Flight_PWS.docx
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- W9124X19Q0013
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Performance Work Statement
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PERFORMANCE WORK STATEMENT (PWS)
FOR
Flight Physician
1.0 General:
1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Aeromedical Services, as defined in this PWS.
1.2 Background: Individual Medical Readiness (IMR) and Fully Medically Ready (FMR) are the basic principles of force-sustainment for Army National Guard (ARNG) forces. Medical readiness is vital for force health protection and failure to achieve a standard of level of medical and dental health could preclude a Soldier from completing necessary aviation missions and deployment. Medical Readiness is a command responsibility. This Performance Work Statement (PWS) is to cover the various components of IMR/FMR to include but not limited to: Medical: Blood Pressure, height & weight, and questionnaire screening, Periodic Health Assessments (PHAs), and Flight Physicals in accordance with AR (Army Regulations) 40-501. Screening for visual acuity and optometry exams, DOEHRS compatible audiometry exams and SPRINT testing for H3 Soldiers as necessary. AERO data entry of all applicable and appropriate IMR/FMR functions with approval of the NVARNG DSS or Designee data entry not to exceed five (5) business days after the event. Services are to be completed on site at NVARNG Armories in Carson City, NV and Reno, NV. The PWS identifies the purpose of the work to be performed by the contractor and provides a description of the work to be completed and any required outcomes. The contractor shall provide qualified personnel and material to perform the services. Personnel will maintain compliance with OSHA, HIPAA, Privacy Act, and appropriate credentialing.
1.3 Period of Performance (PoP): The Period of Performance shall not to exceed nine (9) months, August 2019 – April 2020. The following schedule will be in effect: 6-8 August 2019, 20-22 August 2019, 3-5 September 2019, 17-19 September 2019,1-3 October 2019, 15-17 October 2019, 29-31 October 2019, 5-7 November 2019, 19-21 November 2019, 3-5 December 2019, 17-19 December 2019, 7-9 January 2020, 21-23 January 2020, 4-6 February 2020, 18-20 February 2020, 3-5 March 2020, 17-19 March 2020 and 31 March – 02 April 2020.
1.4 General Information:
1.4.1 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary (PRS). A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after contract award. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.
1.4.2 Quality Assurance (QA): The Government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government will do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) or defect rate(s).
1.4.3 Recognized Holidays: The following are recognized United States (US) holidays. The contractor shall not perform services on these days:
1.4.3.1 New Year’s Day: January 1st
1.4.3.2 Martin Luther King, Jr.’s Birthday
1.4.3.3 President’s Day
1.4.3.4 Memorial Day
1.4.3.5 Independence Day: July 4th
1.4.3.6 Labor Day
1.4.3.7 Columbus Day
1.4.3.8 Veteran’s Day: November 11th
1.4.3.9 Thanksgiving Day
1.4.3.10 Christmas Day: December 25th
1.4.4 Place and Performance of Services: The contractor shall provide services between the hours of 0730 – 1700 Pacific Time on the scheduled dates established in the PoP. Performance shall be at OTAG: 2460 Fairview Drive, Carson City, NV 90701; PLA: 685 East Plumb Lane, Reno, NV 89502; The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential. Teleworking is authorized.
1.4.4.1 Telework: Not Applicable.
1.4.4.2 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.
1.4.4.3 The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times, and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance. The Government reserves the right to direct the removal of an employee for misconduct, security reasons, or any overt evidence of communicable disease. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.
1.4.5 Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DoD), Headquarters Department of Army (HQDA) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.
1.4.5.1 For contractors requiring Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential. CAC issuance requirements are as follows:
In accordance with Department of Defense Manual (DoDM) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. The issuance of a CAC will be based on four criteria: (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 3, 2017, and (d) verification of a claimed identity. Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID System (RAPIDS) using the DD Form 1172-2, or the Trusted Associate Sponsorship System (TASS).
1.4.5.1.1 HSPD-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them, and shall process all CAC card applications. The contractor shall ensure that all employees requiring an initial background investigation complete a Personnel Security Investigation Portal (PSIP) form at Attachment TBD, at the earliest possible date and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward it to the National Guard Bureau (NGB) Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm that the investigative service provider has received the request, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e-QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the background investigation (BI) will be initiated. The contractor shall ensure immediate compliance with all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from two to six weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that contractor employees meet CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.
