W912L1-17-T-0026_Amendment_1.pdf

SEE ADDENDUM

(No Collect Calls)

W912L1-17-T-0026 08-Dec-2016

b. TELEPHONE NUMBER

512-782-5503

8. OFFER DUE DATE/LOCAL TIME

10:00 AM 05 Jan 2017

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.

W912L19. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

KOLIN R CROWDER

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

0010935041

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 ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

USPFO FOR TEXAS

CONTRACTING BRANCH

2200 WEST 35TH STREET

BLDG 66

AUSTIN TX 78703-1222

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 W90S22 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

USP&FO#TEXAS

SAFETY AND OCCUPATIONAL HEALTH OFFICE

2200 W. 35TH STREET

CAMP MABRY, BUILDING #8

ROOM C151

AUSTIN TX 78703-1222

TEL: 512-782-3566 FAX:

512-782-5108FAX:

TEL: 512-782-5529 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$11,000,000

NAICS:

621111

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 OF51

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.

W912L1-17-T-0026

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Each Medical Screening Exams

FFP

Requesting Medical Screening Exams services to support the Texas Military Forces throughout the state of Texas. Quotes provided will be used to establish an annual blanket purchase agreement (BPA). A listing of the required services that need price quotes are attached. Please fill out the prices on the provided document and return to the point of contact for this solicitation at kolin.r.crowder.mil@mail.mil. Vendor selected must meet all the requirements of the performance work statement.

Locations (TX): Austin, Dallas, Fort Worth, Houston, San Antonio, Waco FOB: Destination

PURCHASE REQUEST NUMBER: 0010935041

NET AMT

0002 1 Each OPTION Medical Screening Exams (OY 1)

FFP

Same as CLIN 0001. If your pricing will vary from year to year, please state so on the attached pricing sheet.

0003 1 Each OPTION Medical Screening Exams (OY 2)

FFP

Same as CLIN 0001. If your pricing will vary from year to year, please state so on

0004 1 Each OPTION Medical Screening Exams (OY 3)

FFP

Same as CLIN 0001. If your pricing will vary from year to year, please state so on

0005 1 Each OPTION Medical Screening Exams (OY 4)

FFP

Same as CLIN 0001. If your pricing will vary from year to year, please state so on

0006 1 Each Contract Manpower Reporting

FFP

See PWS, which states " The Contract Manpower Reporting. The contractor shall report all labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Texas Army National Guard via a secure collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013.

Contractor may direct questions to the help desk at help desk at:

http://www.ecmra.mil."

0007 1 Each OPTION Contract Manpower Reporting (OY1)

FFP

See PWS, which states " The Contract Manpower Reporting. The contractor shall report all labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Texas Army National Guard via a secure collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013.

Contractor may direct questions to the help desk at help desk at:

0008 1 Each OPTION Contract Manpower Reporting (OY2)

FFP

See PWS, which states " The Contract Manpower Reporting. The contractor shall report all labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Texas Army National Guard via a secure collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013.

Contractor may direct questions to the help desk at help desk at:

0009 1 Each OPTION Contract Manpower Reporting (OY3)

FFP

See PWS, which states " The Contract Manpower Reporting. The contractor shall report all labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Texas Army National Guard via a secure collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013.

Contractor may direct questions to the help desk at help desk at:

0010 1 Each OPTION Contract Manpower Reporting (OY4)

FFP

See PWS, which states " The Contract Manpower Reporting. The contractor shall report all labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Texas Army National Guard via a secure collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013.

Contractor may direct questions to the help desk at help desk at:

NOTE

This RFQ will be used to set-up an Blanket Purchase Agreement for a total of 5 years.

All questions about the solicitation must be emailed to kolin.r.crowder.mil@mail.mil by 22 December 2016, 10:00am CST. Questions and answers will then be incorporated into the solicitation through an amendment and posted back to FBO.gov Include the unit pricing sheet and sign the SF 1449 - no pricing is required on the line items Department of Labor Wages under the Service Labor Standards Act are required for this solicitation. They can be assesed at www.wdol.gov for each location.

