Solicitation_W912J3-16-T-0030.pdf

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W912J3-16-T-0030 28-Jul-2016

b. TELEPHONE NUMBER

505-474-1818

8. OFFER DUE DATE/LOCAL TIME

03:00 PM 19 Aug 2016

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AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

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ADDENDA ARE

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23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W912J39. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

JOHN MCLUAGHLIN

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

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0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

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

0010904603

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. YOUR OFFER ON SOLICITATION

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% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

USPFO FOR NEW MEXICO CONTRACTING OFFICE

ATTN: JOHN MCLAUGHLIN, 47 BATAAN BLVD

SANTA FE NM 87508

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 16. ADMINISTERED BY

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12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

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14. METHOD OF SOLICITATION

RFQ IFB RFPX

505-474-1821FAX:

TEL: 505-474-1818 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$11,000,000

NAICS:

621111

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)

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

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37. CHECK NUMBER

FINALPARTIALCOMPLETE

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CORRECT FOR

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FINAL

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PARTIAL

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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.

W912J3-16-T-0030

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Each

TECH MEDICAL SURVEILLANCE EXAMS

FFP

New Mexico statewide required Occupational Health Medical Surveillance Physical Examinations for up to a maximum of 140 personnel in accordance with the Performance Work Statement (PWS) shown below.

Attachment #1-Wage Determination (WD) 06-2361 (Rev.-18) shall apply to the following locations of services to be performend in New Mexico: Rio Rancho, Santa Fe, and Springer.

Attachment #2-Wage Determination (WD) 15-2511 (Rev.-1) shall apply to the following locations of services to be performend in New Mexico: Las Cruces and Roswell.

Attachment #3-Wage Determination (WD) 15-2517 (Rev.-2) shall apply to the following location of services to be performend in New Mexico: Clovis.

FOB: Destination

PURCHASE REQUEST NUMBER: 0010904603

NET AMT

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0002 Each Contractor Man Power Reporting

FFP

See Below for Contractor Man Power Reporting requirements.

FOB: Destination

NET AMT

PERFORMANCE WORK STATEMENT

New Mexico Army National Guard Performance Work Statement (PWS) For

Occupational Health Medical Surveillance Physical Examination

1.0. GENERAL

The Performance Work Statement (PWS) supports the New Mexico Army National Guard (NMARNG) for the Occupational Health Medical Surveillance Physical Examination in accordance with the Occupational Safety and Health Administration (OSHA) and other Department of Defense regulations. The preferred method for conducting the exams is for the contracted organization to travel via a mobile medical vehicle to the assigned Field Maintenance Shops (FMS) within the state of New Mexico. The contractor will assign an on-site coordinator to manage the operation as they perform a physical exam to the selected NMARNG employees.

All issues pertaining to the exam process, contractor’s personnel/staffing, mobile medical unit problems, schedule changes, emergencies related to staff and or the Mobile Medical Unit, will be the responsibility of the contractor’s on-site coordinator. The estimated number of personnel to be examined is up to a maximum of 140. The contractor will provide a complete set of all examination forms and questionnaires to be utilized for the physical exam for the purpose of review for any possible editing requirements to meet the needs of the NMARNG. Additionally, once determined that the forms and questionnaires meet the needs for the exam process, the contractor will distribute questionnaires to the scheduled FMS employees to complete in advance of the exam process. The Occupational Health Nurse for the NMARNG is your point of contact for all issues concerning this Performance Work Statement.

1.1. LOCATION OF SERVICES TO BE PERFORMED:

Location of services to be performed in the New Mexico are eight different sites: Santa Fe (two separate locations), Rio Rancho, Roswell, Clovis, Las Cruces, Chaparral, and Springer, New Mexico.

1.2. ADDRESS OF LOCATIONS:

Roswell FMS, 1 Earl Cummings Lp. Roswell, NM 8820

MATES; Dona Ana Range Camp, War Rd Bldg. 8283; Chaparral, NM 88021 Las Cruces FMS, 253 Armory Road, Las Cruces, NM 88005

Rio Rancho FMS, 1702 Southern Blvd SE, Rio Rancho, NM 87124 Santa Fe CSMS, 52 Bataan Blvd., Santa Fe, NM 87508; Include Warehouse employees Santa Fe AASF, 7001 Huey Rd, Santa Fe, NM 87507

Springer FMS, 38 Fairgrounds Rd, Springer, NM 87747 Clovis FMS, 601 South Norris St, Clovis, NM 88101

1.3 PERIOD OF PERFORMANCE:

The estimated period of performance to complete these examinations will take place over one week’s time toward the end of September 2016.

