W912KZ24R0003_Solicitation.pdf

SEE ADDENDUM

(No Collect Calls)

W912KZ24R0003 31-Jan-2024

b. TELEPHONE NUMBER

502-607-1912

8. OFFER DUE DATE/LOCAL TIME

11:00 AM 07 Feb 2024

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 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.

W912KZ9. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

DEVONA J. JACKSON

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

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

0012065497-0001

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 BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

USPFO KY PURCHASING & CONTRACTING

BOONE NATIONAL GUARD CENTER,

BUILDING 120

120 MINUTEMAN PARKWAY

FRANKFORT KY 40601-6192

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

SEE SCHEDULE

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

X 8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$9,000,000

NAICS:

621210

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 OF16

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.

W912KZ24R0003

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 12 Months MED_004 FY24 Dental Payroll

FFP

MED_004 FY24 Dental Payroll FOB: Destination

PURCHASE REQUEST NUMBER: 0012065497-0001

PSC CD: Q503

NET AMT

0002 12 Months MED_004 FY24 Dental Travel

FFP

MED_004 FY24 Dental Travel FOB: Destination

PURCHASE REQUEST NUMBER: 0012065497-0001

PSC CD: R499

1001 12 Months OPTION MED_004 FY25 Dental Payroll

FFP

MED_004 FY25 Dental Payroll FOB: Destination

1002 12 Months OPTION MED_004 FY25 Dental Travel

FFP

MED_004 FY25 Dental Travel

2001 12 Months OPTION MED_004 FY26 Dental Payroll

FFP

MED_004 FY26 Dental Payroll

2002 12 Months OPTION MED_004 FY26 Dental Travel

FFP

MED_004 FY26 Dental Travel

3001 12 Months OPTION MED_004 FY27 Dental Payroll

FFP

MED_004 FY27 Dental Payroll

3002 12 Months OPTION MED_004 FY27 Dental Travel

FFP

MED_004 FY27 Dental Travel

4001 12 Months OPTION MED_004 FY28 Dental Payroll

FFP

MED_004 FY28 Dental Payroll

4002 12 Months OPTION MED_004 FY28 Dental Travel

FFP

MED_004 FY28 Dental Travel

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government 0002 N/A N/A N/A Government 1001 N/A N/A N/A Government 1002 N/A N/A N/A Government 2001 N/A N/A N/A Government 2002 N/A N/A N/A Government 3001 N/A N/A N/A Government 3002 N/A N/A N/A Government 4001 N/A N/A N/A Government 4002 N/A N/A N/A Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 09-FEB-2024 12 USPFO FOR KENTUCKY

DEVONA J. JACKSON

BNGC, BLDG 120

120 MINUTEMAN PARKWAY

FRANKFORT KY 40601-6192

502-607-1912

W912KZ

0002 09-FEB-2024 12 W8A2 KYARNG ELEMENT, JF HQ

W8A2 KYARNG ELEMENT, JF HQ

112 MINUTEMAN PKWY

ROOM 114

FRANKFORT KY 40601-6168

502-607-1771

W900D1

1001 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

1002 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

2001 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

2002 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

3001 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

3002 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

4001 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

4002 09-FEB-2024 12 (SAME AS PREVIOUS LOCATION)

NG AGENCY PROTEST PROGRAM LAN

National Guard Protest Procedures VIII. Solicitation provision. Include the below provision in all solicitations:

NG Agency Protest Program is intended to encourage interested parties to seek resolution of their concerns with the National Guard (NG) as an Alternative Dispute Resolution forum, rather than filing a protest with the Government Accountability Office (GAO) or other external forum.

Contract award or performance is suspended during the protest to the same extent, and within the same time periods as if filed at the GAO. The NG protest decision goal is to resolve protests within 35 calendar days from filing. An agency protest may be filed with either the Contracting Officer or the NG Agency’s Protest Decision Authority, but not both, in accordance with NG protest procedures.

