W911S7-22-Q-0004 KO Signed.pdf

SEE ADDENDUM

(No Collect Calls)

W911S722Q0004 05-Jul-2022

b. TELEPHONE NUMBER

573-596-2429

8. OFFER DUE DATE/LOCAL TIME

12:00 PM 27 Jul 2022

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W911S79. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

CIERRA J. PARKER

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

1 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

0011798529

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

MICC - FORT LEONARD WOOD

8112 NEBRASKA AVENUE

FORT LEONARD WOOD MO 65473

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE W58XTU 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

W1ML USA MEDDAC FT LEONARDWOOD

W1ML USA MEDDAC FT LEONARDWOOD

4430 MISSOURI AVE

BLDG 310A

FORT LEONARD WOOD MO 65473-8952

TEL: 210-808-2837 FAX:

5735960267FAX:

TEL: 5735960266 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$12,000,000

NAICS:

561990

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF55

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

Section B - Supplies or Services and Prices

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Job Onsite Shredding Service

FFP

DESCRIPTION: Onsite shredding IAW HIPAA regulations at all locations as per PWS. Expectation of 26 biweekly services within one year to include delivery and placement of marked bins within 10 days after award.

FOB: Destination

PURCHASE REQUEST NUMBER: 0011798529

PSC CD: R614

NET AMT

0002 4 Job Bulk Shredding Service

FFP

Bulk shredding service expected at 4 each 96-gallon containers.

FOB: Destination

1001 1 Job OPTION Option Year 1 Onsite Shredding Service

FFP

Onsite shredding IAW HIPAA regulations at all locations as per PWS. Expectation of 26 biweekly services within one year.

FOB: Destination

1002 4 Job OPTION OY 2 Bulk Shredding Service

FFP

DESCRIPTION: Bulk shredding service expected at 4 each 96-gallon containers.

FOB: Destination

2001 1 Job OPTION OY 2 Onsite Shredding Service

FFP

: Onsite shredding IAW HIPAA regulations at all locations as per PWS.

Expectation of 26 biweekly services within one year.

FOB: Destination

2002 4 Job OPTION Bulk Shredding Service

FFP

Bulk shredding service expected up to 4 each 96-gallon containers.

FOB: Destination

3001 1 Job OPTION OY 3 Onsite Shredding Service

FFP

DESCRIPTION: Onsite shredding IAW HIPAA regulations at all locations as per PWS. Expectation of 26 biweekly services within one year.

FOB: Destination

3002 4 Job OPTION OY 3 Bulk Shredding Service

FFP

Bulk shredding service expected up to 4 each 96-gallon containers.

FOB: Destination

4001 1 Job OPTION OY 4 Onsite Shredding Service

FFP

Onsite shredding IAW HIPAA regulations at all locations as per PWS.

Expectation of 26 biweekly services within one year.

FOB: Destination

4002 4 Job OPTION OY 4 Bulk Shredding Service

FFP

Bulk shredding service expected at up to 4 each 96-gallon containers.

FOB: Destination

4003 1 Job OPTION Removal of Bins

FFP

Removal and Transportation of bins at end of POP.

FOB: Destination

Section C - Descriptions and Specifications

HIPPAA PRIVACY AND SECURITY

The HIPAA Privacy Rule requires that covered entities apply appropriate administrative, technical, and physical safeguards to protect the privacy of protected health information (PHI), in any form. See 45 CFR 164.530(c). This means that covered entities must implement reasonable safeguards to limit incidental, and avoid prohibited, uses and disclosures of PHI, including in connection with the disposal of such information. In addition, the HIPAA Security Rule requires that covered entities implement policies and procedures to address the final disposition of electronic PHI and/or the hardware or electronic media on which it is stored, as well as to implement procedures for removal of electronic PHI from electronic media before the media are made available for re-use. See 45 CFR 164.310(d)(2)(i) and (ii). Failing to implement reasonable safeguards to protect PHI in connection with disposal could result in impermissible disclosures of PHI.

Further, covered entities must ensure that their workforce members receive training on and follow the disposal policies and procedures of the covered entity, as necessary and appropriate for each workforce member. See 45 CFR 164.306(a)(4), 164.308(a)(5), and 164.530(b) and (i). Therefore, any workforce member involved in disposing of PHI, or who supervises others who dispose of PHI, must receive training on disposal. This includes any volunteers.