2. PURPOSE

2.1. The purpose of Occupational Medical Surveillance is to provide job-related Medical Surveillance Physical Examinations and Occupational Health Services to the NMARNG full-time technician employees and/or temporary technician employees who are or potentially exposed to health hazards in the work environment. The examination shall include personnel assigned to positions requiring specific standards of physical fitness. Personnel not included under these examinations are New Mexico State Employees, civilian contractors, and the NMARNG Traditional Guardsman soldiers.

2.2. The NMARNG may evaluate the quality of professional and administrative services provided, but retain no control over the medical professional aspects of services rendered such as testing procedures. The Contractor will provide Board Certified Occupational Health Physician(s), supervision, all labor, tools, materials, equipment, and incidentals required to conduct the Occupational Health Medical Surveillance Physical Examination / Occupational Health Services for the NMARNG.

3. PROCEDURES and STANDARDS

3.1. This contract is for “Non Personal” Health Care “Services”, as defined in 37.101. In accordance with FAR Part 37.4 the NMARNG may enter into a non-personal health care services contract with physicians, dentists and other health care providers under authority of 10 U.S.C. 2304 and 41 U.S.C. 253. The NMARNG shall evaluate the quality of professional and administrative services provided, while the NMARNG retains non control over the medical, professional aspects of services rendered. The Contractor will indemnify the NMARNG for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance. The Contractor will maintain medical liability insurance in accordance with the State of New Mexico which is not less than the amount normally prevailing within the local community for the medical specialty concerned. The Contractor is required to ensure that its subcontractors, if any, for provisions of health care services, contain the requirements of the clause at 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance.

3.2. Contractor shall ensure all procedures are conducted in accordance with applicable American Board of Occupational and Environmental Medicine (ABOEM), American Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) Standards.

3.3. Contractor shall ensure all clinical laboratory services are performed by a laboratory licensed through the U.S. Department of Health and Human Services (DHHS), Health Care Financing Administration pursuant to the terms of the Clinical Laboratories Improvement Amendment of 1967 (42 U.S.C. 263a) and the College of American Pathologies.

3.4. Contractor shall provide a Board eligible or Certified Occupational Medicine Physician to conduct job-related occupational medical surveillance physical examinations and occupational health consultation services.

3.5. Contractor shall arrange for the opportunity to consult with a representative of the NMARNG by telephone to coordinate or resolve issues that might arise before, during, and after the testing period.

3.6. Contractor shall perform a comprehensive review and evaluation within 30-days following the conclusion of testing. The Contracting Officer’s Representative will contact and schedule a follow-up review and evaluation meeting to discuss positive and negative aspects of testing.

3.7. Contractor shall ensure licensed medical technicians will perform the medical surveillance physical examination screening/testing elements. The medical surveillance person(s) to operate the audiogram must be certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC). Personnel conducting Spirometry shall be certified through a program approved by the National Institute for Occupational Safety and Health (NIOSH).

3.8. Contractor shall ensure instrumentation must meet or exceed appropriate performance standards, and accuracy must be verified in accordance with current Occupational Medicine Certification standards.

3.9. Contractor shall provide the Contracting Officers Representative with a Quality Assurance Medical Surveillance Plan (QAMSP) listing the procedures or processes, which shall be utilized to meet the requirements discussed in the PWS.

4.0. REFERENCES

4.1. Army Regulation 40-5, Preventive Medicine

4.2. National Guard Regulation 385-10, Army National Guard Safety and Occupational Health Program

4.3. U.S. Department of Labor, Code of Federal Regulations 29 (CFR) 1910.120 (b) (5), (f), Medical Surveillance

4.4. Headquarters, Department of the Army Pamphlet (DA PAM) 40-501 Hearing Conservation

4.5 Occupational Medical Examination and Surveillance Manual, DoD 6055.05-M

5.0. MEDICAL SURVEILLANCE - (Annual Physical Examinations)

Occupational Medical Surveillance Protocols shall consist of the following 5 Panels by working group classification numbers:

NOTE:

- Test Panels 1, 2, 3, and 5 require blood chemistries which require CBC, comprehensive metabolic panel tests.

- Each test panel lists “Chest X-Ray: PA (ILO Interpretation) Initiate ILO which does require an X-Ray machine to be at each location. If not able to provide one, patients can be sent to the nearest clinic with a doctor order from the contractor to complete this requirement at contractor’s expense.

