RFQ 75H70624Q00048 PKG.pdf

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the

Federal Acquisition Streamlining Act of 1994) (Public Law 103-355). This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) intends to award a Firm-Fixed Price, Commercial

Item, Purchase Order in response to Request for Quote (RFQ) #75H70624Q00048.

C. This solicitation document and incorporated provisions and clauses are those in effect through

Federal Acquisition Circular 2024-05.

D. This RFQ is issued as 100% Small Business Set-Aside, and the associated NAICS Code is #339115, which has a small business standard size of 1,000 employees.

E. The quoted unit pricing must be all inclusive (to include but not be limited to travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

Complete the attached RFQ # 75H70624Q00048.

F. To be provided for the Wagner Indian Health Service, 110 Washington Street, Wagner, South

Dakota 57380.

The Period of Performance will be Base Year with Three (3) Option Years.

G. FAR 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (SEP

2023).

Quotes shall be submitted on company letterhead stationery, signed, dated and it shall include:

1. RFQ Number: 75H70624Q00048

2. Closing Date: August 19, 2024 at 12PM CT

3. Name, address, and telephone number of company. Email address of a contact person.

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents if necessary.

5. Terms of any express warranty.

6. Price and any discount terms.

7. Remit to address, if different than mailing address.

8. A completed copy of the representations and certifications at FAR 52.212-3. (See FAR 52.212-

3(b) for those representations and certifications that the offeror shall complete electronically.)

9. Acknowledgement of Solicitation Amendments, if any issued.

10. Past Performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references including; contract numbers, points of contact with telephone numbers, and other relevant information.

11. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offerors that fail to furnish representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

H. FAR 52.212-2 Evaluation-Commercial Products and Commercial Services (NOV 2021)

Basis of Award is Lowest Price, Technically Acceptable “LPTA” factors determining the successful contractor. The Government will not use the formal source selection process described in FAR Part 15.

I. FAR 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial

Services (MAY 2024)

See attachment for full text. The Offeror shall complete only paragraphs (b) of this provision if the

Offeror has completed the annual representations and certifications electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. IF the

Offeror has not completed the annual representations and certifications electronically, the

Offeror shall complete only paragraphs (c) through (p) of this provision.

J. FAR 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services

(NOV 2023). Applied to this acquisition and is by reference.

K. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive

Orders-Commercial Products and Commercial Services (MAY 2024) See attachment for full text.

L. Attached are the Federal Acquisition Regulations (FAR) and Health & Human Services Acquisition

Regulation (HHSAR) clauses that are applicable including below.

M. Special Contract Requirements

IT Equipment and Software Acquisitions

The Contractor must provide only new equipment and new parts for the required products described herein; no used, refurbished, or remanufactured equipment or parts shall be provided under any circumstances. Absolutely no "Gray Market Goods" or "Counterfeit Electronic Parts" shall be provided. Gray Market Goods are defined as genuine branded goods intentionally or unintentionally sold outside of an authorized sales-territory or by non-authorized dealers in an authorized territory. All equipment shall be accompanied by the Original Equipment

Manufacturers (OEM's) warranty. Counterfeit Electronic Parts are defined as unlawful or unauthorized reproduction, substitution, or alteration that has been knowingly mismarked, misidentified, or otherwise misrepresented to be an authentic, unmodified electronic part from the original manufacturer, or a source with the express written authority of the original manufacturer or current design activity, including an authorized aftermarket manufacturer.

http://www.acquisition.gov/

Unlawful or unauthorized substitution includes used electronic parts represented as new, or the false identification of grade, serial number, lot number, date code, or performance characteristics.

"The Office of Management and Budget (OMB) mandates that U.S. federal agencies use the

Internet Protocol version 6 (IPv6). In November 2020, OMB issued memorandum M-21-07

"Completing the Transition to IPv6", which outlines the Federal government's strategic intent "to deliver its information services, operate its networks, and access the services of others using only

IPv6". The IHS requires all new IT systems (hardware and software) to operate in a pure IPv6 network environment. This includes on-premises services or third-party hosted services that require network integration into the IHS network. The Offeror's solution shall comply with the

IPv6 standards profile as defined by the NIST USGv6 Program: https://www.nist.gov/programs-projects/usgv6-program.

