W81K00-20-Q-0106-0001 (solicitation amendment).pdf

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

POC: ANGEL D BARKLEY

36000 DARNELL LOOP

FORT HOOD TX 76544

0011465188

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

A. The purpose of this amendment eight-fold: 1) Updated Attachment 1 (added annual usage, average usage, gas rental, lease fee, hydrostatic testing, telemetry per month, delivery charge and emergency delivery charge), 2) Added Attachment 2, 3) Updated 52.212-1;

Technical to read "Attachment 1: Price List (Input monthly and annual price for each item and total amount for the base period and each option year)", 4) Updated 52.212-1; Technical to read "Offeror must submit specifications w ith the quote", 5) Added Telemetry System CLIN,

6) Added annual quantities for bulk oxygen and cylinder gases to para 11 of the Performance Work Statement (PWS), 7) Extended the offer due date and time to 21 May 2020 at 10:00 a.m. CST, and 8) Deadline for questions 18 May 2020 at 2:00 p.m. CST.

B. All other solicitation items and conditions remain the same.

See SUMMARY OF CHANGES

1. CONTRACT ID CODE PAGE OF PAGES

J 1 26

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 18-May-2020

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W81K0020Q0106

X 9B. DATED (SEE ITEM 11)

13-May-2020

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X is extended, is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

18-May-2020

CODE

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

2539 GARDEN AVENUE

FT SAM HOUSTON TX 78234-0000

W81K00 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE W81K00

FACILITY CODECODE

EMAIL:TEL:

W81K0020Q0106

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SOLICITATION/CONTRACT FORM

The required response date/time has changed from 20-May-2020 09:00 AM to 21- May-2020 10:00 AM.

SUPPLIES OR SERVICES AND PRICES

CLIN 0001

This CLIN has been renumbered to CLIN 0002.

CLIN 0002

This CLIN has been renumbered to CLIN 0003.

CLIN 1001

This CLIN has been renumbered to CLIN 1002.

The CLIN extended description has changed from:

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2021 - 31 May 2022. Payment will be made by Government Purchase Card. COR: Michelle Trussel at 785-240- 7314.

To:

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2021 - 31 May 2022. Funds are not available and are contingent upon Congress enacting FY21 appropriations.

Payment will be made by Government Purchase Card. COR: Michelle Trussel at 785-240-7314.

CLIN 1002

This CLIN has been renumbered to CLIN 1003.

CLIN 2001

This CLIN has been renumbered to CLIN 2002.

The CLIN extended description has changed from:

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2022 - 31 May 2023. Payment will be made by Government Purchase Card. COR: Michelle Trussel at 785-240-

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2022 - 31 May 2023. Funds are not available and are contingent upon Congress enacting FY22 appropriations.

CLIN 2002

This CLIN has been renumbered to CLIN 2003.

CLIN 3001

This CLIN has been renumbered to CLIN 3002.

The CLIN extended description has changed from:

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2023 - 31 May 2024. Payment will be made by Government Purchase Card. COR: Michelle Trussel at 785-240-

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2023 - 31 May 2024. Funds are not available and are contingent upon Congress enacting FY23 appropriations.

CLIN 3002

This CLIN has been renumbered to CLIN 3003.

CLIN 4001

This CLIN has been renumbered to CLIN 4002.

The CLIN extended description has changed from:

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2024 - 31 May 2025. Payment will be made by Government Purchase Card. COR: Michelle Trussel at 785-240-

Liquid Bulk Oxygen in accordance with the attached Performance Work Statement. Period of Performance: 01 June 2024 - 31 May 2025. Funds are not available and are contingent upon Congress enacting FY24 appropriations.

CLIN 4002

This CLIN has been renumbered to CLIN 4003.

CLIN 0001 is added as follows:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 12 Each Telemetry System

FFP

Requesting the contractor to provide a supply of medical-grade liquid bulk oxygen for Irwin Army Community Hospital, Fort Riley, KS. Prior to first filling of bulk oxygen tanks, contractor shall perform in-service training to include the following facets for contractor owned and Government owned systems: the refill procedure, any preventitive maintenance support requirements that may be needed from the medical center systems, and an explanation of all the volume alarm and low pressure set-points. Period of Performance: 01 June 2020 - 31 May 2021. Payment will be made by Government Purchase Card. COR: Michelle Trussel at 785-240-

FOB: Destination

NET AMT

CLIN 1001 is added as follows:

1001 12 Each Telemetry System

FFP

Requesting the contractor to provide a supply of medical-grade liquid bulk oxygen for Irwin Army Community Hospital, Fort Riley, KS. Prior to first filling of bulk oxygen tanks, contractor shall perform in-service training to include the following facets for contractor owned and Government owned systems: the refill procedure, any preventitive maintenance support requirements that may be needed from the medical center systems, and an explanation of all the volume alarm and low pressure set-points. Period of Performance: 01 June 2021 - 31 May 2022. Funds are not available and are contingent upon Congress enacting FY21 appropriations.

