S02 Ground Ambulance MVAHCS 36C26326Q0088.docx
DOCX document 322 KB Posted
- Attached to
- MVHAHCS Ground Ambulance IDIQ RFQ Combined Pre-Solicitation Notice and Solicitation Notice
- Solicitation number
- 36C26326Q0088
About this file
This is a Solicitation/Contract/Order for Commercial Products and Commercial Services (Standard Form 1449) for ground ambulance services to support the Minneapolis VA Health Care System. The Minneapolis VA, located at 1 Veterans Drive, Minneapolis, MN 55417, seeks to establish a 5-year firm fixed-price, indefinite delivery/indefinite quantity (IDIQ) contract with an estimated maximum value of $7,600,000 and a minimum guarantee of $1,000. The contract covers an ordering period from April 1, 2026 through March 31, 2031, with pricing periods established for a base year (04/01/2026–03/31/2027) and four option years. The solicitation is unrestricted (not set aside for small business), with a NAICS code of 621910 (Ambulance Services) and a size standard of $22.5 million. The question deadline is March 13, 2026 at 5:00 p.m. CST, and offers are due March 25, 2026 at 5:00 p.m. CST. Offers must be submitted electronically to Jeffrey.Brown8@va.gov in Microsoft Word, Adobe PDF, or Microsoft Excel format, with pricing in Volume I and technical/past performance information in Volume II.
The Performance Work Statement requires the contractor to provide non-emergency ambulance transportation services available 24/7 including weekends and holidays across Minnesota, Wisconsin, Iowa, South Dakota, North Dakota, and Nebraska for veterans and beneficiaries. Services include stretcher transports, Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) up to Tier III capabilities. The contract specifies nine line items for the base period and option years with pricing based on transport type (base rates including first 40 miles and 15 minutes wait time, mileage rates for loaded transports, and waiting time charges). The contractor must maintain a Quality Control Plan, demonstrate capability to handle up to four simultaneous transport requests, maintain compliance with Service Contract Labor Standards (prevailing wage requirements), provide workers' compensation and general liability insurance ($500,000 per occurrence), and comply with HIPAA, blood-borne pathogen protocols, and annual VHA compliance training requirements. Additional requirements include vehicle maintenance standards, EMT/paramedic certifications, background investigations at the Special Agreement Check level, TB testing for all personnel, invoicing via VetRide portal or VA-approved electronic system within 30 days of service, and adherence to COVID-19 and infectious disease prevention protocols.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| S06 Price Ceiling Raise 36C26326Q0088 0002.docx | DOCX document | |
| S06 Amendment Clarifications Ambulance MVAHCS 36C26326Q0088 0001.docx | DOCX document | |
| Pre-Solicitation Notice 36C26326Q0088.docx | DOCX document | |
| S02 DOL WD 2015-4945 R30 12032025.txt | TXT text file |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
36C26326Q0088
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.
UEI:
EFT:
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. NOV 2021)
PREVIOUS EDITION IS NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.212
7. FOR SOLICITATION
INFORMATION CALL:
STANDARD FORM 1449
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
618-26-3-155-0001
36C26326Q0088 03-06-2026 Jeffrey Brown 651-293-3009 03-25-2026 17:00
CST
36C263
DEPARTMENT OF VETERANS AFFAIRS
NETWORK CONTRACTING OFFICE 23
316 ROBERT STREET N, SUITE 506
SAINT PAUL MN 55101
X
Y 621910 $22.5 Million
N/A
DEPARTMENT OF VETERANS AFFAIRS
Minneapolis Health Care System
1 Veterans Drive Minneapolis MN 55417
DEPARTMENT OF VETERANS AFFAIRS
NETWORK CONTRACTING OFFICE 23
316 ROBERT STREET N, SUITE 506
SAINT PAUL MN 55101
Y
FINANCIAL SERVICES CENTER
PO BOX 149971
AUSTIN TX 78714-9971
See CONTINUATION Page Provide ground ambulance services to the VA Minneapolis Health Care System in accordance with the Statement of Work and Schedule below.
Prior to submitting a quote, review ALL documentation within
Review and follow the instructions in the INSTRUCTIONS TO OFFERORS in the Clause 52.212-1 Addendum.