See 45 CFR 160.103 (definition of "workforce").

Thus, covered entities are not permitted to simply abandon PHI or dispose of it in dumpsters or other containers that are accessible by the public or other unauthorized persons. However, the Privacy and Security Rules do not require a particular disposal method. Covered entities must review their own circumstances to determine what steps are reasonable to safeguard PHI through disposal, and develop and implement policies and procedures to carry out those steps. In determining what is reasonable, covered entities should assess potential risks to patient privacy, as well as consider such issues as the form, type, and amount of PHI to be disposed. For instance, the disposal of certain types of PHI such as name, social security number, driver's license number, debit or credit card number, diagnosis, treatment information, or other sensitive information may warrant more care due to the risk that inappropriate access to this information may result in identity theft, employment or other discrimination, or harm to an individual's reputation.

In general, examples of proper disposal methods may include, but are not limited to:

For PHI in paper records, shredding, burning, pulping, or pulverizing the records so that PHI is rendered essentially unreadable, indecipherable, and otherwise cannot be reconstructed.

Maintaining labeled prescription bottles and other PHI in opaque bags in a secure area and using a disposal vendor as a business associate to pick up and shred or otherwise destroy the PHI.

For PHI on electronic media, clearing (using software or hardware products to overwrite media with non-sensitive data), purging (degaussing or exposing the media to a strong magnetic field in order to disrupt the recorded magnetic domains), or destroying the media (disintegration, pulverization, melting, incinerating, or shredding).

Section E - Inspection and Acceptance

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government 0002 Destination Government Destination Government 1001 Destination Government Destination Government 1002 Destination Government Destination Government 2001 Destination Government Destination Government 2002 Destination Government Destination Government 3001 Destination Government Destination Government 3002 Destination Government Destination Government 4001 Destination Government Destination Government 4002 Destination Government Destination Government 4003 Destination Government Destination Government

Section F - Deliveries or Performance

PERFORMANCE WORK STATEMENT

Paper Waste Destruction and Disposal Service General Leonard Wood Army Community Hospital (GLWACH)

1. GENERAL: The General Leonard Wood Army Community Hospital (GLWACH), Fort Leonard Wood, MO (FLW) requires onsite paper shredding and removal services for the main hospital and satellite points of presence.

1.1. BACKGROUND: Waste paper produced, stored and discarded in the medical environment contains very large amounts of Personally Identifiable Information (PII), Personal Health Information (PHI), and Health Insurance and Portability Act (HIPAA) controlled information that must be destroyed to prevent release of sensitive information.

1.2. SCOPE OF WORK: The objective of this contract is to deliver paper catch bins with proper locking devices to all facilities within the scope of this requirement. The bins shall be emptied biweekly and shred onsite in accordance with HIPAA regulations. The contractor shall shred all documents “ON SITE” and will not transport the documents to another location for shredding purposes. Certificates of destruction of each service will be supplied noting quantity of material shred, and other pertinent markings, to the COR at each service visit. Bins will be removed from all locations at one visit upon completion of contracted service.

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1. CONTRACTOR. The term as used in this contract refers to the prime.

2.1.2. CONTRACTING OFFICER (KO). A person with authority to enter into, administer, or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S.

Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4. PHYSICAL SECURITY. All disposal containers shall be physically secured with padlocks or approved locking mechanisms provided by the Contractor. Keys shall be maintained by the Contractor and the COR.

2.1.5. QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are being performed according to acceptable standards.

2.1.6. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.7. SUBCONTRACTOR. . Use only contractors and Subcontractors that are physically located wita jurisdiction subject to the laws of the United States, and ensure that no contractor orSubcontractor maintains, processes, uses, or discloses PHI in any way that will remove the information from such jurisdiction. Contractor shall remain in compliance with FAR 52.219-14 Limitations on subcontracting and 13 CFR 125.6.

2.1.8. WORK DAY. GLWACH is a hospital operating 24 hours a day. Working hours for the purpose of the contract is between the hours of 0700 and 1600. Any waste removal that must occur outside of these hours must be pre-coordinated with the COR two weeks prior to the anticipated service date.

