Solicitation Amendment - W81K0026QA1850001 Professional Appearance.pdf

WOMEN-OWNED SMALL

BUSINESS (WOSB)

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

1. REQUISITION NUMBER PAGE 1 OF

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME b. TELEPHONE NUMBER (No collect 8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NUMBER

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

OFFER

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

BELOW IS CHECKED

REQUEST

FOR QUOTE

(RFQ)

INVITATION

FOR BID

(IFB)

REQUEST

FOR

PROPOSAL

(RFP)

SEE ADDENDUM

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Government Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH

AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND

ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS

SPECIFIED

29. AWARD OF CONTRACT: REFERENCE OFFER

DATED . . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

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

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

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

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS UNRESTRICTED OR

NORTH AMERICAN

INDUSTRY CLASSIFICATION

STANDARD (NAICS):

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

THE DEFENSE PRIORITIES

AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

SET ASIDE: % FOR:

11. DELIVERY FOR FREE ON

BOARD (FOB) DESTINATION

UNLESS BLOCK IS MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

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

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

8(A)

ECONOMICALLY

DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30.

calls)

Solicitation/Contract Form Continuation

Administrative Emergency Medical ServicesInstrument Name:

Product Service Code : Q529

W81K0026QA1850001

Continuation of Supplies or Services and Prices/Costs

Additional Information/Notes

Item Supplies/Service Quantity Unit Unit Price

Amount

0001 The vender shall provide all services required to accomplish the administrative requirements for maintaining and supporting the establishment of applicable Emergency Medical Services (EMS) protocols for the Utah Occupational Health Clinics:

Tooele Army Depot and Dugway Proving Ground IAW the Performance Work Statement (PWS), which are subject to all applicable federal, state and local law and regulation.

Product Service Code: Q529 Pricing Arrangement: Firm Fixed Price

4 Quarter

Additional Descriptive Data:

Additional Information: Item text: EMS Admin located in Utah and serves Dugway and Tooele sites

Option Line Item

The vender shall provide all services required to accomplish the administrative requirements for maintaining and supporting the establishment of applicable Emergency Medical Services (EMS) protocols for the Utah Occupational Health Clinics:

Tooele Army Depot and Dugway Proving Ground IAW the Performance Work Statement (PWS), which are subject to all applicable federal, state and local law and regulation.

Product Service Code: Q529

4 Quarter

Pricing Arrangement: Firm Fixed Price

Option Line Item

The vender shall provide all services required to accomplish the administrative requirements for maintaining and supporting the establishment of applicable Emergency Medical Services (EMS) protocols for the Utah Occupational Health Clinics:

Tooele Army Depot and Dugway Proving Ground IAW the Performance Work Statement (PWS), which are subject to all applicable federal, state and local law and regulation.

Product Service Code: Q529 Pricing Arrangement: Firm Fixed Price

4 Quarter

Option Line Item

The vender shall provide all services required to accomplish the administrative requirements for maintaining and supporting the establishment of applicable Emergency Medical Services (EMS) protocols for the Utah Occupational Health Clinics:

Tooele Army Depot and Dugway Proving Ground IAW the Performance Work Statement (PWS), which are subject to all applicable federal, state and local law and regulation.

Product Service Code: Q529 Pricing Arrangement: Firm Fixed Price

4 Quarter

Option Line Item

The vender shall provide all services required to accomplish the administrative requirements for maintaining and supporting the establishment of applicable Emergency Medical Services (EMS) protocols for the Utah Occupational Health Clinics:

4 Quarter

Tooele Army Depot and Dugway Proving Ground IAW the Performance Work Statement (PWS), which are subject to all applicable federal, state and local law and regulation.

Product Service Code: Q529 Pricing Arrangement: Firm Fixed Price

Continuation of Description

Requirements Administrative Emergency Medical Services

Continuation of Inspection and Acceptance

Overall Contract Inspection/Acceptance Locations

0001 Inspection and Acceptance Location

Both Other Instructions: laura.m.larsen-pitcher.civ@health.mil

DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR

FORT CARSON, CO 80913-4604

UNITED STATES

Option Line Item

Inspection and Acceptance Location

Both Other Instructions: laura.m.larsen-pitcher.civ@health.mil

DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR

FORT CARSON, CO 80913-4604

UNITED STATES

Option Line Item

Inspection and Acceptance Location

Both Other Instructions: laura.m.larsen-pitcher.civ@health.mil

DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR

FORT CARSON, CO 80913-4604

UNITED STATES

Option Line Item

Inspection and Acceptance Location

Both Other Instructions: laura.m.larsen-pitcher.civ@health.mil

DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR

FORT CARSON, CO 80913-4604

UNITED STATES

Option Line Item

Inspection and Acceptance Location

Both Other Instructions: laura.m.larsen-pitcher.civ@health.mil

DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR

FORT CARSON, CO 80913-4604

UNITED STATES

Continuation of Deliveries or Performance

0001 Delivery Schedule Delivery Period From 01 Sep 2026 to 31 Aug 2027

4 QuarterQuantity

Address and POC Service Performance Site DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR FORT CARSON, CO 80913-

