1. THIS CONTRACT IS A RATED ORDER RATING P AGE OF P AGES SOLICITATION, OFFER AND AWARD UNDER DP AS (15 CFR 700) 1 118 2. CONTRACT NO. 3. SOLICITATION NO. 4. TYP E OF SOLICITATION 5. DATE ISSUED 6. REQUISITION/P URCHASE NO. [ ] SEALED BID (IFB) N62645-11-R-0012 11 Oct 2011 [ X ] NEGOTIATED (RFP ) 7. ISSUED BY CODE N62645 8. ADDRESS OFFER TO (If other than Item 7) CODE NAVAL MEDICAL LOGISTICS COMMAND 693 NEIMAN STREET FORT DETRICK MD 21702 TEL: See Item 7 TEL: FAX: FAX: NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder". SOLICITATION 9. Sealed offers in original and 1 copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if handcarried, in the depository located in Section A until 02:00 PM local time 15 Nov 2011 (Hour) (Date) CAUT ION - LAT E Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation. 10. FOR INFORMATION A. NAME B. TELEP HONE (Include area code) (NO COLLECT CALLS) C. E-MAIL ADDRESS CALL: CODE 02 - 024R 301-619-9335 email@example.com .mil 11. T ABLE OF CONT ENT S (X) SEC. DESCRIPT ION PAGE(S) (X) SEC. DESCRIPT ION PAGE(S) PART I - THE SCHEDULE PART II - CO NTRACT CLAUSES X A SOLICIT AT ION/ CONT RACT FORM 1-4 X I CONT RACT CLAUSES 64 - 70 X B SUPPLIES OR SERVICES AND PRICES/ COST S 5 - 17 PART III - LIST O F DO CUMENTS, EXHIBITS AND O THER ATTACHMENTS X C DESCRIPT ION/ SPECS./ WORK ST AT EMENT 18 - 46 X J LIST OF AT T ACHMENT S 71 - 101 D PACKAGING AND MARKING PART IV - REPRESENTATIO NS AND INSTRUCTIO NS X E INSPECT ION AND ACCEPT ANCE 47 REPRESENT AT IONS, CERT IFICAT IONS AND X K 102 - 107 X F DELIVERIES OR PERFORMANCE 48 - 49 OT HER ST AT EMENT S OF OFFERORS X G CONT RACT ADMINIST RAT ION DAT A 50 - 51 X L INST RS., CONDS., AND NOT ICES T O OFFERORS 108 - 117 X H SPECIAL CONT RACT REQUIREMENT S 52 - 63 X M EVALUAT ION FACT ORS FOR AWARD 118 OFFER (Must be fully completed by offeror) NOT E: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period. 12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (60 calendar days unless a different period is inserted by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule. 13. DISCOUNT FOR PROMPT PAYMENT (See Section I, Clause No. 52.232-8) 14. ACKNOWLEDGMENT OF AMENDMENT S AMENDMENT NO. DAT E AMENDMENT NO. DAT E (T he offeror acknowledges receipt of amendments to the SOLICIT AT ION for offerors and related documents numbered and dated): 15A. NAME CODE FACILIT Y 16. NAME AND T IT LE OF PERSON AUT HORIZED T O AND SIGN OFFER (T ype or print) ADDRESS OF OFFEROR 15B. T ELEPHONE NO (Include area code) 15C. CHECK IF REMITTANCE ADDRESS 17. SIGNAT URE 18. OFFER DAT E IS DIFFERENT FROM ABOVE - ENTER SUCH ADDRESS IN SCHEDULE. AWARD (To be completed by Government) 19. ACCEP TED AS TO ITEMS NUMBERED 20. AMOUNT 21. ACCOUNTING AND AP P ROP RIATION 22. AUTHORITY FOR USING OTHER THAN FULL AND OP EN COMP ETITION: 23. SUBMIT INVOICES T O ADDRESS SHOWN IN IT EM 10 U.S.C. 2304(c)( ) 41 U.S.C. 253(c)( ) (4 copies unless otherwise specified) 24. ADMINISTERED BY (If other than Item 7) CODE 25. P AYMENT WILL BE MADE BY CODE 26. NAME OF CONTRACTING OFFICER (Type or print) 27. UNITED STATES OF AMERICA 28. AWARD DATE TEL: EMAIL: (Signature of Contracting Officer) IMPORT ANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice. Previous Edition is Unusable 33-134 STANDARD FORM 33 (REV. 9-97) Prescribed by GSA FAR (48 CFR) 53.214(c) N62645-11-R-0012 Page 2 of 118 Section A - Solicitation/Contract Form SECTION A ALL OFFERORS PLEASE NOTE: A.1. The solicitation and all amendments will be posted to the Naval Medical Logistics Command (NAVMEDLOGCOM) website-http://www.nmlc.med.navy.mil/DBU-RFP.asp It is the offeror’s sole responsibility to periodically check the website for amendments and to ensure that all amendments issued prior to the closing date are acknowledged in accordance with instructions in Block 11 of the Standard Form (SF) 30. All proposed prices for Representative Contract Line Item Numbers (CLINs) shall be submitted on the electronic pricing worksheet posted on the NAVMEDLOGCOM website. Please note that any reformatting of the pricing worksheet may cause serious delay in the evaluation process and may result in rejection of the offeror's entire proposal. Complete Past Performance, Technical (Management Planning and Market Research), and Business volumes shall be submitted in accordance with Section L. A.2. As part of the Business volume each offeror shall identify two official points of contact. Please note that all communication regarding this solicitation and proposals will be directed to the designated contacts. Each offeror shall complete the Offeror’s Information Form of Section A and submit an electronic copy with Volume III (Business). A.3. Additionally, see Section K for information regarding On-line Certification and Representations. A.4. Completed Volume I (Past Performance), Volume II (Technical) and Volume III (Business) shall be submitted at the same time to the address below by the closing time and date referenced in Block 9 of the SF 33. A.5. If any one proposal volume is received past the stated closing date specified in this solicitation, the entire proposal will be considered late. No further consideration will be given to any offeror who submits any of these volumes late IAW FAR 15.208(b). A.6. Offerors who desire to hand deliver their proposals shall submit a request no later than five work days prior to the anticipated submission date to the email address: Acquisitions@med.navy.mil. Attn: Code 024R. The contractor shall provide: 1) Name(s) of point of contact; 2) Phone and Fax Number; 3) Email Address; and, 4) Requested Date/Time of Delivery. The contractor can expect confirmation of their request, with concurrence of the requested delivery date/time or an alternate delivery date/time, within 3 work days of receipt. It is the Offeror’s responsibility to follow-up with NAVMEDLOGCOM if no confirmation is received within 72 hours. Any late or incomplete requests for hand delivery will not be honored. Incomplete is defined as a request missing any of the items 1 through 4 above. The contractor shall be required to make all arrangements for access to the Fort Detrick military installation. It is the Offeror's responsibility to ensure that proposals are delivered by the due date and time required. A.7. The address for proposal submission is: Naval Medical Logistics Command ATTN: Code 024R 693 Neiman Street Fort Detrick, MD 21702 Telephone: (301) 619-9335 A.8. Offerors SHALL NOT contact any incumbent health care workers (HCWs) during their official duty hours. Offerors should direct all questions regarding this requirement as specified in Section L.4 to the Contracting Officer at Acquisitions@med.navy.mil. ATTN: CODE 024R. A.9. The North American Industry Classification System (NAICS) code for this requirement is 622110. This requirement is a 100% small business set-aside. The Small Business Administration (SBA) size standard for the NAICS code 622110 is $34.5M. N62645-11-R-0012 Page 3 of 118 A.10. Offerors shall propose prices for all of the representative CLINs. A.11. In accordance with the Naval Marine Corps Acquisition Regulation Supplement (NMCARS) 5232.903, Responsibilities: For Prompt Payment Act purposes, contracts will be subject to the 7 calendar day constructive acceptance period. A.12. Funds are not presently available for the resulting contracts. The Government's obligation under this solicitation is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for the resulting contracts and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer. NOTE 1: The blank space contained in Block 12 of the SF 33 should read 120 calendar days. NOTE 2: The Navy does not dictate whether a particular company recruits personal services contract workers directly or via another firm(s), such as a subcontractor. Be advised, however, that the Department of Justice (DOJ) has informed the Navy that HCWs performing under a personal services contract awarded under 10 U.S.C. 1091 will be considered by DOJ to be within the class of individuals protected by 10 U.S.C. 1089 only if they are employees of the prime contractor. Employees of a subcontractor are not considered by DOJ to be members of the class of individuals protected by that statute. NOTE 3: Before submitting a proposal in response to the solicitation, a prospective offeror is encouraged to investigate the potential tax consequences should they elect to perform on the resulting contract by using individuals who are not carried on their payrolls as employees. Under this RFP, resulting contracts or its task orders, the Navy does not dictate whether the individual HCWs would be classified by the successful offeror as an "independent contractor" or an "employee” for federal tax purposes. This determination shall be made solely by the offeror. If subsequent to award the successful offeror's determination is challenged, this shall be a matter to be resolved between the offeror and the Internal Revenue Service. The Navy will not consider favorably any request for the equitable adjustment to the contract upon the successful offeror's receipt of an adverse action by the IRS. NOTE 4: It is also the offeror’s responsibility to be aware of applicable federal, state and local laws and regulations concerning wage compensation (e.g., overtime) to HCWs. After award, the Navy will not consider favorably any request for an equitable adjustment to the contract upon the successful offeror’s receipt of an adverse action by a federal, state or local agency. NOTE 5: For those offerors planning to engage in a teaming arrangement or to use subcontractors, a conflict of interest may be created if a company is identified as a prime contractor, teaming partner/subcontractor, or as a member of a Joint Venture on more than one proposal. A conflict of interest may also be created if key personnel from a prime contractor, teaming partner/subcontractor, or a Joint Venture are identified on more than one proposal. The Government's strong preference is that each company and its key personnel participates in only one proposal. If the contracting officer concludes during proposal evaluation that a potential conflict of interest exists the contracting officer reserves the right to require a conflict of interest mitigation plan from the prime contractors (offerors) of those proposals. If an offeror fails to submit a plan, or submits an inadequate plan, the offer may not be considered. N62645-11-R-0012 Page 4 of 118 OFFEROR'S INFORMATION FORM Contacts shall be members of the prime contractor’s organization. All blanks shall be completed. Company Name: _____________________________________________ CAGE Code: _____________________ DUNS: _________________________ TIN: ___________________________ Contact 1 Name: ____________________________________ Title:______________________________________ Phone Number: _____________________________ Email Address: _____________________________ Contact 2 Name: ____________________________________ Title:______________________________________ Phone Number: _____________________________ Email Address: _____________________________ N62645-11-R-0012 Page 5 of 118 Section B - Supplies or Services and Prices SECTION B B.1. The Contractor shall furnish qualified HCWs in accordance with Section C (Statement of Work), individual Task Orders for these services, and all other terms and conditions set forth herein. Government requirements for contracted health care personnel shall be filled in response to Task Orders issued by the Government against the contract. B.2. This solicitation will result in multiple Indefinite-Delivery, Indefinite-Quantity (IDIQ) contract awards, as identified under FAR 16.504(c). Task Orders will be awarded on a firm fixed price basis. B.3. The following activity is the sole authority to issue Task Orders: Naval Medical Logistics Command Code 02 693 Neiman Street Fort Detrick, MD 21702-9203 B.4. The Contracting Officer will order services against the contract through issuance of Task Orders via a DD Form 1155 signed by the Contracting Officer. Task Orders will be executed in writing by the Contracting Officer and transmitted either via facsimile or electronically via e-mail. The contractor shall acknowledge receipt via e-mail. B.5. Each Task Order will contain at a minimum the following information: a. The date of order b. Contract number and order number c. Description of services (labor category, position qualifications, place of performance, hours of operation, and quantity required) d. The unit price e. The period of performance f. Option periods may be included as appropriate. g. Accounting and appropriation data h. Payment office address i. Invoicing and acceptance instructions j. Name of the Contracting Officer’s Representative (COR) k. Any other pertinent data B.6. Location of services. Services shall be performed at locations as follows: a. This acquisition is for various nursing services (e.g. including but not limited to Registered Nurses, Licensed Practical Nurses, and Nurse Practitioners) at Naval Medical Center San Diego, CA; Naval Hospital Twentynine Palms, CA; Naval Hospital Camp Pendleton, CA, Naval Hospital Lemoore, CA and any associated branch clinics as well as any DoD or Coast Guard Military Treatment Facility (MTF) who have been granted authority under §10 USC 1091 and whose personnel are located within the states of California, Arizona, and Nevada. b. In the event that performance requirements at a particular facility differ slightly from that expressed in Section C, those differences shall be defined in the Task Order statement of work. c. The Government reserves the right to reassign HCWs within an MTF to meet patient demand. B.7. Maximum Quantities. All available quantities for this contract are given in CLINs 0003, 0004, 0008, 0009, and 0010. CLINS 0001, 0002, and 0005 through 0007 are not applicable for this solicitation and are designated as reserved. Refer to Section J Attachment AJ for an explanation of CLINs. N62645-11-R-0012 Page 6 of 118 B.8. The ordering period begins with the initial start of contract services and is estimated to be 60 months. The ordering period will end before 60 months if maximum quantities are reached. Refer to section F.1. B.9. Instructions and procedures for Task Order preparation and award are contained in Section H of this solicitation. B.10. The period of performance for the base period or any option periods of a Task Order shall be of one year or less in duration. B.11. Provided below in sections B.11.1 and B.11.2 are Representative CLINs for this requirement which shall be priced by the offeror and included in its business proposal. The services listed under the Representative CLINs are for evaluation purposes only and are not reflective of initial Task Order requirements. All Task Order requirements will be competed after contract awards are made. B.11.1 Period of Performance: 01 October 2012 through 30 September 2013: Line Item Description Quantity Units 1001 Registered Nurse 2088 Hours (Wage Determination: Registered Nurse II) Site of Service: The contractor shall provide a Registered Nurse in the occupational health department at the Naval Hospital Camp Pendleton Branch Health Clinic (BHC) Barstow, CA. The HCW may also be required to provide services at the Nebo and Yerma BHC sites. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty for 9 hours between the hours of 6:30 am and 6:00 pm, Monday through Friday and will not be required to work more than 80 hours in a 2-week period. Duty hours include an uncompensated one hour meal break. The BHCs are not open for patient care on Saturdays, Sundays, or on the day of observance of federal holidays. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Registered Nurses performing similar clinical duties. 1002 Certified Nurse Midwife 2088 Hours (Wage Determination: Registered Nurse III) Site of Service: The contractor shall provide a Certified Nurse Midwife in the OB/GYN Clinic/Maternal-Infant Unit (MIU) at the Naval Hospital, Lemoore, CA and/or area Branch Medical Clinics that are within 35-miles of the hospital. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. The Certified Nurse Midwife must demonstrate current clinical competence to be granted privileges by the MTF Privileging Authority (BUMEDINST 6320.66E, http://www.med.navy.mil/directives/Pages/ExternalDirectives.aspx). Staffing and Scheduling: The HCW shall be on duty for an 8.5-hour shift that includes an uncompensated 30-minute meal break, between the hours of 7:30 am and 6:00 pm, Monday through Friday. The Certified Nurse Midwife may be required to provide on-call coverage on the day of observance of federal holidays. The physician and the certified nurse midwife will rotate primary on-call services, including weekends and federal holidays. On-call duty will be evenly distributed among all providers (contract and military), including the Certified Nurse Midwife. While the N62645-11-R-0012 Page 7 of 118 Line Item Description Quantity Units physician is providing on-call services, he or she shall serve as the primary on-call clinician for all women’s health issues identified by house staff. When a Certified Nurse Midwife assumes the on-call duty, the OB/GYN physicians shall each rotate secondary on-call services for clinical expertise outside the certified nurse midwife’s scope of practice. If the HCW is scheduled for on-call duty on the day of observance of the federal holiday, the HCW will be given an equal amount of time to be taken upon mutual agreement between the Government and the HCW. The HCW may be called back to the facility. The contractor shall be reimbursed for not less than 2 hours when the HCW is called back to the MTF. If the HCW is called back to the MTF, the HCW shall be given an equal amount of time off to be scheduled upon mutual agreement of the HCW and the Government supervisor. The contractor shall factor the cost of on-call services and callback services into a blended hourly rate. Depending on the number of military providers, on-call may rotate every 3rd or 4th day and historical data shows the HCW has been required to return to the MTF approximately 4 times per month. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hour pay period and shall be subject to leave approval in accordance with Section C.3. The contractor HCW will not be required to provide services (on-site, on-call, and call-back service plus approved leave and holidays) in excess of 80 hours per 2 week period. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Duties include a full-range of Certified Nurse Midwife services that are inclusive of the procedures identified in BUMEDINST 6320.66E. Productivity is expected to be comparable with that of other Certified Nurse Midwives performing similar clinical duties. 1003 Licensed Vocational Nurse 2088 Hours (Wage Determination: Licensed Vocational Nurse) Site of Service: The contractor shall provide one full time individual Licensed Vocational Nurse in the Orthopedic Clinic, Surgical Services Directorate at Naval Medical Center, San Diego, CA. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty 80 hours every two weeks, except during periods of approved leave and holidays. In no instance will the HCW be required to provide services (on-site service plus approved leave and holidays) in excess of 160 hours per 4-week period. Services shall be provided Sunday through Saturday between the hours of 6:00 am and 8:00 pm for either an 8 or 10-hour period. Each shift will be extended ½ hour or 1 hour for an uncompensated meal break to cover a full 8 or 10 hours of service. For weekend service, the HCW shall work not more than one weekend per month (Saturday and/or Sunday). At the mutual agreement of the contractor and the Government, alternative schedules may be implemented such as a compressed work schedule. As part of the HCW’s normal tour of duty, services may be required on the day of observance of federal holidays. If services are provided on the day of observance of federal holidays, the HCW will not receive another day off during the pay period and the contractor will invoice at the firm fixed price in Section B of the Task Order. If services are not rendered on the day of observance of federal holidays, the HCW will be compensated for 8 or 10 hours worked, depending on their shift. The Government anticipates scheduling the HCW to work on the day of observance of federal holidays a maximum of two times per period of performance. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. N62645-11-R-0012 Page 8 of 118 Line Item Description Quantity Units Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Licensed Vocational Nurses performing similar clinical duties. 1004 Nurse Practitioner 4176 Hours (Wage Determination: Registered Nurse III) Site of Service: The contractor shall provide Nurse Practitioner services in the Neonatal Intensive Care Unit (NICU), at Naval Medical Center, San Diego, CA. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. The Nurse Practitioner must demonstrate current clinical competence to be granted privileges by the MTF Privileging Authority (BUMEDINST 6320.66E, http://www.med.navy.mil/directives/Pages/ExternalDirectives.aspx). Staffing and Scheduling: This is a coverage requirement. The contractor shall provide qualified replacements when scheduled personnel are unable to work due to planned and unplanned absences. The contractor is responsible for scheduling personnel to cover the schedule, for providing the leave benefit for these personnel, for approving leave for these personnel, and for providing any holiday benefit. These personnel will not accrue leave under this order; individuals on leave, holiday status, or otherwise absent shall be subject to replacement coverage by the contractor in accordance with Section C.3.2. The contractor shall maintain sufficient back-up personnel to ensure coverage of the schedule during periods of both scheduled and unscheduled absence. The contractor shall provide, for a 10-hour period, one qualified Nurse Practitioner; 7-days a week, including federally observed holidays from 7:00 am to 6:00 pm. Each shift will be extended one-hour for an uncompensated meal break to cover a full 10 hours of service. The contractor shall also provide one additional Nurse Practitioner on Mondays from 7:00 am to 6:00 pm, to include federally observed holidays. Each shift will be extended one-hour for an uncompensated meal break to cover a full 10 hours of service. The contractor shall make every effort to utilize full time employees (defined as 32 hours/week or more) and, notwithstanding contractor employee probation policies, shall recruit only HCWs who indicate interest in a long-term commitment under the task order. The Government will only credential and approve a maximum of six Nurse Practitioners to provide services. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Duties include a full-range of Nurse Practitioner services that are inclusive of the procedures identified in BUMEDINST 6320.66E. Productivity is expected to be comparable with that of other Nurse Practitioners performing similar clinical duties. 1005 Licensed Vocational Nurse 2088 Hours (Wage Determination: Licensed Vocational Nurse) Site of Service: The contractor shall provide a Primary Care Licensed Vocational Nurse for the Naval Hospital Twentynine Palms, California and/or the Naval Hospital’s Branch Health Clinics under the direction of the Directorate of Medical Services. The primary duty location of this requirement is Naval Hospital Twentynine Palms. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty for an 8.5 to 10.5 hour period between the hours of 7:00 am and 6:00 pm, and are inclusive of a ½ hour or an 1- N62645-11-R-0012 Page 9 of 118 Line Item Description Quantity Units hour uncompensated meal break, depending on the length of the shift worked. Individual shift hours may occasionally be extended to accommodate travel team requirements or mass screening evolutions, however in no instance will the shift exceed 12 hours in length. The contractor HCW will not be required to provide services (on-site service plus approved leave and holidays) in excess of 80 hours per 2 week period. The HCW is not required to provide services on the day of observance of a federal holiday. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Licensed Vocational Nurses performing similar clinical duties. 1006 Registered Nurse Case Manager 2088 Hours (Wage Determination: Registered Nurse II) Site of Service: The contractor shall provide a Registered Nurse Case Manager in the Deployment Health Clinic at Naval Hospital Camp Pendleton, CA. Services may also be required at the Naval Hospital’s Branch Health Clinics or Branch Medical Clinics. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty for an 8.5 to 9 hour period and include a ½ to 1 hour uncompensated meal break, depending on the length of the shift. Individual shift hours may occasionally be extended to accommodate travel team requirements or mass screenings; however in no instance will the shift exceed 12.5 hours in length. The contract HCW shall be on duty for about 40 hours each week, except during periods of approved leave and holidays. In no instance will the contract HCW be required to provide services (on-site service plus approved leave and holidays) in excess of 80 hours per 2-week period. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Registered Nurse Case Managers performing similar clinical duties. B.11.2 Option Period of Performance 01 October 2013 through 30 September 2014: Line Item Description Quantity Units 2001 Registered Nurse 2088 Hours (Wage Determination: Registered Nurse II) Site of Service: The contractor shall provide a Registered Nurse in the occupational health department at the Naval Hospital Camp Pendleton Branch Health Clinic (BHC) Barstow, CA. The HCW may also be required to provide services at the Nebo and Yerma BHC sites. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty for 9 hours between the hours of 6:30 am and 6:00 pm, Monday through Friday and will not be required to work more than 80 hours in a 2-week period. Duty hours include an uncompensated one hour meal break. The BHCs are not open for patient care on Saturdays, Sundays, or on the N62645-11-R-0012 Page 10 of 118 Line Item Description Quantity Units day of observance of federal holidays. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Registered Nurses performing similar clinical duties. 2002 Certified Nurse Midwife 2088 Hours (Wage Determination: Registered Nurse III) Site of Service: The contractor shall provide a Certified Nurse Midwife in the OB/GYN Clinic/Maternal-Infant Unit (MIU) at the Naval Hospital, Lemoore, CA and/or area Branch Medical Clinics that are within 35-miles of the hospital. Services shall be performed in the following clinical areas. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. The Certified Nurse Midwife must demonstrate current clinical competence to be granted privileges by the MTF Privileging Authority (BUMEDINST 6320.66E, http://www.med.navy.mil/directives/Pages/ExternalDirectives.aspx). Staffing and Scheduling: The HCW shall be on duty for an 8.5-hour shift that includes an uncompensated 30-minute meal break, between the hours of 7:30 am and 6:00 pm, Monday through Friday. The Certified Nurse Midwife may be required to provide on-call coverage on the day of observance of federal holidays. The physician and the certified nurse midwife will rotate primary on-call services, including weekends and federal holidays. On-call duty will be evenly distributed among all providers (contract and military), including the Certified Nurse Midwife. While the physician is providing on-call services, he or she shall serve as the primary on-call clinician for all women’s health issues identified by house staff. When a Certified Nurse Midwife assumes the on-call duty, the OB/GYN physicians shall each rotate secondary on-call services for clinical expertise outside the certified nurse midwife’s scope of practice. If the HCW is scheduled for on-call duty on the day of observance of the federal holiday, the HCW will be given an equal amount of time to be taken upon mutual agreement between the Government and the HCW. The HCW may be called back to the facility. The contractor shall be reimbursed for not less than 2 hours when the HCW is called back to the MTF. If the HCW is called back to the MTF, the HCW shall be given an equal amount of time off to be scheduled upon mutual agreement of the HCW and the Government supervisor. The contractor shall factor the cost of on-call services and callback services into a blended hourly rate. Depending on the number of military providers, on-call may rotate every 3rd or 4th day and historical data shows the HCW has been required to return to the MTF approximately 4 times per month. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hour pay period and shall be subject to leave approval in accordance with Section C.3. The contractor HCW will not be required to provide services (on-site, on-call, and call-back service plus approved leave and holidays) in excess of 80 hours per 2 week period. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Duties include a full-range of Certified Nurse Midwife services that are inclusive of the procedures identified in BUMEDINST 6320.66E. Productivity is expected to be comparable with that of other Certified Nurse Midwives performing similar clinical duties. 2003 Licensed Vocational Nurse 2088 Hours N62645-11-R-0012 Page 11 of 118 Line Item Description Quantity Units (Wage Determination: Licensed Vocational Nurse) Site of Service: The contractor shall provide one full time individual Licensed Vocational Nurse in the Orthopedic Clinic, Surgical Services Directorate at Naval Medical Center, San Diego, CA. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty 80 hours every two weeks, except during periods of approved leave and holidays. In no instance will the HCW be required to provide services (on-site service plus approved leave and holidays) in excess of 160 hours per 4-week period. Services shall be provided Sunday through Saturday between the hours of 6:00 am and 8:00 pm for either an 8 or 10-hour period. Each shift will be extended ½ hour or 1 hour for an uncompensated meal break to cover a full 8 or 10 hours of service. For weekend service, the HCW shall not work more than one weekend per month (Saturday and/or Sunday). At the mutual agreement of the contractor and the Government, alternative schedules may be implemented such as a compressed work schedule. As part of the HCW’s normal tour of duty, services may be required on the day of observance of federal holidays. If services are provided on the day of observance of federal holidays, the HCW will not receive another day off during the pay period and the contractor will invoice at the firm fixed price in Section B of the Task Order. If services are not rendered on the day of observance of federal holidays, the HCW will be compensated for 8 or 10 hours worked, depending on their shift. The Government anticipates scheduling each HCW to work on the day of observance of federal holidays a maximum of two times per period of performance. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Licensed Vocational Nurses performing similar clinical duties. 2004 Nurse Practitioner 4176 Hours (Wage Determination: Registered Nurse III) Site of Service: The contractor shall provide Nurse Practitioner services in the Neonatal Intensive Care Unit (NICU), at Naval Medical Center, San Diego, CA. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. The Nurse Practitioner must demonstrate current clinical competence to be granted privileges by the MTF Privileging Authority (BUMEDINST 6320.66E, http://www.med.navy.mil/directives/Pages/ExternalDirectives.aspx). Staffing and Scheduling: This is a coverage requirement. The contractor shall provide qualified replacements when scheduled personnel are unable to work due to planned and unplanned absences. The contractor is responsible for scheduling personnel to cover the schedule, for providing the leave benefit for these personnel, for approving leave for these personnel, and for providing any holiday benefit. These personnel will not accrue leave under this order; individuals on leave, holiday status, or otherwise absent shall be subject to replacement coverage by the contractor in accordance with Section C.3.2. The contractor shall maintain sufficient back-up personnel to ensure coverage of the schedule during periods of both scheduled and unscheduled absence. The contractor shall provide, for a 10-hour period, one qualified Nurse Practitioner; 7-days a week, including federally observed holidays from 7:00 am to 6:00 pm. Each shift will be extended one-hour for an uncompensated N62645-11-R-0012 Page 12 of 118 Line Item Description Quantity Units meal break to cover a full 10 hours of service. The contractor shall also provide one additional Nurse Practitioner on Mondays from 7:00 am to 6:00 pm, to include federally observed holidays. Each shift will be extended one-hour for an uncompensated meal break to cover a full 10 hours of service. The contractor shall make every effort to utilize full time employees (defined as 32 hours/week or more) and, notwithstanding contractor employee probation policies, shall recruit only HCWs who indicate interest in a long-term commitment under the task order. The Government will only credential and approve a maximum of six Nurse Practitioners to provide services. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Duties include a full-range of Nurse Practitioner services that are inclusive of the procedures identified in BUMEDINST 6320.66E. Productivity is expected to be comparable with that of other Nurse Practitioners performing similar clinical duties. 2005 Licensed Vocational Nurse 2088 Hours (Wage Determination: Licensed Vocational Nurse) Site of Service: The contractor shall provide a Primary Care Licensed Vocational Nurse for the Naval Hospital Twentynine Palms, California and/or the Naval Hospital’s Branch Health Clinics under the direction of the Directorate of Medical Services. The primary duty location of this requirement is Naval Hospital Twentynine Palms. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty for an 8.5 to 10.5 hour period between the hours of 7:00 am and 6:00 pm, and are inclusive of a ½ hour or an 1- hour uncompensated meal break, depending on the length of the shift worked. Individual shift hours may occasionally be extended to accommodate travel team requirements or mass screening evolutions, however in no instance will the shift exceed 12 hours in length. The contractor HCW will not be required to provide services (on-site service plus approved leave and holidays) in excess of 80 hours per 2 week period. The HCW is not required to provide services on the day of observance of a federal holiday. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Licensed Vocational Nurses performing similar clinical duties. 2006 Registered Nurse Case Manager 2088 Hours (Wage Determination: Registered Nurse II) Site of Service: The contractor shall provide a Registered Nurse Case Manager in the Deployment Health Clinic at Naval Hospital Camp Pendleton, CA. Services may also be required at the Naval Hospital’s Branch Health Clinics or Branch Medical Clinics. Qualifications: The HCW shall possess and maintain the qualifications in Section C, Paragraph C.7 of the basic contract, and shall possess the minimum qualifications for the applicable Labor Category in Section C.8. of the basic contract. Staffing and Scheduling: The HCW shall be on duty for an 8.5 to 9 hour period and include a ½ to 1 hour uncompensated meal break, depending on the length of the shift. Individual shift hours may occasionally be extended to accommodate travel team requirements or mass screenings; however in no instance will the shift exceed 12.5 hours in length. The contract HCW shall be on duty for about 40 hours each week, N62645-11-R-0012 Page 13 of 118 Line Item Description Quantity Units except during periods of approved leave and holidays. In no instance will the contract HCW be required to provide services (on-site service plus approved leave and holidays) in excess of 80 hours per 2-week period. The HCW will accrue 8 hours of personal leave (annual plus sick) for each 80 hours worked and shall be subject to leave approval in accordance with Section C.3. Duties: The HCW shall perform the general duties in Section C.9, and the duties specific to the applicable Labor Category in Section C.10. of the basic contract. Productivity is expected to be comparable with that of other Registered Nurse Case Managers performing similar clinical duties. B.12. Maximum Quantities. All available quantities for this contract are given in CLINs 0003, 0004, 0008, 0009 and 0010 below. ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 Reserved FFP FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0002 Reserved FFP FOB: Destination NET AMT N62645-11-R-0012 Page 14 of 118 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0003 373,405 Hours Advanced Practice Nursing FFP Any specialty recognized by the American Nurses Credentialing Center (ANCC) or American Academy of Nurse Practitioners (AANP). FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0004 899,308 Hours Nursing FFP Any Registered Nurse specialty, Licensed Practical Nurse, RN- Health Educator. FOB: Destination NET AMT N62645-11-R-0012 Page 15 of 118 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0005 Reserved FFP FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0006 Reserved FFP FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0007 Reserved FFP FOB: Destination NET AMT N62645-11-R-0012 Page 16 of 118 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0008 100 Lot Travel FFP Reimbursement of travel expenses in accordance with Section C.3.3.8 and C.12 of this solicitation. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0009 22,000 Hours On Call FFP Reimbursement of on-call expenses in accordance with Section C of the Task Order. FOB: Destination NET AMT N62645-11-R-0012 Page 17 of 118 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0010 4,240 Hours Orientation FFP Reimbursement of orientation expenses in accordance with Section C.7.11 of the solicitation and Section C of the Task Order. FOB: Destination NET AMT N62645-11-R-0012 Page 18 of 118 Section C - Descriptions and Specifications SECTION C NOTE 1: The use of Commanding Officer means: Commanding Officer or other activity head, or designated representative, e.g., Contracting Officer’s Representative (COR) or Department Head, of the activity designated in a particular task order. NOTE 2: The term Contractor means the offeror identified in block 15A of Standard Form 33 or block 7 of the Standard Form 26 and its HCWs who are providing services under task orders placed under the contract. NOTE 3: The term HCW refers to the individual(s) providing services under the contract. NOTE 4: The term MTF refers to the Military Treatment Facility or other Federal medical treatment facility at which services are performed. NOTE 5: The term Contracting Officer’s Representative (COR) refers to the government employee appointed in writing by the Contracting Officer to serve as technical liaison between the government and the Contractor. NOTE 6: Psychological Health and Traumatic Brain Injury Program (PHTBI). The program seeks to address gaps in the case available for the prevalent injuries among combatants from the global war on terrorism. Through adoption of risk-based staffing models and a uniform, best practice standard of care across the DoD Military Health System, the program seeks to ensure easy, rapid access to PH and TBI care for all beneficiaries and to ensure that transition across networks of care recognizes the unique care coordination and case management requirements for PH and TBI patients. NOTE 7: Wounded, Ill, and Injured (WII). The program seeks to address gaps in the care available for the prevalent injuries and illnesses among service members retiring for active duty in Iraq and Afghanistan as well as the difficulties of transitioning from military to veteran status. The WII Program is directed by the President, Congress, and the Department of Defense and addresses concerns about the quality and availability of medical, mental health, and dental care services. Through adoption of risk based staffing models and a uniform, best practice standard of care across DoD, the program seeks to ensure easy, rapid access to care for all beneficiaries and to ensure that transition across networks of care recognizes the unique care coordination requirements for WII patients. The WII program focuses on care and treatment to injured and ill service members, studies, case managers, inspections, policies, and other initiatives to improve the management of wounded personnel. NOTE 8. Post Deployment Health Re-Assessment (PDHRA). The Post-Deployment Health Reassessment (PDHRA) Program is a program mandated by the Assistant Secretary of Defense for Health Affairs in March 2005 and designed to identify and address health concerns, with specific emphasis on mental health, that have emerged over time since deployment. STATEMENT OF WORK C.1. The Statement of Work (SOW) requires Nursing services for Department of Defense medical treatment facilities in the state of California. Specific Statements of Work for the Government’s requirements ordered from the maximum order quantities in Section B, CLINs 0003, 0004, 0008, 0009, and 0010 will be included with subsequently issued Task Order Proposal Requests. C.1.1. The Contractor shall provide the health care personnel in accordance with the terms and conditions of the contract and each task order issued under the contract. C.1.2. Contractor services shall be provided for the treatment of active duty military personnel, their dependents, eligible DoD civilian employees, and other eligible beneficiaries, designated by the Government. C.2. SUITS ARISING OUT OF MEDICAL MALPRACTICE N62645-11-R-0012 Page 19 of 118 C.2.1. The HCWs are serving at the MTF under a personal services contract entered into under the authority of section 1091 of Title 10, United States Code. Accordingly, section 1089 of Title 10, United States Code shall apply to personal injury lawsuits filed against the HCW(s) based on negligent or wrongful acts or omissions incident to performance within the scope of the contract. C.2.2. The HCWs are not required to maintain medical malpractice liability insurance. In the event of a claim or lawsuit relating to the HCW's performance of duties under the contract, the parties shall follow the procedures established in SECNAVINST 6300.3A (Medical Malpractice Claims Against Military and Civilian Personnel of the Armed Forces), a copy of which can be viewed at http://doni.daps.dla.mil/. C.2.3. HCWs providing services under the contract shall be rendering personal services to the Government and shall be subject to day-to-day supervision and control by Government personnel. Supervision and control is the process by which the individual HCW receives technical guidance, direction, and approval with regard to a task(s) within the requirements of the contract. C.3. SCHEDULES, ABSENCES, AND LEAVE. Each task order will specify the required schedule and shall specify whether the HCW will either: (1) accrue leave as an individual and be subject to approval by the Government for scheduling accrued leave; or (2) not accrue leave under the task order and be subject to replacement coverage by the Contractor during all scheduled and unscheduled absences. C.3.1. Individuals who accrue leave. Individuals subject to the provisions given in Section C.3.1 and its subparagraphs will be designated in the applicable task order. The Government will administer the leave provisions in this Section. C.3.1.1. Individual HCWs who accrue leave shall accrue personal leave (annual leave plus sick leave) at a rate specified in the task order. The specific work schedule for an individual Contractor HCW who accrues leave will be scheduled in advance by the supervisor (or designee) specified in the task order. Any changes in the schedule shall be coordinated between the individual HCW and the Government. C.3.1.2. Each HCW shall adhere to MTF/supervisor policies and procedures for requesting leave, including requirements for advance notice. Requests by HCWs for taking accrued leave are subject to approval by the supervisor (or designee). Leave shall only be used in quarter hour increments. C.3.1.3. Unless otherwise negotiated between the Contracting Officer, the MTF and the Contractor as specified in the contract or applicable task order, the MTF should administer a HCW’s leave in accordance with the guidelines for Federal civil service employees. These guidelines relate to, among other topics, annual leave, administrative leave, leave without pay (LWOP), and holidays. C.3.1.4. Contractors and HCWs shall ensure that leave requests are submitted with sufficient time in advance to allow the supervisor to adequately plan for adequate staffing levels. Unless otherwise specified in a Task Order, all accrued leave shall be used within 90 days following the completion of a Task Order if a Logical Follow-on Task Order has been issued or within the first 90 days of the exercised option period under a Task Order. If a Logical Follow-on Task Order is not issued or if an option period under a Task Order is not exercised, all unused leave shall be either used by the end of the Task Order or option period of performance or forfeited. If leave is carried over beyond the completion date of the Task Order (i.e. to be used in the subsequent 90 days), the Government reserves the right to require the HCW to provide the supervisor and COR with a schedule for the use of that leave not later than the first workday of the Logical Follow-on Task Order or not later than the first workday of the exercised option period of the Task Order. HCWs shall not presume that their leave schedule has been approved unless notified, in writing, by the supervisor. The Government will make every effort to accommodate all leave requests; however, the Commanding Officer reserves the right to unilaterally deny these leave requests to meet the demand for patient care. C.3.1.5. The Government will compensate the Contractor for periods of authorized absence. The Contractor shall, in turn, compensate the HCW for periods of authorized absence. N62645-11-R-0012 Page 20 of 118 C.3.1.6. If the HCW is absent for three or more consecutive unplanned days, the