1.4.5.1.2 Trusted Associate Sponsorship System (TASS): The contractor shall process CAC applications through the TASS, the procedures for which are described below. Although there is no requirement for the contractor to designate a “Corporate Facility Security Officer" (FSO) to serve as its single point of contact for the BI, the TASS application process and other CAC and security-related matters, such designation facilitates these processes. If an FSO is not established, all contractor employees requiring a CAC will be required to process their own applications. The submission process for CAC applications is as follows:
1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA). The TASS TA for this requirement will be: TBD
2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at: https://www.dmdc.osd.mil/tass/. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.
3. The Government will inform the contractor's applicant, via email, of one of the following:
a. Approval.* Upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a RAPIDS station (RAPIDS Site Locator: http://www.dmdc.osd.mil/rsl/).
b. Rejection.* The Government, in separate correspondence, will provide reason(s) for rejection.
c. Return. Additional information or correction to the application required by the contractor employee.
*The contractor shall maintain records of all approved and rejected applications.
1.4.5.1.3 At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification. Identity source documents must come from the list of acceptable documents included in Form I-9, OMB No. 1615-0047, "Employment Eligibility Verification." Consistent with applicable law, at least one document from the Form I-9 list shall be a valid (unexpired) State or Federal Government-issued picture ID. The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS, and will then issue a CAC. Issued CACs will be valid for no longer than three years, or until the individual's contract end date (inclusive of any options), whichever is earlier.
1.4.5.1.4 The contractor shall return issued CACs to the DEERS office upon departure or dismissal of each contractor employee, and shall obtain a receipt for each card and provide it to the TA/COR.
1.4.5.1.5 The contractor shall manage requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The contractor shall provide at least 10 calendar days advance notice to the TA, unless there are extenuating circumstances approved by the COR or KO.
1.4.5.1.6 The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a government computer network. This can be done by going to: http://www.us.army.mil and registering as an "Army Guest," with the sponsor being the COR or a COR- designated individual if the COR is ineligible to Serve as an AKO Sponsor. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.
1.4.5.2 Reserved.
1.4.5.3 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to COMSEC review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DoD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DoD organizations. Therefore, the contractor is advised that any time contractor personnel place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DoD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.
1.4.5.4 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the Army Enterprise Info-structure (AEI). Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall:
1.4.5.4.1 Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.
1.4.5.4.2 Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil).
1.4.5.4.3 Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.
1.4.5.4.4 Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.
1.4.5.4.5 Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.
1.4.5.5 Protection of Personally Identifiable Information (PII). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.
1.4.5.6 AT Level 1 Awareness Training (AT): All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete Level 1 AT within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee to the COR within 15 calendar days after completion of training. Level 1 AT is available at http://jko.jten.mil/courses/atl1/launch.html .
1.4.5.7 Information Assurance (IA)/Information Technology (IT) Training: All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.
1.4.5.8 Information Awareness: All contractor employees with access to a government information system shall be registered in the Army Training Certification Tracking System (ATCTS) (https://atc.us.army.mil/iastar/index.php) at commencement of services, and shall successfully complete the DoD Information Assurance awareness training prior to access to the IS and then annually thereafter. (https://ia.signal.army.mil/DoDIAA/).
1.4.5.9 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program. This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR) within 15 calendar days after completion of training.
1.4.5.10 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 15 calendar days after completion of training. Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.
1.4.5.11 OPSEC SOP/Plan. Not Applicable
1.4.5.12 Classified Information. Not Applicable.
1.4.5.13 Threat Awareness and Reporting Program (TARP). Per AR 381-12, Threat Awareness and Reporting Program (TARP), contractor employees with security clearances must receive annual TARP training by a counterintelligence (CI) agent or other trainer as specified in Chapter 2 Threat Awareness and Education, Section II, paragraph 2-4b. The contractor shall identify annual TARP training, personnel trained and date of training.
1.4.6 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.
