RFQ_-_W91242-17-R-0002-0001.pdf

Offers 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 or (c) By separate letter or electronic communication 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 letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

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

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

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

12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

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

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

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

NUMBER IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation data, 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)

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.

15C. DATE SIGNED

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

16C. DATE SIGNED

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

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

PAGE OF PAGES

6. ISSUED BY CODE

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, county, State and ZIP Code) (X)

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

Previous edition unusable

1.

2.

SPRINT tests have been added to the following PHA Events: Durham, NC and Lenior, NC.

Added updated Q&A section.

3. Updated Medical Event Request forms are attached for the above mentioned locations.

4. All other terms and conditions remain unchanged.

USPFO FOR NORTH CAROLINA (W91242)

ATTN: HEATHER BUSHOUSE

4201 REEDY CREEK RD

RALEIGH, NC 27607-6412

TEL: 919-664-6021

W91242-17-R-0002

1 4

12/23/2016

12/13/2016

Derek Meilinger

12/23/2016

Medical Numbers

G6PD DNA

FLU HEPA HEPB TDAP

MRR VAR Percent Pano

OPTOMERTY

EKG

ENDO

For G1 MEDICAL use only

POC Email

Event Details

Phone Number

Event State: Event Zip:

Primary POC

HIV

NCARNG Medical Event Request Form

G1 Medical

Event Location

Brigade/MSC:

Battalion:

To:

Event Name:

Event Street Address:

Event City:

PREGNANCY TESTS LIPID PANEL

HEARING EXAMS SPRINT TESTS

Dental Treatment Hours:

LIVE DENCLASS

ORAL SUGURY

LIVE HRR

Data Entry: Additional Notes:

Participating Units/UICs:

Number of Females Over 40

Alternate POC

Phone Number

POC Email

Attending Day 1

Attending Day 3 Attending Day 2

Notes

Total Attending

Dental Numbers

Event Start Date/Time

Event Type:

Portable Medical Equipment Portable Dental Exams Mobile Dental Treatment

Event End Date/Time

30th ABCT

236 BEB

HHC,C,D 236th BEB.E Co 230th BSB

DURHAM 21-22 JAN 2017

801 Stadium Drive

Durham NC 27704

2LT Essic, Robert Autry, Ju L SFC

(984) 661-0527 (919) 220-740 robert.t.essic.mil@mail.mil ju.l.autry.mil@mail.mil

January 21 2017 0730 January 22 2017 1700

300 30 20

5 5 150 30 20 20

0 15 15 7 yes Yes no

20 20 yes 50 20 30 yes

Annual Medical Readiness Event

Medical Numbers

G6PD DNA

FLU HEPA HEPB TDAP

MRR VAR Percent Pano

OPTOMERTY

EKG

ENDO

For G1 MEDICAL use only

POC Email

Event Details

Phone Number

Event State: Event Zip:

Primary POC

HIV

NCARNG Medical Event Request Form

G1 Medical

Event Location

Brigade/MSC:

Battalion:

To:

Event Name:

Event Street Address:

Event City:

PREGNANCY TESTS LIPID PANEL

HEARING EXAMS SPRINT TESTS

Dental Treatment Hours:

LIVE DENCLASS

ORAL SUGURY

LIVE HRR

Data Entry: Additional Notes:

Participating Units/UICs:

Number of Females Over 40

Alternate POC

Phone Number

POC Email

Attending Day 1

Attending Day 3 Attending Day 2

Notes

Total Attending

Dental Numbers

Event Start Date/Time

Event Type:

Portable Medical Equipment Portable Dental Exams Mobile Dental Treatment

Event End Date/Time

113th STB

113th STB

626 Maint Co/ HHC 630th CSSB/ 1450 Trans

LENOIR 11 -12 FEB 2017

1535 Beecher Anderson Road

Lenoir NC 28645

O'Neill, William Robert SFC Blakemore, Bryon A SSG

(984) 661-1233 (984) 661-1232 william.r.oneill.mil@mail.mil bryon.a.blakemore.mil@mail.mil

February 11 2017 0730 February 12 2017 1700

440 44 35

10 10 220 44 35 35

0 25 25 15 440 Yes no

25 25 yes 60 20 15 yes

Annual Medical Readiness Event

Questions/Answers for W91242-17-R-0002

1. Will there be space available within each of the facilities to set up portable equipment for all medical and dental exams (with hearing and dental treatment outside in mobile vehicles)?

Answer: Yes space will be available

2. Each of the events has not SPRINT tests and no optometry:

a. Will an audiologist be needed for H2 CAE?

Answer: No audiologist will be needed.

b. Is the Snellen eye chart and near vision test sufficient for vision requirements (no optometrist needed; only opto tech)?

Answer: Yes, the Snellen eye chart and near vision test sufficient for vision requirements.

3. Are the MMR and VAR listed in three of the four sites immunizations or titres? If titres, how many of the numbers listed are titres?

Answer: Immunizations only

4. Regarding 5.4 On site at Event & Post-Event Case Management of Dental Exam & General/Specialty Treatment Services… Contractor to setup network & account with local general & specialty fixed-site dental facilities and offices near event location and/or home of NCARNG soldier

a. What would be considered an “On site at Event” Case Management item? Does this speak to dental emergencies or is this saying all Cat 3 treatment needs can be transported to local providers near the sites?

Answer: Cat 3 treatment that can be completed on the dental treatment vehicle.

Fillings, simple extractions, ½ rooted root canals.

b. Is the contractor or NCARNG case managing the following:

i. Endo retreats

ii. Lab-fabricated prosthodontics

iii. Difficult surgical extractions requiring sedation or sterile surgical setting

Answer: For dental treatments that cannot be completed on site, the NCARNG will initiate a dental voucher for the Solider that the NCARNG will manage.