Additional Applicable Published Policy & Procedure

These referenced published policies and procedures are applicable to any contractor personnel providing services in accordance with this contract and are hereby incorporated by reference.

The contractor is responsible for ensuring that all applicable contractor and subcontractor employees engaged in the direct delivery of services for this contract are aware of the applicable terms and conditions that apply and have read and familiarized themselves with the content.

• Indian Health Service Circular 2016-04, Mandatory Seasonal Influenza Immunizations for the Civilian Health Care Personnel https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health- care-personnel/.

• IHS Special General Memorandum No. 95-04, Workplace Violence https://www.ihs.gov/ihm/sgm/1995/sgm-9504/.

• HHS Residual Standards of Conduct https://ethics.od.nih.gov/lawreg/hhs-resid-std.htm

• CFR Title 5, Chapter XLV-DHHS, Part 5501, Supplemental Standards of Ethical Conduct for Employees of the Department of Health and Human Services https://ethics.od.nih.gov/lawreg/5-CFR-5501-Unofficial-Compilation.pdf

• CFR Title 5, Part 2635.101, Basic Obligation of Public Service https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101

Service Contract Labor Standards

The Wage Determination, WD 2015-5373 Revision 24 dated April 30, 2024, is hereby incorporated by reference. The full text of the referenced wage determination can be accessed at https://sam.gov/content/wage-determinations.

Other Terms and Conditions

Contractors will provide the facility Clinical Engineering department copies of training certificates and/or a statement of competency for the specific makes/models of equipment their employees will be working on under the subsequent purchase order.

https://www.nist.gov/programs-projects/usgv6-program https://www.nist.gov/programs-projects/usgv6-program https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/circulars/2016/mandatory-seasonal-influenza-immunizations-for-civilian-health-care-personnel/ https://www.ihs.gov/ihm/sgm/1995/sgm-9504/ https://ethics.od.nih.gov/lawreg/hhs-resid-std.htm https://ethics.od.nih.gov/lawreg/5-CFR-5501-Unofficial-Compilation.pdf https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101 https://www.govinfo.gov/app/details/CFR-2019-title5-vol3/CFR-2019-title5-vol3-sec2635-101 https://sam.gov/content/wage-determinations

Contractors performing preventive maintenance (PM) on medical equipment shall provide the facility Clinical Engineering department a copy of that checklist prior to the work being performed, and a copy of the completed checklist after work is performed. The PM checklist shall follow the original equipment manufacturer's prescribed checks at the OEMs prescribed intervals.

Any parts replaced during repair or during routine maintenance that result in a separate charge to the IHS, shall be given to the facility Clinical Engineering department for inspection and will not be removed from the facility without express written consent of clinical engineering.

Security Clearance

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems, each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five business days for I.H.S. processing of fingerprints taken electronically at an I.H.S.

site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov. As soon as practicable, prior to the performance of the work, the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed-Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

Government will pay for the cost to process the contractor's suitability clearances.

However, multiple investigations for the same position may, at the Contracting http://exclusions.oig.hhs.gov/

Officer's discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

N. Invoice Submission and Payment

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum

Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic

Submission and Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis

(FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register, however, we encourage you make sure your organization and designated

IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at

(866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov.

The Contractor shall submit a signed and approved invoice to request payment. For services, it should be submitted at least on a monthly basis.

The Contractor shall include the following information on each invoice in accordance with the

Prompt Payment Act (5 CFR Part 1315.9(b)):

1. Contractor's name;

2. Invoice number and date;

3. Entire award number (Purchase Order Number/Delivery Order Number/Contract

Number) or other authorization number for delivery of goods or services;

4. Description (including dates of service), price, and quantity of goods and services rendered;

5. Shipping and payment terms;

6. SAM Unique Entity ID and Taxpayer Identifying Number (TIN); and

7. Contact name (where practicable), title and telephone number.

Payment shall be made by the:

GREAT PLAINS AREA

INDIAN HEALTH SERVICE

DIVISION OF FINANCIAL MANAGEMENT

114 5TH AVE SE

ROOM 309 FEDERAL BUILDING

https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

ABERDEEN, SOUTH DAKOTA 57401.