Payment will be made by Government Purchase Card. COR: Michelle Trussel at 785-240-7314.

CLIN 2001 is added as follows:

2001 12 Each Telemetry System

FFP

Requesting the contractor to provide a supply of medical-grade liquid bulk oxygen for Irwin Army Community Hospital, Fort Riley, KS. Prior to first filling of bulk oxygen tanks, contractor shall perform in-service training to include the following facets for contractor owned and Government owned systems: the refill procedure, any preventitive maintenance support requirements that may be needed from the medical center systems, and an explanation of all the volume alarm and low pressure set-points. Period of Performance: 01 June 2022 - 31 May 2023. Funds are not available and are contingent upon Congress enacting FY22 appropriations.

Payment will be made by Government Purchase Card. COR: Michelle Trussel at

CLIN 3001 is added as follows:

3001 12 Each Telemetry System

FFP

Requesting the contractor to provide a supply of medical-grade liquid bulk oxygen for Irwin Army Community Hospital, Fort Riley, KS. Prior to first filling of bulk oxygen tanks, contractor shall perform in-service training to include the following facets for contractor owned and Government owned systems: the refill procedure, any preventitive maintenance support requirements that may be needed from the medical center systems, and an explanation of all the volume alarm and low pressure set-points. Period of Performance: 01 June 2023 - 31 May 2024. Funds are not available and are contingent upon Congress enacting FY23 appropriations.

Payment will be made by Government Purchase Card. COR: Michelle Trussel at

CLIN 4001 is added as follows:

4001 12 Each Telemetry System

FFP

Requesting the contractor to provide a supply of medical-grade liquid bulk oxygen for Irwin Army Community Hospital, Fort Riley, KS. Prior to first filling of bulk oxygen tanks, contractor shall perform in-service training to include the following facets for contractor owned and Government owned systems: the refill procedure, any preventitive maintenance support requirements that may be needed from the medical center systems, and an explanation of all the volume alarm and low pressure set-points. Period of Performance: 01 June 2024 - 31 May 2025. Funds are not available and are contingent upon Congress enacting FY24 appropriations.

Payment will be made by Government Purchase Card. COR: Michelle Trussel at

DELIVERIES AND PERFORMANCE

The following Delivery Schedule Item has been deleted from CLIN 0001:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 01-JUN-2020 TO

30-MAY-2021

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

W55XTW

The following Delivery Schedule item has been added to CLIN 0001:

CAGE

POP 01-JUN-2020 TO

31-MAY-2021

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule Item has been deleted from CLIN 0002:

CAGE

POP 01-JUN-2020 TO

31-MAR-2021

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule for CLIN 0003 has been added:

CAGE

POP 01-JUN-2020 TO

31-MAR-2021

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule for CLIN 1003 has been added:

CAGE

POP 01-JUN-2021 TO

31-MAY-2022

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule Item has been deleted from CLIN 2001:

CAGE

POP 01-JUN-2022 TO

31-MAY-2023

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule item has been added to CLIN 2001:

CAGE

POP 01-JUN-2022 TO

31-MAY-2023

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule for CLIN 2003 has been added:

CAGE

POP 01-JUN-2022 TO

31-MAY-2023

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule for CLIN 3001 has been deleted:

CAGE

POP 01-JUN-2023 TO

31-MAY-2024

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule for CLIN 3003 has been added:

CAGE

POP 01-JUN-2023 TO

31-MAY-2024

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

The following Delivery Schedule for CLIN 4003 has been added:

CAGE

POP 01-JUN-2024 TO

31-MAY-2025

N/A FORT RILEY IRWIN ARMY COMMUNITY

HOSPITAL

FORT RILEY IRWIN ARMY COMMUNITY

HOS

BDG. 650 HUEBNER RD

FORT RILEY, KS KS 66442

INSPECTION AND ACCEPTANCE

The following Acceptance/Inspection Schedule was added for CLIN 0001:

INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

N/A N/A N/A Government

The following Acceptance/Inspection Schedule was added for CLIN 1001:

The following Acceptance/Inspection Schedule was added for CLIN 2001:

The following Acceptance/Inspection Schedule was added for CLIN 3001:

The following Acceptance/Inspection Schedule was added for CLIN 4001:

The following have been added by full text:

ATTACHMENT 1

Period of Performance: 1 June 2020 – 31 May 2021

Description/Content

Description Bottle Type (steel, aluminum, etc.)