Contract Ordering Period with pricing periods of:
Base Pricing Period: 04/01/2026-03/31/2027 Option Year One Pricing Period: 04/01/2027-03/31/2028 Option Year Two Pricing Period: 04/01/2028-03/31/2029 Option Year Three Pricing Period: 04/01/2029-03/31/2030 Option Year Four Pricing Period: 04/01/2030-03/31/2031
See CONTINUATION Page
Jeffrey Brown
VA-VHA-RPOC-2024-0033
Table of Contents
| SECTION A | 1 |
| A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES | 1 |
| SECTION B - CONTINUATION OF SF 1449 BLOCKS | 4 |
| B.1 CONTRACT ADMINISTRATION DATA | 4 |
| B.2 SINGLE AWARD ORDER CONTRACT | 5 |
| B.3 PRICE/COST SCHEDULE | 5 |
| ITEM INFORMATION | 5 |
| B.4 Performance Work Statement (PWS) | 16 |
| SECTION C - CONTRACT CLAUSES | 54 |
| C.1 52.204-91 Contractor Identification (DEVIATION NOV 2025) | 54 |
| C.2 52.212-4 Terms and Conditions—Commercial Products and Commercial Services (Deviation OCT 2025) | 55 |
| C.3 52.216-18 ORDERING (AUG 2020) | 60 |
| C.4 52.216-19 ORDER LIMITATIONS (OCT 1995) | 61 |
| C.5 52.216-22 INDEFINITE QUANTITY (DEVIATION) (NOV 2025) | 61 |
| C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) | 62 |
| C.7 52.237-2 PROTECTION OF GOVERNMENT BUILDINGS, EQUIPMENT, AND VEGETATION (APR 1984) | 62 |
| C.8 SUPPLEMENTAL INSURANCE REQUIREMENTS | 62 |
| C.9 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS (NOV 2025) (DEVIATION) | 63 |
| C.10 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018) | 72 |
| C.11 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) | 74 |
| C.12 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 74 |
| C.13 MANDATORY WRITTEN DISCLOSURES | 75 |
| SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS | 76 |
| See attached wage determination document: S02 DOL WD 2015-4945 R30 12032025 | 76 |
| SECTION E - SOLICITATION PROVISIONS | 77 |
| E.1 52.212-1 Instructions to Offerors—Commercial Products and Commercial Services (DEVIATION OCT 2025) | 77 |
| ADDENDUM to 52.212-1 Instructions to Offerors—Commercial Products and Commercial Services. | 81 |
| E.2 Small Business Program Representations. (FEB 2024) (DEVIATION NOV 2025) | 83 |
| E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (DEVIATION NOV 2025) | 85 |
| E.4 52.233-2 SERVICE OF PROTEST. (SEP 2006) (DEVIATION NOV 2025) | 86 |
| E.5 52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS REPRESENTATIONS AND CERTIFICATIONS (NOV 2025) (DEVIATION) | 87 |
| E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) | 91 |
| E.7 52.212-2 Evaluation—Commercial Products and Commercial Services (DEVIATION OCT 2025) | 91 |
| E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (OCT 2025) (DEVIATION FEB 2025) | 93 |
| E.9 52.216-1 TYPE OF CONTRACT (DEVIATION) (NOV 2025) | 109 |
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 36C263 Jeffrey Brown
NETWORK CONTRACTING OFFICE 23
316 ROBERT STREET N, SUITE 506
SAINT PAUL MN 55101
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 |
| [] |
| 52.232-36, Payment by Third Party |
3. INVOICES: Invoices shall be submitted in arrears:
| a. Quarterly | [] |
| b. Semi-Annually | [] |
| c. Other | [X] Monthly |
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.
ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:
| AMENDMENT NO |
| DATE |
B.2 SINGLE AWARD ORDER CONTRACT
Quantities listed are estimated only and are not guaranteed.
This is a 5-year Commercial Firm Fixed Price, Single Award Indefinite Delivery / Indefinite Quantity (IDIQ) contract, for ground ambulance services to support the Minneapolis VA Health Care System.
Accordingly, funds are not obligated on this contract at the award; rather, funds are obligated via orders issued against the contract. Orders shall only be issued by a warranted VA Contracting Officer (CO). VA CO will issue task orders to the contractor authorizing services via Standard Form 1449. Each order shall clearly identify the authorized dollar amount under the individual task order and the period of performance of the individual order. When an order period of performance is completed, additional services shall not be provided unless a new order is issued in accordance with this IDIQ.
References to options in the schedule below refers to the pricing periods identified on the 1449 form of this document as this contract does not contain options.
The minimum dollar amount guaranteed under this contract for the performance period of the five year is $1,000.00. The maximum dollar amount or contract ceiling for this contract is $7,600,000.00. The maximum amount is not guaranteed. The combined total of all orders placed against this contract cannot exceed the maximum amount/ceiling of this contract.
B.3 PRICE/COST SCHEDULE
ITEM INFORMATION
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 670.00 |
| HR |
| __________________ |
| __________________ |
Advanced Life Support (ALS) Transport, (base rate to include first 40 miles and 15 mins of wait time) One-way trip is equivalent to one each for the unit of issue Contract Period: Base POP Begin: 04-01-2026 POP End: 03-31-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 500.00 |
| MI |
| __________________ |
| __________________ |
Basic Life Support (BLS), Non-Emergency Transport, (base rate, to include first 40 miles and 15 mins of wait time) One-Way trip is equivalent to one each for the unit of issue
POP Begin: 04-01-2026 POP End: 03-31-2027
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 10.00 |
| HR |
| __________________ |
| __________________ |
Gurney/Litter Transport Load (base rate, to include first 40 miles and first 15 minutes of wait time)
POP Begin: 04-01-2026 POP End: 03-31-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
LOCAL STOCK NUMBER: 368.12
| 100.00 |
| MI |
| __________________ |
| __________________ |
Critical Care Transport (Upper-Level Care) (base rate to include first 40 miles and 15 mins of wait time) One-Way trip is equivalent to one each for the unit of issue
POP Begin: 04-01-2026 POP End: 03-31-2027
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 9,500.00 |
| HR |
| __________________ |
| __________________ |
ALS Transport Mileage Rate (loaded only)
POP Begin: 04-01-2026 POP End: 03-31-2027
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 19,500.00 |
| MI |
| __________________ |
| __________________ |
BLS Transport Milage Rate (loaded only)
POP Begin: 04-01-2026 POP End: 03-31-2027
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,500.00 |
| HR |
| __________________ |
| __________________ |
Gurney/Litter Transport Milage Rate (loaded only)
POP Begin: 04-01-2026 POP End: 03-31-2027
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 2,500.00 |
| MI |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Milage Rate (loaded only)
POP Begin: 04-01-2026 POP End: 03-31-2027
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 50.00 |
| HR |
| __________________ |
| __________________ |
Waiting Time (after initial 15 mins. More than 30 minutes shall be paid in 30-minute increments)
POP Begin: 04-01-2026 POP End: 03-31-2027
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 670.00 |
| HR |
| __________________ |
| __________________ |
Gurney/Litter Transport Load (first 15 minutes of wait time) Contract Period: Option 1 POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 500.00 |
| MI |
| __________________ |
| __________________ |
Gurney/Litter Transport per mile (loaded only)
POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 10.00 |
| HR |
| __________________ |
| __________________ |
