Sol_75H70721Q00023.pdf

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

IHSZUNI CODE 16. ADMINISTERED BYCODE

X

X

X

511210

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR203

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

06/09/2021 1200 MS

05/26/2021

505-256-6752ERIC WRIGHT

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70721Q00023

5. SOLICITATION NUMBER

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

1 2 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Zuni New Mexico 87327 Route 301 North 21 B Avenue Zuni Service Unit

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$41.50

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Solicitation# 75H70721Q00023 is issued to provide clearinghouse services to the Zuni Service Unit.

Solicitation# 75H70721Q00023 is set-aside for Small Business Indian Firms (SBIF) pursuant to the Buy Indian Act 25 U.S.C. 47. If IHS does not receive at least two offers that are reasonably priced offers from SBIF's, IHS will then evaluate quotes and consider award to other small business concerns under the following 5-tier cascading set-aside (in order of first consideration to last consideration):

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

ERIC K. WRIGHT

. 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

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 FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

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:

REF.

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. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

1st Tier - Small Business Indian Firms

2nd Tier - Service Disabled Veteran Owned Small

Businesses

3rd Tier - Certified HubZone Small Businesses

4th Tier - Small Disadvantage Businesses

5th Tier - All other Small Business Concerns.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

2 2 of

75H70721Q00023, ZSU Clearinghouse Secure Data Services

SF-1449, page 3 of 19

PURPOSE:

To provide clearinghouse secure data transport services to and from the Medicare Administrative Contractor and Commercial Insurance Payers using Centers for Medicaid and Medicare Services approved commercially available Internet-based connection services to the following Albuquerque Area Indian Health Service facility:

Zuni Service Unit Route 301 N21B Avenue Zuni, New Mexico 87327

Acquisition will be for 1 base year and four 1 year options for renewal.

DESCRIPTION OF SERVICES/SUPPLIES

BACKGROUND INFORMATION:

Centers for Medicaid and Medicare Services announced that Novitas Solutions, Inc., LLC (Novitas) was awarded the contract for the combined administration of Part A and Part B Medicare fee-for-service claims. The Novitas MAC (Medicare Administrative Contractor) responsibilities will include Part A Fiscal Intermediary (FI) and Part B carrier for Colorado, New Mexico, Oklahoma, and Texas; the National carrier and FI for Indian Health Service; and the National carrier and FI for the Veterans Affairs Medicare Equivalent Remittance Advice Project. Hence, Novitas Solutions, Inc. is the only FI provider that adjudicates claims for Medicare services for all of the Indian Health Service agency, and as well as all tribal facilities that are enrolled in the Medicare program. To facilitate the implementation, Novitas migrated all electronic claims submitters from their legacy front-end system to the EDI gateway, GPNet for Medicare Part A claims and the Professional Provider Telecommunications Network (PPTN) for Medicare Part B claims. Both of these systems, the GPNet and PPTN require a Network Service Vendor in order to transmit the data files. Medicaid and Private Insurance claims are currently submitted through another vendor. The Zuni Service Unit would like to consolidate vendors and contracts for better administration.

SPECIFICATIONS FOR THE NETWORK SERVER VENDOR:

ESTABLISH ENTRY POINT:

• The contractor shall provide the entry point into the Novitas Solutions, Inc. processing system.

SECURE DATA EXCHANGE SERVICE:

• The contractor shall provide a secure data transport service between ZSU that is recognized by CMS as an authorized Internet- based commercially available connection. The service shall comply with the following constraints:

• The service shall not require ZSU to install contractor software within the AAIHS environment.

• The service shall enable ZSU/Novita’s data exchanges utilizing an ZSU/ contractor VPN and secure File Transfer

Protocol (FTP) as approved by the Indian Health Service (IHS) Office of Information Technology.

• The service shall support EDI transactions and interactive telnet sessions.

• The service shall support multiple users and access shall be workstation independent.

• The service shall not entail development of HIPAA (Health Insurance Portability and Accountability Act) transaction set translation or mapping processes, non-CMS or non-IHS generated data or messages, or data reformatting;

• The service shall conform to the information agreements to be established via an Interconnection Security Agreement and Memorandum of Understanding between the Indian Health Service and the contractor.