2.1.9. WORK WEEK. Defined as Monday through Friday (dependent on workload and mobilization requirements).

2.2 ACRONYMS: List all acronyms used in the PWS and what they represent.

COR Contracting Officer Representative CMRA Contractor Manpower Reporting FLW Fort Leonard Wood, Missouri GLWACH General Leonard Wood Army Community Hospital HIPAA Health Insurance Portability and Accountability Act of 1996 IMD Information Management Division KO Contracting Officer (the only person that can obligate the Government and approve modifications to the contract) OSHA Occupational Safety and Health Administration PHI Personal Health Information PII Personally Identifiable Information POC Point of Contact PWS Performance Work Statement QA Quality Assurance QC Quality Control

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. MATERIALS.

3.1.1. The Government will provide onsite physical security and oversight to include key control. See section 2.1.4

3.1.2 The Government will provide any training materials required for post access, facilities access or clearances.

3.1.3. The Government will provide sponsorship for contractor personnel for post access. Sponsorship is required for contractor employees designated to perform service at the various facilities. Sponsorship will be rescinded in the event that the sponsored contract employee is released from employment with the contractor.

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES: The Contractor shall furnish all supplies, equipment, onsite facilities and services required to perform work under this contract that are not listed under section 3 of this statement.

4.1 The contractor shall provide all collection containers and transport equipment. Initial placement, final removal and roadway transportation are the Contractor’s responsibility. All labor involved in container placing, waste collecting and disposing of paper waste is the responsibility of the Contractor. Any additional material required for collection, disposal and destruction of paper waste material not specifically mentioned in this performance work statement shall be provided by the Contractor but approved by the government prior to provision.

5. DESCRIPTION OF WORK:

5.1 The Contractor shall provide paper waste removal with an onsite collection and shredding system. All containers shall be secured and access shall be restricted to the COR, the COR’s HIPAA representative, and the contractor only. GLWACH employees will not access waste once placed in the disposal containers. The contractor shall provide safe controlled handling of waste paper and provide certification of its destruction in accordance with applicable HIPAA regulation.

5.2 Disposal service shall cover both the primary hospital facility and out buildings in accordance with the following table. Total weight per location is estimated based on 20lbs per 20-gallon container and 250lbs per 96-gallon container.

5.3 All document destruction will be completed on-site, within the immediate vicinity of each pick-up location. Currently GLWACH maintains fourteen (14) distinct locations. See Table Below:

Building Number

Common Name

Physical Address Container Type

Weight

20 Gallon 96 Gallon

LBS

Bldg 310 GLWACH 4430 Missouri Ave, Ft. Leonard Wood, MO 65473

55 9 3350

Bldg 350 Army Wellness 14122 3rd St, Ft. Leonard Wood, MO 65473

1 20

Bldg 487 PX Pharmacy 143 Replacement Ave, Ft. Leonard Wood, MO 65473

3 60

Bldg 500 Harper Clinic 5047 Virginia Ave, Ft Leonard Wood, MO 65473

1 20

Bldg 759 Blood Donor Center

6261 Buckeye Ave, Ft Leonard Wood, MO 65473

1 20

Bldg 789 Boak Dental 12720 Kansas Ave, Ft. Leonard Wood, MO 65473

1 20

Bldg 822 Behavioral Health

6656 Colorado Ave, Ft. Leonard Wood, MO 65473

1 20

Bldg 832 MP Behavioral Health

6722 Colorado Ave, Ft. Leonard Wood, MO 65473

1 20

Bldg 885 CTMC 12683 16th St., Ft. Leonard Wood, MO 65473

1 4 1020

Bldg 1018 Behavioral Health

7621 Big Piney Road, Ft. Leonard Wood, MO 65473

1 20

Bldg 1608 Roll Dental 1724 Nebraska Ave, Ft. Leonard Wood, MO 65473

1 20

Bldg 2100 43rd Reception 4566 Oklahoma Ave, Ft. Leonard Wood, MO 65473

3 60

Bldg 2107 Post Immunization Team (PIT)

4654 Oklahoma Ave, Ft Leonard Wood, MO 65473

1 250

Bldg 2222 Preventative Medicine

16037 Minnesota Ave, Ft. Leonard Wood, MO 65473

1 20

Total Bins Required 71 14 4900 lbs

5.3.1 Disposal containers shall be supplied and placed by the Contractor within 10 days of contract award. The Contractor shall individually identify the containers by location and tracking number and their unique identifiers will be included in the tracking and reporting processes.