4604 UNITED STATES

Period of Performance From 01 Sep 2026 To 31 Aug 2027

Option Line Item

Delivery Schedule Delivery Period From 01 Sep 2027 to 31 Aug 2028

4 QuarterQuantity

Address and POC Service Performance Site DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR FORT CARSON, CO 80913-

4604 UNITED STATES

Period of Performance From 01 Sep 2027

To 31 Aug 2028

Option Line Item

Delivery Schedule Delivery Period From 01 Sep 2028 to 31 Aug 2029

4 QuarterQuantity

Address and POC Service Performance Site DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR FORT CARSON, CO 80913-

4604 UNITED STATES

Period of Performance From 01 Sep 2028 To 31 Aug 2029

Option Line Item

Delivery Schedule Delivery Period From 01 Sep 2029 to 31 Aug 2030

4 QuarterQuantity

Address and POC Service Performance Site DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR FORT CARSON, CO 80913-

4604 UNITED STATES

Period of Performance

From 01 Sep 2029 To 31 Aug 2030

Option Line Item

Delivery Schedule Delivery Period From 01 Sep 2030 to 31 Aug 2031

4 QuarterQuantity

Address and POC Service Performance Site DoDAAC: HT0788

ACH EVANS CARSON - PB

USA MEDICAL DEPT ACTV, 1650 COCHRANE CIR FORT CARSON, CO 80913-

4604 UNITED STATES

Period of Performance From 01 Sep 2030 To 31 Aug 2031

Contract Clauses

FAR Clauses Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements.

2017-01

52.204-13 System for Award Management- Maintenance. (Deviation 2026- O0038)

2026-02

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded. (Deviation 2026- O0038)

2026-02

52.212-4 Terms and Conditions- Commercial Products and Commercial Services. (Deviation 2026-O0038)

2026-02

52.219-6 Notice of Total Small Business Set-Aside. (Deviation 2026- O0038)

2026-02

52.222-36 Equal Opportunity for Workers with Disabilities. (Deviation 2026- O0038)

2026-02

52.222-50 Combating Trafficking in Persons. (Deviation 2026-O0038)

2026-02

52.222-90 Addressing DEI Discrimination by Federal Contractors.

(Deviation 2026-O0040, Revision 1)

2026-04

52.224-3 Privacy Training. 2017-01

52.224-3 Privacy Training. (Alternate I) 2017-01 Alternate I 2017-01

52.226-8 Encouraging Contractor Policies to Ban Text Messaging While Driving.

2024-05

52.232-33 Payment by Electronic Funds Transfer-System for Award Management.

2018-10

52.232-40 Providing Accelerated Payments to Small Business Subcontractors.

2023-03

52.233-3 Protest after Award. (Deviation 2026-O0038)

2026-02

52.233-4 Applicable Law for Breach of Contract Claim. (Deviation 2026- O0038)

2026-02

DFARS Clauses Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

252.203-7000 Requirements Relating to Compensation of Former DoD Officials.

2011-09

252.203-7002 Requirement to Inform Employees of Whistleblower Rights.

2022-12

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting.

2024-05

252.204-7018 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services.

2023-01

252.223-7008 Prohibition of Hexavalent Chromium.

2023-01

252.225-7056 Prohibition Regarding Business Operations with the Maduro Regime.

2023-01

252.225-7060 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region.

2023-06

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports.

2018-12

252.232-7010 Levies on Contract Payments. 2006-12

252.244-7000 Subcontracts for Commercial Products or Commercial Services.

2023-11

252.247-7023 Transportation of Supplies by Sea.

2024-10

FAR Clauses Incorporated by Full Text

Date

Alternate Deviation

Variation Effective Date

52.219-28 Postaward Small Business Program Rerepresentation.

(Deviation 2026-O0038) (Alternate I)

2026-02 Alternate I 2026-02

Alternate I (Feb 2026) (Deviation 2026-O0038). As prescribed in 19.101(a)(2)(iii)(B), substitute the following paragraph (g)(1) for paragraph (g)(1) of the basic clause:

(g)(1) The Contractor represents its small business size status for each one of the NAICS codes assigned to this contract.

NAICS Code Small business concern (yes/no) [Contracting Officer to insert NAICS codes.]

52.222-35 Equal Opportunity for Veterans.

(Alternate I)

2026-02 Alternate I 2014-07

Alternate I (Jul 2014). As prescribed in 22.1310 (a)(2), add the following as a preamble to the clause:

Notice: The following term(s) of this clause are waived for this contract: ____________[List term (s)].

