Solicitation 75H70620Q00013 - Hologic SMA GP Areawide.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

Aberdeen SD 57401 115 Fourth Ave, SE Federal Building Aberdeen Area Indian Health Servic

CODE 16. ADMINISTERED BYCODE

X

X

X

811219

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR159

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

08/27/2020 1300 CT

08/20/2020

605-226-7572SUSAN DAVIS

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70620Q00013

5. SOLICITATION NUMBER

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

1 46 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Multiple Destinations

15. DELIVER TO

Aberdeen SD 57401 115 Fourth Ave, SE Federal Building

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$22.00

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 SCHEDULEX

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)

Aberdeen Area Indian Health Servic

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.

***THIS IS A TOTAL SMALL BUSINESS SET ASIDE***

Firm Fixed Price, Base Plus Four Option Year, Non-Personal Services Contract for an Areawide Service, Support and Maintenance Agreement for Hologic Imaging Equipment for IHS Health Care Facilities throughout the Great Plains Area in North Dakota and South Dakota;

Period of Performance: 09/01/2020 to 12/31/2020 Continued ...

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

CRAIG J. WELLS

. 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.

1 Pine Ridge: Base Year: POP: Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for Selenia Dimensions 6000(3D):

(SN# SDM131500925)(Biomed Control #45PRB-004792);

Please see SOW and List of Equipment;

2 Pine Ridge: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for SecurView Workstation: (SN#

EDWS151500988)(Biomed Control #45PRB-004792A);

Please see SOW and List of Equipment;

3 Pine Ridge: Base Year: POP: Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for TechMate Workstation: (SN#

95LB1T2)(Biomed Control #45PRB-004792B); Please see SOW and List of Equipment;

4 Pine Ridge: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for R2 CAD Workstation: (SN#

C0315): Please see SOW and List of Equipment;

5 Rosebud: Base Year: POP Date of Award to

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

46 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for Selenia Dimensions 5000(3D):

(SN# 81403143220)(Biomed Control #45RRB-003206);

Please see SOW and List of Equipment;

6 Rosebud: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for SecurView Workstation:

Please see SOW and List of Equipment;

7 Rosebud: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for TechMate Workstation: (SN#

CA805965)(Biomed Control #45RRB-003206C); Please see SOW and List of Equipment;

8 Rosebud: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for R2 CAD Workstation:

(SN#-Unknown)(Biomed Control #45RRB-003206D);

Please see SOW and List of Equipment;

9 Belcourt: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for Selenia Dimensions 5000(3D)-

(SN# 81008167096)(Biomed Control #45BLB-002850);

Please see SOW and List of Equipment;

10 Belcourt: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for SecurView Workstation;

Please see SOW and List of Equipment;

11 Belcourt: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for TechMate Workstation: (SN#

81408167114)(Biomed Control#-None); Please see

SOW and List of Equipment;

12 Belcourt: Base Year: POP Date of Award to

Continued ...

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

Sponsored by GSA

FAR (48 CFR) 53.110

4 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for R2 CAD Workstation -(SN#

Unknown) (Biomed Control#-None) Please see SOW and List of Equipment;

13 Sisseton: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for Selenia Dimensions 6000(3D):

(SN# SDM131501006)(Biomed Control #45SIB-001750);

Please see SOW and List of Equipment;

14 Sisseton: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for SecurView Workstation; (SN#

EWS151900423) (Biomed Control #45SIB-001750A)

Please see SOW and List of Equipment;

15 Sisseton: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for TechMate Workdstation

(SN#-None)(Biomed Control#-None); Please see SOW and List of Equipment;

16 Sisseton: Base Year: POP Date of Award to

12/31/2020; Service Support and Maintenance

Agreement (S&MA) for R2 CAD Workstation; (SN#

CD1509)(Biomed Control #45SIB-001750C); Please see SOW and List of Equipment;

17 Pine Ridge: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131500925)(Biomed Control #45PRB-004792);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

18 Pine Ridge: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation (SN#

Continued ...

