2ndREVISEDDentalRFP.pdf

DEPARTMENTS OF THE ARMY AND AIR FORCE

USPFO FOR MINNESOTA

PROCUREMENT DIVISION

15000 HWY 115, CAMP RIPLEY

LITTLE FALLS MN 56345-4173

(320) 616-2751

(320) 632-7799

UNDER DPAS (15 CFR 700)

11. DELIVERY FOR FOB

RFQ

SEE SCHEDULE

14. METHOD OF SOLICITATION

IFB RFP

CODE

SEE ADDENDUM

BLOCK IS MARKED

DESTINATION UNLESS

12. DISCOUNT TERMS

(No Collect Calls)

13b. RATING

13a. THIS CONTRACT IS A RATED ORDER

X

CODE

W912LM-11-R-0003 14-Sep-2011

b. TELEPHONE NUMBER

(320) 616-2751

8. OFFER DUE DATE/LOCAL TIME

10:00 AM 28 Sep 2011

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV 3/2005)

Prescribed by GSA

FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER) 31c. DATE SIGNED

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

22. UNIT 23. UNIT PRICE 24. AMOUNT 21. QUANTITY

CODE 10. THIS ACQUISITION IS

UNRESTRICTED

FAX:

NAICS:

TEL:

CODE 18a. PAYMENT WILL BE MADE BY OFFEROR

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TEL.

W912LM

SIZE STD:

9. ISSUED BY

FACILITY

CODE

17a.CONTRACTOR/

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

15. DELIVER TO CODE W77925 16. ADMINISTERED BY

JOINT FORCES (J1) - MANPOWER & PERSONNEL

BRIGHAM FANNING

OFFICE OF THE STATE SURGEON

600 CEDAR STREET

ST PAUL MN 55101

TEL: 651-268-8841 FAX:

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

COLLEEN M. DALQUIST

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

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

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES

SEE SCHEDULE

TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS

SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

SB

HUBZONE SB

SET ASIDE: % FOR

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

TEL: EMAIL:

1 COPIES

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. OFFER DATED YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 29. AWARD OF CONTRACT: REFERENCE

X

8(A)

SVC-DISABLED VET-OWNED SB

EMERGING SB

X

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

SEE SCHEDULE

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES 21. QUANTITY 22. UNIT 24. AMOUNT

PAGE 2 OF

23. UNIT PRICE

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

FINAL PARTIAL COMPLETE

36. PAYMENT 35. 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 3/2005) BACK

Prescribed by GSA

FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

W912LM-11-R-0003

Section SF 1449 - CONTINUATION SHEET

QUANTITY INFORMATION

NOTE: ALL quantities provided are ESTIMATES for the contract period (one year). To determine monthly estimate, divide the total estimate provided by 12. Contractor is not quaranteed to perform the estimated number of hours listed.

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 300 Hours Dentist - Hourly Rate

FFP

Dentist services to assist MNARNG with Dental exams, X-rays, etc. as specified in the PWS.

Base Year (Oct 1, 2011 - Sep 30, 2012)

FOB: Destination

NET AMT

0002 600 Hours Dental Technician - Hourly Rate

FFP

Dental Technician services to assist MNARNG with Dental exams, X-rays, etc. as specified in the PWS.

0003 12 Each Travel Cost

FFP

All travel costs associated with monthly event. Cost should include mileage, lodging and meals.

1001 300 Hours OPTION Dentist - Hourly Rate

FFP

Option Year 1 (Oct 1, 2012 - Sep 30, 2013)

1002 720 Hours OPTION Dental Technician - Hourly Rate

FFP

1003 12 Each Travel Cost

FFP

2001 300 Hours OPTION Dentist - Hourly Rate

FFP

Option Year 2 (Oct 1, 2013 - Sep 30, 2014)

2002 720 Hours OPTION Dental Technician - Hourly Rate

FFP

2003 12 Each Travel Cost

FFP

3001 300 Hours OPTION Dentist - Hourly Rate

FFP

Option Year 3 (Oct 1, 2014 - Sep 30, 2015)

3002 720 Hours OPTION Dental Technician - Hourly Rate

FFP

3003 12 Each Travel Cost

FFP

4001 300 Hours OPTION Dentist - Hourly Rate

FFP

Option Year 4 (Oct 1, 2015 - Sep 30, 2016)

4002 720 Hours OPTION Dental Technician - Hourly Rate

FFP

4003 12 Each Travel Cost

FFP

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT

DENTAL SERVICES

MINNESOTA NATIONAL GUARD

1. BACKGROUND:

Individual Medial Readiness (IMR) and Medical Readiness Classification (MRC) are the basic principles of force-sustainment for Army National Guard (ARNG) forces. Dental health is vital for force health protection and failure to achieve a standard of level of dental health could preclude a soldier from deploying. Dental Readiness is a soldier and command responsibility.