- The following Technicians will be required per each test panel:

Panel 1‐ 50 Panel 2‐30 Panel 3‐ 10 Panel 4‐15 Panel 5 ‐0

5.1 TEST PANEL: 01

(Work Groups: 5800) Fasting: Standard Flow Rate: One patient every 15 minutes

History: Confidential Worker Health Questionnaire that includes respiratory history for P.P.E.

(Mask) Wearers.

Employee ID: Standard

Noise Exposure/Ear Protection: Hearing Protection questions on the Hearing Test Case History

Special Forms as required: Hearing Conservation Program Attendance Record Hearing Test Case History Respirator Fit Test Record Fit Test Qualification Form Fit Test Card Physician Examination Record Benzene Physician Examination Record

Hearing Conservation Program: DOEHRS-HC Capable/Certified for uploading hearing test results to the DOEHRS-HC computer data base system. Will utilize proper forms, i.e., for base line hearing exams, form 2215 will be utilize for inputting into the DOEHRS-HC system, for subsequent hearing exams following a documented baseline, form 2216 will be utilize for input into the DOEHRS system.

Audiometric: Test Only (500, 1000, 2000, 3000, 4000, 6000, + 8000 Hz).

Blood Pressure: Standard, right and left arm, record results on P.E. Form and Physician Examination Record

Chest X-Ray: PA. (ILO Interpretation.) Initiate ILO form

Height/Weight: Standard, record results on P.E. form and on Physician Examination Record

MD Exam: Hands on physical by a board eligible or board certified doctor

Otoscopic Exam: Standard

Quantitative Fit Testing: The estimated number of personnel to be Fit Tested is 65, the NMARNG has the right to increase and or decrease this number. The masks/respirator will be brought to the testing site by the individual employee who has one assigned to him or her for their utilization. Masks that are generally utilized are the – 3M 6100 - half face mask, 3M 6200 -half face mask, 3M 6300 - half face mask, and 3M 7800 – full face mask.

Temperature and Respirations: Standard, record results on P.E. Form and on Physician Examination Record

Resting Pulse Rate: Standard, record results on P.E. Form and on Physician Examination Record

Spirometry: Standard

Urinalysis: Dipstick

Vision: Near and Far Acuity, color and vertical/lateral phorias, and record results on PE Form

Comparative Data: Done in D.P. Respirator Clearance: Done in D.P.

Benzene Clearance: Asbestos Clearance:

LABORATORY SPECIMENS (Test Panel 01):

One (1) Tiger Top Tube Blood Chemistries/HDL/LDL/CBC One (1) Lavender Top Tube

One (1) Lavender Blood Lead/ZPP One (1) Blue Top Tube Blood Cadmium

One (1) 10 ml Acid Washed Urine Chromium Urine Container or Blood Test

5.2 TEST PANEL: 02

(Work Groups: 912, 5700, 6900, 8600) Fasting: Standard Flow Rate: One patient every 15 minutes

History: Confidential General Health Questionnaire

Employee ID: Standard

Noise Exposure/Ear Protection: Hearing Protection questions on the Hearing Test Case History

Special Forms as required: Hearing Conservation Program Attendance Record Hearing Test Case History Physician Examination Record

Hearing Conservation Program: DOEHRS-HC Capable and or Certified for uploading hearing test results to the DOEHRS-HC computer data base system. Will utilize proper forms, i.e., for base line hearing exams, form 2215 will be utilize for inputting into the DOEHRS-HC system, for subsequent hearing exams following a documented baseline, form 2216 will be utilize for input into the DOEHRS system.

Audiometry: Test Only (500, 1000, 2000, 3000, 4000, 6000, + 8000 Hz).

Blood Pressure: Standard, right and left arm, record results on P.E. Form and Physician Examination Record

Chest X-Ray: PA. (ILO Interpretation.) Initiate ILO form

Height/Weight: Standard, record results on P.E. form and on Physician Examination Record

MD Exam: Hands on physical by a board eligible or board certified doctor

Otoscopic Exam: Standard

Temperature and Respirations: Standard, record results on P.E. Form and on Physician Examination Record

Resting Pulse Rate: Standard, record results on P.E. Form and on Physician Examination Record

Spirometry: Standard

Urinalysis: Dipstick

Vision: Near and Far Acuity, color and vertical/lateral phorias, and record results on PE Form

Comparative Data

LABORATORY SPECIMENS (Test Panel 02):

One (1) Tiger Top Tube Blood Chemistries/HDL/LDL/CBC

One (1) Lavender Top Tube

5.3 TEST PANEL: 03

(Work Groups: 3100, 4600, 8800) Fasting: Standard

Flow Rate: One patient every 15 minutes

History: Confidential Worker Health Questionnaire that includes respiratory history for P.P.E.