5.3.2 The Contractor shall initially place seventy-one (71), 20 gallon and fourteen (14), 96 gallon collection containers. This number may be adjusted up or downward as required with a one-week notice.

The Contracting Officer Representative (COR) along with the GLWACH IMD HIPAA Compliance Officer will determine the placement of collection containers based on waste volume. Locations of containers may be adjusted as necessary to handle dynamic workload but will be pre-approved by COR prior to acceptance or placement.

5.3.3 Regular disposal schedule shall be conducted once bi-weekly for a total of 26 weeks per calendar year. One week minimum notice will be required for the government to suspend service for any postponed or canceled service.

5.3.4 Additional pickup times outside of the regular disposal schedule may be required to dispose of up to 1000lbs of paper waste (approximately four full 96 gallon containers) four times per year. Notification of the requirement for an additional pickup will be sent to the contractor a minimum of one week in advance by the COR. Additional containers shall be spot placed by the contractor to incorporate this process.

5.4 The Contractor shall provide the GLWACH HIPAA Security Officer reports of waste removed to include the quantity measured by weight, and certifications of destruction upon completion of each service visit. The HIPAA Security Officer is designated by the GLWACH Military Commander.

5.5 The Contractor shall perform disposal duties unescorted after the initial site survey, requiring unescorted post access and sponsorship (See Post Sponsorship 4.2.6).

5.6 the Contractor shall provide in writing the on–site destruction process with the technical proposal.

5.7 The Contractor shall comply with all applicable laws, rules and regulations, including but not limited to those included in Section 6 of the PWS.

6 SAFETY REQUIREMENTS: The Contractor shall maintain safety and health standards compliant with requirements of the Occupational Safety and Health Administration (OSHA).

7 SECURITY REQUIREMENTS: The Contractor shall be responsible for the security of all Soldier and Patient information once material has been transferred to their control via the on-site locked containers.

7.1 The Contractor shall disclose or cause to disseminate any information concerning operations of military or medical activities.

7.2 All inquiries, comments or complaints arising from any matter observed, experienced, or learned of as a result of or in connection with the performance of this contract, the resolution of which may require the dissemination of official information, shall be directed to the COR and the Contracting Officer within 24 hours of observance.

7.3 The Contractor shall only conduct business related to contractual obligations with the COR and the Contracting Officer. Names of authorized personnel shall be provided to the Contractor by the government at the time of the award, in writing, and updated as necessary throughout the contract period.

7.4 All documentation retrieved from disposal containers within GLWACH or GLWACH controlled outbuildings, remains the property of the U.S. Government until final destruction; at which time the contractor shall dispose of the destroyed material at their discretion.

7.5 The contractor shall maintain positive control of all waste from point of pick-up to point of destruction.

Loss of control of any PII, PHI, or HIPAA related material shall be reported to GLWACH HIPAA Security Officer within 24 hour of the loss.

8 IDENTIFICATION OF PRIVACY ACT: This contract requires the development of a system of records in accordance with the Privacy Act of 1974. The Contractors records of weights combined with copies of Certificates of Destruction satisfy this requirement. Contractor will provide proof of systems of records with Technical Proposal.

9 Deliverable Schedule:

9.1 Table of deliverables:

Paragraph Number

Deliverables Quantity Schedule of Delivery

1.2 On-Site Document Destruction 26 + 4

26 Scheduled pickups with 4 optional separate purges

5.4 On-Site Secure Collection Containers

71 (20Gal) 14 (96)

Within 10 days of award

5.4 Container Tracking and Identification

Within 10 calendar days of contract start date

5.5 Certificate of Destruction 26 + 4

Upon completion, the day of document destruction.

5.5 Weight Summary Report 26 + 4

Upon completion, the day of document destruction

5.7 On-site Destruction Process Initial Upon contract award

Training Required:

AT Level 1, iWatch, OPSEC

Initial Within 30 calendar days of contract start date

8 HIPAA System of Records Initial With Technical Proposal

9.2 Performance Requirements Summary (PRS)

Performance Objective Standard

Performance Threshold

Method of Surveillance

1.2 On-Site Document Destruction

100% On-Site destruction.