BLS rate/Load (includes first 15 minutes of wait time)
POP Begin: 04-01-2027 POP End: 03-31-2028 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 100.00 |
| MI |
| __________________ |
| __________________ |
BLS Rate per mile (loaded only)
POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 9,500.00 |
| HR |
| __________________ |
| __________________ |
ALS Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 19,500.00 |
| MI |
| __________________ |
| __________________ |
ALS Rates per mile
POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,500.00 |
| HR |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 2,500.00 |
| MI |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Rate per mile (loaded only)
POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 50.00 |
| HR |
| __________________ |
| __________________ |
Waiting time per quarter hour (beyond initial quarter hour)
POP Begin: 04-01-2027 POP End: 03-31-2028
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 670.00 |
| HR |
| __________________ |
| __________________ |
Gurney/Litter Transport Load (first 15 minutes of wait time) Contract Period: Option 2 POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 500.00 |
| MI |
| __________________ |
| __________________ |
Gurney/Litter Transport per mile (loaded only)
POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 10.00 |
| HR |
| __________________ |
| __________________ |
BLS rate/Load (includes first 15 minutes of wait time)
POP Begin: 04-01-2028 POP End: 03-31-2029 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 100.00 |
| MI |
| __________________ |
| __________________ |
BLS Rate per mile (loaded only)
POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 9,500.00 |
| HR |
| __________________ |
| __________________ |
ALS Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 19,500.00 |
| MI |
| __________________ |
| __________________ |
ALS Rates per mile
POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,500.00 |
| HR |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 2,500.00 |
| MI |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Rate per mile (loaded only)
POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 50.00 |
| HR |
| __________________ |
| __________________ |
Waiting time per quarter hour (beyond initial quarter hour)
POP Begin: 04-01-2028 POP End: 03-31-2029
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 670.00 |
| HR |
| __________________ |
| __________________ |
Gurney/Litter Transport Load (first 15 minutes of wait time) Contract Period: Option 3 POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 500.00 |
| MI |
| __________________ |
| __________________ |
Gurney/Litter Transport per mile (loaded only)
POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 10.00 |
| HR |
| __________________ |
| __________________ |
BLS rate/Load (includes first 15 minutes of wait time)
POP Begin: 04-01-2029 POP End: 03-31-2030 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 100.00 |
| MI |
| __________________ |
| __________________ |
BLS Rate per mile (loaded only)
POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 9,500.00 |
| HR |
| __________________ |
| __________________ |
ALS Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 19,500.00 |
| MI |
| __________________ |
| __________________ |
ALS Rates per mile
POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,500.00 |
| HR |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 2,500.00 |
| MI |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Rate per mile (loaded only)
POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 50.00 |
| HR |
| __________________ |
| __________________ |
Waiting time per quarter hour (beyond initial quarter hour)
POP Begin: 04-01-2029 POP End: 03-31-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 670.00 |
| HR |
| __________________ |
| __________________ |
Gurney/Litter Transport Load (first 15 minutes of wait time) Contract Period: Option 4 POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 500.00 |
| MI |
| __________________ |
| __________________ |
Gurney/Litter Transport per mile (loaded only)
POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 10.00 |
| HR |
| __________________ |
| __________________ |
BLS rate/Load (includes first 15 minutes of wait time)
POP Begin: 04-01-2030 POP End: 03-31-2031 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 100.00 |
| MI |
| __________________ |
| __________________ |
BLS Rate per mile (loaded only)
POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 9,500.00 |
| HR |
| __________________ |
| __________________ |
ALS Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 19,500.00 |
| MI |
| __________________ |
| __________________ |
ALS Rates per mile
POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,500.00 |
| HR |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Base Rate/Loads (includes first 15 minutes of wait time)
POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 2,500.00 |
| MI |
| __________________ |
| __________________ |
Critical Care/Specialty Care Transport Rate per mile (loaded only)
POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 50.00 |
| HR |
| __________________ |
| __________________ |
Waiting time per quarter hour (beyond initial quarter hour)
POP Begin: 04-01-2030 POP End: 03-31-2031
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| GRAND TOTAL |
| __________________ |
B.4 Performance Work Statement (PWS)
Line Item
Description of Services 12-Month Quantity (Estimated Maximum) Unit of Issue
Base Rate Transport (Using Bing Maps)
One-Way Trip
| xxx1 |
| Advanced Life Support (ALS) Transport, (base rate to include first 40 miles and 15 mins of wait time) One-way trip is equivalent to one each for the unit of issue |
| 670 Maximum |
(One-Way Trips)
Per One-Way Trip
| xxx2 |
| Basic Life Support (BLS), Non-Emergency Transport, (base rate, to include first 40 miles and 15 mins of wait time) One-Way trip is equivalent to one each for the unit of issue |
| 500 Maximum |
Per One-Way Trip
| xxx3 |
| Gurney/Litter Transport Load (base rate, to include first 40 miles and first 15 minutes of wait time) |
| 10 Maximum |
(One-Way Trips) Per One-Way Trip
| xxx4 |
| Critical Care Transport (Upper-Level Care) (base rate to include first 40 miles and 15 mins of wait time) One-Way trip is equivalent to one each for the unit of issue |
| 100 Maximum |
Per One-Way Trip
| xxx5 |
| ALS Transport Mileage Rate |
(loaded only)
| 9500 |
| Per Mile |
| xxx6 |
| BLS Transport Milage Rate |
(loaded only)
| 19500 |
| Per Mile |
| xxx7 |
| Gurney/Litter Transport Milage Rate |
(loaded only)
| 1500 |
| Per Mile |
| xxx8 |
| Critical Care/Specialty Care Transport Milage Rate |
(loaded only)
| 2500 |
| Per Mile |
| xxx9 |
| Waiting Time (after initial 15 mins. More than 30 minutes shall be paid in 30-minute increments) |
| 50 |
| Each |
(15-minute Increment)
1. Purpose: The Minneapolis VA Medical System (hereafter MVAHCS), its associated Community-Based Outpatient Clinics (CBOCs), and affiliated healthcare clinics require contracted non-emergency ambulance transportation services. The contractor shall provide all vehicles, personnel, management, supplies, equipment, and necessary reporting for the provision of Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), Critical Care Transport (CCT) services. The contactor shall make these ambulance services available to the VA as needed, 24 hours a day, seven days a week (24/7), including weekends and holidays.