• The service shall also conform to a business associate agreement to be established between the ZSU and the contractor.

MAINTENANCE AND SUPPORT:

The contractor shall support end-to-end communication testing, implementation and daily operations of the data transfers from the contractor to ZSU which shall include, at a minimum:

• The contractor shall provide routine technical support to implement corrections to service occurring as a result of errors, flaws or other failures within their service.

• The contractor shall notify a designated ZSU point of contact (Contracting Officer's Representative (COR)) of any scheduled maintenance that shall result in downtime at least two (2) days prior to the maintenance period.

• The contractor shall notify a designated ZSU point of contact of any issues at their facility that results in a disruption of data exchange capabilities. This notification shall occur as soon as possible after the disruption has been identified.

• The contractor shall provide customer support for reporting, documenting, tracking and resolving of service problems, which shall be available via telephone and email to ZSU technical staff during the period 8:00 a.m. through 5:00 p.m.

Mountain Standard Time.

INTERNET BASED CONNECTION SERVICE:

SF-1449, page 4 of 19

• Conformity and standardization – ZSU Hospital and Dental Clinic would have similar access to Medicare and hundreds of payers.

• Unlimited DDE and PPTN online Medicare claims status/corrections, etc., through an enhanced web portal.

• Automated batch 837/835 file transfers to and from Medicare through the Enterprise Server on location at the

Albuquerque Area.

• Automated batch 276/277 claims corrections capability via the Enterprise Server on location at the Zuni Service Unit, Business Office.

• All payer eligibility workflow tool with single and batching inquiries 270/271.

• Single sign-on for Medicare and COMPLETE

• Unlimited support, no annual membership fees

• Medicare Eligibility (HETS)

• Medicaid Eligibility

• Commercial Eligibility

• Veteran’s Administration (VA) Eligibility

• Transaction History

• Multiple/Simultaneous Inquiries

• Batch

• Revalidation

• Dashboard

• Included in CHOICE All Payer Eligibility

• Medicare Eligibility (HETS)

• Medicaid Eligibility

• Commercial Eligibility

• Transaction History

• All-Payer Claims can take electronic claims from RPMS and Alerts billing staff to errors so they can fix claim errors in minutes rather than days or weeks

• Submit all claims at once in batch instead of submitting them separately one at a time.

• Reduce human error and the need to manually re-key transaction data over and over at each payer’s website.

• Provide a single location to manage all electronic claims, including VA claims

• Help avoid prolonged wait-times being on hold with Medicare and other payers inquiring about claim errors.

• Provide knowledgeable support personnel

• Reduce payment cycles leading to more accurate revenue forecasts

• Reduce or eliminate need for paper forms, envelopes and stamps

• Greatly simplifies and speeds up your claims processing

UPGRADE AND/OR ENHANCEMENTS–

Any future upgrades, enhancements including new releases and new versions to the items noted in the specifications shall be addressed and modified, at the discretion of the Contracting Officer, in accordance with Federal Acquisition Regulations.

PERIOD OF PERFORMANCE

The items required under this contract shall commence NLT 10 days after award:

Start End Base TBD/2021 TBD/2022

Option Year #1 TBD/2022 TBD/2023 Option Year #2 TBD/2023 TBD/2024 Option Year #3 TBD/2024 TBD/2025 Option Year #4 TBD/2025 TBD/2026

COMPENSATION (TO BE COMPLETED BY OFFEROR)

SF-1449, page 5 of 19

Clearinghouse secure data transport services to and from the Medicare Administrative Contractor and Commercial Insurance Payers using Centers for Medicaid and Medicare Services approved commercially available Internet-based connection services agreement for the specified Zuni Service Unit in the following format:

Estimated Usage (per month)

Monthly Annual Medicare Claims Commercial Claims Eligibility Lookups

Base 1100 500 400 $_____ $_____ Option Year #1 1100 500 400 $_____ $_____ Option Year #2 1100 500 400 $_____ $_____ Option Year #3 1100 500 400 $_____ $_____ Option Year #4 1100 500 400 $_____ $_____

Total $_____

DDE/FISS Connects Needed: 2

The Contractor shall be compensated at the agreed contract amount based on monthly invoices submitted and only for services in direct performance of this contract. The Contract does not allow for annual or sick leave or other fringe benefits. Per mandate by the U. S. Department of Treasury and effective July 1996, payments by Electronic Funds Transfer System will be made to the Contractor's designated financial institute.