Submit all quotes to kolin.r.crowder.mil@mail.mil

PWS

PERFORMANCE WORK STATEMENT

TEXAS OCCUPATIONAL HEALTH

PROCUREMENT OF OCCUPATIONAL HEALTH EXAMS

1. GENERAL

The Performance Work Statement (PWS) supports the Texas Army National Guard (TXARNG) for Occupational Medical Surveillance Examination Program in accordance with the Occupation Safety and Health Association (OSHA) and other regulations. Examinations are required for approximately 120 TXARNG full time employees. The government reserves the right to increase and/or decrease the number of employees requiring examinations, during the contract period, based on the requirement. Places of Performance. Examinations will be in established permanent building clinics within the state of Texas, in the following cities: Austin, Fort Worth, Dallas, Houston, San Antonio, and Waco.

2. PURPOSE

2.1. The purpose of the Occupational Medical Surveillance Examination Program is to provide job-related Occupational Health Examinations and Medical Surveillance Services to the TXARNG full-time support (FTS) and/or temporary personnel who are exposed to OSHA level PEL 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 State Employees, civilian contractors, Active Guard Reserve, Active Duty for Operational Support (ADOS) and part-time traditional Soldiers.

2.2. The Government will 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, etc. The Contractor will provide Board Certified Physician(s) with experience in Occupational Health, supervision, all labor, tools, materials, equipment, and incidentals required to conduct the Occupational Health Examinations / Medical Surveillance Services for the TXARNG.

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 Government 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 Government shall evaluate the quality of professional and administrative services provided, while the Government retains no control over the medical, professional aspects of services rendered.

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 Act 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 medical surveillance physical examinations and occupational health specialty examinations.

3.5. Contractor shall arrange for the opportunity to consult with the Occupational Health Nurse (OHN) of the TXARNG 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 (COR) will contact and schedule a follow-up review and evaluation meeting to discuss positive and negative aspects of testing.

3.7. Contractor will use documentation provided by TXARNG to conduct and document the physicals and is responsible to ensure all equipment and personnel are available to complete specific exams requirements.

3.8. Contractor will provide a Job Functional Analysis or Kraus-Weber that includes back strength and flexibility if requested. Note any pain or recommended lifting limitations if less than 50 lbs.

3.9. Contractor shall ensure audiogram must be certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC) or the equivalent military Defense Occupational and Environmental Health Readiness System-Hearing Conservation (DOEHRS-HC) training in accordance with 29 CFR 1910.95. The estimated number of personnel to receive audiograms are approximately 5.

a. Hearing screenings will be conducted on employees designated by the OHN to include all workers exposed to occupational noise > 85 dBA or 140 dBA impact noise as part of their job duties.

b. All hearing tests will be entered into DOEHRS-HC by the contractor.

c. An otoscopic exam will be conducted to ensure

d. Test Only 500, 1000, 2000, 3000, 4000 and 6000.

e. Hearing aids must be removed.

f. Contractor must verify that worker has been noise free for at least 14 hours prior to screening.

g. All hearing screenings besides the baseline will be compared against the employee’s baseline to determine if there is a Significant Threshold Shift (STS) and retested immediately to verify results. Contractor will notify the Occupational Health Nurse within 10 days so that timely follow-up can be scheduled.

3.10. Contractor shall ensure Pulmonary Function Tests (PFTs) Performed by a licensed physician, Certified Pulmonary Function Technologist, or Registered Respiratory Therapist in accordance with 29 CFR 1910.1001. The estimated number of personnel to receive PFTs is approximately 10.

a. Screenings will only be conducted on employees designated by the OHN to include all those exposed to respiratory hazards that will require a respirator to mitigate hazards identified as above the action level.

b. Test will include as a minimum Forced Expiratory Volume in one second

(FEV1), Forced Vital Capacity (FVC), comparison with recognized normal’ s for the individual's height and weight, sex, race, age and a documented interpretation by a pulmonologist or certified Occupational Health physician.

c. Follow NIOSH and ATS-ERS standard requirements:

1. Continue testing individual when the patient is improving until improvement is <30ml.

2. Test results are acceptable with a minimum of three acceptable maneuvers that are free from a leak, obstructed mouthpiece, hesitation, false starts, cough, glottis closure, early termination, and have a good curve of at least 6 seconds duration.