Bottle/Cylinder Color

Bottle Cylinder Size (A, G, M, etc.)

Monthly Price

Annual

Oxygen

(0OXYGSTEELCAPD)

Steel w/ cap Green D

Oxygen (0OXYGSTEELD) Steel w/o cap Green D Oxygen (0OXYGALUMD) Aluminum Green D Oxygen (0OXYGENESTL) Steel Green E Oxygen (RCYMEDEAL) Aluminum Green E Oxygen (0OXYGENK200) NTE K Oxygen (0OXYGENM125) Steel M Nitrogen (0NITROGENK200) Steel Black K Nitrous Oxide

(0NITROXIDEH64)

Blue H

Carbon Dioxide

(0CARDIOXIDEG50)

Gray G

Carbon Dioxide

(0CARDIOXIDEE)

Gray E

Bulk Oxygen per 100 N/A N/A Bulk Liquid Nitrogen 48GL N/A N/A N/A Lung Diffusion Gas Inspections on bulk tank

Total: $_______

Other Equipment or Testing Charges

Requirement How Charged Total # Required

Frequency Charge

Monthly Price

Annual Price

Liquid Nitrogen Doer (size???)

Lease Fee 2 required Monthly /3

Hydro Static Testing

Per bottle/cylinder

Each

(0HYDROTEST

CHARGE)

Required annually Telemetry Per month 12 Monthly 12 Rent (Contractor Owned Equipment)

Per month

Delivery Charge Per Delivery Emergency Delivery Charge

When Applicable

Period of Performance: 1 June 2021 – 31 May 2022

Bottle Cylinder

Oxygen

(0OXYGSTEELCAPD)

Steel w/ cap Green D

Oxygen (0OXYGSTEELD) Steel w/o cap Green D Oxygen (0OXYGALUMD) Aluminum Green D Oxygen (0OXYGENESTL) Steel Green E Oxygen (RCYMEDEAL) Aluminum Green E Oxygen (0OXYGENK200) NTE K Oxygen (0OXYGENM125) Steel M Nitrogen (0NITROGENK200) Steel Black K Nitrous Oxide

(0NITROXIDEH64)

Blue H

Carbon Dioxide

(0CARDIOXIDEG50)

Gray G

Carbon Dioxide

(0CARDIOXIDEE)

Gray E

Bulk Oxygen per 100 N/A N/A Bulk Liquid Nitrogen 48GL N/A N/A N/A

Inspections on bulk tank

Requirement How Charged Total # Required

Frequency Charge

Monthly Price

Annual Price

Liquid Nitrogen Doer (size???)

Lease Fee 2 required Monthly /3

Hydro Static Testing

(0HYDROTEST

CHARGE)

Required annually

Per bottle/cylinder

Each Bottle/Cylinder

Telemetry Per month 12 Monthly 12

Period of Performance: 1 June 2022 – 31 May 2023

Bottle Cylinder

Oxygen

(0OXYGSTEELCAPD)

Steel w/ cap Green D

Oxygen (0OXYGSTEELD) Steel w/o cap Green D Oxygen (0OXYGALUMD) Aluminum Green D Oxygen (0OXYGENESTL) Steel Green E Oxygen (RCYMEDEAL) Aluminum Green E Oxygen (0OXYGENK200) NTE K Oxygen (0OXYGENM125) Steel M Nitrogen (0NITROGENK200) Steel Black K Nitrous Oxide

(0NITROXIDEH64)

Blue H

Carbon Dioxide

(0CARDIOXIDEG50)

Gray G

Carbon Dioxide

(0CARDIOXIDEE)

Gray E

Bulk Oxygen per 100 N/A N/A Bulk Liquid Nitrogen 48GL N/A N/A N/A

Monthly Rent

Requirement How Charged Total # Required

Frequency Charge

Monthly Price

Annual Price

Liquid Nitrogen Doer (size???)

Lease Fee 2 required Monthly /3

Hydro Static Testing

(0HYDROTEST

CHARGE)

Required annually

Per bottle/cylinder

Each Bottle/Cylinder

Telemetry Per month 12 Monthly 12

Period of Performance: 1 June 2023 – 31 May 2024

Bottle Cylinder

Oxygen

(0OXYGSTEELCAPD)

Steel w/ cap Green D

Oxygen (0OXYGSTEELD) Steel w/o cap Green D Oxygen (0OXYGALUMD) Aluminum Green D Oxygen (0OXYGENESTL) Steel Green E Oxygen (RCYMEDEAL) Aluminum Green E Oxygen (0OXYGENK200) NTE K Oxygen (0OXYGENM125) Steel M Nitrogen (0NITROGENK200) Steel Black K Nitrous Oxide

(0NITROXIDEH64)

Blue H

Carbon Dioxide

(0CARDIOXIDEG50)

Gray G

Carbon Dioxide

(0CARDIOXIDEE)

Gray E

Bulk Oxygen per 100 N/A N/A Bulk Liquid Nitrogen 48GL N/A N/A N/A

Requirement How Charged Total # Required

Frequency Charge

Monthly Price

Annual Price

Liquid Nitrogen Doer (size???)