The Government reserves the right to accept or reject services if the level of work is unsatisfactory.

O. Offers will be accepted electronically only. Submit via to the following:

Great Plains Area Indian Health Service

Attn: William Kohl, Contract Specialist

115 4th Ave SE – Room 309

Aberdeen, SD 57401

EMAIL: William.Kohl@ihs.gov

Any questions, please submit by email to: William.Kohl@ihs.gov before August 16, 2024 by 12PM

CT.

Contractors will need a Unique Entity ID (UEI) number, TIN number, and be registered with www.sam.gov.

The contractor must provide only new equipment and new parts for the required products described herein; no used, refurbished, or remanufactured equipment or parts shall be provided under any circumstances.

mailto:William.Kohl@ihs.gov mailto:William.Kohl@ihs.gov http://www.sam.gov/

75H70624Q00048

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

08/07/2024 IHS1483969

1 6

INDIAN HEALTH SERVICE

Division of Acquisition Management Rm 309 Fed Bldg-115 4th Ave SE

Great Plains Area

Aberdeen SD 57401

Multiple

IHSWAGNER

110 WASHINGTON ST

WAGNER SD 57380

WAGNER

SD 57380

WILLIAM KOHL

08/19/2024 1200 CT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

***100% SMALL BUSINESS SET-ASIDE***

Solicitation for firm, fixed-price, non-personal service purchase order for to provide a

COMPREHENSIVE SERVICE AND SUPPORT AGREEMENT FOR

THE CARL ZEISS MEDITEC, INC EYE CARE INSTRUMENTS

at the Wagner Indian Health Service, 110 Washington Street, Wagner, South Dakota 57380.

Period of Performance will be a Base Year, plus 3 Option Years.

BASIS FOR AWARD: Quoters are advised that award shall be made to the Lowest Price Technically Acceptable (LPTA) offer. Quotes will also include the following to be considered acceptable.

Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 6

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70624Q00048

1. Complete and signed SF-18, Request for

Quotations

2. Provide Items per Specifications

Any questions regarding this solicitation shall be requested before August 16, 2024, before 12PM

CT in writing by email to William Kohl, at

William.Kohl@ihs.gov.

The quoted unit price is an all-inclusive cost.

All-inclusive is defined to include travel, lodging, per diem, fringe benefits, Federal/State/Local taxes, plus any other costs pertinent to the performance of this contract.

Period of Performance: 08/26/2024 to 08/25/2025

1 BASE YEAR: 08/26/2024 - 08/25/2025

ITEM CODE: 000000-2149-432

DESCRIPTION: HFA3 860 S/N #860-11400

Carl Zeiss Meditec, Inc - OPTINE SERVICE COMPLETE

HFA 3 - 1 Year

Delivery: 08/25/2025

2 BASE YEAR: 08/26/2024 - 08/25/2025

ITEM CODE: 000000-2042-098

DESCRIPTION: CIRRUS 5000 S/N# 5000-18553

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

CIRRUS 5000 - 1 YEAR

Delivery: 08/25/2025

3 BASE YEAR: 08/26/2024 - 08/25/2024

ITEM CODE: 000000-2207-345

DESCTRIPTION: VISUCAM 224 S/N #1170017

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

VISUCAMM 224 - 1 YEAR

Delivery: 08/25/2025

4 OPTION YEAR ONE (1): 08/26/2025 - 08/25/2026

ITEM CODE: 000000-2149-432

DESCRIPTION: HFA3 860 S/N #860-11400

Carl Zeiss Meditec, Inc - OPTINE SERVICE COMPLETE

Continued ...