To be timely, the protests must be filed with the periods specified in FAR 33.103. To file a protest under the NG Agency Protest Program, the protest must request resolution under that program and be sent to the address below:

National Guard Bureau Office of the Director of Acquisitions/ Head of Contracting Activity

ATTN: NGB-AQ-O

111 S. George Mason Dr.

Arlington, VA 22204 Email: ng.ncr.ngb-arng.mbx.ngb-task-order-ombudsman@mail.mil

All other agency-level protests should be sent to the Contracting Officer for resolution at the address in the solicitation. See FAR clause 52.233-2.

NG Public-facing, general Protest information is found at:

https://www.nationalguard.mil/Leadership/Joint-Staff/Special-Staff/Director-of-Acquisitions/

Directorate of Acquisitions information for the contracting enterprise is found at https://gko.portal.ng.mil/ngb/STAFF/D01/D01/OI/Protests%20and%20Complaints/Forms/AllIte ms.aspx

CLAUSES INCORPORATED BY REFERENCE

52.203-6 Alt I Restrictions On Subcontractor Sales To The Government

(JUN 2020) -- Alternate I

NOV 2021

52.203-11 Certification And Disclosure Regarding Payments To Influence Certain Federal Transactions

SEP 2007

52.203-12 Limitation On Payments To Influence Certain Federal Transactions

JUN 2020

52.204-7 System for Award Management OCT 2018 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.204-10 Reporting Executive Compensation and First-Tier

Subcontract Awards

JUN 2020

52.204-13 System for Award Management Maintenance OCT 2018 52.204-14 Service Contract Reporting Requirements OCT 2016 52.204-16 Commercial and Government Entity Code Reporting AUG 2020 52.204-17 Ownership or Control of Offeror AUG 2020 52.204-20 Predecessor of Offeror AUG 2020 52.204-21 Basic Safeguarding of Covered Contractor Information

Systems

NOV 2021

52.204-23 Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab Covered Entities

DEC 2023

52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment

NOV 2021

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

OCT 2020

52.204-27 Prohibition on a ByteDance Covered Application JUN 2023 52.209-6 Protecting the Government's Interest When Subcontracting

With Contractors Debarred, Suspended, or Proposed for Debarment

NOV 2021

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations

NOV 2015

52.212-3 (Dev) Offeror Representations and Certifications - Commercial Products and Commercial Services (DEVIATION 2024- O0002)

JAN 2024

52.217-5 Evaluation Of Options JUL 1990 52.217-8 Option To Extend Services NOV 1999 52.217-9 Option To Extend The Term Of The Contract MAR 2000 52.219-1 (Dev) Small Business Program Representations (DEVIATION

2024-O0002)

JAN 2024

52.219-8 (Dev) Utilization of Small Business Concerns (DEVIATION 2024- O0002)

JAN 2024

52.219-14 (Dev) Limitations on Subcontracting (DEVIATION 2021-O0008) FEB 2023 52.219-17 Section 8(a) Award OCT 2019 52.219-18 Notification Of Competition Limited To Eligible 8(a)

Participants

OCT 2022

52.222-3 Convict Labor JUN 2003 52.222-19 (Dev) Child Labor - Cooperation with Authorities and Remedies

(DEVIATION 2020-O0019)

NOV 2023

52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-22 Previous Contracts And Compliance Reports FEB 1999 52.222-25 Affirmative Action Compliance APR 1984 52.222-26 Equal Opportunity SEP 2016 52.222-37 Employment Reports on Veterans JUN 2020

52.222-40 Notification of Employee Rights Under the National Labor Relations Act

DEC 2010

52.222-41 Service Contract Labor Standards AUG 2018 52.222-42 Statement Of Equivalent Rates For Federal Hires MAY 2014 52.222-43 Fair Labor Standards Act And Service Contract Labor

Standards - Price Adjustment (Multiple Year And Option Contracts)

AUG 2018

52.222-50 Combating Trafficking in Persons NOV 2021 52.222-54 Employment Eligibility Verification MAY 2022 52.223-6 Drug-Free Workplace MAY 2001 52.223-16 Alt I Acquisition of EPEAT - Registered Personal Computer

Products - Alternate I

JUN 2014

52.223-18 Encouraging Contractor Policies To Ban Text Messaging While Driving

JUN 2020

52.223-20 Aerosols JUN 2016 52.223-21 Foams JUN 2016 52.224-1 Privacy Act Notification APR 1984 52.224-2 Privacy Act APR 1984 52.224-3 Privacy Training JAN 2017 52.229-11 Tax on Certain Foreign Procurements--Notice and

