Sol_75H71026Q00130.pdf
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- Solicitation number
- 75H71026Q00130
About this file
This is a Solicitation/Contract/Order for Commercial Items (Standard Form 1449) issued by Northern Navajo Medical Center for non-personal healthcare services. The solicitation number is 75H71026Q00130, with an offer due date of April 9, 2026 at 12:00 PM MT. The contracting officer is Michelle A. James, and the contact for solicitation information is Matthew Atcitty.
The requirement is for Five (5) Registered Nurses to provide non-personal healthcare services in the Ambulatory Care Department at Northern Navajo Medical Center, located at US Highway 491 North, Shiprock, New Mexico 87420. This is a Labor-Hour Contract Line Item (CLIN) with an estimated 1,040 hours per period. The contract consists of a base period from June 1, 2026 to November 30, 2026, followed by four option periods of similar duration extending through November 30, 2028. Services must be provided in accordance with Attachment A - Performance Work Statement. Contractor exceeding estimated values assumes the risk. The solicitation is set aside 100% for Indian Small Business Economic Enterprise (ISBEE) under NAICS code 561320 (Temporary Help Services). Payment will be made through electronic submission via www.ipp.gov in accordance with FAR 52.212-4(g) and clause 352.232-71. This is a rated order under the Defense Priorities and Allocations System (DPAS) per 15 CFR 700. Delivery is FOB Destination, and invoices must be submitted to the address in Block 18a.
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| 3. PWS_ACD RN.pdf |
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Text version
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
53CODE 16. ADMINISTERED BYCODE
X
X
561320
SIZE STANDARD:
100.00 % FOR:SET ASIDE:UNRESTRICTED OR53
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
04/22/2026 1200 MT
04/09/2026
MATTHEW ATCITTY
(No collect calls)
INFORMATION CALL:
FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME
4. ORDER NUMBER3. AWARD/ 6. SOLICITATION
75H71026Q00130
5. SOLICITATION NUMBER
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF
1 4 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
TELEPHONE NO.
17a. CONTRACTOR/
15. DELIVER TO
Shiprock NM 87420
US Hwy 491 North
9. ISSUED BY
7.
2. CONTRACT NO.
EFFECTIVE DATE
$34
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)
Northern Navajo Medical CTR WOMEN-OWNED SMALL
BUSINESS (WOSB)
ECONOMICALLY DISADVANTAGED
WOMEN-OWNED SMALL
BUSINESS (EDWOSB)
Shiprock NM 87420
US Hwy 491 North
Northern Navajo Medical Center
Shiprock NM 87420
US Hwy 491 North
Northern Navajo Medical CTR
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
Set-Aside Information - ***100% ISBEE SET-ASIDE***
This contract is subject to the electronic payment process by the Department of Treasury.
All invoices complying to the requirements at 52.212-4(g) must be submitted through www.ipp.gov. For additional information, refer to the incorporated clause of 352.232-71 Electronic Submission of Payments Requests (FEB 2022).
Period of Performance: 06/01/2026 to 11/30/2028 (Use Reverse and/or Attach Additional Sheets as Necessary)
HEREIN, IS ACCEPTED AS TO ITEMS:
X
XX
DATED
MICHELLE A. JAMES
. 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 (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.
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 Period:
Non-Personal Healthcare Services for Five (5)
Registered Nurse for the Ambulatory Care
Department.
Hours: 1040
The Contractor shall provide required services
IAW Attachment A - Performance Work Statement.
This is a Labor-Hour CLIN. Values are estimated.
Contractor exceeds value at its own risk.
Period of Performance: 06/01/2026 to 11/30/2026
2 Option Period 1:
Non-Personal Healthcare Services for Five (5)
Registered Nurse for the Ambulatory Care
Department.
Hours: 1040
The Contractor shall provide required services
IAW Attachment A - Performance Work Statement.
This is a Labor-Hour CLIN. Values are estimated.
Continued ...
32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE
4 2 of
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
NAME OF OFFEROR OR CONTRACTOR
3 4
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
(A) (B) (C) (D) (E) (F)
75H71026Q00130
Contractor exceeds value at its own risk.
(Option Line Item)
11/30/2026
Period of Performance: 12/01/2026 to 05/31/2027
3 Option Period 2:
Non-Personal Healthcare Services for Five (5)
Registered Nurse for the Ambulatory Care
Department.
Hours: 1040
The Contractor shall provide required services
IAW Attachment A - Performance Work Statement.
This is a Labor-Hour CLIN. Values are estimated.
Contractor exceeds value at its own risk.
(Option Line Item)
05/31/2027
Period of Performance: 06/01/2027 to 11/30/2027
4 Option Period 3:
Non-Personal Healthcare Services for Five (5)
Registered Nurse for the Ambulatory Care
Department.
Hours: 1040
The Contractor shall provide required services
IAW Attachment A - Performance Work Statement.
This is a Labor-Hour CLIN. Values are estimated.
Contractor exceeds value at its own risk.
(Option Line Item)
11/30/2027
Period of Performance: 12/01/2027 to 05/31/2028
5 Option Period 4:
Non-Personal Healthcare Services for Five (5)
Registered Nurse for the Ambulatory Care
Department.
Continued ...
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
NAME OF OFFEROR OR CONTRACTOR
4 4
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
(A) (B) (C) (D) (E) (F)
75H71026Q00130
Hours: 1040
The Contractor shall provide required services
IAW Attachment A - Performance Work Statement.
This is a Labor-Hour CLIN. Values are estimated.
Contractor exceeds value at its own risk.
(Option Line Item)
05/31/2028
Period of Performance: 06/01/2028 to 11/30/2028
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110
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