(Mask) Wearers.

Employee ID: Standard

Noise Exposure/Ear Protection: Hearing Protection questions on the Hearing Test Case History

Special Forms as required: Hearing Conservation Program Attendance Record Hearing Test Case History Respirator Fit Test Record Fit Test Qualification Form Fit Test Card Physician Examination Record

Hearing Conservation Program: DOEHRS-HC Capable and or Certified for uploading hearing test results to the DOEHRS-HC computer data base system. Will utilize proper forms, i.e., for base line hearing exams, form 2215 will be utilize for inputting into the DOEHRS-HC system, for subsequent hearing exams following a documented baseline, form 2216 will be utilize for input into the DOEHRS system.

Audiometric: Test Only (500, 1000, 2000, 3000, 4000, 6000, + 8000 Hz).

Blood Pressure: Standard, right and left arm, record results on P.E. Form and Physician Examination Record

Chest X-Ray: PA. (ILO Interpretation.) Initiate ILO form

Height/Weight: Standard, record results on P.E. form and on Physician Examination Record

MD Exam: Hands on physical by a board eligible or board certified doctor

Otoscopic Exam: Standard

Quantitative Fit Testing

Temperature and Respirations: Standard, record results on P.E. Form and on Physician

Resting Pulse Rate: Standard, record results on P.E. Form and on Physician Examination Record

Spirometry: Standard

Urinalysis: Dipstick

Vision: Near and Far Acuity, color and vertical/lateral phorias, and record results on PE Form

Comparative Data: Accomplished in Data Processing Respirator Clearance:

LABORATORY SPECIMENS (Test Panel 03):

One (1) Tiger Top Tube Blood Chemistries/HDL/LDL/CBC

5.4 TEST PANEL: 04

(Work Groups: 2600, 3300, 6600) Fasting: Standard Flow Rate: One patient every 15 minutes

History: Confidential General Health Questionnaire

Employee ID: Standard

Noise Exposure/Ear Protection: Hearing Protection questions on the Hearing Test Case History

Special Forms as required: Hearing Conservation Program Attendance Record Hearing Test Case History Physician Examination Record

Hearing Conservation Program: DOEHRS-HC Capable and or Certified for uploading hearing test results to the DOEHRS-HC computer data base system. Will utilize proper forms, i.e., for base line hearing exams, form 2215 will be utilize for inputting into the DOEHRS-HC system, for subsequent hearing exams following a documented baseline, form 2216 will be utilize for input into the DOEHRS system.

Audiometry: Test Only (500, 1000, 2000, 3000, 4000, 6000, + 8000 Hz).

Blood Pressure: Standard, right and left arm, record results on P.E. Form and Physician

Chest X-Ray: PA. (ILO Interpretation.) Initiate ILO form

Height/Weight: Standard, record results on P.E. form and on Physician Examination Record

MD Exam: Hands on physical by a board eligible or board certified doctor

Otoscopic Exam: Standard

Temperature and Respirations: Standard, record results on P.E. Form and on Physician Examination Record

Resting Pulse Rate: Standard, record results on P.E. Form and on Physician Examination Record

Spirometry: Standard

Urinalysis: Dipstick

Vision: Near and Far Acuity, color and vertical/lateral phorias, and record results on PE Form

Comparative Data:

LABORATORY SPECIMENS (Test Panel 04):

One (1) Tiger Top Tube Blood Chemistries/HDL/LDL/CBC

One Lavender Top Tube Blood Lead/ZPP

5.5 TEST PANEL: 05

(Work Groups: 3400, 3700, 3800, 4100) Fasting: Standard

Flow Rate: One patient every 15 minutes

History: Confidential Worker Health Questionnaire that includes respiratory history for P.P.E.

(Mask) Wearers.

Employee ID: Standard

Noise Exposure/Ear Protection: Hearing Protection questions on the Hearing Test Case History

Special Forms as required: Hearing Conservation Program Attendance Record Hearing Test Case History Respirator Fit Test Record Fit Test Qualification Form Fit Test Card

Physician Examination Record

Hearing Conservation Program: DOEHRS-HC Capable and or Certified for uploading hearing test results to the DOEHRS-HC computer data base system. Will utilize proper forms, i.e., for base line hearing exams, form 2215 will be utilize for inputting into the DOEHRS-HC system, for subsequent hearing exams following a documented baseline, form 2216 will be utilize for input into the DOEHRS system.

Audiometry: Test Only (500, 1000, 2000, 3000, 4000, 6000, + 8000 Hz).