This Performance Work Statement (PWS) covers the various components of IMR/FMR to include, but not limited to: Annual dental exams, digital bitewings radiographs, digital panoramic radiographs, identification (to 90+%) of all Class 3 soldiers on alert orders. Services are to be completed on site at the General E.A. Walsh Training Site, Camp Ripley, Little Falls, MN. This PWS identifies the purpose of the work to be performed by the contractor and provides a description of the work to be completed and any required outcomes. The contractor shall provide qualified personnel to complete these tasks. ALL equipment and supplies will be provided by the MNARNG.

DoD established a uniform dental classification in HA Policy 02-11, Policy on Standardization of Oral Health and Readiness Classifications. DoD policy requires dental screening examinations and remediation to be accomplished and documented on 90%+ of service members. Members of the MNARNG shall receive an annual dental screening examination to determine their dental classification. Dental treatment that may be required is essential to be identified at the Soldier Readiness Processing (SRP) site to ensure the highest Dental Deployable Rate for the Mobilizing Soldiers.

2. OBJECTIVES AND SCOPE:

The objective of this PWS is to award a single contract to assist the MNARNG in completing the requirements of IMR/MRC –Dental Readiness on all eligible (mobilizing or not) Service Members (SMs). Dental services shall be performed by licensed professionals. Contractor shall be held liable and is responsible to ensure and verify the appropriate level of Credentialing / Privileging (Licensure, Diploma, etc.) for all contract providers in support of any service event.

DENTAL

Clinical evaluation by a licensed dentist of the oral cavity using a visual, clinical exam supported by bitewings taken by dental technicians.

Personnel performing the dental screening examination have a moral and ethical obligation to inform the Soldier if they observe or are apprised of any sign or symptom for which the Soldier should obtain further evaluation or care.

Hardcopy medical documentation file and organization in accordance with AR 40-66 in the Soldier Treatment Record (STR).

3. REFERENCES (http://www.usapa.army.mil/)

AR 40-501 Standards of Medical Fitness

AR 40-35 Dental Readiness & Community Oral Health Protection

4. ACRONYMS

DA Department of the Army DoD Department of Defense DTR Dental Treatment Record HIPAA Health Insurance Portability and Accountability Act IMR Individual Medical Readiness MNARNG Minnesota Army National Guard NGB National Guard Bureau OSArS Office of the State Army Surgeon OSHA Occupational Safety and Health Administration SRP Soldier Readiness Processing STR Soldier Treatment Record DSS Deputy State Surgeon

5. SERVICES TASKS - GENERAL

The contractor shall provide all labor necessary to provide all listed services Events are currently scheduled to take place at Camp Ripley, Little Falls, MN. Alternate locations throughout the State may be necessary. The services provided shall ensure that soldiers dental health meets mandated readiness and deployability standards to ensure mission capability of the MNARNG. A minimum of 30 days prior to a scheduled event, the MNARNG will notify the contractor of the number of personnel required accomplish required tasks.

DENTAL TASKS:

Digital Bitewings, Digital Panoramic Radiographs & Dental Exams: The contractor shall perform required dental examinations to include digital bitewings and digital panoramic radiographs if clinically indicated in support of the annual dental screenings in accordance with the AR 40-501 and AR 40-35. The contractor shall ensure all soldiers have a current

Panoramic Radiograph on file and if missing, the contractor shall perform new radiographs.

Adherence to all OSHA requirements, State and Federal Regulations are mandatory.

Exam. A periodic oral evaluation shall assess the current state of oral health, risk for future dental disease as well as assessing general health factors that relate to the treatment of the patient. 6 exams per hour are necessary to ensure completion during time available.

The following measures are required for each periodic oral evaluation:

a. Caries risk assessment – Classify Soldiers as low, moderate or high risk for caries as outlined by the American Dental Association’s 1995 Special Supplement. This assessment will allow the Army Dental Care System (ADCS) to identify those at high risk for future disease.

b. Periodontal assessment – Periodontal Screening and Recording (PSR), a screening procedure endorsed by the American Dental Association and the American Academy of Periodontology, should be utilized to determine the need for periodontal treatment.

c. Tobacco risk assessment – Classify Soldiers as a smoker, user of smokeless tobacco or both.

d. Oral cancer screening – Perform a thorough oral cancer screening on all soldiers as part of annual examinations.

e. Digital radiographs should be taken only for clinical reasons according to FDA guidelines as determined by the patient’s dentist. Radiographs should be of diagnostic quality, properly identified and dated. A panograph is required to be present in dental record and that it is of adequate quality for diagnostic/identification purposes. There is no time requirement on updating panographic radiographs. However, the panographic radiograph will adequately represent the current oral condition of the Soldier. Digital radiographs shall be performed on all service members who do not have a Panograph on file in the DENCLASS system, regardless of when the hardcopy panograph is dated or at the discretion of the State Dental Officer.

6. CONTRACTOR PROVIDED EQUIPMENT AND PERSONNEL:

Contractors shall provide all licensed personnel to perform the Dental Readiness service requirements. All equipment and supplies will be provided by the MNARNG.

Dental Staffing:

Dentist

Dental Assistant/Technician

7. APPLICABLE DOCUMENTS

The contractor shall ensure that all appropriate DA or DD forms (in accordance with references) are utilized for each service supplied. The forms will be made available through the State

Medical Command office. The contractor shall provide all documentation concerning dental treatment (to include recommendations) to the MNARNG Office of the Deputy State Surgeon or Designee.

8. PLACE OF PERFORMANCE

Services are required at General E.A. Walsh Training Center, 15000 Hwy 115, Camp Ripley, Little Falls, MN 56345-4173. Other armory sites across the State may be utilized as deemed necessary by the Deputy State Surgeon.

9. PERIOD OF PERFORMANCE

The overall period of performance for this contract is 12 months. The typical performance will be one event per month, consisting of 3 days (Friday-Sunday). However the performance is specific to each event and may vary.

10. OTHER CONDITIONS/ SECURITY

Safety: The contractor shall establish a safety and health program in accordance with the standards of the Federal Occupational Safety and Health Standard (OSHA), Health Information Portability and Accountability Act (HIPAA), the Privacy Act and the American Dental Association

(ADA).

Performance work statement is “UNCLASSIFIED” and under HIPAA guidelines. OSArS shall notify the Contractor if requirement exists for a secret classification and circumstances requiring secret classification for Readiness impact reporting.

Quality Control: The contractor shall create a quality assurance program that monitors all services being provided. The program must be approved by the MNARNG Deputy State Surgeon within 10 days of contract award.

Hours of Operation: Soldiers will be made available to the contractor during regular drill weekends and training periods between the normal hours of operations to be estimated at 10 hours a day. Usual hours are between 0700 and 1900 unless special arrangements are made.

Security Requirements: All contractor employees and affiliated personnel of the contractor are to possess identification that identifies them as such. All vehicles are subject to search without reason. The contractor shall comply with any and all installation security requirements.

Reporting: The contractor shall provide a final report for all services provided to include a by name, unit, and social security number roster of all soldiers receiving services. The report shall be approved and verified by the MNARNG liaison with the Office of the State Surgeon.

See Appendix A.

Invoice: Contractor shall invoice using Wide Area Work Flow (WAWF). A detailed listing of all services provided shall be attached to the invoice.

11. ACCEPTANCE PLAN:

All work performed, and data to be submitted under this task will be made available to be inspected for compliance with the PWS and accepted by the COR or authorized representative as specified herein.

12. APPENDICES:

A. Estimated Workload Data

B. Dental Classification

APPENDIX A

ESTIMATED WORKLOAD DATA

The following data elements will be reported at the end of an event:

Date Location List of contract employees Total number of patients scheduled Total number of patients examined Total number of Soldiers by dental classification: 1, 2, 3 Total number of bitewing radiographs (sets of 4 per patient) taken Total number of panograph radiographs taken A by name listing of all Soldiers examined and the dental classification of the Soldier

APPENDIX B

Department of Defense

Oral Health and Readiness Classification System

The oral health status of uniformed personnel shall be classified as follows:

a. Class 1 (Oral Health): Patients with a current dental examination, who do not require dental treatment or reevaluation. Class 1 patients are worldwide deployable.

b. Class 2: Patients with a current dental examination, which require non-urgent dental treatment or reevaluation for oral conditions, which are unlikely to result in dental emergencies within 12 months. Class 2 patients are worldwide deployable. Patients in dental class 2 may exhibit the following:

(1) Treatment or follow-up indicated for dental caries or minor defective restorations that can be maintained by the patient.

(2) Interim restorations or prosthesis that can be maintained for a 12 month period. This includes teeth that have been restored with permanent restorative materials for which protective cuspal coverage is indicated.

(3) Edentulous areas requiring prostheses but not on an immediate basis.

(4) Periodotium that:

(a) requires oral prophylaxis

(b) requires maintenance therapy

(c) requires treatment for slight to moderate periodontitis and stable cases of more advanced periodontitis

(5) Unerupted partially erupted or malposed teeth that are without historical, clinical or radiographic signs or symptoms of pathosis, but which are recommended for prophylactic removal.

(6) Active orthodontic treatment. The provider should consider placing the patient in passive appliances for deployment up to six months. For longer periods of deployment, the provider should consider removing active appliances and placing the patient in passive retention.

(7) Temporomandibular disorder patients in remission. The provider anticipates the patient can perform duties while deployed without ongoing care and any medications or appliances required for maintenance will not interfere with duties.

c. Class 3: Patients who require urgent or emergent dental treatment. Class 3 patients normally are not considered to be worldwide deployable.

(1) Treatment or follow-up indicated for dental caries, symptomatic tooth fracture or defective restorations that cannot be maintained by the patient.

(2) Interim restorations or prostheses that cannot be maintained for a 12 month period.

(3) Patients requiring treatment for the following periodontal conditions that may result in dental emergencies within the next 12 months.

(a) Edentulous areas or teeth requiring immediate prosthodontic treatment for adequate mastication or communication or acceptable esthetics.

(b) Active progressive moderate or advanced periodontitis.

(c) Periodontontal abscess

(d) Progressive mucogingival condition

(e) Periodontal manifestations of systemic disease or hormonal disturbances

(f) Heavy subgingival calculus

(4) Edentulous areas or teeth requiring immediate prosthodontic treatment for adequate mastication or communication or acceptable esthetics.

(5) Unerupted, partially erupted or malposed teeth with historical, clinical or radiographic signs or symptoms of pathosis that are recommended for removal.

(6) Chronic oral infections or other pathologic lesions including:

(a) Pulpal, periapical or resorptive pathology requiring treatment.

(b) Lesions requiring biopsy or awaiting biopsy report.

(7) Emergency situations requiring therapy to relieve pain, treat trauma, treat acute oral infections or provide timely follow-up care (e.g., drain or suture removal) until resolved.

(8) Acute Temporomandibular disorders requiring active treatment that may interfere with duties.

d. Class 4. Patients who require periodic dental examinations or patients with unknown dental classifications. Class 4 patients normally are not considered to be worldwide deployable.

QUALITY ASSURANCE

Service Delivery Summary Worksheet Dental Services

Objective: Provide on-site dental exams for the Minnesota National Guard at Soldier Readiness Process (SRP) events.

Services to be provided at the General E.A. Walsh Training Center, 15000 Hwy 115, Camp Ripley, Little Falls, MN with other locations as deemed necessary. Services will be performed on weekends (one weekend per month).

Deliverable

Performance

Standard

Acceptable Quality Level (AQL)

Method Used /

Frequency

Contractor provides qualified and sufficient personnel to conduct all required Dental

Services

Go/No Go Vendor coordinates with the Deputy State

Surgeon prior to conducting services to determine the personnel required to conduct dental services for in the period identified.

Contractor personnel to posses appropriate level of credentialing

Review

Spot Check or

Inspection

Customer

Complaint

Contractor performs Dental

Exams at a rate of 6 per hour Go/No Go Contractor completes exams at a rate that will complete services within the identified period

Contractor completes Dental

Exams Completes

98% of all identified testing

Contractor completes oral exams IAW AR

40-501 & AR 40-35 & completes -

Caries risk assessment

Periodontal assessment

Oral cancer screening

Panoramic Radiographs as needed to represent soldiers current condition

Contractor completes required paperwork & final reporting Completes

98% of needed paperwork

Contractor completes any required paperwork for dental files – ie SF 603 & DA 5570 NLT 10 days.

Contract completes and submits final data to

Deputy State Surgeon & tracks special cases

Government Quality Assurance Plan:

In your role as Contracting Officers Representative (COR), you assume some Quality Assurance duties. You will monitor contractor performance, complete and sign the Quality Assurance Worksheet provided below at least monthly, but you can submit the worksheet more frequently if needed. This worksheet allows you to document compliance with the Contract and fill a regulatory requirement to ensure adequate oversight is being performed.

Quality Assurance Plan Worksheets are to be sent directly to the Contracting Officer (CO), not later than the 5 th day of the month following the service (every month). At a minimum, the COR must send a completed copy of the worksheet to the CO after the first month of service and for any months where there is a rating other than Green. The

CO will assume a quality performance rating of ―Green‖ on all measured deliverables unless otherwise notified.

The quality rating may change from ―Green‖ to ―Red‖ without notice, however we encourage the COR to utilize the

―Yellow‖ quality rating to alert the CO of quality issues that have the potential for a ―Red‖ quality rating if corrective action is not taken.

Any time the rating is less than Green the COR shall clearly document the worksheet to indicate what did or did not occur per the PWS requirement. When an observation indicates other than a ―Green‖ rating, the COR will require the Contractor to initial the observation. Initialing the observation does not constitute concurrence with the observation; it only acknowledges that they have been made aware of the defective performance. If the Contractor’s response to an identified quality deficiency is unsatisfactory, the Contracting Officer will contact the Contractor to implement a plan of action to remedy the identified deficiency.

The COR referred to in this QAP is: MSG Brigham Fanning, 651.268.8841,Brigham.fanning@us.army.mil

Rating Description

Green Yes performance and technical specifications are being met at AQL.

Yellow

Yes, performance and technical specifications are currently being met at the minimum AQL, but the following service / deliverable needs contractor attention.

The Customer must identify what component of the deliverable and/or service requires attention.

Red

No, performance and technical specifications are not being met at AQL and the following service / deliverable needs immediate contractor resolution.

The Customer must identify what component of the deliverable and/or service is below the minimum AQL.

mailto:Brigham.fanning@us.army.mil

RECEIVERS - DENTAL QUALITY ASSURANCE PLAN WORKSHEET

Performance Rating

Deliverable/Service

Quality

Rating

Causative Factors Effect on Mission Action Required / Date

Contractor provides qualified and sufficient personnel to conduct all required Dental Services

Green Comments Unnecessary for “Green” QA Rating.

Yellow

Red

Contractor performs services 6 soldiers per hr Green Comments Unnecessary for “Green” QA Rating.

Yellow

Red

Contractor completes

Dental Exams Green Comments Unnecessary for “Green” QA Rating.

Yellow

Red

Contractor completes required paperwork & final reporting

Green Comments Unnecessary for “Green” QA Rating.

Yellow

Red

Signed ____________________________________________ Dated ______________________________

CONTRACTOR MANPOWER REPORTING

Manpower Reporting Requirement

The office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the contractor will report ALL contractor manpower (including subcontractor manpower) required for performance of this contract. The contractor is required to completely fill in all the information in the format using the following web address -https://contractormanpower.army.pentagon.mil. The required information includes:

1) Contracting Office, Contracting Officer, Contracting Officer’s Technical Representative.

2) Contract number including task and delivery order number.

3) Beginning and ending dates covered by reporting period.

https://contractormanpower.army.pentagon.mil/

4) Contractor name, address, phone number, e-mail address, identity of contractor employee entering the data.

5) Estimated direct labor hours (including sub-contractor).

6) Estimated direct labor dollar paid this reporting period (including sub-contractor).

7) Total payments (including sub-contractor).

8) Predominant Federal Service Code (FSC) reflecting services provided by contractor (and predominant FSC code for subcontractor if different).

9) Organizational title associated with the Unit Identification Code (UIC) for the Army Requiring

Activity (the Army Requiring Activity is responsible for providing the contractor with its UIC for the purposes of reporting this information).

10) Locations where contractor and sub-contractor perform the work (specified by zip code in the

United States and nearest City, Country, when in an overseas location, using standardized nomenclature provided on website.

11) Presence of deployment contingency contract language.

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

13) The estimated total cost (if any) incurred to comply with this reporting requirement.

Reporting period will be the period of performance not to exceed 12 months ending September 30 of each government fiscal year and must be reported by 31 October of each calendar year.

CLAUSES INCORPORATED BY FULL TEXT

52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS (JUN 2008)

(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 (http://assist.daps.dla.mil).

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

(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 (http://assist.daps.dla.mil/wizard);

(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) Data Universal Numbering System (DUNS) Number. (Applies to all offers exceeding $3,000, and offers of

$3,000 or less if the solicitation requires the Contractor to be registered in the Central Contractor Registration (CCR) database. The offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation

―DUNS‖ or ―DUNS +4‖ followed by the DUNS or DUNS +4 number that identifies the offeror's name and address.

The DUNS +4 is the DUNS number plus a 4-character suffix that may be assigned at the discretion of the offeror to establish additional CCR records for identifying alternative Electronic Funds Transfer (EFT) accounts (see FAR

Subpart 32.11) for the same concern. If the offeror does not have a DUNS number, it should contact Dun and

Bradstreet directly to obtain one. An offeror within the United States may contact Dun and Bradstreet by calling 1-

866-705-5711 or via the internet at http://fedgov.dnb.com/webform. An offeror located outside the United States must contact the local Dun and Bradstreet office for a DUNS number. The offeror should indicate that it is an offeror for a Government contract when contacting the local Dun and Bradstreet office.

(k) Central Contractor Registration. 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 CCR 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 CCR 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 Internet at http://www.ccr.gov or by calling 1-888-227-

2423 or 269-961-5757.

(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 (JAN 1999)

(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 and Past Performance

Past performance and Price are approximately equal.

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.

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (APR 2011)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically at http://orca.bpn.gov. If an offeror has not completed the annual representations and certifications electronically at the ORCA website, the offeror shall complete only paragraphs (c) through (o) of this provision.

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

―Economically disadvantaged women-owned small business (EDWOSB) Concern‖ means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

"Forced or indentured child labor" means all work or service-

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

Inverted domestic corporation means a foreign incorporated entity which is treated as an inverted domestic corporation under 6 U.S.C. 395(b), i.e., a corporation that used to be incorporated in the United States, or used to be a partnership in the United States, but now is incorporated in a foreign country, or is a subsidiary whose parent corporation is incorporated in a foreign country, that meets the criteria specified in 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Manufactured end product means any end product in Federal Supply Classes (FSC) 1000-9999, except--

(1) FSC 5510, Lumber and Related Basic Wood Materials;

(2) Federal Supply Group (FSG) 87, Agricultural Supplies;

(3) FSG 88, Live Animals;

(4) FSG 89, Food and Related Consumables;

(5) FSC 9410, Crude Grades of Plant Materials;

(6) FSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) FSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) FSC 9610, Ores;

(9) FSC 9620, Minerals, Natural and Synthetic; and

(10) FSC 9630, Additive Metal Materials.

Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the

Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment

Act of 2007) conducting the business can demonstrate--

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.

Service-disabled veteran-owned small business concern--

(1) Means a small business concern--

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

"Small business concern" means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation.

Veteran-owned small business concern means a small business concern--

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

"Women-owned business concern" means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women;

and whose management and daily business operations are controlled by one or more women.

"Women-owned small business concern" means a small business concern--

(1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least

51 percent of its stock is owned by one or more women; or

(2) Whose management and daily business operations are controlled by one or more women.

Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part

127)‖, means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the

United States.

(b) (1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted on the Online Representations and Certifications Application (ORCA) website.

(2) The offeror has completed the annual representations and certifications electronically via the ORCA website at http://orca.bpn.gov. After reviewing the ORCA database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications--Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR

4.1201), except for paragraphs ----------.

(Offeror to identify the applicable paragraphs at (c) through (o) of this provision that the offeror has completed for the purposes of this solicitation only, if any.)

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted on ORCA.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United

States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it ( ) is, ( ) is not a small business concern.

(2) Veteran-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents as part of its offer that it ( ) is, ( ) is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. (Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.) The offeror represents as part of its offer that it ( ) is, ( ) is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents, for general statistical purposes, that it ( ) is, (

) is not a small disadvantaged business concern as defined in 13 CFR 124.1002.

(5) Women-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ) is, ( ) is not a women-owned small business concern.

Note to paragraphs (c)(8) and (9): Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that--

(i) It * is, * is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It * is, * is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate in reference to the WOSB concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the

WOSB concern or concerns that are participating in the joint venture: .] Each WOSB concern participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that--

(i) It * is, * is not an EDWOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It * is, * is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(ii) of this provision is accurate in reference to the EDWOSB concern or concerns that are participating in the joint venture. The offeror shall enter the name or names of the EDWOSB concern or concerns that are participating in the joint venture: ------------.