PAGE 1 OF1. REQUISITION NO.2. CONTRACT NO.3. AWARD ...



PAGE 1 OF1. REQUISITION NO.2. CONTRACT NO.3. AWARD/EFFECTIVE DATE4. ORDER NO.5. SOLICITATION NUMBER6. SOLICITATION ISSUE DATEa. NAMEb. TELEPHONE NO. (No Collect Calls)8. OFFER DUE DATE/LOCALTIME9. ISSUED BYCODE10. THIS ACQUISITION IS UNRESTRICTED ORSET ASIDE:% FOR:SMALL BUSINESSHUBZONE SMALLBUSINESSSERVICE-DISABLEDVETERAN-OWNEDSMALL BUSINESSWOMEN-OWNED SMALL BUSINESS(WOSB) ELIGIBLE UNDER THE WOMEN-OWNEDSMALL BUSINESS PROGRAMEDWOSB8(A)NAICS:SIZE STANDARD:11. DELIVERY FOR FOB DESTINA-TION UNLESS BLOCK ISMARKEDSEE SCHEDULE12. DISCOUNT TERMS 13a. THIS CONTRACT IS ARATED ORDER UNDERDPAS (15 CFR 700)13b. RATING14. METHOD OF SOLICITATIONRFQIFBRFP15. DELIVER TOCODE16. ADMINISTERED BYCODE17a. CONTRACTOR/OFFERORCODEFACILITY CODE18a. PAYMENT WILL BE MADE BYCODETELEPHONE NO.DUNS:DUNS+4:PHONE:FAX:17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKEDSEE ADDENDUM19.20.21.22.23.24.ITEM NO.SCHEDULE OF SUPPLIES/SERVICESQUANTITYUNITUNIT PRICEAMOUNT(Use Reverse and/or Attach Additional Sheets as Necessary)25. ACCOUNTING AND APPROPRIATION DATA26. TOTAL AWARD AMOUNT (For Govt. Use Only)27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDAAREARE NOT ATTACHED.27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDAAREARE NOT ATTACHED28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________29. AWARD OF CONTRACT: REF. ___________________________________ OFFERCOPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH ANDDATED ________________________________. YOUR OFFER ON SOLICITATIONDELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH AREADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIEDSET FORTH HEREIN IS ACCEPTED AS TO ITEMS:30a. SIGNATURE OF OFFEROR/CONTRACTOR31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)30c. DATE SIGNED31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)31c. DATE SIGNEDAUTHORIZED FOR LOCAL REPRODUCTION(REV. 2/2012)PREVIOUS EDITION IS NOT USABLEPrescribed by GSA - FAR (48 CFR) 53.2127. FOR SOLICITATIONINFORMATION CALL:STANDARD FORM 1449OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 73VA246-13-Q-205601-30-2014Kathryn Avent-Ortega757-728-712702-21-20142:00 p.m.Hatasha HanleyDepartment of Veterans AffairsVISN 6 Centralized Acquisition Service100 Emancipation DriveHampton VA 23667X621910$14 MillionX xx N/ADepartment of Veterans AffairsFayetteville VAMC2300 Ramsey StreetFayetteville NC 28301Department of Veterans AffairsVISN 6 Centralized Acquisition Service100 Emancipation DriveHampton VA 23667The contractor shall submit paymentrequests in electronic form via VA'sPayment System. (See web site at)PROVIDE AMBULANCE SERVICE FOR THE FAYETTEVILLE VAMCInsert prices on schedule pages(s) xx of xxCONTRACTORS: DUNS_______________TAX ID____________BUSINESS SIZE: SDVOSB_____ VOSB_______8(A) ______ WOSB_______ HUBZONE ______ SB_________LARGE_____________________XX 1Hatasha HanleyContracting OfficerSECTION AA.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMSTable of Contents TOC \o &quot;1-4&quot; \f \h \z \u \x SECTION A PAGEREF _Toc378254243 \h 1A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS PAGEREF _Toc378254244 \h 1SECTION B - CONTINUATION OF SF 1449 BLOCKS PAGEREF _Toc378254245 \h 5B.1 CONTRACT ADMINISTRATION DATA PAGEREF _Toc378254246 \h 5B.2 SUBCONTRACTING COMMITMENTS - MONITORING AND COMPLIANCE PAGEREF _Toc378254247 \h 7B.3 SCHEDULE OF SUPPLIES / SERVICES PAGEREF _Toc378254248 \h 8B.4 PERFORMANCE WORK STATEMENT (PWS) PAGEREF _Toc378254249 \h 12B.5 SPECIAL CONTRACT REQUIREMENTS PAGEREF _Toc378254250 \h 18SECTION C - CONTRACT CLAUSES PAGEREF _Toc378254251 \h 28C.1 52.216-18 ORDERING (OCT 1995) PAGEREF _Toc378254252 \h 28C.2 52.216-19 ORDER LIMITATIONS (OCT 1995) PAGEREF _Toc378254253 \h 28C.3 52.216-21 REQUIREMENTS (OCT 1995) ALTERNATE III (OCT 1995) PAGEREF _Toc378254254 \h 28C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) PAGEREF _Toc378254255 \h 29C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) PAGEREF _Toc378254256 \h 29C.6 52.228-5 INSURANCE - WORK ON A GOVERNMENT INSTALLATION (JAN 1997) PAGEREF _Toc378254257 \h 29C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS PAGEREF _Toc378254258 \h 29C.8 VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008) PAGEREF _Toc378254259 \h 30C.9 VAAR 852.203-71 DISPLAY OF DEPARTMENT OF VETERAN AFFAIRS HOTLINE POSTER (DEC 1992) PAGEREF _Toc378254260 \h 30C.10 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009) PAGEREF _Toc378254262 \h 30C.11 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (JAN 2008) PAGEREF _Toc378254263 \h 30C.12 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984) PAGEREF _Toc378254264 \h 31C.13 VAAR 852.273-76 ELECTRONIC INVOICE SUBMISSION (Interim - October 2008) PAGEREF _Toc378254265 \h 31C.14 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (NOV 2013) PAGEREF _Toc378254266 \h 31C.15 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) PAGEREF _Toc378254267 \h 35SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS PAGEREF _Toc378254268 \h 37D.1 WAGE DETERMINATION PAGEREF _Toc378254269 \h 37D.2 QUALITY ASSURANCE SURVEILLANCE PLAN PAGEREF _Toc378254270 \h 37D.3 BUSINESS ASSOCIATE AGREEMENT PAGEREF _Toc378254272 \h 42D.4 PAST PERFORMANCE SURVEY PAGEREF _Toc378254273 \h 47PAST PERFORMANCE SURVEY PAGEREF _Toc378254274 \h 47SUBCONTRACTOR PLAN MODEL PAGEREF _Toc378254275 \h 50E.2 52.212-2 EVALUATION—COMMERCIAL ITEMS (JAN 1999) PAGEREF _Toc378254327 \h 62E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013) PAGEREF _Toc378254328 \h 62E.4 52.216-1 TYPE OF CONTRACT (APR 1984) PAGEREF _Toc378254329 \h 63E.5 52.233-2 SERVICE OF PROTEST (SEP 2006) PAGEREF _Toc378254330 \h 63E.6 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (JAN 2008) PAGEREF _Toc378254331 \h 63E.7 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998) PAGEREF _Toc378254332 \h 64E.8 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) PAGEREF _Toc378254333 \h 64E.9 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO BENEFICIARIES (JAN 2008) PAGEREF _Toc378254334 \h 64E.10 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003) PAGEREF _Toc378254335 \h 64E.11 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (NOV 2013) PAGEREF _Toc378254336 \h 64E.12 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) PAGEREF _Toc378254337 \h 73SECTION B - CONTINUATION OF SF 1449 BLOCKSB.1 CONTRACT ADMINISTRATION DATA(continuation from Standard Form 1449, block 18A.) 1. Contract Administration: All contract administration matters will be handled by the following individuals: a. CONTRACTOR: b. GOVERNMENT: Contracting Officer 00246 Hatasha HanleyHatasha HanleyDepartment of Veterans AffairsVISN 6 Centralized Acquisition Service100 Emancipation DriveHampton VA 23667 2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:[X]52.232-34, Payment by Electronic Funds Transfer -Other than Central Contractor Registration, or[]52.232-36, Payment by Third Party 3. INVOICES: Invoices shall be submitted in arrears: a. Quarterly[] b. Semi-Annually[] c. Other[X] MONTHLY IN ARREARS 4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.The contractor shall submit paymentrequests in electronic form via VA'sPayment System. (See web site at) ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:AMENDMENT NODATEB.2 SUBCONTRACTING COMMITMENTS - MONITORING AND COMPLIANCESubcontracting Commitments - Monitoring and Compliance This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.B.3 SCHEDULE OF SUPPLIES / SERVICESThe Contractor shall supply all necessary personnel, management, administrative support, and equipment required to provide twenty four (24) hour ambulance services in accordance with the terms and conditions of the contract. The quantities specified in the Schedule are estimates only.BASE YEAR: 1 March 2014 THROUGH FEBRUARY 28, 2015CLINDescriptionEst. QtyUnitUnit PriceEstimatedTotal Price0001Basic Life Support (BLS): 0001AABLS: Any trip within twenty (20) Miles from the Fayetteville VAMC. Includes arrival and acceptance of patient at point of departure and delivery of patient to destination. 319Trip$ _______$ _________0001ABRate per mile beyond the 20 miles radius from VAMC (ONE WAY ONLY) – This rate is in addition to the rate per trip in item 1) above.58667miles$ _______$ _________0001ACFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Asheville VAMC, 1100 Tunnel Road, Asheville, NC 28805 (ONE WAY ONLY) 1Trip$ _______$ _________0001ADFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Durham VAMC,508 Fulton Street, Durham, NC 27705 (ONE WAY ONLY)50Trip$ _______$ _________0001AEFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Richmond VAMC, 1201 Broad Rock Blvd, Richmond, VA 23249 (ONE WAY ONLY)2Trip$ _______$ _________0001AFFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Salem VAMC, 1970 Roanoke Blvd, Salem, VA 24153 (ONE WAY ONLY)2Trip$ _______$ _________0001AGFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Salisbury VAMC, 1601 Brenner Ave, Salisbury, NC 28114 (ONE WAY ONLY)2Trip$ _______$ _________0002Advanced Life Support (ALS):0002AAAdvanced Life Support (ALS): Any trip within twenty (20) Miles from the Fayetteville VAMC. Includes arrival and acceptance of patient at point of departure and delivery of patient to destination. 220Trip$________$ _________0002ABRate per mile beyond the 20 miles radius from VAMC (ONE WAY ONLY) – This rate is in addition to the rate per trip in item 2) above.22000miles$ _______$ _________ESTIMATED BASE YEAR TOTAL $_____________________OPTION YEAR 1: 1 March 2015 THROUGH FEBRUARY 29, 2016CLINDescriptionEst. QtyUnitUnit PriceEstimatedTotal Price1001Basic Life Support (BLS): 1001AABLS: Any trip within twenty (20) Miles from the Fayetteville VAMC. Includes arrival and acceptance of patient at point of departure and delivery of patient to destination. 319Trip$ _______$ _________1001ABRate per mile beyond the 20 miles radius from VAMC (ONE WAY ONLY) – This rate is in addition to the rate per trip in item 1) above.58667miles$ _______$ _________1001ACFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Asheville VAMC, 1100 Tunnel Road, Asheville, NC 28805 (ONE WAY ONLY) 1Trip$ _______$ _________1001ADFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Durham VAMC,508 Fulton Street, Durham, NC 27705 (ONE WAY ONLY)50Trip$ _______$ _________1001AEFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Richmond VAMC, 1201 Broad Rock Blvd, Richmond, VA 23249 (ONE WAY ONLY)2Trip$ _______$ _________1001AFFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Salem VAMC, 1970 Roanoke Blvd, Salem, VA 24153 (ONE WAY ONLY)2Trip$ _______$ _________1001AGFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Salisbury VAMC, 1601 Brenner Ave, Salisbury, NC 28114 (ONE WAY ONLY)2Trip$ _______$ _________1002Advanced Life Support (ALS):1002AAAdvanced Life Support (ALS): Any trip within twenty (20) Miles from the Fayetteville VAMC. Includes arrival and acceptance of patient at point of departure and delivery of patient to destination. 220Trip$________$ _________1002ABRate per mile beyond the 20 miles radius from VAMC (ONE WAY ONLY) – This rate is in addition to the rate per trip in item 2) above.22000miles$ _______$ _________ESTIMATED OPTION YEAR 1 TOTAL $_____________________OPTION YEAR 2: 1 March 2016 THROUGH FEBRUARY 28, 2017CLINDescriptionEst. QtyUnitUnit PriceEstimatedTotal Price2001Basic Life Support (BLS): 2001AABLS: Any trip within twenty (20) Miles from the Fayetteville VAMC. Includes arrival and acceptance of patient at point of departure and delivery of patient to destination. 319Trip$ _______$ _________2001ABRate per mile beyond the 20 miles radius from VAMC (ONE WAY ONLY) – This rate is in addition to the rate per trip in item 1) above.58667miles$ _______$ _________2001ACFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Asheville VAMC, 1100 Tunnel Road, Asheville, NC 28805 (ONE WAY ONLY) 1Trip$ _______$ _________2001ADFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Durham VAMC,508 Fulton Street, Durham, NC 27705 (ONE WAY ONLY)50Trip$ _______$ _________2001AEFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Richmond VAMC, 1201 Broad Rock Blvd, Richmond, VA 23249 (ONE WAY ONLY)2Trip$ _______$ _________2001AFFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Salem VAMC, 1970 Roanoke Blvd, Salem, VA 24153 (ONE WAY ONLY)2Trip$ _______$ _________2001AGFlat Rate of Beneficiary one-way between the Fayetteville VAMC and Salisbury VAMC, 1601 Brenner Ave, Salisbury, NC 28114 (ONE WAY ONLY)2Trip$ _______$ _________2002Advanced Life Support (ALS):2002AAAdvanced Life Support (ALS): Any trip within twenty (20) Miles from the Fayetteville VAMC. Includes arrival and acceptance of patient at point of departure and delivery of patient to destination. 220Trip$________$ _________2002ABRate per mile beyond the 20 miles radius from VAMC (ONE WAY ONLY) – This rate is in addition to the rate per trip in item 2) above.22000miles$ _______$ _________ESTIMATED OPTION YEAR 2 TOTAL $_____________________ESTIMATED Total Base plus 2 option YEAR TOTAL $________________The Contractor shall supply all necessary personnel, management, administrative support, and equipment required to provide twenty four (24) hour ambulance services in accordance with the terms and conditions of the contract. The quantities specified in the Schedule are estimates only.B.4 PERFORMANCE WORK STATEMENT (PWS)1.0 INTRODUCTIONThe Department of Veterans Affairs Medical Center, 2300 Ramsey Street, Fayetteville, North Carolina (VAMC), provides diagnostic and therapeutic services in medicine, surgery, rehabilitation medicine, psychiatry, and skilled nursing home care for the beneficiaries of the Department of Veterans Affairs. ?This facility also provides ambulance services to those veterans not requiring hospitalization.? The contract will include a requirement for Basic Life Support (BLS) and/or Advanced Life Support (ALS) Ambulance Services. The contractor shall furnish twenty four (24) hour ambulance service for the beneficiaries of the Department of Veterans Affairs Medical Center (VAMC), Fayetteville, North Carolina and the following locations: Fayetteville VAMC2300 Ramsey StFayetteville, NC 28301Asheville VAMC1100 Tunnel RoadAsheville, NC 28805Salisbury VAMC1601 Brenner AveSalisbury, NC 28114Richmond VAMC1201 Broad Rock BlvdRichmond, VA 23249Salem VAMC1970 Roanoke Blvd Salem, VA 24153 2.0 REQUIREMENTSAny and all equipment, machinery, linens, etc. taken with patients from the VA Medical Center must be returned to the Medical Center.? The Contractor is responsible for furnishing linen and blankets for use in the ambulance.? Clean and fresh linen and blankets must be used for each patient.? The Medical Center will not furnish linen or participate in a linen exchange program.? The following items must be provided on each ambulance:? 2 sheets, disposable or cloth2 pillowcases, disposable or cloth for each pillow2 cloth towelsUniversal Precautions will be used on all VA patients.Scheduling/Coordination:Requests for services will be made in writing or by telephone under the authority of the Chief, Health Administration Service, typically by the Travel Clerk, Contracting Officers Representative (COR), or Administrative Officer on Duty (AOD).? The contractor will be informed of that time and location for pick-up and drop-off of the patient. The contractor shall notify the VAMC of any delays in the transporting of patients.If the contractor fails to furnish ambulance service within one hour after receiving a VAMC request for service, the VAMC reserves the right to obtain the services from another source and to charge the contractor any excess cost which may result.? The VAMC will be the sole judge in determining when to order service from another source.?When conditions, neither foreseeable and/or controllable by the Contractor occur, such as but not limited to severe storms, flooding, hazardous road and travel conditions, time and distance requirements shall be considered secondary to safety precautions. Delays or exceptions to the required quality of services shall be reported to the Travel Clerk or Administrative Officer of the Day (AOD). The Contracting Officers Representative (COR) will make a determination as to whether such delays in service will be excused.For excusable time lost in waiting at either or both ends of a trip, the contractor will be reimbursed at the rate of one-fourth the hourly rate for each quarter hour.? As soon as a delay is anticipated, the contractor will contact the transportation office at (910)822-7903, Monday thru Friday 8:00 a.m. to 4:30 p.m.? During other than normal duty hours, the contractor shall contact the Administrative Officer of the Day (AOD) at (910)822-7903.Adherence to schedules is of the utmost importance. Contractor shall pick up the customer as near to the scheduled pickup time as possible. If Contractor arrives earlier than the scheduled pickup the driver shall wait at the pickup location until fifteen (15) minutes past the scheduled pickup time before calling the dispatcher for instructions.The Contractor shall be required to maintain 95% on time performance on a daily basis. Trips shall be considered “on-time” as long as they arrive at the destination on or before the scheduled arrival time.C. Unless specifically authorized by the Chief, Health Administration Service or his/her designee, the driver is to take the shortest distance available.? The contractor will be reimbursed accordingly if advised to take the most expeditious route regardless of mileage.D. If a BLS unit is requested and dispatched and after arrival at the pick-up point, the crew feels an ALS unit is needed, approval must be granted by an official of the Medical Center prior to transporting the patient if ALS rates are to be applied.E. On evenings and weekends the contractor shall have the right staff units in accordance with the typical demand requirements of the Medical Center.? Reduction in