Commanding Officer may require written documentation from a qualified health care provider, that the HCW is free from communicable disease. The Government reserves the right to examine and/or re-examine any HCW who meets this criterion. C.3.1.7. At the discretion of the Commanding Officer and subject to the advance approval by the supervisor, COR, and the Contractor, a HCW shall enter a LWOP status upon exhaustion of any leave balance. Unless waived by the Contracting Officer, the Contractor shall replace any HCW who has been on LWOP status for a total of 40 hours per task order. At the discretion of the Commanding Officer, LWOP taken in conjunction with family or medical leave is not subject to this limitation, but must be approved in advance by the Commanding Officer or designee. C.3.1.8. Upon request, up to 12 weeks of family or medical leave, accrued leave plus LWOP, may be granted to the HCW if the circumstances specified in the Family and Medical Leave Act (FMLA), Sec. 102, apply. C.3.1.9. During MTF check-in processing, HCWs shall report their reserve status to the MTF COR. Documented military leave for military reservists may be allowed, not to exceed 15 days per fiscal year, in accordance with 5 U.S.C. 6323(a). This leave may be taken intermittently, i.e., 1 day at a time, and may be carried over into the next fiscal year provided a follow on task order in place or an option period under the Task Order has been exercised. Military reservists who perform full-time military service as a result of a call or order to active duty in support of a contingency operation may take up to 22 days per calendar year of military leave, in accordance with 5 U.S.C. 6323(b). Documented military leave taken in accordance with 5 U.S.C. 6323(a) and (b) is compensated leave. HCWs shall follow the policy of the MTF with respect to notification of scheduled military duties to the Commanding Officer. “Unless waived by the Contracting Officer, the Contractor shall replace any HCW who has been on LWOP status for a total of 40 hours, unless otherwise specified in the task order.” C.3.1.10. Administrative leave may be granted for HCWs selected to serve jury duty. Requests for administrative jury duty leave shall be submitted to the Commanding Officer in the same manner as planned leave is requested. The HCW is required to provide the Commanding Officer with as much written notice as possible prior to reporting for jury duty, and is responsible for supplying documentation regarding the necessity for and length of absence for jury duty. A HCW whose position is deemed critical by the Commanding Officer may be issued a written request for the court to excuse the HCW from jury duty. The HCW shall be compensated by the Contractor for these periods of authorized administrative leave. No individual HCW will be granted more than 15 days of administrative leave for jury duty per year; in those instances where a contract HCW who accrues leave is anticipated to be in jury duty status in excess of 15 days, the Contractor shall provide a replacement worker. C.3.1.11. In the event that a task order allows a leave accrual position to be staffed by part-time individuals, no leave will be accrued by any individual who works less than 40 hours during a two week invoice period. This clause does not apply to labor categories covered by the Service Contract Act. C.3.1.12. All accrued leave shall be forfeited without compensation or reimbursement at the expiration or termination of a task order or the contract or at the voluntary or involuntary separation of a contract HCW or option exercise. The only exception to this is in the case of a logical follow-on task order or exercise of an option, which includes a provision for carry over from the expiring task order of a specified maximum leave balance for a defined period. C.184.108.40.206. In the event that the HCW gives notice of employment termination, all accrued leave must be used within that notice period, or forfeited. The Government will not extend the healthcare worker’s termination date to accommodate unused leave balances. C.3.1.13. Holidays. Unless otherwise specified in the task order, requirements for holiday work are defined in each task order. Compensation for holidays will be managed as follows: C.220.127.116.11. Full-time and Part-time HCWs. Each full-time or part-time individual HCW who accrues personal leave will also receive a paid holiday benefit. If additional Federal holidays are created as a result of an Executive Order, N62645-11-R-0012 Page 21 of 118 the benefit will also be extended to the HCW. The Government will compensate the Contractor for the number of hours the HCW is normally scheduled to work on the day on which holiday is observed. The Contractor shall fully compensate the HCW for the number of hours the HCW is normally scheduled to work on the holiday observance. C.18.104.22.168. A HCW who is not normally scheduled for duty on the day a holiday is observed will not be compensated for the holiday. For example, a HCW who works 10 hours per day, Tuesday through Friday, will not receive compensation for a Monday holiday, since the HCW is not normally scheduled to work on Mondays. C.22.214.171.124. The Government supervisor will review, and approve on a case-by-case basis, HCW requests for schedule changes which remove the HCW from a holiday schedule. The Government supervisor will approve the requests as appropriate to the circumstance. C.126.96.36.199. If the Government requires the services of a HCW who is not normally scheduled to work on a day of a holiday observance, the Government will compensate the Contractor for the hours worked, and the HCW will receive compensatory time equal to the number of hours worked on the holiday. C.188.8.131.52. Part-time HCWs who do not accrue leave also do not accrue a holiday benefit or a holiday created by Executive Order. The Government will compensate the Contractor only for the number of hours the HCW actually works. C.184.108.40.206. In no instance will the Government provide holiday compensation or compensatory time in excess of 12 hours for each holiday observance. C.3.2. REPLACEMENT COVERAGE (Positions for which replacement coverage is required). Positions subject to the provisions given in Section C.3.2 and its subparagraphs will be designated in the applicable task order. The Contractor shall be responsible for administering the leave for individuals filling coverage positions. C.3.2.1. The Contractor shall have sufficient qualified reserve personnel so that all services are provided in the event a HCW scheduled to work becomes ill, resigns, is terminated, or is otherwise unavailable to work. Contract requirements are not mitigated by inclement weather. C.3.2.2. If a HCW becomes ill or is otherwise unable to fulfill his/her obligation to work, they shall notify the Contractor who in turn shall notify the COR. C.3.2.3. The Contractor is responsible for replacing a HCW who, for any reason, misses more than 2 hours of a shift. C.3.2.4. The Contractor shall provide replacement coverage by a HCW who meets the minimum HCW contract qualifications and is approved for work (i.e., has been credentialed and privileged as appropriate and has satisfactorily completed orientation). C.3.2.5. The Contractor shall prepare the schedule of workers for all positions for which replacement coverage is required. Unless otherwise specified in the task order, the specific schedule for each two week period shall be provided to the DoD Supervisor one month in advance of the two week period. The schedule shall be complete and include the name of the specific individual(s) who will provide the required coverage. C.3.3. Provisions for all HCWs. C.3.3.1. Administrative Leave. For unusual and compelling circumstances (e.g., natural disasters, weather emergencies) in which the Commanding Officer either excuses all facility personnel from reporting to work or dismisses all personnel early, the Commanding Officer is authorized to grant administrative leave to the HCW. This administrative leave may be compensated leave. Personnel who occupy “essential” positions may be required to remain on duty or return to the MTF in order to maintain continuity of patient care services. N62645-11-R-0012 Page 22 of 118 C.3.3.2. Furlough. Unless otherwise authorized by a defense appropriations bill, Contractors shall not be reimbursed by the Government for services not rendered during a Government furlough. In the event of a Government furlough, the Commanding Officer will determine which contract employees are considered exempt and therefore must report to work. Contract employees deemed exempt shall be compensated for services rendered during a furlough. All other contract employees shall be furloughed until the Government shutdown ends or they are notified by the Contracting Officer’s Representative that they have become exempt employees. C.3.3.3. A HCW with a bona fide medical emergency occurring while on duty, or with an on-the-job injury, will be provided stabilizing medical care according to the procedures of the MTF. The Contractor shall reimburse the Government for all medical services provided unless the HCW is otherwise entitled to Government medical services. C.3.3.4. In the instance where the Government directs the HCW to remain on duty in excess of their scheduled shift due to an unforeseen emergency or to complete patient treatment where lack of continuity of care would otherwise jeopardize patient health, the HCW shall remain on duty. The HCW will be given an equal amount of compensatory time to be scheduled upon mutual agreement of the HCW and the Commanding Officer. This provision is not intended to apply to the time required to complete routine tasks (e.g., completion of paperwork or routine administrative tasks at the end of a shift) which are to be completed as part of the shift. C.3.3.5. HCWs providing services shall (unless otherwise specified in the task order) receive uncompensated meal breaks of 30 minutes when assigned an 8 hour or 10 hour shift and 45 minutes when assigned a 12 hour shift. The HCW’s shift will be extended between 30 and 45 minutes, respectively, to constitute a full 8, 10 or 12 hours of on- site service. This includes extending the work shift beyond the scheduled clinic closing time to complete patient care and administrative duties. No shift shall exceed 12 ¾ hours unless otherwise specified in the task order. C.3.3.6. Contractor employees may receive one compensated work break in the morning and one in the afternoon, work load permitting, at the discretion of the Government. Neither break shall exceed 15 minutes or be taken with the intention of extending the lunch break or in conjunction with the start or end of a shift. C.3.3.7. Reserved. C.3.3.8. Continuing Education. The Commanding Officer may also grant authorization for planned absences to allow the HCW to attend continuing education courses. This is in addition to the planned and unplanned absences specified above. The Government may compensate the HCW for these periods of authorized absence if the continuing education course(s) are determined to be a necessary expense by the government. This determination will be made on a case by case basis, weighing the costs associated with the training of Contractor personnel against the benefit gained by the Government in support of the appropriation that will incur the expense. This compensation will not exceed 40 hours per 12-month Task Order, equivalently apportioned for part-time employees and/or partial year Task Orders. The Commanding Officer may also advance leave for continuing education. C.220.127.116.11. Unless authorized in advance, the Government will not reimburse the HCW for the cost of any training and/or other related expenses (travel). If authorized, the Contractor shall be compensated for those expenses deemed reasonable using the Travel/Training Contract Line Item Number (CLIN) in Section B, CLIN 0008. The HCW shall provide proof of attendance and successful completion of continuing education to the Commanding Officer upon request. C.18.104.22.168.1. The Contractor shall submit an invoice in accordance with Wide Area Work Flow (WAWF) instructions itemizing expenses in amounts allowable by the COR. C.22.214.171.124.2. All reimbursements will be retrospective, payable only upon presentation of a properly prepared invoice (as specified by the facility) to the COR. The government shall reimburse the Contractor only for actual training costs incurred, and any authorized travel expenses deemed reasonable. See Section C.11. C.126.96.36.199.3. The Government reserves the right to require additional documentation, including memoranda from the HCW obtaining the training. N62645-11-R-0012 Page 23 of 118 C.188.8.131.52.4. Such training shall not be conducted prior to the appropriate funding being applied to CLIN 0008 through a task order and task order modification. C.3.3.9. Training necessary to maintain the professional qualifications required by the contract (e.g. Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), etc.) may be available at the MTF on a space available basis. HCWs participating in such training shall not be in a contract duty status, i.e. training hours are not paid hours of service. Failure of the HCW to obtain training on a space available basis does not release the Contractor from the contract requirement. C.3.3.10. Due to the nature of medical personal services which require Government supervision, the need for HCW access to CHCS/AHLTA, and patients that present only at the MTF, this contract does not lend itself to allow HCWs to telecommute. C.4. FAILURE AND/OR INABILITY TO PERFORM C.4.1. Should a HCW who accrues leave in accordance with section C.3.1 be unable to perform duties under any Task Order due to medical or physical disability for more than 13 consecutive days, that individual’s performance under the Task Order may be suspended by the Contracting Officer until such medical or physical disability is resolved. If performance under the Task Order is so suspended, no reimbursement shall be made to the Contractor for the affected HCW so long as performance is suspended. C.4.2. If clinical privileges or duties of a HCW have been summarily suspended or are being held in abeyance (per BUMEDINST 6320.66E (or latest version)), pending an investigation into questions of professional ethics or conduct, performance under the Task Order may be suspended until clinical privileges are reinstated. No reimbursement shall be made and no other compensation shall accrue to the Contractor for the affected HCW so long as performance is suspended or clinical privileges are held in abeyance. The denial, suspension, limitation, or revocation of clinical privileges based upon practitioner impairment or misconduct will be reported to the appropriate licensing authorities of the state in which the license is held IAW BUMEDINST 6320.66E (or latest version) and BUMEDINST 6320.67A CH01. C.4.3. Any HCW demonstrating impaired judgment will be removed from providing health care services. The Government reserves the right to remove any employee who, in the judgment of a licensed physician, is impaired by drugs or alcohol. C.4.4. Any HCW with alcohol or drug abuse problems may be allowed to return to work under the terms of this contract only with prior written approval from the Commanding Officer. C.5. GENERAL PROVISIONS FOR HCWS. C.5.1. Healthcare Workers shall comply with Executive Order 12731, October 17, 1990, (55 Fed. Reg. 42547), Principles of Ethical Conduct for Government Officers and Employees, and shall also comply with Department of Defense (DOD) and other government regulations implementing this Executive Order. C.5.2. Healthcare Workers shall be neat, clean, well groomed, and in appropriate clothing when in patient care and public areas. All clothing shall be free of visible dirt and stains and shall fit correctly. Fingernails shall be clean and free from dirt, and hair shall be neatly trimmed and combed. Healthcare Workers shall display an identification badge, which includes the HCW’s full name and professional status (furnished by the Government) on the right breast of the outer clothing. Security badges provided by the Government shall be worn when on duty. HCWs shall identify themselves as contract personnel in all meetings; telephone conversations; formal and informal written communication with government personnel. C.5.3. Healthcare Workers shall become acquainted with and obey all station regulations, shall perform in a manner to preclude the waste of utilities, and shall not use Government resources (i.e. copiers, telephone, and computers, N62645-11-R-0012 Page 24 of 118 etc.) for personal business. All motor vehicles operated on these installations by HCWs shall be registered with the base security service according to applicable directives. Eating by HCWs is prohibited in patient care areas/clinics and is restricted to designated areas. Smoking is prohibited in all clinic facilities. C.5.4. The Contractor and all HCWs shall comply with all MTF checkout processes. These processes include returning government property, i.e., identification badges, pagers, cellular phones, etc., to the MTF upon a HCW’s last day of service. Failure to do so promptly may result in delay of payment to the Contractor. C.5.5. Except as provided in this clause and in section H, HCWs are not prohibited from conducting a private practice of their professions or from engaging in other employment. However, the HCWs shall not, simultaneously with performance under this contract, engage in other employment that creates a conflict of interest, violates federal law (see Section H), or potentially compromises the quality of their work under this contract. Further, such private practice or other employment shall not be conducted during those hours in which the HCW is required to render services under this contract. Healthcare Workers shall make no use of the Government facilities or property provided under this contract in connection with other employment. (NAVMED P-117, Chapter 1, Article 1-22 applies http://www.med.navy.mil/directives/Pages/NAVMEDP-MANMED.aspx) C.5.6. While on duty, HCWs shall not advise, recommend, or suggest to individuals authorized to receive services at Government expense that such individuals should receive services from the HCW when they are not on duty, or from a partner or group associated in practice with the Contractor, except with the express written consent of the Commanding Officer. The Contractor shall not bill individuals entitled to those services rendered pursuant to this contract. C.5.7. The Secretary of the Navy has determined that the illegal possession or use of drugs and paraphernalia in a military setting contributes directly to military drug abuse and undermines Command efforts to eliminate drug abuse among military personnel. The policy of the Department of the Navy (including the Marine Corps) is to deter and detect drug offenses on military installations. Measures to be taken to identify drug offenses on military installations, and to prevent introduction of illegal drugs and paraphernalia, include routine random inspection of vehicles while entering or leaving, with drug detection dogs when available, and random inspection of personal possessions on entry or exit. If there is probable cause to believe that a HCW has been engaged in use, possession, or trafficking of drugs, the HCW may be detained for a limited period of time until he/she can be removed from the installation or turned over to local law enforcement personnel having jurisdiction. When illegal drugs are discovered in the course of an inspection or search of a vehicle operated by a HCW, the HCW and vehicle may be detained for a reasonable period of time necessary to surrender the individual and vehicle to appropriate civil law enforcement personnel. Action may be taken to suspend, revoke, or deny clinical privileges as well as installation driving privileges. Implicit with the acceptance of this contract is the agreement by the HCW to comply with all Federal and State laws as well as regulations issued by the Commander of the military installation concerning illegal drugs and paraphernalia. C.5.8. All financial, statistical, personnel, and technical data which are furnished, produced, or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. Such data shall not be released by the Contractor without prior written consent of the COR. Any presentation of any statistical or analytical materials, or any reports based on information obtained from studies covered by this contract, will be subject to review and approval by the COR before publication or dissemination. C.5.9. The Contractor shall comply with all applicable Government instructions and policies. C.5.10. Contract staff shall participate in executing the Emergency Preparedness Plan (drills and actual emergencies) as scheduled by the MTF (typically semiannually). A MTF personnel re-call list with personal contact information for all military, federal service, and Contractor staff is required to prepare in advance for an actual emergency. Upon commencement of performance, the Contractor shall provide the COR with a list of personal contact information for a designated Contractor representative as well as all Contractor staff performing services. The Contractor shall provide an updated list to the COR bimonthly. Should an emergency occur that will affect the HCWs’ shifts, the designated Contractor representative and the HCWs will be contacted. In the event of an actual emergency, essential N62645-11-R-0012 Page 25 of 118 Contractor personnel may be required to remain on duty or to return to duty in order to maintain continuity of patient care services. C.5.11. Healthcare Workers providing services under this contract shall arrive for each scheduled shift in a well- rested condition and shall have had at least 6 hours of rest from all other duties as a HCW immediately prior to reporting for the shift. C.5.12. HCWs who demonstrate a health or safety risk to patients or staff may be immediately removed from service. In the event of such a removal, the Contracting Officer will request a corrective plan of action from the contractor and may issue a stop work order while the contractor's response, contractor's implementation of the plan, and/or any government investigation is pending. Removal of an HCW for the reasons above does not mitigate the contractor's obligations under this contract. C.5.13. Each HCW will be assigned to a primary location; however, the Government retains the right to assign the HCW to another location within a 25-mile commuting radius of their assigned MTF. HCWs shall receive notification two weeks prior to reassignment to locations within a 25-mile limit. The Government will consider the use of CLIN 0008 to reimburse HCWs for reassignment within a 25-mile limit on a case by case basis. C.6. PERSONNEL QUALIFICATIONS. The Contractor shall provide personnel having certain minimum levels of training and experience. General qualifications that apply to all HCWs are given in Section C.7. Specific qualifications for various labor categories are given in Section C.8. Additional and/or supplemental qualifications specific to a particular Task Order are contained in the applicable