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

5 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

EDWS151500988)(Biomed Control #45PRB-004792A);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

19 Pine Ridge: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN# 95LB1T2)(Biomed

Control #45PRB-004792B); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

20 Pine Ridge: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# C0315) Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

21 Rosebud: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)-(SN#

81403143220)(Biomed Control #45RRB-003206);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

22 Rosebud: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation - Please see SOW and

List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

23 Rosebud: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA)

Continued ...

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

6 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013 for TechMate Workdstation (SN# CA805965)(Biomed

Control #45RRB-003206C); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

24 Rosebud: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# Unknown)(Biomed

Control #45RRB-003206D); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

25 Belcourt: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)- (SN#

81008167096)(Biomed Control #45BLB-002850);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

26 Belcourt: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; Please see SOW and

List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

27 Belcourt: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN#

81408167114)(Biomed Control# - None); Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

Continued ...

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

7 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

28 Belcourt: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation; (SN# Unknown) (Biomed

Control# - None) Please see SOW and List of

Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

29 Sisseton: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131501006)(Biomed Control #45SIB-001750);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

30 Sisseton: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; (SN#

EWS151900423)(Biomed Control #45SIB-001750A)

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

31 Sisseton: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation (SN#-None)(Biomed

Control#-None); Please see SOW and List of

Equipment;

(Option Line Item)

12/31/2020

Period of Performance: 01/01/2021 to 12/31/2021

32 Sisseton: OY#1: POP: 01/01/2021 to 12/31/2021;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation-(SN# CD1509)(Biomed

Control #45SIB-001750C); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2020

Continued ...

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

8 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

Period of Performance: 01/01/2021 to 12/31/2021

33 Pine Ridge: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131500925)(Biomed Control #45PRB-004792);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

34 Pine Ridge: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation (SN#

EDWS151500988)(Biomed Control #45PRB-004792A);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

35 Pine Ridge: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN# 95LB1T2)(Biomed

Control #45PRB-004792B); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

36 Pine Ridge: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# C0315) Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

37 Rosebud: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)-(SN#

81403143220)(Biomed Control #45RRB-003206);

Please see SOW and List of Equipment;

Continued ...

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

9 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

38 Rosebud: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation - Please see SOW and

List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

39 Rosebud: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for TechMate Workdstation (SN# CA805965)(Biomed

Control #45RRB-003206C); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

40 Rosebud: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# Unknown)(Biomed

Control #45RRB-003206D); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

41 Belcourt: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)- (SN#

81008167096)(Biomed Control #45BLB-002850);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

42 Belcourt: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; Please see SOW and

Continued ...

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

10 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

43 Belcourt: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN#

81408167114)(Biomed Control# - None); Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

44 Belcourt: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation; (SN# Unknown) (Biomed

Control# - None) Please see SOW and List of

Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

45 Sisseton: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131501006)(Biomed Control #45SIB-001750);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

46 Sisseton: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; (SN#

EWS151900423)(Biomed Control #45SIB-001750A)

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

47 Sisseton: OY#2: POP: 01/01/2022 to 12/31/2022;

Continued ...

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

11 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation (SN#-None)(Biomed

Control#-None); Please see SOW and List of

Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

48 Sisseton: OY#2: POP: 01/01/2022 to 12/31/2022;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation-(SN# CD1509)(Biomed

Control #45SIB-001750C); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2021

Period of Performance: 01/01/2022 to 12/31/2022

49 Pine Ridge: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131500925)(Biomed Control #45PRB-004792);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

50 Pine Ridge: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation (SN#

EDWS151500988)(Biomed Control #45PRB-004792A);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

51 Pine Ridge: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN# 95LB1T2)(Biomed

Control #45PRB-004792B); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Continued ...

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

12 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

Period of Performance: 01/01/2023 to 12/31/2023

52 Pine Ridge: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# C0315) Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

53 Rosebud: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)-(SN#

81403143220)(Biomed Control #45RRB-003206);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

54 Rosebud: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation - Please see SOW and

List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

55 Rosebud: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for TechMate Workdstation (SN# CA805965)(Biomed

Control #45RRB-003206C); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

56 Rosebud: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# Unknown)(Biomed

Control #45RRB-003206D); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Continued ...