available units during the evening and weekend does not relieve the contractor of the responsibility to provide ambulance services when requested. F. Contractor shall report to the COR any and all vehicle breakdowns or other problems, which may cause service disruptions immediately. When a breakdown occurs, it is the responsibility of the Contractor’s to provide a back-up vehicle to minimize any delay or inconvenience to the customer(s).PATIENT PICK-UP AND DELIVERY FROM/TO VAMCA. Ambulance drivers shall report to the floor in which the patient is located.? The VAMC Fayetteville is staffed 24 hours a day, seven days a week.??The contractor will follow the following protocol.Report to the personnel at the respective Nursing Station and (1) announce his/her arrival to pick-up and?transfer patient, and (2) obtain report of pertinent information regarding patient’s condition from the primary nurse/physician.When delivering a patient, after checking in at the assigned floor, the driver shall take patient to specified location in the facility and provide report to appropriate nursing personnel along with a copy of the run which will be retained by the facility for the patient’s medical record.NUMBER OF PATIENTS? A. Only one patient shall be transported on a trip unless specifically authorized by the VAMC.? When, pursuant to the Department of Veterans Affairs authorization, more than one patient is transported concurrently on a trip, reimbursement shall be made at the rate not exceeding the cost of transporting a single patient.? No more than one psychiatric patient shall be transported at one time.? If the patient is being committed by a physician no law enforcement escort is needed. Regardless of the number of patients transported concurrently on a single trip beyond the mileage threshold, the Contractor shall be reimbursed at the Mileage Rate for only one trip to the longest distance traveled with any one patient on that particular trip. The contractor shall ensure that the pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.? B. An authorized official of the Department of Veterans Affairs Medical Center, Fayetteville may in the interest of the patient, allow a relative to accompany him/her at no extra charge to the Government.PATIENT WELFARE AND ABUSE The contractor shall be held responsible for patient welfare during transport.? The contractor shall be held responsible for patient and/or Government property during transport.? Any damaged or lost wheelchairs, walkers, crutches or personal belongings shall be replaced by the contractor.The contractor shall exercise extreme caution and care in the handling of patients.? Any abuse of patients shall be grounds for default action or termination of the contract.The contractor must take into consideration that he will be transporting ill patients.? Drivers of vehicles are required to observe speed limits, vehicles should be swept clean and the exteriors washed periodically, and drivers will refrain from smoking. Drivers are to escort patients in need of assistance to and from point of pick-up and destination.INCIDENT REPORT?? Contractor shall immediately report all medical incidents or accidents, including those where there is no apparent injury to the patient, which occurs while transporting VA beneficiaries. A written report from the driver documenting the facts of the incident/accident shall be provided to the Contracting Officer Representative (COR) within 24 hours of the occurrence. The written report shall include the names, addresses, and telephone numbers of any witnesses as well as any applicable Police Reports. Any accident involving major damage, serious personal injury or loss of life shall be reported to the COR immediately. Records shall be kept for three (3) years for each accident a vehicle is involved in, including the repair work required to return the vehicle to service.PATIENT CUSTODYContractor shall not release the patient from his/her custody, unless custody is released to charge nurse on duty at the facility patient is being transported, or to a designated point of contact at the patient’s residence. Contractor shall take every reasonable measure to assure the well being of the patient at their destination. Patients brought in by ambulance for a scheduled clinic appointment shall be delivered directly to that specific clinic, released to the custody of clinic personnel, and picked up, as ordered, in the clinic after the appointment by the ambulance crew. EQUIPMENT SPECIFICATIONS – VEHICLESThe ambulance (Emergency Medical Services Vehicle) under the terms of this contract shall be licensed and meet the minimal vehicle requirements as established by the North Carolina office of Emergency Medical services North Carolina Office of Emergency Medical Services, pertaining to ambulance services and (OMES Rules and Regulations) and must be a licensed EMS Provider in the State of North Carolina. All applications apply in which are applicable to the needs and requirement of the Department of Veterans Affairs, Fayetteville VAMC. VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with contract specifications, and State Laws, rules, regulations and guidelines governing Emergency Medical Transport Vehicles (ambulances).? VA inspections of contractor facilities shall in no way constitute a warranty by the VA that the contractor’s vehicles and equipment are properly maintained.? The VA reserves the right to restrict the Contractor’s use of equipment and vehicles which are in need of repair, unclean, unsafe, contain damages to the interior or exterior body, and are not in compliance with contract requirements.? The restriction of such equipment and vehicles shall not relieve the contractor from performing in accordance with the strict intent and meaning of the contract without additional cost to the VA.EMERGENCY VEHICLES BASIC LIFE SUPPORT AMBULANCE (BLS) shall be defined as a Class B Emergency Medical Services (EMS) vehicle. BLS is defined in the “Rules of Regulations of the Board of the North Carolina Office of Emergency Medical Services” (see Sec. 10A NCAC 13P).? The Class B EMS vehicle is primarily intended for the response to the location of a call for the delivery of basic life support, and for the transportation of patients who require such care.ADVANCED LIFE SUPPORT AMBULANCE (ALS) shall be defined as a Class C Emergency Medical Services (EMS) vehicle.? ALS is defined in the “Rules of Regulations of the North Carolina Office of Emergency Medical Services” (see Sec. 10A NCAC 13P).? The Class C EMS vehicle is primarily intended for the response of the call, delivery of basic and advanced life support, and for the transportation of patients who require such care. EMERGENCY MEDICAL CARE VEHICLE shall have patient compartment facilities, oxygen, suction systems and equipment, and additional systems equipment, accessories, and supplies (see Sec. 10A NCAC 13P .0207), as well as environmental climatic equipment, and communications.BASIC LIFE SUPPORT AMBULANCE (BLS) (North Carolina) shall be defined as an Ambulance Service that includes the necessary equipment to render basic emergency medical care and services as outlined by the North Carolina Office of Emergency Medical Services. ADVANCED LIFE SUPPORT AMBULANCE (ALS)(North Carolina) shall be defined as Ambulance Service that includes the necessary equipment and staff to render advanced life support services as outlined by the North Carolina Office of Emergency Medical Services. Each ambulance shall have patient compartment facilities, oxygen and suction systems and environmental climatic supplies as required by the North Carolina Office of Emergency Medical Services On evenings and weekends the contractor shall have the right staff units in accordance with the typical demand requirements of the Medical Center.? Reduction in available units during the evening and weekend does not relieve the contractor of the responsibility to provide ambulance services when requested. In accordance with the North Carolina Office of Emergency Medical Services, each ambulance shall be equipped as outlined for vehicles designated to provide Advanced Life Support (ALS) and Basic Life Support (BLS) services. The contractor must provide the inspection reports on all vehicles that will be used in the performance of this contract.? New vehicles must be reported before being used for this contract.Each contractor operating in North Carolina must comply with inspections and reporting as required by the North Carolina Office of Emergency Medical Services.DRIVER/ATTENDANTS CONTRACTOR SHALL INSURE THAT:A record of each employee as to character and physical capabilities of performing the duties of an ambulance driver and/or attendant shall be maintained and made available for inspection upon request.All attendants providing EMS services shall be in accordance with the North Carolina Office of Emergency Medical Services pertaining to EMT-D, EMT-I and EMT-P their duties with due regard for the safety, comfort and convenience of customers and their ply with all applicable Federal and State laws, regulations and licensing requirements, including drug testing.Have and maintain a current Driver’s License, valid in the State in which service provider’s facility is located, with less than five current points, none of which were assessed for “Reckless Driving.”Contact the Contactor’s dispatcher before leaving the designated location without picking up the customer(s) and when encountering problems such as customer(s) not being ready, incorrect addresses or addresses which are inaccessible to wheelchairs.Wear clothing that is clean and neat in appearance and display an AOPC approved name tag stating the driver’s name and Contractor’s company name.Ensure that no playing of audio/visual equipment in vehicles will be allowed without the approval of all customers aboard unless such equipment is used by a passenger with a headset.Ensure its personnel comply with 49 Code of Federal Regulations (CFR) Parts 40, 653 and 654 on Substance Abuse Prevention, which are respectively incorporated herein by reference and made part of this contract.At no time shall the Contractor leave vehicles on VA premises unless a pick-up or delivery is in process. Contractor employees shall conduct themselves in a businesslike manner at all times while on VA premises. When transporting patients to or from VAMC Fayetteville, the driver, acting for the Contractor, shall ensure that the patient’s luggage and medical record (when appropriate) is properly accounted for and delivered with the patient.EMERGENCY MEDICAL TECHNICIAN (EMT):A. Contractor Emergency Medical Technicians (EMTs) who perform emergency services on ambulances servicing the VAMC Fayetteville shall have the qualifications/training in accordance with the published standards of the North Carolina Department of Health under the regulating requirements for local EMS Systems supported by the Department of Health.The “equivalent” training program successfully completed by the EMT shall be submitted to the Contracting Officer for appropriate action.The EMT shall be certified, licensed or otherwise officially recognized by the Local, State, or Regional Government or public entity where the emergency ambulance service is operated, or by which it is governed.The EMT shall be enrolled periodically in “refresher” continuing education, or advanced training programs as required by the Local or State government entity in which the service is rendered to veterans, but in no instance shall this be less frequently than every three years. Such “refresher” training shall be equivalent of that developed by the Department of Transportation, National Highway Safety Administration. Proof of such refresher training must be submitted to the Contracting Officer and COR.PARAMEDICSA. Paramedics providing emergency services on ambulances servicing the VAMC Fayetteville shall have the following qualifications:Complete training in accordance with the standards published by the Department of Health and to be licensed in the state of North Carolina, of the equivalent thereof.The paramedic shall be certified, licensed or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated, or by which it is governed governs it. Proof of such certification must be submitted to the Contracting Officer.The paramedic shall be enrolled periodically in “refresher” continuing education, or advanced training programs as required by the local or state government entity in which the service is rendered to veterans, but in no instance shall this be less frequently than every three (3) years. Such “refresher” training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration. Proof of such refresher training must be submitted to the Contracting Officer for appropriate action. B. Paramedics providing emergency services on ambulances servicing the VAMC Fayetteville, North Carolina shall be required to have the following qualifications:Complete training in accordance with the standards published by the North Carolina Office of Emergency Medical Services.Shall be certified, licensed or otherwise official recognized by the local, state, or regional government or public entity where the ambulance service is operated, or by which is governed governs it. Proof of such certification must be submitted to the Contracting Officer.Paramedic refresher and continuing education or advanced training programs must be completed as required by the North Carolina Office of Emergency Medical Services.B.5 SPECIAL CONTRACT REQUIREMENTSTOLL CHARGESA. Prices quoted in the schedules do not include any ferry, bridge, tunnel, or road charge. Any such legitimate toll charges incurred shall be limited to ONE WAY ONLY and shall be listed separately on Contractor’s invoices.B. If Contractor’s place of business is located beyond the local telephone call zone of the hospital; the Contractor agrees to accept telephone orders for service on a collect basis. It is estimated that all orders will be placed by telephone.C. Service Provider shall be responsible for all county, cities, local or state fees imposed on the Service Provider during performance of this contract.CONDUCTThe following acts are not permissible, while providing services under this contract or while on VA premises:Use of intoxicating liquors, narcotics or controlled substances of any kind (excluding doctors’ prescriptions which do not impair drive’s driving ability) while on duty or reporting for duty while under the influence of liquors, narcotics or controlled substance of any kind (excluding doctors’ prescriptions which do not impair driver’s driving ability).Gambling in any form.Carrying of pistols, firearms or concealed weapons.Smoking and other uses of tobacco while on duty.Resorting to physical violence to settle a dispute with a fellow employee, customer(s) or the general public while on duty.Spitting in prohibited places or any other unsanitary, offensive or insensitive practices or behavior.Use of loud, indecent or profane language and/or making threatening or obscene gestures toward customers or other employees.Stopping for personal business, including use or restroom facilities, while vehicle is occupied by a passenger. The driver shall not leave the vehicle with the key in the ignition at any time.Engaging customer in a verbal confrontation in an attempt to settle a disagreement. Should a disagreement arise, the driver is to contact his dispatcher/supervisor via the radio system.Soliciting or accepting tips from customer, companions or others at any MUNICATION SYSTEMContractor’s Communication System shall consist of:Telephone SystemContractor shall have sufficient telephone capacity to ensure immediate communication access between the Fayetteville VAMC and the Contractor’s facility for the purposes of canceling trip requests as well as handling other emergencies. If the Contractor’s place of business is located beyond the local telephone call zone, the Contractor shall accept telephone orders for service on a collect basis or provide a toll free. The Contractor shall have telephone coverage to accept calls from Fayetteville VAMC seven (7) days a week/24 hours a day Sunday through Saturday.Vehicle CommunicationContractor shall ensure the availability of mobile radio and /or cellular telephone communication with all vehicles providing transportation service at all time. COMPLAINTSComplaints against behavior or courtesy shall be taken by VAMC Fayetteville may result in requiring Contractor to remove offender from the provisions of contracted services. Offenders who accumulate five (5) unrelated, substantiated complaints in a 12 month period shall be prohibited from providing any further services under this contract. The COR shall monitor the service provided. Contractor shall cooperate with the COR in providing information and answering questions in a timely manner when requested. Contractor shall refer complaints received directly from the customer(s) to the COR. All complaints received by the COR and forwarded to the Contracting Officer (CO) shall be investigated promptly. After investigation and disposition, Contractor shall respond to the CO within five (5) working days after receipt of documented findings.QUALITY CONTROLThe Contractor shall develop a Quality Assurance Plan (QAP) which will provide the Contractor’s strategy for monitoring performance internally, providing performance information to the Government, and reporting in compliance with the PWS. Within the QAP, the Contractor shall propose and maintain an established reporting system to promptly notify VA of any problems, issues, risks, or concerns with workflow performance, programmatic improvement, security, and schedule adherence. Quality control is the exclusive responsibility of the Contractor.The work performed under this contract shall be subject to evaluation by the COR/CO via the Quality Assurance Surveillance Plan (QASP) located in Section D.CONTRACT ADMINISTRATIONNotwithstanding the Contractor's responsibility for total management during the performance of this contract, the administration of the contract will require maximum coordination between the Government and the Contractor. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes that shall affect price, quantity or quality of performance of this contract.C. The COR shall be responsible for the overall technical administration of this contract as outlined in the COR Delegation of Authority. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereofPoints of Contact Contract SpecialistKathryn Avent-OrtegaContract SpecialistVA Mid-Atlantic Health Care Network - VISN 6100 Emancipation DriveHampton, VA 23667Office: (757) 728-7127Fax:??? (757) 728-3132Email: Kathryn.avent-ortega@ Contracting Officer (CO)Hatasha HanleyDepartment of Veterans AffairsNetwork Contracting Activity Building 27100 Emancipation DriveHampton, VA 23667757-315-3933 Fax: 757-728-3132EMAIL: Hatasha.hanley@ Contracting Officer’s Representative (COR)TBD PAYMENTTrip tickets shall be delivered daily to the Travel Unit indicating date of trip, pickup and delivery points, veteran’s name, charges, driver’s name or number, and who ordered the vehicle. Transport vouchers should faxed to Contractor to verify completed runs.Invoices shall be submitted by the 10th calendar day of each month for trips provided during the prior month. The invoice shall contain the following information:Contract numberDate of tripTicket numberNumber of miles, if billing for mileageName of patient transported, andDocumentation of circumstances when billing for attempted pick-up and/or waiting time.Pick-up location and Drop-off LocationsC. Invoices will be reviewed and reconciled to trip tickets and travel logs. Unauthorized charges will be suspended. Supporting documentation may be provided and submitted for payment consideration or suspended charges.Payment will be made monthly in arrears.VA INFORATION AND INFORMATION SYSTEM SECURITY/PRIVACY LANGUAGEGENERALContractors and contractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.ACCESS to VA INFORMATION AND VA INFORMATION SYSTEMSA contractor shall request logical (technical) or physical access to VA information and VA information systems for their employees and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.All contractors and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness.Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor.The contractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor’s employ. The Contracting Officer must also be notified immediately by the contractor prior to an unfriendly termination.VA INFORMATION CUSTODIAL LanguageInformation made available to the contractor by VA for the performance or administration of this contract or information developed by the contractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor’s rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).VA information should not be co-mingled, if possible, with any other data on the contractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements. VA reserves the right to conduct on site inspections of contractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.Prior to termination or completion of this contract, contractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.The contractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.The contractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor electronic storage media for restoration in case any electronic equipment or data used by the contractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.The contractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.The contractor’s firewall and Web services security controls, if applicable, shall meet or exceed VA’s minimum requirements. VA Configuration Guidelines are available upon request.Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA’s prior written approval. The contractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.Notwithstanding the provision above, the contractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor is in receipt of a court order or other requests for the above mentioned information, that contractor shall immediately refer such court orders or other requests to the VA contracting officer for response.For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COTR.SECURITY INCIDENT INVESTIGATIONThe term “security incident” means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor shall immediately notify the COTR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor has access.To the extent known by the contractor, the contractor’s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor considers relevant.With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement.In instances of theft or break-in or other criminal activity, the contractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident.LIQUIDATED DAMAGES FOR DATA BREACHConsistent with the requirements of 38 U.S.C. §5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor processes or maintains under this contract. The contractor shall provide notice to VA of a “security incident” as set forth in the Security Incident Investigation section above. Upon such notification, VA must secure from a non-Department entity or the VA Office of Inspector General an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of any sensitive personal information involved in the data breach. The term 'data breach' means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Contractor shall fully cooperate with the entity performing the risk analysis. Failure to cooperate may be deemed a material breach and grounds for contract termination.Each risk analysis shall address all relevant information concerning the data breach, including the following: Nature of the event (loss, theft, unauthorized access); Description of the event, including: (a) date of occurrence; (b) data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code; (3) Number of individuals affected or potentially affected; (4) Names of individuals or groups affected or potentially affected;(5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text; (6) Amount of time the data has been out of VA control; (7) The likelihood that the sensitive personal information will or has been compromised (made accessible to and usable by unauthorized persons); (8) Known misuses of data containing sensitive personal information, if any; (9) Assessment of the potential harm to the affected individuals; (10) Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and (11) Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised. Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $37.50 per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following: (1) Notification; (2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports; (3) Data breach analysis; (4) Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution; (5) One year of identity theft insurance with $20,000.00 coverage at $0 deductible; andNecessary legal expenses incurred by the subjects of an SPI data breach, to repair falsified or damaged credit, are not included in the liquidated damages amount and will be handled as actual damages, which the contractor should anticipate as among the costs of doing business, and should consider in developing its cost estimates. SECURITY CONTROLS COMPLIANCE TESTINGOn a periodic basis, VA, including the Office of Inspector General, reserves the right to evaluate any or all of the security controls and privacy practices implemented by the contractor under the clauses contained within the contract. With 10 working-day’s notice, at the request of the government, the contractor must fully cooperate and assist in a government-sponsored security controls assessment at each location wherein VA information is processed or stored, or information systems are developed, operated, maintained, or used on behalf of VA, including those initiated by the Office of Inspector General. The government may conduct a security control assessment on shorter notice (to include unannounced assessments) as determined by VA in the event of a security incident or at any other time.TRAININGAll contractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems: Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems; Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training; Successfully complete the appropriate VA privacy training and annually complete required privacy training; and Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system.The contractor shall provide to the contracting officer and/or the COTR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required. These online courses are located at the following web site: . Detailed instructions on account setup will be provided to the successful offeror.Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete. REQUIRED REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT SYSTEM (CPARS)a.?? As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials.? The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing.? To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire.? CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS.? CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS).? FAPIIS is a web-enabled application accessed via CPARS for contractor responsibility determination information.b.?? Each contractor whose contract award is estimated to exceed $150,000 is required to register with CPARS database at the following web address: cpars.csd.disa.mil.? Help in registering can be obtained by contacting Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690. Registration should occur no later than thirty days after contract award, and must be kept current should there be any change to the contractor’s registered representative.? c.?? For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete.? For contracts exceeding one year, the contracting officer will evaluate the contractor’s performance annually.? Interim reports will be filed each year until the last year of the contract, when the final report will be completed.? The report shall be assigned in CPARS to the contractor’s designated representative for comment.? The contractor representative will have thirty days to submit any comments and re-assign the report to the VA contracting officer. d.????Failure to have a current registration in the CPARS database, or to re-assign the report to the VA contracting officer within those thirty days, will result in the Government’s evaluation being placed on file in the database with a statement that the contractor failed to respond.?SECTION C - CONTRACT CLAUSESADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The following clauses are incorporated into 52.212-4 as an addendum to this contract:C.1 52.216-18 ORDERING (OCT 1995) (a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from date of contract through completion date of contract. (b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control. (c) If mailed, a delivery order or task order is considered "issued" when the Government deposits the order in the mail. Orders may be issued orally, by facsimile, or by electronic commerce methods only if authorized in the Schedule.(End of Clause)C.2 52.216-19 ORDER LIMITATIONS (OCT 1995) (a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than 25 trips, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract. (b) Maximum order. The Contractor is not obligated to honor— (1) Any order for a single item in excess of 400; (2) Any order for a combination of items in excess of 400; or (3) A series of orders from the same ordering office within 60 days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section. (c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section. (d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 5 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.(End of Clause)C.3 52.216-21 REQUIREMENTS (OCT 1995) ALTERNATE III (OCT 1995) (a) This is a requirements contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies or services specified in the Schedule are estimates only and are not purchased by this contract. Except as this contract may otherwise provide, if the Government's requirements do not result in orders in the quantities described as "estimated" or "maximum" in the Schedule, that fact shall not constitute the basis for an equitable price adjustment. (b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. Subject to any limitations in the Order Limitations clause or elsewhere in this contract, the Contractor shall furnish to the Government all supplies or services specified in the Schedule and called for by orders issued in accordance with the Ordering clause. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations. (c) The Government's requirements for each item or subitem of supplies or services described in the Schedule are being purchased through one non-set-aside contract and one set-aside contract. Therefore, the Government shall order from each Contractor approximately one-half of the total supplies or services specified in the Schedule that are required to be purchased by the specified Government activity or activities. The Government may choose between the set-aside Contractor and the non-set-aside Contractor in placing any particular order. However, the Government shall allocate successive orders, in accordance with its delivery requirements, to maintain as close a ratio as is reasonably practicable between the total quantities ordered from the two Contractors. (d) The Government is not required to purchase from the Contractor requirements in excess of any limit on total orders under this contract. (e) If the Government urgently requires delivery of any quantity of an item before the earliest date that delivery may be specified under this contract, and if the Contractor will not accept an order providing from the accelerated delivery, the Government may acquire the urgently required goods or services from another source. (f) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after .(End of Clause)C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 60 days of the period of performance end date..(End of Clause)C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) (a) The Government may extend the term of this contract by written notice to the Contractor within 60 days of the period of performance end date.; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension. (b) If the Government exercises this option, the extended contract shall be considered to include this option clause. (c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 2 years and 6 months.(End of Clause)C.6 52.228-5 INSURANCE - WORK ON A GOVERNMENT INSTALLATION (JAN 1997) (a) The Contractor shall, at its own expense, provide and maintain during the entire performance of this contract, at least the kinds and minimum amounts of insurance required in the Schedule or elsewhere in the contract. (b) Before commencing work under this contract, the Contractor shall notify the Contracting Officer in writing that the required insurance has been obtained. The policies evidencing required insurance shall contain an endorsement to the effect that any cancellation or any material change adversely affecting the Government's interest shall not be effective-- (1) For such period as the laws of the State in which this contract is to be performed prescribe; or (2) Until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer, whichever period is longer. (c) The Contractor shall insert the substance of this clause, including this paragraph (c), in subcontracts under this contract that require work on a Government installation and shall require subcontractors to provide and maintain the insurance required in the Schedule or elsewhere in the contract. The Contractor shall maintain a copy of all subcontractors' proofs of required insurance, and shall make copies available to the Contracting Officer upon request.(End of Clause)C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS In accordance with FAR 28.307-2 and FAR 52.228-5, the following minimum coverage shall apply to this contract: (a) Workers' compensation and employers liability: Contractors are required to comply with applicable Federal and State workers' compensation and occupational disease statutes. If occupational diseases are not compensable under those statutes, they shall be covered under the employer's liability section of the insurance policy, except when contract operations are so commingled with a Contractor's commercial operations that it would not be practical to require this coverage. Employer's liability coverage of at least $100,000 is required, except in States with exclusive or monopolistic funds that do not permit workers' compensation to be written by private carriers. (b) General Liability: $500,000.00 per occurrences. (c) Automobile liability: $200,000.00 per person; $500,000.00 per occurrence and $20,000.00 property damage. (d) The successful bidder must present to the Contracting Officer, prior to award, evidence of general liability insurance without any exclusionary clauses for asbestos that would void the general liability coverage.(End of Clause)C.8 VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008) The bidder or offeror agrees that if a contract is awarded to him/her, as a result of this solicitation, he/she will not advertise the award of the contract in his/her commercial advertising in such a manner as to state or imply that the Department of Veterans Affairs endorses a product, project or commercial line of endeavor.