Statement of Work 1 Dec 2025.pdf

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Sources Sought IAW Buy Indian Act of 1910 for ED Registered Nurse Services at Parker Indian Hospital
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SS-26-PHX-011
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This Statement of Work (SOW) is for Emergency Room Registered Nurse Services for the Colorado River Service Unit (CRSU), specifically the Parker Indian Health Center in Arizona. The contract seeks a 12-month base period with four 1-year option periods to provide non-personal professional nursing services to minimize disruptions in clinical staffing. The facility is a 17-bed Critical Access Hospital with a 6-bed Emergency Department serving approximately 13,000 active tribal members across Arizona, California, and Nevada.

Registered Nurse candidates must have a minimum of 2 years recent Emergency Department experience, current nursing licensure, and certifications including BLS, ACLS, and PALS. Nurses will work 12-hour shifts in the Emergency Department, with schedules subject to change based on patient needs. Contractors must submit detailed candidate profiles, undergo a security clearance process including fingerprint and background checks, and provide documentation of qualifications. The performance-based contract includes a Quality Assurance Surveillance Plan with strict compliance requirements, and incentives or penalties based on meeting documentation and licensure standards.

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STATEMENT OF WORK

Emergency Room Registered Nurse Services

1 December 2025

It is the intent of the Colorado River Service Unit (CRSU) to acquire non-personal professional

Emergency Room Registered Nurse Services as described herein located in Parker, Arizona. Contractor is requested to provide non-personal professional Registered Nurse Services for a 12-month base period and four

(4) one (1) year option periods. The intent of this contract is to establish a method whereby the Parker Indian

Health Center can minimize disruptions in clinical service because of staff changes and shortages over the next

(5) years. Also, even when the best plans are laid to hire and retain staff, our remote location makes this difficult and we can have staff shortages despite trying to hire a full-time employee. Requests for contractor coverage will be based on the consistently changing needs of the clinic.

The Colorado River Service Unit includes Parker Indian Health Center, Parker, Arizona, Peach Springs Health

Center, Peach Springs, Arizona, Supai Health Station, Grand Canyon, Arizona, Moapa Health Center, Moapa, Nevada, and the Chemehuevi Health Center, Havasu Lake, California and serves approximately 13,000+ active user tribal members/other Native American communities in the Arizona, California, and Nevada area.

Residents to each respective area are served at each local facility of the Colorado River Service Unit.

The CRSU work site is primarily a Critical Access Hospital (CAH) providing, 24/7 inpatient and emergency service with seventeen in-patient beds. The outpatient clinics provide services to about 58,000 patients per year. The services include general medical, ambulatory, emergency medicine, pediatric, community health, preventative health, and mental health. Dental care is also available. Special ambulatory services are provided on-site by IHS staff based in Phoenix or professional medical locum tenens contractors. Ground and air transport are available for emergency care. CRSU uses a multi-disciplinary team approach to patient care; the

Service Unit also provides community-public health programs/services, including public health nursing, social services, health education, environmental health and nutritional services. The CAH is accredited by The Joint

Commission.

Parker Indian Health Center: Located in Parker, Arizona. The Parker Indian Hospital is a 17-bed, TJC-accredited acute care hospital associated with a 6-bed Emergency Department (ED), and an Outpatient Department (OPD). Parker Indian Hospital Outpatient Services include general medical, pediatric, prenatal, and a variety of specialty clinics. Outpatient visits for the Parker Indian Hospital totaled 37,000 for Fiscal Year

2023, including 6,000+ Emergency Department visits, with over 8,000+ active patients.

All responses to this solicitation and for candidate submission shall contain a complete profile and current work history of the candidate(s) presented, including licensure, certifications and education.

Selected candidate shall undergo the Indian Health Service mandated security clearance requirement prior to commencement of services at the CRSU. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check of candidates through the office of the inspector general's exclusion list at http://exclusions.oig.hhs.gov/.

Please note: The contractor shall provide and identify at least (3) weeks in advance of the scheduled performance date the candidate for the scheduled shift(s). This is due to the Government’s security clearance and credentialing/ and or privileging requirement. To ensure that the candidate is cleared for commencement of services.

http://exclusions.oig.hhs.gov/.%20D

LOCATION:

All services shall be performed at Parker Indian Health Center located at 12033 Agency Road; Parker, Arizona 85344.

