NAVAHCS) - PRESCOTT

1 Hospital beds with side rails (sets) 8

2 Hospital Bed Accessories (bed Extender, hand control pendent) 5

3 Standard mattresses 8

4 Bariatric beds 4

5 Specialty mattresses 0

6 Trapeze assemblies 8

7 Over-bed tables 8

8 Patient lifts & Accessories 4

9 Wheelchairs (manual) 0

10 Electric mobility devices (i.e., power wheelchairs & scooters) 0

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 30

12 Ambulatory aids (rollators, walkers, crutches, etc.) 0

13 Vehicle and Van lifts 0

14 Portable wheelchair ramps 0

15 Feeding Pumps & IV Poles 0

16 Wheelchair batteries (repair and replace dead batteries) 5

EQUIPMENT MONTHLY AVERAGE

1 Hospital beds with side rails (sets) 2

2 Hospital Bed Accessories (bed Extender, hand control pendent) 2

3 Standard mattresses 0

4 Bariatric beds 0

5 Specialty mattresses 0

6 Trapeze assemblies 0

7 Over-bed tables 0

8 Patient lifts & Accessories 0

9 Wheelchairs (manual) 0

10 Electric mobility devices (i.e., power wheelchairs & scooters) 0

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 0

12 Ambulatory aids (rollators, walkers, crutches, etc.) 0

13 Vehicle and Van lifts 0

14 Portable wheelchair ramps 0

15 Feeding Pumps & IV Poles 0

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SOUTHERN ARIZONA VA HEALTH CARE SYSTEM (SAVAHCS) - TUCSON

2 Hospital Bed Accessories (bed Extender, hand control pendent) 10

3 Standard mattresses 5

4 Bariatric beds 2

5 Specialty mattresses 5

6 Trapeze assemblies 5

7 Over-bed tables 5

8 Patient lifts & Accessories 5

9 Wheelchairs (manual) 1

10 Electric mobility devices (i.e., power wheelchairs & scooters) 0

11 Bathroom safety aids (commode chairs, tub seats, tub benches) 1

12 Ambulatory aids (rollators, walkers, crutches, etc.) 1

13 Vehicle and Van lifts 0

14 Portable wheelchair ramps 0

15 Feeding Pumps & Intravenous Therapy (IV)Poles 1

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7. EQUIPMENT MAINTENANCE AND REPAIRS

7.1 All HME retrieved from a patient’s home will be held in a designated contaminated equipment area. Within five (5) working days of the pick-up, the contractor will assess the equipment and notify the COR or designee, in writing, via the "HOME MEDICAL EQUIPMENT RETURN TO STOCK REQUEST" form, provided to the contractor by the VA, that the item(s) have either been: 1) cleaned and ready for re-issuance in accordance with the requirements specified herein and placed in inventory, or 2) is in need of repair.

7.2 Before being placed in the clean HME storage area, all retrieved HME, in addition to being cleaned, will be checked for proper operation, function, safety, and serviceability. HME will then be inventoried and protectively wrapped in plastic. Cleaning and assessment are at no charge to the Government.

7.3 All reusable HME will be cleaned by steam or other approved methods. This will include, but not be limited to, washing by hand with a detergent disinfectant solution, quaternary ammonium and hospital grade disinfectants as identified and accepted by the Center of Disease Control.

7.4 Notification of items in need of repair will include a descriptive assessment of the item(s) condition and any recommendations for and/or estimated number of labor hours and parts needed to repair or refurbish PRIOR to starting any repair via the "HOME MEDICAL EQUIPMENT RETURN TO STOCK REQUEST" form. The contractor will not be reimbursed for repairs made without proper authorization. The estimate will also include the initials and last four of the SSN of the patient who last utilized the HME. The spare parts may be purchased by the VA for drop shipment to the contractor. Cost for repairs (other than minor repairs) will be billed as per Labor Rates in the Schedule of Supplies/Services. Repairs and refurbishment will be accomplished by appropriately trained and qualified personnel.

7.5 When it is it is determined by the VA that an item is beyond economical reconditioning or repair, the item will be held in storage, tagged as unserviceable, and returned to the VA (at no charge) or disposed as instructed.

7.6 In accordance with sound industry practice, and the terms and conditions of the contract, the contractor will be responsible for the proper care, maintenance, and use of government-owned HME in its possession or control from the time of receipt until properly relieved of responsibility from that property by the COR or COR representative.

8. STORAGE

8.1 Clean HME: All government-owned HME, (new) and retrieved (used), that has been cleaned, sanitized, disinfected and refurbished, will be stored on the contractor's premises in a secured area designated solely for "clean" government-owned HME. A separate storage area will be designated for each VAHCS. The vendor should allow for adequate space to service equipment and to store equipment that is awaiting parts and service.