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

3 6

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70624Q00048

HFA 3 860 - 1 Year

(Option Line Item)

08/26/2025

Delivery: 08/25/2026

Period of Performance: 08/26/2025 to 08/25/2026

5 OPTION YEAR ONE (1): 08/26/2025 - 08/25/2026

ITEM CODE: 000000-2042-098

DESCRIPTION: CIRRUS 5000 S/N# 5000-18553

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

CIRRUS 5000 - 1 YEAR

(Option Line Item)

08/26/2025

Delivery: 08/25/2026

Period of Performance: 08/26/2025 to 08/25/2026

6 OPTION YEAR ONE (1): 08/26/2025 - 08/25/2026

ITEM CODE: 000000-2207-345

DESCTRIPTION: VISUCAM 224 S/N #1170017

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

VISUCAMM 224 - 1 YEAR

(Option Line Item)

08/26/2025

Delivery: 08/25/2026

Period of Performance: 08/26/2025 to 08/25/2026

7 OPTION YEAR TWO (2): 08/26/2026 - 08/25/2027

ITEM CODE: 000000-2149-432

DESCRIPTION: HFA3 860 S/N #860-11400

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

HFA 3 860 ? 1 Year

(Option Line Item)

08/26/2026

Delivery: 08/25/2027

Period of Performance: 08/26/2026 to 08/25/2027

8 OPTION YEAR TWO (2): 08/26/2026 - 08/25/2027

ITEM CODE: 000000-2042-098

DESCRIPTION: CIRRUS 5000 S/N# 5000-18553

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

CIRRUS 5000 - 1 YEAR

(Option Line Item)

08/26/2026

Delivery: 08/25/2027

Period of Performance: 08/26/2026 to 08/25/2027

4 6

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70624Q00048

9 OPTION YEAR TWO (2): 08/26/2026 - 08/25/2027

ITEM CODE: 000000-2207-345

DESCTRIPTION: VISUCAM 224 S/N #1170017

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

VISUCAMM 224 - 1 YEAR

(Option Line Item)

08/26/2026

Delivery: 08/25/2027

Period of Performance: 08/26/2026 to 08/25/2027

10 OPTION YEAR THREE (3): 08/26/2027 - 08/25/2028

ITEM CODE: 000000-2149-432

DESCRIPTION: HFA3 860 S/N #860-11400

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

HFA 3 860 ? 1 Year

(Option Line Item)

08/26/2027

Delivery: 08/25/2028

Period of Performance: 08/26/2027 to 08/25/2028

11 OPTION YEAR THREE (3): 08/26/2027 - 08/25/2028

ITEM CODE: 000000-2042-098

DESCRIPTION: CIRRUS 5000 S/N# 5000-18553

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

CIRRUS 5000 - 1 YEAR

(Option Line Item)

08/26/2027

Delivery: 08/25/2028

Period of Performance: 08/26/2027 to 08/25/2028

12 OPTION YEAR THREE (3): 08/26/2027 - 08/25/2028

ITEM CODE: 000000-2207-345

DESCTRIPTION: VISUCAM 224 S/N #1170017

Carl Zeiss Meditec, Inc - OPTIME SERVICE COMPLETE

VISUCAMM 224 - 1 YEAR

(Option Line Item)

08/26/2027

Delivery: 08/25/2028

Period of Performance: 08/26/2027 to 08/25/2028

Quotation must set forth, full, accurate and complete information as required by the Request for Quotation (RFQ) and be returned no later than the date referenced in Block #10 of the Request for Quotation form SF-18. All required Quotation must set forth, full, accurate and complete information as required by the Request for

Quotation (RFQ) and be returned no later than the

5 6

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70624Q00048 date referenced in Block #10 of the Request for

Quotation form SF-18. All required information must be submitted in order to be considered responsive and eligible for award.

ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least THIRTY (30) days from the date of receipt by the Government. Quotation must set forth full, accurate and complete information as required by the Request for

Quotation (RFQ) and be returned no later than the date reference in Block #10 of the Request for

Quotation Form SF-18. All required information must be submitted in order to be considered responsive and eligible for award.

No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

Contractor must be registered with the System for

Award Management (SAM) before award can be made.