Task Order. Additional/supplemental qualifications may include, but are not limited to, experience, or other professional certifications appropriate to the particular labor category. C.7. GENERAL QUALIFICATIONS THAT APPLY TO ALL HCWS. C.7.1. Healthcare Workers shall read, write, speak, and understand the English language fluently and maintain good communication skills with patients and other health care personnel. C.7.2. Healthcare Workers shall be physically capable of standing and/or sitting for extended periods of time and capable of normal ambulation. C.7.3. Healthcare Workers shall be in good standing and under no sanction or suspension by the Federal Government. C.7.4. In order to carry out the duties required by the contract, all HCWs will be required to access Navy information technology networks/systems containing sensitive information. Only HCWs who are U.S. citizens can be granted access to Department of Navy (DON) Information Technology networks/systems and sensitive information (see Section H, Information Technology/Sensitive Information Security Requirements and Section J, Attachment AA Citizenship Requirements). C.7.5. Healthcare Workers shall represent an acceptable malpractice risk to the Government. C.7.6. Healthcare Workers shall be in good standing, and under no restrictions, with the state licensure board in any state in which a license is held or has been held within the last 10 years. C.7.7. Healthcare Workers shall maintain current certification in American Heart Association Basic Life Support (BLS) for Healthcare Providers; American Heart Association Healthcare Provider Course; American Red Cross CPR (Cardio Pulmonary Resuscitation) for the Professional Rescuer. Certification cards must display the American Heart Association, American Red Cross or Military Training Network emblem C.7.8. Healthcare Workers shall be current with and have completed all continuing education requirements specified by their professional licensure or certification. N62645-11-R-0012 Page 26 of 118 C.7.9 Occupational Health C.7.9.1. Within 60 days prior to performance of services by the HCW, the HCW shall obtain, at Contractor expense, documentation of required immunizations and physical testing, and a statement from the HCW's licensed medical practitioner or a report of a physical examination. The physical examination and immunization documentation shall indicate that the HCW is free from mental or physical impairments that would restrict the HCW from providing the services described herein. The requirements are provided on the HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM, the current version of which is available at: http://www2.nmlc.med.navy.mil/handbooks/Physical%20Exam%20and%20Immunization%20Form.pdf. The Contractor shall always obtain the current version from the web page and shall have the form completed in its entirety in accordance with its instructions. The facility shall identify any incumbent HCWs who are not required to complete this documentation after contract award. Declinations shall only be permitted based on either the HCW’s religious convictions or medical contraindications (as documented by a qualified health care provider). The Hepatitis B vaccine declination can be found on the World Wide Web at http://www.osha.gov/SLTC/etools/hospital/hazards/bbp/declination.html. C.184.108.40.206. Except for those workers who decline the Hepatitis B vaccine as described in C.7.9.1, the Hepatitis B requirements given in HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM provide that a HCW must either show a positive titer or demonstrate persistent non-response to the vaccine. A HCW may be approved for service at the MTF prior to achieving a Hepatitis B positive titer or demonstrating a persistent non-response according to the following provisions: C.220.127.116.11.1. A HCW must receive the first vaccination of his/her initial vaccination series prior to commencing service under the contract and must complete the series not later than 6 months after commencing service and, if a negative titer is obtained, must complete the second series within another 6 months; or C.18.104.22.168.2. A HCW who has completed his/her initial series and obtained a negative titer must commence his/her second vaccine series prior to commencing service and must complete the second series not later than 6 months after commencing service. C.22.214.171.124. Healthcare Workers approved according to the provisions above will be considered persistent non- responders until there is evidence to the contrary and will be counseled by a licensed practitioner regarding the implications of non-response. C.126.96.36.199. If a HCW fails to comply with the applicable schedule above, the Contractor shall replace the HCW if so directed by the contracting officer. C.7.9.2. Except as provided in paragraph C.7.9.3 and C.7.9.4, below, no medical tests or procedures required by the contract may be performed in the MTF. Expenses for all required tests and/or procedures shall be borne by the Contractor at no additional expense to the Government. C.7.9.3. Healthcare Workers shall agree to undergo personal health examinations and such other medical and dental examinations at any time during the term of this contract, as the Commanding Officer may deem necessary for preventive medicine, medical surveillance, performance improvement, or privileging purposes. These examinations will be provided by the Government. If the Contractor chooses, these examinations may be provided by private physician or dentist, at no expense to the Government. C.7.9.4. It is essential that HCWs be vaccinated annually against influenza according to BUMED and CDC guidelines aimed at reducing the impact of influenza disease in health care settings. The Government will provide the influenza vaccine free of charge. If the HCW chooses to be immunized by the Government, the HCW shall sign a waiver releasing the Government from the legal liability in accordance with local procedures and policies. Alternately, the HCW may obtain the vaccine at another facility, with the HCW bearing the total cost, and provide N62645-11-R-0012 Page 27 of 118 proof of vaccination to the Government. If the HCW declines vaccination, a signed declination form shall be provided to the Government in accordance with CDC recommendations and MTF policies. C.7.9.5. Healthcare Workers who do not show a positive antibody titer after immunization and appear to have a "non-immune" status must report varicella exposure to the COR . In accordance with CDC Recommendations, such HCWs may be removed from patient care duties beginning on the tenth day following exposure and remain away from work for the maximum incubation period of varicella (21 days). In this instance, personnel under this contract who accrue leave will be considered to be in a leave status; personnel under C.3.1.11 of this contract will be considered to be in a leave without pay (LWOP) status; and all other personnel must be replaced during this period to ensure maintenance of contractually required coverage. C.7.9.6. Prior to reporting for service at an MTF, each contract HCW shall be screened at contractor expense for risk of exposure to tuberculosis (TB) as part of the Health Examination and Immunization/Screening Requirement Form in C.7.9.1. If the HCW is determined to have a low risk of exposure, no further screening or testing is required under this contract. The initial screening may be waived, at the discretion of the MTF, if the contractor provides evidence of a prior low risk assessment by a licensed physician. If the initial screening results in a determination that the HCW has an increased risk of exposure to TB, the contractor is responsible for ensuring that the HCW receives targeted screening and testing in accordance with CDC Guidelines for Health-Care Settings and submitting timely records of subsequent screening or testing to the COR. C.7.9.7. BLOODBORNE PATHOGEN ORIENTATION PROGRAM. HCWs shall participate in the Command’s Bloodborne Pathogen Orientation Program. The HCW shall also participate in all required annual training and in periodic training for all procedures that have the potential for occupational exposure to bloodborne pathogens. C.7.9.8. MANAGEMENT OF HIV POSITIVE HCWs. HIV positive HCWs will be managed in accordance with the current CDC guidelines and Section 503 of the Rehabilitation Act (29 U.S.C. Section 793) and its implementing regulations (41 CFR Part 60-741). C.7.9.9. PREVENTION OF THE TRANSMISSION OF THE HIV VIRUS. HCWs shall comply with the CDC’s “Universal Precautions” for the prevention of the transmission of the HIV virus. C.7.9.10. MANAGING THE CLINICAL RISK IN THE WORK ENVIRONMENT. The work environment inherently involves risks typically associated with the performance of clinical procedures. The HCW may be exposed to contagious disease, infections and flying debris, requiring the wearing of personal protection equipment such as scrub attire, gloves, masks, and eye protection. C.7.10. CREDENTIALING REQUIREMENTS C.7.10.1 Upon receipt of a complete Individual Credentials File (ICF) or Individual Professional Files (IPF), the COR will forward it to the Medical Staff Services Office for approval and credentialing of the individual health care provider/worker. The Medical Staff Services Office will ensure the IPF is complete in accordance with BUMEDINST 6320.66E of 29 August 2006 and subsequent revisions. The Contractor shall not assign an individual to work at the MTF until the HCW’s ICF or IPF has been approved and shall discontinue the service of an individual who fails to maintain compliance with qualification and credentialing requirements. C.7.10.2 BUMEDINST 6320.66E is available at http://www.med.navy.mil/directives/Pages/ExternalDirectives.aspx. Click BUMED Directives and scroll down to the instruction number. The instruction is now contained in several separate files. C.7.10.3 Unless otherwise specified in an individual Task Order Proposal Request, the Government reserves the right to transfer to the gaining Contractor the credentials of a HCW who has been granted delineated clinical privileges on a predecessor contract/task order without a new or additional credentialing action. This extension may only occur: a) within the same command; b) when there is no increased clinical competency requirement of the N62645-11-R-0012 Page 28 of 118 HCW; c) when there is no significant change in the scope of clinical practice of the HCW; d) when there is no gap in performance between the contracts; and e) when the HCW has had acceptable performance evaluations. C.7.10.4 Notwithstanding licensure and certification requirements given below in Section C.8, each HCW is responsible for complying with all applicable licensure and certification regulations. C.7.10.5 The Contractor shall continuously maintain a current list of all individuals who have been privileged, credentialed, or approved for service under each task order. The Contractor shall provide a copy of the updated list to the COR monthly, or more often as requested by the COR. C.7.11. ORIENTATION C.7.11.1. Each HCW providing service under this contract or resultant Task Orders shall undergo an orientation and shall complete mandatory Navy and DoD on-line training as required. Orientation may be waived for personnel who have previously provided service at the treatment facility. DoD on-line training may require that the HCW enter their Social Security Number to document and track compliance with training requirements. C.7.11.2. Orientation shall consist of Command Orientation and Information Systems Orientation. Command orientation of up to 40 hours includes annual training requirements for topics such as but not limited to fire, safety, infection control, family advocacy, Chemical, Biological, Radiological, Nuclear, and Explosive Events (CBRNE) Basic Awareness, and various Navy required on-line trainings. Additional Command Orientation for nurses (local certifications) will comprise an estimated additional 28 hours. Information Systems Orientation of approximately 24 hours includes the Composite Health Care System (CHCS), Armed Forces Health Longitudinal Technology Application (AHLTA), and the Ambulatory Data System (ADS). In addition, HCWs identified as CHCS and/or AHLTA Super-users shall undergo an additional 8 hours of information systems orientation. Any additional or specific requirements for orientation will be provided in the applicable Task Order. C.7.11.3. Orientation will be provided to Contractor employees, as required, during initial regularly scheduled shifts under the task order or as specified in the task order. C.7.11.4. Those Contractor employees who are required to be oriented during initial regularly scheduled work shifts shall be scheduled by the Contractor for shifts occurring at times when orientation classes are available. The COR will provide a list of training times up to 30 days in advance. C.7.11.5. For each task order requiring services of an individual the Contractor shall not invoice for orientation, and the government will not reimburse the Contractor for orientation, until such time as the individual has provided an amount of clinical services equal to the amount of orientation received. The HCW shall complete all orientation within 60 days after commencement of services by the HCW. C.7.12. Turnover of HCWs. The Contractor shall recognize the potentially negative impact on continuity of care created by staff turnover and the expense incurred by the Government for orientation and privileging of new workers. Therefore, the Contractor shall make every effort to minimize turnover and, notwithstanding Contractor employee probation policies, shall recruit only individuals who indicate interest in a long-term commitment under the contract and task order. C.7.13. HCWs shall possess basic computer skills. The Contractor shall provide a completed Computer Competency Form for each health worker (Attachment AF). The Computer Skills Competency Form shall be provided with the candidate’s credentials or qualification package. C.8. SPECIFIC QUALIFICATIONS FOR LABOR CATEGORIES. Experience will be addressed in the task order for each labor category. N62645-11-R-0012 Page 29 of 118 C.8.1. CURRENT COMPETENCY. Each HCW requesting clinical privileges shall have clinical experience within the past 2 years to demonstrate clinical competency in the clinical discipline required by the contract and/or task order (e.g., Advance Practice Nurses). C.8.2 All Advance Practice Nurses shall comply with the applicable Utilization Guideline listed below: C.8.2.1. BUMEDINST 6550.10A, Utilization Guidelines for Nurse Practitioners C.8.2.2. BUMEDINST 6550.11, Utilization Guidelines for Nurse Midwives C.8.2.3. BUMEDINST 6550.7A for Nurse Anesthetists. C.8.3 ADVANCE PRACTICE NURSE. C.8.3.1. ADVANCED PRACTICE NURSE (Also known as Credentialed Health Care Practitioners) the Healthcare Worker shall: C.188.8.131.52. Possess a Master’s, Post-Master’s or Doctorate degree from an advanced practice nursing program accredited by the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE). C.184.108.40.206. Possess current unrestricted license to practice as an Advance Practice Nurse in one of the fifty states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands. C.8.3.2. CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) C.220.127.116.11. Be a graduate of a Certified Registered Nurse Anesthetist (CRNA) education program accredited by the American Association of Nurse Anesthetists (AANA) Council on Accreditation of Nurse Anesthesia Educational Programs. C.18.104.22.168. Possess and maintain a current certification by the relevant certification body for the given advanced practice nursing specialty. National certification must be obtained within 12 months of graduation from an approved program. C.8.3.3. CERTIFIED NURSE MIDWIFE (CNM) C.22.214.171.124. Be a graduate of a Certified Nurse Midwife Education Program accredited by the American College of Nurse-Midwives. C.126.96.36.199. Possess and maintain a current certification by the American Midwifery Certification Board. C.8.4. NURSING. C.8.4.1 LICENSED VOCATIONAL NURSE (LVN) C.188.8.131.52. Possess a current unrestricted license to practice as an LVN in any one of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands. C.184.108.40.206. Prior to commencing services, Licensed Practical (Vocational) nurses shall attend a 2-hour lecture on IV certification. Contractor nurses shall then obtain certifications (e.g., IV, medications and blood administration) in accordance with clinic nursing service and command policy not later than 60 days after commencement of services, including MTF observation of three completed IV sticks. C.8.4.2. REGISTERED NURSE (RN) N62645-11-R-0012 Page 30 of 118 C.220.127.116.11. Possess a Baccalaureate Degree in Nursing or an Associate Degree in Nursing or a Diploma from a Nursing Program accredited by the National League for Nursing Accrediting Commission (NLNAC). C.18.104.22.168. Possess and maintain a current unrestricted license to practice as a registered nurse in any one of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands. C.22.214.171.124. Prior to commencing service, at Naval Medical Center San Diego, under this contract, Registered Nurses shall attend a 2-hour lecture on IV certification. Registered nurses shall then obtain certifications (e.g., IV, medications and blood administration) in accordance with clinic nursing service and command policy not later than 60 days after commencement of services, including MTF observation of three completed IV sticks during this time. C.8.4.3. REGISTERED NURSE, CASE MANAGER In addition to C.8.4.2 the HCW shall: C.126.96.36.199. Possess and maintain a current certification from one of the following accredited organizations: Commission for Case Manager Certification Certified Case Manager (CCM) Certification of Disability Management Specialists Commission : Certified Disability Management Specialist (CDMS) Association of Rehabilitation Nurses : Certified Rehabilitation Registered Nurse (CRRN) American Board for Occupational Health Nurses Certified Occupational Health Nurse (COHN) National Board for Certification in Continuity of Care: Advanced Certification in Continuity of Care (ACCC) Commission on Rehabilitation Counselor Certification: Certified Rehabilitation Counselor (CRC) American Nurses Credentialing Center Nurse Case Manager (RN-NCM) National Academy of Certified Care Managers: Care Manager Certified (CMC) OR C.188.8.131.52. Possess a Masters Degree in Nurse Case Management from a program accredited by the American Nurses Credentialing Center (ANCC). The HCW is required to obtain any one of the above certifications within 6-months of contract start. C.9. GENERAL DUTIES. Contractor personnel shall perform a full range of duties consistent with their labor category, education, training, experience, clinical privileges (as applicable), and assigned position. General duties that apply to all personnel or across certain labor categories are given below. Additional and/or supplemental duties which are labor category specific, service area specific, or facility specific, including duties such as on-call or hospital admissions, are contained in Section C.10, C.11 and in the specific Task Order. Duties that apply to all Contractor personnel are as follows: C.9.1. Maintain a level of productivity comparable with that of other individuals performing similar services. C.9.2. Comply with the standards of the Joint Commission, applicable provisions of law, and the rules and regulations of any and all governmental authorities pertaining to licensure and regulation of health care personnel and medical treatment facilities, the regulations and standards of medical practice of the MTF and the bylaws of the MTF’s medical staff. Adhere to and comply with all Department of the Navy, Bureau of Medicine and Surgery and local instructions and notices which may be in effect during the term of the contract. C.9.3. Participate in peer review and performance improvement activities. N62645-11-R-0012 Page 31 of 118 C.9.4. Practice aseptic techniques as necessary. Comply with infection control guidelines to include the proper handling, storage, and disposal of infectious wastes, the use of universal precautions to prevent the spread of infections. C.9.5. Function with an awareness and application of safety procedures. C.9.6. Perform efficiently in emergency patient situations following established protocols, remaining calm, informing appropriate persons, and documenting events. Anticipate potential problems/emergencies and make appropriate interventions. Notify supervisor, director, or other designated person regarding problems that the HCW is unable to manage. C.9.7. Apply an awareness of legal issues in all aspects of patient care and strive to manage situations in a reduced risk manner. C.9.8. Participate in the implementation of the Family Advocacy Program as directed. Participation shall include, but not be limited to, appropriate medical examination, documentation, and reporting. C.9.9. Exercise awareness and sensitivity to patient/significant others' rights, as identified within the institution. C.9.10. Maintain an awareness of responsibility and accountability for own professional practice. C.9.11. Participate in continuing education to meet own professional growth. C.9.12. Attend annual renewal of hospital provided annual training such as family advocacy, disaster training, infection control, sexual harassment, and bloodborne pathogens. C.9.13. Actively participate in the command’s performance improvement program. Participate in meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist. C.9.14. Participate in the provision of in-service training to clinic staff members. Provide training and/or direction as applicable to supporting Government employees (e.g., hospital corpsmen, students, etc.). C.9.15. Attend and participate in various meetings as directed. C.9.16. Perform timely, accurate, and concise documentation of patient care. C.9.17. Use computerized systems such as CHCS, AHLTA, ADS, and Clinical Information System (CIS). C.9.18. Operate and manipulate automated systems such as CHCS, AHLTA, participate in clinical staff Performance Improvement (PI) and Risk Management (RM) functions, as prescribed by the Commander. Maintain DoD email account as directed. The HCW is responsible for all email and voicemail communications. C.9.19. Exercise appropriate delegation of tasks and duties in the direction and coordination of health care team members, patient care, and clinic activities. C.9.20. HIPAA Compliance. The HCW shall comply with the HIPAA (Health Insurance Portability and Accountability Act) privacy and security policies of the treatment facility. Providers shall obtain/maintain a National Provider Identifier (NPI) in accordance with DOD and MTF policy/instruction as applicable. C.10. SPECIFIC DUTIES. The following specific labor category duties are additional to the general duties given in Section C.9 and may be further supplemented by specific duties contained in the applicable task order. N62645-11-R-0012 Page 32 of 118 C.10.1.ADVANCE PRACTICE NURSE C.10.1.1. Provide a full range of nurse practitioner services in accordance with the core