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

13 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

Period of Performance: 01/01/2023 to 12/31/2023

57 Belcourt: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)- (SN#

81008167096)(Biomed Control #45BLB-002850);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

58 Belcourt: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; Please see SOW and

List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

59 Belcourt: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN#

81408167114)(Biomed Control# - None); Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

60 Belcourt: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation; (SN# Unknown) (Biomed

Control# - None) Please see SOW and List of

Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

61 Sisseton: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131501006)(Biomed Control #45SIB-001750);

Please see SOW and List of Equipment;

Continued ...

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

14 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

62 Sisseton: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; (SN#

EWS151900423)(Biomed Control #45SIB-001750A)

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

63 Sisseton: OY#3: POP: 01/01/2023 to

12/31/2023;Service Support and Maintenance

Agreement (S&MA) for TechMate Workstation

(SN#-None)(Biomed Control#-None); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

64 Sisseton: OY#3: POP: 01/01/2023 to 12/31/2023;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation-(SN# CD1509)(Biomed

Control #45SIB-001750C); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2022

Period of Performance: 01/01/2023 to 12/31/2023

65 Pine Ridge: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131500925)(Biomed Control #45PRB-004792);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

66 Pine Ridge: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA)

Continued ...

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

15 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013 for SecurView Workstation (SN#

EDWS151500988)(Biomed Control #45PRB-004792A);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

67 Pine Ridge: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN# 95LB1T2)(Biomed

Control #45PRB-004792B); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

68 Pine Ridge: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# C0315) Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

69 Rosebud: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)-(SN#

81403143220)(Biomed Control #45RRB-003206);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

70 Rosebud: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation - Please see SOW and

List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

71 Rosebud: OY#4: POP: 01/01/2024 to 12/31/2024;

Continued ...

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

16 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

Service Support and Maintenance Agreement (S&MA) for TechMate Workdstation (SN# CA805965)(Biomed

Control #45RRB-003206C); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

72 Rosebud: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation - (SN# Unknown)(Biomed

Control #45RRB-003206D); Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

73 Belcourt: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 5000(3D)- (SN#

81008167096)(Biomed Control #45BLB-002850);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

74 Belcourt: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; Please see SOW and

List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

75 Belcourt: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation -(SN#

81408167114)(Biomed Control# - None); Please see

SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

Continued ...

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

17 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

76 Belcourt: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation; (SN# Unknown) (Biomed

Control# - None) Please see SOW and List of

Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

77 Sisseton: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for Selenia Dimensions 6000(3D)- (SN#

SDM131501006)(Biomed Control #45SIB-001750);

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

78 Sisseton: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for SecurView Workstation; (SN#

EWS151900423)(Biomed Control #45SIB-001750A)

Please see SOW and List of Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

79 Sisseton: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for TechMate Workstation (SN#-None)(Biomed

Control#-None); Please see SOW and List of

Equipment;

(Option Line Item)

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

80 Sisseton: OY#4: POP: 01/01/2024 to 12/31/2024;

Service Support and Maintenance Agreement (S&MA) for R2 CAD Workstation-(SN# CD1509)(Biomed

Control #45SIB-001750C); Please see SOW and List of Equipment;

(Option Line Item)

Continued ...

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

18 46

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70620Q00013

12/31/2023

Period of Performance: 01/01/2024 to 12/31/2024

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

Award - Award/Contract Number

The clauses, terms and conditions from this Solicitation will be incorporated into Contract #(to be determined);

B - Supplies or Services and prices/costs

Unit Price

The "Unit Price" is an all-inclusive cost. "All inclusive cost" is defined to include travel, lodging, per diem, fringe benefits, i.e., life insurance, social security, federal, state, and local taxes, plus all other costs pertinent to the performance of this purchase order.