(End of Clause)C.9 VAAR 852.203-71 DISPLAY OF DEPARTMENT OF VETERAN AFFAIRS HOTLINE POSTER (DEC 1992) (a) Except as provided in paragraph (c) below, the Contractor shall display prominently, in common work areas within business segments performing work under VA contracts, Department of Veterans Affairs Hotline posters prepared by the VA Office of Inspector General. (b) Department of Veterans Affairs Hotline posters may be obtained from the VA Office of Inspector General (53E), P.O. Box 34647, Washington, DC 20043-4647. (c) The Contractor need not comply with paragraph (a) above if the Contractor has established a mechanism, such as a hotline, by which employees may report suspected instances of improper conduct, and instructions that encourage employees to make such reports.(End of Clause)C.10 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009) The offeror agrees, if awarded a contract, to use the service-disabled veteran-owned small businesses or veteran-owned small businesses proposed as subcontractors in accordance with 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, or to substitute one or more service-disabled veteran-owned small businesses or veteran-owned small businesses for subcontract work of the same or similar value.(End of Clause)C.11 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (JAN 2008) (a) Indemnification. The contractor expressly agrees to indemnify and save the Government, its officers, agents, servants, and employees harmless from and against any and all claims, loss, damage, injury, and liability, however caused, resulting from, arising out of, or in any way connected with the performance of work under this agreement. Further, it is agreed that any negligence or alleged negligence of the Government, its officers, agents, servants, and employees, shall not be a bar to a claim for indemnification unless the act or omission of the Government, its officers, agents, servants, and employees is the sole, competent, and producing cause of such claims, loss, damage, injury, and liability. At the option of the contractor, and subject to the approval by the contracting officer of the sources, insurance coverage may be employed as guaranty of indemnification. (b) Insurance. Satisfactory insurance coverage is a condition precedent to award of a contract. In general, a successful bidder must present satisfactory evidence of full compliance with State and local requirements, or those below stipulated, whichever are the greater. More specifically, workers' compensation and employer's liability coverage will conform to applicable State law requirements for the service contemplated, whereas general liability and automobile liability of comprehensive type shall, in the absence of higher statutory minimums, be required in the amounts per vehicle used of not less than $200,000 per person and $500,000 per occurrence for bodily injury and $20,000 per occurrence for property damage. State-approved sources of insurance coverage ordinarily will be deemed acceptable to the Department of Veterans Affairs installation, subject to timely certifications by such sources of the types and limits of the coverages afforded by the sources to the bidder. [Contracting Officer's Note: In those instances where airplane service is to be used, substitute the word "aircraft" for "automobile" and "vehicle" and modify coverage to require aircraft public and passenger liability insurance of at least $200,000 per passenger and $500,000 per occurrence for bodily injury, other than passenger liability, and $200,000 per occurrence for property damage. Coverage for passenger liability bodily injury shall be at least $200,000 multiplied by the number of seats or passengers, whichever is greater.](End of Clause)C.12 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984) The contractor shall obtain all necessary licenses and/or permits required to perform this work. He/she shall take all reasonable precautions necessary to protect persons and property from injury or damage during the performance of this contract. He/she shall be responsible for any injury to himself/herself, his/her employees, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by his/her employees fault or negligence, and shall maintain personal liability and property damage insurance having coverage for a limit as required by the laws of the State of NORTH CAROLINA. Further, it is agreed that any negligence of the Government, its officers, agents, servants and employees, shall not be the responsibility of the contractor hereunder with the regard to any claims, loss, damage, injury, and liability resulting there from.(End of Clause)C.13 VAAR 852.273-76 ELECTRONIC INVOICE SUBMISSION (Interim - October 2008) (a) To improve the timeliness of payments and lower overall administrative costs, VA strongly encourages contractors to submit invoices using its electronic invoicing system. At present, electronic submission is voluntary and any nominal registration fees will be the responsibility of the contractor. VA intends to mandate electronic invoice submission, subject to completion of the federal rulemaking process. At present, VA is using a 3rd party agent to contact contractors regarding this service. During the voluntary period, contractors interested in registering for the electronic system should contact the VA's Financial Services Center at .(End of Clause)(End of Addendum to 52.212-4)C.14 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (NOV 2013) (a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items: (1) 52.222-50, Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g)). Alternate I (AUG 2007) of 52.222-50 (22 U.S.C. 7104 (g)). (2) 52.233-3, Protest After Award (Aug 1996) (31 U.S.C. 3553). (3) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004) (Pub. L. 108-77, 108-78). (b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: [X] (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 253g and 10 U.S.C. 2402). [] (2) 52.203-13, Contractor Code of Business Ethics and Conduct (APR 2010)(Pub. L. 110-252, Title VI, Chapter 1 (41 U.S.C. 251 note)). [] (3) 52.203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (JUN 2010) (Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009.) [X] (4) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Jul 2013) (Pub. L. 109-282) (31 U.S.C. 6101 note). [] (5) 52.204-11, American Recovery and Reinvestment Act-Reporting Requirements (JUL 2010) (Pub. L. 111-5). [X] (6) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. (Aug 2013) (31 U.S.C. 6101 note). [X] (7) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Jul 2013) (41 U.S.C. 2313). [] (8) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (MAY 2012) (section 738 of Division C of Pub. L. 112-74, section 740 of Division C of Pub. L. 111-117, section 743 of Division D of Pub. L. 111-8, and section 745 of Division D of Pub. L. 110-161). [] (9) 52.219-3, Notice of HUBZone Set-Aside or Sole Source Award (NOV 2011) (15 U.S.C. 657a). [X] (10) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (JAN 2011) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a). [] (11) [Reserved] [] (12)(i) 52.219-6, Notice of Total Small Business Set-Aside (NOV 2011) (15 U.S.C. 644). [] (ii) Alternate I (NOV 2011). [] (iii) Alternate II (NOV 2011). [] (13)(i) 52.219-7, Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644). [] (ii) Alternate I (Oct 1995) of 52.219-7. [] (iii) Alternate II (Mar 2004) of 52.219-7. [X] (14) 52.219-8, Utilization of Small Business Concerns (Jul 2013) (15 U.S.C. 637(d)(2) and (3)). [] (15)(i) 52.219-9, Small Business Subcontracting Plan (Jul 2013) (15 U.S.C. 637(d)(4)). [] (ii) Alternate I (Oct 2001) of 52.219-9. [] (iii) Alternate II (Oct 2001) of 52.219-9. [] (iv) Alternate III (JUL 2010) of 52.219-9. [] (16) 52.219-13, Notice of Set-Aside of Orders (NOV 2011) (15 U.S.C. 644(r)). [] (17) 52.219-14, Limitations on Subcontracting (NOV 2011) (15 U.S.C. 637(a)(14)). [] (18) 52.219-16, Liquidated Damages—Subcontracting Plan (Jan 1999) (15 U.S.C. 637(d)(4)(F)(i)). [] (19)(i) 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns (OCT 2008) (10 U.S.C. 2323) (if the offeror elects to waive the adjustment, it shall so indicate in its offer.) [] (ii) Alternate I (June 2003) of 52.219-23. [X] (20) 52.219-25, Small Disadvantaged Business Participation Program—Disadvantaged Status and Reporting (Jul 2013) (Pub. L. 103-355, section 7102, and 10 U.S.C. 2323). [] (21) 52.219-26, Small Disadvantaged Business Participation Program—Incentive Subcontracting (Oct 2000) (Pub. L. 103-355, section 7102, and 10 U.S.C. 2323). [] (22) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (NOV 2011) (15 U.S.C. 657f). [X] (23) 52.219-28, Post Award Small Business Program Rerepresentation (Jul 2013) (15 U.S.C 632(a)(2)). [] (24) 52.219-29, Notice of Set-Aside for Economically Disadvantaged Women-Owned Small Business (EDWOSB) Concerns (Jul 2013) (15 U.S.C. 637(m)). [] (25) 52.219-30, Notice of Set-Aside for Women-Owned Small Business (WOSB) Concerns Eligible Under the WOSB Program (Jul 2013) (15 U.S.C. 637(m)). [X] (26) 52.222-3, Convict Labor (June 2003) (E.O. 11755). [] (27) 52.222-19, Child Labor—Cooperation with Authorities and Remedies (NOV 2013) (E.O. 13126). [X] (28) 52.222-21, Prohibition of Segregated Facilities (Feb 1999). [X] (29) 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246). [X] (30) 52.222-35, Equal Opportunity for Veterans (SEP 2010) (38 U.S.C. 4212). [X] (31) 52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010) (29 U.S.C. 793). [X] (32) 52.222-37, Employment Reports on Veterans (SEP 2010) (38 U.S.C. 4212). [X] (33) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). [X] (34) 52.222-54, Employment Eligibility Verification (AUG 2013). (Executive Order 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.) [] (35)(i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C.6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.) [] (ii) Alternate I (MAY 2008) of 52.223-9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off-the-shelf items.) [] (36) 52.223-15, Energy Efficiency in Energy-Consuming Products (DEC 2007)(42 U.S.C. 8259b). [] (37)(i) 52.223-16, IEEE 1680 Standard for the Environmental Assessment of Personal Computer Products (DEC 2007) (E.O. 13423). [] (ii) Alternate I (DEC 2007) of 52.223-16. [X] (38) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (AUG 2011) [] (39) 52.225-1, Buy American Act—Supplies (FEB 2009) (41 U.S.C. 10a-10d). [] (40)(i) 52.225-3, Buy American Act—Free Trade Agreements—Israeli Trade Act (NOV 2012) (41 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41, 112-42, and 112-43). [] (ii) Alternate I (MAR 2012) of 52.225-3. [] (iii) Alternate II (MAR 2012) of 52.225-3. [] (iv) Alternate III (NOV 2012) of 52.225-3. [X] (41) 52.225-5, Trade Agreements (NOV 2013) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note). [X] (42) 52.225-13, Restrictions on Certain Foreign Purchases (JUN 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury). [] (43) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). [] (44) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150). [] (45) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150). [] (46) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 255(f), 10 U.S.C. 2307(f)). [] (47) 52.232-30, Installment Payments for Commercial Items (Oct 1995) (41 U.S.C. 255(f), 10 U.S.C. 2307(f)). [] (48) 52.232-33, Payment by Electronic Funds Transfer—System for Award Management (Jul 2013) (31 U.S.C. 3332). [X] (49) 52.232-34, Payment by Electronic Funds Transfer—Other than System for Award Management (Jul 2013) (31 U.S.C. 3332). [] (50) 52.232-36, Payment by Third Party (Jul 2013) (31 U.S.C. 3332). [] (51) 52.239-1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a). [] (52)(i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631). [] (ii) Alternate I (Apr 2003) of 52.247-64. (c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: [X] (1) 52.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.). [X] (2) 52.222-42, Statement of Equivalent Rates for Federal Hires (May 1989) (29 U.S.C. 206 and 41 U.S.C. 351, et seq.).EMTGS7 $18.59 [X] (3) 52.222-43, Fair Labor Standards Act and Service Contract Act—Price Adjustment (Multiple Year and Option Contracts) (Sep 2009) (29 U.S.C. 206 and 41 U.S.C. 351, et seq.). [] (4) 52.222-44, Fair Labor Standards Act and Service Contract Act—Price Adjustment (Sep 2009) (29 U.S.C. 206 and 41 U.S.C. 351, et seq.). [] (5) 52.222-51, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment—Requirements (Nov 2007) (41 U.S.C. 351, et seq.). [] (6) 52.222-53, Exemption from Application of the Service Contract Act to Contracts for Certain Services—Requirements (FEB 2009) (41 U.S.C. 351, et seq.). [] (7) 52.222-17, Nondisplacement of Qualified Workers (JAN 2013) (E.O.13495). [] (8) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (MAR 2009)(Pub. L. 110-247) [] (9) 52.237-11, Accepting and Dispensing of $1 Coin (SEP 2008) (31 U.S.C. 5112(p)(1)). (d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records—Negotiation. (1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract. (2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved. (3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law. (e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c), and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause— (i) 52.203-13, Contractor Code of Business Ethics and Conduct (APR 2010) (Pub. L. 110-252, Title VI, Chapter 1 (41 U.S.C. 251 note)). (ii) 52.219-8, Utilization of Small Business Concerns (Jul 2013) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $650,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities. (iii) 52.222-17, Nondisplacement of Qualified Workers (JAN 2013) (E.O. 13495). Flow down required in accordance with paragraph (l) of FAR clause 52.222-17. (iv) 52.222-26, Equal Opportunity (Mar 2007) (E.O. 11246). (v) 52.222-35, Equal Opportunity for Veterans (SEP 2010) (38 U.S.C. 4212). (vi) 52.222-36, Affirmative Action for Workers with Disabilities (Oct 2010) (29 U.S.C. 793). (vii) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222-40. (viii) 52.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.). (ix) 52.222-50, Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g)). Alternate I (AUG 2007) of 52.222-50 (22 U.S.C. 7104(g)). (x) 52.222-51, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment—Requirements "(Nov 2007)" (41 U.S.C. 351, et seq.). (xi) 52.222-53, Exemption from Application of the Service Contract Act to Contracts for Certain Services-Requirements (FEB 2009)(41 U.S.C. 351, et seq.). (xii) 52.222-54, Employment Eligibility Verification (AUG 2013). (xiii) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). (xiv) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (MAR 2009)(Pub. L. 110-247). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6. (xv) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64. (2) While not required, the contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.(End of Clause)C.15 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): (End of Clause)FAR NumberTitleDate52.204-9PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNELJAN 201152.224-1PRIVACY ACT NOTIFICATIONAPR 198452.224-2PRIVACY ACTAPR 198452.237-3CONTINUITY OF SERVICESJAN 1991SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTSD.1 WAGE DETERMINATIONWage Determination for Ambulance ServicesThe DOL Wage Determination for the specific locality applies to this solicitation and any contract awarded is available at . Please note the listing below is not all inclusive wage determination of each area of performance. It is the contractor’s responsible to obtain and evaluate each wage determination locality.**********************************************************************************REGISTER OF WAGE DETERMINATIONS UNDER | U.S. DEPARTMENT OF LABOR THE SERVICE CONTRACT ACT | EMPLOYMENT STANDARDS ADMINISTRATIONBy direction of the Secretary of Labor | WAGE AND HOUR DIVISION | WASHINGTON, D.C. 20210 | | Diane C. Koplewski Division of Wage | Wage Determination No: 1985-0949Director Determinations | Revision No: 25 | Date Of Revision: 02/01/2013----------------------------------------------------------------------------------State: North CarolinaArea: North Carolina Counties of Alamance, Beaufort, Bertie, Bladen, Brunswick,Carteret, Caswell, Chatham, Columbus, Craven, Cumberland, Davidson, Davie,Duplin, Durham, Edgecombe, Forsyth, Franklin, Granville, Greene, Guilford,Halifax, Harnett, Hoke, Hyde, Johnston, Jones, Lee, Lenoir, Martin, Moore, Nash,New Hanover, Onslow, Orange, Pamlico, Pender, Person, Pitt, Randolph, Robeson,Rockingham, Sampson, Scotland, Stokes, Surry, Tyrrell, Vance, Wake, Warren,Washington, Wayne, Wilson, YadkinD.2 QUALITY ASSURANCE SURVEILLANCE PLANThe contractor shall be evaluated in accordance with the following QASP.For: Ambulance Services VAMC Fayetteville, North CarolinaContract Number: < Upon award, Government shall enter contract number>Contract Description: The contractor shall furnish ambulance services for beneficiaries of the Department of Veterans Affairs, Fayetteville VA Medical Center (VAMC) for the above purpose. Contractor’s name: <Enter your company name.> (hereafter referred to as the contractor).1. PURPOSEThis Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:What shall be monitored.How monitoring shall take place.Who shall conduct the monitoring.How monitoring efforts and results shall be documented.This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance. This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.2. Government Roles and Responsibilities The following personnel shall oversee and coordinate surveillance activities. a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.Assigned CO: Hatasha Hanley Department of Veterans Affairs VISN 6 Network Contract Activity 100 Emancipation Drive Hampton, VA 23667Assigned CS: Kathryn Avent-Ortega Department of Veterans Affairs VISN 6 Network Contract Activity 100 Emancipation Drive Hampton, VA 23667 b. Contracting Officer’s Technical Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf. Assigned COR: To be listed prior to award c. Other Key Government Personnel – <Upon award, Government will enter name, if applicable. This may include Performance Monitors, Clinical Quality experts, etc. who act on behalf of the COR to monitor performance.