DFARS Clauses Incorporated by Full Text

Date

Alternate Deviation

Variation Effective Date

252.232-7006 Wide Area WorkFlow Payment Instructions.

2023-01

WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JAN 2023)

(a) Definitions. As used in this clause-

"Department of Defense Activity Address Code (DoDAAC)" is a six position code that uniquely identifies a unit, activity, or organization.

"Document type" means the type of payment request or receiving report available for creation in Wide Area WorkFlow (WAWF).

"Local processing office (LPO)" is the office responsible for payment certification when payment certification is done external to the entitlement system.

"Payment request" and "receiving report" are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(b) Electronic invoicing. The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (DFARS) 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) WAWF access. To access WAWF, the Contractor shall-

(1) Have a designated electronic business point of contact in the System for Award

Management at https://www.sam.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site.

(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web- Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the "Web Based Training" link on the WAWF home page at https://wawf.eb.mil/

(e) WAWF methods of document submission. Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol.

(f) WAWF payment instructions. The Contractor shall use the following information when submitting payment requests and receiving reports in WAWF for this contract or task or delivery order:

(1) Document type. The Contractor shall submit payment requests using the following document type(s):

(i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher.

(ii) For fixed price line items-

(A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer.

receiving report

(Contracting Officer: Insert applicable invoice and receiving report document type(s) for fixed price line items that require shipment of a deliverable.)

(B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer.

2in1 invoice

(Contracting Officer: Insert either "Invoice 2in1" or the applicable invoice and receiving report document type(s) for fixed price line items for services.)

(iii) For customary progress payments based on costs incurred, submit a progress payment request.

(iv) For performance based payments, submit a performance based payment request.

(v) For commercial financing, submit a commercial financing request.

(2) ) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract.

[Note: The Contractor may use a WAWF "combo" document type to create some combinations of invoice and receiving report in one step.]

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table*

Field Name in WAWF Data to be entered in WAWF Pay Official DoDAAC HQ0940 Issue By DoDAAC W81K00 Admin DoDAAC W81K00 Inspect By DoDAAC HT0788 Ship To Code N/A Ship From Code N/A Mark For Code N/A Service Approver (DoDAAC) HT0788 Service Acceptor (DoDAAC) HT0788 Accept at Other DoDAAC N/A LPO DoDAAC N/A DCAA Auditor DoDAAC N/A Other DoDAAC(s) N/A (*Contracting Officer: Insert applicable DoDAAC information. If multiple ship to/acceptance locations apply, insert "See Schedule" or "Not applicable.")

(**Contracting Officer: If the contract provides for progress payments or performance-based payments, insert the DoDAAC for the contract administration office assigned the functions under FAR 42.302(a)(13).)

(4) Payment request. The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable.

(5) Receiving report. The Contractor shall ensure a receiving report meets the requirements of DFARS Appendix F.

(g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact.

COR: laura.m.larsen-pitcher.civ@health.mil

(Contracting Officer: Insert applicable information or "Not applicable.")

(2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed.

(End of clause)

Addendum to 52.212-4, Contract Terms and Conditions - Commercial Products and Commercial Services

52.212-4 ADDENDUM

The Government may make unilateral modifications considered administrative in nature. These include, but are not limited to, changes in the accounting and appropriation data, payment and issuing office addresses, and other corrections that have no effect on the terms and conditions of the contract.

(w) The non-FAR Part 12 discretionary FAR, DFARS, AFARS, and LOCAL clauses included herein are incorporated into this contract either by reference or in full text. If incorporated by reference, see clause 52.252-2 herein for locations where full text can be found.

(End of Clause)

*** END OF NARRATIVE ***

Contract Terms and Conditions Required To Implement Statutes or Executive Orders — Commercial Products and Commercial Services

FAR Clauses Incorporated by Full Text

Number Title Effective Date

Alternate Deviation

Variation Effective Date

52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders - Commercial Products and Commercial Services. Alternate

II (DEVIATION 2025-O0003)

2025-03 Alternate

II

Deviation 2025- O0003

2025-03 2025-03

Alternate II (MAR 2025) (DEVIATION 2025-O0003).

(d)(1) The Comptroller General of the United States, an appropriate Inspector General appointed under section 3 or 8 G of the Inspector General Act of 1978 (5 U.S.C. App.), or an authorized representative of either of the foregoing officials shall have access to and right to-

(i) Examine any of the Contractor's or any subcontractors' records that pertain to, and involve transactions relating to, this contract; and

(ii) Interview any officer or employee regarding such transactions.