C - Description/specifications/statement of work

SCOPE OF WORK FOR SERVICE & SUPPORT:

Hologic Imaging Systems - Great Plains Area Indian Health Service

C-1 PURPOSE:

The purpose of this contract is to provide a comprehensive service and support agreement for various imaging equipment manufactured by Hologic located at multiple facilities within the region served by the Great Plains Area Indian Health Service (SD & ND.

The award of a contract will be a firm-fixed price type.

C-2 SCOPE OF WORK:

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

Calibration/ Preventive Maintenance:

The service to be performed by the contractor under this contract and for the bid price shall include ALL parts, labor, tools, equipment, literature, transportation, per diem necessary to provide complete calibration/preventive maintenance and mechanical/electrical safety testing as recommended by the original equipment manufacturer (OEM) and required by the Center for Medicare and Medicaid Services and various accrediting bodies.

Only new or original equipment manufacturer (OEM) certified replacement parts will be used for replacement of any component found defective.

The Contractor shall submit, upon issuance of the contract, a schedule showing the dates of future/scheduled services per the OEM recommended and/or statutorily required intervals.

This schedule will comply with the interval/time definitions of TJC Environment of Care accreditation standards.

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

Quarterly: once every three months +/- 10 days Semi-annual: 6 months from the last scheduled event month +/- 20 days

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

Unscheduled Maintenance and parts:

Unscheduled maintenance, repair, emergency call back, recall, modification, breakdown repair is covered under this contract, except as specifically listed under C-4 Exclusions.

Contractor will provide at no additional cost to the Government all parts, labor, tools, equipment, literature, transportation and per diem necessary to provide complete repair of all unscheduled maintenance requirements.

Only new or original equipment manufacturer (OEM) certified replacement parts will be used for replacement of any component found defective.

Glassware:

Glassware coverage, to include x-ray tubes, detectors, and other parts typically associated with, or commonly referred to as `glassware' will be covered on a non-prorated basis.

Removal:

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

Representative or Clinical Engineering.

Hours of Performance:

Unless otherwise stated, or negotiated, work shall be performed Monday through Friday, 8am to 5 pm excluding weekends and holidays.

C-3 EQUIPMENT:

All equipment that is part of the system shall be covered to include associated workstations (SecurView, Techmate, CAD):

SEE ATTACHED EQUIPMENT LISTING - Contractor is expected to contact each facility to verify/validate list

C-4 EXCLUSIONS:

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

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

The following are specifically excluded from this contract:

Operating supplies or accessories not furnished by Contractor during the course of normal Preventive Maintenance Inspection and Services, such as expendable items including recording charts, paper, ink, pens, ribbons, pen arms, etc.

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

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

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

C-5 DOCUMENTATION:

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

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

The Contractor is required to present the service tickets/calibration record with the P.O. number of the service contract on them for each time a service is performed on the equipment, including PM's.

These service tickets shall not take the place of the PM checklist.

Lack of service tickets being presented will be cause for non-payment by the Government.

One copy of the service ticket (together with the PM checklist) shall be left with the Department Supervisor and one copy (together with the PM checklist) shall be provided to the COR within one week of the service.

Service tickets may be submitted via email to abr_oehbiomed@ihs.gov (note there is an underscore between abr and oeh (abr_oeh)).

Notifications of service ticket availability for retrieval through iCenter is also acceptable.

C-6 QUALITY CONTROL:

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

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

C-7 BASIS OF PAYMENT:

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

Prompt Payment Act.

Invoices shall be submitted with all information and supporting documentation as described in C-5 Documentation.

A complete and accurate invoice is substantially correct in that all aspects of the required information are clearly evident on the invoice.

If items such as invoice number, date, dates of service, contract/purchase order number, etc., are not on the invoice, it will be returned to the Contractor for resubmission.

C-8 LIABILITY:

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

Government employees.

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

C-9 RELEASES:

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

C-10 WARRANTY:

All contractor labor shall be warranted for 30 days from the date the work was performed.

All parts and material sold/provided by the contractor for installation under this contract will be warranted for a minimum of 30 days.

Warranty call back service shall be provided during the warranty period at no additional charge.