privileges as defined by the BUMEDINST 6320.66E and approved by the Commanding Officer (e.g., supervise and provide general screening and medical care and examinations of patients for routine, acute and chronic conditions involving any and all organ systems; provide immunizations; diagnose, treat, and counsel patients as indicated). C.10.1.2. Adhere to BUMEDINST 6550.10A, Utilization Guidelines for Nurse Practitioners OR BUMEDINST 6550.11, Utilization Guidelines for Nurse Midwives, OR BUMEDINST 6550.7A for Nurse Anesthetists. These instruction includes the following requirements: permits nurse practitioner ordering and administration approved list of drugs according to protocol, and requires random review of records of patients seen by the nurse practitioner. Utilization Guides for each labor category mentioned above is available at http://www.med.navy.mil/directives/Pages/ExternalDirectives.aspx. Click BUMED Directives and scroll down to the applicable instruction number. C.10.1.3. Promote economical ordering and utilization of equipment, supplies, and lab and radiological studies. C.10.1.4. Technically direct and teach other staff, provide educational lectures and participate in in-service training to staff members. Such direction and interaction will conform to Government and professional clinical standards and accepted clinical protocols and includes signing training evaluations for students assigned to the Women’s Health Service. This requirement is consistent with the personal services nature of this contract. C.10.1.5. Always promote preventive care and health maintenance including annual physicals, positive health behaviors and self-care through both formal and individual education and counseling. C.10.1.6. Recognize conditions that require isolation and ensure universal precautions are used in all patient encounters. C.10.1.7. Perform administrative and educational duties that directly-contribute to timely and efficient service and maintain the optimum standard of care. Administrative responsibilities include the preparation of morbidity and mortality reports, and coordinating risk management activities. C.10.1.8.Attend staff meetings to provide case discussion, continuing education, and continuous quality improvement. C.10.1.9. Become familiar with the Military/Medical Treatment Facilities formulary. Providers authorized to prescribe pharmaceuticals shall do so according to the availability of drugs listed therein. C.10.2. CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) C.10.2.1.Administer anesthesia to any patient undergoing a surgical procedure, as designated by the attending physician. C.10.2.2.Perform a pre-anesthetic assessment and evaluation of the patient. This includes obtaining an informed consent from the patient, requesting consultations and/or diagnostic studies and ordering pre-anesthetic medications. C.10.2.3. Develop and implement an anesthetic plan of care. C.10.2.4. Perform an assessment immediately prior to induction of anesthesia of the patient. This shall include a review of the medical record with regard to completeness, pertinent laboratory data, time of administration and dosage of pre-anesthesia medication, together with an appraisal of any changes in the patient's condition from that noted on previous visits. This note shall include any previous anesthetic experiences and complications thereof noted in the medical record. N62645-11-R-0012 Page 33 of 118 C.10.2.5. Initiate the anesthetic plan by selecting the type of anesthesia. C.10.2.6. Obtain consultations, as appropriate, with a staff anesthesiologist (i.e., patients meeting ASA classification 3 or greater; pediatric patients less than 3 months old). C.10.2.7. Maintain the patient's physiologic homeostasis and corrects abnormal responses to the anesthesia and/or surgery. C.10.2.8. Collect and interpret patient physiological data by selecting, applying or inserting noninvasive monitoring modalities. C.10.2.9. Manage the patient's airway and pulmonary status. C.10.2.10. Manage the patient's emergence and recovery from anesthesia by maintaining homeostasis, providing relief from pain and anesthesia side effects and preventing and managing complications through selecting, obtaining, ordering and administrating medications, fluids or ventilatory support. C.10.2.11. Remain with the patient as long as required by the patient's condition relative to his/her anesthesia status and until responsibility for proper patient care has been assumed by other qualified individuals. Personnel responsible for post-anesthetic care are to be advised of specific problems presented by the patient's condition. C.10.2.12. Record all pertinent events taking place during the introduction of, maintenance of and emergence from anesthesia, including the dosage and duration of all anesthetic agents, other drugs, intravenous fluids and blood or blood components on all patients that have received anesthesia care. C.10.2.13. Record post-anesthetic visits, including at least one note describing the presence or absence of anesthesia related complications within 48 hours of the procedure. While the number of visits will be determined by the status of the patient in relation to the procedure performed and the anesthetic administered, a visit should be made early in the postoperative period. C.10.2.14. Discharge or release from PACU according to established criteria. Provide follow-up evaluation and care related to anesthesia complications and/or side effects. C.10.2.15. In his/her observation, if the CRNA feels that an anesthetic will put the patient's life in jeopardy, then this condition must be discussed with the operating surgeon or the Head, Anesthesiology Department (or designated representative). The CRNA can rightfully and legally decline to administer an anesthetic to a patient in this category without repercussion. The choice of anesthetic should be discussed with the operating surgeon. C.10.2.16. Check all equipment and agents to be used in the administration of the anesthetic to be sure it is in safe working order. Report all malfunctioning equipment to the Head, Anesthesiology Department or Chief Nurse Anesthetist. C.10.2.17. Check all resuscitative equipment prior to the beginning of the first surgery of the day. Any malfunctioning or missing equipment shall be reported to the Head, Anesthesiology Department or Chief Nurse Anesthetist immediately. C.10.2.18. Provide care appropriate to the age of the patients served. Interpret data about the patient's status in order to identify each patient's age specific needs and provide the care needed by the patient group including neonate, pediatric, adolescent and geriatric patients, such as interpreting nonverbal communication, safety practices and medication dosing of Neonates/Pediatrics; enlisting Adolescent patients in treatment, safety and security practices; and recognizing physical limitations, psychosocial needs, age related conditions, safety and medication precautions for geriatrics. C.10.3. CERTIFIED NURSE MIDWIFE (CNM) N62645-11-R-0012 Page 34 of 118 C.10.3.1. Provide comprehensive primary care to a select population of essentially healthy women and their babies in a variety of settings to include prenatal care, intrapartum management, postpartum care, immediate newborn care, and well-woman visits. C.10.3.2. Participate in the care of women with medical complications in collaboration with Obstetricians- Gynecologists. C.10.3.3. Manage the care of normal antepartum women to include teaching, counseling and support. C.10.3.4. Collect, document, and evaluate patient data. Take health history and perform and record the obstetrical physical evaluation. C.10.3.5. Assess patient needs and formulate and implement a plan of care for each patient consistent with established guidelines. C.10.3.6. Operate support, consultation or collaborative management for those patients and families experiencing critical illness and/or potential death. C.10.3.7. Manage labor, including teaching and support. C.10.3.8. Perform the following: start intravenous infusions; administer analgesia according to standing orders; manage and control normal spontaneous deliveries; record the labor and delivery. C.10.3.9. Perform and record physical evaluation of newborns. C.10.3.10. Manage the care of normal newborn including nutrition, elimination and activity. C.10.3.11. Maintain all required patient records and reports pertinent information. C.10.3.12. Prepare and submit all reports and statistics in a timely manner. C.10.3.13. Keep current in nursing practice within the nurse Midwife specialty in accordance with the criteria of the American College of Nurse-Midwives. C.10.4. FAMILY NURSE PRACTITIONER C.10.4.1. Analyze the results of the health care plan, modify the health care plan as needed, and implement and participate in follow-up. C.10.4.2. Participate in meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist. Should a meeting occur outside of the HCW’s regular working hours, the HCW shall be required to read and initial the minutes of the meeting. C.10.4.3. Participate in the provision of monthly in-service training to non-health care-practitioner members of the clinical and administrative staff on subjects germane to the HCW’s specialty. C.10.4.4. Provide for an optimum physical environment for patients and staff, emphasizing good safety practices and cleanliness. C.10.4.5. Support preventive maintenance and report equipment failures and inadequacies. C.10.4.6. Promote economical utilization of equipment, supplies and be cost conscious when ordering lab and radiological studies. N62645-11-R-0012 Page 35 of 118 C.10.4.7. Know the location and operation of emergency equipment. C.10.4.8. Adhere to departmental and hospital safety guidelines. C.10.4.9. Attend Boards and Committees, Continuing Education, and Quality Assurance Functions consistent with the requirements of the position. C.10.5. NEONATAL NURSE PRACTITIONER C.10.5.1. Provide comprehensive medical assessment, examination, consultation, diagnosis, and treatment plan for neonates, under the direction of a staff Pediatrician. C.10.5.2. Provide medical management of neonates in the Nursery and Level II Nursery and other areas to include neonatal resuscitation, conventional ventilation, stabilize and maintain Level III care prior to transport, prescription of medications (including controlled substances), to treat neonatal medical disorders, under direction of a staff Pediatrician. C.10.5.3.Request and interpret laboratory tests, electrocardiograms, and radiographic procedures, and other tests as needed under the direction of staff Pediatricians. C.10.5.4. Perform procedures including sedation, endothracheal intubation, routine phlebotomy, arterial phlebotomy, percutaneous central venous line placement, umbilical line placement, lumbar puncture, suprapubic bladder taps, bladder catherization, needle thoracentesis, chest tube placement, circumcision as deemed appropriate under the supervision of the staff Pediatrician. C.10.5.5. Attend routine and high-risk deliveries as a member of the Resuscitation Team and perform Neonatal Resuscitation. C.10.5.6. Provide medical care to neonates awaiting transport to other facilities and from other higher level of care NICUs, under direction of a staff Pediatrician. C.10.5.7.Provide outpatient care for routine well baby appointments, NICU follow-up appointments. C.10.5.8. (NMC San Diego only) Provide instruction to students and resident physicians rotating through the nursery at NMC San Diego, CA. C.11. NURSING, (REGISTERED AND LICENSED VOCATIONAL/PRACTICAL). The following specific labor category duties are additional to the general duties given in Section C.9 and may be further supplemented by specific duties contained in the applicable task order. C.11.1. HEALTH EDUCATOR C.11.1.1. Review Health Enrollment Assessment Review (HEAR) reports and PCM reports for high risk and frequent users of health care. Contact these patients to schedule education opportunities in a classroom format, in one on one appointments, or through other appropriate means. C.11.1.2. Review HEAR Reports and PCM reports for delinquent preventive services, contact the patient, and schedule an appointment for the clinical preventive service. Ensure that all enrollees receive their clinical preventive services at recommended age intervals. C.11.1.3. Use the HEAR group data to determine the health risk of the population and how to improve the overall health of the enrolled population. N62645-11-R-0012 Page 36 of 118 C.11.1.4. Educate the enrolled population about the Healthwise handbook and how to use it for home care. C.11.1.5. Use the PPIP Flow Sheet DD2766 medical records form for documenting clinical preventive services. C.11.1.6. Provide health promotion and education opportunities including, but not limited to, tobacco awareness; tobacco cessation classes or appointments consistent with the MTF tobacco cessation program; and nutrition education and weight management. C.11.2. LACTATION CONSULTANT C.11.2.1. Actual clinical performance will be a function of the Commanding Officer’s credentialing process and the overall demand for Clinical Lactation Consultant services. Productivity is expected to be comparable with that of other Lactation Consultants assigned to the same facility and authorized the same scope of practice. C.11.2.2. The HCW shall obtain and document patient and pertinent family history. Orient new patients and their families as required. C.11.2.3. The HCW shall receive patient assignments, formulate, document, and implement a care plan for assigned patients and review and update them as required. C.11.2.4. The HCW shall check patient identification, physician’s orders, preadmission and transfer information as applicable. C.11.2.5. The HCW shall requisition and arrange for ordered diagnostic and therapeutic services as directed. C.11.2.6. The HCW shall provide antepartum, intrapartum, and postpartum classes on breastfeeding, breast care, and related topics to inpatients and/or outpatients in a group or one on one. C.11.2.7. The HCW shall provide clinical oversight activities of military and civilian staff who provide breastfeeding support to antepartum, intrapartum, and postpartum patients who require breastfeeding support throughout the facility. C.11.2.8. The HCW shall assess and evaluate lactation education for mother-infant in response to written requests by nursing and medical staff. C.11.2.9. The HCW shall serve as a liaison between patient and physician, as well as between hospital and the fleet, and the community. C.11.2.10. The HCW shall provide staff education and training in breastfeeding/lactation within the Maternal Child Product Line. C.11.2.11. The HCW shall assist in responding to calls placed to the WARM LINE message center. C.11.2.12. The HCW shall plan, teach and evaluate classes for expectant and new breastfeeding mothers. C.11.2.13. The HCW shall create a milieu that promotes learning for staff and patients. C.11.2.14. The HCW shall consult with mothers having breastfeeding problems. C.11.2.15. Conduct quality assurance programs to monitor the caliber of the program. C.11.2.16. Perform other duties related to lactation and mother-baby services as assigned. C.11.3. LICENSED PRACTICAL/VOCATIONAL NURSE N62645-11-R-0012 Page 37 of 118 C.11.3.1. Ensure patient care is carried out in accordance with the Standards of Nursing Care and the policies and procedures of the clinic. C.11.3.2. Check patients into the clinic and triage using clinic guidelines. Inform the nurse or physician of the patient’s condition and potential problems. C.11.3.3. Obtain and document patient and pertinent family history. C.11.3.4. Perform a full range of diagnostic support duties which include taking vital signs, collecting specimens, obtaining, recording and tracking results of diagnostic tools. C.11.3.5. Assist the physician in a variety of diagnostic examinations such as lumbar punctures, colposcopies and sigmoidoscopies, by preparing, positioning and monitoring patients, and setting out and handling instruments and equipment. C.11.3.6. Perform laboratory tests such as checking urine for sugar and stool for blood. Record and report results of test. C.11.3.7. Perform a range of treatment procedures that include sterile dressing changes, applying compresses, monitoring IV fluids, inserting catheters and suctions, inserting nasogastric tubes, administering medications, giving enemas, setting up and giving treatment that requires auxiliary equipment such as oxygen and suction. Ambulate patients to other areas to include Radiology, various clinics, and physical therapy. C.11.3.8. Prepare patients for tests, examinations, treatments, and/or surgery. Collect specimens such as urine, sputum and stool. Label specimens for laboratory examinations and follow up by using CHCS/AHLTA or calling the laboratory for reports. Alert provider to conditions which deviate from expected findings. C.11.3.9. Prepare, start, monitor and discontinue intravenous fluids with accuracy and in accordance with established procedures. C.11.3.10. Observe, report and document all observed symptoms, reactions, treatments and changes in the patient condition to the registered nurseor physician. Make careful observations to assess that nursing procedures and treatment do not cause additional distress. C.11.3.11. Perform routine nursing care activities such as taking blood pressures, temperatures, baths and hygiene care, passing and removal of trays, changing of linen, and otherwise assist in the care of the physical needs of the patient. C.11.3.12. Operate basic equipment required in delivery of patient care such as pumps, IV pumps, oxygen administration apparatus and incentive spirometers. C.11.3.13. Execute physician’s orders within the guidelines of standard nursing practice. Ensure accurate medication is administered in correct form and dosage to the proper patient as directed by the physician. C.11.3.14. Maintain records of nursing care, dose and time of medication administered, and indicate if the medication was not administered and the reason. C.11.3.15. Administer immunizations in a safe and accurate manner with strict adherence to all Military/Medical and DoD Treatment Facilities and CDC Immunization policies. C.11.3.16. Recognize conditions which require isolation. Ensure universal precautions are used in all patient encounters. N62645-11-R-0012 Page 38 of 118 C.11.3.17. Recognize emergency situations and assist with, or institute emergency measures for sudden adverse developments in patients such as cardiac arrests. C.11.3.18. Perform preoperative procedures for minor surgery, and fill out pre-op checklist. C.11.3.19. Assist patients in admission, transfer, and perform discharge planning follow-up and documentation. C.11.3.20. Support the patient and/or family members toward the achievement of treatment plan goals. Provide instructions to the patient on invasive procedures, surgical procedures and post surgical conditions which were previously provided to the patient by a nurse or physician. C.11.3.21. Instruct patients on how equipment is used such as oxygen, suction, cardiac monitor and pulse oximeter. Instruct patients and family on use of prescribed medications, contraindications of medications, and the necessity of proper follow-up care. C.11.3.22. Provide emotional support to patients and families. C.11.3.23. Ensure necessary supplies are available and equipment is in functioning order. C.11.3.24. Provide an orderly, clean and safe environment for patients and staff. C.11.3.25. Handle telephone information requests with courtesy, accuracy and respect for patient confidentiality. Receive information and distribute messages as necessary. C.11.3.26. Ensure maintenance and re-supply of pharmaceuticals in the clinic. C.11.3.27. Ensure upkeep and perform checks of emergency equipment i.e., oxygen, emergency cart, suction apparatus, etc. and maintain appropriate logs. Inform the Charge Nurse of any discrepancy on daily checks. C.11.4.REGISTERED NURSE. Perform a full range of RN duties in accordance with assignment under the task order, including: triage; patient assessment and monitoring; use of patient monitoring and treatment equipment; appropriate nursing care, procedures, and treatments; execution of physicians’ orders within the guidelines of standard nursing practice; documentation of patient care and observations; and patient education and emotional support. C.11.4.1. Assess each patient and perform triage duties as assigned. C.11.4.2. Formulate and carry out a goal directed plan of care which based on determined nursing diagnosis and patient outcomes and which is prioritized according to patient needs and available resources including time, personnel, equipment, and supplies. C.11.4.3. Evaluate effectiveness of self care given by all health team members, and contribution of systems, environment, and instrumentation in progressing patient toward outcomes. C.11.4.4. Provide treatment and discharge instructions upon patient release. C.11.4.5. Perform assessment/data collection in an ongoing and systematic manner, focusing on physiological, psychological, and cognitive status. C.11.4.6. Provide a safe and clean environment for each patient. C.11.4.7. Identify patient/significant other learning needs and implement appropriate measures to meet identified needs. N62645-11-R-0012 Page 39 of 118 C.11.4.8. Assist in planning, provide clinical direction and provide instruction to LPNs/LVNs, nursing assistants and ancillary personnel. C.11.5. REGISTERED NURSE, CASE MANAGER. C.11.5.1. Participate in all phases of the Case Management Program (CMP) and ensure that the CMP meets established case management (CM) standards of care. Assist in coordinating a multidisciplinary team to meet the health care needs, including medical and/or psychosocial management, of specified patients. C.11.5.2. Serve as consultant to all disciplines regarding CM issues. Provide nursing expertise about the CM process, including assessment, planning, implementation, coordination, and monitoring. Identify opportunities for CM and identify and integrate local CM processes. C.11.5.3. Develop and implement local strategies using inpatient, outpatient, onsite and telephonic CM; develop and implement policies and protocols for home health assessments and outcome measures. C.11.5.4. Develop and implement tools to support case management, such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, CM software, databases for community resources, etc. C.11.5.5. Integrate CM and utilization management (UM) and integrate nursing case management with social work case management. Prepare routine reports and conduct analyses. C.11.5.6. Assist in establishing and maintaining liaison with appropriate community agencies and organizations, the TRICARE Lead Agent office, and the Managed Care Support Contractor. C.11.5.7. Maintain adherence to JCAHO, URAC, CMSA and other regulatory requirements. Apply medical care criteria (e.g., InterQual). C.11.5.8. Ensure accurate collection and input of patient care data and ensure basic CM budgetary management. C.11.5.9. Provide input on MTF CM resources and make recommendations to the Command as to how those resources can best be utilized. C.11.5.10. Collaborate with the multidisciplinary team members to set patient-specific goals. Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions to ensure continuity of care toward the goal of optimal wellness. C.11.5.11. Establish and implement mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community health care settings. C.11.5.12. Provide nursing advice and consultation in person and via telephone. C.11.5.13. Ensure appropriate health care instruction to patient and/or caregivers based on identified learning needs. C.11.5.14. Alert physicians to significant changes or abnormalities in patients and provide information concerning their relevant condition, medical history and specialized treatment plan or protocol. C.11.5.15. Facilitate multidisciplinary discharge planning and other professional staff meetings as indicated for complex patient cases and develop a database and knowledge of local community resources. C.11.5.16. Develop and implement mechanisms to evaluate the patient, family and provider satisfaction and use of resources and services in a quality-conscious, cost-effective manner. N62645-11-R-0012 Page 40 of 118 C.11.5.17. Implement strategies to ensure smooth transition and continued health care treatment for patients when the military member transfers out of the area. Develop a policy for, and assist with, region-to-region transfers. C.11.5.18. Facilitate screening and assist with transfers of Exceptional Family Member Program (EFMP) families. C.11.5.19. Plan for professional growth and development as related to the case manager position and maintenance of CM certification. Actively participate in professional organizations including participation in at least one annual national CM conference to be funded by the Government to be scheduled at the convenience of the government if funding, location and time permit. C.11.5.20. Establish cost containment/cost avoidance strategies for case management and develop mechanisms to measure its cost effectiveness. C.11.5.21. Assist with the CHCS/AHLTA CM interface or other database designed to support CM. C.11.5.22. Participate in video teleconferences (VTCs) and other meetings as required. C.11.6. REGISTERED NURSE, UTILIZATION MANAGEMENT Participate in all phases of the Utilization Management Program (UMP) and ensure that the UMP meets established Utilization Management (UM) standards of care. Assist in coordinating a multidisciplinary team to meet the health care needs, including medical and/or psychosocial management, of specified patients. Perform a full range of utilization management services including referrals, care coordination, utilization review, discharge planning, continued stay reviews, and appeal reviews. C.11.6.1. Serve as consultant to all disciplines regarding UM issues. Provide nursing expertise about the UM process, including assessment, planning, implementation, coordination, and monitoring. C.11.6.2. Collect and analyze clinical utilization data to identify information on resource consumption and outcomes of care. C.11.6.3. Develop and implement tools to support utilization management, such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, UM software, databases for community resources, etc. C.11.6.4. Prepare routine reports and conduct analyses relating to Utilization Management initiatives. C.11.6.5. Assist in establishing and maintaining liaison with appropriate community agencies and organizations, the TRICARE Regional Office, and the Managed Care Support Contractor. C.11.6.6. Maintain adherence to JCAHO, URAC (Utilization Review Accreditation Commission), CMSA (Case Management Society of America) and other regulatory requirements. Apply medical care criteria (e.g., InterQual). C.11.6.7. Establish and implement mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community health care settings. C.11.6.8. Coordinate patient care by obtaining necessary clinical information from referring provider. C.11.6.9. Alert physicians to significant changes or abnormalities in patients and provide information concerning their relevant condition, medical history and specialized treatment plan or protocol. C.11.6.10. Participate in multidisciplinary discharge planning and other professional staff meetings as indicated for complex patient cases and develop a database and knowledge of local community resources. N62645-11-R-0012 Page 41 of 118 C.11.6.11. Plan for professional growth and development as related to the utilization manager position and maintenance of UM certification. Actively participate in professional organizations including participation in at least one annual national UM conference to be funded by the Government if funding, location and time permit. C.11.6.12. Establish cost containment/cost avoidance strategies for utilization management and develop mechanisms to measure its cost effectiveness. C.11.6.13. Assist with the Composite Health care System CHCS/AHLTA UM interface or other database designed to support UM (Enterprise-Wide Referral and Authorization System (EWRAS) and Canopy). C.11.6.14. Participate in video teleconferences (VTCs) and other meetings as required. C.11.7. REGISTERED NURSE, LABOR AND DELIVERY Provide nursing care to routine and high-risk Obstetrical patients including newborns during the transition period within assigned inpatient unit based on relevant specialty care standards. C.11.7.1. Establish priorities of patient care based on triage, nursing diagnosis, essential patient needs and outcomes. C.11.7.2. Collaborate with multi-disciplinary team in assessing the effectiveness of existing therapies and interventions for patients with illnesses, their families and significant others. C.11.7.3. Apply understanding and operation of specialty equipment. Maintain a safe patient care environment. Monitor and troubleshoot equipment assuring appropriate patient response. Provide intervention when indicated. C.11.7.4 Ensure upkeep, perform checks and maintain appropriate logs of medical equipment. C.11.7.5. Administer medications and IV therapy employing knowledge of pharmacological agents and blood/blood components, their indications, routes of administration, expected actions and potential side effects, as related to specific patient population served. Manage complex central and peripheral intravenous lines/infusions. C.11.7.6. Provide recovery care for post-anesthesia patients following C-Sections, cerclage, tubal ligations, and spontaneous pregnancy loss. C.11.7.7. Serve as a patient advocate and maintain patient’s right to confidentiality. Assist patients, families and significant others in identifying limitations. C.11.7.8. Provide telephone advice based on clinical knowledge and accepted standards. Assist as needed in accessing appropriate ambulatory/emergency care for beneficiaries. C.11.7.9. Consult and work collaboratively with social work and other ancillary services at the medical center and in the community to aid patients in maintaining independence, dignity, and quality of life. C.11.7.10. Evaluate effectiveness of own performance and clinically direct and evaluate the clinical care provided by health team members. C.11.7.11. Contribute to health care system and support clinical environment resulting in quality services and positive patient outcomes. C.11.7.12. Assist management and staff to develop and implement standards of care in keeping with unit and command’s strategic patient care goals. C.11.7.13. Demonstrate clinical expertise and independent practice necessary to function as a resource for medical and nursing personnel and mentor to staff. Provide clinical consultation and participate in problem-solving efforts of nursing staff, medical staff and other disciplines. N62645-11-R-0012 Page 42 of 118 C.11.7.14. Conduct and participate in patient bedside rounds with care team, patient care conferences and discharge planning. C.11.7.15. Assess and address the learning needs of patients and families, as well as, cultural and spiritual needs, individualizing each plan of care to meet patients’ specific needs. C.11.7.16. Participate in formal patient education and development of patient education materials. C.11.7.17. Monitor patient responses to medications/procedures/treatments and provide timely, accurate, and concise documentation, manually and/or by use of computer. C.11.7.18. Perform efficiently in emergency patient situations following established protocols, remaining calm, informing appropriate persons, and documenting events. C.11.7.19. Participate in staff development, professional practice review, and evaluation for unit and directorate personnel. C.11.7.20. Participate in the development, application and monitoring of clinical pathways. Act as pathway manager for specific pathways, assesses and tracks variances to established parameters. Initiate corrective action as needed. C.11.7.21. Act as change agent. Influence policy and procedures; introduce and support new approaches to nursing practice. Practice effective problem identification and resolution skills as a method of sound decision making. C.11.7.22. Participate in unit and Command Improvement activities. Assist with the development of programs that comply with all regulatory agencies and JCAHO requirements with a focus on CI, professional practice, and patient care/teaching. C.11.8. REGISTERED NURSE, MOTHER-INFANT UNIT Provide nursing care to routine Obstetrical patients including newborns within assigned inpatient unit based on relevant specialty care standards. C.11.8.1. Establish priorities of patient care based on triage, nursing diagnosis, essential patient needs and outcomes and available unit, command, and community resources including time, personnel, equipment, and supplies. C.11.8.2. Collaborate with multi-disciplinary team in assessing the effectiveness of existing therapies and interventions for patients with illnesses, their families and significant others. C.11.8.3.Apply understanding and operation of specialty equipment. Maintain a safe patient care environment. Monitor and troubleshoot equipment assuring appropriate patient response. Provides intervention when indicated. C.11.8.4. Maintain a clean, safe environment for the patient either by active participation in the cleaning of clinical spaces and medical equipment, or by guiding and directing other personnel in the environmental maintenance. Ensure upkeep, perform checks and maintain appropriate logs of medical equipment. C.11.8.5. Administer medications and IV therapy employing knowledge of pharmacological agents and blood/blood components, their indications, routes of administration, expected actions and potential side effects, as related to specific patient population served. C.11.8.6. Reserved. C.11.8.7. Serve as a patient advocate and maintain patient’s right to confidentiality. Assist patients, families and significant others in identifying limitations. N62645-11-R-0012 Page 43 of 118 C.11.8.8. Provide telephone advice based on clinical knowledge and accepted standards. Assist as needed in accessing appropriate ambulatory/emergency care for beneficiaries. C.11.8.9. Consult and work collaboratively with social work and other ancillary services at the medical center and in the community to aid patients in maintaining independence, dignity, and quality of life. C.11.8.10. Evaluate effectiveness of own performance and clinically direct and evaluate the clinical care provided by health team members. C,11.8.11. Contribute to health care system and support clinical environment resulting in quality services and positive patient outcomes. C.11.8.12. Assist management and staff to develop and implement standards of care in keeping with unit and command’s strategic patient care goals. C.11.8.13. Demonstrate clinical expertise and independent practice necessary to function as a resource for medical and nursing personnel and mentor to staff. Provide clinical consultation and participate in problem-solving efforts of nursing staff, medical staff and other disciplines. C.11.8.14. Conduct and participate in patient bedside rounds with care team, patient care conferences and discharge planning. C.11.8.15. Assess and address the learning needs of patients and families, as well as, cultural and spiritual needs, individualizing each plan of care to meet patients’ specific needs. C.11.8.16. Participate in formal patient education and development of patient education materials. C.11.8.17. Demonstrate awareness and sensitivity to patient/significant others' rights, as identified within the institution. C.11.8.18. Monitor patient responses to medications/procedures/treatments and provide timely, accurate, and concise documentation, manually and/or by use of computer. C.11.8.19. Perform efficiently in emergency patient situations following established protocols, remaining calm, informing appropriate persons, and documenting events. C.11.8.20. Participate in staff development, professional practice review, and evaluation for unit and directorate personnel. C.11.8.21. Participate in the development, application and monitoring of clinical pathways. Act as pathway manager for specific pathways, assesses and tracks variances to established parameters. Initiate corrective action as needed. C.11.8.22. Act as change agent. Influence policy and procedures; introduce and support new approaches to nursing practice. Practice effective problem identification and resolution skills as a method of sound decision making. C.11.8.23. Demonstrate effective and professional communication methods, and skills, using lines of authority appropriately. C.11.8.24. Participate in unit and Command Improvement activities. Assist with the development of programs that comply with all regulatory agencies and JCAHO requirements with a focus on CI, professional practice, and patient care/teaching. C.11.9. REGISTERED NURSE, PERIOPERATIVE. Perform a full range of RN duties in accordance with assignment under the task order. N62645-11-R-0012 Page 44 of 118 C.11.9.1. Provide professional nursing care in a knowledgeable, skillful, consistent, and continuous manner. C.11.9.2. Plan, implement, deliver, provide clinical direction, and coordinate Perioperative, Post Anesthesia Care Unit (PACU), and Ambulatory Procedure Unit (APU) nursing care using scientific and professional principles as a basis for all techniques and procedures. C.11.9.3. Pre-admission: Confirm scheduled surgery date and procedure with the Main Operating Room, check procedure on consult against written consent form, ensure surgical checklist is completed. Make pre-op telephone call to client to confirm arrival time and re-enforce physician/anesthesia instructions. Provide any pre-op teaching, post procedure transportation arrangements or significant other teaching. C.11.9.4. Day of surgery: Greet client, properly identify client with placement of identification and/or allergy band(s). Orient client to Unit. Verify post procedure transportation arrangement. C.11.9.5. Conduct and document pre-op nursing assessment. Verify client compliance with instructions. Prepare client for procedure, may need to obtain additional labs. Arrange transport to OR (if necessary). C.11.9.6. Develop an individualized plan of care that prescribes nursing action to achieve desired patient outcomes. C.11.9.7. Confer with surgeon on procedures concerning instruments, sutures, and equipment, assuring all prescribed equipment is present and functional. C.11.9.8. Provide equipment and supplies based on patient need. Select equipment in an organized, timely and cost effective manner. C.11.9.9. Assure emergency equipment is functional before use. Report defective equipment. C.11.9.10. Monitor patients under local infiltration and block anesthesia. C.11.9.11. Perform duties as circulatory for surgical procedures, assuming responsibilities for coordinating patient care activities. Assume responsibilities for aseptic technique maintenance during procedures, accuracy of sponge counts and adequacy of supplies. C.11.9.12. Perform as a scrub nurse. C.11.9.13. Monitor and control environment. Regulate temperature and humidity as indicated. Adhere to operating room sanitation policy/procedures. C.11.9.14. Post-op: Receive, assess, monitor and document findings on client. Provide education. Ambulate. Verify post-op voiding. Discharge patient after re-enforcement of teaching. Complete nursing care document, reorganize chart and sign out patient. Make follow up clinic appointment for patient. C.11.9.15. Set up, operate, and maintain medical equipment during a medical/surgical procedure treatment. Administer prescribed medications. Provide emergency medical/surgical treatment. Provide nutrition and nourishment. Assist with transporting patient(s). Maintain nursing record(s) and plans. Provide patient and family teaching. Provide consultative services. C.11.9.16. Perform telephone follow up assessment of patient and provide instruction reinforcement. C.11.9.17. Assume responsibility when assigned for inservice programs and training activities relative to surgical procedures and maintenance of aseptic technique and basic aseptic principles. Orient and train new staff member or operating room tech/nursing students in scrubbing and circulating duties. N62645-11-R-0012 Page 45 of 118 C.11.9.18. Demonstrate a working knowledge of the supply procurement system C.11.9.19. Adhere to Clinical Sterile Resupply (CSR) policies, procedures and regulations. C.11.9.20. Monitor economic use of supplies and equipment. C.11.9.21. Investigate new developments and trends in perioperative, PACU, and APU nursing practice and analyze impact on improved patient care equipment. C.11.9.22. Assist in maintaining suite readiness and structural safety/integrity by reporting discrepancies to Division Officer. C.11.9.23. Demonstrate knowledge of the special needs (Perioperative, PACU, and APU) nursing considerations for high-risk age group: infant, pediatric, adolescents, and geriatrics. C.11.9.24. Monitor patient emergence from a variety of anesthetic agents; uses the nursing process in rendering this care. C.11.9.25. Use the Alderete scoring system to Guide PACU care. C.12. TRAVEL. The Commanding Officer may request that the HCW travel to provide services, attend training and/or attend Government specified conferences when in the best interest of the Government and patient care. The COR will determine the reasonableness of all costs incurred in accordance with the Government's Joint Travel Regulations (JTR). The Contractor shall be compensated for travel per Contract Line Item 0008 in Section B of the contract. C.12.1. When using a personal vehicle for official duties, the HCW (HCW) will be compensated for mileage at the prevailing rate. HCW shall not transport the patient or the patient’s family in his/her personal or Government vehicle without prior approval from the supervisor. C.12.2. The Government will not issue Government Travel Orders to the HCW. C.12.3. Government contract air carriers and the Government's contract airfares are not available to the HCW. Airfare will be paid at the coach rate with a minimum of seven days advance purchase, non-refundable ticket price; unless the Government grants prior written approval. The Government shall reimburse the fee charges to reschedule the non-refundable ticket only if the Government reschedules the trip. C.12.4. The JTR shall serve as the basis for the cost limits for lodging, per diem, miscellaneous expenses and mileage reimbursement if use of privately owned vehicle is authorized. The Contractor shall utilize discount hotel/motel and car rental practices. Per diem rates can be found on the World Wide Web at: http://www.defensetravel.dod.mil/site/perdiem.cfm. C.12.5. Costs for transportation, lodging, meals and incidental expenses incurred by the HCW are allowable subject to Federal Acquisition Regulations 31.205.46 and Federal Travel Regulations prescribed by the General Services Administration or deemed reasonable by the COR. C.12.6. When possible, the HCW shall use government-provided quarters (BOQ/BEQ) and transportation. If not available, the Government will provide the HCW with an identification letter for presentation to transportation and lodging firms (see Attachment AC). The Government retains the right to direct the mode of travel including the availability and size of rental cars. It should be noted that vendors are not obligated to extend discounted Government rates to Contractors working on behalf of the Federal Government. C.12.7. The Contractor shall submit an invoice in accordance with WAWF instructions (See Section G) itemizing expenses in amounts allowable by the COR. N62645-11-R-0012 Page 46 of 118 C.12.8. The COR will specify the MTF's procedure to document that the travel was completed and that the expenses were actually incurred. C.12.9. All reimbursements will be retrospective, payable only upon presentation of a properly prepared invoice (as specified by the facility) to the COR. C.12.10. The Government reserves the right to require additional documentation, including memoranda from the HCW performing the travel. C.12.11. The travel shall not be conducted prior to the appropriate funding being added to Contract Line Item 0008 in Section B of the appropriate task order by modification. C.13. FILL RATE REPORTING C.13.1 On a monthly basis, Naval Medical Logistics Command will distribute an excel spreadsheet electronically to each Contractor containing their respective active task orders. The Contractor shall submit the completed fill rate spreadsheet (Attachment AH) electronically to NMLCfirstname.lastname@example.org. C.13.2 The submission deadline will be specified in the distribution email and will be no earlier than the 5 th and no later than the 10th of each month. Submissions that do not follow submission instructions will be rejected for correction and resubmission. C.13.3. The Fill Rate Report is not a substitute for the Contractor Discrepancy Report, which must be prepared and responded to in accordance with the Contract Administration Plan (see Attachment AB). N62645-11-R-0012 Page 47 of 118 Section E - Inspection and Acceptance SECTION E E.1. For the purpose of this clause, the Contracting Officer’s Representative (COR) is the duly authorized representative of the Contracting Officer. E.2. The COR(s) for any awarded contracts resulting from this solicitation shall be appointed at award. The specific COR(s) for each task order written under the contracts awarded will be named within the task order. E.3. The COR will perform inspection and acceptance of services to be provided. Inspection and acceptance will be performed at the locations listed in individual task orders written under the contracts awarded. INSPECTION AND ACCEPTANCE TERMS Supplies/services will be inspected/accepted at: CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY 0001 N/A N/A N/A N/A 0002 N/A N/A N/A N/A 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 N/A N/A N/A N/A 0006 N/A N/A N/A N/A 0007 N/A N/A N/A N/A 0008 Destination Government Destination Government 0009 Destination Government Destination Government 0010 Destination Government Destination Government CLAUSES INCORPORATED BY REFERENCE 52.246-4 Inspection Of Services--Fixed Price AUG 1996 252.246-7000 Material Inspection And Receiving Report MAR 2008 N62645-11-R-0012 Page 48 of 118 Section F - Deliveries or Performance SECTION F F.1 PERIOD OF PERFORMANCE