SF-1449 - SOL - Terms-Conditions 75H70723Q00140 - Automated Appt Reminder System - SFIHC.pdf

PDF 108 KB Posted Aug 15, 2023

Attached to: Automated Appointment Reminder System - Pharmacy
Solicitation number: 75H70723Q00140
Issued by: Department of Health and Human Services Indian Health Service

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Written by GovTribe AI · Dec 20, 2023

This document is a solicitation for an automated appointment reminder system and pharmacy software. The Indian Health Service Albuquerque Area Office and Santa Fe Indian Health Center seek to lease equipment and software to provide medication refill reminders for clinic patients and an automated refill request system for the Santa Clara Health Center pharmacy. The base period of performance is TBD 2023 to TBD 2024 with four one-year option periods extending to TBD 2028. The solicitation was issued on August 15, 2023 with responses due on August 30, 2023 to the Albuquerque Area Office. The anticipated award date is TBD. Pricing shall be provided by line item for the equipment lease and software for the base and option years. This is an unrestricted solicitation under NAICS code 513210 with no set-asides.

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File	Type	Posted
SOL Terms - Conditions - Automated Appointment Reminder System-Equip Lease-Software - SFIHC.pdf	PDF	Aug 15, 2023
Past Performance Survey Form.docx	DOCX document	Aug 15, 2023

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SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

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

OFFEROR

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225 Albuquerque Indian Health Service

CODE 16. ADMINISTERED BYCODE

513210

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR203

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

08/30/2023 1530 MD

08/15/2023

505-256-6754PATRICIA TRUJILLO

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70723Q00140

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 56 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

2. CONTRACT NO.

EFFECTIVE DATE

$47

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

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

The Indian Health Service (IHS), Albuquerque Area Office (AAO), Santa Fe Indian Health Center (SFIHC) has a need for an Automated Appointment Reminder System Equipment Lease and Software to be utilized for medication refill request processing and automated reminder for SFIHC clinic appointments, and automated medication refill request system for Santa Clara Health Center (SCHC) Pharmacy Department.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED

PATRICIA P. TRUJILLO

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

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

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

1 BASE: TBD, 2023 to TBD, 2024, for an Automated

Appointment Reminder System/Equipment Lease and

Software to be utilized for medication refill request processing and automated reminder for

SFIHC clinic appointments, and automated medication refill request system for Santa Clara

Health Center (SCHC).

2 OPTION YEAR ONE: TBD, 2024 to TBD, 2025, for an

Automated Appointment Reminder System/Equipment

Lease and Software to be utilized for medication refill request processing and automated reminder for SFIHC clinic appointments, and automated medication refill request system for Santa Clara

Health Center (SCHC).

3 OPTION YEAR TWO: TBD, 2025 to TBD, 2026, for an

Automated Appointment Reminder System/Equipment

Lease and Software to be utilized for medication refill request processing and automated reminder for SFIHC clinic appointments, and automated medication refill request system for Santa Clara

Health Center (SCHC).

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

56 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 56

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70723Q00140

4 OPTION YEAR THREE: TBD, 2026 to TBD, 2027, for an

Automated Appointment Reminder System/Equipment

Lease and Software to be utilized for medication refill request processing and automated reminder for SFIHC clinic appointments, and automated medication refill request system for Santa Clara

Health Center (SCHC).

5 OPTION YEAR FOUR: TBD, 2027 to TBD, 2028, for an

Automated Appointment Reminder System/Equipment

Lease and Software to be utilized for medication refill request processing and automated reminder for SFIHC clinic appointments, and automated medication refill request system for Santa Clara

Health Center (SCHC).

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