2. Background: The Minneapolis VA main campus is located 1 Veterans Drive, Minneapolis, MN 55417, serving over 96,807 veterans, primarily from the Twin Cities Metro area and it’s 14 Community-Based Outpatient Clinics. The hospital has 310 inpatient beds and sees approximately 14,000 -inpatient admissions and 1,022,755 outpatient visits a year. Veterans served within this facility lives within the following counties and zip codes.
| County/Zip Code |
| County/Zip Code |
| County/Zip Code |
| County/Zip Code |
| County/Zip Code |
Minnesota Counties
Aitkin 55072, 55735, 55748, 55752, 55760, 55783, 55785, 55787, 55798, 56342, 56350, 56431, 56444, 56469 Anoka 55005, 55011, 55014, 55025, 55038, 55040, 55070, 55079, 55092, 55110, 55126, 55303, 55304, 55330, 55421, 55432, 55433, 55434, 55448, 55449 Becker 56464, 56470, 56477, 56501, 56502, 56511, 56521, 56544, 56552, 56554, 56569, 56570, 56572, 56575, 56577, 56578, 56585, 56589, 56591, 56593 Beltrami 56601, 56619, 56630, 56633, 56647, 56650, 56652, 56661, 56663, 56666, 56667, 56670, 56671, 56676, 56678, 56683, 56685, 56727 Benton 55371, 56303, 56304, 56329, 56330, 56333, 56357, 56367, 56373, 56377, 56379, 56387
Big Stone 56208, 56210, 56211, 56221, 56219, 56211, 56227, 56225, 56240, 56276, 56278 Blue Earth 56001, 56003, 56010, 56024, 56034, 56037, 56041, 56048, 56050, 56055, 56060, 56062, 56063, 56065, 56068, 56073, 56078, 56080, 56088, 56090 Brown 55333, 56019, 56030, 56041, 56062, 56073, 56081, 56081, 56083, 56084, 56085, 56087, 56266 Carlton 55707, 55718, 55720, 55726, 55733, 55736, 55749, 55756, 55757, 55767, 55780, 55783, 55787, 55797, 55798, 55810 Carver 55315, 55317, 55318, 55322, 55328, 55331, 55339, 55360, 55363, 55367, 55368, 55375, 55386, 55387, 55388, 55395, 55397, 56011
Cass 55785, 56401, 56425, 56433, 56435, 56448, 56452, 56461, 56464, 56466, 56468, 56472, 56473, 56474, 56477, 56479, 56481, 56484, 56626, 56633, 56636, 56641, 56655, 56662, 56672 Chippewa 56208, 56215, 56222, 56241, 56252, 56260, 56262, 56265, 56271, 56282, 56285, 56295 Chisago 55006, 55008, 55012, 55013, 55025, 55032, 55045, 55056, 55069, 55073, 55074, 55078, 55079, 55080, 55084, 55092 Clay 56514, 56519, 56525, 56529, 56536, 56546, 56547, 56549, 56552, 56554, 56560, 56561, 56562, 56563, 56572, 56574, 56580, 56584, 56585, 56594 Clearwater 56470, 56557, 56621, 56634, 56644, 56646, 56652, 56676, 56678
Cook 55604, 55605, 55606, 55612, 55613, 55615 Cottonwood 56019, 56083, 56101, 56118, 56120, 56131, 56137, 56145, 56152, 56159, 56166, 56174, 56180, 56183 Crow Wing 56338, 56364, 56401, 56425, 56431, 56435, 56441, 56442, 56444, 56447, 56448, 56449, 56450, 56455, 56465, 56468, 56472, 56474, 56662 Dakota 55009, 55010, 55018, 55024, 55031, 55033, 55044, 55057, 55065, 55068, 55075, 55076, 55077, 55085, 55089, 55109, 55118, 55120, 55121, 55122, 55123, 55124, 55150, 55306, 55337, 55372, 55378 Douglas 56308, 56309, 56315, 56319, 56326, 56327, 56332, 56334, 56339, 56341, 56343, 56349, 56354, 56355, 56360, 56361, 56385, 56446
Faribault 56009, 56010, 56013, 56014, 56023, 56025, 56027, 56033, 56039, 56047, 56051, 56065, 56068, 56072, 56097, 56098 Fillmore 55922, 55923, 55935, 55939, 55949, 55951, 55954, 55961, 55962, 55965, 55971, 55975, 55976, 55979, 55990 Freeborn 55912, 55917, 55953, 56007, 56009, 56016, 56020, 56026, 56029, 56032, 56035, 56036, 56042, 56043, 56045, 56051, 56072, 56089, 56097 Goodhue 55009, 55018, 55026, 55027, 55033, 55041, 55053, 55057, 55065, 55066, 55089, 55946, 55956, 55963, 55983, 55985, 55992 Grant 56235, 56248, 56274, 56309, 56311, 56324, 56326, 56339, 56522, 56531, 56537, 56590
Hennepin 55107, 55111, 55113, 55305, 55311, 55316, 55317, 55323, 55327, 55328, 55331, 55340, 55341, 55343, 55344, 55345, 55346, 55347, 55356, 55357, 55359, 55361, 55364, 55369, 55373, 55374, 55375, 55384, 55387, 55388, 55391, 55401, 55402, 55403, 55404, 55405, 55406, 55407, 55408, 55409, 55410, 55411, 55412, 55413, 55414, 55415, 55416, 55417, 55418, 55419, 55420, 55421, 55422, 55423, 55424, 55425, 55426, 55427, 55428, 55429, 55430, 55431, 55435, 55436, 55437, 55438, 55439, 55440, 55441, 55442, 55443, 55444, 55445, 55446, 55447, 55450, 55454, 55455, 55458, 55467, 55474, 55479, 55480, 55487, 55488 Houston 55919, 55921, 55931, 55941, 55943, 55947, 55954, 55971, 55974 Hubbard 56433, 56435, 56436, 56458, 56461, 56464, 56467, 56470, 56484, 56601, 56633, 56678 Isanti 55005, 55006, 55008, 55017, 55029, 55032, 55040, 55056, 55070, 55079, 55080, 55371, 55398, 56353, 56358 Itasca 55721, 55722, 55723, 55736, 55742, 55744, 55745, 55746, 55748, 55752, 55753, 55764, 55769, 55771, 55775, 55781, 55784, 55786, 55793, 56628, 56630, 56631, 56636, 56637, 56639, 56657, 56659, 56661, 56680, 56681, 56688