Periods of Performance shall be detailed in individual Task Orders written under the contracts awarded as a result of this solicitation. The contracts awarded as a result of this solicitation will have an ordering period starting on 01 October 2012. The Contracting Officer reserves the right to adjust the start date of service based on the actual award date. No single Task Order shall exceed 12 months in duration unless options are included. The contract ordering period shall not exceed 60 months. F.2 PLACE OF PERFORMANCE Places of performance shall be detailed in individual Task Orders written under the contracts awarded as a result of this solicitation. DELIVERY INFORMATION CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC 0001 N/A N/A N/A N/A 0002 N/A N/A N/A N/A 0003 POP 01-OCT-2012 TO N/A SEE TASK ORDERS N00000 30-SEP-2017 SEE TASK ORDERS SEE TASK ORDERS AA VARIOUS FOB: Destination 0004 POP 01-OCT-2012 TO N/A (SAME AS PREVIOUS LOCATION) N00000 30-SEP-2017 FOB: Destination 0005 N/A N/A N/A N/A 0006 N/A N/A N/A N/A 0007 N/A N/A N/A N/A 0008 POP 01-OCT-2012 TO N/A SEE TASK ORDERS N00000 30-SEP-2017 SEE TASK ORDERS SEE TASK ORDERS AA VARIOUS FOB: Destination 0009 POP 01-OCT-2012 TO N/A (SAME AS PREVIOUS LOCATION) N00000 30-SEP-2017 FOB: Destination N62645-11-R-0012 Page 49 of 118 0010 POP 01-OCT-2012 TO N/A (SAME AS PREVIOUS LOCATION) N00000 30-SEP-2017 FOB: Destination CLAUSES INCORPORATED BY REFERENCE 52.242-15 Stop-Work Order AUG 1989 52.242-17 Government Delay Of Work APR 1984 52.247-34 F.O.B. Destination NOV 1991 N62645-11-R-0012 Page 50 of 118 Section G - Contract Administration Data CLAUSES INCORPORATED BY FULL TEXT 252.232-7003 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS AND RECEIVING REPORTS (MAR 2008) (a) Definitions. As used in this clause-- (1) Contract financing payment and invoice payment have the meanings given in section 32.001 of the Federal Acquisition Regulation. (2) Electronic form means any automated system that transmits information electronically from the initiating system to all affected systems. Facsimile, e-mail, and scanned documents are not acceptable electronic forms for submission of payment requests. However, scanned documents are acceptable when they are part of a submission of a payment request made using Wide Area WorkFlow (WAWF) or another electronic form authorized by the Contracting Officer. (3) Payment request means any request for contract financing payment or invoice payment submitted by the Contractor under this contract. (b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests and receiving reports using WAWF, in one of the following electronic formats that WAWF accepts: Electronic Data Interchange, Secure File Transfer Protocol, or World Wide Web input. Information regarding WAWF is available on the Internet at https://wawf.eb.mil/. (c) The Contractor may submit a payment request and receiving report using other than WAWF only when-- (1) The Contracting Officer authorizes use of another electronic form. With such an authorization, the Contractor and the Contracting Officer shall agree to a plan, which shall include a timeline, specifying when the Contractor will transfer to WAWF; (2) DoD is unable to receive a payment request or provide acceptance in electronic form; (3) The Contracting Officer administering the contract for payment has determined, in writing, that electronic submission would be unduly burdensome to the Contractor. In such cases, the Contractor shall include a copy of the Contracting Officer's determination with each request for payment; or (4) DoD makes payment for commercial transportation services provided under a Government rate tender or a contract for transportation services using a DoD-approved electronic third party payment system or other exempted vendor payment/invoicing system (e.g., PowerTrack, Transportation Financial Management System, and Cargo and Billing System). (d) The Contractor shall submit any non-electronic payment requests using the method or methods specified in Section G of the contract. (e) In addition to the requirements of this clause, the Contractor shall meet the requirements of the appropriate payment clauses in this contract when submitting payments requests. (End of clause) N62645-11-R-0012 Page 51 of 118 SUP 5252.232-9402 INVOICING AND PAYMENT (WAWF) INSTRUCTIONS (April 2008) (a) Invoices for goods received or services rendered under this contract shall be submitted electronically through Wide Area Work Flow -- Receipt and Acceptance (WAWF): (1) The vendor shall have their cage code activated by calling 866-618-5988. Once activated, the vendor shall self-register at the web site https://wawf.eb.mil. Vendor training is available on the Internet at http://www.wawftraining.com. Additional support can be obtained by e-mailing BUMED WAWF support at email@example.com. (2) WAWF Vendor “Quick Reference” Guides are located at the following web site: http://acquisition.navy.mil/rda/home/acquisition_one_source/ebusiness/don_ebusiness_solutions/wawf_overview/ven dor_information. (3) Select the invoice type within WAWF as specified below. Back up documentation (such as timesheets, receiving reports etc.) can be included and attached to the invoice in WAWF. Attachments created in any Microsoft Office product are attachable to the invoice in WAWF. Total limit for each file is not to exceed 2MB. Multiple attachments are allowed. (b) The following information regarding invoice routing DODAACs must be entered for completion of the invoice in WAWF: ROUTING TABLE WAWF Invoice Type (2-in-1, Combo, or Cost Voucher) See Task Order Contract Number See Task Order Delivery Order Number See Task Order Issuing Office DoDAAC N62645 Admin Office DoDAAC N62645 Inspector DoDAAC (usually when Inspector & Acceptor are different N/A people) Ship To DoDAAC (for Combo), Service Acceptor DoDAAC (for 2- See Task Order in-1), Service Approver DoDAAC (for Cost Voucher) Acceptance At Other DoDAAC N/A Local Processing Office (Certifier) DoDAAC See Task Order DCAA Office DoDAAC (Used on Cost Voucher’s only) N/A Paying Office DoDAAC HQ0248 Acceptor/COR Email Address See Task Order (c) Contractors approved by DCAA for direct billing will not process vouchers through DCAA, but may submit directly to DFAS. Vendors MUST still provide a copy of the invoice and any applicable documentation that supports payment to the Acceptor/Contracting Officer's Representative (COR) if applicable. Additionally, a copy of the invoice(s) and attachment(s) at time of submission in WAWF must also be provided to each point of contact identified in section (d) of this clause by email. If the invoice and/or receiving report are delivered in the email as an attachment it must be provided as a .PDF, Microsoft Office product or other mutually agreed upon form between the Contracting Officer and vendor. (d) For each invoice / cost voucher submitted for payment, the contractor shall include the following email addresses for the WAWF automated invoice notification to the following points of contact: NAME EMAIL PHONE ROLE See Task Order See Task Order See Task Order See Task Order N62645-11-R-0012 Page 52 of 118 Section H - Special Contract Requirements SECTION H H.1. TASK ORDER CONTRACT. H.1.1. The Government intends this solicitation to result in award of multiple indefinite delivery indefinite quantity (ID/IQ) contracts. Services will be procured via the award of Task Orders issued against the basic contracts. H.2. TASK ORDER PROCEDURES H.2.1. Fair Opportunity For Consideration. H.2.1.1. One or more Task Orders will be issued during the performance period of the contract. The Government will provide all awardees a fair opportunity for consideration. In accordance with FAR 16.505(b), the Contracting Officer will give each awardee a "fair opportunity" to be considered for each order in excess of $3,000 unless one of the conditions in paragraph H.2.1.2 below applies. H.2.1.2. Exceptions to Fair Opportunity for Consideration. Awardees will not be given a fair opportunity to be considered for Task Orders which are expected to exceed $3,000 when the Contracting Officer determines one of the following conditions apply: H.184.108.40.206. The agency need for services is of such urgency that providing such an opportunity would result in unacceptable delays; H.220.127.116.11. Only one awardee is capable of providing the services required at the level of quality required because the services ordered are unique or highly specialized; H.18.104.22.168. The order should be issued on a sole-source basis in the interest of economy and efficiency as a logical follow-on to a Task Order already issued under this contract, provided that all awardees were given fair opportunity to be considered for the original order. For the purposes of this solicitation the contracting officer may negotiate a sole source logical follow-on Task Order with the current contractor providing previously competed services. In the event an increase in the amount of previously competed services is required by the Government, the Contracting Officer may negotiate a sole source logical follow-on Task Order with the current contractor provided the required additional services do not represent more than one full time equivalent position or 20% of the total competed labor hours on the entire Task Order, whichever is greater. When deciding whether to negotiate a sole source logical follow-on Task Order with the current contractor, consideration will be given to the contractor's Past Performance, continuity of HCW services, and price. H.22.214.171.124. It is necessary to place an order to satisfy a minimum guarantee. All successful contract awardees are guaranteed a minimum award of a Task Order(s) totaling $25,000. H.2.2. The Contracting Officer has broad discretion in determining which awardee should receive a Task Order. Each Task Order award decision will consider the following three factors (i.e., H.2.2.1., H.2.2.2., and H.2.2.3.). Factors four, five, and six (i.e., H.2.2.4., H.2.2.5., and H.2.2.6.) may be considered as described in the Task Order Proposal Request (TOPR). H.2.2.1. The price of the Task Order. The factors to be considered in evaluating prices proposed are: H.126.96.36.199. COMPLETENESS. All price information required by the Task Order proposal request has been submitted and supplemental price worksheets have been completed for the base period and any option periods. H.188.8.131.52. REASONABLENESS. The degree to which the proposed prices (base period and any option periods) compare to the prices a reasonable prudent person would expect to incur for the same or similar services. N62645-11-R-0012 Page 53 of 118 H.184.108.40.206. REALISM. The offeror’s Line Item prices and information provided on the Supplemental Pricing Worksheets (see Section J, Attachment AI) will be used in the evaluation of the offeror's proposal. The Contracting Officer will use the minimum compensation information to determine the price realism of the proposed compensation and may use the minimum and average compensation information for best value determinations. The offeror’s Line Item prices and the Supplemental Pricing Worksheets will be examined to identify unusually low price estimates, understatements of costs, inconsistent pricing patterns, potential misunderstandings of the solicitation requirements, and the risk of personnel recruitment and retention problems during contract performance. The realism examination will be performed for the base period and any option periods. H.2.2.2. Timeliness of submission of Task Order proposal. Task Order proposals which are submitted late may not be considered for award. H.2.2.3. The Past Performance and management record of the awardee in previous Task Orders and Task Order proposals under this contract will be evaluated. Performance within the past 5 years on other contracts for the facilities covered by this contract may also be considered. This Past Performance evaluation will include a review of all aspects of contract performance, both positive and negative, including but not limited to performance enhancements or problems, management enhancements or problems, timeliness of proposal submission, continuity of HCWs, shift fill rates, and quality of HCWs provided. H.2.2.4. Quality of the HCW(s) proposed under the Task Order. General ranking factors of HCWs will be detailed in each Task Order Proposal Request (TOPR). H.220.127.116.11. The quality and characteristics of the proposed personnel mix in relationship to the labor mix requirements specified in the Task Order. H.18.104.22.168. Quality and quantity of qualifications, including education, training, and experience, as they relate to the duties in the Task Order. Prior experience in a military medical/dental setting may enhance the candidate’s ranking. H.22.214.171.124. Letters of Recommendation. H.126.96.36.199. Additional certifications and licensure, as applicable. H.188.8.131.52. Total continuing education within the 3 years immediately preceding the Task Order. H.2.2.5. Management plan for accomplishment of the Task Order requirements. H.2.2.6. Certificate of availability. H.2.3. When placing orders, the Contracting Officer is not required to prepare formal evaluation plans, score offers, post notice on the Federal Business Opportunities (FedBizOpps) web site (except when using an exception to fair opportunity) or hold discussions or negotiations with each awardee. Even though the Contracting Officer does not have to comply with the competition rules in Part 6 of the Federal Acquisition Regulation and does not have to conduct discussions before issuing an order, there will be an internal record of why a particular offeror provided the best value based on the particular requirements of each Task Order. H.2.4. Issues arising from the placement of orders are not protestable to the Government Accountability Office unless the protest alleges that the order exceeded the value, scope, or period of the contract or in the case where a single Task Order exceeds $10 million IAW FAR 16.505(a)(9) and FAR 33.104. H.2.5. Task Order Proposal Request, Proposal Submission, and Task Order Award. The process for requesting Task Order proposals, evaluating the proposals, selecting an awardee for each Task Order, issuing the Task Order, and the commencement of services under each Task Order is shown below. H.2.5.1. Task Order Proposal Request (TOPR). N62645-11-R-0012 Page 54 of 118 H.184.108.40.206. The Contracting Officer will issue a written Task Order Proposal Request (TOPR) and will forward it to all awardees unless one of the exceptions to the fair opportunity for consideration listed above in H.2.1 applies. H.220.127.116.11. The TOPR will include as a minimum the following information: * The due date for proposal submission (generally between 7 and 14 days following the date of the TOPR). * A description of the services, including minimum qualification requirements and specific ranking factors. * The place of performance. * The period of performance including the quantity required. * Option periods may be included as appropriate. * Any additional instructions for proposal submission not contained in this section. * Any other information deemed appropriate by the Contracting Officer. H.2.6. Proposal Submission. H.2.6.1. If an awardee is unable to submit a proposal, they must notify the Contracting Officer in writing as soon as practicable. A brief written statement as to why the awardee is unable to submit a proposal is required. Failure to submit a Task Order proposal without sufficient justification may be considered as negative Past Performance information which may jeopardize the award of future Task Orders. H.2.6.2. The contractor's Task Order proposal shall always be required to contain a price section and may be required to include a past performance or technical section. The price section shall include a completed Supplemental Pricing Worksheet for each proposed HCW for the base period of performance and any option periods. The proposal shall be forwarded to the Naval Medical Logistics Command. Certified cost or pricing data is not required for individual Task Orders. Direct labor rates must be consistent with that currently being paid in the geographic location where services are to be performed. If required, the proposal shall include the personnel and past performance information required by the TOPR. H.2.7. Task Order Award. H.2.7.1. Upon completion of the evaluation of the Past Performance, Technical and/or Price volumes, the Contracting Officer will issue a Task Order to the contractor whose proposal is most advantageous to the Government considering the evaluation factors specified in H.2.2 above. H.2.7.2. In the event issues pertaining to a proposed Task Order cannot be resolved to the satisfaction of the Contracting Officer, the Contracting Officer reserves the right to withdraw or cancel the proposed Task Order. In such event, the contractor will be notified, via letter or email, of the Contracting Officer's decision and this decision shall be final and conclusive and shall not be subject to the "Disputes" clause or the "Contract Disputes Act". H.2.7.3. In order for a proposal that contains option periods to be considered complete, all options must be priced. In the event that required option periods are not proposed, the Contracting Officer may reject the contractor’s proposal and it will not be considered for award. H.2.8. Commencement of Performance. H.2.8.1. Upon award, a Task Order will be transmitted to the contractor on a DD Form 1155. Approved HCWs will generally be required to begin performance between 30 and 60 days after execution of the Task Order by the Contracting Officer. Urgent requirements may require expedited processing and a shortened performance start up period. Conversely, some difficult to fill positions may require a longer performance start up period. If a HCW who was proposed in response to the Task Order Proposal Request is not available to begin performance on the Task Order, the contractor must notify the Contracting Officer immediately. N62645-11-R-0012 Page 55 of 118 H.2.8.2. Failure to begin performance with the approved HCW may result in termination of the Task Order and reconsideration of the other Task Order proposals received in response to the Task Order Proposal Request. The contractor may or may not be given the opportunity to propose a new HCW. The Government reserves the right to terminate the contract for default if the contractor fails to begin performance. H.2.9. Option Periods Under Task Orders H.2.9.1. The Government at its sole discretion may issue Task Orders with a base period of performance as well as option periods that provide for continued performance of the Task Order. Task Orders issued with option periods will include FAR clause 52.217-9 “Option to Extend the Term of the Contract.” H.2.9.2. Option periods will be exercised in writing by the issuance of task order modifications. H.18.104.22.168. Task order modifications will be issued unilaterally by the Contracting Officer when the written notices required by FAR 52.217-9 have been provided within the timeframes listed therein. H.22.214.171.124. Task order modifications may be issued bilaterally as agreed upon by the Contracting Officer and the contractor in cases where the written notices or timeframes required by FAR 52.217-9 have not been met. H.2.10 ECONOMIC PRICE ADJUSTMENT (EPA). Task Orders under this contract with option periods may include an Economic Price Adjustment. The following language will be included in a task order with option periods for which the Government determines a mechanism for an EPA adjustment is appropriate. H.2.10.1. ECONOMIC PRICE ADJUSTMENT – LABOR H.126.96.36.199. The Contractor agrees to incorporate the substance of this section in all subcontracts for HCW services. H.2.10.2. EPA terms will apply only to rates for performance commencing with the third year of performance (option period 2) of a task order that includes this section. H.188.8.131.52. The contractor shall provide written notification to the Contracting Officer if the medical care services expenditure category of the Consumer Price Index (CPI) has increased or decreased since contract award, and shall propose increases or decreases to the unburdened rates of pay for labor (including fringe benefits) for its HCWs beginning in the third year of performance (option period 2) under this task order. The Contractor shall furnish this notice not later than 90 calendar days prior to the beginning of the next applicable option period, and any adjustments shall only be applicable in the next option period(s). The Contractor is limited to one adjustment in labor rates per annual performance period. The notice shall include the Contractor's proposal for an adjustment in the labor rates, its revised compensation plan which shall include the Contractor’s initial proposed base labor and fringe benefits for all affected HCWs and its proposed increases or decreases in labor and fringe benefits, a breakout of all cost components (e.g., to include but not limited to general and administrative costs, overhead, and profit) of its original and proposed rates, and the applicable CPI rate and supporting underlying data. For proposed increases, the Contractor's proposal shall also include an explanation of how the change in the CPI has affected its ability to recruit and retain qualified HCWs to perform under the contract, using specific examples if available. H.2.10.3. The Contracting Officer and Contractor shall negotiate a rate adjustment and its effective date within 60 days after the Contracting Officer receives the notice and data described in H.184.108.40.206. The Contracting Officer will verify the Contractor's underlying data, conduct separate market research in sufficient depth to satisfy the Contracting Officer as to whether, and the extent to which, pricing adjustments are appropriate, and request assistance from the Defense Contract Audit Agency (DCAA) as required by DFARS 216.203-4. If the Contracting Officer determines that an EPA adjustment is justified, the Contracting Officer shall modify the applicable rates and establish their effective date, subject to availability of funding. The Contractor shall continue performance pending agreement on, or determination of, any adjustment and its effective date. The Contracting Officer will make the final determination in the event of a disagreement between the Contracting Officer and the Contractor over whether or not an EPA adjustment will be made, or over the amount of such an adjustment. N62645-11-R-0012 Page 56 of 118 H.2.10.4. Any price adjustment in accordance with this section is subject to the following limitations: H.220.127.116.11. Data tables supplied by the Bureau of Labor Statistics are used for calculations. Using the link, http://www.bls.gov/cpi/#tables, select the CPI Detailed Report for the appropriate timeframe. After selecting the appropriate timeframe, go to table 3 titled “Consumer Price Index for all Urban Consumers (CPI-U): U.S. city average, detailed expenditure categories”. The EPA adjustments will be based on the unadjusted indexes for the medical care services expenditure categories of Table 3, which is published monthly by the U.S. Department of Labor, Bureau of Labor