SHIFTS:

Shift times and schedules are subject to change based on the medical needs of the patient populace and hospital/clinic operations. The contracted services will augment the current full-time staff.

CRSU currently has the following operational hours: Emergency Department services 24 hours 7 days a week. Coverage will be required when any full-time staff is on leave. Specific days may change based upon the needs of CRSU. All services shall be performed at the Parker Indian Health Center located in Parker, Arizona. Work week is Sunday 12:00 am to Saturday 11:59 pm.

SHIFTS: Contractors will be expected to abide by the facility’s Uniform Code and shift hour assigned, modalities of charting and care delivery and other rules and regulations of the facility. Work within a designated schedule prepared by the Deputy Chief Nursing Executive or his/her designee. Any period of absence or changes in the schedule will be communicated with the Chief Nursing Executive or his/her designee

14 days prior, except for emergency situations.

Contractors who accept long full-time assignments (1 continuous week of 7 days or more) shall attend meetings and training and participate fully as staff members. Routine Shifts Schedules are:

Emergency Department: 12-hour shifts: 0700 to 1930 hours; 1900 to 0730 hours; and 1000 to 2230 hours.

Schedules may be adjusted but will have a 30-60 minute unpaid lunch break, depending on the needs of the unit, and timing of peak patient care activity. * Government does not pay time taken for lunch. Total shifts worked annually shall be in accordance to the total number of work hours allocated for the year by CRSU.

Thirty (30-60) minute lunch breaks are included in shift hours and Government does not pay time taken for lunch. The Service Unit shall make every effort to submit a schedule two (2) weeks in advance.

Shifts may be cancelled or shortened without time restriction or monetary penalty before the

Contractor’s employee arrives for duty.

Unless exempt, medical professionals covered by the Fair Labor Standards Act on a compressed schedule must receive overtime pay for hours worked over 80 in a two week pay period, as defined by the HHS payroll calendar. Contractors may be scheduled in excess of 80 hours in a defined pay period.

PRICING SCHEDULE (Complete Attachment A- Rate Schedule):

The unit price paid to the Contractor shall be considered as payment in full for services provided under this award. In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible.

Contractor shall provide an hourly fixed rate. Hourly fixed rate shall be inclusive of all the following rates:

holiday, week nights, weekends, all city, state, federal and local taxes and all associated rates with the provision of services and overtime must be priced out separately. The Government will pay one hourly flat fixed rate. The Contractor shall be paid only for actual time services are performed under the terms of the contract at the hourly fixed rate. Overtime is projected to be needed for these services on needed basis.

QUALIFICATION/CERTIFICATION – PROFESSIONAL SERVICES:

Contractor shall provide nursing professionals with experience in these areas.

A) Registered Nurse (RN) – Specialty (Emergency Department):

1. Years of Experience: Minimum of (2) two years experience in the past 24 months in an Emergency Department.

2. Minimum Education: Graduated from a National League of Nursing Accredited Nursing Program; OR:

3. Minimum Education: A graduate or higher-level degree, bachelor’s degree, associate degree, or diploma from an accredited professional nursing education program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, or an accrediting body recognized by the U.S. Department of

Education at the time the degree was obtained. Degree from Foreign Nursing School: Official Certification from the Commission on Graduates of Foreign Nursing Schools is required or individuals who graduated from foreign nursing schools.

4. Current certification in BLS (Basic Life Support).

5. Current certification in ACLS (Advanced Cardiac Life Support)

6. Current certification in PALS (Pediatric Advance Life Support)

7. NRP (Neonatal Resuscitation Program-preferred but not required)

8. TNCC (Trauma Nursing Core Course- preferred but not required)

9. CEN (Certified Emergency Nurse – preferred but not required)

10. Applicant must have active and unrestricted, current licensure as a Professional Registered Nurse in any State, District of Columbia, the Commonwealth of Puerto Rico, or the Territory of the United

States

MAJOR DUTIES REQUIRED BY POSITION:

Nursing services by the contractor will include: Nursing diagnosis and treatment within the limits of their nursing job title professional qualification and within the standards of the State of Arizona. In providing these services, the Contractor shall assume and provide guidance and quality of treatment to patients under the terms of this contract, as is provided to the general public.

The work to be performed includes, but not limited to the following:

A. Registered Nurse (RN)-Specialty: Emergency Department

1. Initiate the nursing process for admitted patients. Utilize the nursing process in the delivery of nursing care and intervention. Follow through with planned nursing action and patient education. Prioritization of nursing care in their respective setting.

2. Take off, initiate and carry out medical orders placed by physicians: Administer medications, blood and/or blood by-products, oxygen, and a variety of treatments.

3. Manage a wide variety of therapeutic devices such as drainage, feeding and suction tubes also respiratory and electrocardiograph machines and other medical equipment and supplies.

4. Measure and asses vital signs, height, weight, and neurological status, effects of medication, visual acuity and hearing.

5. Provide direct patient care; assist patient with activities of daily living and ambulation.

6. Observe and document patient care provided changes in patient’s conditions, observations and other designated unit activities in the accepted format and form.

7. Collaborate and coordinate patient care with other health care providers and hospital staff.

8. Assign and direct the patient care provided by ancillary nursing staff.

9. Perform quality control for crash cart checks, lab checks, capillary blood glucose monitoring checks, etc.

10. Collet or assist in collection of specimens, i.e., blood, urine, stool, etc.

11. Recognize life-threatening emergencies, initiate and maintain resuscitation measures and other emergency procedures ass appropriate to the situation.

12. Recognize adverse reactions to medications, treatments, and procedures and initiate interventions as appropriate to the situation.

13. The Emergency Department Nurse will serve as a member of the health care team in Emergency Department and provide comprehensive, skilled, competent nursing care specific to the age of patients (neonate, infant, school age, adolescent, adult and geriatric) based on nurse assessment, the nurse process, and the providers plan of care, where conditions and treatments can range from non-critical to critical. Provides nursing care in a safe and legal manner.

14. Answer and screen telephone calls.

B. All RNs

Contractor shall have strict adherence to any and all Centers for Medicare & Medicaid Services (CMS) and Joint Commission standards. Contractor, a minimum, will follow approved abbreviation guidelines and will provide timely completion and sign off on all medical records per Joint Commission standards.

Provide comprehensive nursing or discipline appropriate clinical related care in outpatient department. Must be able to be a team player and function as an effective team member.

Utilize nursing or discipline appropriate clinical related service knowledge, skills and critical thinking in the application of nursing and related care by using the nursing process to assess, intervene, and administer nursing and related care based on patient needs, problems and doctor’s plan of care.

Comply with nationally accepted standards of nursing or discipline appropriate clinical related care practices.

Administer medication, treatments, and other therapeutic measures as required by the patient’s condition, diagnosis, and needs.

Provide nursing or discipline appropriate clinical related care to meet age specific physical, emotional, spiritual and socio-cultural needs of the patient, by means of direct care and teaching.

Physical demands – work requires walking, standing, bending and some lifting, i.e., to assist patients out of wheelchairs, move patients on and off examining tables, stretchers, etc.

Staff Development and Nursing Unit Supervisor will provide contractor with staff training and unit specific competencies via Relias. Staff Development will give the new hire contractor access to Relias, once contract staff is hired/contract signed. Contract staff will be required to complete competency assessment before reporting to the assigned unit to work.

Contractor shall have tact and diplomacy while working in stressful situations.

Contractor shall have skill in working with people from a wide variety of backgrounds and different cultures.

STATEMENT OF WORK:

The overall scope of this contract is to provide qualified and experienced healthcare and medical care providers under a Government service contract. The contractor(s) will be expected to have the necessary education, training, licensing, previous work experience and competence in being able to provide the services within the department(s). Work performance shall be performed according to the requirements and conditions contained in this Statement of Work. The contractors(s) shall be expected to assist and provide services and duties as may be requested for the normal operational requirements for the respective department and personnel. The contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure of the contractor to meet these standards can result in cancellation of this contract or at a minimum a request that the candidate(s) be dismissed and new candidates(s) be dispatched. The contractor’s performance and abilities shall be evaluated based upon performance standards that are contained in this statement of work.

The contractor(s) shall prepare and complete in a timely manner the required documents, in accordance with the CRSU Medical By-Laws and Service Unit Policy. Chart notes (where applicable) are to be completed on the day services are rendered and specifically, with rare exception, immediately after finishing with the patient.

During the performance of their duties, the contractor shall provide for the consistent performance of patient care processes according to the standards for AAAHC accreditation within IHS. The contractor(s) shall:

1. Be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software applications.

2. Have sufficient knowledge, competence and experience in providing these services on a regular schedule at CRSU.

3. Possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that he/she can relate constructively to IHS employees, contractors, vendors and individuals from the Native American community.

4. Have a valid state driver’s license or government issued identification card from any of the 50 United

States or the Commonwealth of Puerto Rico.

5. Not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services.

6. Maintain acceptable standards of personal hygiene, grooming and professional attire such that their image as a Federal contractor is compatible with the expectations of the IHS staff.

7. Be required to utilize the electronic health record for chart documentation (where applicable) after receiving training.

8. Be sensitive to the unique culture factors of the people they serve, which may include use of an interpreter as necessary in communication of services being rendered. Unique cultural factors that may contribute to the patient’s treatment include: use of their language communications; village and tribal customs; use of traditional healers; isolation; housing conditions and lack of resources.

9. Have tact and diplomacy while working in stressful situations.

CONDITIONS FOR REMOVAL/REPLACEMENT OF MEDICAL PERSONNEL:

As mutually agreed between the Contracting Officer and the Contractor there may be grounds for removal and/or replacement of a medical personnel.

The Contractor(s) shall be removed from an IHS facility if services are not performed in accordance with terms and conditions of this award.

The Contractor shall relieve contracted staff within 24 hours of notice and, if a replacement is needed, the replacement should be available within one week of the removal.

CONTRACTOR REQUIREMENTS:

Any candidates submitted for credentialing shall undergo Indian Health Service (IHS) mandated security clearance for work on-site at CRSU. The security pre-clearance requirement must be adhered to; the process includes a fingerprint check and a screen check through the Office of the Inspector General's exclusion list at http://exclusions.oig.hhs.gov/ and www.sam.gov (best checked through www.verifycomply.com as this checks all exclusion lists). The clearance and credentialing process may take six (6) weeks or more.

• Current resume

• OF-306 – Declaration for Federal Employment (all questions must answered and signature with date in 17a is required)

• OF-306 Addendum – Addendum to the OF-306 (Declaration for Federal Employment)

• IHS Provisional Access Memo

• Protecting Children from Sexual Abuse in Health Care Settings; complete the Certificate of Completion

• No FEAR Act Training; complete the Certificate of Completion

• Information Systems Security Awareness (ISSA); complete the Certificate of Completion

• OFI-86C form along with two fingerprint cards and applicable state forms

• HHS-745, Section A

• Two IDs (driver’s license and social security card – names must match and be unexpired)

• Educational (college & nursing ) Certification/License

• BLS/ACLS & PALS Certification

NOTE: No photo submission of forms, please have the forms scanned. Wet signature and date is highly recommended. No PDF signatures will be accepted.

MAJOR DUTIES REQUIRED BY POSITION:

SUPERVISORY CONTROLS:

The supervisor of the respective department to which Contractor(s) is assigned to work or his/her designee, provide primarily administrative supervision. The Supervisor or designee:

1. Set overall health care objectives and specifies resources available.

2. Provides for clinical supervision during the tour of duty.

3. Assigns work.

4. Reviews work performance on a periodic basis in order to evaluate proficiency in providing health care, discuss deficiencies and problems encountered, outline and/or approve new or changed practice to be employed and provides consultation on specific cases and related problems.

Work which involves out-of-the-ordinary diagnostic decisions or treatment is discussed with Supervisor or designee who keeps aware of the conditions of such patients and all aspects of treatment regimen. Wok performance is reviewed for conformance to IHS policy, procedures and accepted professional practices.

Within established guidelines, contractor(s) may exercise latitude in planning and carrying out health care assignments and in undertaking new procedures, practices and approaches to extend both services provided and increase individual proficiency. Overall work performance is reviewed by the Supervisor for effectiveness in meeting requirements for healthcare services.

http://exclusions.oig.hhs.gov/ http://www.sam.gov/ http://www.verifycomply.com/

DELIVERABLES:

The Contractor is required to provide a copy of each Contractor profile to the Contracting Officer Representative (or service unit representative(s)) prior to providing services at CRSU.

Timesheet shall be submitted to the supervisor of the respective department to which the Contractor(s) is assigned to work or his/her designee. The timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment, then forwarded to the receiving official for further processing of receipt of services through US Treasury utilizing IPP.

CONTRACTING OFFICER REPRESENTATIVE (COR) RESPONSIBILITIES:

The Contracting Officer will designate in writing a COR who shall be responsible for:

1. Monitoring the Contractor’s technical progress, including the surveillance and assessment of performance and recommending to the Contracting Officer, changes in requirements

2. Interpreting scope of work

3. Performing technical evaluations required

4. Performing technical inspections and acceptances required by this contract

5. Monitoring funds available for obligation under this contract

6. The resolution of technical problems encountered during performance of this contract

In no event is the COR empowered to change any of the terms and conditions of the contract. Changes in the scope of work, contract price, quantity, and quality or delivery schedule shall be made only by the Contracting

Officer by a properly exercised modification.

The designation of a COR does not authorize or provide a legal right to change any kind of contractual terms regardless of the Contractor’s apparent difficulties in fulfilling contract requirements.

CONTRACTING OFFICER (CO) RESPONSIBILITIES:

The Contracting Officer is the only person delegated the authority to negotiate changes in terms, conditions, or amounts cited in this contract.

PERFORMANCE CONDITIONS:

The COR (or service unit representative(s)) will submit schedules of required coverage a minimum of 15 calendar days prior to the first day of coverage requested. In the event the Contractor is unable to render service on a previously agreed schedule, the Contractor shall provide a minimum seventy-two (72) hour notification to the COR and service unit representative(s). The Contractor shall then make a full, good-faith effort to provide coverage with a replacement.

Both parties recognize that on occasion there shall be a need to fill coverage requests with less than a 15-day notice. In such an scheduling situation, the Contractor shall make a full, good-faith effort to accommodate the request. If the Contractor is unable to meet the emergency scheduling request, they shall immediately notify the Project Officer and those involved in scheduling and provide a suitable replacement.

For extenuating and unforeseen circumstances (e.g., illness or family emergency) must be communicated in a timely manner, with confirmation that the proper SERVICE UNIT representative and the contract COR and Contracting Specialist have received the communication.

If a Contractor’s employee/candidate fails to arrive at the service unit for a scheduled shift, the Contractor must provide coverage by another provider with temporary, provisional or courtesy privileges approved by the Service Unit Medical staff and the Governing Body. If no coverage is provided, the Contractor shall be required to pay the IHS for the cost incurred for providing that coverage. Not providing coverage on more than one occasion will be reviewed and discussed by the Chief Medical Officer and the Contracting Officer as to whether there was a compromise of patient care. All compromised situations that arise from lack of patient care by the Contractor shall be referred to the Contracting Officer for action and resolution.

All communication must be inclusive of the appropriate PAO Acquisitions and Service Unit personnel and all email communication must include the contract number in the subject line.

Timesheets:

Timesheet shall be submitted to the supervisor of the Emergency Department to which the Contractor(s) is assigned to work or his/her designee. The timesheets shall be reviewed for accuracy and certified by signature as accurate and acceptable for payment, then forwarded to the receiving official for further processing of receipt of services through US Treasury utilizing IPP.

PAYMENT AND INVOICING INSTRUCTIONS:

Invoices shall be prepared with the following information CLEARLY identified on the invoice:

1. Invoice Date and Number

2. Contract Number

3. Charges for service or products identified BY LINE ITEM Number

4. Brief description of products or services rendered

5. Charges should follow Line Item structure on contract to include Quantity, Unit of Issue, Unit Price, and Total Amount as applicable

6. Dates of Services or Shipment

Invoices shall be prepared and submitted electronically and in accordance with rates and terms as stated in the contract. Invoices shall be submitted electronically in IPP through the US Treasury.

Notification and a copy of the Invoice shall be submitted to:

1. Acquisitions: Michele.Lodge@ihs.gov, A copy of the invoice should be sent electronically to the Contract specialist(s) at the address listed above.

2. Service Unit Representatives: Erica.Deysie@ihs.gov a copy of the invoice should be sent electronically to the Service Unit Representative(s) at the address listed above.

ADDENDUM:

Pro-Children Act of 1994

The Contractor certifies that it will comply with the provisions of Public Law 103-227, Pro-Children

Act of 1994 which imposes restrictions on smoking where federally funded children’s services are provided. The Act requires that smoking should be prohibited in any indoor facility of portion of a facility owned, leased, or contracted for a used for the routine or regular provision of health care, day care, or early childhood development (Head Start) services to children under the age of 18. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 per violation and/or the imposition of an administrative compliance order on the responsible entity. By submitting an offer and entering into a contractual agreement with the Government, Contractors certify that they will comply with the requirements of the Act. Contractors must obtain the same certification from subcontractors.