The Contractor's pricing/cost includes all mandatory Federal, State and Local taxes. It is the sole responsibility of the Contractor to collect and pay for all New Mexico State Gross Receipt Taxes for business/work performed in the State of New Mexico, regardless of county the business/service/work was performed. A firm fixed-price purchase order will be awarded for a base year, with four, one-year options for renewal. Total contract award shall not exceed five years. Option renewals will be on the basis of satisfactory services provided and contingent upon availability of funds for the appropriate fiscal year.

CONTRACT OFFICER REPRESENTATIVE (COR)

Keith Martinez, 505-782-7345, is hereby designated as Contract Officer’s Representative for this service. The Contract Officer Representative responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Contract Officer’s Representative does not have the authority to change or alter the order amount, terms and conditions.

The Contract Officer’s Representative responsibilities include ensuring contractor accountability, monitoring the contractor's technical progress- including the surveillance and assessment of performance and recommending to the Contracting Officer changes in requirements, interpreting the statement of work, performing technical evaluations as required, performing technical inspection and acceptance required, assisting the contractor in the resolution of technical problems encountered during performance and receiving and processing invoices for payment.

CLIENT BACKGROUND

Some of the IHS patients receiving services under this contract may only speak a native language or may have limited comprehension of the English language, and/or may reside on a Native American Indian Reservation. The Contractor is expected to demonstrate sensitivity to cross-cultural and language difference and have the ability to work through interpreters.

SUBCONTRACTS:

None of the services furnished under this agreement shall be subcontracted or transferred to another contractor, or organization, without the specific prior written approval of the Contracting Officer.

IHS CONTRACTING OFFICER:

The authority to negotiate a change in terms, conditions, or amounts cited is reserved for the IHS contracting Officer. The COR designated holds no such authority.

PAYMENT OFFICE

The payment office is: Electronic Funds Transfer (EFT) Disbursed by:

SF-1449, page 6 of 19

Albuquerque Indian Health Service U S Department of Treasury Division of Accounting Services Office of Disbursements 4101 Indian School Road NE, Suite 225 Austin, TX 73301 Albuquerque, NM 87110

MANAGEMENT OF MEDICAL INFORMATION:

The Contractor must manage all patient information in accordance with HIPAA standards, Privacy Act, and IHS Service Unit and/or Health Center specific policies and protocols. The Contractor must immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

GOVERNMENT HOLIDAYS (https://www.federalpay.org/holidays) New Year’s Day Martin Luther King’s Birthday President’s Day Memorial Day Independence Day Labor Day Columbus Day Veteran’s Day Thanksgiving Day Christmas Day *Any other day specifically declared by the President of the United States to be a national holiday (www.opm.gov/fedhol).

FAR 52.212-4(G) INVOICE.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include-

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the contract number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice;

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-Central Contractor Registration, or 52.232-34, Payment by Electronic Funds Transfer-Other Than Central Contractor Registration), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as “Small Business.”

SF-1449, page 7 of 19

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors.

Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - Central Contractor Registration.

Failure to submit directly to the offices listed above will delay prompt payment of your invoice.

CONTRACTOR PERFORMANCE EVALUATION REPORT

Evaluation factors for award will be based on past performance, cost/price, technical support and management. The Government intends to award a single contract to the Offeror that provides the best overall value to the government.

Each proposal will be evaluated and its stated evaluation factors and sub factors for award.

Color Rating Adjectival Rating Description

Blue Outstanding Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths including positive past performances.

Purple Good Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength.

Green Acceptable Proposal meets requirements and indicates an adequate approach and understanding of the requirements, and risk of unsuccessful performance is no worse than moderate.

Yellow Marginal Proposal has not demonstrated an adequate approach and understanding of the requirements, and/or risk of unsuccessful performance is high.

Red Unacceptable Proposal does not meet requirements of the solicitation, and thus, contains one or more deficiencies, and/or risk of unsuccessful performance is unacceptable. Proposal is unawardable.

EVALUATION FACTORS FOR AWARD

To be considered for award of a contract under this solicitation, the offeror must comply with the following criteria.