Lease Fee 2 required Monthly /3

Hydro Static Testing

(0HYDROTEST

CHARGE)

Required annually

Per bottle/cylinder

Each Bottle/Cylinder

Telemetry Per month 12 Monthly 12

Period of Performance: 1 June 2024 – 31 May 2025

Bottle Cylinder

Oxygen

(0OXYGSTEELCAPD)

Steel w/ cap Green D

Oxygen (0OXYGSTEELD) Steel w/o cap Green D Oxygen (0OXYGALUMD) Aluminum Green D Oxygen (0OXYGENESTL) Steel Green E Oxygen (RCYMEDEAL) Aluminum Green E Oxygen (0OXYGENK200) NTE K Oxygen (0OXYGENM125) Steel M Nitrogen (0NITROGENK200) Steel Black K Nitrous Oxide

(0NITROXIDEH64)

Blue H

Carbon Dioxide

(0CARDIOXIDEG50)

Gray G

Carbon Dioxide

(0CARDIOXIDEE)

Gray E

Bulk Oxygen per 100 N/A N/A Bulk Liquid Nitrogen 48GL N/A N/A N/A

Requirement How Charged Total # Required

Frequency Charge

Monthly Price

Annual Price

Liquid Nitrogen Doer (size???)

Lease Fee 2 required Monthly /3

Hydro Static Testing

(0HYDROTEST

CHARGE)

Required annually

Per bottle/cylinder

Each Bottle/Cylinder

Telemetry Per month 12 Monthly 12

Note: The Government is in the process of changing over the D and E sized oxygen bottles (without caps) from steel to aluminum. The capped steel cylinder will not change.

ATTACHMENT 2

PERFORMANCE WORK STATEMENT

Performance Work Statement (PWS) Medical Gases (Bulk and Cylinders)

Irwin Army Community Hospital Fort Riley, KS

1. General

1.1. Requesting the contractor to provide bulk & bottles medical-grade gases (bulk liquid oxygen, bottled oxygen, nitrogen, carbon dioxide, lung diffusion gas) for the period of 1 June 2020-30 May 2021, plus four option years to Irwin Army Community Hospital, Fort Riley, KS.

1.2. The tanks located at building 650 Huebner Road consist of: a 1,500 gallon main tank, with a full level of 135in, and an alarm point of 40, and a 500 gallon reserve tank, with a full level of 52in and an alarm set point of 20.

1.3. All bulk tanks are required to be equipped with Telemetry Systems.

1.4. Prior to first filling of bulk oxygen tanks, the contractor shall perform in-service training to include the following facets for contractor owned and Government owned systems: the refill procedure, any preventive maintenance support requirements that may be needed from the medical center systems, and an explanation of all the volume alarm and low pressure set-points.

1.5. The marked Government owned bulk oxygen storage tanks and appurtenances will be maintained by and at the expense of the Government, in a manner that will ensure compliance with applicable regulations, standards and normal good practices.

1.6. Contractor Management Reporting (CMR): The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract via secure data collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/, and then click on "Department of the Army CMRA" or the icon of the DoD organization that is receiving or benefitting from the contracted services.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. Contractors may direct questions to the help desk by clicking on "Send an email" which is located under the Help Resources ribbon on the right side of the login page of the applicable Service/Component's CMR website.

The required data fields include: (1) Contracting Office, Contracting Officer, or also known as the Contracting Officer’s Representative (COR); (2) Contract number, including task and delivery order number; (3) Beginning and ending dates covered by reporting period; (4) Contractor's name, address, phone number, e-mail address, identity of Contractor employee entering data; (5) Estimated direct labor hours (including sub-Contractors); (6) Estimated direct labor dollars paid this reporting period (including sub-Contractors); (7) Total payments (including sub- Contractors); (8) Predominant Federal Service Code (FSC) reflecting services provided by Contractor (and separate predominant FSC for each sub-Contractor if different); (9) Estimated data collection cost; (10) Organizational title associated with the Unit Identification Code (UIC) for the Army Requiring Activity (the Army Requiring Activity is responsible for providing the Contractor with its UIC for the purposes of reporting this information); (11) Locations where Contractor and sub-Contractors perform the work (specified by zip code in the United States and nearest city, country, when in an overseas location, using standardized nomenclature provided on website); (12) Presence of deployment or contingency contract language; and (13) Number of Contractor and sub-Contractor employees deployed in theater this reporting period (by country). As part of its submission, the Contractor shall provide the estimated total cost (if any) incurred to comply with this reporting requirement.