Jackson 56101, 56111, 56118, 56119, 56127, 56131, 56137, 56143, 56150, 56159, 56160, 56161, 56167, 56187 Kanabec 55006, 55007, 55030, 55037, 55051, 55072, 56342, 56353, 56358 Kandiyohi 56201, 56209, 56216, 56222, 56243, 56251, 56252, 56253, 56273, 56277, 56279, 56281, 56282, 56284, 56288, 56289, 56312, 56316, 56362 Kittson 56720, 56728, 56729, 56731, 56732, 56733, 56734, 56735, 56740, 56755 Koochiching 55771, 55772, 56623, 56627, 56629, 56639, 56649, 56653, 56654, 56658, 56660, 56661, 56668, 56669, 56679
Lac qui Parle 56208, 56212, 56218, 56220, 56223, 56232, 56256, 56257, 56265, 56276, 56278 Lake 55601, 55602, 55603, 55607, 55609, 55614, 55616, 55731, 55796 Lake of the Woods 56623, 56673, 56686, 56711, 56741 Le Sueur 56011, 56017, 56028, 56044, 56050, 56052, 56057, 56058, 56063, 56069, 56071, 56082, 56096 Lincoln 56113, 56136, 56142, 56149, 56164, 56170, 56178, 56220, 56264, 56280, 56291
Lyon 56113, 56115, 56132, 56157, 56169, 56170, 56175, 56178, 56220, 56229, 56239, 56258, 56263, 56264, 56291, 56292, 56297 McLeod 55312, 55321, 55334, 55335, 55336, 55338, 55339, 55350, 55354, 55355, 55367, 55368, 55370, 55381, 55385, 55395, 55396, 55397 Mahnomen 56516, 56540, 56542, 56557, 56566, 56589, 56592, 56621, 56651 Marshall 56701, 56710, 56713, 56724, 56725, 56727, 56732, 56737, 56738, 56744, 56757, 56758, 56759, 56760, 56762 Martin 56013, 56027, 56031, 56039, 56075, 56088, 56098, 56111, 56121, 56127, 56160, 56162, 56171, 56176, 56181
Meeker 55321, 55324, 55325, 55329, 55342, 55350, 55353, 55355, 55382, 55389, 56209, 56228, 56243, 56362 Mille Lacs 55051, 55371, 56313, 56330, 56338, 56342, 56353, 56357, 56358, 56359, 56363, 56386, 56450 Morrison 56307, 56314, 56318, 56328, 56329, 56331, 56336, 56338, 56340, 56344, 56345, 56347, 56353, 56359, 56364, 56367, 56373, 56382, 56384, 56438, 56443, 56449, 56466, 56473, 56475 Mower 55909, 55912, 55917, 55918, 55926, 55933, 55936, 55940, 55950, 55951, 55953, 55961, 55967, 55970, 55973, 55975, 55976, 55977, 55982 Murray 56114, 56115, 56122, 56123, 56125, 56128, 56131, 56132, 56141, 56149, 56151, 56170, 56172, 56175, 56180, 56183, 56185, 56186
Nicollet 55332, 55334, 55335, 56001, 56003, 56021, 56054, 56058, 56073, 56074, 56082
Nobles 56110, 56117, 56119, 56122, 56128, 56129, 56131, 56137, 56141, 56147, 56153, 56155, 56158, 56165, 56167, 56168, 56185, 56187 Norman 56510, 56516, 56519, 56540, 56541, 56545, 56546, 56548, 56550, 56557, 56568, 56574, 56581, 56584, 56585, 56589 Olmsted 55901, 55902, 55903, 55904, 55905, 55906, 55920, 55923, 55929, 55932, 55934, 55940, 55944, 55955, 55956, 55960, 55963, 55964, 55972, 55973, 55976, 55991 Otter Tail 56309, 56315, 56324, 56326, 56354, 56361, 56437, 56446, 56453, 56464, 56477, 56482, 56501, 56514, 56515, 56518, 56522, 56524, 56527, 56528, 56531, 56533, 56534, 56537, 56538, 56543, 56544, 56551, 56567, 56571, 56572, 56573, 56576, 56579, 56586, 56587, 56588
Pennington 56701, 56725, 56748, 56750, 56754, 56760 Pine County 55006, 55007, 55030, 55036, 55037, 55051, 55063, 55069, 55072, 55704, 55712, 55735, 55749, 55756, 55767, 55783, 55795, 56350 Pipestone 56128, 56139, 56144, 56149, 56164, 56170, 56186 Polk 56517, 56523, 56535, 56540, 56542, 56556, 56568, 56592, 56621, 56644, 56646, 56651, 56684, 56710, 56716, 56721, 56722, 56723, 56736, 56742, 56744, 56750, 56762 Pope 56215, 56226, 56244, 56289, 56308, 56316, 56323, 56327, 56334, 56343, 56349, 56360, 56378, 56381, 56385
Ramsey 55038, 55101, 55102, 55103, 55104, 55105, 55106, 55107, 55108, 55109, 55110, 55112, 55113, 55114, 55116, 55117, 55118, 55119, 55125, 55126, 55127, 55128, 55130, 55144, 55146, 55155, 55421, 55432, 55449 Red Lake 56535, 56684, 56715, 56716, 56736, 56742, 56748, 56750, 56754 Redwood 55333, 56083, 56085, 56087, 56152, 56166, 56175, 56180, 56214, 56224, 56237, 56255, 56258, 56263, 56266, 56270, 56283, 56284, 56287, 56292, 56293, 56294, 56297 Renville 55310, 55314, 55332, 55333, 55335, 55342, 55350, 55385, 56228, 56230, 56241, 56260, 56270, 56277, 56283, 56284, 56285 Rice 55018, 55019, 55020, 55021, 55046, 55049, 55052, 55053, 55057, 55087, 55088, 55946, 56052, 56069, 56071, 56096
Rock 56116, 56128, 56129, 56134, 56138, 56144, 56146, 56147, 56156, 56158, 56173 Roseau 56673, 56714, 56726, 56732, 56735, 56751, 56756, 56759, 56761, 56763 Saint Louis 55602, 55616, 55702, 55703, 55705, 55706, 55708, 55710, 55711, 55713, 55717, 55719, 55720, 55723, 55724, 55725, 55731, 55732, 55733, 55734, 55736, 55738, 55741, 55746, 55750, 55751, 55758, 55763, 55765, 55768, 55769, 55771, 55779, 55781, 55782, 55790, 55791, 55792, 55796, 55798, 55802, 55803, 55804, 55805, 55806, 55807, 55808, 55810, 55811, 55812, 55816, 56669 Scott 55020, 55044, 55054, 55088, 55337, 55352, 55372, 55378, 55379, 56011, 56044, 56071 Sherburne 55303, 55308, 55309, 55319, 55330, 55371, 55377, 55398, 56304, 56329, 56379