(e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), and (c), of this clause, the Contractor is not required to flow down any FAR clause in a subcontract for commercial products or commercial services, other than-

(i) Paragraph (d) of this clause. This paragraph flows down to all subcontracts, except the authority of the Inspector General under paragraph (d)(1)(ii) does not flow down; and

(ii) Those clauses listed in this paragraph (e)(1). Unless otherwise indicated below, the extent of the flow down shall be as required by the clause-

(A) 52.203-13, Contractor Code of Business Ethics and Conduct (Nov 2021) (41 U.S.C. 3509).

(B) 52.203-15, Whistleblower Protections Under the American Recovery and Reinvestment Act of 2009 (Jun 2010) (Section 1553 of Pub. L. 111-5).

(C) 52.203-17, Contractor Employee Whistleblower Rights (Nov 2023) (41 U.S.C. 4712).

(D) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab Covered Entities (Dec 2023) (Section 1634 of Pub. L. 115-91).

(E) 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (Nov 2021) (Section 889(a)(1)(A) of Pub. L. 115-232).

(F) 52.204-27, Prohibition on a ByteDance Covered Application (Jun 2023) (Section 102 of Division R of Pub. L. 117-328).

(G)[ ]( 1) 52.204-30, Federal Acquisition Supply Chain Security Act Orders- Prohibition. (Dec 2023) (Pub. L. 115-390, title II).

[ ](2) Alternate I (Dec 2023) 52.204-30.

(H) 52.219-8, Utilization of Small Business Concerns (Jan 2025) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds the applicable threshold specified in FAR 19.702(a) on the date of subcontract award, the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities.

(I) [Reserved]

(J) [Reserved]

(K) 52.222-35, Equal Opportunity for Veterans (Jun 2020) (38 U.S.C. 4212).

(L) 52.222-36, Equal Opportunity for Workers with Disabilities (Jun 2020) (29 U.S.C. 793).

(M) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222- 40.

(N) 52.222-41, Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67).

(O) [ ] (1) 52.222-50, Combating Trafficking in Persons (Nov 2021) (22 U.S.C. chapter 78 and E.

O 13627).

[ ] (2) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O. 13627).

(P) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment-Requirements (May 2014) (41 U.S.C. chapter 67).

(Q) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-Requirements (May 2014) (41 U.S.C. chapter 67).

(R) 52.222-54, Employment Eligibility Verification (Jan 2025) (Executive Order 12989).

(S) 52.222-55, Minimum Wages for Contractor Workers Under Executive Order 14026 (Jan 2022).

(T) 52.222-62, Paid Sick Leave Under Executive Order 13706 (Jan 2022) (E.O. 13706).

(U)[ ] (1) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

[ ] (2) Alternate I (Jan 2017) of 52.224-3.

(V) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. Subtitle A, Part V, Subpart G Note).

(W) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (Jun 2020) (42 U.S.

C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6.

(X) 52.232-40, Providing Accelerated Payments to Small Business Subcontractors (MAR 2023) (31 U.S.C. 3903 and 10 U.S.C. 3801). Flow down required in accordance with paragraph (c) of 52.232-40.

(Y) 52.240-1, Prohibition on Unmanned Aircraft Systems Manufactured or Assembled by American Security Drone Act-Covered Foreign Entities (Nov 2024) (Sections 1821-1826, Pub.

L. 118-31, 41 U.S.C. 3901 note prec.).

(Z) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Nov 2021) (46 U.

S.C. 55305 and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64.

Addendum to Contract Clauses

FAR Clauses Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations.

(Deviation 2026-O0038)

2026-02

52.222-3 Convict Labor. (Deviation 2026- O0038)

2026-02

52.223-2 Reporting of Biobased Products Under Service and Construction Contracts. (Deviation 2026- O0038)

2026-02

52.223-3 Hazardous Material Identification and Safety Data. (Deviation 2026- O0038) (Alternate I)

2026-02 Alternate I 2026-02

52.223-5 Pollution Prevention and Right-to- Know Information.

2024-05

52.223-23 Sustainable Products. (Deviation 2026-O0038)

2026-02

52.232-39 Unenforceability of Unauthorized Obligations.

2013-06

52.244-6 Subcontracts for Commercial Products and Commercial Services. (Deviation 2026-O0038)

2026-04

DFARS Clauses Incorporated by Reference

Alternate Deviation

Variation Effective Date

252.201-7000 Contracting Officer's Representative.

1991-12

252.204-7003 Control of Government Personnel Work Product.

1992-04

252.223-7006 Prohibition on Storage, Treatment, and Disposal of Toxic or Hazardous Materials.

(Alternate I)

2014-09 Alternate I 2014-09

252.237-7010 Prohibition on Interrogation of Detainees by Contractor Personnel.

2023-01

FAR Clauses Incorporated by Full Text

Date

Alternate Deviation

Variation Effective

52.217-8 Option to Extend Services. 1999-11

Option to Extend Services (Nov 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 30 days[insert the period of time within which the Contracting Officer may exercise the option].

52.217-9 Option to Extend the Term of the Contract.

2000-03

Option to Extend the Term of the Contract (Mar 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within 30 calendar days[insert the period of time within which the Contracting Officer may exercise the option]; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days days[60days unless a different number of days is inserted] before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 60 months. (months) (years).

52.252-2 Clauses Incorporated by Reference.

1998-02

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(es):

acquisition.gov ____ ____[Insert one or more Internet addresses]

52.252-6 Authorized Deviations in Clauses. 2020-11

Authorized Deviations in Clauses (Nov 2020)

(a) The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause.

(b) The use in this solicitation or contract of any DoD FAR Supplement[insert regulation name] (48 CFR chapter 2) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

List of Contract Documents, Exhibits, or Attachments

PERFORMANCE WORKSTATEMENT

EMS ADMINISTRATOR

1. GENERAL

1.1. DESCRIPTION OF WORK. The Contract Company shall provide all services required to accomplish the administrative requirements for maintaining and supporting the establishment of applicable Emergency Medical Services (EMS) protocols for the Utah Occupational Health Clinics:

Tooele Army Depot and Dugway Proving Ground, which are subject to all applicable federal, state and local law and regulation.

1.1.1. This is a NON-PERSONAL SERVICES contract under which the personnel rendering the services are not subject, either by the contract's terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

1.1.2. Performance Measurements Requirement Summary. The following performance objectives and measures will be used to evaluate Contractor performance and compliance under the contract. This information will be used to prepare annual past performance evaluations. See Attachment 1, Quality Assurance Surveillance Plan (QASP), for additional details.

PERFORMANCE

MEASUREMENT

OBJECTIVE

STANDARD ACCEPTABLE

QUALITY LEVEL

METHOD OF

ASSESSMENT

Comply with Qualifications 1.2.

Maintain Qualifications and Requirements

Comply initially and annually with 100% of the time.

Annual review of COR files.

Customer satisfaction.

Para 1.5.10.

Maintain a high level of customer satisfaction.

No more than one Review assessment of customer complaints.

COR Monitors.

substantiated customer complaint per year.

Comply with Specific Tasks as requested PWS Para 4.6.

Complete tasks as required by the PWS.

Comply with tasks 100% of the time.

As requested only to KO, COR and or Director.

Annual Evaluation PWS Para 4.2

Complete the task in December of each year and provide the KO and COR with a report.

Comply with task 100% of the time.

Annual review sent to KO and COR.

Quarterly Report PWS Para 4.3

Complete a quarterly review within 30 calendar days of quarterly review

Comply with task 100% of the time.

Quarterly review sent to KO, COR, Director, EMS Coordinator.

Monthly Analysis PWS Para 4.4

Complete a monthly analysis within 30 calendar days of due date

Comply with task 100% of the time.

Monthly analysis sent to KO and COR.

Random Audits PWS Para 4.5

Complete at least quarterly and report on the yearly report.

Comply with task 100% of the time.

Submit random audits, that are at least quarterly on the yearly report to the KO and COR.

1.1.3. The inspection and acceptance point for all services rendered under this contract will be by the department where the services are provided. The performance by the health care professional (HCP), the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance and review for acceptance by the

Contracting Officer's Representative (COR) or designated representative. Any services rendered by the HCP to patients or interaction with military/civilian personnel deemed unprofessional /threatening/dangerous by the Department Chief will be considered as grounds for immediate removal of the HCP and termination under clause 52.212-4 (m) Termination for Cause. Services provided by the Contractor shall be reviewed and rated in accordance with the Military Treatment Facility (MTF) by-laws and Joint Commission (JC) standards.

1.2. QUALIFICATIONS

1.2.1. Shall be a Doctor of Medicine (MD) or Doctor of Osteopathy (DO) with a degree from an accredited college or university.

1.2.2. Shall be board certified in Emergency Medicine.

1.2.3. Shall have effective interpersonal skills.

1.2.4. Must be able to read, write and speak English well enough to effectively communicate with all Occupational Health staff.

1.2.5. Shall maintain and support the standards necessary to meet Joint Commission and CMS (Centers for Medicare and Medicaid Services) certification.

1.2.6. Licensure/Certification/Registration: Must have and maintain a current license to practice in the state of Utah. This license must be current (not revoked, suspended, or lapsed in registration), valid (the issuing authority accepts and considers QA information (i.e. practitioner professional performance and conduct in determining continued licenses)), and unrestricted (not subject to restriction pertaining to the scope, location, or type of practice ordinarily granted to other applicants for similar licenses in granting jurisdiction).

1.3. ADMINISTRATIVE.

1.3.1. Orientation and Training.

1.3.1.1. Prior to working, the HCP will be provided with a government paid orientation to familiarize him/her with the policies and procedures of the MTF. Orientation attendance will be required of all HCPs and will be scheduled by the COR or Department Chief during normal duty hours.