As part of its submission, the contractor will also provide the estimated total cost (if any) incurred to comply with this reporting requirement. The specific formats for the XML direct transfer may be downloaded from the website.

2. Government Furnished Equipment

2.1. If contractor owned equipment is required, in the event of an emergency, each Government facility that requires installation of contractor owned equipment shall provide a suitable location and foundation for the installation of the contractor owned bulk oxygen tank(s). Additionally, each facility shall provide access to an electrical power source and hook-up to a facility-maintained alarm system. The contractor shall perform the hook-up of contractor owned equipment to the facility-maintained alarm system.

2.2. Individual Agency Ownership of Cylinders: Government owned cylinders shall remain the property of the individual ordering (owning) agency and shall not be exchanged for other cylinders, either Government-owned or contractor-owned, without authorization of the Government Point of Contact (POC)) at the ordering agency.

3. Contractor-Furnished Equipment

3.1. For those facilities requiring contractor owned tanks, the contractor shall provide, install and maintain bulk oxygen tank(s) with appropriate back-up system(s). Any of the contractor equipment will need to mark for identification. Through the duration of the contract, the contractor shall be liable for the integrity, suitability, and safety of contractor owned tank(s) that will insure compliance with applicable regulations, standards and normal good practices. The tank capacity and reserve system shown in the schedule are minimum capacities required by the using facilities. Manifold, cylinders for the reserve supply, liquid converter, alarm switch, regulator, valves, level indicator, and any other devices or connections required for proper tie-ins with the facility’s gas system shall be furnished by the contractor, without cost to the Government. The manifold or liquid converter shall deliver gas at a pressure and rate of flow adequate to supply the system. Each liquid oxygen storage container shall have an outlet that allows access for testing the purity of the oxygen.

3.2. All equipment and materials required to perform on the contract (other than what is specifically listed in section 2, Government-Furnished Property) shall be provided by the contractor. Contractor owned equipment shall be installed, inspected and maintained by the contractor without additional cost to the Government. (i.e., all installation, inspection and maintenance costs shall be included in the contract’s monthly equipment rental fee for the applicable facility). Contractor owned equipment shall be kept in good operating condition and appearance, in accordance with applicable regulations, standards and normal good practices. The contractor shall be provided reasonable access to the bulk oxygen systems for this purpose.

4. Installation of Contractor-Owned Equipment

4.1. Unless otherwise directed by the using facility, contractor owned equipment shall be installed by the effective date of the contract and shall be connected to the medical gas system on that date, provided: that the contractor shall be allowed a maximum of ninety days after receipt of notice of award to complete installation. If the contractor’s equipment replaces equipment already in use, the exchange of equipment shall be accomplished without interruption of gas supply to the using facility. Contractor installed equipment shall remain the property of the contractor and shall be removed upon termination of the contract, when directed by the ordering facility and in full cooperation with the succeeding contractor so as to avoid interruption of gas supply.

4.2. To permit orderly transition from one contractor to another, the contractor shall continue to honor the contract’s monthly equipment rental fee and bulk oxygen contract price for a maximum of ninety days beyond the scheduled expiration of the contract period, unless transition from one contractor to another is completed prior to the ninety day transition period. For any partial month, the contractor shall prorate the monthly equipment rental fee accordingly. The contractor shall continue to provide and maintain its equipment during this transition period.

4.3. All contractor owned equipment shall be installed in accordance with NFPA 50: Standard for Bulk Oxygen Systems at Consumer Sites, 2001, NFPA 99 Standard for Health Care Facilities, 2002 Edition, and FDA’s Current Good Manufacturing Practices (CGMP) Regulations. The contractor shall comply with all OSHA standards and applicable safety requirements, including proper signage and use of personal protective equipment.

5. Quality Assurance Specifications and Requirements

5.1. All medical gas manufacturers and fillers of medical gases must be registered with FDA as drug manufacturers.

All oxygen shall be manufactured, processed, packed, transported, and stored according to FDA’s Current Good Manufacturing Practices (CGMP) regulations, and all labeling shall comply with FDA’s labeling regulations (21 CFR Part 201).

5.2. All liquid bulk gases delivered under the contract shall be medical-grade and shall meet or exceed the standards cited in the current edition of the United States Pharmacopoeia/National Formulary (U.S.P.).