The website to register at is: www.sam.gov.

INVOICE SUBMISSION AND PAYMENT

In compliance with the Office of Management and

Budget (OMB) M-15-19 memorandum Improving

Government Efficiency and Saving Taxpayer Dollars

Through Electronic Invoicing directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors.

Invoices submitted under any award resulting from this solicitation will be required to utilize the

Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and

Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasury?s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St.

Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if

6 6

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70624Q00048 they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register, however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or

IPPCustomerSupport@fiscal.treasury.gov.

The Contractor shall submit a signed and approved invoice to request payment. For services, it should be submitted at least on a monthly basis.

The Contractor shall include the following information on each invoice in accordance with the Prompt Payment Act (5 CFR Part 1315.9(b)):

1. Contractor's name

2. Invoice number and date

3. Entire award number (Purchase Order

Number/Delivery Order Number/Contract Number) or other authorization number for delivery of goods or services

4. Description (including dates of service), price, and quantity of goods and services rendered

5. Shipping and payment terms

6. SAM Unique Entity ID and Taxpayer Identifying

Number (TIN)

7. Contact name (where practicable), title and telephone number

Payment shall be made by the:

GREAT PLAINS AREA

INDIAN HEALTH SERVICE

DIVISION OF FINANCIAL MANAGEMENT

114 5TH AVE SE

ROOM 309 FEDERAL BUILDING

ABERDEEN, SOUTH DAKOTA 57401.

SCOPE OF WORK FOR SERVICE & SUPPORT:

Wagner Optometry Instruments

C-1 PURPOSE:

The purpose of this contract is to provide a comprehensive service and support agreement for Zeiss eye care instruments located at the Wagner Health Center, Wagner, SD. The award of a contract will be a firm-fixed price type.

C-2 SCOPE OF WORK:

Contractor shall provide to the Great Plains Area Indian Health Service, hereafter referred to as the Government, with the services described in this statement of work for the period specified.

Calibration/ Preventive Maintenance: The service to be performed by the contractor under this contract and for the bid price shall include ALL parts, labor, tools, equipment, literature, transportation, per diem necessary to provide complete calibration/preventive maintenance and mechanical/electrical safety testing as recommended by the original equipment manufacturer (OEM) and required by the Center for Medicare and Medicaid Services and various accrediting bodies. Only new or original equipment manufacturer (OEM) certified replacement parts will be used for replacement of any component found defective.

The Contractor shall submit, upon issuance of the contract, a schedule showing the dates of future/scheduled services per the

OEM recommended and/or statutorily required intervals. This schedule will comply with the interval/time definitions of TJC

Environment of Care accreditation standards.

All services are to be performed within the windows prescribed by CMS, TJC, DNV-GL and other accrediting entities:

• Quarterly: once every three months +/- 10 days

• Semi-annual: 6 months from the las scheduled event month +/- 20 days

• Annual: 12 months from the last scheduled event month +/- 30 days

Unscheduled Maintenance and parts: Unscheduled maintenance, repair, emergency call back, recall, modification, breakdown repair is covered under this contract, except as specifically listed under C-4 Exclusions. Contractor will provide at no additional cost to the Government all parts, labor, tools, equipment, literature, transportation and per diem necessary to provide complete repair of all unscheduled maintenance requirements. Only new or original equipment manufacturer (OEM) certified replacement parts will be used for replacement of any component found defective.

Removal: At no time shall the contractor remove, or cause to be removed, any device, operation option, or accessory from the healthcare clinic, hospital, or health station without express written consent from the Contracting Officer Representative or

Clinical Engineering.

Hours of Performance:

Unless otherwise stated, or negotiated, work shall be performed Monday through Friday, 8am to 5 pm excluding weekends and recognized Federal holidays. Preventative maintenance visits will be scheduled and notice given at least 2 weeks prior to visit.

This ensures adequate preparations for the clinic and scheduling or re-scheduling of patients as necessary.