Representation

JUN 2020

52.229-12 Tax on Certain Foreign Procurements FEB 2021 52.232-33 Payment by Electronic Funds Transfer--System for Award

Management

OCT 2018

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

Subcontractors

MAR 2023

52.233-2 Service Of Protest SEP 2006 52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.237-3 Continuity Of Services JAN 1991 52.239-1 Privacy or Security Safeguards AUG 1996 52.242-13 Bankruptcy JUL 1995 52.242-15 Stop-Work Order AUG 1989 252.201-7000 Contracting Officer's Representative DEC 1991 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7001 Prohibition On Persons Convicted of Fraud or Other Defense- Contract-Related Felonies

JAN 2023

252.203-7002 Requirement to Inform Employees of Whistleblower Rights DEC 2022 252.203-7003 Agency Office of the Inspector General AUG 2019 252.203-7005 Representation Relating to Compensation of Former DoD

Officials

SEP 2022

252.204-7000 Disclosure Of Information OCT 2016 252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7004 Antiterrorism Awareness Training for Contractors JAN 2023 252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

OCT 2016

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting

JAN 2023

252.204-7014 Limitations on the Use or Disclosure of Information by Litigation Support Contractors

JAN 2023

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

JAN 2023

252.204-7016 Covered Defense Telecommunications Equipment or Services -- Representation

DEC 2019

252.204-7017 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services -- Representation

MAY 2021

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

JAN 2023

252.204-7019 Notice of NIST SP 800-171 DoD Assessment Requirements NOV 2023 252.204-7020 NIST SP 800-171 DoD Assessment Requirements NOV 2023 252.204-7021 Contractor Compliance with the Cybersecurity Maturity

Model Certification Level Requirement

JAN 2023

252.204-7022 Expediting Contract Closeout MAY 2021 252.204-7024 Notice on the Use of the Supplier Performance Risk System MAR 2023 252.211-7003 Item Unique Identification and Valuation JAN 2023 252.219-7009 Section 8(a) Direct Award OCT 2018 252.219-7010 (Dev) Notification of Competition Limited to Eligible 8(a)

Participants- Partnership Agreement (Deviation 2023-O0007)

AUG 2023

252.223-7008 Prohibition of Hexavalent Chromium JAN 2023 252.225-7002 Qualifying Country Sources As Subcontractors MAR 2022 252.225-7012 Preference For Certain Domestic Commodities APR 2022 252.225-7052 Restriction on the Acquisition of Certain Magnets, Tantalum, and Tungsten.

JAN 2023

252.225-7055 Representation Regarding Business Operations with the Maduro Regime

MAY 2022

252.225-7056 Prohibition Regarding Business Operations with the Maduro Regime

JAN 2023

252.225-7059 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region - Representation

JUN 2023

252.225-7060 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region

JUN 2023

252.225-7061 Restriction on the Acquisition of Personal Protective Equipment and Certain Other Items from Non-Allied Foreign Nations

JAN 2023

252.229-7014 Full Exemption from Two-Percent Excise Tax on Certain Foreign Procurements

OCT 2022

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports

DEC 2018

252.232-7010 Levies on Contract Payments DEC 2006 252.239-7001 Information Assurance Contractor Training and Certification JAN 2008 252.239-7017 Notice of Supply Chain Risk DEC 2022 252.239-7018 Supply Chain Risk DEC 2022 252.243-7002 Requests for Equitable Adjustment DEC 2022 252.244-7000 Subcontracts for Commercial Products or Commercial

Services

NOV 2023

CLAUSES INCORPORATED BY FULL TEXT

52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO

SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services-- Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications- Commercial Products and Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision-

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L.

115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to--

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L.

115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to--

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services."

(d) Representations. The Offeror represents that--

(1) It [ ___ ] will, [ ___ ] will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that--

It [ ___ ] does, [ ___ ] does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment--

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services--

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment--

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services--

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(End of provision)

52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (NOV 2020)

(a) The use in this solicitation of any Federal Acquisition Regulation (48 CFR Chapter 1) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the provision.

(b) The use in this solicitation of any Defense Federal Acquisitions Regulations Supplement (48 CFR Chapter 2) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

(End of provision)

52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (NOV 2020)

(a) The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause.

(b) The use in this solicitation or contract of any Defense Federal Acquisitions Regulations Supplement (48 CFR 2) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

(End of clause)

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JAN 2023)

(a) Definitions. As used in this clause—

“Department of Defense Activity Address Code (DoDAAC)” is a six position code that uniquely identifies a unit, activity, or organization.

“Document type” means the type of payment request or receiving report available for creation in Wide Area WorkFlow (WAWF).

“Local processing office (LPO)” is the office responsible for payment certification when payment certification is done external to the entitlement system.

“Payment request” and “receiving report” are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(b) Electronic invoicing. The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (DFARS) 252.232- 7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) WAWF access. To access WAWF, the Contractor shall—

(1) Have a designated electronic business point of contact in the System for Award Management at https://www.sam.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site.

(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the “Web Based Training” link on the WAWF home page at https://wawf.eb.mil/.

(e) WAWF methods of document submission. Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol.

(f) WAWF payment instructions. The Contractor shall use the following information when submitting payment requests and receiving reports in WAWF for this contract or task or delivery order:

(1) Document type. The Contractor shall submit payment requests using the following document type(s):

(i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher.

(ii) For fixed price line items—

(A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer.

(B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer.

___Invoice 2in1________________________________________________

(iii) For customary progress payments based on costs incurred, submit a progress payment request.

(iv) For performance based payments, submit a performance based payment request.

(v) For commercial financing, submit a commercial financing request.

(2) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract.

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table*

Field Name in WAWF Data to be entered in WAWF

Pay Official DoDAAC HQ0670

Issue By DoDAAC HQ0670

Admin DoDAAC** W912KZ

Inspect By DoDAAC W912KZ

Ship To Code ____

Ship From Code ____

Mark For Code ____

Service Approver (DoDAAC) W912KZ

Service Acceptor (DoDAAC) W912KZ

Accept at Other DoDAAC ____

LPO DoDAAC ____

DCAA Auditor DoDAAC ____

Other DoDAAC(s) ____

(4) Payment request. The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable.

(5) Receiving report. The Contractor shall ensure a receiving report meets the requirements of DFARS Appendix F.

(g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity’s WAWF point of contact.

_WILL BE PROVIDED ON AWARD_________________________

(2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed.

(End of clause)

FY24 DENTAL CONTRACT

STATEMENT OF WORK

Dental - Service Delivery Summary

1.0 Organizational Analysis: Kentucky Army National Guard (ARNG):

Vision: Provide a healthy, resilient, readiness and deployable force for federal, state and community missions.

Mission: To Provide a Responsive Medical Force and a Healthy Medically Ready Army National Guard.

General: The qualif ied contractor will provide a licensed dentist to perform annual dental examinations on KYARNG Soldiers IAW DoD Guidelines for a Periodic Annual Evaluation, American Dental Association procedure code D0120. The dentist will work under the clinical guidance of the State Dental Of f icer and the administrative direction of the Deputy State Surgeon or their designee.

• Federal Role: To maintain well-trained, well-equipped units available for prompt mobilization during war, and assist during national emergencies.

• State Role: To protect life and property, and to preserve peace, order, and public safety.

• Community Role: To participate in local, state, and national programs that adds value to America.

Technical Specif ications: The purpose of this requirement is to provide Dental staf f ing in support of Individual Medical Readiness (IMR). This requirement is designed to be f lexible, responsive, and meets the ever-evolving needs of the government. DoDI 6025.19 establishes aggressive quarterly and annual metric goals for the separate IMR elements and for the overall IMR category of Fully Medically Ready (FMR) soldiers. The ultimate goals are to produce real-time reports based on complete, accurate data.

The minimum goal for overall medical readiness is more than 85% of Service members FMR, with the ideal goal being 100%. The Kentucky Army National Guard (ARNG) Surgeon’s Of f ice requires a highly responsive process whereby the government can quickly obtain needed support and services. This PWS ref lects existing National Guard Bureau policies and regulations.

Period of Performance (PoP): The period of performance shall be a base year with an option of 4 years.

All plans, reports and program shall be reviewed and approved by a government official prior to release.

2.0 Dentist (1 pax):

The Contractor shall:

Specif ic Requirements:

1. Throughout the contract period, the Contractor must maintain an unrestricted dental license and meet the qualif ications of the State of Kentucky Dental Board for Licensing. It is the company’s responsibility to ensure these requirements are met and documentation is submitted to the

KYNG.

2. The contractor will have to be privileged through the KYNG, which is the responsibility of the Deputy State Surgeon once the company submits all required documentation. Contractor will be unable to perform all aspects of this contract until that is done.

3. The contract is a non-personal services contract, and the contract is not intended to create an employer-employee relationship between the Government and the individual HCP’s.

4. The contractor company must fund the investigation in order of their employee(s) to be able to obtain a secret security clearance and CAC card. DD 254 is attached.

5. In the process of the dental examination the contractor will perform bite wing and panographic x-rays as required. Any def iciencies or equipment issues need to be reported in writing to HS NCO IC/ DSS immediately.

6. The contractor will obtain and maintain a valid HIPAA certif ication of training.

7. The contractor will obtain and maintain accounts in MODS that relate to dental readiness that include MEDPROS, DENCLASS, E-prof ile, E-case.

8. The contractor will need to be able to prof ile DRC3 Soldiers as needed IAW NGB/DoD standards.

9. The contractor will enter all required Soldier Dental data in DENCLASS as required to include translation of DD2813.

10. The contractor will participate in weekly and monthly brief ings regarding dental readiness as requested by the KYNG POC to include but not limited to case management meetings.

11. When necessary, the dental contractor will liaison with other private dentists to obtain necessary dental documentation.

12. When necessary, the dental contractor will work with MMSO and MetLife to facilitate any needed referral.

13. The contractor will maintain dental readiness reports and records monthly that indicate both current and historical dental readiness metrics ICW this contract in support of KYARNG.

14. The contractor should learn and maintain an understanding and working knowledge of ef fects of dental readiness on USR reporting.

15. The contractor is required to complete all KYARNG regulatory trainings listed below:

a. Anti-Terrorism Level 1 Course: “Contractor employees with an area of performance within an Army controlled installation, facility, or area. All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I Awareness training within 30 days”.

b. Controlled Unclassif ied Information Training: “Include DFARS clause 252.204-7012, which requires the contractor to comply with NIST 800-171”.

c. Threat Awareness Reporting Program Training: “Per AR 381-12 Threat Awareness and Reporting Program (TARP), contractor employees must receive annual TARP training by a CI agent or other trainer as specified in 2-4b”.

d. IWatch Program Training: “Contractor employees with an area of performance within an Army controlled installation, facility, or area. The contractor and all associated sub‐contractors shall brief all employees on the local iWATCH Army program”.

e. Operations Security Program Training: “Per AR 530‐1, Operations Security, the contractor employees must complete Level I OPSEC Awareness training. New employees must be trained within 30 calendar days of their reporting for duty and annually thereafter”.

3.0 WORK WEEK. Typically, the contractor will be employed at Boone National Guard Center, 100 Minuteman PKWY, Frankfort, KY 40601 f rom 0830-1500, Tuesday, Wednesday, and Thursday.

However, occasional travel to other National Guard facilities within the state and weekend (Two days) work will be required. It is anticipated that the weekend requirement will be approximately one weekend a month and when required, the work schedule of the week preceding or following will be adjusted to account for the time worked on the weekend.

Recognized Holidays: The following are recognized US holidays during the Period of Performance.

Additional holiday schedules will be af forded to the contract company upon request.

o January 1, 2024 - New Year’s Day o January 15, 2024 - Martin Luther King, Jr.’s Birthday o February 19, 2024 - President George Washington’s Birthday o March 29, 2024 - Good Friday o May 27, 2024 - Memorial Day o June 19, 2024 - Juneteenth o July 04, 2024 - Independence Day o September 02, 2024 - Labor Day o November 11, 2024 - Veteran’s Day o November 28, 2024 - Thanksgiving Day o December 25, 2024 - Christmas Day o December 31, 2024 – New Year’s Eve o January 1, 2025 - New Year’s Day o January 20, 2025 - Martin Luther King, Jr.’s Birthday o February 17, 2025 - President George Washington’s Birthday

3.1 Primary location of work is Boone National Guard Center, Frankfort, KY. However alternate duty sites could be necessary as mission dictates.

3.2 Contractor Travel: Contractors will be reimbursed for travel and per diem expenses as specif ically authorized in the contract. Charges cannot exceed those stipulated in the Joint Travel Regulation unless documented by conditions in FAR 31.205-46, Travel Costs. Contractor travel must be approved by the COR as specif ied prior to departure. Actual modes of transportation and costs shall be agreed to in advance and reimbursed on a cost basis upon receipt of the invoice in and all receipts turned in to the appropriate Government Of f icial. Travel on non-duty days shall be accomplished only when it is required to meet Government mission requirements. Such travel shall be approved by the designated Contracting Of f icer and Contracting Of f icer Representative in advance.

3.3 The contractor will be provided with adequate working space, all equipment (e.g., desk, chair, computer, printer, copier, telephone, etc.), utilities, janitorial services, and expendable operating supplies for the duration of this contract. The contractor shall maintain the assigned of f ice space in a neat and orderly manner. The use of government-furnished facilities, equipment and supplies is for of f icial government business only. KYARNG will also furnish all required dental equipment for exams and diagnostic test.

3.4 The contractor and Government representative shall conduct an inventory of all Government furnished equipment within ten days of commencement. The contractor shall sign a receipt for all furnished equipment. The contractor and Government representative shall determine the working condition of all equipment. The Government will replace and/or repair any item not in working order.

3.5 Identif ication of Contractor Employees: Contractor employees are required to wear identif ication badges at all times while performing all aspects of this contract. The badges will be supplied by the Contract Company. All contractor personnel attending meetings and answering Government telephones are required to identify themselves as contract employees to avoid creating an impression they are Government employees. The contractor shall ensure all documents or reports produced by contractor personnel are suitably marked as contractor products or contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities. Contractor personnel shall wear identif ication badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed.

4.0 Security Requirements:

4.1 A National Agency Check with Inquiries (NACI) or equivalent is required, and a favorable completion of FBI f ingerprint History Check must be completed. A Common Access Card (CAC) is required for Base access and the Local Access Network (LAN). “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”.

4.2 Contractor shall work with the contracting of f ice for processing into the Trusted Associate Sponsorship System (TASS) formerly known as Contractor Verif ication System (CVS).

4.3 Contractor shall comply with all applicable physical security regulations and procedures applicable to the government locale. Contractor shall not disclose and shall safeguard all procurement sensitive information, contractor’s proprietary data, computer systems and data, privacy act data, and government personnel work products obtained or generated in the performance of this task order. Any documentation created in the performance of this contract is the government property of the Kentucky Army National Guard. Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. The requirements of obtaining a CAC card and funding the security authorizations is the sole responsibility of the Contract Company. Contractors who do not have a CAC and the appropriate clearance to access programs af ter four weeks will be sent home until access and proper clearance is obtained. The Contract Company will ensure all their Contractor employees shall:

Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation and complete initial and/or annual Information Assurance (IA) training as def ined in the IA Best Business Practices (BBP) training.

5.0 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

5.1 The contractor’s employees shall become familiar with and obey the regulations of the installation.

Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identif ication with them at all times.

The contractor shall ensure compliance with all regulations and orders of the installation which may af fect performance.

5.2 AT Level 1 Awareness Training (AT): All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I Awareness training within calendar days af ter contract start date or ef fective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certif icates of completion for each af fected contractor employee and subcontractor employee, to the COR or to the contracting of f icer, if a COR is not assigned, within calendar days af ter completion of training by all employees and subcontractor personnel. AT level I Awareness training is available at the following website: http://jko.jten.mil.

5.3 Access and general protection/security policy and procedures: Contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Of f ice, Director of Emergency Services or Security Of f ice. Contractor workforce must comply with all personal identity verif ication requirements (FAR clause 52.204‐9, Personal Identity Verif ication 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.

5.4 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 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI f ingerprint check and a successfully scheduled NACI at the Of f ice of Personnel Management.

5.5 For contractor not eligible for CAC, but requires access to 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 Identif ication Index (NCIC‐III) and Terrorist Screening Database (Army Directive 2014‐05/AR 190‐13), applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative); or, at OCONUS locations, in accordance with status of forces agreements and other theater regulations.

5.6 AT Awareness Training for Contractor Personnel Traveling Overseas: This standard language required US based contractor employees and associated subcontractor employees to make available and to receive Government provided area of responsibility (AOR)-specif ic AT http://jko.jten.mil/ awareness training as directed by AR 525‐13. Specif ic AOR training content is directed by the combatant commander, with the unit ATO being the local point of contact.

5.7 iWATCH Training: The contractor and all associated sub‐contractors shall brief all employees on the local iWATCH Army program (training standards provided by the requiring activity ATO). This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within calendar days of contract award and within calendar days of new employees commencing performance with the results reported to the COR NLT calendar days af ter contract award.

5.8 Army Training Certification Tracking System (ATCTS) registration for contractor employees who require access to government information systems: All contractor employees with access to a Government info system must be registered in the ATCTS (Army Training Certif ication Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the information system and then annually thereaf ter.

5.9 For contracts that require a formal OPSEC program: The contractor shall develop an OPSEC

Standing Operating Procedure (SOP)/Plan within 90 calendar days of contract award, to be reviewed and approved by the responsible Government OPSEC of f icer. This plan will include a process to identify critical information, where it is located, who is responsible for it, how to protect it and why it needs to be protected. The contractor shall implement OPSEC measures as ordered by the commander. In addition, the contractor shall have an identif ied certif ied Level II OPSEC coordinator per AR 530‐1.

5.10 For contracts that require OPSEC Training: Per AR 530‐1, Operations Security, the contractor employees must complete Level I OPSEC Awareness training. New employees must be trained within 30 calendar days of their reporting for duty and annually thereaf ter.

5.11 For IA/IT training: All contractor employees and associated subcontractor employees must complete the DoD IA awareness training before issuance of network access and annually thereaf ter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01‐M and AR 25‐2 within six months of appointment to IA/IT functions.

5.12 For IA/IT certification: Per DoD 8570.01‐M , DFARS 252.239.7001 and AR 25‐2, the contractor employees supporting IA/IT functions shall be appropriately certif ied upon contract award. The baseline certif ication as stipulated in DoD 8570.01‐M must be completed upon contract award.

5.13 Controlled Unclassified Information (CUI): Include DFARS clause 252.204-7012, which requires the contractor to comply with NIST 800-171. Also include DFARS provision 252.204- 2019 into solicitations. Acquisition of f icials should follow procedures outlined in DFARS 204.73 and verify vendors have an adequate NIST SP 800-171 summary assessment score within the Supplier Performance Risk System (within PIEE). If the score doesn't show a medium- or high-level assessment with a score of 110 or better (as described in the "NIST SP 800-171 DoD Assessment Methodology"), include clause 252.204-7020 and obtain the vendor's "system security plan" and "plan of action" for NIST SP 800-171 verif ication and assurance by Army security of f icials.

5.14 Threat Awareness Reporting Program: For all contractors with security clearances. Per AR

381-12 Threat Awareness and Reporting Program (TARP), contractor employees must receive annual TARP training by a CI agent or other trainer as specif ied in 2-4b.

5.15 COMSEC/IT Security. All communications with DOD organizations are subject to communications security (COMSEC) review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DOD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating f rom, or terminating at, DOD organizations. Therefore, the contractor is advised any time contractor place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and f requent dissemination of the above information to all employees dealing with DOD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

5.16 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy, and their actions af fect the most vulnerable portion of the AEI. Contractor employees shall have a favorable background investigation or hold a secret security clearance and access approvals commensurate with the level of information processed or available on the system. Contract Companies will fund all Security Clearance.

5.17 Investigations: Contractor employees shall: Comply with the command's Acceptable Use Policy

(AUP) for Government owned IS and sign an AUP prior to or upon account activation. Complete initial and/or annual Information Assurance (IA) training as def ined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil). Mark and safeguard f iles, output products, and storage media per classif ication level and disseminate them only to individuals authorized to receive them with a valid need to know.