> 3. Contractor RepresentativesThe following employees of the contractor serve as the contractor’s program manager for this contract. a. Program Manager - <Enter name.> b. Other Contractor Personnel - <Enter name(s) or delete these lines if not applicable> Title: <Enter title(s) or delete these lines if not applicable.> 4. Performance StandardsPerformance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets or does not meet these standards. The Performance Requirements are listed below. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL). IDPerformance ObjectiveAQLMethod of SurveillanceIncentive/Disincentive1The Contractor shall perform the General Requirements that meet the requirements of PWS Section195%COR periodic inspection and documentation. Incentive: Positive Past Performance RatingDisincentive: A Contract Discrepancy Report (CDR) will be issued on the first instance of failure to provide the acceptable level of service.2The Contractor shall perform the Patient Pick-Up and Delivery that meet the requirements of PWS Section 2 & 395%COR periodic inspection and documentation. Incentive: Positive Past Performance RatingDisincentive: A Contract Discrepancy Report (CDR) will be issued on the first instance of failure to provide the acceptable level of service.3The Contractor shall adhere to the Patient Welfare and Abuse and Incident Reporting that meet the requirements of PWS Sections 4 & 598%COR periodic inspection and documentation. Incentive: Positive Past Performance RatingDisincentive:A Contract Discrepancy Report (CDR) will be issued on the first instance of failure to provide the acceptable level of service.4The Contractor shall adhere to Patient Custody that meet the requirements of PWS Sections 695%COR periodic inspection and documentation. Incentive: Positive Past Performance RatingDisincentive: A Contract Discrepancy Report (CDR) will be issued on the first instance of failure to provide the acceptable level of service.5The Contractor shall adhere to Vehicle specifications that meet the requirements of PWS Sections 9 & 1098%COR periodic inspection and documentation. Incentive: Positive Past Performance RatingDisincentive: A Contract Discrepancy Report (CDR) will be issued on the first instance of failure to provide the acceptable level of service.6The Contractor shall adhere to Personnel requirements that meet the requirements PWS Sections 11&1298%COR periodic inspection and documentation of required training will be obtain yearly. Incentive: Positive Past Performance RatingDisincentive: A Contract Discrepancy Report (CDR) will be issued on the first instance of failure to provide the acceptable level of service.5. Incentives/DisincentivesThe Government shall use favorable contractor performance evaluations as incentives. The Government shall use unfavorable contractor performance evaluation as disincentives. Incentives/Disincentives shall be based on exceeding, meeting, or not meeting performance standards. 6. PROCEDURES/Methods of QA Surveillance Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP. a. Direct Observation. (Can be performed periodically or through 100% surveillance.) b. Complaints. Any complaint data is reviewed by the COR – any validated complaints against a contractor will be further investigated. c. PERIODIC INSPECTION. (Evaluates outcomes on a periodic basis. Inspections may be scheduled [Daily, Weekly, Monthly, Quarterly, or annually] or unscheduled, as required.)7. RatingsMetrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used:Positive outcome: No more than 2incident of not meeting the performance standard during the period of performanceNegative outcome: More than 3 incidents of not meeting the performance standard during the period of performance.8. DOCUMENTING PERFORMANCEa. Acceptable PerformanceThe Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action. b. Unacceptable performanceWhen unacceptable performance occurs, the COR shall inform the Contracting Officer (CO).? This will normally be in writing unless circumstances necessitate verbal communication.? In any case the COR and the CO?shall document the discussion and place it in their respective file.? When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the CO.? The CO will in turn review and submit to the contractor's program manager for corrective action.? The contractor shall acknowledge receipt of the CDR in writing. The CDR shall specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR shall also state how long after receipt the contractor has to present this corrective action plan to the CO and COR. The Government shall review the contractor's corrective action plan to determine acceptability. Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO. 9. Frequency of Measurementa. Frequency of Measurement.During contract performance, the COR will periodically analyze whether the frequency of surveillance is appropriate for the work being performed. b. Frequency of Performance Assessment Meetings.The COR shall meet with the contractor quarterly to assess performance and shall provide a written assessment.D.3 BUSINESS ASSOCIATE AGREEMENTWhereas, <COMPANY/ORGANIZATION> (Business Associate) provides AMBULANCE SERVICES to the Department of Veterans Affairs Veterans Health Administration (Covered Entity), and Whereas, in order for Business Associate to provide IACUC evaluation services to the Covered Entity, Covered Entity discloses to Business Associate Protected Health Information (PHI) and Electronic Protected Health Information (EPHI) that is subject to protection under regulations issued by the Department of Health and Human Services, as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Parts 160 and 164, Subparts A and E, the Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”), and 45 CFR Parts 160 and 164, Subparts A and C, the Security Standard (“Security Rule”); and Whereas, Department of Veterans Affairs Veterans Health Administration is a “Covered Entity” as that term is defined in the HIPAA implementing regulations, 45 CFR 160.103, and Whereas, <COMPANY/ORGANIZATION>, as a recipient of PHI from Covered Entity in order to provide AMBULANCE SERVICES to Covered Entity, is a “Business Associate” of Covered Entity as the term “Business Associate” is defined in the HIPAA implementing regulations, 45 CFR 160.103; and Whereas, pursuant to the Privacy and Security Rules, all Business Associates of Covered Entities must agree in writing to certain mandatory provisions regarding the Use and Disclosure of PHI and EPHI; andWhereas, the purpose of this Business Associate Agreement (BAA) is to comply with the requirements of the Privacy and Security Rules, including, but not limited to, the Business Associate Agreement requirements at 45 CFR 164.308(b), 164.314(a), 164.502(e), and 164.504(e), and as may be amended.NOW, THEREFORE, the Covered Entity and Business Associate agree as follows:Definitions. Unless otherwise provided in this BAA, capitalized terms and phrases that are defined in the Privacy and Security Rules have the same meanings as set forth in the Privacy and Security Rules. When the phrase “Protected Health Information” and the abbreviation “PHI” are used in this BAA, they include the phrase “Electronic Protected Health Information” and the abbreviation “EPHI”. 2.Ownership of PHI. PHI provided by Covered Entity to Business Associate and its agents and subcontractors, or gathered by them on behalf of the Covered Entity, under this BAA are the property of Covered Entity. 3. Scope of Use and Disclosure by Business Associate of Protected Health InformationA. Business Associate is permitted to make Use and Disclosure of PHI that is disclosed to it by Covered Entity, or received by Business Associate on behalf of Covered Entity, as necessary to perform its obligations under all applicable agreements and this BAA with covered entity, provided that the Covered Entity may make such Use or Disclosure under the Privacy and Security Rules, and the Use or Disclosure complies with the Covered Entity’s minimum necessary policies and procedures. B.Unless otherwise limited herein, in addition to any other Uses and/or Disclosures permitted or authorized by this BAA or Required by Law, Business Associate may:(1) Use the PHI in its possession for its proper management and administration and to fulfill any legal responsibilities of Business Associate;(2) Make a Disclosure of the PHI in its possession to a third party for the purpose of Business Associate’s proper management and administration or to fulfill any legal responsibilities of Business Associate; provided, however, that the Disclosure is permitted by the Privacy Rule if made by the Covered Entity, or Required by Law; and provided further that where the Disclosure is not permitted by the Privacy Rule, or Required by Law, Business Associate has received from the third party written assurances that (a) the information will be held confidentially and Used or further Disclosed only as Required By Law or for the purposes for which it was disclosed to the third party; and (b) the third party will notify the Business Associate of any instances of which it becomes aware in which the confidentiality of the information has been breached;(3) Engage in Data Aggregation activities, consistent with the Privacy Rule; and (4) De-identify any and all PHI created or received by Business Associate under this BAA; provided that the de-identification conforms to the requirements of the Privacy Rule. Obligations of Business Associate. In connection with its Use and Disclosure of PHI under this BAA, Business Associate agrees that it will:Use or make further Disclosure of PHI only as permitted or required by the Privacy Rule, or this BAA or as Required by Law;Ensure any employee of BA, contractor, subcontractor or agent of BA receives at least annual privacy training that conforms to the requirements of VHA Privacy Training; Ensure any employee of BA, contractor, subcontractor or agent of BA, receives at least annual security awareness training that conforms to the requirements of the Department of Veterans Affairs Office of Cyber and Information Security Training;Use reasonable and appropriate safeguards to prevent Use or Disclosure of PHI other than as provided by this BAA;E.To the extent practicable, mitigate any harmful effect of a Use or Disclosure of PHI by Business Associate in violation of this BAA that is known to Business Associate;F.Maintain a system or process to account for any Security Incident, Privacy Incident, or Use or Disclosure of PHI not provided for by this BAA of which Business Associate becomes aware;Within 24 hours of Business Associate first becoming aware of a HIPAA Electronic Transactions and Code Sets, Privacy, Security or Standard Identifier Incident, or Use or Disclosure of PHI not provided for by this BAA, notify the Covered Entity and promptly provide a report to Covered Entity. An incident will be considered any physical, technical or personal activity or event that increases the Covered Entity’s risk to inappropriate or unauthorized use or disclosure of PHI or causes the Covered Entity to be considered non-compliant with the Administrative Simplification provisions of HIPAA as determined by the Department of Health and Human Services.Notification will be made by Business Associate to the Director, Health Data & Informatics by telephone, 202-461-5874 or secure fax of any HIPAA Electronic Transactions and Code Sets, Privacy, Security or Standard Identifier Incident, or Use or Disclosure of PHI not provided for by this BAA.(3) A written report of the incident, submitted to the Director, Health Data & Informatics within ten (10) business days after initial notification, will document specifics surrounding the incident, what mitigation procedures were implemented to lessen the impact of the incident and what processes have been established to prevent the incident from occurring in the future (reasonable and appropriate safeguards). This report should be documented as a letter and sent to:Director, Health Data & InformaticsDepartment of Veterans Affairs – Veterans Health AdministrationOffice of Information (19F)810 Vermont Avenue NWWashington, DC 20420 Phone: 202-461-5874 Fax: 202-273-9386H.Require contractors, subcontractors or agents to whom Business Associate provides PHI received from the CE to agree to the same restrictions and conditions that apply to Business Associate pursuant to this BAA, including implementation of reasonable and appropriate safeguards to protect PHI. Such third party shall be required to adopt and implement information security controls and safeguards that comply with the Federal Information Security Management Act (FISMA), Title III, Pub. L. No. 107-347, codified at 44 U.S.C. § 3541, and other applicable laws pertaining to the VA, including, without limitation, 38 U.S.C. § 5725, together with applicable VA policies pertaining to safeguarding VA Sensitive Data.I.Make available to the Secretary of Health and Human Services Business Associate’s internal practices, books and records, including policies and procedures, relating to the Use or Disclosure of PHI for purposes of determining Covered Entity’s compliance with the Privacy and Security Rules, subject to any applicable legal privileges;J.If the Business Associate maintains PHI in a Designated Record Set, maintain the information necessary to document the Disclosures of PHI sufficient to make an accounting of those Disclosures as required under the Privacy rule and the Privacy Act, 5?USC 552a, and within ten (10) days of receiving a request from Covered Entity, make available the information necessary for Covered Entity to make an accounting of Disclosures of PHI about an individual in the Designated Record Set or Covered Entity’s Privacy Act System of Records;K.If the Business Associate maintains PHI in a Designated Record Set or Privacy Act System of Records, within ten (10) days of receiving a written request from Covered Entity, make available PHI in the Designated Record Set or System of Records necessary for Covered Entity to respond to individuals’ requests for access to PHI about them that is not in the possession of Covered Entity;L.If the Business Associate maintains PHI in a Designated Record Set or Privacy Act System of Records, within ten (10) days of receiving a written request from Covered Entity, incorporate any amendments or corrections to the PHI in the Designated Record Set or System of Records in accordance with the Privacy Rule and Privacy Act;M.Not make any Uses or Disclosures of PHI that Covered Entity would be prohibited from making.N.Utilize only contractors, subcontractors, or agents who are physically located within a jurisdiction subject to the laws of the United States. Business associate will ensure that it does not use or disclose PHI received from Covered Entity in any way that will remove the PHI from such jurisdiction.O.When Business Associate is uncertain whether it may make a particular Use or Disclosure of PHI in performance of this BAA, the Business Associate will consult with the Covered Entity before making the Use or Disclosure.P. The Business Associate will implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality and integrity, and availability of the PHI that Business Associate receives, maintains, or transmits on behalf of the Covered Entity as required by the Privacy and Security Rules and shall also be required to adopt and implement information security controls and safeguards that comply with FISMA, and other applicable laws pertaining to the VA, including, without limitation, 38 U.S.C. § 5725, together with applicable VA policies pertaining to safeguarding VA Sensitive Data. Q. The BA will provide satisfactory assurances that the confidentiality, integrity, and availability of the PHI, which it receives, creates, transmits or maintains, is reasonably and appropriately protected.R. The BA will provide satisfactory assurances that any agent, including a subcontractor, to whom it provides such information agrees to implement reasonable and appropriate safeguards to protect the data.S. Upon completion of the applicable contract(s) or agreement(s), the Business Associate shall return and/or destroy the PHI gathered, created, received or processed during the performance of the contract(s) or agreement(s), and no data will be retained by the Business Associate, or any agents or subcontractors of the Business Associate, unless retention is required by law or regulation. The Business Associate shall assure that all PHI has been returned to the Covered Entity, destroyed by the Business Associate, or both; as deemed appropriate by the Covered Entity. If immediate return or destruction of all data is not possible, the Business Associate shall assure that all PHI retained will be safeguarded to prevent unauthorized Uses or Disclosures. Until the Business Associate provides assurance, Covered Entity may withhold 15% of the final payment of the contract(s) or agreement(s). 5.Obligations of Covered Entity. Covered Entity agrees that it:Has obtained, and will obtain, from Individuals any consents, authorizations and other permissions necessary or required by laws applicable to Covered Entity for Business Associate and Covered Entity to fulfill their obligations under this BAA. Will promptly notify Business Associate in writing of any restrictions on the Use and Disclosure of PHI about Individuals that Covered Entity has agreed to that may affect Business Associate’s ability to perform its obligations under this BAA;Will promptly notify Business Associate in writing of any change in, or revocation of, permission by an Individual to use or disclose PHI, if such change or revocation may affect Business Associate’s ability to perform its obligations under this BAA. 6.Material Breach of the BAA. Upon Covered Entity’s determination of a material breach of this BAA by Business Associate, Covered Entity shall provide an opportunity for Business Associate to cure the breach; and if cure is not possible, Covered Entity shall report the violation to the Secretary of Health and Human Services. 7.Termination. A. Termination for Cause. Upon Covered Entity’s knowledge of a material breach by Business Associate, Covered Entity shall either: (1) Provide an opportunity for Business Associate to cure the breach or end the violation and terminate this Agreement and underlying contract(s) if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity; (2) Immediately terminate this Agreement and underlying contract(s) if Business Associate has breached a material term of this Agreement and cure is not possible; (3) If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary of Health and Human Services. (4) This BAA may be terminated by the Covered Entity, if appropriate, upon review as defined in Section 13 of this BAA.B. Automatic Termination. This Agreement will automatically terminate upon completion of the Business Associate’s duties under all underlying agreements or by mutual written agreement to terminate underlying agreements.C. Effect of Termination. Termination of this Agreement will result in cessation of activities by the Business Associate, and any agents or subcontractors of it involving PHI under this Agreement. 8.Amendment. Business Associate and Covered Entity agree to take such action as is necessary to amend this BAA for Covered Entity to comply with the requirements of the Privacy and Security Rules or other applicable law.9.No Third Party Beneficiaries. Nothing expressed or implied in this BAA is intended to confer, nor shall anything herein confer, upon any person other than the parties and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever.10.Other Applicable Law. This BAA does not, and is not intended to, abrogate any responsibilities of the parties under any other applicable law.11. Effect of Agreement. With respect solely to the subject matter herein, in the case of any conflict in terms between this BAA and any other previous agreement or addendum between the parties, the terms of this BAA shall control and supersede and nullify any conflicting terms as it relates to the parties in a business associate relationship. 12. Effective Date. This BAA shall be effective on _____________________.13. Review Date.The provisions of this BAA will be reviewed by the Covered Entity every two years from Effective Date to determine the applicability of the agreement based on the relationship of the parties at the time of review.Hatasha HanleyDepartment of Veterans Affairs COMPANY/ORGANIZATIONVeterans Health Administration By: By:Name: Name: Title: Title:Date: Date: D.4 PAST PERFORMANCE SURVEYPAST PERFORMANCE SURVEYAmbulance Service VA246-14-Q-2056RETURN BY: February 18, 2014 REFERENCE INSTRUCTIONS: The Department of Veterans Affairs is considering the Offeror listed above for award of a VA contract. Your comments would be appreciated regarding this firm’s past performance. Your comments are considered Source Selection Sensitive; therefore, you are advised that the Federal Acquisition Regulation (15.506) prohibits the release of the names of individuals providing reference information about Offeror’s past performance. Survey should be completed by evaluator and returned no later than February 18, 2014 by email or Facsimile to: Kathryn.avent-ortega@ or FAX 757-728-3132.NAME OF COMPANY_______________________________________Please evaluate the past performance using only the following ratings without variation. If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.“O” =Outstanding =Performance greatly exceeded the contract requirements“A” =Above Average =Performance exceeded the contract requirements“S” =Satisfactory =Performance met the contract requirements“M” =Marginal =Performance met the minimum contract requirements but some material aspects of the contractor’s performance were less than satisfactory“U” =Unacceptable =Performance was poor and/or did not satisfy contract requirementsPlease rate and provide information/comments for the following:Circle oneQ1. To what extent did the contractor comply with contract requirements?O A S M UQ2. How timely was the contractor’s performance? O A S M UQ3. How well did the contractor comply with labor and safety standards? O A S M UQ4. Rate the effectiveness of the contractor’s management of the contract.O A S M UQ5. Rate the contractor’s handling of staff integrity issues.O A S M UQ6. Rate the contractor’s personnel management practices.O A S M UQ7. Quality control: Rate the over all quality on the contractors work.O A S M USOURCE SELECTION INFORMATIONSee FAR 2.101 and 3.104FOR OFFICIAL USE ONLYPlease rate and provide information/comments for the following:Circle oneT1. To what extent was contractor able to meet the performance schedule:O A S M UT2. What extent was contractor flexible in responding to changing needs?O A S M UT3. To what extent was the contractor reliable? O A S M UT4. To what extent was the contractor responsive to technical directions? O A S M UT5. Have any cure notices, show cause letters, suspension of payment, or termination been issued? If yes, please explain. Yes NoC1. Would you award another contract to the party being evaluated? If no, please explain: Yes NoC2. Was the patient satisfied with the end product? If no, please explain: Yes NoC3. To what extent did contractor notify you of problems or potential problems? O A S M U SOURCE SELECTION INFORMATIONSee FAR 2.101 and 3.104FOR OFFICIAL USE ONLY15. Additional Remarks: Printed Name/Signature/Telephone Number of Evaluator DateSOURCE SELECTION INFORMATIONSee FAR 2.101 and 3.104FOR OFFICIAL USE ONLYSUBCONTRACTOR PLAN MODEL U.S. Department of Veterans Affairs (VA)Office of Small and Disadvantaged Business Utilization (00SB)Subcontracting Plan ModelJanuary 2011 In accordance with FAR 19.704, 52.219 and P.L. 109-461Prime Contractor: Address: City: State: Zipcode:Solicitation/Contract Number: Description of Requirement: Total Contract Amount (Including Option Years): $Period of Contract Performance Including Option Years (Month and Year): Activity Awarding Contract: Contracting Officer Name:Prime Contractor is:[ ] Architect-Engineer [ ] Janitorial[ ] Blood [ ] Laboratory Testing Services[ ] Bulk Oxygen Services [ ] Laundry and Linen Services[ ] Clinical Diagnostic Equipment[ ] Medical Equipment[ ] Community Based Outpatient Clinic [ ] Medical Equipment and Supplies[ ] Construction [ ] Medical Equipment and Supplies[ ] Consulting Services and Pharmaceuticals[ ] Dental Equipment[ ] Medical Gas and Medical Bulk[ ] Dental Equipment and Supplies Oxygen[ ] Dental Supplies[ ] Medical Healthcare Services[ ] Diagnostic Imaging Equipment and Supplies[ ] Medical Surgical Prime Vendor[ ] Diagnostic X-Ray and Related Systems and Equipment[ ] Niche Markers Including Installation[ ] Pharmaceuticals[ ] Dietary Supplements[ ] Pharmaceutical and Cost Per Test[ ] Digital Hearing Aids and Batteries[ ] Prosthetics[ ] Elevator Maintenance[ ] Publisher/Subscription Services[ ] External Peer Review [ ] Radiation Therapy Systems[ ] Healthcare Staffing[ ] Real Estate[ ] Home Healthcare Services[ ] Studies[ ] Home Medical Equipment[ ] Support Services[ ] Home Oxygen[ ] Telephone System Hardware/[ ] Information Technology Software Maintenance[ ] InVitro Diagnostics Reagents[ ] Transportation[ ] InVitro Diagnostics Substances Reagents, Test Kits and[ ] Other (Not Checked) Blood Laboratory ___________________________Prime Contractor (Please check if you are):[ ] Manufacturer[ ] Distributor[ ] Manufacturer/DistributorType of Plan (Check One)___Commercial Plan - means a subcontracting plan (including goals) that covers the offeror’s fiscal year and that applies to the entire production of commercial items sold by either the entire company or a portion thereof (e.g., division, plant, or product line).(Represents ______% of Total Annual Sales)____Individual Plan - means a subcontracting plan that covers the entire contract period (including option periods), applies to a specific contract, and has goals that are based on the offeror’s planned subcontracting in support of the specific contract, except that indirect costs incurred for common or joint purposes may be allocated on a prorated basis to the contract.1 - 2.GOALS - Please state separate dollar and percentage goals for Small Business (including Alaska Native Corporation’s (ANCs)); Service-Disabled Veteran-Owned Small Business, Veteran-Owned Small Business; Small Disadvantaged, Women-Owned, and Historically Underutilized Business Zone (HUBZone) Small Business Concerns. NOTE: VA’s required percentage goals are shown below. “Zero” percent value for goals or “N/A” are unacceptable. Goals and percentages must be rounded to the nearst dollar and tenth of a percent. Example of how to calculate the goals:DOLLARSPERCENTTotal Contract Price$1,500,000Total to be Subcontracted 1,000,000100%Subcontract to Small Business (including Alaska Native Corporations (ANC) and Indian tribes) 177,00017.7%Subcontract to Service Disabled Veteran-Owned Small Business 30,000 3.0%Subcontract to Veteran-Owned Small Business 50,000 5.0%Small Disadvantaged Business (including ANC and Indian tribes) 50,000 5.0%Women-Owned Small Business 50,000 5.0%Subcontract to HUBZone Small Businesses 30,000 3.0%If percentage goals below are lower than example above, please submit justification as to why.Please enter the information listed below:Total dollars to be subcontracted:$____________________________ Total dollars to be subcontracted to Small Business (SB) (including Alaska Native Corporation’s (ANCs) and Indian tribes):$_______________ ______%Total dollars to be subcontracted to Service-Disabled Veteran-Owned Small Business (SDVOSB) – P.L. 109-461 signed by the President December 22, 2006. Goal shall not be less than 3.0%. $_______________ ______%Total dollars to be subcontracted to Veteran-Owned Small Business (VOSB) – P.L. 109-461 signed by the President December 22, 2006. Goal shall not be less than the 7.0% as mandated by the Secretary, Department of Veterans Affairs: $_______________ ______%Total dollars to be subcontracted to Small Disadvantaged Business (SDB) (including Alaska Native Corporation’s (ANCs) and Indian tribes): $_______________ ______%Total dollars to be subcontracted to Women-Owned Small Business (WOSB): $_______________ ______%Total dollars to be subcontracted to HUBZone Small Business Concerns: $_______________ ______%Total dollars to be subcontracted to Large Business: $_______________ ______%3.Provide a description of the principal types of supplies and services to be subcontracted under this contract, and an identification of the types planned for subcontracting to small (including ANCs and Indian tribes), service-disabled veteran-owned and veteran-owned small business concerns), small disadvantaged (including ANCs and Indian tribes), women-owned, HUBZone.You must identify the products/services to be subcontracted in each category. (Example: office supplies, maintenance and repair)Products/ServicesLarge BusinessSmall businessSmall disadvantaged businessWomen-Owned Small businessHUBZone Small businessService-Disabled Veteran-Owned Small Business (sdvosb) – in accordance with P.L. 109-461, signed by the President December 22, 2006, please list the name, address, and telephone number for each service-disabled and veteran-owned small business concerns as follows. Please ensure that the service-disabled veteran-owned small business concerns are registered in the Central Contractor’s Registry and the Vendor Information Pages . If more than one, please utilize the format listed below to indicate additional service-disabled veteran-owned small business:Name of SDVOSB:Address:City/State/Zipcode:Email address of point of contact:Telephone: FAX: Veteran-Owned Small Business (vosb) - In accordance with P.L. 109-461, signed by President December 22, 3006, please list the name, address, and telephone number for each veteran-owned small business concerns as follows. Please ensure that the veteran-owned small business concerns are registered in the Central Contractor’s Registry and the Vendor Information Pages .. If more than one, please utilize the format listed below to indicate additional veteran-owned small business:Name of VOSB:Address:City/State/Zipcode:Email address of point of contact:Telephone: FAX: In accordance with P.L. 109-461, verification process is mandated to certify that the service-disabled and veteran-owned small business concerns listed for subcontracting opportunities do have a subcontract with you as the prime contractor.This information will be a report to the Department of Veterans Affairs, Office of Small and Disadvantaged Business Utilization (00SB) on a quarterly basis, (form attached) for the service-disabled and veteran-owned small business concerns to report.4.A description of the method used to develop the subcontracting goals. 5. A description of the method used to identify potential sources for solicitation purposes (e.g., existing company source lists, the Central Contractor Registration database (CCR), veterans service organizations, the National Minority Purchasing Council Vendor Information Service, the Research and Information Division of the Minority Business Development Agency in the U.S. Department of Commerce, or small, HUBZone, small disadvantaged and women-owned small business trade associations). A firm may rely on the information contained in CCR as an accurate representation of a concern’s size and ownership characteristics for the purposes of maintaining a small, veteran-owned small, service-disabled veteran-owned small, HUBZone small, small disadvantaged, and women-owned small business source list. Use of CCR as its source list does not relieve a firm of its responsibilities (e.g., outreach, assistance, counseling, or publicizing subcontracting opportunities)NOTE: VA expects contractors to advertise subcontracting opportunities at: . Contractors should also search the Vendor Information Pages (VIP) Database at the web portal ), to ensure maximum practicable consideration in subcontracting with Veteran-Owned and Service-Disabled Veteran-Owned Small Businesses. 6. A statement as to whether or not the offeror included indirect costs in establishing subcontracting goals, and a description of the method used to determine the proportionate share of indirect costs to be incurred with small business (including ANC and Indian tribes); service-disabled veteran-owned small business; veteran-owned small business; small disadvantaged business concern (including ANC and Indian tribes); women-owned small business, and HUBZone small business concerns.[ ] Yes[ ] No7.Name of the individual employed by the offeror who will administer the offeror’s subcontracting program and a description of the duties of the individual.SUBCONTRACTING PLAN ADMINISTRATORNAME:TITLE:ADDRESS:CITY: STATE: ZIPCODE: TELEPHONE: FAX NUMBER:E-MAIL: DUTIES: List duties and responsibilities of the Plan Administrator and a statement of the extent and scope of the Plan Administrator’s authority in subcontracting source selections: Attach duties of the Subcontracting Plan Administrator8. A description of the efforts the offeror will make to assure that small business, service-disabled veteran-owned small business; veteran-owned small business, small disadvantaged business, women-owned small business and HUBZone small business concerns have an equitable opportunity to compete for subcontracts.9. Assurances that the offeror will include the clause of this contract entitled “Utilization of Small Business Concerns” in all subcontracts that offer further subcontracting opportunities, and that the offeror will require all subcontractors (except small business concerns) that receive subcontracts in excess of $550,000 ($1,000,000 for construction) to adopt a subcontracting plan that complies with the requirements of this clause.