8.2 The “clean” HME storage area will be segregated from other functions of the contractor’s business. The storage area must be adequately equipped with industrial steel shelves and bins to properly accommodate the items being stored and use the space most efficiently. Storage areas will be labeled with the following information: a) Item Master Number (if applicable), assigned by the VA for each model of equipment; b) Manufacturer, c) Stock level, d) Re-order levels (stock and re-order levels will be determined by each facility). Oversized boxes or containers will not be stored on the floor, but on raised pallets and/or platforms. The storage area must be climate controlled, no lower than 55 degrees and no higher than 85 degrees Fahrenheit, with adequate ventilation/air circulation to protect HME from deterioration from dust, moisture/humidity and extreme temperatures. HME will be stored in an orderly manner to allow for immediate access to all items and to its component parts. Only HME which is suitable and ready for immediate issuance to patients will be stored in the clean equipment storage area.

8.3 The contractor will ensure HME is marked appropriately for identification as government-owned property and identify the VA facility accountable for the HME. All HME tags will be marked in bold lettering 'VA' along with the following information:

Date picked up Patient’s initials and last four of social Make & Model Serial Number Date Cleaned & inspected Date of last preventive maintenance Status:

To be repaired Ready to issue

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Cannot be repaired

8.4 The contractor will provide a separate secured holding area for HME pending cleaning, sanitizing, disinfecting, servicing and/or refurbishing. The holding area will be secured and maintained in such a manner as to prevent the possibility of contamination of cleaned HME. The holding area may be a shared area in which the contractor uses for the same purpose.

Note: There will be no additional charge for storage of HME

9. INVENTORY

9.1 The VA will purchase HME and/or parts for repairs for drop-shipment directly to the contractor for storage. It is the contractor’s responsibility to: 1) properly receive HME, 2) check for damage before accepting receipt from shipper, 3) document receipt, 4) tag appropriately as government-owned HME, 5) place in storage area, 6) immediately EMAIL and/or FAX shipping documents along with purchase order information and acceptance certification to the appropriate VA ordering facility's COR. The contractor may provide acceptance certification on the packing list/shipping document provided by the supplier. All invoices, receiving documents, and acceptance certification shall be forwarded to the COR no later than five (5) calendar days of receipt of HME.

9.2 In the event overages, shortages, or damages are discovered upon receipt of government-owned HME and/or parts, the contractor will provide a statement of the condition and apparent causes to the COR immediately, no later than twenty-four (24) hours after occurrence. Only the quantity received will be recorded in the inventory control record.

9.3 The contractor will maintain inventory controls and prepare a perpetual inventory control record of all government-owned HME, new and retrieved, held in storage under the terms of this contract. The contractor will perform weekly inventory counts to maintain the required inventory levels and to ensure that proper inventory procedures are operating effectively. A copy of the weekly inventory report will be provided via email and/or FAX (FAX Numbers will be provided upon contract award) as determined by the appropriate COR by Friday of each week. The contractor will provide a listing of all inventory awaiting repairs and item status.

9.4 The contractor's inventory control record will contain the following basic information for every item of government-owned HME in the contractor's possession:

HME Description Model Number Serial Number New or Used Location (clean storage, temporary storage or patients’ home)

9.5 Discrepancies of inventory will be investigated by the contractor and a written explanation provided to the appropriate facilities COR via email and/or FAX. Resolution of discrepancies must be completed before the next inventory reporting period.

9.6 The contractor and each facility COR will establish procedures to notify COR if inventory of an item reaches a point that an emergency order for that item needs to be completed.

9.7 The contractor will also maintain a cumulative log of HME issued during the contract period. The log will contain the following information:

Date issued Patient’s initials and SSN Make, Model and Serial Numbers

9.8 Immediately upon termination or completion of the contract, the contractor will perform a physical inventory, adequate for disposal purposes, of all government-owned HME applicable to the contract and provide the CORs with the Inventory Control Record document within seventy-two (72) hours after termination or completion.

9.9 The Department of Veterans Affairs has placed a high priority on inventory control. If, during the duration of the contract, new VA Inventory System becomes a reality a Bar Code Reader to assist with maintaining an accurate inventory may be furnished to the contractor by the VA. In the event this occurs, the contractor will be responsible for the safe storage and proper use of the Bar Code Reader.

10. REPORTS

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10.1 Sentinel Events: The contractor is required to verbally inform the COR of all accidents, malfunctions, injuries and deaths related to the delivery and use of HME IMMEDIATELY. A follow-up written report of contact describing the event, analysis of cause/effect, and corrective action taken, will be provided to the COR within five (5) working days of the verbal report.