5.3. A valid certificate of analysis shall be provided with each delivery of liquid oxygen.

5.3.1. The certificate shall include, at a minimum:

a) Supplier’s name and complete address

b) Name of the Product (i.e. Oxygen U.S.P.)

c) An Air Liquefaction Statement where appropriate

d) Lot number or other unique identification number

e) Actual analytical results for full U.S.P. monograph testing. (A statement that only states that the product meets the minimum purity of 99.5%, etc. is not acceptable.)

f) Test method used to perform the analysis. (A statement such as “Meets U.S.P. specifications” is not acceptable;

nor would “Tested via Servomex” be acceptable since the specific model number is not provided.)

g) Signature of authorized supplier representative and date.

5.4. Material Safety Data Sheets shall be provided to the facility COR upon request.

5.5. A copy of all inspection reports shall be provided to the facility POC upon the completion of any contractor owned or Government owned bulk oxygen system inspections that are required by regulation.

5.6. All contractors owned equipment shall be maintained or repaired in accordance with NFPA 50: Standard for Bulk Oxygen Systems at Consumer Sites, 2001 and FDA’s Current Good Manufacturing Practices (CGMP) Regulations.

6. Applicable Regulations & Standards

6.1. The following is a list of some of the regulations and standards that are applicable to this contract. The list is not comprehensive, and the contractor is responsible for ensuring that all products, equipment and services provided under the contract are in compliance with applicable Federal, state, and local regulations. If applicable, the editions in effect as of the date of this solicitation are listed. Contractor is responsible for remaining compliant with any future revisions that are effective at the time of contract performance.

a) Title 21, Code of Federal Regulations, Parts 210 & 211 - CGMP regulations for supplying medical grade oxygen.

b) 29 CFR 1910.104 Applies to the installation of bulk oxygen systems on industrial and institutional consumer premises

c) 49 CFR – Transportation

d) Federal Food, Drug, and Cosmetic Act

e) NFPA 50: Standard for Bulk Oxygen Systems at Consumer Sites, 2001 Edition

f) NFPA 99: Standard for Health Care Facilities, 2015 Edition

g) U.S.P. 23Density data and volume measurement equivalents published in Compressed Gas Association Pamphlet No. P-6, titled "Standard Density Data, Atmospheric Gases and Hydrogen," shall be used when necessary to convert measurement of gases from one form to another. For example, the following conversion factor shall apply for conversion from gallons to cubic feet.

h) Calculation based on data in CGA P-6

1 ft³ liquid O2 = 860.6 ft³ gas (Table 1) 1 ft³ liquid O2 = 7.48052 gal ((Table 2) Therefore:7.48052 gal (1 ft³) liquid O2 = 860.6 ft³ gas 1 gal liquid O2 = 860.6 ft³ gas 7.48052 1 gal liquid O2 = 115.05 ft³ gas or more commonly quoted as 1 gal liquid O2 = 115.1 ft³ gas

8. Payment method:

8.1. Payment will be made by Government credit card. Contractor shall fax or mail invoice to the credit card holder that will be stated in the award.

9. TOBACCO FREE MEDICAL CAMPUS (TFMC)

The Contractor shall ensure that all employees comply with the U.S. Army Medical Command and MTF smoking policies while performing services under this contract. Smoking restrictions will apply at any location or building where healthcare activities are performed under this contract.

In accordance with Army Regulation 600-63, paragraph 7-3, 14 April 2015; Operations Order 15-48 (Army Medical Command (MEDCOM) Tobacco Free Living – USAMEDCOM), 8 May 2015; and any Operations Order, regulation or other instruction implementing, defining or otherwise addressing the Tobacco Free Medical Campus

(TFMC) on any military installation or DoD-controlled location, Contractor personnel are prohibited from using any tobacco product on or within any TFMC while performing under this contract. TFMCs are established at each installation or DoD-controlled location and include: (1) any property or non-residential building that is operated, maintained or assigned to support medical activities, including but not limited to, hospitals, medical laboratories, outpatient clinics (including medical, dental, and veterinary facilities), or aid stations operating for the primary purpose of delivering medical care and services for DOD eligible beneficiaries and/or meeting the mission of the Army Medical Command; (2) all other facilities in which medical activities or administration take place, to include HQ MEDCOM and Defense Health Headquarters; (3) all internal roadways, sidewalks and parking lots; and (4) all sidewalks, parking lots and grounds external but adjacent to the building or related to the migratory corridors surrounding the medical facility. The Contractor shall obtain from the COR any orders, regulations, instructions or other documents implementing, defining or otherwise addressing the TFMC for any given installation or DoD-controlled location where Contractor personnel may perform under this contract and shall instruct Contractor personnel on the TFMC limitations for installations or DoD-controlled locations where they may perform under this contract.