All containers empty of waste after each visit.

Certificates of destruction.

Spot checks by the HIPAA

Security Officer.

5.4 On-Site Secure Collection Containers

Locked collection containers at all times.

Discarded paper un-reachable by office personnel after being discarded.

Installed within 30 days of award.

Maintained in 100% working order to ensure integrity.

Reports of unsecured containers by office personnel.

Spot checks by the HIPAA Security Officer.

5.4 Container Tracking and Identification

Individually unique numbering system

Inventoried by location.

Used as a reference in all related documentation.

Validated by COR upon installation.

5.5 Certificate of Destruction

Completed day of destruction.

References container tracking number.

Collected and validated by HIPAA Security Officer.

5.5 Weight Summary Report

Completed day of destruction.

References container tracking number.

Collected and validated by HIPAA Security Officer.

5.7 On-site Destruction Process

Must detail the ability to ensure 100% destruction of waste on-site.

Delivered upon contract award.

Validated by COR and HIPAA Security Officer.

Training Required:

AT Level 1, iWatch, OPSEC

Complete online training.

Mandatory completion within 30 days of award

Certificates of Training on file with COR.

Collected and validated by

COR

HIPAA System of Records

100% record of waste removed from GLWACH facility by date and weight.

Contractor certifies they maintain a HIPAA compliant system of record.

Collected and validated by

COR

APPLICABLE REGULATIONS AND MANUALS:

10.1 Health Insurance Portability and Accountability Act of 1996 (HIPAA)

10.2 DoD Health Information Privacy Regulation (DoD 6025.18-R)

11. Security:

11.1 AT Level I training

All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within 30 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: http://jko.jten.mil

11.2 iWATCH Training

The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program.

This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. Training shall be completed within 60 calendar days of contract award and within 30 calendar days of new employees commencing performance. Training results will be delivered to the COR NLT 90 calendar days after contract award.

11.3 OPSEC Training

New Contractors shall complete Level I OPSEC training within 30 calendar days of their reporting for duty. All Contractors shall complete annual OPSEC Awareness training. GLWACH offers monthly OPSEC classes the second Tuesday of each month at MEDDAC Orientation training. Online training is not acceptable for OPSEC training. Attendance verification shall be provided to the COR within five calendar days of completion. The education department logs this training and can provide the sign in roster.

W911S722Q0004

12 PRIVACY AND SECURITY OF PROTECTED HEALTH INFORMATION:

12.1 The contractor shall not use or further disclose PHI other than as permitted or required by the contract or as required by law.

12.2 The contractor shall use appropriate safeguards to prevent use or disclosure of the protected PHI other than as provided for by this contract.

12.3 The contractor shall use administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that it creates, receives, maintains, or transmits in the execution of this contract. The Contractor will not make electronic copies of any PHI, transmit, or retain in a digitally stored state any ePHI.

12.4 The contractor shall mitigate, to the extent practicable, any harmful effect that is known to the contractor of a use or disclosure of PHI by the contractor in violation of the requirements of this contract.

12.5 The contractor shall report to the government any security incident involving PHI of which it becomes aware.

12.6 The contractor shall report to the government any use or disclosure of PHI not provided for by this contract.

12.7 The contractor shall ensure that any agent, including a subcontractor, to whom it provides PHI received from, or created or received by the contractor on behalf of the government, agrees to the same restrictions and conditions that apply through this contract to the contractor with respect to such information.

12.8 The contractor shall ensure that any agent, including a subcontractor, who receives PHI or ePHI, agrees to implement reasonable and appropriate safeguards to protect it.

12.9 The contractor shall provide access, at the request of the government and in the time and manner designated by the government, to PHI in a designated record set, to the government or, as directed by the government, to an Individual in order to meet the requirements under 45 CFR 164.524.

13 OBLIGATIONS OF THE GOVERNMENT:

Provisions for the government to inform the contractor of privacy practices and restrictions:

13.1 Upon request, the government will provide the contractor with the notice of privacy practices that the government produces in accordance with 45 CFR 164.520 as well as any changes to such notice.