Sibley 55307, 55312, 55314, 55332, 55334, 55335, 55336, 55338, 55339, 55366, 55385, 55396, 56011, 56044, 56054, 56058 Stearns 55320, 55329, 55353, 55382, 55389, 56301, 56302, 56303, 56307, 56310, 56312, 56314, 56316, 56320, 56321, 56325, 56331, 56335, 56336, 56340, 56352, 56356, 56360, 56362, 56367, 56368, 56369, 56371, 56374, 56375, 56376, 56377, 56378, 56385, 56387, 56388, 56393, 56395, 56398, 56399 Steele 55021, 55049, 55052, 55060, 55917, 55924, 55946, 55985, 56026, 56035, 56042, 56046, 56072, 56093 Stevens 56207, 56221, 56225, 56235, 56244, 56248, 56267, 56278, 56323, 56343 Swift 56208, 56215, 56226, 56227, 56231, 56244, 56249, 56252, 56262, 56271, 56289
Todd 56318, 56319, 56331, 56336, 56347, 56360, 56378, 56382, 56389, 56434, 56437, 56438, 56440, 56443, 56446, 56453, 56466, 56475, 56479, 56481, 56482 Traverse 56211, 56219, 56221, 56236, 56240, 56248, 56274, 56296, 56565, 56583 Wabasha 55027, 55041, 55906, 55910, 55932, 55945, 55956, 55957, 55960, 55964, 55968, 55981, 55991 Wadena 56434, 56464, 56470, 56477, 56479, 56481, 56482 Waseca 55052, 56026, 56028, 56042, 56048, 56063, 56065, 56068, 56072, 56078, 56091, 56093, 56096, 56097
Washington 55001, 55003, 55013, 55016, 55025, 55033, 55038, 55042, 55043, 55047, 55055, 55071, 55073, 55082, 55083, 55090, 55109, 55110, 55115, 55119, 55125, 55128, 55129 Watonwan 56019, 56022, 56041, 56056, 56060, 56062, 56081, 56088, 56120, 56159, 56160, 56162 Wilkin 56514, 56520, 56522, 56543, 56553, 56560, 56565, 56572, 56579, 56583, 56594 Winona 55910, 55923, 55925, 55943, 55947, 55952, 55959, 55962, 55964, 55969, 55971, 55972, 55979, 55987 Wright 55301, 55302, 55313, 55320, 55321, 55325, 55327, 55328, 55330, 55341, 55349, 55358, 55362, 55363, 55373, 55374, 55376, 55381, 55382, 55388, 55390, 55395
Yellow Medicine 56142, 56214, 56218, 56220, 56223, 56229, 56237, 56241, 56245, 56264, 56265, 56280, 56291, 56292, 56297
Wisconsin Counties
Douglas 54820, 54836, 54838, 54842, 54849, 54854, 54864, 54873, 54874, 54880, 54890 Burnett 54830, 54024, 54801, 54813, 54830, 54837, 54840, 54845, 54853, 54859, 54871, 54872, 54893 Polk 54001, 54001, 54004, 54005, 54006, 54007, 54009, 54017, 54020, 54024, 54025, 54026, 54810, 54824, 54826, 54829, 54837, 54840, 54853, 54858, 54872, 54889 St. Croix 54002, 54005, 54007, 54013, 54015, 54016, 54017, 54020, 54022, 54023, 54025, 54026, 54027, 54028, 54082, 54734, 54749, 54751, 54767 Dunn 54005, 54013, 54027, 54701, 54703, 54721, 54724, 54725, 54728, 54730, 54734, 54735, 54736, 54737, 54739, 54740, 54749, 54751, 54755, 54757, 54761, 54762, 54763, 54764, 54765, 54767, 54772
Pierce 54002, 54003, 54011, 54014, 54021, 54022, 54721, 54723, 54740, 54750, 54759, 54761, 54767, 54769 Buffalo 54610, 54612, 54622, 54629, 54736, 54738, 54743, 54747, 54755, 54756 Chippewa 54433, 54703, 54724, 54726, 54727, 54729, 54730, 54732, 54739, 54745, 54748, 54757, 54766, 54768, 54774 Eau Claire 54701, 54702, 54703, 54720, 54722, 54726, 54727, 54729, 54738, 54739, 54741, 54742, 54755, 54758, 54768, 54770 Barron 54004, 54005, 54728, 54733, 54757, 54762, 54763, 54805, 54812, 54813, 54817, 54822, 54826, 54829, 54841, 54857, 54868, 54870, 54889
Sawyer 54552, 54817, 54821, 54828, 54835, 54843, 54862, 54867, 54876, 54896
Bayfield 54517, 54806, 54814, 54816, 54820, 54821, 54827, 54832, 54838, 54839, 54844, 54847, 54856, 54865, 54873, 54891 Rusk 54526, 54530, 54563, 54728, 54731, 54745, 54757, 54766, 54817, 54819, 54835, 54848, 54868, 54895 Ashland 54514, 54517, 54527, 54546, 54559, 54806, 54846, 54850, 54855, 54856, 54861 Pepin 54721, 54736, 54737, 54755, 54759, 54761, 54769
3. Acronyms ALS – Advanced Life Support AOD – Administrative Officers of the Day BLS – Basic Life Support CCT – Critical Care Transport CCTP – Critical Care Transport Paramedic CCEMTP – Critical Care Emergency Medical Transport CO – Contracting Officer COR – Contracting Officer’s Representative CPR – Cardiopulmonary Resuscitation DOL – Department of Labor EMT – Emergency Medical Technician IAW – In Accordance With OO – Ordering Officer PWS – Performance Work Statement QASP – Quality Assurance Surveillance Plan QC – Quality Control Plan TB – Tuberculosis TJC – The Joint Commission VTS – Veteran Transportation Service
4. Scope/Requirements
4.1. Types of Ambulance Service
4.1.1. The contractor shall provide Emergent, non-emergent Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) Tier 1, 2, and 3 ambulance services on an as-needed basis in accordance with all federal, state, and local regulations.