3. Test results are reproducible in that they have the same result from the individual (two largest FVCs are within 0.150 L of each other and two largest FEV1's are within 0.150 L of each other) when the test is repeated several times. Testing is continued until criteria are met or 8 trials are attempted, or the employee being tested cannot or should not continue.

4. If three (3) acceptable and two (2) repeatable tests cannot be obtained, the technician performing the PFT must document the reason the standard could not be met.

5. Always use measured height not reported height by the nearest half inch without footwear.

6. Always indicate source of reference value on reports for adjusted predicted value

7. No smoking within 1 hour prior

8. No cold, flu or allergies within two weeks

9. No inhaler use prior to test that would still be in the patient’s system

d. Specifications regarding equipment guidelines and calibration, test administration, and test interpretation must meet applicable OSHA and ANSI standards.

Supporting documentation will be provided to this office daily or annually depending on manufacturing guidelines of spirometer.

e. Respirator clearance documented and a copy given to employee at time of visit.

3.11. Contractor will ensure that vision screenings are in accordance with DA PAM 40-506 using multiphasic vision screening equipment to measure the following primary visual skills and will be documented on a form provided by TXARNG.

a. Visual acuity for distance and near.

b. Lateral phorias for distance and near.

c. Vertical phorias for distance and near.

d. Depth perception.

e. Color perception.

f. Peripheral vision.

3.12. Contractor shall ensure laboratory tests will be processed by certified clinical laboratories and performed by personnel certified under the American Society of Clinical Pathology. The supporting laboratory will provide employee instruction and equipment necessary for tests requiring special collection methods and/or containers. Document that employee has been counseled by examining provider about laboratory test results. Provide a copy of lab results to employee for their primary care physician.

3.13. Contractor shall ensure a review of systems on physical examinations must be performed by a physician with emphasis on areas most likely to be affected by the employee's occupational exposures or desired certification.

3.14. Contractor shall ensure that chest X-rays will be performed by a certified X-ray technician. The interpretation and classification will be performed by a B-reader, or a board eligible or certified radiologist meeting the requirements of 29 CFR 1910.1001 Appendix E:

The estimated number of personnel to receive chest X-rays are none, but services must be available if requested.

a. Chest X-rays are only performed for employees that have documented enrollment into an asbestos program or other medical surveillance program as required.

b. Chest X-ray will include posterior-anterior and left lateral view.

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

3.17. Contractor shall provide the COR with a Quality Assurance Medical Surveillance Plan listing the procedures or processes, which shall be utilized to meet the requirements discussed in the PWS.

3.18. The Contract Manpower Reporting. The contractor shall report all labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Texas Army National Guard via a secure collection site. The contractor is required to completely fill in all required data fields using the following web address:

http://www.ecmra.mil/. Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September

30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013. Contractor may direct questions to the help desk at help desk at: http://www.ecmra.mil.

4. PERSONAL PROTECTIVE EQUIPMENT (PPE)

4.1. Contractor shall furnish and assure healthcare workers are provided with the appropriate PPE such as, but not limited to: gloves, protective eyewear, and etc., where there is a potential for exposure to blood or other potentially infectious materials.

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

1910.1030 Blood borne Pathogens Standard.

5. INFECTIOUS WASTE DISPOSAL

5.1. Disposal of all infectious waste shall be in accordance with local, state, and federal regulation and disposed of by the contractor unless other accommodations have been coordinated in writing.

5.2. 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.

6. MEDICAL REPORTS AND RECORDKEEPING

6.1. Contractors shall immediately contact the Occupational Health Nurse by telephone at 512- 782-3566 if results of medical surveillance screening(s), which are questionable and / or of critical significance and / or require follow-up. Contractor shall ensure that all results to include all diagnostic tests, graphs, charts, reports, questionnaires, waivers, employee consent forms, physical findings, and examination results are made available to the Occupational Health Nurse within 30 working days of completion of testing. Any electronic access to records must be in printable format suitable to be filed in the employee’s medical record. Mailed documentation will be sent to the address listed below and the contractor is responsible for all postage fees.

6.2. 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 and medical reports are complete and legible (typed / printed).

6.3. Contractor shall ensure that each employee signs the Privacy Act Statement (DD Form 2005) during the registration process.

7. SUMMARY REPORT:

The Contractor will provide a comprehensive report as follows:

7.1 Reports will be provided every six months directly to shops that were supported.

Addresses and a point of contact for each shop will be provided. Each report will include a summary of shops employees by name and the date and type of physical(s) performed and indicate qualified or not qualified for each type and expiration. Documentation of these qualifications with expirations will be provided as a certification card for each worker examined and copies of these cards will be included in the report. All information contained within the report must be sufficient for the supervisor to refer to during an inspection without violating HIPAA. A duplicate report will be sent to the Occupational Health Nurse via electronic format.

8. EXAMINATION SCHEDULING

8.1. Coordination of scheduling shall be a joint effort between the Facility Supervisor and the Contractor, a draft copy of the scheduled will be initiated by the Facility Supervisor and sent to the Contractor for review and any needed adjustments. Contractor will provide the Occupational Health Nurse the estimated time needed for each employee based on physical components required to ensure efficient use of scheduled time. Scheduling of employees to be examined at clinic locations will be accommodated by the Contractor within 30 days for routine visits and 7 days for urgent.

8.2. In the event of a Contractor equipment failure, specific testing and / or parts of examinations that are not completed during the testing period shall be completed at a scheduled time mutually convenient for the Contractor, Occupational Health Nurse and the Shops. Unfinished testing / examinations will be completed at no additional cost to the Government. 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 Government. The Contractor shall be directly responsible to cover costs for completing these make-up screenings.

9. SERVICE DELIVERY SUMMARY (SDS)

9.1. The service delivery summary is designed to be a concise statement of key deliverables which are measured to determine the contractor's performance success or failure.

PERFORMANCE OBJECTIVE PERFORMANCE SCHEDULE

Insurance & Licensed and/or certified staff for all physicians and technicians, 100% of the time Equipment Certification Instrumentation meets or exceed performance standards, 100% of the time

Occupational Exams Scheduled within contract timeframe and proper exam elements performed 100 % of the time

Infectious Waste Disposal urine All sharp instruments, blood, and is handled and disposed of in accordance with federal, state, and local regulations, 100% of the time

Medical Reports and Recordkeeping

Completed records are accessible within agreed time frame and reports are submitted in a timely manner, 100% of the time

10. DESCRIPTION OF SERVICES

Examinations are determined based upon job codes and identified occupational hazard exposure.

10.1 The following standard services are to be provided under this PWS:

10.1.1 Lab Services

10.1.1.2 - Frequently Used Labs Units Schedule Unit

a) Occ Health Profile (Bundle: CBC, liver function test, BUN, Creatinine, Urinalysis) Each

b) CBC (HGB, HCT, WBC, MCV, MCH, MCHC) with diff Each

c) CBC (HGB, HCT, WBC, MCV, MCH, MCHC) without diff Each

d) Liver Function Test (AST, ALT, ALB, ALK PHOS, dBil, TBil, Protein) Each

e) BUN /Creatinine Each

f) Urinalysis with Micro Each

g) Urinalysis without Micro Each

h) Blood Glucose Each

10.1.1.3 - Infrequently Used Labs Units Schedule Unit Price

a) Cadmium Profile (Per Lab Corp)

b) Human Chorionic Gonadotropin HCG beta

c) Chromium (Blood)

d) Lead, industrial whole blood

e) ZPP, Blood Protoporphyrins, zinc

10.1.2 Procedures

a) Audiometry

b) B-Reading

c) Chest X-Ray (PA & Lat View)

d) Spirometry

e) Comprehensive Vision

f) Vital Signs / Body Ht and Wt. (no charge with exam) Each

g) Venipuncture and Specimen Handling Each

10.1.3 Exams Units Schedule Unit Price

a) Comprehensive Exam (Medical Surveillance)

b) Billing Terms

c) OHC Terms Units Schedule Unit Price

d) Record Processing services as related to Exams or Clearances

e) Record Processing (Mailing of X-rays)

f) Missed Work-up or missed procedure

g) Missed Exam

12. PERIOD OF PERFORMANCE: 15 Jan 2017 – 30 Sep 2017. This contract includes four

(4) option years

13. PURCHASE LIMITATION:

Individual purchases under this Blanket Purchase Agreement will not exceed an aggregated amount of $50,000.00. Individual calls will not exceed $10,000.00. BPA Master Dollar Limit for this Blanket Purchase Agreement will not exceed $200,000.00. Aggregate amount should not exceed funded amount (one year)

14. INVOICE:

14.1. When billing procedures provide for an individual invoice for each delivery these invoices shall be accumulated; provided that;

14.1.1. A consolidated payment will be made for each specified period; and

14.1.2. The period of any discount will commence on the final date of the billing period or on the date of receipt of invoices for all deliveries accepted during the billing period, whichever is later.

14.2. An itemized invoice (1 copy) shall be submitted at least monthly or upon expiration of this Blanket Purchase Agreement, whichever occurs first, for all deliveries made during a billing period and for which payment has not been received.

14.3 In accordance with terms and conditions of this Blanket Purchase Agreement the contractor is authorized partial payments for goods and/or services received and accepted by the Government.

14.4 The contractor will upload a monthly invoice, for all services performed under this contract, to the Wide Area Workflow (WAWF) Website and will send an electronic copy to the COR in the TXARNG SOH Office.

15. REFERENCES

15.1. Title 29, Code of Federal Regulations, Part 1910: Occupational Safety and Health Standards.

15.2. Title 29, Code of Federal Regulations, Part 1960: Safety and Health Provisions for Federal Employees.

15.3. American National Standards Institute (ANSI) 288.6-1884, American National Standard for Respiratory Protection, Respirator Use, Physical Qualifications for Personnel.

15.4. Threshold Limit Values and Biological Exposure Indices (TLVs), American Conference of Governmental Industrial Hygienists (ACGIH), Cincinnati, Ohio.

15.5. Army Regulation 40-5, Preventive Medicine

15.6. Department of Defense 6055.05M, Occupational Medical Surveillance Manual

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

15.8. Army Regulation 11-34, The Army Respiratory Protection Program

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

15.10. Headquarters, Department of the Army Pamphlet (DA PAM) 40-506 Vision Conservation

PRICE SHEET

Type of service Name of Service Cost

Lab Occ Health Profile (Bundle: CBC, liver function test, BUN, Creatinine, Urinalysis

Lab CBC (HGB, HCT, WBC, MCV, MCH, MCHC) with diff

Lab CBC (HGB, HCT, WBC, MCV, MCH, MCHC) without diff

Lab Liver Function Test (AST, ALT, ALB, ALK PHOS, dBil, TBil, Protein)

Lab BUN /Creatinine Each

Lab Urinalysis with Micro Each

Lab Urinalysis without Micro Each

Lab Blood Glucose Each

Lab Cadmium Profile (Per Lab Corp)

Lab Human Chorionic Gonadotropin HCG beta

Lab Chromium (Blood)

Lab Lead, industrial whole blood

Lab ZPP, Blood Protoporphyrins, zinc

Procedure Audiometry

Procedure B‐Reading

Procedure Chest X‐Ray (PA & Lat View)

Procedure Spirometry (Pulmonary Function Test)

Procedure Comprehensive Vision

Procedure Vital Signs / Body Ht and Wt. (no charge with exam) Each

Procedure Venipuncture and Specimen Handling Each

Procedure Comprehensive Exam (Medical Surveillance)

Administration Billing Terms

Fees

Administration Fees

OHC Terms Units Schedule Unit Price

Administration Fees

Record Processing services as related to Exams or Clearances

Administration Fees

Record Processing (Mailing of X‐rays)

Administration Fees

Missed Work‐up or missed procedure

Administration Fees

Missed Exam

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 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 Destination Government Destination Government 0006 N/A N/A N/A Government 0007 N/A N/A N/A Government 0008 N/A N/A N/A Government 0009 N/A N/A N/A Government 0010 N/A N/A N/A Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

0001 POP 15-JAN-2017 TO

14-JAN-2018

N/A USP&FO#TEXAS

SAFETY AND OCCUPATIONAL HEALTH

OFFICE

2200 W. 35TH STREET

CAMP MABRY, BUILDING #8

ROOM C151

AUSTIN TX 78703-1222

512-782-3566

W90S22

0002 POP 15-JAN-2018 TO

14-JAN-2019

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 15-JAN-2019 TO

14-JAN-2020

N/A (SAME AS PREVIOUS LOCATION)

0004 POP 15-DEC-2020 TO

14-DEC-2021

N/A (SAME AS PREVIOUS LOCATION)

0005 POP 15-JAN-2021 TO

14-JAN-2022

N/A (SAME AS PREVIOUS LOCATION)

0006 30-SEP-2017 1 (SAME AS PREVIOUS LOCATION)

0007 30-SEP-2018 1 (SAME AS PREVIOUS LOCATION)

0008 30-SEP-2019 1 (SAME AS PREVIOUS LOCATION)

0009 30-SEP-2020 1 (SAME AS PREVIOUS LOCATION)

0010 30-SEP-2021 1 (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.203-3 Gratuities APR 1984 52.203-6 Alt I Restrictions On Subcontractor Sales To The Government

(Sep 2006) -- Alternate I

OCT 1995

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

MAY 2011

52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards

OCT 2016

52.204-16 Commercial and Government Entity Code Reporting JUL 2016 52.204-18 Commercial and Government Entity Code Maintenance JUL 2016 52.209-6 Protecting the Government's Interest When Subcontracting

With Contractors Debarred, Suspended, or Proposed for Debarment

OCT 2015

52.219-4 Notice of Price Evaluation Preference for HUBZone Small Business Concerns

OCT 2014

52.219-8 Utilization of Small Business Concerns NOV 2016 52.222-3 Convict Labor JUN 2003 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-26 Equal Opportunity SEP 2016 52.222-35 Equal Opportunity for Veterans OCT 2015 52.222-36 Equal Opportunity for Workers with Disabilities JUL 2014 52.222-37 Employment Reports on Veterans FEB 2016

52.222-43 Fair Labor Standards Act And Service Contract Labor Standards - Price Adjustment (Multiple Year And Option Contracts)

MAY 2014

52.222-50 Combating Trafficking in Persons MAR 2015 52.222-54 Employment Eligibility Verification OCT 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

52.232-40 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 252.201-7000 Contracting Officer's Representative DEC 1991 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

252.204-7008 Compliance With Safeguarding Covered Defense Information Controls

OCT 2016

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting

OCT 2016

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

MAY 2016

252.213-7000 Notice to Prospective Suppliers on Use of Past Performance Information Retrieval System--Statistical Reporting in Past Performance Evaluations

JUN 2015

252.215-7007 Notice of Intent to Resolicit JUN 2012 252.215-7008 Only One Offer OCT 2013 252.222-7007 Representation Regarding Combating Trafficking in Persons JAN 2015 252.225-7012 Preference For Certain Domestic Commodities AUG 2016 252.225-7031 Secondary Arab Boycott Of Israel JUN 2005 252.225-7050 Disclosure of Ownership or Control by the Government of a

Country that is a State Sponsor of Terrorism

OCT 2015

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports

JUN 2012

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

Personnel

JUN 2013

252.243-7002 Requests for Equitable Adjustment DEC 2012 252.244-7000 Subcontracts for Commercial Items JUN 2013

CLAUSES INCORPORATED BY FULL TEXT

52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS (OCT 2016)

(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.

(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 limitations. Unless otherwise provided in the Schedule, offers may not be submitted for quantities less than those specified. The Government reserves the right to make an award on any item for a quantity less than the quantity offered, at the unit prices offered, unless the offeror specifies otherwise in the offer.

(i) Availability of requirements documents cited in the solicitation. (1)(i) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to--GSA Federal Supply Service Specifications Section, Suite 8100, 470 East L'Enfant Plaza, SW, Washington, DC 20407, Telephone (202) 619-8925, Facsimile (202) 619-8978.

(ii) If the General Services Administration, Department of Agriculture, or Department of Veterans Affairs issued this solicitation, a single copy of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained free of charge by submitting a request to the addressee in paragraph (i)(1)(i) of this provision.

Additional copies will be issued for a fee.

(2) Most unclassified Defense specifications and standards may be downloaded from the following ASSIST websites:

(i) ASSIST (https://assist.dla.mil/online/start/).

(ii) Quick Search (http://quicksearch.dla.mil/).

(iii) ASSISTdocs.com (http://assistdocs.com).

(3) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point (DoDSSP) by--

(i) Using the ASSIST Shopping Wizard (https://assist.dla.mil/wizard/index.cfm);

(ii) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or

(iii) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone

(215) 697-2667/2179, Facsimile (215) 697-1462.

(4) Nongovernment (voluntary) standards must be obtained from the organization responsible for their preparation, publication, or maintenance.

(j) Unique entity identifier. (Applies to all offers exceeding $3,500, and offers of $3,500 or less if the solicitation requires the Contractor to be registered in the System for Award Management (SAM) database.) The Offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation ``Unique Entity Identifier'' followed by the unique entity identifier that identifies the Offeror's name and address. The Offeror also shall enter its Electronic Funds Transfer (EFT) indicator, if applicable. The EFT indicator is a four-character suffix to the unique entity identifier. The suffix is assigned at the discretion of the Offeror to establish additional SAM records for identifying alternative EFT accounts (see subpart 32.11) for the same entity. If the Offeror does not have a unique entity identifier, it should contact the entity designated at www.sam.gov for unique entity identifier establishment directly to obtain one. The Offeror should indicate that it is an offeror for a Government contract when contacting the entity designated at www.sam.gov for establishing the unique entity identifier.

(k) System for Award Management. Unless exempted by an addendum to this solicitation, by submission of an offer, the offeror acknowledges the requirement that a prospective awardee shall be registered in the SAM database prior to award, during performance and through final payment of any contract resulting from this solicitation. If the Offeror does not become registered in the SAM database in the time prescribed by the Contracting Officer, the Contracting Officer will proceed to award to the next otherwise successful registered Offeror. Offerors may obtain information on registration and annual confirmation requirements via the SAM database accessed through https://www.acquisition.gov.

(l) Debriefing. If a post-award debriefing is given to requesting offerors, the Government shall disclose the following information, if applicable:

(1) The agency's evaluation of the significant weak or deficient factors in the debriefed offeror's offer.

(2) The overall evaluated cost or price and technical rating of the successful and the debriefed offeror and past performance information on the debriefed offeror.

(3) The overall ranking of all offerors, when any ranking was developed by the agency during source selection.

(4) A summary of the rationale for award;

(5) For acquisitions of commercial items, the make and model of the item to be delivered by the successful offeror.

(6) Reasonable responses to relevant questions posed by the debriefed offeror as to whether source-selection procedures set forth in the solicitation, applicable regulations, and other applicable authorities were followed by the agency.

(End of provision)

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

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

Price, Technical Ability, Past Performance

Technical and past performance, when combined, are approximately equal to price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (OCT 2016)

ALTERNATE I (OCT 2014)

The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site located at https://www.sam.gov/portal . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (s) of this provision.

(a) Definitions. As used in this provision--

Per Court Injunction dated 24 Oct 2016 and OMB memo dated 25 Oct 2016 do not implement the following until further direction.

“Administrative merits determination” means certain notices or findings of labor law violations issued by an enforcement agency following an investigation. An administrative merits determination may be final or be subject to appeal or further review. To determine whether a particular notice or finding is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“Arbitral award or decision” means an arbitrator or arbitral panel determination that a labor law violation occurred, or that enjoined or restrained a violation of labor law. It includes an award or decision that is not final or is subject to being confirmed, modified, or vacated by a court, and includes an award or decision resulting from private or confidential proceedings. To determine whether a particular award or decision is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“Civil judgment” means--

(1) In paragraph (h) of this provision: A judgment or finding of a civil offense by any court of competent jurisdiction.

Per Court Injunction dated 24 Oct 2016 and OMB memo dated 25 Oct 2016 do not implement the following until further direction.

(2) In paragraph (s) of this provision: Any judgment or order entered by any Federal or State…