13.2 The government will provide the contractor with any changes in, or revocation of, permission by Individual to use or disclose PHI if such changes affect the contractor's permitted or required uses and disclosures.

13.3 The government will notify the contractor of any restriction to the use or disclosure of PHI that the government has agreed to in accordance with 45 CFR 164.522.

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 15-AUG-2022 TO

14-AUG-2023

N/A W1ML USA MEDDAC FT

LEONARDWOOD

W1ML USA MEDDAC FT

LEONARDWOOD

4430 MISSOURI AVE

BLDG 310A

FORT LEONARD WOOD MO 65473-8952

210-808-2837 FOB: Destination

W58XTU

0002 POP 15-AUG-2022 TO

14-AUG-2023

N/A (SAME AS PREVIOUS LOCATION)

1001 POP 15-AUG-2023 TO

14-AUG-2024

N/A (SAME AS PREVIOUS LOCATION)

1002 POP 15-AUG-2023 TO

14-AUG-2024

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 15-AUG-2024 TO

14-AUG-2025

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 15-AUG-2024 TO

14-AUG-2025

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 15-AUG-2025 TO

14-AUG-2026

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 15-AUG-2025 TO

14-AUG-2026

N/A (SAME AS PREVIOUS LOCATION)

4001 POP 15-AUG-2026 TO

14-AUG-2027

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 15-AUG-2026 TO

N/A (SAME AS PREVIOUS LOCATION)

4003 POP 15-AUG-2026 TO

N/A (SAME AS PREVIOUS LOCATION)

Section G - Contract Administration Data

CLAUSES INCORPORATED BY REFERENCE

252.232-7006 Wide Area WorkFlow Payment Instructions DEC 2018

CONTRACT ADMINISTRATION

CONTRACT ADMINISTRATION

MICC, FLW will retain post award administration of this contract. Contact the Contract specialist or Contracting Officer if any post award delivery delay, performance problems or other issues arise during the performance of this contract. No person in the Government, other than a Contracting Officer, has the authority to provide direction to the Contractor, which alters the Contractor’s obligations or changes this contract in any way. If any person representing the Government, other than a Contracting Officer, attempts to alter contract obligations, change the contract Specifications/statement of work or tells the contractor to perform some effort which the Contractor believes to be outside the scope of this contract, the Contractor shall immediately notify the Contracting Officer. Contractor personnel shall not comply with any order or direction, which they believe to be outside the scope of this contract unless the order or direction is issued by a Contracting Officer.

COR ADMINISTRATION

The COR will act as the Contracting Officer’s Representative for technical matters providing technical direction and discussion as necessary with respect to the Specification/Statement of Work and monitoring the progress and quality of the Contractor’s performance. The COR is NOT an Administrative Contracting Officer (ACO) and does not have the authority to take any action, either directly or indirectly that would change the pricing, quality, quantity, place of performance, delivery schedule, or any other terms and conditions of the contract, or to direct the accomplishment of effort, which goes beyond the scope of the specifications/Statement of Work in the contract.

POC Information Contract Specialist MICC, FLW-Missions Division Cierra Parker Phone; 572-596-1800 Email: cierra.j.parker.civ@army.mil

Contracting Officer MICC, FLW-Missions Division Melaine E. Godina Phone: 573-596-7280 E-mail: melaine.e.godina.civ@army.mil

Government Representative General Leonard Wood Army Community Hospital (GLWACH) Resource Mgmt Division – Acquisition Tina Gallen Phone: 573-596-9043 Email: tina.d.gallen.civ@mail.mil

CONTRACTOR:

TBD

INVOICING INSTRUCTIONS:

Wide Area Workflow (WAWF) will be utilized for this purchase order/contract. The contractor is required to comply with DFAR 252.232-7003 Electronic Submission of Payment Requests (MAR 20

07) and with DFAR252.232-7006 Wide Area Workflow Payment Instructions (JUN 2012).

PAYMENT INFORMATION:

The Government anticipates paying fully certified invoices on a Net 30 day basis. Payment of fully certified invoices for partial deliveries of material is hereby authorized. Distribution of payment will be made by Electronic Funds Transfer (EFT) to the contractors account established in the CCR database. It is the responsibility of the contractor to review such accounts to ensure that payment has been received.