1.3.1.2. The Contractor shall ensure that HCP is knowledgeable of the policies and procedures of his/her specific place of duty and of the medical activity. The Contractor shall ensure HCPs receive any staff training required by the MTF as a precondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled shift of the HCP.

1.3.1.3. Government unique training. The Government may elect to provide unique Government training to HCP who are performing services under this contract. If the Government elects to provide such training, the Government will provide such training at no additional expense to the Contractor or to the HCP. When directed by the Contracting Officer, HCP shall attend all such training in paid status as part of the normal services required and be billed under the contract.

Such training shall require a performance commitment by the Contractor and the Contractor shall reimburse the Government (by means of a reduction in an invoice) if HCP fails to satisfy the performance commitment after HCP receives the unique Government training. The amount of the reimbursement shall be the prorated cost of training, calculated based on the total cost of the training and the number of months by which the HCP fails to complete the performance commitment. The length of the performance commitment shall be 12 months or until the end of all performance under this contract, whichever occurs first. Details of any subsequent training agreement will be agreed upon by all parties, and such training agreements will be designated by modification to the contract.

1.3.1.4. Electronic Medical Record Keeping System, MHS Genesis. The Government will provide training to HCP in the Electronic Medical Record Keeping Systems and other procedures that the medical activity staff is required to use. Access to such patient data systems is an "Automated Data Processing Sensitive (ADP)" position requiring compliance with AR 25-2 and AR 380-67.

Refer to the Additional Information section "ADP Security Requirements" in this contract for further guidance.

1.3.1.4.1. Vocera contains the MTF's appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF. The Government will provide training to HCPs in the Vocera system and/or other procedures that the medical activity staff is required to use. Access to such patient data systems is an "Automated Data Processing Sensitive" position requiring compliance with AR 380- 19 and AR 380-67.

1.3.1.4.2. Ambulatory Data System (ADS). This computer system produces forms on which the providers identify the appropriate billing codes for diagnoses and procedures for each patient.

1.3.1.4.3. Training for MHS Genesis and other computer training will be scheduled through the department management team. The training will be on-site and during normal duty hours. This training will be at no cost to the Contractor.

1.3.1.4.4. If additional training is needed due to mission changes, the MTF Information Management Office will conduct required computer training. This training will be at no cost to the Contractor. The department management team will schedule this training. The MTF will not reimburse the Contractor for any expenses incurred while undergoing any computer training.

1.3.2. Reports. The Contractor shall submit reports to the COR as requested for use in monitoring Contractor performance on a monthly basis.

1.3.3. Safety. The Contractor shall ensure that its HCP complies with all installation safety regulations. Such regulations include, but are not limited to, general safety, fire prevention, and waste disposal. Copies of these regulations are on file in the medical activity safety office or may be obtained through the department management team..

1.3.4. Security.

1.3.5.1. The Contractor shall ensure that all HCP comply with the local installation requirements for vehicle registration and operation on the military facility. Any vehicle operated by the Contractor or its employees in performance of this contract must have the minimum liability coverage required by the state in which the performance is located.

1.3.4.2. The Contractor shall ensure that its HCP complies with installation and MTF personnel identification and access requirements. The Contractor is responsible for absences of HCP due to expired identification and access documents.

1.3.4.4. Safeguarding Material. The Contractor shall be responsible for safeguarding all Government property provided for Contractor use. The Contractor shall safeguard information of a confidential or sensitive nature. Neither the Contractor nor any of its HCP shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the likelihood of the possibility of breach of security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974; however, the Contractor may be required to provide testimony or deposition in lawsuits or other administrative, civil, or criminal proceedings.

1.3.5. Health. The Contractor shall ensure that all HCP performing services under this contract comply with the health and immunization requirements as stated in the Additional Instructions section "Health and Immunization Requirements" in this contract at the time of starting performance and annually thereafter. The Contractor shall also provide equally current certification of health for backup/replacement HCP. The expense for all physical examinations to comply with the health requirements shall be borne by the Contractor at no additional cost to the Government.

1.3.6. Contracting Officer's Representative (COR). The COR will be appointed in writing by the KO after the contract is awarded. The KO will provide a copy of this designation and COR contact information to the Contractor.

1.4. HOURS OF PERFORMANCE.

1.4.1. The Contractor shall meet four (4) times per year (quarterly) with the EMS Coordinator from Dugway Proving Ground. The EMS Coordinator will collect the EMS run sheets from Tooele and Dugway Proving Ground and conduct the review quarterly and as needed to ensure that Protocols are current, questions are answered, and EMS run sheets are reviewed. The quarterly meeting can be held at the normal place of duty, Mountain West Medical Center, Tooele, Utah. It is anticipated that the HCP shall work 60 hours per year.

1.5. CONDUCT.

1.5.1. The Contractor shall ensure that its HCP complies with MTF policies regarding personal appearance and conduct.

1.5.2. The Contractor shall ensure that its HCP abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the

HCP as may be necessary for security and personnel reliability programs. The Contractor shall also ensure that its HCP abide by federal and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act of 1996. All regulations referenced are available for review from the COR or MTF. All medical records and reports are and will remain the property of the Government.

1.5.3. Contractor shall abide by all MTF policies, rules and ARs. All personnel shall maintain and support the standards necessary to meet JC and CMS (Centers for Medicare and Medicaid Services) certification. When commencing work under this contract, Contractor shall obtain an in-processing checklist from the COR and provide the COR a copy when completed. The Contractor shall wear a MTF identification badge. The COR will assist the Contractor in obtaining the identification badge through the MTF Security Officer. Upon termination of work at this MTF, the Contractor is required to return the hospital identification badge and out- process through the activities identified on the out-processing checklist obtained from the COR.

1.5.4. The Contractor shall ensure that its HCP abide by MTF bylaws, the Joint Commission (JC), DoD and Medical Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in-service training, maintenance of records, and release of medical information.

1.5.5. The Contractor shall ensure that its HCP make use of all appropriate equipment; supplies and services made available by the Government.

1.5.6. Removal of HCP.

1.5.7.1. Removal of HCP. At any time during the performance of this contract, the KO or COR may direct the Contractor to immediately remove any HCP whose actions or impaired state raises reasonable suspicion that clear and present danger of physical harm exists to a patient, other HCP, Government personnel or to the impaired individual.

This provision will be used in emergency situations only and not for the purpose of bringing performance issues or other non-urgent concerns to the attention of the Contractor.

1.5.7.2. If the need for a removal occurs, the COR will contact the Contractor's point of contact and direct the Contractor to remove that individual from the military facility and to not use that individual to perform any services required under this contract until the issue has been resolved by the KO.

The Contractor shall formally meet with the COR to discuss further action in accordance with the MTF Quality Assurance and Inspection (QA&I) Plan and AR 40-68. A review of the basis for removal will be made by the KO within three working days after the COR directed the removal.

1.5.7.3. If, after any investigation deemed necessary by the KO and discussions with the Contractor's representative, the KO concludes that the HCP's impairment requires permanent removal from performance under the contract, the KO will notify the Contractor that permanent removal is required. In the event of disagreements between the Government and the Contractor's representative concerning matters of impaired HCP, the decision of the KO will be final. During the period of time between the removal and the final decision of the KO, the Contractor shall provide a backup/replacement HCP in accordance with the terms and conditions of this contract.

1.5.8. Inquiries. Contractor shall ensure that its personnel do not respond to any media inquiries.

Any inquiries from the media shall be immediately relayed to the COR, who will relay them to the MTF Commander. There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the HCP's Government supervisor.

1.5.9. Smoking. The Contractor shall ensure that its HCP complies with the MTF smoking policy.

1.5.10. Complaints. Complaints will be validated by the COR and be reported in writing to the KO and to the Contractor for action, if it constitutes a failure to perform, as determined by the Government. The HCP shall have no more than one substantiated complaint per 12-month period per HCP. The Department Chief will submit documentation to the COR regarding all complaints.

Receipt of two valid complaints on the HCP within any twelve- month period may be considered grounds for immediate removal.

1.6. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which are furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. The Contractor shall not release any of the above information without prior written consent of the KO and shall ensure that its HCP do not do so.

2. DEFINITIONS/ACRONYMS.

2.1. Definitions. Following is a list of basic definitions.

2.1.1. Ancillary Personnel. This includes all HHCPs with the exception of Medical Doctors (MD) and Doctors of Osteopathy (DO).

2.1.2. Beneficiaries of the Military Healthcare System. Those individuals entitled to care at the MTF in accordance with AR 40-3.

2.1.3. MHS Genesis. An automated medical information system which will provide integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.

2.1.4. Contracting Officer (KO). A person with the authority to enter into, administer, and/or terminate contracts/task orders and make related determinations and findings.

2.1.5. Contracting Officer's Representative (COR). A Government employee selected and designated in writing by the KO to act as his/her designated representative in administering a contract. A COR has no authority to change or modify the terms of a contract.

2.1.6. DMHRSi. Defense Medical Human Resource System - Internet. A system that allows timekeeping for all employees.

2.1.7. Military Time is on a 24-hour clock, e.g.:

8:00 a.m. - 0800

9:10 a.m. - 0910

Noon - 1200

8:00 p.m- - 2000

9:10 p.m- - 1110

Midnight - 2400

12:01 a.m. - 0001

2.1.8. Military Dates are written by placing the day of the month, followed by the first three letters of the month, followed by the last two digits of the year, e.g.:

January 02, 2011 - 02 Jan 11

January 10, 2011 - 10 Jan 11

2.1.9. Physician. Medical healthcare professional possessing a doctorate degree as a Medical Doctor (MD) or Doctor of Osteopathy (DO).