Equipment Listing

Existing Equipment Listing - Hologic

Location and Item Serial # Biomed Control #

Pine Ridge

Selenia Dimensions 6000 (3D) SDM131500925 45PRB-004792

SecurView Workstation EWS151500988 45PRB-004792A

TechMate Workstation 95LB1T2 45PRB-004792B

R2 CAD Workstation C0315 ---

Rosebud Hospital

Selenia Dimensions 5000 (3D) 81403143220 45RBB-003206

SecurView Workstation --- ---

TechMate Workstation CA805965 45RBB-003206C

R2 CAD Workstation Unknown 45RBB-003206D

Belcourt (Quentin N. Burdick Memorial Health Care Facility) Hospital

Selenia Dimensions 5000 (3D) 81008167096 45BLB-002850

SecurView Workstation --- ---

TechMate Workstation 81408167114 None

R2 CAD Workstation Unknown None

Sisseton (Woodrow Wilson Keeble Memorial Health Care Center) Health Center

Selenia Dimensions 6000 (3D) SDM131501006 45SIB-01750

SecurView Workstation EWS151900423 45SIB-001750A

TechMate Workstation --- ---

R2 CAD Workstation CD1509 45SIB-001750C

G - Contract Administration Data

Period of Performance

Period of Performance will be from Date of Award to December 31, 2020 with four 1-year options with performance dates of:

Option Year One (1): January 1, 2021 to December 31, 2021 Option Year Two (2): January 1, 2022 to December 31, 2022 Option Year Three (3): January 1, 2023 to December 31, 2023 Option Year Four (4): January 1, 2024 to December 31, 2024

COR/Contact Person

COR: Mr. Anthony Stayner, Chief of Clinical Engineering for the Great Plains Area who may be reached at 605- 226-7572 and/or at Anthony.Stayner@ihs.gov;

Invoice Submission & Payment

The Contractor shall bill either monthly or quarterly and shall submit invoices accordingly.

a) The Contractor shall submit invoices electronically. After delivery of goods or services, the Contractor shall email invoices to both Rachel.Olson@ihs.gov and ABR_OEHBiomed@ihs.gov. Any invoice inquiries can be directed to Rachel.Olson@ihs.gov.

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

1. Contractor's Name;

2. Invoice number and date;

3. Entire award number or other authorization number for delivery of goods or services (Task Order No. and

Contract No.);

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

5. Shipping and payment terms;

6. DUNS number and taxpayer identifying number (TIN); and

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

Payments shall be made by the Great Plains Area Financial Management Branch, Federal Building, Room 309, Aberdeen, SD 57401-4360.

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

H - Special Contract Requirements

Contractor's Agreement

Contractor's Agreement is hereby incorporated by reference as a part of this purchase order. In the event of a conflict between any terms of the agreement and the purchase order, applicable federal laws and statutes will prevail.

mailto:Rachel.Olson@ihs.gov mailto:ABR_OEHBiomed@ihs.gov mailto:Rachel.Olson@ihs.gov

Service Contract Labor Standards

The Wage Determinations listed below are hereby incorporated by Reference.

1. WD #2015-5385 Revision #10 dated 12/23/2019

2. WD #2015-5379 Revision #9 dated 12/23/2019

3. WD #2015-5373 Revision #12 dated 12/23/2019

4. WD #2015-5377 Revision #12 dated 12/26/2019

5. WD #2015-5375 Revision #9 dated 12/23/2019

6. WD #2015-5367 Revision #12 dated 12/23/2019

The full text of the referenced wage determination can be accessed at http://beta.sam.gov.

Contractor's Performance Conditions & Responsibilities

1. Contractor is responsible for reporting all taxes from wages earned under this contract to the appropriate State and Federal Agencies, provided the awardee is an individual.

2. Contractor is responsible for his/her own reliable transportation in the performance of the contract.

3. Contractor is responsible for Fringe Benefits and other benefits such as health, retirement, etc. for his/her employees, if other than self.

4. Contractor is responsible for maintaining satisfactory standards of competence, conduct, appearance and integrity. The quality of work performance of the contractor shall be subject to review.