C-3 EQUIPMENT:

ZEISS HFA3 860 S/N: 860-11400

ZEISS CIRRUS 5000 OCT S/N: 5000-18553

ZEISS VISUCAM 224 S/N: 1170017

C-4 EXCLUSIONS:

Contractor is not responsible for damage caused by failure to operate the equipment in accordance with manufacturer’s instructions, abuse, misuse, or neglect, or damage by fire, lightning, flood, tornado, windstorm, hail, earthquake, explosion, smoke, aircraft accident, motor vehicle accident, collapse of building, strike, riot, vandalism, power failure or fluctuations, heating or air conditioning failure.

In the event that the Contractor determines that there is probable cause to believe that an operator or equipment user is abusing, neglecting, or mishandling an item of equipment, the Contractor shall notify the COR.

The following are specifically excluded from this contract:

• Operating supplies or accessories not furnished by Contractor during the course of normal Preventive Maintenance

Inspection and Services, such as expendable items including recording charts, paper, ink, pens, ribbons, pen arms, etc.

• Work external to the equipment or maintenance of accessories, alterations, attachments or other devices not specifically covered under this contract unless noted in writing.

• Equipment which has been modified, altered, added to, improperly repaired, improperly installed, or used in violation of the manufacturer’s instructions or damages resulting from other than ordinary use.

• Peripherals, printers, UPS (unless otherwise specifically covered)

Any questions regarding the applicability of any or all determinations and/or findings that are subject to protest and/or disputes will be adjudicated by the Great Plains Area Indian Health Service Senior Contracting Officer.

C-5 DOCUMENTATION:

The Contractor shall provide all inspection forms and labels necessary to perform services as specified.

Preventive Maintenance must be a checklist showing the OEM’s recommended checks, that they were performed, and the results of the checks, the date next due, and the recommended interval(s)

The Contractor is required to present the service tickets/calibration record with the P.O. number of the service contract on them for each time a service is performed on the equipment, including PM’s. These service tickets shall not take the place of the

PM checklist. Lack of service tickets being presented will be cause for non-payment by the Government. One copy of the service ticket (together with the PM checklist) shall be left with the Department Supervisor and one copy (together with the

PM checklist) shall be provided to the COR within one week of the service. Service tickets may be submitted via email to abr_oehbiomed@ihs.gov (note there is an underscore between abr and oeh (abr_oeh)).

C-6 QUALITY CONTROL:

The Government reserves the right to review and verify the contractor’s work.

The Contractor shall have a prior successful history in providing services that demonstrates and ability to provide these services to the Government.

The Contractor shall provide documentation that any of their staff/employees servicing the equipment under this contract are qualified (i.e. OEM trained) and competent do perform the work if requested.

The Contractor shall also ensure that any of their staff/employees servicing the equipment have completed (via presenting certificates of completion) any mandatory training directed by the Indian Health Service, which may include annual information security awareness, protecting children from abuse/sexual assault, etc. Any required training will be available from the IHS and contractor staff provided access to those trainings.

C-7 BASIS OF PAYMENT:

All payments are due and payable upon receipt of complete and accurate invoices and in accordance with the Prompt Payment

Act. Invoices shall be submitted with all information and supporting documentation as described in C-5 Documentation. A complete and accurate invoice is substantially correct in that all aspects of the required information are clearly evident on the invoice. If items such as invoice number, date, dates of service, contract/purchase order number, etc., are not on the invoice, it will be returned to the Contractor for resubmission.

Invoices shall be submitted monthly via the U.S. Treasury’s Invoice Processing Platform (IPP) system for review, reconciliation and approval for payment.

mailto:abr_oehbiomed@ihs.gov

C-8 LIABILITY:

In no event shall the Government release the Contractor from liability arising from acts of omission, improper repair, negligence, or deliberate or non-deliberate acts that jeopardize the health and safety of patients and/or Government employees.

The rules of law governing such incidents or actions shall prevail.

C-9 RELEASES:

No information, findings, or determinations generated in pursuit of this contract may be released outside of the contractors’ immediate possession without the concurrence of the Contracting Officer.