1.4.6.1 Key Control. NOTE: All references to keys include key cards. The contractor shall establish and implement methods of ensuring that no keys/key cards issued by the Government are lost or misplaced or are used by unauthorized persons. No keys issued by the Government shall be duplicated. The contractor shall include procedures covering key control in the QCP. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the COR.
1.4.6.1.1 In the event keys, other than master keys, are lost or duplicated, the contractor shall, upon direction by the KO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the Government replaces or re-keys the locks, the Government will deduct the total cost of lock replacement or re-keying from the monthly payment due the contractor. In the event a master key is lost or duplicated, the Government will replace all locks and keys for that system, and will deduct the total cost from the monthly payment due the contractor.
1.4.6.1.2 The contactor shall prohibit the use of the Government issued keys/key cards by any persons other than the contractor’s employees. The contractor shall prohibit the opening of locked areas by contractor employees to permit entrance of persons other than contactor employees engaged in the performance of services in those areas, or personnel authorized entrance by the KO.
1.4.6.2 Lock Combinations: Not Applicable.
1.4.7 Special Qualifications: The contractor shall ensure all employees possess all required licenses for skills applicable
1.4.8 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR Subpart 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will apprise the contractor of how the Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.
1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.
1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities. Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed. The contractor shall retrieve all identification media (including vehicle passes) from its employees who depart employment for any reason. The contractor shall return all identification media (i.e., badges and vehicles passes) to the KO within 14 days of an employee’s departure.
1.4.11. Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.
1.4.12 Contractor Travel
1.4.12.1 The contractor shall travel to OTAG: 2460 Fairview Drive, Carson City, NV 90701; PLA: 685 East Plumb Lane, Reno, NV 89502; during the performance of this contract to ensure proper coverage for aviation medical readiness events.
1.4.12.2 The contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires COR recommendation for approval and/or authorization by the KO prior to travel arrangements being made. A separate Not to Exceed (NTE) Contract Line Item Number (CLIN) will be added to the contract to pay for travel expenses. Note: COR may authorize travel if fully funded travel CLIN exists and funding is validated prior to travel arrangements being made. KO approval is only necessary if funding is unavailable for KO has retained COR responsibilities.
1.4.13 Data Rights: The Government has unlimited rights to all documents/materials produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.
1.4.14 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.
1.4.15 Phase-In / Phase-Out Periods: Not Applicable.
1.4.16 Other Requirements: The contractor shall establish a safety and health program in accordance with the standards of the Federal Occupational Safety and Health Standard (OSHA), Health Information Portability and Accountability Act (HIPPA), the Privacy Act and the American Dental Association (ADA). PWS is “UNCLASSIFIED” and under HIPAA guidelines.
1.4.16.1 Additional Training: The contractor will complete HIPAA training at http://www.health.mil/Training-Center/Joint-Knowledge-Online-JKO (https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf).
2.0 Definitions and Acronyms:
2.1 Definitions:
2.1.1 Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.
2.1.2 Contracting Officer (KO): A person with authority to enter into, administer, and 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 Representative (COR): An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will 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 Defective Service: A service output that does not meet the standard of performance associated with the PWS.
2.1.5 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.
2.1.6 Key Personnel: Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.
2.1.7 Physical Security: Actions that prevent the loss or damage of Government property.
2.1.8 Quality Assurance: The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.
2.1.9 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.
2.1.10 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements.