5. Contractor is responsible for notifying the designated supervisor/director if he/she will be late, ill or unable to work for other reasons.

6. Contractor earns no leave and is compensated only for hours actually worked at the agreed compensatory rate.

7. Contractor is responsible for signing-in and signing-out of immediate work area, utilizing in-house system of accountability.

Other Terms and Conditions

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

Any contractor employees who will be accessing a government owned/rented/leased data system (including medical devices) will be required to complete the IHS Information System Security Awareness Training and provide a copy of the certificate of completion to the facility Clinical Engineering department.

Any contractor employees who will be working on-site in an IHS facility shall pass a security clearance, including fingerprints, prior to working on-site and wear and display at all times contractor issued and (if provided) IHS issued photographic identification badges.

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

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

http://beta.sam.gov/

Security Clearance

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems, each person must complete a FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five business days for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

The Indian Health Service utilizes the eQIP (Electronic Questionnaire Investigations Processing) system to process background investigations. Contractors are required to work with the Service Unit Background Coordinator or other designee to properly complete their eQIP entry without error. Proper submission of the eQIP entry to the Office of Personnel Management (OPM) is required prior to the individual being allowed to begin their performance under this contract. Computers have been provided to the service unit for this purpose.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov.

As soon as practicable, prior to the performance of the work, the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access.

If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings.

If this is a Fixed-Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

Government will pay for the cost to process the contractor's suitability clearances. However, multiple investigations for the same position may, at the Contracting Officer's discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

Indian Health Service Circular No. 19-05

Contractors within the Great Plains Area Indian Health Service (GPAIHS) that have access to IHS Facilities are required to complete the Child Sexual Abuse Briefing (IHS June 2019) training.

The PowerPoint presentation is available on-site and will be provided by the Facility where the individual is under contract.

Once the PowerPoint presentation has been reviewed and understood by the contractor, they shall send an e-mail notification to Ms. Sara Syhre, e-mail address: Sara.Syhre@ihs.gov as follows:

Email Subject Line: Child Sexual Abuse Briefing - Vendor Name Email Body: I have reviewed and understand the PowerPoint presentation titled "Child Sexual Abuse

Briefing (IHS June 2019)".

Signature: Full name of sender that has completed the training http://exclusions.oig.hhs.gov/ mailto:Sara.Syhre@ihs.gov

Additional Applicable Published Policy & Procedure

These referenced published policies and procedures are applicable to any contractor personnel providing services in accordance with this contract and are hereby incorporated by reference. The contractor is responsible for ensuring that all applicable contractor and subcontractor employees engaged in the direct delivery of services for this contract are aware of the applicable terms and conditions that apply and have read and familiarized themselves with the content.

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

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

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

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

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

I - FAR Clauses Incorporated by Reference & In Full Text

52.204-6 Unique Entity Identifier. (OCT 2016)

52.204-7 System for Award Management. (OCT 2018)

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

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

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations. (NOV 2015)

52.212-4 Contract Terms and Conditions - Commercial Items. (OCT 2018)

52.232-40 Providing Accelerated Payments to Small Business Subcontractors. (DEC 2013)

52.233-3 Protest After Award. (AUG 1996)

52.233-4 Applicable Law for Breach of Contract Claim. (OCT 2004)

352.203-70 Anti-Lobbying. (DEC 2015)

352.222-70 Contractor Cooperation in Equal Employment Opportunity Investigations. (DEC 2015)

352.223-70 Safety and Health. (DEC 2015)

352.224-70 Privacy Act. (DEC 2015)

352.226-1 Indian Preference. (DEC 2015)

52.212-5 Contract Terms and Conditions Required To Implement Statutes or Executive Orders - Commercial Items.

(JUL 2020)

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

(1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (JAN 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

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

(2) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (JUL 2018) (Section 1634 of Pub. L. 115-91).

(3) 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(AUG 2019) (Section 889(a)(1)(A) of Pub. L. 115-232).

(4) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (NOV 2015).

(5) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).

(6) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Public Laws 108-77 and 108-78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: (Contracting Officer check as appropriate.)