Failure to provide evidence of the following shall automatically disqualify an offeror from further consideration. The following responsibility factors will be used as a basis for the technical evaluation of offeror’s proposals. The contractor shall meet the technical requirements, possess the required experience and provide Point of Contacts for any government contracts and DUNS number for the following:

SF-1449, page 8 of 19

1. Technical Approach

a. The contractor must include with their quote documentation detailing the technical approach to provide secure data services for data transport services to and from the Medicare Administrative and Commercial Insurance.

b. The contractor must include with their quote documentation detailing 3-5 years of experience detailing the background, experience, and qualifications to perform the contract requirements and the degree of the risk of non-performance.

2. Availability

a. The contractor must include with their quote documentation detailing customer support for reporting, documenting, tracking and resolving of service problems, which shall be available via telephone and email to ZSU technical staff during the period 8:00 a.m. through 5:00 p.m. Mountain Standard Time.

b. The contractor must include with their quote documentation detailing open communication for testing, implementation, and monitoring daily operation of the data transfer from non-performance or other features

3. Cost:

a. The cost evaluation will determine whether the proposed costs are realistic, complete and compatible with the technical proposal.

The contractor shall provide a customer service representative assigned to the account to assist in providing information on product description, product ordering and coordinating service arrangements. The Contractor is responsible for performing or having performed all inspections and tests necessary to substantiate that the supplies or services furnished under this contract conform to contract requirements, including any applicable technical requirements. This clause takes precedence over any Government inspection and testing required in the contract’s specifications, except for specialized inspections or tests specified to be performed solely by the Government.

RELATIVE IMPORTANCE OF EVALUATION CRITERIA

Factors 1-2, when combined, are significantly more important than price. The award will be made on a best-value basis; both price and other factors considered. The Source Selection Team will evaluate the technical aspects; the contracting officer will evaluate the pricing.

QUESTIONS

In accordance with FAR 15.201 Exchanges with Industry before receipt of proposals, please refer to solicitation #(RFP19-242-SOL-00016) when requesting information regarding the solicitation via e-mail to eric.wright@ihs.gov, facsimile: (505) 256-6848 or phone: (505) 256-6752.

IDENTIFICATION AND DISPOSITION OF DATA, REPORTS, AND OTHER DELIVERABLES

• The Contractor is not permitted to make use of any data derived from these services for any purpose not directly related to and/or authorized by the Albuquerque Area Indian Health Service.

• All patient data/information are subject to the Privacy Act and the Confidentiality of Information Clause (HHSAR

352.224-70)

• Upon completion/termination of the contract, all information, statistical or analytical material or reports and other data generated by the Contractor shall become the property of the Albuquerque Area Indian Health Service.

• The Contractor is prohibited from gathering data, statistics, or use of material for publication and/or research for its own benefits. Dissemination of information, prior approval shall be obtained from the Government Contracting Officer for the release or dissemination of information related to this contract.

ADDITIONAL REQUIREMENTS CONCERNING DATA, DATA RIGHTS AND COMPUTER SOFTWARE

• Copies of the final Reports and Deliverables under each task must be officially sent to the Indian Health Service and kept on file by the Contractor. At the end of the contract, all files must be kept by the Contractor for audit purposes.

• Works other than Software Development or Enhancements:

• No software will be developed, modified, or enhanced under this acquisition.

SUBCONTRACTS:

SF-1449, page 9 of 19

None of the services furnished under this agreement shall be subcontracted or transferred to another contractor, or organization, without the specific prior written approval of the Contracting Officer.

PAYMENT OFFICE

The payment office is: Electronic Funds Transfer (EFT) Disbursed by:

Albuquerque Indian Health Service U S Department of Treasury Division of Accounting Services Office of Disbursements 4101 Indian School Road NE, Suite 225 Austin, TX 73301 Albuquerque, NM 87110

INVOICE.

Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule, progress payments, partial payments, deliverables, etc. All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all invoices for it to constitute a proper invoice.

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on each invoice.

For additional information about the Dun & Bradstreet (D&B) DUNS number, please visit http://fedgov.dnb.com/webform.