10.2 Patient Inquiries: The contractor will make a written report of all inquiries, complaints, and requests received from patient or caregivers and furnish a copy to the COR. The written report must contain at a minimum: the nature of the inquiry, complaint, or request; the contractor’s decision; and, the basis for the decision and outcome. The report will be signed by the contractor’s employee who received the call and the contractor’s official who reviewed it for appropriate action. All complaints will be addressed and resolved within five (5) days. All records will be provided to the COR for review upon request and/or at quarterly site visits.

10.3 Patient Satisfaction Report: patient satisfaction surveys will be conducted quarterly with a random 10% sampling. Analysis of the surveys along with originals of the actual surveys will be provided to the COR or designee, (along with any actions taken) quarterly, or upon request.

11. REQUIREMENTS AND STANDARDS

11.1 JOINT COMMISSION ACCREDITATION: The contractor must be accredited by the Joint Commission and maintain that accreditation. If at any time the contractor loses Joint Commission accreditation or receives provisional accreditation, the VA must receive immediate notification in writing citing the deficiencies and supplemental recommendations. As a result of any of the above actions, the VA reserves the right to terminate the contract.

11.2 The contractor will have a minimum of two (2) years’ experience in storage, delivery, set-up, education, maintenance and pick-up of Home Medical Equipment related to the requirements contained herein, or in a related field.

11.3 The contractor will develop and maintain personnel records for all employees providing services under this contract and make available for review upon request of the Contracting Office or COR. Personnel must submit to drug testing and back-ground check as required by the contractor’s policy.

11.4 The contractor will provide and document employee orientation, ongoing employee education, and ongoing assessment of employee competence for all employees involved with the performance of this contract. The contractor will ensure that only contractor employees that have been properly trained and who have demonstrated competency perform equipment deliveries, recoveries, and patient education on the equipment provided under this contract.

11.5 The contractor will be sufficiently staffed to render satisfactory and courteous service at all times to patients. The Contractor will be responsible for the acts and omissions of its employees, its sub-contractors or satellite office and their employees. Sub-contractors are required to adhere to the requirements of this contract; the contractor will ensure its sub-contractors adhere to the requirements of this contract.

11.6 It is of the utmost importance that a high degree of sensitivity and professionalism be demonstrated when patient/caregiver contact is made. The patients serviced by this contract have significant physical disabilities or chronic illnesses that, in many cases, influence their behavior and lifestyle. The contractor is expected to be discreet and tactful, and to demonstrate concern, compassion, and patience.

11.7 The contractor shall require that its employees wear a uniform when providing on-site services to patients under this contract and that employees present and maintain a professional appearance during the performance of this contract. Contractor’s employees shall bear identification when providing services or making deliveries. Such identification will show the company name, employee’s name and the employee’s picture

11.8 The VA reserves the right to remove any contractor employee from the performance of service under this contract if their behavior and the level of service provided are not in accordance with the specifications and requirements contained herein.

11.9 The contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPPA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs. In accordance with HIPPA, the contractor may be required to enter into a Business Associate Agreement (BAA) with the VA.

11.10 The contractor shall employ Universal Precautions in ALL aspects of services provided under this contract in accordance with Joint Commission requirements. All packaging and marking for infection control shall meet Joint Commission requirements, as well as

Page 18 of storage methods and facilities. VA Survey Teams will be responsible for periodic inspections to insure Joint Commission compliance is met.

11.11 Infection control requirements: If contaminated and clean items are transported in the same vehicle, the vehicle will have clearly demarcated areas for contaminated and clean items. The contractor’s procedure for handling the pick-up of contaminated equipment will meet Joint Commission Standards.

a. Contractor will have a current plan for surveillance, prevention and control of infection. The plan must meet or exceed current Joint Commission standards.

b. Contractor will provide a list of names to the COR or designee of all patients exposed to communicable diseases by contracted staff during an identified incubation period within 24 hours of identifying this exposure. The type of exposure will also be identified.

c. The COR or designee will consult with VA infection control staff regarding the need to contact exposed patients and/or complete any needed medical follow-up

11.12 Contractor Vehicles: The contractor will have duly licensed vehicles able to transport the maximum weight recommended by the vehicle manufacturer. The contractor will ensure the vehicles used in the performance of this contract are licensed and meet the minimum requirements as mandated by each state/county/city in which performance occurs. All vehicles will be clearly identified with the contractor’s name.

11.13 Insurance Requirements: The contractor agrees to procure and maintain, while the contract is in effect, Worker's Compensation, Employer's Liability, General Liability and Motor Vehicle Liability Insurance in accordance with the laws of the States wherein services will be provided. The policy will provide coverage for Public Liability Limits of not less than the statutory limitation for any one accident, and at least meeting the statutory limitation, if more than one person is involved.

11.14 Evidence of Coverage: Before commencing work under the contract, the contractor will furnish to the Contracting Officer a certificate of insurance indicating the coverage outlined herein and containing an endorsement to the effect that cancellation of, or any material change in the policies which adversely affect the interests of the Government in such insurance will not be effective unless a 30-day advance written notice of cancellation or change is furnished the Government.

11.15 EQUIPMENT CHANGE OUT FROM PREVIOUS CONTRACTOR(S): When there is a change in the contractor, the new contractor will pick-up all government-owned HME and related supplies from the previous contractor and will store that equipment until it is ready to be issued to patients. A mutually acceptable relocation date will be coordinated by the COR with the new and prior contractors to facilitate a smooth transition without disrupting the provisions of services to patients. The transition will include the transfer of all inventory records.

12. CONTRACT MONITORING

12.1 The VA COR or designee will monitor the contractor's performance in the following areas:

a. Was the set-up or delivery completed within 48 hours

b. Was all documentation received in Prosthetics within five (5) working days

c. Did the paperwork indicate New or Used

d. Serial Numbers annotated

e. Was patient education completed

f. Were patient or caregivers’ signatures obtained

g. Were any safety issues identified & noted

h. Was the overall documentation correct, complete and timely

12.2 The contract will be monitored in the above areas and will allow for a maximum non-compliance rate of no more than 15% in any individual area and will allow for an overall non-compliance rate of 10% in all areas combined.

12.3 The COR will perform a scheduled on-site visit of the contractor's facility bi-annually or as needed, to inspect the facilities and review necessary documented records to monitor contractor’s compliance with the specifications of the contract. The Government reserves the right to conduct unscheduled on-site visits at any time of contractor's facility to visually inspect all government-owned HME and to insure contractor compliance. The contractor agrees to make available all records and documentation necessary during any on-site visit.

13. CONTRACTOR’S FACILITY

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13.1 The contractor’s facility will meet the requirements of the solicitation as it relates to storage of government-owned equipment.

Clean equipment, equipment awaiting repairs/reconditioning and equipment to be turned-in will be segregated in accordance with Joint Commission standards.

13.2 The contractor’s facility will provide a proper area for providing instructions to VA beneficiaries and an environment that is safe and secure for VA beneficiaries seeking services required under this contract. The contractor’s facility will be accessible for persons with disabilities and be representative of the VA’s good image in appearance and safety.

14. HOURS OF SERVICE: The contractor shall perform the services as specified herein twenty-four (24) hours per day seven (7) days per week, including National Holidays. Services will normally be requested during normal business hours, however, after hour and weekend services may be required (see 4. EMERGENCY SERVICE REQUEST). Normal business hours are 7:30 a.m. to 5:00 p.m.

Monday through Friday. The contractor must present the COR with a plan for handling requests outside of normal business hours.

B.4 SUPPLIES OR SERVICES AND PRICES/COSTS

GREATER LOS ANGELES VA HEALTH CARE SYSTEM

(GLAVAHCS)

BASE YEAR: XX/XX/XXXX through XX/XX/XXXX

ITEM

NUMBER

DESCRIPTION OF SUPPLIES/SERVICES ESTIMATED

ANNUAL

QUANTITY

UNIT UNIT

PRICE

ESTIMATED

PRICE

A001GLA Delivery/pick up within 50 miles of NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

600 JOB

A002GLA Delivery/pick up within 51 - 100 miles of NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

150 JOB

A003GLA Delivery/pick up within 101 - 150 miles of NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

195 JOB

A004GLA Delivery/pick up within 151 - 200 miles of NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

125 JOB

A005GLA Delivery/pick up over 200 miles from NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

90 JOB

A006GLA Veteran self pick up of HME at Contractor facility with instructions. No charge for self pick up without instructions

12 JOB

A007GLA Labor charges for repairs (other than minor repairs, PMIs or adjustments) to HME maintained under the contract

110 HOUR

A008GLA Emergency service charges will be ADDED to the base delivery charge. Delivery/repair shall be made within 4 hours.

105 JOB

BASE

YEAR

GRAND

TOTAL

1st OPTION YEAR: XX/XX/XXXX through XX/XX/XXXX

NUMBER

DESCRIPTION OF SUPPLIES/SERVICES ESTIMATED

ANNUAL

QUANTITY

UNIT UNIT

PRICE

ESTIMATED

PRICE

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A001GLA Delivery/pick up within 50 miles of NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

600 JOB

A002GLA Delivery/pick up within 51 - 100 miles of NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

150 JOB

A003GLA Delivery/pick up within 101 - 150 miles of NMVAHCS or HME Facility, whichever is closest to delivery/pick up location

195 JOB

A004GLA Delivery/pick up within 151 - 200 miles of NMVAHCS or HME Facility, whichever is closest to…