2.1.10. Quality Assessment and Improvement. Those actions taken by the Government to check services to determine if they meet the requirements of the Joint Commission, U.S. Army Medical Command, quality assurance and risk management program, and ensure that the Contractor and its HHCPs comply with the terms and conditions of the contract.

2.1.11. Quality Control. Those actions taken by a Contractor to control the performance of services to ensure that they meet the requirements of the contract.

2.1.12. Replacement Personnel. HCP selected to fill a position for the duration of the contract period that was previously occupied by another HCP.

2.1.13. TRICARE. A regionalized, tri-service, Contractor-supported, DoD-managed healthcare system.

2.2. Acronyms/Abbreviations. Following is a list of basic acronyms/abbreviations used in this contract.

ADP - Automated Data Processing

AR - Army Regulation

BCLS - Basic Cardiac Life Support.

BLS - Basic Life Support

CFR - Code of Federal Regulations

CLIN - Contract Line Item Number

CONUS - Continental United States

COR - Contracting Officer's Representative

CPARS - Contractor Performance Assessment Reporting System CPR - Cardiopulmonary Resuscitation

CV - Curriculum Vitae

DA - Department of the Army

DCCS - Deputy Commander for Clinical Services DEA - Drug Enforcement Administration

DoD - Department of Defense

DODI - Department of Defense Instruction

DMHRSi - Defense Medical Human Resource System - Internet ECFMG - Educational Commission for Foreign Medical Graduates EFT - Electronic Funds Transfer

EKG - Electrocardiogram

ETS - Expiration Term of Service

FAR - Federal Acquisition Regulation

FBI - Federal Bureau of Investigation

FL - Form Letter

FPP - Family Practice Physician

FTE(s) - Full Time Equivalent(s)

HCAA - Health Care Acquisition Activity HCP - Health Care Provider

HHS - Health and Human Services

HIPAA - Health Insurance Portability & Accountability Act of 1996 IAW - In Accordance With

IRC - Installation Record Check

IV - Intravenous

JC - Joint Commission (formerly referred to as the Joint Commission on Accreditation of Healthcare Organizations [JCAHO])

LOSS - Line of Sight Supervision

KO - Contracting Officer MEDCOM - Medical Command MEDDAC - Medical Department Activity

MHS Genesis - An automated medical information system which will provide integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.

MTF - Medical Treatment Facility

NACI - National Agency Check with Inquiries NCOIC - Noncommissioned Officer in Charge NP - Nurse Practitioner

OCONUS - Outside the Continental United States OIC - Officer in Charge

OSHA - Occupational Safety and Health Administration or Act PA - Physician Assistant

PAD - Patient Administration Division

PALS - Pediatric Advance Life Support

Pam - Pamphlet

PAR - Performance Assessment Report

PCF - Practitioner's Credentials File

PCO - Procurement KO/Procuring KO

PCS - Permanent Change of Station

PL - Public Law

POC - Point of Contact

PWS - Performance Work Statement (may also be referred to as work statement or statement of work)

QA - Quality Assurance

QA&I - Quality Assessment & Improvement OBGYN - Obstetrics and Gynecology

QC - Quality Control

RN - Registered Nurse

RFQ - Request for Quotation

RFP - Request for Proposal

RPO - Radiation Protection Officer

SF - Standard Form

SRP - Soldier Readiness Processing

TAB - Therapeutic Agents Board

TDY - Temporary Duty

TO(s) - Task Order(s)

USC - United States Code

USPS - United States Postal Service

WRCO - Western Regional Contracting Office WRMC - Western Regional Medical Command

3. GOVERNMENT PROPERTY

3.1. The Government will provide use of all available MTF facilities and support services, materials, publications and forms, and equipment required for contract performance (except as designated in the contract). The Contractor shall ensure that its HCP keep Government-furnished supplies, equipment, and work areas in a safe, orderly and clean condition. The Contractor shall notify the Government whenever maintenance of equipment is required. Personal long distance calls are not authorized and the cost of all personal long distance calls made will be deducted from the Contractor's invoice.

3.2. The Government will provide an MTF identification card and vehicle access stickers/passes.

The Contractor shall ensure its HCP complies with MTF policy regarding the identification cards and stickers/passes. The HCP shall coordinate with the COR in obtaining an identification badge and vehicle decal. The HCP shall wear the identification badge in accordance with MTF policy.

The HCP shall surrender both identification badge and vehicle decal to the COR on his/her last contracted day of duty at the MTF.

3.3. Any space or equipment used by the Contractor's HCP in performance of this contract may be used by the Government for other purposes during…