The Contractor shall submit proper invoices (excluding patient identifiers i.e. patient name, etc.) and all required back-up documentation to:

a. COR: Deena Evans, Deena.evans@ihs.gov

b. Albuquerque Finance: ALB_AOAPinvoices@ihs.gov

Do not send non-invoice related documents (i.e. deliverables, reports, and balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the offices as listed above will delay prompt payment of your invoice.

FAR 52.212-4(G):

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include-

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the contract number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice;

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-Central Contractor Registration, or 52.232-34, Payment by Electronic Funds Transfer-Other Than Central Contractor Registration), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as “Small Business.”

mailto:ALB_AOAPinvoices@ihs.gov

SF-1449, page 10 of 19

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors.

Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - Central Contractor Registration.

Failure to submit directly to the offices listed above will delay prompt payment of your invoice.

METHOD OF PAYMENT:

- Payment shall be made in arrears upon receipt of MONTHLY invoices;

- Electronic Funds Transfer (EFT) shall be utilized as method for processing payment;

- Upon receipt of a properly prepared Contractor invoice, the COR is responsible for certifying the invoice for acceptance of service and contacting a UFMS receiver to request a receiving receipt.

- Per the invoice submission instructions provided within your contract, the contractor shall submit invoices per the frequency stated in their contract (e.g. biweekly, monthly, quarterly, etc.). Advance payments cannot be issued by our office unless the contract award includes a clause stating prepayment of goods and/or services are authorized.

CONTRACTOR PERFORMANCE EVALUATION REPORT

During the life of this contract, the contractor’s performance will be evaluated on an interim and final basis pursuant to FAR Subpart 42.15. Evaluation will become part of the contract file and will be used as past performance information in evaluating the Contractor’s, and any significant subcontractors’ or affiliates, past performance on future contracts.

Contractor Performance Assessment Report System (CPARS) is an on-line reporting system https://www.cpars.gov/. The Contractor Performance Report is completed by the COR electronically and sent to the Contractor for review and approval at the end of each performance period as an interim report and at the end of the contract performance as a final report.

After review by the Contracting Officer, the report becomes a permanent record of the Contractor’s past performance.

FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address: https://www.acquisition.gov/?q=/browse/far/52

FAR TITLE DATE

52.212-4 Contract Terms and Conditions—Commercial Items (OCT 2018) 52.246-4 Inspection of Services – Fixed-Price (AUG 1996)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS-COMMERCIAL ITEMS (FEB 2021)

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. 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;

https://www.acquisition.gov/?q=/browse/far/52

SF-1449, page 11 of 19

(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, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3)of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

Service-disabled veteran-owned small business concern—

(1) Means a small business concern—

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veteransor, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service connected, as defined in 38 U.S.C. 101(16).

Small business concern—

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR part 121 and size standards in this solicitation.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

Small disadvantaged business concern, consistent with13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that—

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by—

(i) One or more socially disadvantaged (as defined at13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

Subsidiary means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation Successor means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term "successor" does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

Veteran-owned small business concern means a small business concern—

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127), 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.

Women-owned small business concern means a small business concern—

(1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

(b)

(1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications in SAM

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications-Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard(s) applicable to the NAICS code(s) referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ______________.

[Offeror to identify the applicable paragraphs at (c) through (v) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on SAM.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it □ is, □ is not a small business concern.

(2) Veteran-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents as part of its offer that it □ is, □ is not a veteran-owned small business concern.

SF-1449, page 12 of 19

(3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that it □ is, □ is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, that it □ is, □ is not a small disadvantaged business concern as defined in 13 CFR124.1002.

(5) Women-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it □ is, □ is not a women-owned small business concern.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that-

(i) It □ is, □ is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: __________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that-

(i) It □ is, □ is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: __________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it □ is a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price:____________________________________

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that–

(i) It □ is, □ is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR Part 126; and

(ii) It □ is, □ is not a HUBZone joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: __________.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(d) Representations required to implement provisions of Executive Order11246-

(1) Previous contracts and compliance. The offeror represents that-

(i) It □ has, □ has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and

(ii) It □ has, □ has not filed all required compliance reports.

(2) Affirmative Action Compliance. The offeror represents that-

(i) It □ has developed and has on file, □ has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or

(ii) It □ has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 http://uscode.house.gov/ U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract.