W912QR18T0011-0002.pdf

MILITARY/RESERVE BRANCH

ATTN: TRAVIS I DUNN

600 DR M L KING JR PL, RM 821

LOUISVILLE KY 40202-2236

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

Solicitation W912QR18T0011 for professional services as a Registered Nurse in the U.S. Army Corps of Engineers, Louisville District Occupational Health Unit, located in Louisville, Kentucky is hereby amended as follows:

SEE SUMMARY OF CHANGES (AMDT 0002)

1. CONTRACT ID CODE PAGE OF PAGES

1 9

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W912QR18T0011

X 9B. DATED (SEE ITEM 11)

08-Feb-2018

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

20-Feb-2018

CODE

U. S. ARMY ENGINEER DISTRICT, LOUISVILLE

600 DR. MARTIN LUTHER KING, JR. PLACE

ROOM 821

LOUISVILLE KY 40202-2239

W912QR 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE 964859

FACILITY CODECODE

EMAIL:TEL:

W912QR18T0011

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 30 - BLOCK 14 CONTINUATION PAGE

The following have been added by full text:

SUMMARY OF CHANGES (AMDT 0002)

Scope of Work- 4 Day RN has been replaced in its entirety by Performance Work Statement- 4 Day RN

- Grace period added for those not certified to obtain certification as an American Heart Association Heartsaver First Aid, Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) instructor.

Scope of Work- 3 Day RN has been replaced in its entirety by Performance Work Statement- 3 Day RN

- Grace period added for those not certified to obtain certification as an American Heart Association Heartsaver First Aid, Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) instructor.

Scope of Work- PRN has been replaced in its entirety by Performance Work Statement- PRN

- Grace period added for those not certified to obtain American Heart Association Basic Life Support (BLS) Card.

- Requirement has been deleted to be certified as an American Heart Association Heartsaver First Aid, Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) instructor.

The due date and time have not changed and remain 02 March 2017 at 10:00 AM Eastern.

All other terms and conditions remain unchanged.

SECTION SF 1449 - CONTINUATION SHEET

The following have been added by full text:

PWS- 4 DAY RN

PERFORMANCE WORK STATEMENT- 4 DAY RN

CHARACTER AND EXTENT OF SERVICES

The Contractor will provide professional services as a Registered Nurse approximately thirty two (32) hours every week for a one year period as directed by the government nurse in the U.S. Army Corps of Engineers, Louisville District Occupational Health Unit, located in Louisville, Kentucky in the Ron Mazzoli Federal Building, Rm. 138.

These medical services are for all government employees in the participating agencies and others in an emergency situation.

The Contractor will work under the technical direction of the government nurse and under the administrative control of the Occupational Health and Safety Office, U.S. Army Corps of Engineers, Louisville District.

Services will be performed eight (8) hours per day, four (4) days per week. The hours are from 8:00 a.m. - 4:30 p.m.

Eastern Time, Monday – Friday. During holidays, such as Christmas and Thanksgiving, the contractor may not be called in for the entire week.

Payment will be made on actual hours worked with no accumulation of sick leave, annual leave or holiday compensation. Contractor must agree to be paid electronically and be responsible for all taxes, workman’s compensation, social security and professional liability and health insurance.

The Government is obligated only to the extent of such requests as are actually made against this contract. The Government will give the Contractor a reasonable notice, except under extreme emergency conditions, prior to when service is required to be performed. If the Contractor cannot perform when notified under an emergency condition, services will be procured elsewhere.

Quantities should not exceed 1600 hours per year. The contract will be for the base period from 01 April 2018 through 31 March 2019 and include options to extend the period of services for four (4) one-year periods. Total contract amount is estimated.

REQUIREMENTS

All Offerors shall provide documentation as proof for the following requirements or their offer will NOT be considered:

Education:

Minimum educational requirement is an Associate Degree (ADN) or Diploma Program in Nursing.

Experience:

Minimum of five (5) years working as a Registered Nurse in an Urgent Care, Ambulatory Care, or Occupational Health clinical setting.

License and Certifications:

Current, active, and unrestricted license as a Registered Nurse in the Commonwealth of Kentucky.

Current/Valid American Heart Association Basic Life Support (BLS) Card.

Current certification or must obtain certification as an American Heart Association Heartsaver First Aid, Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) instructor within 120 days of contract acceptance.

RESPONSIBILITIES

Triage and provide appropriate care for employee injuries and illnesses following medical protocols.

Conduct pre-physical screening and instruct employees about pre-physical lab testing.

Perform diagnostic tests such as Electrocardiograms (EKG), Snellen eye tests, glucose testing, strep screens, urine dip tests and hemoccult testing.

Administer vaccinations, over the counter medications and allergy injections per medical protocols.

Recognize clinical abnormalities and follow up with appropriate action per medical protocols.

Counsel employees on preventative health measures and procedures.

Provide first aid and CPR in emergency situations following BLS protocols.

Report and follow-up on needle stick and body fluid exposures, including detailed record of occurrences.

Collect and document employee data and information according to empirical data, history and clinical findings.

Maintain employee medical files within federal guidelines, ensuring confidentiality and privacy of health and personal information.

Transcription of physician dictated encounters.

Schedule comprehensive employee health maintenance examinations.

Maintain a daily census and a log of activities including medical service or assistance rendered.

Coordinate with the physician and government nurse to provide high quality patient care in a caring and professional manner.

PWS- 3 DAY RN

PERFORMANCE WORK STATEMENT- 3 DAY RN

The Contractor will provide professional services as a Registered Nurse approximately twenty four (24) hours every week for a one year period as directed by the government nurse in the U.S. Army Corps of Engineers, Louisville District Occupational Health Unit, located in Louisville, Kentucky in the Ron Mazzoli Federal Building, Rm. 138.

These medical services are for all government employees in the participating agencies and others in an emergency situation.

The Contractor will work under the technical direction of the government nurse and under the administrative control of the Occupational Health and Safety Office, U.S. Army Corps of Engineers, Louisville District.

Services will be performed eight (8) hours per day, three (3) days per week. The hours are from 8:00 a.m. - 4:30 p.m. Eastern Time, Monday – Friday. During holidays, such as Christmas and Thanksgiving, the contractor may not be called in for the entire week.

Payment will be made on actual hours worked with no accumulation of sick leave, annual leave or holiday compensation. Contractor must agree to be paid electronically and be responsible for all taxes, workman’s compensation, social security and professional liability and health insurance.

The Government is obligated only to the extent of such requests as are actually made against this contract. The Government will give the Contractor a reasonable notice, except under extreme emergency conditions, prior to when service is required to be performed. If the Contractor cannot perform when notified under an emergency condition, services will be procured elsewhere.

Quantities should not exceed 1200 hours per year. The contract will be for the base period from 01 April 2018 through 31 March 2019 and include options to extend the period of services for four (4) one-year periods. Total

All Offerors shall provide documentation as proof for the following requirements or their offer will NOT be considered:

Education:

Minimum educational requirement is an Associate Degree (ADN) or Diploma Program in Nursing.

Experience:

Minimum of five (5) years working as a Registered Nurse in an Urgent Care, Ambulatory Care, or Occupational Health clinical setting.

License and Certifications:

Current, active, and unrestricted license as a Registered Nurse in the Commonwealth of Kentucky.

Current/Valid American Heart Association Basic Life Support (BLS) Card.

Current certification or must obtain certification as an American Heart Association Heartsaver First Aid, Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) instructor within 120 days of contract acceptance.

Conduct pre-physical screening and instruct employees about pre-physical lab testing.

Perform diagnostic tests such as Electrocardiograms (EKG), Snellen eye tests, glucose testing, strep screens, urine dip tests and hemoccult testing.

Administer vaccinations, over the counter medications and allergy injections per medical protocols.

Recognize clinical abnormalities and follow up with appropriate action per medical protocols.

Counsel employees on preventative health measures and procedures.

Provide first aid and CPR in emergency situations following BLS protocols.

Report and follow-up on needle stick and body fluid exposures, including detailed record of occurrences.

Collect and document employee data and information according to empirical data, history and clinical findings.

Maintain employee medical files within federal guidelines, ensuring confidentiality and privacy of health and personal information.

Transcription of physician dictated encounters.

Schedule comprehensive employee health maintenance examinations.

Maintain a daily census and a log of activities including medical service or assistance rendered.

Coordinate with the physician and government nurse to provide high quality patient care in a caring and professional

PWS- PRN

PERFORMANCE WORK STATEMENT- PRN

The Contractor will provide professional services as a Registered Nurse not to exceed 300 hours for a one year period as directed by the government nurse in the U.S. Army Corps of Engineers, Louisville District Occupational Health Unit, located in Louisville, Kentucky in the Ron Mazzoli Federal Building, Rm. 138. These medical services are for all government employees in the participating agencies and others in an emergency situation.

The Contractor will work under the technical direction of the government nurse and under the administrative control of the Occupational Health and Safety Office, U.S. Army Corps of Engineers, Louisville District.

Services will be performed on an as-needed basis for up to eight (8) hours per day. The hours are from 8:00 a.m. - 4:30 p.m. Eastern Time, Monday – Friday. During holidays, such as Christmas and Thanksgiving, the contractor may not be called in for the entire week.

Payment will be made on actual hours worked with no accumulation of sick leave, annual leave or holiday compensation. Contractor must agree to be paid electronically and be responsible for all taxes, workman’s compensation, social security and professional liability and health insurance.

The Government is obligated only to the extent of such requests as are actually made against this contract. The Government will give the Contractor a reasonable notice, except under extreme emergency conditions, prior to when service is required to be performed. If the Contractor cannot perform when notified under an emergency condition, services will be procured elsewhere.

Quantities should not exceed 300 hours per year. The contract will be for the base period from 01 April 2018 through 31 March 2019 and include options to extend the period of services for four (4) one-year periods. Total

All Offerors shall provide documentation as proof for the following requirements or their offer will NOT be considered:

Education:

Minimum educational requirement is an Associate Degree (ADN) or Diploma Program in Nursing.

Experience:

Minimum of five (5) years working as a Registered Nurse in an Urgent Care, Ambulatory Care, or Occupational Health clinical setting.

License and Certifications:

Current, active, and unrestricted license as a Registered Nurse in the Commonwealth of Kentucky.

Current/Valid American Heart Association Basic Life Support (BLS) Card or must obtain within 30 days of contract acceptance.

Conduct pre-physical screening and instruct employees about pre-physical lab testing.

Perform diagnostic tests such as Electrocardiograms (EKG), Snellen eye tests, glucose testing, strep screens, urine dip tests and hemoccult testing.

Administer vaccinations, over the counter medications and allergy injections per medical protocols.

Recognize clinical abnormalities and follow up with appropriate action per medical protocols.

Counsel employees on preventative health measures and procedures.

Provide first aid and CPR in emergency situations following BLS protocols.

Report and follow-up on needle stick and body fluid exposures, including detailed record of occurrences.

Collect and document employee data and information according to empirical data, history and clinical findings.

Maintain employee medical files within federal guidelines, ensuring confidentiality and privacy of health and personal information.

Transcription of physician dictated encounters.

Schedule comprehensive employee health maintenance examinations.

Maintain a daily census and a log of activities including medical service or assistance rendered.

Coordinate with the physician and government nurse to provide high quality patient care in a caring and professional

The following have been deleted:

SCOPE OF WORK- 4 DAY RN

SCOPE OF WORK- 3 DAY RN

SCOPE OF WORK- PRN

(End of Summary of Changes)