C-10 WARRANTY:

All contractor labor shall be warranted for 30 days from the date the work was performed. All parts and material sold/provided by the contractor for installation under this contract will be warranted for a minimum of 30 days. Warranty call back service shall be provided during the warranty period at no additional charge.

C-11 CONTRACTOR’S TERMS & CONDITIONS:

The contractor’s terms and conditions shall be incorporated into the contract by reference. Where conflicts arise, the Federal

Acquisition Regulations, and other Federal Regulations, Laws and Rules shall take precedence.

C-12 PERIOD OF PERFORMANCE:

Base Year + Three (3) Option Years

CLAUSES INCORPORATED BY REFERENCE

Firm-Fixed Price, Commercial

FAR CITATION: 52.252-2 Clauses Incorporated by Reference (FEB 1998)

I. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR Citation Clause Title Clause Date

1. 52.204-7 System for Award Management OCT 2018

2. 52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards

JUN 2020

3. 52.204-13 System for Award Management Maintenance OCT 2018

4. 52.204-16 Commercial and Government Entity Code Reporting AUG 2020

5. 52.204-17 Ownership or Control of Offeror AUG 2020

6. 52.204-18 Commercial and Government Entity Code Maintenance AUG 2020

7. 52.204-19 Incorporated by Reference of Representations and Certifications DEC 2014

8. 52.204-21 Basic Safeguarding of Covered Contractor Information Systems NOV 2021

9. 52.209-6 Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment

NOV 2021

10. 52.211-6 Brand Name or Equal AUG 1999

11. 52.211-17 Delivery of Excess Quantities SEP 1989

12. 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services

SEP 2023

13. 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services

NOV 2023

14. 52.223-1 BioBased Product Certification MAY 2024

15. 52.225-13 Restrictions on Certain Foreign Purchases FEB 2021

16. 52.225-25 Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-Representation and Certifications

JUN 2020

17. 52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

18. 52.232-40 Providing Accelerated Payments to Small Business Subcontractors MAR 2023

19. 52.247-34 F.o.b.-Destination NOV 1991

20. 52.253-1 Computer Generated Forms JAN 1991

CLAUSES INCORPORATED IN FULL TEXT

II. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR Citation Clause Title Clause Date

1. 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

NOV 2021

2. 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services

MAY 2024

3. 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Products and Commercial Services

MAY 2024

4. 52.217-9 Option to Extend the Term of the Contract MAR 2000

5. 52.252-1 Solicitation Provisions Incorporated by Reference FEB 1998

6. 52.252-2 Clauses Incorporated by Reference FEB 1998

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or

Equipment.

As prescribed in 4.2105(a), insert the following provision:

Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

(Nov 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered

Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Products or Commercial Services.

The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision—

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video

Surveillance Services or Equipment.

(b) Prohibition. (1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for

Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements;

or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019

(Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements;

or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award

Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for

"covered telecommunications equipment or services".

(d) Representation. The Offeror represents that—

(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—

It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures. (1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided;

and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded

"does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(End of provision)

52.212-3 Offeror Representations and Certifications—Commercial Products and Commercial Services.

As prescribed in 12.301(b)(2), insert the following provision:

Offeror Representations and Certifications—Commercial Products and Commercial Services (May 2024)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.

(a) Definitions. As used in this provision—

Covered telecommunications equipment or services has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or

Equipment.

Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United

States and who are economically disadvantaged in accordance with 13 CFR part 127, and the concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

Forced or indentured child labor means all work or service—

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

Highest-level owner means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

Immediate owner means an entity, other than the offeror, that has direct control of the offeror.

Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

Inverted domestic corporation, means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Manufactured end product means any end product in product and service codes (PSCs) 1000-9999, except—

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the

Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

Predecessor means an entity that is replaced by a successor and includes any predecessors of the predecessor.

Reasonable inquiry has the meaning provided in the clause 52.204-25, Prohibition on Contracting for

Certain Telecommunications and Video Surveillance Services or Equipment.

Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174).

Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate—

(1) Are conducted under contract directly and exclusively with the regional government of southern

Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the

Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended. "Sensitive technology"—

Sensitive technology—

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically—

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor,…