2.1.11 Subcontractor: One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.
2.2 Acronyms:
| ADA | American Dental Association |
| AEI | Army Enterprise Infostructure |
| AR | Army Regulation |
| AT/OPSEC | Antiterrorism/Operational Security |
| BI | Background Investigation |
| CM | Contract Manager |
| CMRA | Contractor Manpower Reporting Application |
| COR | Contracting Officer Representative |
| DA | Department of the Army |
| DD254 | Department of Defense Contract Security Classification Specification |
| DSS | Deputy State Surgeon |
| DFARS | Defense Federal Acquisition Regulation Supplement |
| DoD | Department of Defense |
| DNA | Deoxyribonucleic Acid |
| DTR | Dental Treatment Record |
| FAR | Federal Acquisition Regulation |
| FMR | Fully Medically Ready |
| GFP/M/E/S | Government Furnished Property/Material/Equipment/Services |
| HCG | Human Chorionic Gonadotropin |
| HIPAA | Health Insurance Portability and Accountability Act |
| HIV | Human Immunodeficiency Virus |
| HQDA | Headquarters, Department of the Army |
| HSPD | Homeland Security Presidential Directive |
| IA | Information Assurance |
| IMR | Individual Medical Readiness |
| IS | Information System(s) |
| KO | Contracting Officer |
| MEB | Medical Evaluation Board |
| MEDCOM | U.S. Army Medical Command |
| MEDPROS | Medical Protection System |
| MMRB | Medical MOS Retention Board |
| MODS | Medical Operational Data System |
| NGB | National Guard Bureau |
| OCI | Organizational Conflict of Interest |
| OSArS | Office of the State Army Surgeon |
| OSHA | Occupational Safety and Health Administration |
| PDHRA | Post Deployment Health Reassessment |
| PEB | Physical Evaluation Board |
| PHA | Periodic Health Assessment |
| PII | Personally Identifiable Information |
| PIPO | Phase In/Phase Out |
| POC | Point of Contact |
| PPD | Tuberculosis/Tuberculin Skin Test |
| PRS | Performance Requirements Summary |
| PWS | Performance Work Statement |
| QA | Quality Assurance |
| QASP | Quality Assurance Surveillance Plan |
| QC | Quality Control |
| QCP | Quality Control Program |
| RDA | Registered Dental Assistant |
| RPR | Rapid Plasma Reagin |
| SRC | Soldier Readiness Check |
| SRP | Soldier Readiness Processing |
| SSN | Social Security Number |
| STR | Soldier Treatment Record |
| TE | Technical Exhibit |
| TMC | Troop Medical Clinic |
| USD(I) | Under Secretary of Defense for Intelligence |
3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S): The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:
3.1 Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include an office, desk space, telephones, computers, monitors, electronic medical record compatible scanner and other items necessary to maintain an office environment. All property issued will be done utilizing DA 3161, Request for Issue or Turn in that will be maintained by the COR or designated representative.
3.1.1 Access to a printer, copier, scanner, copier, and fax machine (may be shared and not individually provided.)
3.2 Materials: N/A
3.3 Equipment: The government will provide required computers, scanners, telephones, and materials necessary to comply with contract requirements at the job site (listed in 3.1).
3.4 Services: N/A
3.5 Utilities: All utilities in the facility will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.
4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):
4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.1, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.
4.2 Secret Facility Clearance: Not applicable
5.0 Requirements:
5.1 The contractor shall provide Aviation Medical Support for the NVARNG. The Flight Physician shall support the NVARNG, State Surgeon’s Office, and the Deputy State Surgeon in all aspects of maintaining and supporting ARNG Aviation Medical Readiness for 130 Soldier’s within the Organization. Contractor must be a licensed flight qualified provider. Contractor must have access to AHLTA and AERO systems.
5.1.1 The contractor shall conduct flight physical exams in accordance with the AR 40-501 to include the clinical portions of a flight physical. The contractor shall conduct physicals in a HIPAA, Privacy Act and OSHA Compliant designated area. All professionals shall be licensed and adhere to all requirements of OSHA, State & Federal Regulations is mandatory.
5.1.1.1 Initial and Comprehensive FDME: Performed on the same DD Form 2807-1 and DD Form 2808 on which other military physicals are performed. When the crewmember shows up for Part 1 of his/her FDME, he/she should fill out all the demographic data either on paper and/or directly to AERO. All entries (dental, optometry, etc.) should be annotated either electronically or manually. Submission to USAAMA when completed should be done via AERO.
5.1.1.2 Interim FDHS/Flying Duty Health Screen: Performed on DD Form 2807-1 and DA Form 4497-R and entered as detailed in the paragraph above. Submission to USAAMA should be done via AERO. DA Form 4497-R or DD Form 2808 with the DD Form 2807-1 and the required USPSTF age-specific counseling and screening meet the requirement for the annual PHA and must be documented in AERO.
5.1.1.3 The DD Form 2807-1 and DD Form 2808 or the DA Form 4497-R, whichever is submitted to meet requirements, must be reviewed. Submission in AERO will put an electronic signature on the forms. All physicals submitted by any method other than AERO requires a manual signature on the physical forms. ECGs with abnormal readings may be requested by USAAMA but remember to code the interpretation on the AERO FDME or FDHS.
5.1.1.4 Extensions: If the FDME or FDHS cannot be performed prior to the end of the birth month, the aviator may request and the flight surgeon may grant a one calendar month extension (to the last day of the following month). An extension must be requested in the birth month prior to the end of the birth month. Any extensions requested and granted in the month after the birth month are not valid. The effective date of the extension is the day it was requested.
5.1.1.5 Aviation Unique Special Tests: The flight physical is conducted just like any other physical exam. The procedure is the same. There are a few items that are commonly checked on the flight physical that most physicians are unfamiliar with because they are unique. Some of these items may be performed somewhat differently between the various military services and the FAA. These tests and procedure instructions are written in the form of US Army Aeromedical Technical Bulletins (ATB). Aeronautical Adaptability is found in the APLs and AR 40-501 and the remaining topics below are in the ATBs.
-The Valsalva Maneuver -Reading Aloud Test -Anthropometrics -Cycloplegic Refraction -Color Vision Testing -Binocular Depth Perception -Aeronautical Adaptability -Aeromedical Graded Exercise Tolerance (AGXT) Test
5.1.1.6 DD Form 2992: The aeromedical provider first makes the fitness for duty determination after careful examination and thoughtful application of current aeromedical standards and annotating such on the DD Form 2992, Medical Recommendation For Flying or Special Operational Duty,(up and downslip).
5.1.1.7 Waivers: Waiver [WR (Waiver recommended), WG (Waiver granted)]: For most aeromedical summaries, USAAMA will recommend a waiver from the waiver authority. A document, waiver letter, from the waiver authority (e.g. HRC, NGB, or DAC/contract officials) grants continued flight status in spite of a disqualifying defect. This document waives the requirement for the aviator to meet a specific medical standard and provides the annual waiver requirements to maintain the waiver specified. Medical to include USAAMA recommends waivers and the waiver authority grants the waiver.
5.1.2 The contractor shall conduct PHAs in accordance with the PHA guidance set forth by the Department of Defense Instruction 6200.06. The contractor must utilize either OSHA-Compliant Mobile Health Practices and/or sites determined by the ARNG. Compliance with OSHA, State & Federal Regulations is mandatory.
5.1.3 The contractor shall review the medical records and AHLTA for disqualifying medical conditions. The goal is to ensure maintenance of aircrew health, fitness for aviation duty, and to serve as an opportunity for health promotion. With the introduction of the annual PHA, additional screening and counseling requirements will be set forth in AERO so all annual military needs are met in one setting. To ensure the annual FDME or FDHS meets the requirements for a PHA, all should be familiar with the United States Preventive Services Task Force (USPSTF) requirements and any modifications to the USPSTF recommendations as detailed in AR 40-501, chapter 8. The USPSTF homepage can be found at http://www.uspreventiveservicestaskforce.org.
5.2 Contractor Manpower Reporting Application (CMRA):
5.2.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Nevada Army National Guard via a secure data collection site. The Unit Identification Code (UIC) for the Requiring Activity is W90092, and the Issuing Office DoDAAC is W9124X.
5.2.2 The contractor shall completely fill in all required data fields using the following web address: http://www.ecmra.mil/. Reporting inputs shall 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, beginning with 2020. Contractors may direct questions to the help desk at http://www.ecmra.mil.
6.0 Applicable Publications: Publications applicable to this PWS are listed below:
Publication (Chapter/Page)
| Date of Publication |
| Mandatory or Advisory |
| Website |
Federal Acquisition Regulation https://www.acquisition.gov/?q=browsefar
Defense Federal Acquisition Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html
DoDM 1000.13-M-V1 DoD Identification (ID) Cards (Enclosure 2, paragraph 3.b) 01/23/2014 http://www.esd.whs.mil/Directives/issuances/dodm/
Federal Information Processing Standards (FIPS) Publication 201-2 Personal Identity Verification (PIV) of Federal Employees and Contractors (paragraph 9) August 2013 http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201-2.pdf
| DoDM 5200.2 Regulation 5200.02 Procedures for the DoD Personnel Security Program (PSP) |
| 04/03/2017 |
http://www.dtic.mil/whs/directives/corres/pub1.html
Army Directive 2014-05 Policy and Implementation Procedures for Common Access Card Credentialing and Installation Access for Uncleared Contractors
03/07/2014 http://www.apd.army.mil/ProductMaps/PubForm/ArmyDir.aspx
AR 190-13
The Army Physical Security Program 02/25/2011 http://www.apd.army.mil/ProductMaps/PubForm/AR.aspx
Homeland Security Presidential Directive (HSPD)-12 Policy for a Common Identification Standard for Federal Employees and Contractors 08/27/2004 https://www.dhs.gov/homeland-security-presidential-directive-12
DoDD 5400.11 Department of Defense Privacy Program 10/29/2014 http://www.dtic.mil/whs/directives/corres/dir.html#
DoD 5400.11-R Department of Defense Privacy Program
05/14/2007 http://www.dtic.mil/whs/directives/corres/pub1.html
DoDD 8140.01 Cyberspace Workforce Management
| 08/11/2015 |
| OK |
| http://www.dtic.mil/whs/directives/corres/dir.html |
DoD 8570.01-M Information Assurance Workforce Improvement Program
| 12/19/2005 (Change 4: 11/10/2015) |
| OK |
| http://www.dtic.mil/whs/directives/corres/pub1.html |
AR 25-2
Information Assurance
| 10/24/2007 |
| OK |
| http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx |
AR 530-1
Operations Security
| 09/26/2014 |
| OK |
| http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx |
DoD 5220.22-M National Industrial Security Program Operating Manual 02/28/2006 (Change 2: 05/18/2016)
| OK |
| http://www.dtic.mil/whs/directives/corres/pub1.html |
AR 381-12
Threat Awareness and Reporting Program (TARP) (Section II, ¶ 2-4.b)
| 06/01/2016 |
| OK |
| http://armypubs.army.mil/ProductMaps/PubForm/AR.aspx |
AR 40-501
Standards of Medical Fitness 06/14/2017 https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/ARN3801_AR40-501_Web_FINAL.pdf
AR 40-35
Dental Readiness & Community Oral Health Prevention 07/16/2016 https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/AR%2040-35_Final_Web_ARN641.pdf
DODi 6200.06 Periodic Health Assessment 09/8/2016 https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/DODi/620006p.pdf
| Army National Guard Implementation Guidance on Selected Reserve (SELRES) Dental Readiness System (ASDRS) for providing Dental Treatment outside of Alert. |
| 05/28/2012 |
https://apps.dtic.mil/dtic/tr/fulltext/u2/a592706.pdf
| Flight Physician Checklist |
| 5/2015 |
https://vfso.rucker.amedd.army.mil/public/downloads/Army_APLs_May2015.pdf
6.1 Applicable Forms: Forms applicable to the PWS are listed below:
| Form |
| Date |
| Website |
DD 1172-2
Application for Identification Card/DEERS Enrollment
| Mar 2017 |
| http://www.dtic.mil/whs/directives/forms/index.htm |
I-9 Employment Eligibility Verification
| 11/14/16 |
| https://www.uscis.gov/sites/default/files/files/form/i-9.pdf |
DD 441
Department of Defense Security Agreement
| Jan 2017 |
| http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm |
DD 2992
Medical Recommendation for Flight Duties
| 1/1/2015 |
| https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd2992.pdf |
DD 2808
Report of Medical Exam
| 10/1/2005 |
| https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd2808.pdf |
DD 2807-1
Report of Medical History
| 10/29/2005 |
| https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd2807-1.pdf |
DA 4497
Interim (Abbreviated) Flying Duty Medical Examination
| 3/1/2002 |
| https://armypubs.army.mil/pub/eforms/DR_a/pdf/A4497.pdf |
TECHNICAL EXHIBIT 1
Performance Requirements Summary (PRS) This PRS includes performance objectives the Government will use to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).
| Performance Objective |
| Performance Standard |
| Acceptable Quality Levels (AQL) |
| Surveillance Method / By Whom |
| 5.1.1 The contractor shall conduct flight physical exams in accordance with the AR 40-501 to include the clinical portions of a flight physical. The contractor shall conduct physicals in a HIPAA, Privacy Act and OSHA Compliant designated area. All professionals shall be licensed and adhere to all requirements of OSHA, State & Federal Regulations is mandatory. |
| Initial and follow up screenings will be conducted |
| 90% of screenings will be conducted within during the three days with 10% left for follow up. |
| Periodic inspection and random monitoring by COR. |
| 5.1.1.1 Initial and Comprehensive FDME: Performed on the same DD Form 2807-1 and DD Form 2808 on which other military physicals are performed. When the crewmember shows up for Part 1 of his/her FDME, he/she should fill out all the demographic data either on paper and/or directly to AERO. All entries (dental, optometry, etc.) should be annotated either electronically or manually. Submission to USAAMA when completed should be done via AERO. |
| Initial and follow up screenings will be conducted |
| 90% of screenings will be conducted within during the three days with 10% left for follow up. |
| Periodic inspection and random monitoring by COR. |
| 5.1.1.2 Interim FDHS/Flying Duty Health Screen: Performed on DD Form 2807-1 and DA Form 4497-R and entered as detailed in the paragraph above. Submission to USAAMA should be done via AERO. DA Form 4497-R or DD Form 2808 with the DD Form 2807-1 and the required USPSTF age-specific counseling and screening meet the requirement for the annual PHA and must be documented in AERO. |
| Initial and follow up screenings will be conducted |
| 90% of screenings will be conducted within during the three days with 10% left for follow up. |
| Periodic inspection and random monitoring by COR. |
| 5.1.1.3 The DD Form 2807-1 and DD Form 2808 or the DA Form 4497-R, whichever is submitted to meet requirements, must be reviewed. Submission in AERO will put an electronic signature on the forms. All physicals submitted by any method other than AERO requires a manual signature on the physical forms. ECGs with abnormal readings may be requested by USAAMA but remember to code the interpretation on the AERO FDME or FDHS. |
| Initial and follow up screenings will be conducted |
| 90% of screenings will be conducted within during the three days with 10% left for follow up. |
| Periodic inspection and random monitoring by COR. |
| 5.1.1.4 Extensions: If the FDME or FDHS cannot be performed prior to the end of the birth month, the aviator may request and the flight surgeon may grant a one calendar month extension (to the last day of the following month). An extension must be requested in the birth month prior to the end of the birth month. Any extensions requested and granted in the month after the birth month are not valid. The effective date of the extension is the day it was requested. |
| As required |
| 90% of initiated extensions will be conducted within during the three days with 10% left for follow up. |
| Periodic inspection and random sampling by COR. |
| 5.1.1.5 Aviation Unique Special Tests: The flight physical is conducted just like any other physical exam. The procedure is the same. There are a few items that are commonly checked on the flight physical that most physicians are unfamiliar with because they are unique. Some of these items may be performed somewhat differently between the various military services and the FAA. These tests and procedure instructions are written in the form of US Army Aeromedical Technical Bulletins (ATB). Aeronautical Adaptability is found in the APLs and AR 40-501 and the remaining topics below are in the ATBs. |
| Initial and follow up screenings will be conducted. |
| 90% of screenings will be conducted within during the three days with 10% left for follow up. |
| Periodic inspection and random sampling by COR. |
| 5.1.1.6 DD Form 2992: The aeromedical provider first makes the fitness for duty determination after careful examination and thoughtful application of current aeromedical standards and annotating such on the DD Form 2992, Medical Recommendation For Flying or Special Operational Duty,(up and downslip). |
| Completed at the time of submission to Fort Rucker (except Initial physicals). Completed when medical DQ or clearance has been established. |
| Less than 1% error rate |
| Monthly inspection and random sampling by COR |
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