4.1.2. Occasionally a veteran will need to be transported with VA staff and equipment; the contractor shall return VA Staff and equipment to the original place of pick-up.
4.2. Transport of Miscellaneous Items with the Patient
The Contractor may also be required to transport patient luggage, medical records, medication, and comfort items from pickup points to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types. When patients are transported to the Minneapolis VA, destination is deemed to be the ER, Admissions, the clinic, or service within the hospital, or directly to the ward as instructed by VA Staff.
4.3. Contractor Personnel: Contractor personnel shall be courteous and always conduct themselves in a businesslike manner while providing services under this contract.
4.3.1. Emergency Medical Technicians (EMTs), Critical Care Transport Paramedics (CCTPs) & Other Personnel
4.3.1.1. EMTs, CCTPs and other medical personnel (as applicable) shall at all times meet the qualifications specified in this contract as well as all applicable federal, state, and local government laws, regulations, and standards. EMTs, CCTPs and other medical personnel (as applicable) shall be certified, licensed, or otherwise officially recognized by the local, state, or regional government or public entity where the emergency service is operated or by which it is governed.
4.3.1.2. If the contractor wishes to add or replace personnel throughout the life of the contract, it shall provide evidence of required training, certifications, licensing, and any other qualifications to the Contracting Officer’s Representative (COR) for review.
4.3.1.3. All ambulance drivers shall have a valid driver’s license in accordance with state requirements for their place of operation and the services they perform. If the contractor wishes to add or replace drivers throughout the life of the contract, it shall provide a valid driver’s license to the COR.
4.3.1.4. CCTPs shall have met all state requirements for the tier in which they are performing services in (I, II, III). Proof in the form of a current certificate for the successful completion of such must be provided to the COR upon request.
4.3.1.5. Investigative Requirements for Contract Personnel: Contract personnel will be subject to the same investigative requirements as those for regular VA appointees and employees. The level of investigation commensurate with the level of access to perform the performance work statement is: Special Agreement Checks (SAC). Fingerprinting for contract personnel will be conducted at Minneapolis VA. Thereafter the contracted employees will be subject annually to the same requirement, with a 90-day window to complete such requirement as provided by Minneapolis VA, The VA Security and Investigation Center (SIC) is responsible for adjudicating all background investigations for contract employees.
4.3.1.6. EMTs, CCTPs, and other contractor personnel as applicable must pass the Contractor’s background check and must not have been convicted of (or have any pending charges for) a felony for the past five years. Personnel (and Contractor) must report any new or additional charges or convictions if they arise during the course of performance under this contract so VA can review them and determine whether the employee in question needs to be discharged of his or her duties until the matter is adjudicated.
4.3.2. Tuberculosis Exposure Control Policy
4.3.2.1. The contractor shall provide the VA with a policy on tuberculosis (TB) exposure and control, to include TB decontamination.
4.3.2.2. The contractor shall have its personnel tested for TB in accordance with state guidelines and provide written confirmation to the COR that all personnel (current employees and any new hires) performing services under this contract are current in their TB test by at the start of each Ordering Period.
4.4. Contractor Equipment, Vehicles, and Inspection
4.4.1. Ambulances shall meet all applicable federal, state, and local regulations and specifications, including but not limited to licensing, registration, and safety standards.
4.4.2. The VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with state laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of contractor equipment do not constitute a warranty or guarantee that the contractor’s vehicles and equipment are properly maintained. The VA reserves the right to restrict the contractor’s use of equipment and vehicles in the performance of this contract which are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performance in accordance with the contract nor necessitate additional cost to the VA.
4.4.3. Vehicles shall be clean and maintained in good repair in accordance with manufacturer’s instructions.
4.4.4. The contractor shall not borrow or exchange supplies, equipment, and/or medications with the VA. Equipment attached to or in use by the patient at time of pick-up may remain with the patient during transport to ensure continuity of care. Medical Control Authorities are responsible for maintaining and supplying medication during patient transport. All VA equipment and unused medications must be returned to VA during patient drop-off or as promptly as feasible within 24 hours.
4.4.5. The contractor shall furnish all linen required for patient transport at no additional cost. Linen shall not be exchanged with linen belonging to Minneapolis VA or its CBOCs.
4.4.6. The contractor must be capable of transporting the drugs and/or equipment as required by the patient as listed in Addendum A Critical Care Transport Capabilities Confirmation. The contractor shall have the appropriate medications, up to and including CCT Tier III if necessary, based on the EMS region the ambulance provider is functioning in.
4.4.7. The contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under this contract.
4.4.7.1. The contractor personnel performing services for the VA, shall, at all times, conduct themselves in a professional manner, and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, uniforms, nametags and/or badges for performance of services under this contract. Employee identifications shall be worn in clear view above the waist. The contractor personnel shall not smoke/play loud music originating from any device in vehicles while transporting VA patients.
4.4.7.2. Each driver shall possess a driver’s license that is valid for the class of vehicle driven. Evidence of a special transportation service vehicle permit, or endorsement issued by the commissioner of public safety.
· Be at least 18 years of age and have not less than one year of experience as a licensed driver; and
· For the past three years:
· Have not had a driver’s license canceled or suspended.
· Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance.
· Have a driving record clear of convictions for driving a motor vehicle without a valid current license for the class of vehicle driven
· Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance.
4.4.7.3. The contractor personnel will ensure that the patient is secured to the stretcher/cot and that the stretcher /cot is secure in the back of the ambulance before the vehicle moves.
4.4.7.4. Ambulance drivers shall have a valid driver’s license, in accordance with Federal, State, and local government requirements for their place of operation for the services they perform, be capable of administering oxygen and shall have successfully completed the standard and advanced first aid course of the American Red Cross of U.S. Bureaus of Mines of equivalent and be capable of providing necessary medical assistance to the attending emergency medical technician or paramedic.
4.4.7.5. Emergency Medical Technician (EMT) and Paramedic Qualifications: EMT’s and Paramedic’s providing services under this contract shall have the following qualifications, in additions to those required by Federal, State, and Local Government:
· Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 150 hours or equivalent including an in-hospital training period. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154, Federal Register 39:24304. (1974).
· Shall be certified, licensed, or otherwise officially recognized by the local, state of regional government or public entity where the emergency ambulance service is operated or by which it is governed.
4.5. Transportation Request
4.5.1 VetRide or VA-Approved Transportation Software Utilization:
The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved Transportation Software with every patient transported under this contract.
Department of Veteran Affairs will provide the software and access to the VetRide Vendor Portal or VA-Approved Transportation Software for the vendor/contractor in this contract. The Contractor will utilize the VetRide Vendor Portal or VA-Approved Transportation Software fully as instructed:
a) Receive and respond to electronic trip requests
b) Receive, use, and ensure the use of the Vendor pass by the driver.
c) Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA-Approved Transportation Software system.
d) All invoices must be submitted within 30 calendar days of date of service in accordance with 38 CFR 70 to be considered timely submission.
i. The contractor’s invoice must be on the HCFA 1500 to include:
ii. Contract Number
iii. Date of Service (to include Box 24 A-J)
iv. Authorization number(s)
v. Pick-up and drop-off location of the patient
vi. Base Rate
vii. Name (Last, First and Middle Initial (if any)) and Full Social Security number (Box 1a) of patient transported
viii. Date of Birth and Sex
ix. Diagnosis Codes or Nature of Illness or Injury
x. Documentation of circumstances when billing for waiting time
xi. Any miscellaneous charges for which the contractor is expecting reimbursement i.e., Tool charges, waiting time, etc.
xii. VA authorizing official’s name
xiii. Healthcare Procedure Coding System/National Level II (HCPCS)
e) Unauthorized charges will be reviewed by the Contracting Officer Representative (COR) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges, which are being suspended.
4.5.1.1. A transportation request is defined as one incidence of a request for one-way service (Stretcher Transports, BLS, ALS, CCT). No more than one patient will be transported per order unless approved by an authorized VA staff. Transportation requests will be made through VetRide or VA-Approved Transportation Software Utilization. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. Minneapolis VA Travel Program Staff will be available to assist with account setup and training for the Contractor’s Staff. In the event VetRide or other VA-Approved Transportation Software Utilization is down, other methods of communication (i.e., telephone, facsimile) will be used to place Transportation requests.
4.5.1.1.1. Minneapolis VA Travel Program Staff/or authorized VA employees will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VetRide or VA-Approved Transportation Software Utilization.
4.5.1.1.2. The Contractor must update VetRide or VA-Approved Transportation Software Utilization with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc. Minneapolis VA Travel Program Staff/or authorized VA employees may place a “hold” on payment of this order until it has been reconciled.
4.5.1.2. Only the following VA staff are authorized to place, cancel, or make changes to transportation requests:
| Contracting Officer (CO) | Ordering Officers (OO) | |
| Administrative Officer of the Day (AOD) | Beneficiary Travel Office Staff |
Contracting Officer’s Representative (COR)
The Contracting Officer will furnish the Contractor with the names of individuals above, who are authorized as Ordering Officers, by separate memorandum upon issuance of the contract. The Contracting Officer will update this list throughout the life of the contract as Ordering Officers change.
Ordering Officers are responsible for issuing and administering orders placed under this contract. Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. The Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.
Non-authorized VA employees and private agencies (e.g., nursing homes) are not considered authorized to place transportation requests.
4.5.1.2.1. All patient pick-up(s) and drop-off(s) shall be authorized via “orders” which shall only be issued by the designated Ordering Officers.
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .