STATEMENT OF WORK - Dental Pediatrics.docx

STATEMENT OF WORK

WEWOKA SERVICE UNIT

February 6, 2023 A. Services

The Contractor shall provide an operating room, Anesthesia services for Dental Pediatric patients from Wewoka health clinic, Wewoka, Oklahoma.

1. The Contractor shall provide a facility with an Operating Room to perform Dental Pediatric surgeries.

2. The Contractor shall provide an Anesthesiologist along with Anesthesia for each patient.

3. The Contractor needs to be Joint Commission Accredited and provide documentation.

4. The Contractor shall provide an Operating Room with an Anesthesiologist and Anesthesia at least one day per week.

B. PERIOD OF PERFORMANCE: Approximately one year.

C. Wewoka Indian Health Service Unit will provide:

1. Pediatric Dentist

2. One to two Dental Assistants D. QUALIFICATIONS: Contractor shall be Joint Commission Accredited Hospital along with being up to date with Accreditation.

E. WORK SCHEDULE:

A. The Contractor shall conduct all services during normal business hours, Monday thru Friday, 8:00 a.m. to 5:00 p.m.

B. Any changes to the proceeding shall require mutual agreement of the Contractor and Contracting Officer’s Representative.

F. INVOICES: An original invoice shall be submitted monthly and/or quarterly depending on how the PO is set up, to the Oklahoma City Area Indian Health Service, Attn: Finance, 701 Market Drive, Oklahoma City, OK 73114.

Invoice shall include:

1. Contractor’s name, title, phone number, mailing address

2. Invoice date

3. Purchase Order Number

4. Description of Services

5. Quantity of Services Rendered

6. Cost

7. Payment terms

8. Email a copy of the invoice to the Facility Manager at Casey.Kelley@IHS.GOV and to Accounts Payable Denis.Karr@IHS.Gov

Contracting Officer’s Representative and Project Site Contact:

Casey Kelley Wewoka Indian Health Center 36640 Hwy 270, barking-water Road Wewoka, OK 74884 405-257-7516 Casey.kelley@ihs.gov

Signature COR Date