[ ] Yes[ ] No10. Assurances that the offeror will—(i) cooperate in any studies or surveys as may be required; (ii) Submit periodic reports so that the Government can determine the extent of compliance by the offeror with the subcontracting plan; Submit the Subcontracting Report for Individual Contracts (ISR) and/or the Summary Subcontract Report (SSR), in accordance using the Electronic Subcontracting Reporting System (eSRS) at following the instruction in the eSRS;Ensure that its subcontractors with subcontracting plans agree to submit the ISR and/or the SSR using eSRS; (v) Provide its prime contract number, its DUNS number, and the e-mail address of the Government or Contractor official responsible for acknowledging or rejecting the reports, to all first-tier subcontractors with subcontracting plans so they can enter this information into the eSRS when submitting their reports; and Require that each subcontractor with a subcontracting plan provide the prime contract number, its own DUNS number, and the e-mail address of the Government or Contractor official responsible for acknowledging or rejecting the reports, to its subcontractors with subcontracting plans. [ ] Yes[ ] NoNOTE:When entering your subcontracting information, you must include the email address of the following individuals whom will be reviewing the Subcontracting Report for Individual Contracts ISR 294, as well as, SSR 295 “Summary Subcontracting Report”.Reporting Agency (Veterans Affairs, Department of (3600)Please enter the contracting officer’s email address: ____________________________________11. A description of the types of records that will be maintained concerning procedures that have been adopted to comply with the requirements and goals in the plan, includingestablishing source lists; and a description of the offeror’s efforts to locate small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns and award subcontracts to them. The records shall include at least the following (on a plant-wide or company-wide basis, unless otherwise indicated): (i) Source lists (e.g., CCR, Vendor Information Pages (VIP) Database at the web portal (), to ensure maximum practicable consideration of Veteran-Owned and Service-Disabled Veteran-Owned Small Businesses:), guides, and other data that identify small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns. (ii) Organizations contacted in an attempt to locate sources that are small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, or women-owned small business concerns. (iii) Records on each subcontract solicitation resulting in an award of more than $100,000, indicating:(A) Whether small business concerns were solicited and, if not, why not;(B) Whether veteran-owned small business concerns were solicited and, if not, why not; (C) Whether service-disabled veteran-owned small business concerns were solicited and, if not, why not; (D) Whether HUBZone small business concerns were solicited and, if not, why not;(E) Whether small disadvantaged business concerns were solicited and, if not, why not;(F) Whether women-owned small business concerns were solicited and, if not, why not; and (G) If applicable, the reason award was not made to a small business concern. (iv) Records of any outreach efforts to contact:(A) Trade associations;(B) Business development organizations;(C) Conferences and trade fairs to locate small, HUBZone small, small disadvantaged, and women-owned small business sources; and (D) Veterans service organizations. (v) Records of internal guidance and encouragement provided to buyers through:Workshops, seminars, training, etc.; Monitoring performance to evaluate compliance with the program’s requirements.(vi) On a contract-by-contract basis, records to support award data submitted by the offeror to the Government, including the name, address, and business size of each subcontractor.(vii) Contractors having commercial plans need not comply with this requirement. (e) In order to effectively implement this plan to the extent consistent with efficient contract performance, the Contractor shall perform the following functions:(1) Assist small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns by arranging solicitations, time for the preparation of bids, quantities, specifications, and delivery schedules so as to facilitate the participation by such concerns. Where the Contractor’s lists of potential small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business subcontractors are excessively long, reasonable effort shall be made to give all such small business concerns an opportunity to compete over a period of time. (2) Provide adequate and timely consideration of the potentialities of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business concerns in all “make-or-buy” decisions. (3) Counsel and discuss subcontracting opportunities with representatives of small business, veteran-owned small business, service-disabled veteran-owned small business, HUBZone small business, small disadvantaged business, and women-owned small business firms. (4) Confirm that a subcontractor representing itself as a HUBZone small business concern is identified as a certified HUBZone small business concern by accessing the Central Contractor Registration (CCR) database or by contacting SBA. (5) Provide notice to subcontractors concerning penalties and remedies for misrepresentations of business status as small, veteran-owned small business, HUBZone small, small disadvantaged, or women-owned small business for the purpose of obtaining a subcontract that is to be included as part or all of a goal contained in the Contractor’s subcontracting plan.SIGNATURES REQUIREDPRIME CONTRACTOR: _____________________________DATE: ______________PRINT/TYPE NAME: TITLE: DATE: EMAIL: CONTRACTING OFFICER NAME WHOAPPROVED BY: __________________________________DATE: _________TYPE NAME: TITLE: EMAIL: For Commercial Plans OnlyEffective period of this subcontracting plan is:______________________________________thru__________________________CONTRACTING OFFICER NAME WHOAPPROVED BY: __________________________________DATE: _________TYPE NAME: TITLE: EMAIL:SECTION E - SOLICITATION PROVISIONSADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS Provisions that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The following provisions are incorporated into 52.212-1 as an addendum to this solicitation:The following provisions are incorporated into 52.212-1 as an addendum to this solicitation: E.1 ADDENDUM to FAR 52.212-1 Instructions to Offerors --- Commercial Items - Sub-Part 13.5 Test Program for Certain Commercial ItemsThis procurement is being conducted under the Subpart 13.5 test program where simplified acquisition procedures apply and the conduct of the procurement will be in accordance with Parts 12, 13 or 15 of the FAR or some combination thereof.? Subpart 13.5 authorizes use of simplified procedures for the acquisition of supplies and services in amounts greater than the simplified acquisition threshold but not exceeding $6.5 million ($12 million for acquisitions as described in 13.500(e)), including options if the contracting officer reasonably expects, based on the nature of the supplies or services sought, and on market research, that offers will include only commercial items.Under this test program, contracting officers may use any simplified acquisition procedure in this part, subject to any specific dollar limitation applicable to the particular procedure. The purpose of this test program is to vest contracting officers with additional procedural discretion and flexibility, so that commercial item acquisitions in this dollar range may be solicited, offered, evaluated, and awarded in a simplified manner that maximizes efficiency and economy and minimizes burden and administrative costs for both the Government and industry (10 U.S.C. 2304(g) and 2305 and 41 U.S.C. 253(g) and 253a and 253b).INSTRUCTIONS TO OFFERORSAll proposals shall be submitted in electronic format on disc (PDF or MS Word) and (1) one hard copy shall be assembled as follows:Section 1 - Offer Form (Standard Form 1449) – original signature and date; Contract Administration Data; DUNS Number; Acknowledgement of Solicitation AmendmentsSection 2 - Pricing shall be submitted as requested in the Schedule of Supplies/Services comprised within the solicitation document No price/cost information should be included in the technical proposal document. Offerors are not required to submit detailed cost and pricing information with their initial offer beyond the overall price. Section 3 - The offeror must submit a completed copy of the provision at FAR 52.212-3, Offeror Representations and Certifications - Commercial Items. An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically at . Section 4. Technical Proposal: Submit technical proposal in a format which clearly addresses the evaluation factors. Each response shall address each factor/sub factor in the sequence listed below and clearly identify which factor is being addressed. The offeror must identify any subcontractors proposed under this solicitation. All technical elements applicable to the utilization of subcontractors must be addressed in the technical proposal and detail provided. The Technical Volume shall not exceed twenty five (25) pages in length (minimum 12-point font). Page limitation includes any drawings, charts, etc., and excludes section dividers, table of contents, list of figures/tables, glossary of terms and cross-referencing indices and resumes (all of which are not considered content pages).Section 5 – Past PerformanceIdentify all federal, state, and local government contracts as well as any private/commercial contracts of similar scope, size, complexity that are ongoing or have been completed within the last three yearsList the following information for each contract:Company Name and addressDescription of services performed Name, telephone number and e-mail address of responsible individuals who have first- hand knowledge of performance relative to the same type of services Dates of contract performanceContract type (e.g. fixed-price, cost reimbursable) and total contract valueSection 6 – Subcontracting Plan MODEL - Pursuant to the requirements of FAR part 19.702(a)(1), if the total amount of the proposal exceeds $650,000, and there are subcontracting possibilities, offerors must submit a subcontracting plan. FAR part 52.219-9 defines a subcontracting plan and its requirements. Provided in this solicitation under ATTACHMENT “D” is a Subcontracting Plan Outline Model. Additional information regarding subcontracting can be found on the DVA’s Office of Small and Disadvantaged Business Utilization website: : Before the Contracting Officer determines the responsibility of an offeror the subcontracting plan submitted with the offer shall be reviewed for compliance. For Large Businesses, failure to submit a plan, which shows good faith effort to use small business, small disadvantaged business, women-owned business, HUBZone business, service connected disabled business and Veteran-Owned small business concerns, SHALL BE a factor in determining the responsibility of the offeror. A determination of non-responsibility shall result in disqualification of the offer.Failure to submit a complete proposal may result in the proposal being deemed technically unacceptable.AWARD BASISThe Government will award a firm fixed priced contract to the responsible offeror whose offer, conforming to the requirements in this request for proposal, will be most advantageous to the Government, price and other factors considered. A best value award will be made based upon the following factors: Technical/Management Approach, Past Performance, Socio-Economic Status and Usage, and Price. All evaluation factors other than Price, when combined, are considered significantly more important than price.The following factors shall be used to evaluate offers:Factor I – Technical/Management Approach Offeror shall submit company’s detailed technical approach/methodology for completing all requirements of the Performance Work Statement (PWS). The submission shall include but not limited to: A. Contractor PersonnelProvide documentation of education, training, experience, licensure and certification required to perform the duties herein in accordance with Federal and/or State of North Carolina regulations. Training should include (safe driver training, CPR; infection control; accident reporting; body mechanics; equipment use; communication; fire and safety; etc. Proof of a continuing education “refresher” program as required by the local or state government entity not less than every two years. Training should be defined and consistent. Documentation must also be provided to demonstrate an annual/follow-up physical and TB test. (ALS Only)B. VehiclesOfferors shall identify all vehicles to be used under this contract. Vehicle Descriptions shall include, make, model, maintenance/insurance records, and accident history at a minimum.Provide proof of the current state inspection certificate for any vehicle to be used to provide services under this contract. Evaluation may involve a site visit to inspect vehicles prior to award.Provide proof that each ambulance has patient compartment facilities, oxygen and suction systems and equipment, environmental climatic equipment, communications and additional systems equipment accessories and supplies as mandated by North Carolina Department of Health.Factor II – Past Performance Past performance information will be utilized to determine the quality of the contractor’s past performance as it relates to the probability of success of the required effort. The Government will evaluate customer satisfaction, responsiveness to customer needs, and past demonstration of meeting delivery schedules and the delivery of quality services. Emphasis will be on recent, relevant past performance in the previous 3 years. Recent is defined as work performed within the last three years. Relevant is defined as work similar in size and scope of the work described in the Performance Work Statement (PWS). Past performance information is one indicator of an offeror’s ability to perform the contract successfully. Current and relevant information, source of information, context of data, and general trends in Contractor’s performance shall be considered as it pertains to the performance of work described in this solicitation. Offerors may provide information on problems encountered on identified contracts and the offeror’s corrective action. The Government shall consider this information as well as information obtained from any other sources when evaluating the offeror’s past performance. Since the Government may not necessarily interview all of the sources provided by the offerors, it is incumbent upon the offeror to explain the relevance of the data provided. Offerors are reminded that the Government may elect to consider data obtained from other sources.Offerors with no relevant past performance or whom information is not available, shall not be evaluated favorably or unfavorably on past performanceOfferors are required to have past performance surveys completed by 3 identified references and sent from the identified reference office within one day of the solicitations closing date (See Section D - Past Performance Survey).Factor III - Socioeconomic Status and UsageVA recognizes the contributions of our Nation’s veterans, and we strive to make contract awards to small businesses owned by veteran-and service-disabled veterans. In an effort to achieve socioeconomic small business goals, VA will evaluate offerors based on their service-disabled veteran-owned small business (SDVOSB) or veteran-owned small business (VOSB) status, and their proposed use of eligible service-disabled veteran-owned small businesses and veteran-owned small businesses as subcontractors. Eligible service-disabled veteran-owned offerors will receive full credit, and offerors qualifying as veteran-owned small businesses will receive partial credit for this Service-Disabled Veteran-Owned and Veteran-Owned Small Business Status evaluation factor. To receive evaluation credit, an offer or must be verified in Vendor Information Pages (). Non-veteran offerors proposing to use service-disabled veteran-owned small businesses or veteran-owned small businesses as subcontractors in proportions which meet or exceed the VA subcontracting goals for these firms (regardless of business size) will receive the lowest amount of credit under this evaluation factor. Offerors must state in their proposals the names of the SDVOSBs and VOSBs with whom they intend to subcontract and provide a brief description of the proposed subcontracts and the approximate dollar values of the proposed subcontracts. In addition, the proposed subcontractors must be verified in the Vendor Information Pages (VIP) ().SDVOSB offerors will weighed higher than Veteran Owned Small Business (VOSB), if proposals are considered technically equal considering all factors and quoted prices are significantly balanced. Non-veteran offerors which use no service-disabled veteran-owned or veteran-owned small businesses as subcontractors shall receive no credit under this evaluation factor.Factor IV- PriceTotal price will be evaluated by the Government. In evaluating the offeror’s proposed price for this project, the government concern includes determining whether:Proposed price reflects a clear understanding of the requirements, and is consistent with the various elements of the offeror’s proposal. b. Proposed price is reasonable in comparison with proposed prices received in response to the solicitation.c. Proposed price is reasonable in comparison with prices with the independent Government cost estimate.Unrealistically low or high proposed prices, initially or subsequently, may be grounds for eliminating a proposal from competition either on the basis that the offeror does not understand the requirement or the offeror has provided an unrealistic proposal.TECHNICAL QUESTIONS Offerors should submit all technical questions regarding this solicitation to the Contracting Officer in writing on or before February 10, 2014. No question will be accepted after February 10, 2014. Questions may be sent via e-mail to Kathryn.avent-ortega@. Please address your subject line as follows: Emergency Ambulance Services. Telephonic (verbal) questions Will Not be addressed. All responses to questions, which may affect offers, will be incorporated into a written amendment to the Request for Proposal. DUE DATES All proposals shall be submitted by February 21, 2014, 2:00PM to the following address: Department of Veterans Affairs, VISN 6 NCA Attn: Kathryn Avent-Ortega, Bldg 27, 100 Emancipation Drive, Hampton, VA 23667. Facsimile and electronic submission is not authorized under this announcement.E.2 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: Factor I Technical Factor II Past Performance Factor III Socioeconomic Factor IV Price Technical and past performance, when combined, are significantly more important than 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)E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013) (a) Definitions. As used in this provision— "Administrative proceeding" means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables. "Federal contracts and grants with total value greater than $10,000,000" means— (1) The total value of all current, active contracts and grants, including all priced options; and (2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules). "Principal" means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions). (b) The offeror [ ] has [ ] does not have current active Federal contracts and grants with total value greater than $10,000,000. (c) If the offeror checked "has" in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information: (1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions: (i) In a criminal proceeding, a conviction. (ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more. (iii) In an administrative proceeding, a finding of fault and liability that results in— (A) The payment of a monetary fine or penalty of $5,000 or more; or (B) The payment of a reimbursement, restitution, or damages in excess of $100,000. (iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision. (2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence. (d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management database via (see 52.204-7).(End of Provision)E.4 52.216-1 TYPE OF CONTRACT (APR 1984) The Government contemplates award of a Firm Fixed Price, Indefinite Quantity contract resulting from this solicitation.(End of Provision)E.5 52.233-2 SERVICE OF PROTEST (SEP 2006) Protests, as defined in section 33.101 of the Federal Acquisition Regulation, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the Contracting Officer (addressed as follows) by obtaining written and dated acknowledgment of receipt from: HATASHA HANLEY Hand-Carried Address: Department of Veterans Affairs Contracting Office Bldg 27 VISN 6 Centralized Acquisition Service 100 Emancipation Drive Hampton VA 23667 Mailing Address: Department of Veterans Affairs Contracting Office VISN 6 Centralized Acquisition Service 100 Emancipation Drive Hampton VA 23667 (b) The copy of any protest shall be received in the office designated above within one day of filing a protest with the GAO.(End of Provision)E.6 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (JAN 2008) (a) Any protest filed by an interested party shall: (1) Include the name, address, fax number, and telephone number of the protester; (2) Identify the solicitation and/or contract number; (3) Include an original signed by the protester or the protester's representative and at least one copy; (4) Set forth a detailed statement of the legal and factual grounds of the protest, including a description of resulting prejudice to the protester, and provide copies of relevant documents; (5) Specifically request a ruling of the individual upon whom the protest is served; (6) State the form of relief requested; and (7) Provide all information establishing the timeliness of the protest. (b) Failure to comply with the above may result in dismissal of the protest without further consideration. (c) Bidders/offerors and contracting officers are encouraged to use alternative dispute resolution (ADR) procedures to resolve protests at any stage in the protest process. If ADR is used, the Department of Veterans Affairs will not furnish any documentation in an ADR proceeding beyond what is allowed by the Federal Acquisition Regulation.(End of Provision)E.7 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998) As an alternative to filing a protest with the contracting officer, an interested party may file a protest with the Deputy Assistant Secretary for Acquisition and Materiel Management, Acquisition Administration Team, Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, or for solicitations issued by the Office of Construction and Facilities Management, the Director, Office of Construction and Facilities Management, 810 Vermont Avenue, NW., Washington, DC 20420. The protest will not be considered if the interested party has a protest on the same or similar issues pending with the contracting officer.(End of Provision) PLEASE NOTE: The correct mailing information for filing alternate protests is as follows:Deputy Assistant Secretary for Acquisition and Logistics,Risk Management Team, Department of Veterans Affairs810 Vermont Avenue, N.W.Washington, DC 20420 Or for solicitations issued by the Office of Construction and Facilities Management:Director, Office of Construction and Facilities Management811 Vermont Avenue, N.W.Washington, DC 20420(End of Addendum to 52.212-1)E.8 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) The contracting officer reserves the right to designate representatives to act for him/her in furnishing technical guidance and advice or generally monitor the work to be performed under this contract. Such designation will be in writing and will define the scope and limitation of the designee's authority. A copy of the designation shall be furnished to the contractor.(End of Provision)E.9 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO BENEFICIARIES (JAN 2008) The contractor agrees to provide all services specified in this contract for any person determined eligible by the Department of Veterans Affairs, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered. The contractor further warrants that he/she will not resort to subcontracting as a means of circumventing this provision.(End of Provision)E.10 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (JAN 2003) The Government intends to evaluate proposals and award a contract without exchanges with offerors. Therefore, each initial offer should contain the offeror's best terms from a cost or price and technical standpoint. However, the Government reserves the right to conduct exchanges if later determined by the contracting officer to be necessary.(End of Provision)E.11 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL ITEMS (NOV 2013) An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically via . If an offeror has not completed the annual representations and certifications electronically at the System for Award Management (SAM) 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", as used in this section, 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). An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue Code at 26 U.S.C. 7874. "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. "Sensitive technology"— (1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically— (i) To restrict the free flow of unbiased information in Iran; or (ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and (2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)). "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. "Subsidiary" means an entity in which more than 50 percent of the entity is owned— (1) Directly by a parent corporation; or (2) Through another subsidiary of a parent corporation. "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 its stock 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 the stock of which is owned by one or more women; and (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 SAM website. (2) The offeror has completed the annual representations and certifications electronically via the SAM website access through . After reviewing the SAM 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 . (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. (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 for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ___________.] Each WOSB concern eligible under the WOSB Program 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, 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)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: ___________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold. (8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it [ ] is a women-owned business concern. (9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price: ___________________________________________ (10) [Complete only if the solicitation contains the clause at FAR 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns, or FAR 52.219-25, Small Disadvantaged Business Participation Program—Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.] (i) General. The offeror represents that either— (A) It [ ] is, [ ] is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged business concern in the SAM Dynamic Small Business Search database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); or (B) It [ ] has, [ ] has not submitted a completed application to the Small Business Administration or a Private Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted. (ii) [ ] Joint Ventures under the Price Evaluation Adjustment for Small Disadvantaged Business Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR 124.1002(f) and that the representation in paragraph (c)(10)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. [The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture: ___________________.] (11) HUBZone 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— (i) It [ ] is, [ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified by the Small Business Administration in accordance with 13 CFR Part 126; and (ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(11)(i) of this provision is accurate for the HUBZone small business concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the HUBZone small business concern or concerns that are participating in the joint venture:____________.] Each HUBZone small business concern participating in the joint venture shall submit a separate signed copy of the HUBZone representation. (d) Representations required to implement provisions of Executive Order 11246— (1) Previous contracts and compliance. The offeror represents that— (i) It [ ] has, [ ] has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and (ii) It [ ] has, [ ] has not filed all required compliance reports. (2) Affirmative Action Compliance. The offeror represents that— (i) It [ ] has developed and has on file, [ ] has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or (ii) It [ ] has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor. (e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made. (f) Buy American Act Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act—Supplies, is included in this solicitation.) (1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of "domestic end product." The terms "commercially available off-the-shelf (COTS) item," "component," "domestic end product," "end product," "foreign end product," and "United States" are defined in the clause of this solicitation entitled "Buy American Act—Supplies." (2) Foreign End Products: Line Item No Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. (g)(1) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American Act—Free Trade Agreements—Israeli Trade Act, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms "Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American Act—Free Trade Agreements—Israeli Trade Act." (ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American Act—Free Trade Agreements—Israeli Trade Act": Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American Act—Free Trade Agreements—Israeli Trade Act." The offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of "domestic end product." Other Foreign End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. (2) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled "Buy American Act—Free Trade Agreements—Israeli Trade Act": Canadian End Products: Line Item No. __________________________________________ __________________________________________ __________________________________________[List as necessary] (3) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled "Buy American Act—Free Trade Agreements—Israeli Trade Act": Canadian or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (4) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American Act—Free Trade Agreements—Israeli Trade Act”: Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled "Trade Agreements". (ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products. Other End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________[List as necessary] (iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American Act. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation. (h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals— (1) [ ] Are, [ ] are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; (2) [ ] Have, [ ] have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; (3) [ ] Are, [ ] are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and (4) [ ] Have, [ ] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied. (i) Taxes are considered delinquent if both of the following criteria apply: (A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted. (B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded. (ii) Examples. (A) The taxpayer has received a statutory notice of deficiency, under I.R.C. Sec. 6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights. (B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights. (C) The taxpayer has entered into an installment agreement pursuant to I.R.C. Sec. 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment. (D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code). (i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). (1) Listed end products.Listed End ProductListed Countries of Origin (2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.] [ ] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. [ ] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor. (j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly— (1) __ In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or (2) __ Outside the United States. (k) Certificates regarding exemptions from the application of the Service Contract Act. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [ ] (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror [ ] does [ ] does not certify that— (i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations; (ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003- 4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and (iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers. [ ] (2) Certain services as described in FAR 22.1003- 4(d)(1). The offeror [ ] does [ ] does not certify that— (i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial quantities in the course of normal business operations; (ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii)); (iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a month) servicing the Government contract; and (iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers. (3) If paragraph (k)(1) or (k)(2) of this clause applies— (i) If the offeror does not certify to the conditions in paragraph (k)(1) or (k)(2) and the Contracting Officer did not attach a Service Contract Act wage determination to the solicitation, the offeror shall notify the Contracting Officer as soon as possible; and (ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause. (l) Taxpayer Identification Number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to the SAM database to be eligible for award.) (1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS). (2) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN. (3) Taxpayer Identification Number (TIN). [ ] TIN: _____________________. [ ] TIN has been applied for. [ ] TIN is not required because: [ ] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States; [ ] Offeror is an agency or instrumentality of a foreign government; [ ] Offeror is an agency or instrumentality of the Federal Government. (4) Type of organization. [ ] Sole proprietorship; [ ] Partnership; [ ] Corporate entity (not tax-exempt); [ ] Corporate entity (tax-exempt); [ ] Government entity (Federal, State, or local); [ ] Foreign government; [ ] International organization per 26 CFR 1.6049-4; [ ] Other _________________________. (5) Common parent. [ ] Offeror is not owned or controlled by a common parent; [ ] Name and TIN of common parent: Name _____________________. TIN _____________________. (m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan. (n) Prohibition on Contracting with Inverted Domestic Corporations (1) Relation to Internal Revenue Code. An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue Code 25 U.S.C. 7874. (2) Representation. By submission of its offer, the offeror represents that— (i) It is not an inverted domestic corporation; and (ii) It is not a subsidiary of an inverted domestic corporation. (o) Prohibition on contracting with entities engaging in certain activities or transactions relating to Iran. (1) The offeror shall email questions concerning sensitive technology to the Department of State at CISADA106@. (2) Representation and certifications. Unless a waiver is granted or an exception applies as provided in paragraph (o)(3) of this provision, by submission of its offer, the offeror— (i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran; (ii) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act; and (iii) Certifies that the offeror, and any person owned or controlled by the offeror, does not knowingly engage in any transaction that exceeds $3,000 with Iran’s Revolutionary Guard Corps or any of its officials, agents, or affiliates, the property and interests in property of which are blocked pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701 et seq.) (see OFAC’s Specially Designated Nationals and Blocked Persons List at ). (3) The representation and certification requirements of paragraph (o)(2) of this provision do not apply if— (i) This solicitation includes a trade agreements certification (e.g., 52.212–3(g) or a comparable agency provision); and (ii) The offeror has certified that all the offered products to be supplied are designated country end products.(End of Provision)E.12 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): (End of Provision)FAR NumberTitleDate52.217-5EVALUATION OF OPTIONSJUL 199052.225-25PROHIBITION ON CONTRACTING WITH ENTITIES ENGAGING IN CERTAIN ACTIVITIES OR TRANSACTIONS RELATING TO IRAN—REPRESENTATION AND CERTIFICATIONSDEC 2012 ................
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