Blood Pressure: Standard, right and left arm, record results on P.E. Form and Physician Examination Record

Chest X-Ray: PA. (ILO Interpretation.) Initiate ILO form

Height/Weight: Standard, record results on P.E. form and on Physician Examination Record

MD Exam: Hands on physical by a board eligible or board certified doctor

Otoscopic Exam: Standard

Quantitative Fit Testing

Temperature and Respirations: Standard, record results on P.E. Form and on Physician Examination Record

Resting Pulse Rate: Standard, record results on P.E. Form and on Physician Examination Record

Spirometry: Standard

Urinalysis: Dipstick

Vision: Near and Far Acuity, color and vertical/lateral phorias, and record results on PE Form

Comparative Data:

Respirator Clearance:

LABORATORY SPECIMENS (Test Panel 05):

One (1) Tiger Top Tube Blood Chemistries/HDL/LDL/CBC One (1) Lavender Top Tube

One Lavender Top Tube Blood Lead/ZPP One Blue Top Tube Blood Cadmium

One (1) 10 ml Acid Washed

Urine Container or Blood Test Urine Chromium

6.0. PERSONAL PROTECTIVE EQUIPMENT (PPE)

6.1. Contractor shall ensure each healthcare worker complies with the requirements of 29 CFR

1910.1030 Blood borne Pathogens Standard.

7.0. INFECTIOUS WASTE DISPOSAL

7.1. Disposal of all infectious waste shall be in accordance with local, state, and federal regulation and disposed of by the Contractor.

7.2. Contractor shall ensure puncture resistant sharps containers are readily accessible to healthcare workers and located in all treatment areas where sharps could potentially be used.

8.0. MOBILE UNIT CONFIGURATION

8.1. Medical Surveillance testing that is accomplished via mobile unit or a portable unit will be designed to ensure complete individual privacy. Features of the unit shall include, but not limed to, a climate-controlled atmosphere, patient waiting / holding area for registration, changing room, on board restroom with hand washing capability, testing and phlebotomy station, individual audiometric testing booth, and physical examination area. The unit will be clean and orderly with clear access to hand washing. There will be a main entrance, to include an emergency exit.

8.2. Mobile units shall be equipped with a self-contained power source. The NMARNG shall not provide power to the Contractor’s mobile unit.

9. MEDICAL REPORTS AND RECORDKEEPING

9.1. Contractor shall ensure two (2) copies of the employee’s examination findings are furnished. One copy shall be sent to the Contracting Officer Representative (COR) and one copy shall be mailed directly to the individual employee’s home of record. Copies provided (sent) in bulk to the COR shall be sent in appropriately secured, correctly sized individual envelops not folded. Each to be identified with the employee’s full name, job code, and work location on the front of the sealed envelope, in alphabetical order, and if stapling is required; documents will be stapled in the upper left hand corner, at a minimum. Medical examination results shall include all diagnostic tests, graphs, charts, reports, questionnaires, waivers, employee consent forms, physical findings, and examination results. The Contractor shall provide the COR with a hard copy of these results within 30 working days of completion of testing.

9.2. Required Computer Access by Common Access Card (CAC): The Contractor shall have CAC access to upload all exam results into the Defense Occupational Environmental

Health Readiness System (DOEHRS) and Occupational Health Module contained in MedChart, within 45 working days of the completion of testing. Results of medical surveillance testing, which are questionable and /or of critical significance shall be communicated directly and immediately to the COR by telephone or express mail.

MedChart is a DOD monitored medical tracking program that requires CAC ONLY access.

Contractor shall have access to MedChart to be able to submit and approve examination records to be approved in the OH module in order to complete the medical record upload.

9.3. Contractor shall identify all medical records with the employee’s full name, social security number, date of birth, job code, and the name of the employee’s work place or facility at a minimum. The Contractor shall ensure work / health history forms (OSHA standardized medical questionnaires may be utilized) and medical reports are complete and legible (typed / printed). The Contractor will provide a cover letter to each employee whom exam results are sent. The letter will be individualized and will summarize in lay terms individual test results; along with a recommendation as warranted by the results, for the employee to follow up with their personal physician as indicated. At the discretion of the Contractor, a disclaimer may be added to the exam cover letter stating, “If you require further information, and or have questions related to the exam results; you are welcome to reply within thirty days of receipt. If no response, we presume you acknowledge and accept”. (A checklist method to disseminate test results is not acceptable).

9.4. Contractor shall be provided the Privacy Act Statement (DD Form 2005) for each employee to sign during the registration process, should employees be instructed to complete a release form by the Contractor.

10.0. AUDIOMETRIC TESTING:

Meet all applicable Hearing Conservation Program requirements in accordance with DA PAM 40-501, Hearing Conservation, 10 December 1998, and the U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) Technical Guide (TG) No. 167A. To be DOEHRS-HC Capable, and or Certified for uploading hearing test results to the DOEHRS-HC computer data base system.

10.1. Contractor shall perform an air condition audiogram at 500, 1000, 3000, 4000, and 6000-hertz (Hz) in both ears. Audiometric reports must contain:

a) The examiner’s name and CAHOC certification number

b) The reviewer’s name (audiologist or physician), state license or certification number, or the NMARNG equivalent civilian job code (e.g. 0665- Audiologist)

c) The make, model, serial number and the most recent electro acoustic calibration date of the audiometer used.

10.2. Contractor shall, prior to the contract test date, provide documented proof of each audiometers last calibration date in accordance with the ANSI S3.6-1996 standard. The calibration date must be within one year of contract test dates.

11. EXAMINATION SCHEDULING

11.1. Coordination of scheduling shall be a joint effort between the Occupational Health Nurse and the Contractor. A draft copy of the scheduled will be initiated by the OHN and sent to the Contractor for review and any needed adjustments. One patient/employee per 15 minute intervals. All workdays include a one-hour lunch break. No testing shall be performed between 1130 – 1230 hours, however, due to fasting employees, all efforts will be made to obtain blood and urine samples before lunch.

11.2. In the event of a Contractor equipment failure, specific testing and / or parts of examinations that are not completed during the testing period will be completed at a scheduled time mutually convenient for the Contractor and the OHN. Unfinished testing / examinations will be completed at no additional cost to the NMARNG. The option to schedule physicals not completed due to equipment failure, through a local occupational medical facility shall be done at no cost to the NMARNG. The Contractor shall be directly responsible to cover costs for completing these make-up examinations.

11.3. POC for all clinical issues is the NMARNG OHN, LTC Monica Martinez-Archibeque, 600 Wyoming Blvd. NE, Albuquerque, NM 87123. (505) 271-7179 or 505-670-8298

12.0 Quality Assurance Surveillance Plan (QASP):

The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each

Specification Item Performance Objective AQL Method of Surveillance

Sample Size

Frequency

Health Assessments

Exams are performed in accordance with all regulations

95% Inspection 100% 100%

Visual Acuity Testing

Testing is performed in accordance with Army Regulation

Respiratory Fit testing accordance with Army Regulation

Chest x-ray accordance with Army Regulation

95% Customer Feedback

100% 100%

Administrative Functions

All reports and documents are submitted and inputted within 3 days

100% Inspection 100% 100%

Audiology Testing Testing is performed within Army regulations

95% Inspection 100% 100%

Phlebotomy Services Testing is performed within Army regulations

95% Inspection 100% 100%

Eye Exam Testing is performed within Army regulations

12.1 QASP Evaluation Ratings:

The evaluation ratings are as follows:

Exceptional – Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the tasks being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good – Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the tasks being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory – Performance meets contractual requirements. The contractual performance of the tasks contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal – Performance does not meet contractual requirements. The contractual performance of the tasks being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions were only marginally effective or were not fully implemented.

Unsatisfactory – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the tasks contains a serious problem(s) for which the contractor’s actions were ineffective.

CONTRACTOR MAN POWER REPORTING

Contractor Manpower Reporting (CMR) Requirements:

CMR: The Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the Contractor shall report ALL Contractor manpower (including subcontractor manpower) required for performance of this contract. The contractor shall completely fill in all the information in the format using the following web address https://cmra.army.mil/Login.aspx. The required information includes:

(1) Contracting Office, KO, Contracting Officer’s Technical Representative (COTR) or also known as the Contracting Officer’s Representative (COR);

(2) Contract number, including task and delivery order number;

(3) Beginning and ending dates covered by reporting period;

(4) Contractor's name, address, phone number, e-mail address, identity of Contractor employee entering data;

(5) Estimated direct labor hours (including sub-Contractors);

(6) Estimated direct labor dollars paid this reporting period (including sub- Contractors);

(7) Total payments (including sub-Contractors);

(8) Predominant Federal Service Code (FSC) reflecting services provided by Contractor (and separate predominant FSC for each sub-Contractor if different);

(9) Estimated data collection cost;

(10) Organizational title associated with the Unit Identification Code (UIC) for the Army Requiring Activity (the Army Requiring Activity is responsible for providing the Contractor with its UIC for the purposes of reporting this information);

(11) Locations where Contractor and sub-Contractors perform the work (specified by zip code in the United States and nearest city, country, when in an overseas location, using standardized nomenclature provided on website);

(12) Presence of deployment or contingency contract language;

(13) Number of Contractor and sub-Contractor employees deployed in theater this reporting period (by country).

As part of their submission, the Contractor shall provide the estimated total cost (if any) incurred to comply with this reporting requirement on CLIN 00002. Reporting period shall be the period of performance not to exceed 12 months ending September 30 of each government fiscal year and must be reported by 31 October of each calendar year. Contractors may use a direct XML data transfer to the database server or fill in the fields on the website. The XML direct transfer is a format for transferring files from a Contractor’s system to the secure website without the need for separate data entries for each required data element at the website. The specific formats for the XML direct transfer may be downloaded from the website shown above.

5352.242-9001 - CAC

5352.242-9001 Common Access Cards (CAC) for Contractor Personnel

COMMON ACCESS CARDS (CAC) FOR CONTRACTOR PERSONNEL (NOV 2012)

(a) For installation(s)/location(s) cited in the contract, contractors shall ensure Common Access Cards (CACs) are obtained by all contract or subcontract personnel who meet one or both of the following criteria:

(1) Require logical access to Department of Defense computer networks and systems in either:

(i) the unclassified environment; or

(ii) the classified environment where authorized by governing security directives.

(2) Perform work, which requires the use of a CAC for installation entry control or physical access to facilities and buildings.

(b) Contractors and their personnel shall use the following procedures to obtain CACs:

(1) Contractors shall provide a listing of personnel who require a CAC to the contracting officer. The government will provide the contractor instruction on how to complete the Contractor Verification System (CVS) application and then notify the contractor when approved.

(2) Contractor personnel shall obtain a CAC from the nearest Real Time Automated Personnel Identification Documentation System (RAPIDS) Issuing Facility (typically the local Military Personnel Flight (MPF)).

(c) While visiting or performing work on installation(s)/location(s), contractor personnel shall wear or prominently display the CAC as required by the governing local policy.

(d) During the performance period of the contract, the contractor shall:

(1) Within 7 working days of any changes to the listing of the contract personnel authorized a CAC, provide an updated listing to the contracting officer who will provide the updated listing to the authorizing government official;

(2) Return CACs in accordance with local policy/directives within 7 working days of a change in status for contractor personnel who no longer require logical or physical access;

(3) Return CACs in accordance with local policy/directives within 7 working days following a CACs expiration date; and

(4) Report lost or stolen CACs in accordance with local policy/directives.

(e) Within 7 working days following completion/termination of the contract, the contractor shall return all CACs issued to their personnel to the issuing office or the location specified by local policy/directives.

(f) Failure to comply with these requirements may result in withholding of final payment.

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A N/A N/A Government 0002 N/A N/A N/A Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

0001 N/A N/A N/A N/A

0002 N/A N/A N/A N/A

CLAUSES INCORPORATED BY REFERENCE

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 52.204-16 Commercial and Government Entity Code Reporting JUL 2015 52.204-17 Ownership or Control of Offeror NOV 2014 52.204-18 Commercial and Government Entity Code Maintenance JUL 2015 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

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations

NOV 2015

52.222-3 Convict Labor JUN 2003 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-26 Equal Opportunity APR 2015 52.222-36 Equal Opportunity for Workers with Disabilities JUL 2014 52.222-41 Service Contract Labor Standards MAY 2014 52.222-50 Combating Trafficking in Persons MAR 2015 52.222-55 Minimum Wages Under Executive Order 13658 DEC 2015 52.223-18 Encouraging Contractor Policies To Ban Text Messaging

While Driving

AUG 2011

52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.232-33 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 52.247-34 F.O.B. Destination NOV 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

252.204-7011 Alternative Line Item Structure SEP 2011 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

252.211-7008 Use of Government-Assigned Serial Numbers SEP 2010 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006 252.244-7000 Subcontracts for Commercial Items JUN 2013 252.247-7023 Transportation of Supplies by Sea APR 2014

CLAUSES INCORPORATED BY FULL TEXT

52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A

FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

(a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that--

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that--

(1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS (OCT 2015)

(a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code and small business size standard for this acquisition appear in Block 10 of the solicitation cover sheet (SF 1449). However, the small business size standard for a concern which submits an offer in its own name, but which proposes to furnish an item which it did not itself manufacture, is 500 employees.

(b) Submission of offers. Submit signed and dated offers to the office specified in this solicitation at or before the exact time specified in this solicitation. Offers may be submitted on the SF 1449, letterhead stationery, or as otherwise specified in the solicitation. As a minimum, offers must show--

(1) The solicitation number;

(2) The time specified in the solicitation for receipt of offers;

(3) The name, address, and telephone number of the offeror;

(4) A technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary;

(5) Terms of any express warranty;

(6) Price and any discount terms;

(7) "Remit to" address, if different than mailing address;

(8) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically);

(9) Acknowledgment of Solicitation Amendments;

(10) Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information); and

(11) If the offer is not submitted on the SF 1449, include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

In Addition, Contractors shall submit with their offer the following:

(12) A detailed Technical description of how the Contractor can perform the required work and medical exams defined in the Performance Work Statement (PWS). A description of the Contractor’s mobile unit that will be used to travel across New Mexico to the various sites defined in the PWS to conduct the exams. Contractor shall define their management experience and approach in handling contracts for the same or similar services.

(13) Documentation showing that required personnel have Common Access Card (CAC) access to the Department of Defense (DoD) computer systems Defense Occupational Environmental Health Readiness System (DOEHRS) and Occupational Health Module contained in MedChart. Contractor shall have CAC access before and/or at time of Contract award to stay on schedule for the required services.

If a contractor cannot gain access to these systems by the time of contract award or provide documentation showing they have access with their proposal, they shall not be considered for award.

(14) Three (3) most prior contracts for same or like services that shall include: Contract Number, a Point of Contact, their contact information (Telephone Number, Email and Mailing Address), and total dollar amount.

(15) The Contractor shall submit One (1) volume of their technical, management, documentation of CAC access to the required computer systems, and past performance proposal and One (1) copy of their cost proposal in another volume by responding to this solicitation or by submitting their proposal via email to the Contract Specialist John P. McLaughlin at john.p.mclaughlin74.civ@mail.mil.

(c) Period for acceptance of offers. The offeror agrees to hold the prices in its offer firm for 30 calendar days from the date specified for receipt of offers, unless another time period is specified in an addendum to the solicitation.

(d) Product samples. When required by the solicitation, product samples shall be submitted at or prior to the time specified for receipt of offers. Unless otherwise specified in this solicitation, these samples shall be submitted at no expense to the Government, and returned at the sender's request and expense, unless they are destroyed during preaward testing.

(e) Multiple offers. Offerors are encouraged to submit multiple offers presenting alternative terms and conditions or commercial items for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately.

(f) Late submissions, modifications, revisions, and withdrawals of offers:

(1) Offerors are responsible for submitting offers, and any modifications, revisions, or withdrawals, so as to reach the Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that offers or revisions are due.

(2)(i) Any offer, modification, revision, or withdrawal of an offer received at the Government office designated in the solicitation after the exact time specified for receipt of offers is “late” and will not be considered unless it is received before award is made, the Contracting Officer determines that accepting the late offer would not unduly delay the acquisition; and--

(A) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of offers; or

(B) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of offers and was under the Government's control prior to the time set for receipt of offers; or

(C) If this solicitation is a request for proposals, it was the only proposal received.

(ii) However, a late modification of an otherwise successful offer, that makes its terms more favorable to the Government, will be considered at any time it is received and may be accepted.

(3) Acceptable evidence to establish the time of receipt at the Government installation includes the time/date stamp of that installation on the offer wrapper, other documentary evidence of receipt maintained by the installation, or oral testimony or statements of Government personnel.

(4) If an emergency or unanticipated event interrupts normal Government processes so that offers cannot be received at the Government office designated for receipt of offers by the exact time specified in the solicitation, and urgent Government requirements preclude amendment of the solicitation or other notice of an extension of the closing date, the time specified for receipt of offers will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume.

(5) Offers may be withdrawn by written notice received at any time before the exact time set for receipt of offers.

Oral offers in response to oral solicitations may be withdrawn orally. If the solicitation authorizes facsimile offers, offers may be withdrawn via facsimile received at any time before the exact time set for receipt of offers, subject to the conditions specified in the solicitation concerning facsimile offers. An offer may be withdrawn in person by an offeror or its authorized representative if, before the exact time set for receipt of offers, the identity of the person requesting withdrawal is established and the person signs a receipt for the offer.

(g) Contract award (not applicable to Invitation for Bids). The Government intends to evaluate offers and award a contract without discussions with offerors. Therefore, the offeror's initial offer should contain the offeror's best terms from a price and technical standpoint. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received.

(h) Multiple awards. The Government may accept any item or group of items of an offer, unless the offeror qualifies the offer by specific…