10. Acronyms

10.1 This section lists acronyms that are used in this Statement of Work BOP – Federal

CCF – 100 cubic feet

CF – Cubic feet

CGA – Compressed Gas Association

CGMP – Current Good Manufacturing Practices

CO – Contractor owned

COR - Contracting Officer Technical Representative

DOD – Department of Defense

DOT – Department of Transportation

FDA – U.S. Food & Drug Administration

GO – Government owned

NFPA – National Fire Protection Association

OGA – Other Government Agency (Other than VA)

OSHA – U.S. Department of Labor, Occupational Safety and Health Administration

USP – United States Pharmacopeia

VA – Department of Veterans Affairs

11. Requirement and Usage

Description/Content Bottle Type (steel, aluminum, etc.)

Bottle/ Cylinder Color

Bottle Cylinder Size (A, G, M, etc.)

Annual Usage

(FY18/FY19)

Average Usage

Oxygen

(0OXYGSTEELCAPD)

Steel w/ cap Green D 88/179 133

Oxygen (0OXYGSTEELD) Steel w/o cap Green D 109/158 133 Oxygen (0OXYGALUMD) Aluminum Green D 53/65 59 Oxygen (0OXYGENESTL) Steel Green E 38/41 40 Oxygen (RCYMEDEAL) Aluminum Green E 0/3 1 Oxygen (0OXYGENK200) Green K 2/78/2 78 Oxygen (0OXYGENM125) Steel M 8 December 8

Nitrogen

(0NITROGENK200)

Steel Black K 78/30 54

Nitrous Oxide

(0NITROXIDEH64)

Blue H 8 April 8

Carbon Dioxide

(0CARDIOXIDEG50)

Gray G 14/22 18

Carbon Dioxide

(0CARDIOXIDEE)

Gray E 34/13 24

Bulk Oxygen N/A N/A N/A 438,184/464,709

CB FT

6x per year

Bulk Liquid Nitrogen 48GL N/A N/A N/A 29/22 25

(0LUNGDIFFGAS)

N.A N/A N/A 0/1 1

Requirement How Charged Total # Required

Frequency Charge

Liquid Nitrogen Doer (size???)

Lease Fee 2 required Monthly /3

Hydro Static Testing

(0HYDROTEST

CHARGE)

Required annually

Per bottle/cylinder Each Bottle/Cylinder

Telemetry Per month 12 Monthly 12

12. Performance Requirements Summary

REQUIRED

SERVICE

PARAGRA

PH

NUMBER

STANDARD MAXIMUM

ALLOWABLE

DEGREE OF

DEVIATION

FROM

REQUIREMENT

(ACL)

METHOD OF

SURVEILLA

NCE

THE PROPORTION

OF REQUIRED

SERVICE TO

TOTAL CONTRACT

PRICE

Provide Bulk Medical Gases

1.1 Bulk liquid

oxygen, bottled oxygen, nitrogen, carbon dioxide, lung diffusion gas will be provided

0% 100% 100%

Training Requirement

1.4 Includes: refill

procedure, Preventive Maintenance.

Volume alarm and low pressure sets points.

0% 100% 20%

Contractor owned equipment installation

3.1 Installation shall

comply with applicable regulations, standards, and normal good practices.

0% 100% 100%

Contractor Liability

3.1 Contractor shall be

liable for the integrity, suitability, and safety of contractor tanks.

0% 100% 100%

Contractor install date

4.1, 4.3 Equipment shall be installed on the effective date of the contract and by the guidelines listed in 4.3.

2% Periodic surveillance

20%

Contractor shall provide certificate of analysis

5.3, 5.3.1 Certificate shall include information listed in PWS 5.3.1

0% 100% 20%

Material Safety Data sheets

5.4 Material safety

data sheets shall be supplied to the Government POC

0% 100% 50%

Inspection Reports PWS para 5.5

5.5 Reports for

Contractor and Government equipment shall be supplied to the Government

0% 100% 50%

Invoicing 8.1 Payment will be made by Government Credit Card

0% 100% 100%

(END OF PERFORMANCE WORK STATEMENT)

The following have been modified:

ADDENDUM TO 52.212-1

Offeror shall submit signed and dated quotes via e-mail no later than the date and time specified in Block 8, of the Standard Form 1449, Solicitation/Contract/Order for Commercial Items. The quote shall have a title page identifying the offeror, the full address, phone and facsimile numbers, points of contact (POCs) of the offeror, the solicitation number and its contents.

Note: E-mail is the only method. Quote can e-mailed to Angel Barkley. Offer shall clearly identify each part of their quote, as described below.