SALES TAX EXEMPT

The Contractor is hereby advised that the United States Government and Agencies thereof are exempt from State and Local Government Tax by virtue of Article 6 of the United States Constitution. No exemption certificate is required.

Section I - Contract Clauses

CLAUSES INCORPORATED BY REFERENCE

52.202-1 Definitions JUN 2020 52.203-6 Restrictions On Subcontractor Sales To The Government JUN 2020 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.204-13 System for Award Management Maintenance OCT 2018 52.204-13 System for Award Management Maintenance OCT 2018 52.204-18 Commercial and Government Entity Code Maintenance AUG 2020 52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

NOV 2021

52.204-26 Covered Telecommunications Equipment or Services-- Representation.

OCT 2020

52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law

FEB 2016

52.212-1 Instructions to Offerors--Commercial Products and Commercial Services

NOV 2021

52.212-1 Instructions to Offerors--Commercial Products and Commercial Services

NOV 2021

52.212-4 Contract Terms and Conditions--Commercial Products and Commercial Services

NOV 2021

52.213-3 Notice to Suppliers APR 1984 52.216-24 Limitation Of Government Liability APR 1984 52.232-1 Payments APR 1984 52.232-39 Unenforceability of Unauthorized Obligations JUN 2013 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

NOV 2021

52.232-40 Providing Accelerated Payments to Small Business Subcontractors

NOV 2021

52.233-2 Service Of Protest SEP 2006 52.233-3 Protest After Award AUG 1996 52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.244-6 Subcontracts for Commercial Products and Commercial

Services

JAN 2022

252.201-7000 Contracting Officer's Representative DEC 1991 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013 252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7015 Notice of Authorized Disclosure of Information for Litigation

Support

MAY 2016

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

JAN 2021

252.225-7048 Export-Controlled Items JUN 2013 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

DEC 2018

252.232-7010 Levies on Contract Payments DEC 2006 252.244-7000 Subcontracts for Commercial Items JAN 2021

CLAUSES INCORPORATED BY FULL TEXT

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAY 2022)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.

(a) Definitions. As used in this provision --

“Covered telecommunications equipment or services” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

“Economically disadvantaged women-owned small business (EDWOSB) Concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

"Forced or indentured child labor" means all work or service-

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

“Inverted domestic corporation” means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

“Manufactured end product” means any end product in product and service codes (PSCs) 1000-9999, except--

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

“Place of manufacture” means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

“Predecessor” means an entity that is replaced by a successor and includes any predecessors of the predecessor.

“Reasonable inquiry” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

“Restricted business operations” means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate--

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.

“Sensitive technology”--

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically--

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

“Service-disabled veteran-owned small business concern”--

(1) Means a small business concern--

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

"Small business concern"--

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR part 121 and size standards in this solicitation.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

“Small disadvantaged business concern”, consistent with 13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that--

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by--

(i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13 CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

“Subsidiary” means an entity in which more than 50 percent of the entity is owned--

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

“Successor” means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term “successor” does not include new offices/divisions of the same company or a company that only changes its name.

The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

“Veteran-owned small business concern” means a small business concern--

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

"Women-owned business concern" means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

“Women-owned small business concern” means a small business concern--

(1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; or

(2) Whose management and daily business operations are controlled by one or more women.

“Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127)”, means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States.

(b) (1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications in SAM.

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications--Commercial Products and Commercial Services, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard(s) applicable to the NAICS code(s) referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs __.

[Offeror to identify the applicable paragraphs at (c) through (v) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on SAM.]

(c) Offerors must complete the following representations when the resulting contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii). Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it ( ___ ) is, ( ___ ) is not a small business concern.

(2) Veteran-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents as part of its offer that it ( ___ ) is, ( ___ ) is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. (Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.) The offeror represents as part of its offer that it ( ___ ) is, ( ___ ) is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ___ ) is, ( ___ ) is not a small disadvantaged business concern as defined in 13 CFR 124.1002.

(5) Women-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ___ ) is, ( ___ ) is not a women-owned small business concern.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that--

(i) It [ ___ ] is, [ ___ ] is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ___ .] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that--

(i) It [ ___ ] is, [ ___ ] is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: ___ -.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB…