W912GY-16-T-0030.pdf

SEE ADDENDUM

(No Collect Calls)

W912GY-16-T-0030 28-Jun-2016

b. TELEPHONE NUMBER

530-827-4776

8. OFFER DUE DATE/LOCAL TIME

10:00 AM 28 Jul 2016

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.

W912GY9. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

LISSA KAARBO

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

SEE SCHEDULE

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

SIERRA ARMY DEPOT

CONTRACTING OFFICE

74 C STREET BUILDING 60

HERLONG CA 96113

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 W62G2W 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

DIRECTORATE OF RISK MANAGEMENT

SAFETY OFFICE

SIERRA ARMY DEPOT

HERLONG CA 96113

TEL: 530-827-4431 FAX: 530-827-4866

530-827-4722FAX:

TEL: 530-827-5146 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$7,500,000

NAICS:

621320

X

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 OF54

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.

W912GY-16-T-0030

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1001 300 Each Base Year- Optometry Services

FFP

Description: Exam and Fitting for a base year 1 September 2016 through 31 August 2017 per the provided statement of work. Contractor shall provide per service below. The government estimates 300 exams per year.

Eye Exam $________________ Prescription Eye Wear Fitting $_________________ FOB: Destination

NSN: AASSVC609200Y4

MILSTRIP: W62G2W609200Y4

PURCHASE REQUEST NUMBER: W62G2W609200Y4

NET AMT

1002 1 Lot Base Year- Optometry Eye Wear

FFP

Description: Prescription Glasses, Lens, Frames and Tinting for a Base year 1 September 2016 through 31 August 2017 per the statement of work provided.

Contractor Shall provide price per service below. The government estimates not-to-exceed 300 as per CLIN 1001.

Single Vision Clear Lens $_____________________ F-28 Bi Focal Clear Lens $_____________________ Tri-Focal Clear Lens $_________________________ Prescription Safety Frames $___________________ Lens Tinting $____________________ FOB: Destination

NSN: AASSVC609200Y5

MILSTRIP: W62G2W609200Y5

PURCHASE REQUEST NUMBER: W62G2W609200Y5

1003 1 Each

CMR

FFP

Description: Contractor Manpower Reporting in accordance with Clause 52.237- 4000. The CMR is a government requirement for all service contracts that include labor. The contractor is required to login into the CMR website after completion of the contract and record labor hours worked in support of the contract. Typically requires approximately 2-3 hours of time. Contractor can include in bid a reasonable rate to comply or leave as "no charge".

FOB: Destination

NSN: AASSVC609200Y4

MILSTRIP: W62G2W609200Y4

PURCHASE REQUEST NUMBER: W62G2W609200Y4

2001 300 Each OPTION Option Year 1- Optometry Services

FFP

Description: Exam and Fitting for an option year of 12 months per the provided statement of work. Contractor shall provide per service below. The government estimates 300 exams per year.

Eye Exam $________________ Prescription Eye Wear Fitting $_________________ FOB: Destination

2002 1 Lot OPTION Option Year 1- Optometry Eye Wear

FFP

Description: Prescription Glasses, Lens, Frames and Tinting for an option year of 12 months per the statement of work provided. Contractor Shall provide price per service below. The government estimates not-to-exceed 300 as per CLIN 1001.

Single Vision Clear Lens $_____________________ F-28 Bi Focal Clear Lens $_____________________ Tri-Focal Clear Lens $_________________________ Prescription Safety Frames $___________________ Lens Tinting $____________________

2003 1 Each

OPTION CMR

FFP

Description: Contractor Manpower Reporting in accordance with Clause 52.237- 4000. The CMR is a government requirement for all service contracts that include labor. The contractor is required to login into the CMR website after completion of the contract and record labor hours worked in support of the contract. Typically requires approximately 2-3 hours of time. Contractor can include in bid a reasonable rate to comply or leave as "no charge".

3001 300 Each OPTION Option Year 2- Optometry Services

FFP

Description: Exam and Fitting for an option year of 12 months per the provided statement of work. Contractor shall provide per service below. The government estimates 300 exams per year.

Eye Exam $________________

3002 1 Lot OPTION Option Year 2- Optometry Eye Wear

FFP

Description: Prescription Glasses, Lens, Frames and Tinting for an option year of 12 months per the statement of work provided. Contractor Shall provide price per service below. The government estimates not-to-exceed 300 as per CLIN 1001.

Single Vision Clear Lens $_____________________ F-28 Bi Focal Clear Lens $_____________________ Tri-Focal Clear Lens $_________________________ Prescription Safety Frames $___________________

3003 1 Each

OPTION CMR

FFP

Description: Contractor Manpower Reporting in accordance with Clause 52.237- 4000. The CMR is a government requirement for all service contracts that include labor. The contractor is required to login into the CMR website after completion of the contract and record labor hours worked in support of the contract. Typically requires approximately 2-3 hours of time. Contractor can include in bid a

4001 300 Each OPTION OptionYear 3- Optometry Services

FFP

Description: Exam and Fitting for an option year of 12 months per the provided statement of work. Contractor shall provide per service below. The government estimates 300 exams per year.

Eye Exam $________________

4002 1 Lot OPTION Option Year 3- Optometry Eye Wear

FFP

Description: Prescription Glasses, Lens, Frames and Tinting for an option year of 12 months per the statement of work provided. Contractor Shall provide price per service below. The government estimates not-to-exceed 300 as per CLIN 1001.

Single Vision Clear Lens $_____________________ F-28 Bi Focal Clear Lens $_____________________ Tri-Focal Clear Lens $_________________________ Prescription Safety Frames $___________________

4003 1 Each

OPTION CMR

FFP

Description: Contractor Manpower Reporting in accordance with Clause 52.237- 4000. The CMR is a government requirement for all service contracts that include labor. The contractor is required to login into the CMR website after completion of the contract and record labor hours worked in support of the contract. Typically requires approximately 2-3 hours of time. Contractor can include in bid a

5001 300 Each OPTION Option Year 4- Optometry Services

FFP

Description: Exam and Fitting for an option year of 12 months per the provided statement of work. Contractor shall provide per service below. The government estimates 300 exams per year.

Eye Exam $________________

5002 1 Lot OPTION Option Year 4- Optometry Eye Wear

FFP

Description: Prescription Glasses, Lens, Frames and Tinting for an option year of 12 months per the statement of work provided. Contractor Shall provide price per service below. The government estimates not-to-exceed 300 as per CLIN 1001.

Single Vision Clear Lens $_____________________ F-28 Bi Focal Clear Lens $_____________________ Tri-Focal Clear Lens $_________________________ Prescription Safety Frames $___________________

5003 1 Each

OPTION CMR

FFP

Description: Contractor Manpower Reporting in accordance with Clause 52.237- 4000. The CMR is a government requirement for all service contracts that include labor. The contractor is required to login into the CMR website after completion of the contract and record labor hours worked in support of the contract. Typically requires approximately 2-3 hours of time. Contractor can include in bid a

STATEMENT OF WORK

Sierra Army Depot Optometry Services Statement of Work

INTRODUCTION/SERVICES

Contractor shall provide optometry services and all labor, transportation/travel, licenses/permits/certificates, and staff required to provide optometry services to employees at Sierra Army Depot (SIAD), located in Herlong, California. The Contractor assumes full responsibility for the provision of these professional eye care services.

Contractor shall provide optometry visual services in accordance with Medical Standards of Care and national standards. Services shall include primary eye and vision care for the diagnosis, visual treatment and prevention of associated disorders for the improvement of vision by the prescription of spectacles and/or by use of functional or optical means as regulated by law.

LICENSES/PERMITS/CERTIFICATIONS REQUIREMENTS

The Contractor must be licensed to practice optometry and must either be:

An Optometrist with a Certificate of Registration to practice Optometry issued by the State Board of Optometry, or

An Ophthalmologist with a Physician’s license, specialty in Ophthalmology, issued by the State Medical Board; or

A Health Care Service Plan with a Department or Corporations Health Maintenance Organization license.

In addition, the Contractor shall be a Diagnostic Pharmaceutical Agent (DPA) certified by the State Board of Optometry to use diagnostic pharmaceutical agents.

Contractor shall be certified by the State Board of Optometry to use Therapeutic Pharmaceutical Agents (TPAs).

Contractors shall meet all terms and conditions for operating a business in the location in which the business in headquartered. Contractors shall submit an affidavit to show that the business is in good standing in that state, province, or country.

A copy of the Contractor’s license, and all other required licenses, permits and certifications, must be submitted with the Contractor’s Bid Proposal and remain valid throughout the term of the contract. There must be no current or prospective limitations on said licenses, permits or certifications.

For continuation of privileges with SIAD, the Contractor shall be responsible for the timely renewal of all providers State issued identification card and any other licenses and/or certifications required to perform optometry. The Contractor shall maintain such licenses at Contractor’s expense. The preceding shall also be a condition of SIAD’s obligation to pay for services provided under this contract.

Contractor is responsible for verifying through the appropriate licensing board that no adverse actions have been taken by the State licensing authorities against any optometrist/ ophthalmologist assigned to SIAD and that all licenses are active and void of misconduct. SIAD may, at its discretion, verify the current status of the optometrist/ophthalmologist assigned.

CONTRACTOR RESPONSIBILITIES

Contractor shall ensure that all ordered optometry services would be scheduled consistent with the optometry need. Once scheduled, service shall be delivered at the time scheduled unless unavoidable circumstances occur.

Contractor shall provide examination to obtain prescription information for safety glasses only.

Upon request, the Contractor shall provide a copy of the examination to the Safety Office who may provide a copy to the employee for their records. Contractor shall maintain records of examination for the length of the contract period.

Contractor shall at Contractor’s expense, provide professional staff necessary to perform all of the optometry services as defined by applicable statutes and regulations pertaining to optometry services.

Contractor shall, at Contractor’s expense, provide and maintain the organizational and administrative capabilities to carry out the Contractor’s duties and responsibilities under this contract and all applicable statutes and regulations pertaining to optometry service.

Contractor shall maintain continuity of all work performed from start to finish.

The Contractor shall make every effort to provide the same fully licensed optometrist on an ongoing basis for the term of the contract.

Contractor or their employees shall provide professional service to Sierra Army Depot Employees. Any complaints will be investigated by the Depot Safety Office with no more than 2 valid cases of unprofessional conduct being sustained during the contract year.

SIERRA ARMY DEPOT RESPONSIBILITIES

SIAD shall issue all policies and procedures pertaining to patient treatment.

SIAD reserves the right to establish written criteria for the provision of optometry services under the contract.

OPTOMETRY SERVICES (MINIMUM REQUIREMENTS):

Optometry services under this contract shall include, but not be limited to the following:

I. Complete optometry/optometric evaluation/diagnostic assessment.

A. FULL EXAMINATION

1. Preliminary Testing

a. Cover Test Near and Far

b. Anterior segment exam

c. Rotations

d. Pupils

2. Ophthalmoscopy (undilated)

3. Refraction

a. Retinoscopy

b. Subjective

c. Muscle Balance

d. Near Point Add

e. PD and Segment Height Measurements

B. RECHECK: If an error in the prescription is found the contractor will redo refraction at no additional charge.

C. Optometry examination and writing/issuance of prescription.

D. Development of an individual treatment plan and coordination of professional services (includes government approved and/or specified frame selection, dispensing and fitting of corrective lenses when medically necessary and approved by the Occupational Health Physician). Frames and lenses must meet or exceed established & applicable laws & regulations pertaining to protective eyewear. ANSI Z87, OSHA 29 CFR 1910.133.

E. Provide ophthalmic recommendations when necessary.

F. Follow-up services.

G. Contractor shall accept prescription from outside source if employee already was issued one to be able to request contracted eyeglasses/tint/frames.

II. Performance may be entirely at the Contractor’s facility entirely or may be performed onsite at Sierra Army Depot if Contractor can provide a Mobile treatment clinic that is self-contained and self-supported. Must provide detailed information as to the place of performance your offer includes. SIAD has no on-site building space available.

III. It is the sole responsibility of the depot employee to schedule, modify and cancel their appointment with the contractor. Authorized orders will be sent along with the depot employee to designate their official capacity for services rendered in the above service requirements. Once the employee has completed their appointment the contractor’s stamp/signature will be placed on the authorized order verifying that the employee did receive services per the contract put in place with SIAD.

IV. Once the employee calls to request an appointment the contractor is required to schedule and perform the appointment within 30 calendar days of request with no more than 10% exceeding the deadline. This will ensure that SIAD employees can receive authorized eyewear in a timely manner to perform their duties.

V. Contractor shall produce finished frames and lenses within 45 calendar days of the examination with no more than 10% being late during the contract year.

VI. Upon award SIAD may have an initial influx of requests for exams. A not-to exceed amount of up to 25 exams per month will be initiated into the contract to separate the influx of requests upon award commencement.

VII. Contractor shall make itself available for appointments on Fridays if place of performance is at the contractor’s facility. SIAD operates from 0630-1700 Monday- Thursday. If a mobile onsite clinic is offered, appointment schedule will be based on the operation times of SIAD. In general, contractor shall examine depot employees during regular working days and hours, excluding holidays, unless otherwise agreed upon by Contractor and Sierra Army Depot.

Times begin and end at the designated exam room.

VIII. Unless otherwise indicated, Contractor shall provide all necessary and appropriate optometry services to employees of Sierra Army Depot. Contractor shall allow Depot authorized representatives to inspect, monitor performance and evaluate the quality of customer service, appropriateness and timeliness of optometry services provided under this contract. This shall include review of Contractor’s records to determine the names and number of employees and the times and locations of examinations performed, as well as audits of any fiscal books, reports and records pertaining to the contract. Contractor shall provide said records during normal working hours within reasonable time of the Depot’s written notice and request.

FAILURE TO PERFORM

In order to determine if optometry standards and depot policies and procedures are being adhered to and maintained SIAD will routinely evaluate the work performance Contracted personnel.

Any personnel who fails to perform, does not meet the minimum qualifications, or who is physically or mentally incapable of performing the required duties of the position, shall not be permitted to perform services. SIAD shall not be required to pay Contractor for any hours worked by a provider deemed incapable or unqualified. Contractor will be required to provide an immediate replacement.

SIERRA ARMY DEPOT CONTACT INFORMATION

Should questions or problems arise during the term of this contract, the contractor should contact the following offices:

Billing/Payment Issues/ General Contract Issues:

Sierra Army Depot Contracting Office

(530) 827-4776

Scope of Service/Performance Issues:

Safety Office: Gregg Masnick (530) 827-5237 or Robert DeMartini (530) 827-5282.

Occupational Health Clinic (530) 827-4141

PHYSICIAN OWNERSHIP AND REFERRAL ACT OF 1993

In accordance with the Physician Ownership and Referral Act of 1993, Contractor shall not refer an employee to any health care provider or health-related facility if the Contractor has a financial interest with that health care provider or health-related facility

Contractor may make a referral to or requires consultation from a sole source health care provider or health-related facility in which financial interest is held if the Contractor is located where there is no alternative provider or service within either twenty-five (25) miles or forty (40) minutes of traveling time. The Contractor shall disclose, in writing to Sierra Army Depot, the Contractor’s financial interest at the time of referral or request for consultation. In no event will this prohibit employees from receiving emergency health care services.

PAST PERFORMANCE QUESTIONNAIRE

Past Performance – The Offeror must submit at least three (3), but not more than five (5) references. It is the responsibility of the contractor to send the questionnaires to their customers and to ensure that they are received on time. Failure to submit surveys will result in non-responsiveness and proposal will not be evaluated.

Additional Government Past Performance Information

The Government reserves the right to obtain past performance information through random checks of provided contract references or through information maintained in the Government’s past performance database. Should this information be sufficient to negatively impact the Offeror's chance of being awarded a contract under this solicitation, the Government will provide this negative information to the Offeror and provide an opportunity for rebuttal, explanation, or clarification.

Offerors may identify federal, state, or local government or commercial contracts that were similar in nature to the current acquisition. References are limited to those for which services have been performed, in whole or in part, within the past five (5) calendar years. Any references not meeting this condition will not be evaluated. The Government will randomly check the provided past performance history, and may check and consider performance on tasks not identified by the Contractor.

PAST PERFORMANCE QUESTIONNAIRE INSTRUCTIONS

Army Contracting Command – Warren Sierra Army Depot, CA

The information obtained from this questionnaire will be utilized to evaluate the past and present performance of offerors submitting proposals in response to W912GY-16-T-0030 – Sierra Army Depot (SIAD) for Optometry Services. The information you provide will be instrumental in allowing the Government to evaluate how well the contractor performed under your contract(s).

a. Please complete all sections of the attached questionnaire. Include your name and title, organizational address, e-mail address, telephone and fax number.

b. Include the contractor’s name and address, the title and/or description of the type of work performed, the award number, the value of the contract (including options), the award and completion date of the project and the type of award/solicitation.

c. Use the rating scale found on the bottom left corner of the questionnaire to rate each performance element.

d. Comments are encouraged and would be appreciated. The last page may be used if additional space is needed for comments. Clear handwritten responses are sufficient.

e. Due to time constraints, it is important that the questionnaire be completed and returned by the date proposal is due July 28, 2016 by 10:00am PST. Please FAX or e-mail your response to the Contract Specialist whose number and address is shown at the bottom right corner of the questionnaire.

Thank you for your time and participation.

YOUR NAME & TITLE

YOUR ORGANIZATIONAL NAME AND ADDRESS

TEL NO.

FAX :

E-MAIL:

CONTRACTOR’S NAME & ADDRESS

TITLE OR DESCRIPTION OF REQUIREMENT:

CONTRACT NUMBER: CONTRACT VALUE (INCLUDING OPTIONS):

CONTRACT TYPE:

FIXED PRICE COST + FEE

COMPETITIVE NON-COMPETITIVE

SET-ASIDE

SEALED BID NEGOTIATED

CONTRACT AWARD & COMPLETION DATE:

PAST PERFORMANCE ELEMENT

RATING

1 2 3 4 5 6 NA

1. Contractor demonstrated a thorough understanding of technical requirements of the contract/task.

Comments:

2. Contractor anticipated/identified and resolved problems effectively.

3. Contractor managed and directed resources (i.e.

personnel, subcontractors, equipment, etc.)

effectively.

4. Rate the Contractor’s use of available resources to accomplish tasks identified in the contract.

Comments:

5. Contractor was responsive to most questions, inquiries and general communication.

PAST PERFORMANCE ELEMENT

RATING

1 2 3 4 5 6 NA

6. Contractor met scheduled contract delivery dates.

7. Contractor provided accurate, complete and high quality deliverables.

8. Contractor complied with the terms of the contract.

9. Contractor was diligent in forecasting and controlling contract cost.

10. I would recommend award to this contractor again.

1 0 – 25% of the time Strongly Disagree PLEASE RETURN COMPLETED

RESPONSE TO:

Army Contracting Command-Warren Sierra Army Depot Contracting Office ATTN: Melissa Kaarbo 74 Currant Street Building 60 Herlong, CA 96113

E-MAIL:

Melissa.m.kaarbo.civ@mail.mil

FAX: 530-827-4722

2 26 – 40% of the time Disagree

3 41 – 55% of the time Somewhat Disagree

4 56 – 70% of the time Somewhat Agree

5 71 – 85% of the time Agree

6 86 – 100% of the time Strongly Agree

NA No Knowledge of This Element

FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED

QASP

Performance Objective Performance Indicator Performance

Threshold Method of Surveillance

PRS #1. Customer Relations (SOW- Contractor Responsibilities)

Contractor or their employees shall provide professional service to Sierra Army Depot Employees. Any complaints will be investigated by the Depot Safety Office with no more than 2 verified cases of unprofessional conduct being sustained during the contract year.

90% compliance Periodic employee surveys to ensure that requirement is met.

PRS #2. Scheduled Eye Exams (SOW- para IV)

Appointments scheduled and performed within 30 days of employee call to contractor

90% fulfilled Periodic employee surveys to ensure that requirement is met.

PRS #3. Eye Glasses & Prescription Safety Glasses (SOW- para V)

Frames and lenses provided within 45 days of exam.

90% fulfilled Periodic inspection of eyewear provided to employees by contractor

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

1001 Destination Government Destination Government 1002 N/A Government Destination Government 1003 N/A Government Destination Government 2001 N/A Government Destination Government 2002 N/A Government Destination Government 2003 N/A Government Destination Government 3001 N/A Government Destination Government 3002 N/A Government Destination Government 3003 N/A Government Destination Government 4001 N/A Government Destination Government 4002 N/A Government Destination Government 4003 N/A Government Destination Government 5001 N/A Government Destination Government 5002 N/A Government Destination Government

5003 N/A Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

1001 POP 01-SEP-2016 TO

31-AUG-2017

N/A DIRECTORATE OF RISK MANAGEMENT

SAFETY OFFICE

SIERRA ARMY DEPOT

HERLONG CA 96113

530-827-4431

W62G2W

1002 POP 01-SEP-2016 TO

31-AUG-2017

N/A (SAME AS PREVIOUS LOCATION)

1003 POP 01-SEP-2016 TO

31-AUG-2017

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 01-SEP-2017 TO

31-AUG-2018

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

2003 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 01-SEP-2018 TO

31-AUG-2019

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 01-SEP-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

3003 POP 01-SEP-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

4001 POP 01-SEP-2019 TO

31-AUG-2020

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 01-SEP-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

4003 POP 01-SEP-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

5001 POP 01-SEP-2020 TO

31-AUG-2021

N/A (SAME AS PREVIOUS LOCATION)

5002 POP 01-SEP-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

5003 POP 01-SEP-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.202-1 Definitions NOV 2013 52.203-3 Gratuities APR 1984 52.203-6 Alt I Restrictions On Subcontractor Sales To The Government

(Sep 2006) -- Alternate I

OCT 1995

52.203-12 Limitation On Payments To Influence Certain Federal Transactions

OCT 2010

52.203-17 Contractor Employee Whistleblower Rights and Requirement To Inform Employees of Whistleblower Rights

APR 2014

52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber Content Paper

MAY 2011

52.204-7 System for Award Management JUL 2013 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.204-10 Reporting Executive Compensation and First-Tier

Subcontract Awards

OCT 2015

52.204-13 System for Award Management Maintenance JUL 2013 52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment

OCT 2015

52.212-1 Instructions to Offerors--Commercial Items OCT 2015 52.212-4 Contract Terms and Conditions--Commercial Items MAY 2015 52.217-5 Evaluation Of Options JUL 1990 52.219-6 Notice Of Total Small Business Set-Aside NOV 2011 52.219-8 Utilization of Small Business Concerns OCT 2014 52.219-14 Limitations On Subcontracting NOV 2011 52.219-28 Post-Award Small Business Program Rerepresentation JUL 2013 52.222-3 Convict Labor JUN 2003 52.222-19 Child Labor -- Cooperation with Authorities and Remedies FEB 2016 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-26 Equal Opportunity APR 2015 52.222-37 Employment Reports on Veterans FEB 2016 52.222-40 Notification of Employee Rights Under the National Labor

Relations Act

DEC 2010

52.222-50 Combating Trafficking in Persons MAR 2015 52.223-5 Pollution Prevention and Right-to-Know Information MAY 2011 52.223-6 Drug-Free Workplace MAY 2001 52.223-18 Encouraging Contractor Policies To Ban Text Messaging

While Driving

AUG 2011

52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.228-5 Insurance - Work On A Government Installation JAN 1997 52.229-3 Federal, State And Local Taxes FEB 2013

52.232-17 Interest MAY 2014 52.232-33 Payment by Electronic Funds Transfer--System for Award

Management

JUL 2013

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.237-2 Protection Of Government Buildings, Equipment, And

Vegetation

APR 1984

52.237-7 Indemnification and Medical Liability Insurance JAN 1997 52.242-13 Bankruptcy JUL 1995 52.242-15 Stop-Work Order AUG 1989 52.246-4 Inspection Of Services--Fixed Price AUG 1996 52.246-25 Limitation Of Liability--Services FEB 1997 52.253-1 Computer Generated Forms JAN 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 252.203-7005 Representation Relating to Compensation of Former DoD

Officials

NOV 2011

252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7004 Alt A System for Award Management Alternate A FEB 2014 252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

DEC 2015

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting.

DEC 2015

252.204-7015 Notice of Authorized Disclosure of Information for Litigation Support

MAY 2016

252.209-7004 Subcontracting With Firms That Are Owned or Controlled By The Government of a Country that is a State Sponsor of Terrorism

OCT 2015

252.223-7006 Prohibition On Storage, Treatment, and Disposal of Toxic or Hazardous Materials

SEP 2014

252.225-7001 Buy American And Balance Of Payments Program-- Basic (Nov 2014)

NOV 2014

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2012 252.225-7048 Export-Controlled Items JUN 2013 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006 252.237-7010 Prohibition on Interrogation of Detainees by Contractor

Personnel

JUN 2013

252.243-7001 Pricing Of Contract Modifications DEC 1991 252.243-7002 Requests for Equitable Adjustment DEC 2012 252.244-7000 Subcontracts for Commercial Items JUN 2013 252.247-7023 Transportation of Supplies by Sea APR 2014

CLAUSES INCORPORATED BY FULL TEXT

52.201-4001 CONTRACT MANAGEMENT

Notwithstanding the total management responsibility on the part of the Contractor for his performance during this contract the administration of the contract will require maximum coordination between the Government and the contractor. The following individuals will be the Government's points of contact during the performance of the contract:

(a) Contracting Officer's Representative (COR); A COR will be designated in writing by the Contracting Officer with specifically delegated authority to monitor certain aspects of performance and assist in the administration of the contract. The types of action within the purview of the COR's authority are generally to assure that the Contractor performs the requirements of the contract; to perform or cause to be performed inspections necessary in connection with performance of the contract; to monitor the Contractor’s performance under the contract and notify the Contracting Officer of any observed deficiencies; and if required to provide for site entry of Contractor personnel. A letter of designation will be issued to the COR with a copy supplied to the Contractor which states the specific responsibilities and limitations of authority for the COR. This letter will clarify to all parties to this contract those specific responsibilities and limitations of authority of the COR. This letter will further clarify to all parties to this contract the responsibilities which would result in a modification to the scope of work; changes in cost or price totals or estimates; changes in delivery dates; and changes in any other mutually agreed upon term or provision of the contract.

(b) Contracting Officer (KO): the KO will effect all contract administration. The KO will generally rely upon the Administrator to prepare any required correspondence or communicate with the contractor on issues concerning the administration of the contract. Contractor communications pertaining to contractual administrative matters will be addressed to the KO. Only the KO, not the COR or Administrator has the authority to change the terms and conditions of the contract.

CLAUSES INCORPORATED BY FULL TEXT

52.204-4001 ACCESS TO SIERRA ARMY DEPOT (MAY 2002)

(a) Contractors by virtue of contract award will be given access privileges to Sierra Army Depot. Contractors and Sub-Contractors are required to provide a completed SIAD Form 1246R, 96 hours prior to the start of work. Form may be submitted via email to the contract POC or faxed to 530-827-4675. (Applies to contracts that require access to restricted areas)

(b) Each member of the Contractor’s work force shall be individually badged at the Depot Pass & Identification Office in Building 106. The badge shall be retained and worn by the Contractor’s employees throughout the contract period. (Applies to contracts that require access to restricted areas)

(c) Contractor is responsible for the turn-in of all security badges, including sub-contractors badges, daily and upon completion of the contract or termination of individual employees. (Applies to contracts that require access to restricted areas)

(d) Report lost badges to the Depot Pass & Identification Office and the Contracting Officer as soon as the loss is discovered. (Applies to contracts that require access to restricted areas)

(e) Be prepared to produce security badges each time entering a security area. Temporary badges for any individual who may have forgotten his/her badge can be obtained form the Depot Pass & Identification Office. (Applies to contracts that require access in restricted areas)

(f) Traffic Enforcement:

(1) Sierra Army Depot traffic laws are enforced by the Law Enforcement and Security Division using California state codes. All roads/streets have speed limit signs posted;

(2) Traffic violations are adjudicated by the U.S. Magistrate located at Sierra Army Depot. Court appearances may be requested or mandatory; and (c) Radar is used to enforce traffic speed limits.

(g) Vehicles:

(1) Vehicles entering Sierra Army Depot, whether Contractor-owned or privately owned, shall undergo inspections and may be issued a pass if entering a restricted area. Vehicle permits for restricted areas will be issued for up to 30 days maximum. Each vehicle will be required to carry a fire extinguisher at all times;

(2) Company or privately-owned vehicles, when parked, must have ignition keys removed. After duty hours, vehicles left on the Depot will be parked outside restricted areas unless otherwise stipulated in the contract. Vehicles or equipment remaining inside restricted areas will be locked or immobilized;

(3) Contractor is solely responsible for the removal of incapacitated vehicles or equipment from restricted areas;

(4) All vehicles shall be parked at least 20 meters from all buildings unless unloading or loading; and

(5) The contractor can expect to be inspected at any of the manned gates. The contractor should expect five to ten minute delays at each gate. In addition, to get to some of the remote areas, the contractor should expect at least a 15-minute delay both in and out to allow security to open necessary gates.

(End of clause)

52.204-4002 ELECTRONIC BIDS/PROPOSALS/OFFERS/QUOTES REQUIRED IN RESPONSE TO THIS

SOLICITATION (AUG 2015)

(a) All Army Contracting Command - Warren (SIAD) solicitations will be publicized on the Federal Business Opportunities website (https://www.fbo.gov). Any additional attachments, when available electronically, will be separate attachments or links embedded in the solicitation.

(b) Bids/Proposals must be submitted in electronic media. When submitting your bid/proposal electronically, the bid/proposal and any supplemental information (such as spreadsheets, backup data, technical information), can be submitted using any of the following electronic formats:

(1) Microsoft* Office Products (Sierra can read Microsoft* Office 2007 and lower); Word, Excel, or PowerPoint. Spreadsheets must be sent in a format that includes all formulate macro and format information. Print image is not acceptable.

(2) Files in Adobe PDF (Portable Document Format). Scanners should be set to 300 dots per inch.

(3) Files in HTML (Hypertext Markup Language). HTML documents must not contain active links to live Internet sites or pages. All linked information must be contained within your electronic bid/offer and be accessible offline.

(4) Other electronic formats are not acceptable.

(c) Transmission methods:

(1) As of 10 August 2015, online via the Federal Business Opportunities (FBO) System.

Requirements for the online FBO bid submission:

Vendors must login to the FBO System to be able to submit electronic responses for opportunities.

Vendors must also registered in the System for Award Management (SAM) at www.sam.gov (a Federal Government owned and operated free web site) and have a CAGE Code and CCR Marketing Partner Identification Number

(MPIN).

Once logged into the FBO System, vendors will be asked to enter basic information and then will be directed to upload one or more files containing the offer and any additional information as outlined in the solicitation.

FBO will send an email to the email address on file for the user confirming the electronic submission.

For additional information on submitting electronic bid responses via the Federal Business Opportunities System reference the FBO Vendor Guide – Section 4.3.1 Submitting an Electronic Response Topic (https://www.fbo.gov/downloads/FBO_Vendor_Guide.pdf).

(2) E-mail. If you choose to use e-mail, address your bid/proposal usarmy.sierra.tacom.mbx.sier-contracting-offers@mail.mil . DO NOT E-MAIL BIDS/PROPOSALS TO THE BUYERS. ENSURE THE EMAIL HAS A

SUBJECT LINE. THE SUBJECT LINE OF THE E-MAIL MUST READ:

BID-[solicitation number] or PROPOSAL-[solicitation number], whichever is applicable [Name of Company/offeror] OPENS [opening date for bids] or CLOSES [closing date for proposals], whichever is applicable.

Maximum size of each e-mail shall be 10 megabytes. Use the file compression described in the NOTE in paragraph

(a) (4) above. You may use multiple e-mail messages for each bid/submission, however, you must annotate the subject lines as described above for each message, and number them in this manner: “Message 1 of 3, 2 of 3, 3 of 3”.

Attachments CANNOT have any of the following extensions: ade, adp, app, asx, bas, bat, chm, cmd, com, cpl, crt, csh, exe, fxp, hlp, hta, inf, ins, isp, js, jse, ksh, lnk, mda, mdb, mde, mdt, mdw, mdz, msc, msi, msp, mst, ops, pcd, pif, prf, prg, reg, scf, scr, sct, shb, shs, url, vb, vbe, vbs, wsc, wsf, wsh, ade, adp, asx, bas, bat, chm, cmd, com, cpl, crt, exe, hlp, hta, htm, html, htc, inf, ins, isp, js, jse, lnk, mda, mdb, mde, mdz, mht, mhtml, msc, msi, msp, mst, pcd, pif, prf, reg, scf, scr, sct, shb, shs, shtm, shtml, stm, url, vb, vbe, vbs, wsc, wsf, wsh, xml, dir, dcr, plg, spl, swf

Ensure that filenames of attachments DO NOT contain spaces to limit virus scanners rejecting the email as unscannable.

NOTE (Compression): The above formats may be submitted in compressed form using Winzip*. NOTE: Winzip file(s) will need to have an extension of .zzz in order to be received at Sierra Army Depot.

(d) Please select only one medium by which to transmit each bid/proposal. For instance, do not submit a bid/proposal via ASFI BRS AND e-mail.

(e) Timely receipt of offers/proposals:

(1) Your attention is called to the solicitation closing date and time on the solicitation is local time for the Army Contracting Command – Warren (SIAD). Lateness rules for electronic submissions for bids are outlined in FAR 52.214-7, “Late Submissions, Modifications, and Withdrawal of Bids,” for proposals in FAR 52.215-1, “Instructions to Offerors—Competitive Acquisition” or FAR 52.212-1, “Instructions to Offerors-Commercial Items.” Pay particular attention to the applicable clause as it relates to the timing of submissions.

(2) NOTE: There is no “expected” or “target” length of time for proposal submission; size and content may be factors, therefore offerors are strongly cautioned to submit their proposals allowing adequate time for submission.

(3) Solicitations may remain posted on the ASFI Open Solicitation Web page after the solicitation closes.

Even though the system will allow you to submit a proposal after the closing date/time, your proposal will be considered late and may not be considered for award.

(f) Security Note: If you choose to password-protect access to your bid/offer, you must provide the password to Sierra Army Depot at least ten days prior to the opening/closing date. Contact the buyer identified in the solicitation Passwords used only for the purpose of write protecting files need not be provided.

(g) Electronic bids/proposals must include, as minimum:

(1) E-mailed bids/proposals must include a signed SF 33 cover sheet, SF 1449 or SF 1442 (whichever is applicable) that can be scanned. If scanned, attach it to your e-mail offer (or first e-mail message if you are sending multiple e-mails due to length).

(2) All applicable fill-in provisions. For solicitations issued on an SF 33, this would include Sections A, B, F, and K., For solicitations issued on an SF 1442, this would include Sections 00010 and 00600. For solicitations issued on an SF 1449, you must review the solicitation to ascertain where all of the required fill-ins are located since commercial acquisitions do not have designated sections.

(3) A statement of agreement to all the terms, conditions, and provisions of the solicitation.

(4) Any other information required by the solicitation.

(h) Please see FAR 14.406 for a description of the steps the Government shall take with regard to unreadable electronic bids received via the media described in paragraphs (b) above. See FAR 15.207(c) for a description of steps the government shall take with regard to unreadable proposals.

(i) Bidders/Offerors shall make every effort to ensure that their bid/proposal is virus-free. Bids/proposals (or portions thereof) submitted which DO reflect the presence of a virus, or which are otherwise rendered unreadable by damage in electronic transit, shall be treated as “unreadable” per paragraph (h) above. Use of any formats other than those listed above may result in the file being quarantined and will be considered by Sierra Army Depot to be “unreadable” files.

Note (Macros): The virus scanning software used by our e-mail systems cannot always distinguish a macro from a virus. Therefore, sending a macro embedded in an email message or an email attachment may cause the email bid/offer to be quarantined. In that event paragraph (g) above applies.

*Registered trademark

(End of Provision)

52.204-4020 ACCESS AND GENERAL PROTECTION/SECURITY POLICY AND PROCEDURES (MAR

2015)

(a) The contractor and all associated subcontractors’ employees shall comply with applicable installation, facility, and area commander installation and facility access and local security policies and procedures (provided by the Government representative). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by the installation Provost Marshal Office, Director of Emergency Services, or Security Office. The contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9 “Personal Identity Verification of Contractor Personnel”) as directed by DoD, HQDA, and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

(b) For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05, The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of six (6) months or more. At the discretion of the sponsoring activity, an initial CAC may be issued on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personal Management (see clause 52.204-4600 “Trusted Associate Sponsorship System (TASS) Program” (Local Warren)).

(c) For contractors that do not require CAC, but require access to a DoD facility or installation. Contractor and all associated sub-contractors employees shall comply with adjudication standards, and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), applicable installation, facility and area commander installation/facility access and local security policies and procedures (52.204-4001, Access to Sierra Army Depot), or at OCONUS locations, in accordance with Status of Forces Agreement and other theater regulations.

52.204-4023 NOTICE OF ELEVATED THREAT LEVEL FORCE PROTECTION CONDITION (FPCON)

(JUNE 2014)

Contractor is hereby notified that there is a potential impact on contractor performance during periods of increased threat. During FPCONs Charlie and Delta, services may be discontinued / postponed due to higher threat. Services will resume when FPCON level is reduced to level Bravo or lower.

52.204-4024 RANDOM ANTITERRORISM MEASURES PROGRAM (RAMP) PARTICIPATION (JUNE

2014)

In accordance with AR 525-13, Contractor personnel working on an Army installation, arsenal, base or other DoD facility (owned or leased by DoD/Department of the Army), are subject to participation in Installation RAMP security program (e.g. vehicles searches, wearing of ID badges, etc).

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

(i) Past Performance

(a) The Government will assess the degrees of relevancy and success in past performance efforts in the past 5 years of a similar scope, size, complexity and subject matter in accordance with the solicitation. This criterion is also assessed by performance risk associated with an offeror’s likelihood of success in performing the solicitation’s requirements and quality as indicated by that offeror’s record of current or past performance with the same or similar requirements. The Government will assess each Offeror’s general corporate background, and recent success in managing similar or related work. Also, they will assess each Offeror’s problems encountered in the performance of similar services and the description of how the problem(s) was/were resolved.

The SSEB can make calls, use personal experience, and search the Internet to evaluate past performance.

(b) Each offeror will be required to forward a copy of the Past Performance Questionnaire (an

Attachment to the solicitation) to each of their…