B. P.L. 101-630, The Indian Child Protection and Family Violence Prevention Act

Contractors whose duties and responsibilities involve regular contact or control over children are mailto:Michele.Lodge@ihs.gov mailto:Erica.Deysie@ihs.gov subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act. IHS will conduct these investigations following award of a contract. The character investigation may be waived if, in judgment of the Contracting Officer, in consultation with the Personnel Officer, an investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractor must not have unsupervised contact with Indian children.

C. Department of Health and Human Services Tobacco Policy

The Contractor’s employee shall comply with the Department of Health & Human Services Tobacco-

Free Policy (copy available upon request). Contractor’s employee shall not use tobacco products of any kind (e.g., cigarettes, cigars, pipes, and smokeless tobacco) while on any HHS Property- owned or controlled.

D. Indian Child Protection and Family Violence Prevention Act

No performance under this contract will be allowed without full compliance with the Indian child protection and family violence prevention act, Public Law 101-630 and the Indian Health Service memo dated February 3, 1997, investigations on child care workers. Contractor shall ensure that proposed providers cooperate with and assist the government in the conduction of any necessary background checks.

B. Crime Control Act of 1990

No performance under this contract will be allowed without full compliance with the crime control act of 1990, Public Law 101-647 and the Indian Health Service memo dated February 3, 1997, investigations on child care workers. Contractor shall ensure that proposed providers cooperate with and assist the government in the conduction of any necessary background checks.

PERFORMANCE BASED ASSESSMENT:

(a) Introduction – Performance Requirements:

(1) A Quality Assurance Surveillance Plan (QASP) has been developed for in-house operations or to implement a service contract. It is designed to aid the PO in providing effective and systematic surveillance of all aspects of professional nursing services. This plan provides for monitoring the contract requirements

(b) The objective of this surveillance plan is to evaluate how the Contractor is performing in key areas. The government is primarily interested in the final service being provided and not in the details of accomplishment.

(c) The principal method of surveillance will be daily in some cases or by use or periodic inspections. Appropriate indicators are provided for recording observations in this type of surveillance.

(d) How to Use the Performance Based Matrix

(i) Each defect observed will be recorded on the tally report. These documents will then become a formal record for later reference. The tally of defects at the end of each clinic or year (dependent on criteria) will be compared to the acceptable number of defects appearing in the surveillance plan. Errors detected by the PO in the course of surveillance will be transmitted to the Contractor or in-house personnel for correction. Notification of errors will take place within five (5) working days. Specifics concerning any errors should be recorded on the tally checklist. The Contractor or in-house personnel, as applicable, should be asked to initial this record.

(ii) Project Officer shall forward a copy of Contractor’s compliance with performance and non- performance compliance reports.

(e) Quality Assurance Surveillance Plan (QASP):

(i) The Government shall monitor the Contractors’ performance through a Quality

Assurance Surveillance Plan (QASP). The QASP is for informational purposes only and not considered part of the contract.

(ii) Surveillance systems will include periodic inspection and acceptance of all Deliverables as cited in the contract.

PERFORMANCE-BASED MATRIX

Outcome Required Services AQL

Standard

Max

Allowable

Degree of

Deviation from Requirement

(AQL)

Normal Method of

Surveillance

Incentives and

Deduction from

Contract Price

Registered

Nurses Non- Personal Services Contract

Minimum

Qualification for RN services

Contractor shall submit supporting documentation for approval

100%

Compliant

Government review of contractors documentation for compliance

Incentive: Government approves documentation

De-incentive: Government reject documentation no award, Registered

Nurses Non-

Personal

Services

Contract

Licensure for RN Contractor shall submit supporting documentation of Licensure;

licensure shall be in good standing and

100%

Compliant

Government review of contractors documentation for compliance

Incentive: Government approves documentation

De-incentive: Government rejects documentation, payment may be withheld

Registered

Nurses

Non-

Personal

Services

Contract

Background

Investigation in compliance with

Indian Child

Protection and

Family Violence

Prevention Act, Public Law 101-

Contractor shall submit supporting documentation of Background investigation results

100%

Compliant

Government review of contractors documentation for compliance

Incentive: Government approves documentation

De-incentive: Government reject documentation no award, Registered

Nurses Non-

Personal

Services Contract

Immunization Compliance

Contractor shall submit supporting documentation of

100%

Compliant

Government review of contractors documentation for compliance

Incentive: Government approves documentation

De-incentive: Government reject documentation no award

END OF STATEMENT OF WORK

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