Administrative:

a. Request for Quotes. The offeror shall include a copy of the completed SF 1449, with the signature and include the name of the offeror, address, phone and fax numbers in Block 17a.

b. The offeror shall submit a completed copy of FAR 52.212-3, Representations and Certifications – Commercial Items. If the offeror has completed the Online Representations and Certifications Application(ORCA) at https://beta.sam.gov/ the offeror shall indicate such on the FAR clause. All offerors must be registered in the System for Award Management (SAM) prior to award, and lack of registration shall make an offer ineligible for award.

Pricing:

a. Pricing for Requirements. The offeror shall submit quote pricing for all Contract Line Item Numbers (CLINs) identified in the Request for Quote, unless otherwise noted. Include the unit price and the total extended price for each CLIN.

b. Include shipping, if any or enter $0.00 on shipping CLIN.

Technical:

a. The technical quote shall be addressed in sufficient written detail for the Government to determine if the offeror’s product(s) adequately perform the specific requirements as stated in 52.212-2.

b. Offeror must meet the salient physical, functional, or performance characteristic specified in this solicitation and clearly describes any modification the offeror plans to make in a product to make it conform to the solicitation requirements. Mark any descriptive material to clearly show the modification.

c. THE FOLLOWING MUST BE SUBMITTED WITH THE QUOTE

- Attachment 1: Price List (Input annual price for each item and total amount for the base period and each option year)

- Specifications

- Signed and dated Solicitation

(End of Addendum)

ADDENDUM TO 52.212-2

Award will be made using the lowest price technically acceptable (LPTA) source selection process. Award will be made to the responsible offeror on the basis of the lowest evaluated price of proposals meeting or exceeding the acceptability standards for non-cost factors. Award may be made without discussions with offerors (except communications conducted for the purpose of minor clarification). Therefore, each initial offer should contain the offeror's best terms from a technical and price standpoint. However, the Government reserves the right to conduct discussions if it is later determined by the contracting officer to be necessary.

(a) The Government will award a Purchase Order resulting from this solicitation, to the responsible Request For Quote (RFQ) conforming to the solicitation, that is lowest price technically acceptable (LPTA). Award will be on an all or none basis. The following evaluation factors shall be used to evaluate offers: Technical Acceptability, Past Performance, and Price.

EVALUATION PROCESS:

Award will be made using the lowest-price, technically-acceptable source selection process. The Government will initially list proposals from lowest to highest price. The Government will evaluate the lowest priced proposal first. If that proposal is determined technically unacceptable, the Government will evaluate the next lowest priced proposal and continue in that manner until a proposal is rated Technically Acceptable. If a proposal is rated Technically Unacceptable, the Government will not evaluate any other factor. USING THIS PROCEDURE, THE

GOVERNMENT MIGHT NOT EVALUATE ALL PROPOSALS.

The following evaluation factors shall be used to evaluate offers:

1. Technical

(a) Ability to provide Medical Gases (Bulk and Cylinders) in Attachment “1” as evidenced by offeror submitting pricing for Medical Gases (Bulk and Cylinders).

(b) If the offeror does not provide specifications as mentioned in 52.212-1, the offeror will not be eligible for award.

Acceptable: Proposal clearly meets the minimum requirements of the solicitation.

Unacceptable: Proposal clearly does not meet the minimum requirements of the solicitation.

2. Past Performance:

This factor will be rated as either “acceptable” or “unacceptable”.

Table A-2. Past Performance Evaluation Ratings Rating Description Acceptable Based on the offeror’s performance record, the

Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror’s performance record is unknown.

Unacceptable Based on the offeror’s performance record, the Government has no reasonable expectation that the offeror will be able to successfully perform the required effort.

2. Price: Price will be evaluated using various price analysis techniques and procedures IAW FAR 15.404-1(b) including, but not limited to, comparison of proposed prices received in response to the solicitation with a comparison to historical prices paid, whether by the Government or other than Government, for the same or similar items. Evaluation of price will include a determination that the price is fair and reasonable.

(a) Quotes must be submitted NLT the offer due date/local time CST by e-mailing to: Angel Barkley at angel.d.barkley.civ@mail.mil. No telephonic questions will be accepted, only through email. A signed SF form 1449 with completed pricing data must be submitted. E-mail is the preferred method.

(b) Evaluation Process: Quote will be evaluated on overall technical acceptability and price. Must meet the functional characteristics and test agreement reference. The award decision will be based on fair and reasonable price determination for the CLINs.

(c) Options. The Government will evaluate proposals for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that a proposal is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(d) A written notice of award or acceptance of an offer, will be furnished via e-mail to the successful offeror within the time for acceptance specified in the offer and shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of Addendum)

(End of Summary of Changes)