Statistics. For the purposes of this EPA example, the June 2011 index will be used. [There is an approximately two-week lag from the reference month to the date on which the index is released. (e.g., the CPI for April is released in mid-May.)] The Contractor is limited to one adjustment in labor rates per annual performance period. H.18.104.22.168. On Table 3, as described in H.22.214.171.124, the percent change from one year to the next is already calculated. Under the Expenditure category, locate the medical care services category. Use the CPI rate located under the left subcolumn of the column titled Unadjusted percentage change to “x month year” from –. For example, assume that in late July/early August 2011 you wish to know the percent change for the past year in medical services. The most current available data is in the table for June 2011 which shows a 2.9% change in the column for Unadjusted Percent Change from June 2010 to June 2011. The calculation that the Bureau of Labor Statistics used to derive that percent change is as follows: CPI for medical services for June 2011 422.813 Less CPI for medical services for June 2010 410.802 Equals index point change 12.011 Divided by CPI for medical services for June 2010 410.802 Equals 0.029 Result multiplied by 100 0.029 x 100 Equals percent change 2.9 H.126.96.36.199. When the Contractor requests an adjustment, the Contractor must submit a revised compensation plan for the year in which the adjustment is effective and base wage rates and fringes for all remaining years. If the Contracting Officer approves the adjustment amount, the Contractor shall submit revised figures reflecting the approved amounts. H.188.8.131.52. Adjustments shall be to rates of pay (including fringe benefits) only. Changes to any other elements of cost/price will not be considered under this section. General and administrative expenses, profit, and similar costs will remain unchanged. The contractor shall be required to submit a detailed explanation that identifies how the Contractor arrived at the adjustment/revision in the rate. H.184.108.40.206. No upward adjustment in rates shall apply to services that were performed before the effective date of the adjustment. H.220.127.116.11. There shall be no adjustment (increase or decrease) for any change in rates of pay for labor (including fringe benefits) which would not result in a net change of at least 3 percent above or below the rates established in the current period of performance of the task order. H.18.104.22.168. The total EPA increase made in accordance with this section in any option period shall not exceed 10 percent of the fixed rates in the current period of performance of the task order. There is no percentage limitation on the amount of decreases that may be made in accordance with this section. N62645-11-R-0012 Page 57 of 118 H.2.10.5. The Contracting Officer may unilaterally initiate a downward adjustment in applicable rates in the task order in the event the CPI rate decreases, even in the absence of a contractor request for a decrease in rates in accordance with the timelines stated in paragraph 1 above. If the Contracting Officer initiates such an action, the Contractor shall submit a revised compensation plan and proposed reductions in labor rates consistent with this provision and shall provide such other information the Contracting Officer deems appropriate for purposes of making a downward adjustment in rates. H.2.10.6. The Contracting Officer may examine the Contractor's books, records, and other supporting data relevant to the rate adjustment during the life of the contract and each task order. This right shall remain in effect until the end of three years after the date of final payment of the last task order under the contract. H.2.10.7. Nothing contained in this section shall be considered as prohibiting changes in the contract prices made pursuant to any other provision of this contract. H.2.10.8. In the event the Bureau of Labor Statistics discontinues publication or changes the content of the index used in this section, the parties shall mutually agree on an appropriate substitute for the affected index for use in determining economic price adjustments in accordance with this section. In the event the Bureau of Labor Statistics alters its methods of calculating or reporting an index used in this section (including a change in the base period), the appropriate adjustments shall be made by the parties to put the revised index on a comparable basis with the index as calculated before the change. Current base periods in effect for the Medical care services expenditure categories of Table 3 of the Consumer Price Index for all Urban Consumers (CPI-U): U.S. city average, detailed expenditure categories are as follows: Services by other medical professionals Base: December 1986 = 100 H.2.10.9. Any dispute arising under this section shall be determined in accordance with and subject to the provisions of the “Disputes” clause of this contract. H.2.10.10. The Contractor hereby agrees that the index used herein is proper and appropriate for use. H.3. OMBUDSMAN. H.3.1. The Ombudsman will review complaints from contractors regarding the award of Task Orders and ensure that all contractors are afforded a fair opportunity to be considered, consistent with the procedures in the contract. The Task Order contract Ombudsman for this contract is the Navy Competition Advocate General. Contractors are encouraged to settle their complaints through the Competition Advocate chain of command, seeking review by the Command Competition Advocate at the Naval Medical Logistics Command before taking their complaints to the Navy Competition Advocate General. The Naval Medical Logistics Command's Competition Advocate can be reached at (301) 619-2158 or at the following address: Naval Medical Logistics Command ATTN: Competition Advocate 693 Neiman St. Fort Detrick, MD 21702-9203 H.4. PRIOR WRITTEN PERMISSION REQUIRED FOR SUBCONTRACTS. None of the services required by this contract shall be subcontracted to or performed by persons other than the contractor or the contractor's employees without the prior written consent of the Contracting Officer. H.5. RESTRICTION ON THE USE OF GOVERNMENT-AFFILIATED PERSONNEL. Except in very limited cases, the federal criminal statutes at 18 USC 203 and 18 USC 205 bar Government personnel, both active duty and civil service, from working as a contractor employee in a Government workplace, N62645-11-R-0012 Page 58 of 118 including a medical treatment facility, either as a second job ("moonlighting") or while on terminal leave. The contractor agrees that, before making an employment offer to an active duty member or a civil servant, it shall inform the individual of the potential applicability of these statutes and further agrees to encourage that individual to seek an advisory opinion from his/her local ethics counsel before accepting an employment offer. In addition, without the prior written approval of the contracting officer, the contractor shall not use in the performance of this contract any persons currently performing medical or dental services under other Navy contracts. H.6. SUBSTITUTION OF PERSONNEL FOR HCWS WHO ACCRUE LEAVE. H.6.1. Except as provided in this section (H.6), the contractor agrees to perform this contract using only HCW(s) whose professional qualifications have been determined technically acceptable by the Government to provide services under each specific Task Order. H.6.2. During Task Order performance, no personnel substitutions shall be made by the contractor without the express consent of the Contracting Officer or in accordance with a procedure specified by the Contracting Officer. All substitution requests will be processed in accordance with this clause. H.6.3. No personnel substitutions shall be permitted during the first 60 days of Task Order performance, unless they are necessitated by a HCW's unexpected illness, injury, death or termination of employment. Should one of these events occur, the contractor shall promptly notify the Contracting Officer and provide the information required in paragraph H.6.4 below. After the initial 60 day period, all substitution requests shall be submitted, in writing, at least 30 days prior to the planned change of personnel. All such requests must provide the information required by paragraph H.6.4 below. H.6.4. All substitution requests must provide a detailed explanation of the circumstances necessitating the proposed replacement of personnel. The contractor shall also demonstrate that the substitute HCW(s) possess professional qualifications that are equal to or higher than the qualifications in Section C.6. The COR will evaluate such requests and promptly notify the contractor of the approval or disapproval thereof. H.7. HCW BACKGROUND INVESTIGATION REQUIREMENTS. H.7.1. CRIME CONTROL ACT OF 1990 REQUIREMENT. H.7.1.1. Section 21 of the Crime Control Act of 1990, 42 U.S.C. 13041, as amended by section 1094 of Public Law 1-02-190, requires every facility operated by the Federal Government (or operated under contract with the Federal Government) that hires (or contracts to hire) individuals involved in the provision of child care services to assure that all existing and newly-hired employees undergo a criminal background investigation. The term "child care services" is defined to include health and mental health care. H.7.1.2. In accordance with 42 U.S.C. 13041(d) the contractor shall ensure that employment applications for potential HCWs contain a question asking whether the individual has ever been arrested for or charged with a crime involving a child, and if so, requiring a description of the disposition of the arrest or charge. The application shall further state that it is being signed under penalty of perjury, with the applicable Federal punishment for perjury stated on the application. H.7.1.3. The Government will conduct criminal background investigations for all potential HCWs who will be providing child care services under this contract based on fingerprints obtained by a Government law enforcement office (e.g., local, state, federal, etc.) and a completed SF 85P form (Questionnaire for Public Trust Positions). H.7.1.4. The COR will identify the appropriate Navy Component for billing purposes and the appropriate security point of contact and/or installation commander who will receive the background results. H.7.1.5. With written recommendation from the Commanding Officer, and the approval of the Contracting Officer, a HCW with a background investigation pending completion may be permitted to perform work under this contract N62645-11-R-0012 Page 59 of 118 prior to the completion of the background investigation, provided the HCW is within sight and continuous supervision of an individual with a successful background investigation. H.7.2 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL. H.7.2.1 The Homeland Security Presidential Directive dated 27 August 2004 requires a mandatory government-wide standard for secure and reliable forms of identification for Federal employees, contractors and HCWs who access federally controlled facilities or have access to Federally controlled IT systems. H.7.2.2. Personnel background investigations must be initiated and an advance fingerprint and NAC results received by the MTF prior to a Common Access Card (CAC) being issued to the HCW. H.7.2.3. See Section I, FAR 52.204-9 for additional information. H.8. LIABILITY INSURANCE. H.8.1. Before commencing work under a contract, the contractor shall certify to the Contracting Officer in writing that the required insurance has been obtained. The following insurance as referenced in FAR 28.307, is the minimum insurance required: H.8.1.1. General liability - Bodily injury liability insurance coverage written on the comprehensive form of policy of at least $500,000 per occurrence. H.8.1.2. Automobile liability - Automobile liability insurance written on the comprehensive form of policy. The policy shall provide for bodily injury and property damage liability covering the operation of all automobiles used in connection with performing the contract. Policies covering automobiles operated in the United States shall provide coverage of at least $200,000 per person and $500,000 per occurrence for bodily injury and $20,000 per occurrence for property damage. The amount of liability coverage on other policies shall be commensurate with any legal requirements of the locality and sufficient to meet normal and customary claims. H.8.1.3. Workers' compensation and employer's 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 shall be required, except in States with exclusive or monopolistic funds that do not permit workers' compensation to be written by private carriers. H.9. NON-COMPETE CLAUSES. H.9.1. The use of non-compete agreements (including non-compete clauses within employment agreements) that are aimed at preventing the loss of contract providers are acceptable only if the non-competition is limited to the current performance period specified in the contract/Task Order. The use of non-compete agreements or clauses that prevent employees of an incumbent contractor from accepting future employment with either the Government or with another contractor is not acceptable. Awardees (including sub-contractors) may not include conditions in employment agreements that hinder the Government's ability to accomplish the current or future mission of providing health and medical care to beneficiaries. H.9.2. The Government reserves the right to query each offeror or contractor regarding the use and purpose of these clauses or agreements and to use this information in award, logical follow-on or option period exercise decisions. If such conditions are included in employment agreements, the Government further reserves the right to reject an offeror's proposal or to terminate existing contracts or Task Orders. N62645-11-R-0012 Page 60 of 118 H.10. LIMITATION OF PAYMENT FOR PERSONAL SERVICES. Under the provisions of 10 U.S.C. 1091 and DODI 6025.5, “Personal Services Contracting”, implemented 6 January 1995, the total amount of compensation paid to an individual direct health care provider in any year cannot exceed the full time equivalent annual rate specified in 10 U.S.C. 1091. Effective 21 January 2000, the maximum amount the Government is allowed to pay for these personal services is $400,000 per year for this contract. H.11. MIGRATION OF CONTRACT HCWS TO CIVIL SERVICE POSITIONS. H.11.1. If a contract HCW is selected by the Government for a civil service position and commences work as a civil servant, the contractor may be entitled to compensation towards recruitment costs of the contract position. Upon the contractor’s written submittal of a request for compensation, the contracting officer will consider all circumstances relative to the request and make a determination to grant or deny compensation in accordance with the subparagraphs below on a case by case basis. H.11.2. In order for the contractor to be eligible for compensation, all of the following criteria must be met: H.11.2.1. The HCW selected for Civil Service must not have previously provided services for the same contractor at the same MTF under a previous contract. H.11.2.2. The civil service position must require the same qualifications and be located at the same MTF (which includes any location which receives credentials review services from the MTF) as required by the contract. H.11.2.3. The HCW must have occupied a position subject to credentials review in accordance with BUMED Instruction 6320.66E (or current version), and must have performed at least one shift of service. H.11.2.4. The HCW commences work as a civil servant not later than 180 days following initial commencement of work under the contract or prior to the expiration date of the current contract, whichever occurs first. H.11.2.5. The contractor must submit their request and all supporting documentation no later than 90 days following change in status of HCW from contractor employee to civil service employee. H.11.3. If compensation is determined appropriate by the Contracting Officer, this one-time payment will be calculated by multiplying the current hourly rate for the contract position times the number of contract service hours scheduled for the HCW in a typical two-week payment period. For example, if the contract hourly rate is $40.00 per hour, and the HCW is typically scheduled for 80 hours of service in one payment period, the total compensation paid to the contractor is $3,200.00. H.11.4. At such time as the Contracting Officer determines compensation towards recruiting costs is appropriate, a contract modification will be executed. The contract modification will define the total amount of compensation for which the contractor may invoice, the CLIN under which the compensation is to be invoiced, the appropriate adjustment to the period of performance for contract services, and include a contractor release statement barring the contractor from seeking additional compensation. CLAUSES INCORPORATED BY REFERENCE 52.217-5 Evaluation Of Options JUL 1990 CLAUSES INCORPORATED BY FULL TEXT N62645-11-R-0012 Page 61 of 118 SUP 5252.204-9400 Contractor Access to Federally Controlled Facilities and/or Unclassified Sensitive Information or Unclassified IT Systems (May 2010) Homeland Security Presidential Directive (HSPD)-12, requires government agencies to develop and implement Federal security standards for Federal employees and contractors. The Deputy Secretary of Defense Directive-Type Memorandum (DTM) 08-006 – “DoD Implementation of Homeland Security Presidential Directive – 12 (HSPD- 12)” dated November 26, 2008 (or its subsequent DoD instruction) directs implementation of HSPD-12. This clause is in accordance with HSPD-12 and its implementing directives. This clause applies to contractor employees requiring physical access to any area of a federally controlled base, facility or activity and/or requiring access to a DoD computer/network, to perform certain unclassified both non-sensitive and sensitive duties. It is the responsibility of the command/facility where the work is performed to ensure compliance. The requirement to control access to sensitive information applies to all US government IT systems and/or areas where unclassified but sensitive information may be discussed, displayed or maintained. DON policy prescribes that all unclassified data that has not been approved for public release and is stored on mobile computing devises must be treated as sensitive data and encrypted using commercially available encryption technology. Whenever granted access to sensitive information, contractor employees shall follow applicable DoD/DoN instructions, regulations, policies and procedures when reviewing, processing, producing, protecting, destroying and/or storing that information. Operational Security (OPSEC) procedures and practices must be implemented by both the contractor and contract employee to protect the product, information, services, operations and missions related to the contract. The contractor shall designate an employee to serve as the Contractor’s Security Representative. Within three work days after contract award, the contractor shall provide to the Navy Command’s Security Manager and the Contracting Officer, in writing, the name, title, address and phone number for the Contractor’s Security Representative. The Contractor’s Security Representative shall be the primary point of contact on any security matter. The Contractor’s Security Representative shall not be replaced or removed without prior notice to the Contracting Officer. Non-Sensitive Positions Contractor employee whose work is unclassified and non-sensitive (e.g., performing certain duties such as lawn maintenance, vendor services, etc ...) and who require physical access to publicly accessible areas to perform those duties shall meet the following minimum requirements: Must be either a US citizen or a US permanent resident with a minimum of 3 years legal residency in the US (as required by The Deputy Secretary of Defense DTM 08-006 or its subsequent DoD instruction) and Must have a favorably completed National Agency Check with Written Inquiries (NACI) including a Federal Bureau of Investigation (FBI) fingerprint check prior to installation access. To be considered for a favorable trustworthiness determination, the Contractor’s Security Representative must submit for all employees each of the following: SF-85 Questionnaire for Non-Sensitive Positions Two FD-258 Applicant Fingerprint Cards Original Signed Release Statements The contractor shall ensure each individual employee has a current favorably completed NACI. The Contractor’s Security Representative shall be responsible for initiating reinvestigations as required. Failure to provide the required documentation at least 30 days prior to the individual’s start date shall result in delaying the individual’s start date. Sensitive Positions Contractor employee whose duties require accessing a DoD unclassified computer/network, working with sensitive unclassified information (either at a Government or contractor facility), or physical access to a DoD facility must be a US citizen and possess a favorable trustworthiness determination prior to installation access. To obtain a favorable N62645-11-R-0012 Page 62 of 118 trustworthiness determination, each contractor employee must have a favorably completed National Agency Check with Local Credit Checks (NACLC) which consists of a NACI including a FBI fingerprint check plus credit and law enforcement checks. Each contractor employee applying for a trustworthiness determination is required to complete: SF-85P Questionnaire for Public Trust Positions Two FD-258 Applicant Fingerprint Cards Original Signed Release Statements Failure to provide the required documentation at least 30 days prior to the individual’s start date shall result in delaying the individual’s start date. To maintain continuing authorization for an employee to access a DoD unclassified computer/network, and/or have access to sensitive unclassified information, the contractor shall ensure that the individual employee has a current requisite background investigation. The Contractor’s Security Representative shall be responsible for initiating reinvestigations as required and ensuring that background investigations remain current (not older than 10 years) throughout the contract performance period. IT Systems Access When access to IT systems is required for performance of the contractor employee’s duties, such employees shall in- process with the Navy Command’s Security Manager and Information Assurance Manager upon arrival to the Navy command and shall out-process prior to their departure at the completion of the individual’s performance under the contract. Completion and approval of a System Authorization Access Request Navy (SAAR-N) form is required for all individuals accessing Navy Information Technology resources. The SAAR-N shall be forwarded to the Navy Command’s Security Manager at least 30 days prior to the individual’s start date. Failure to provide the required documentation at least 30 days prior to the individual’s start date shall result in delaying the individual’s start date. When required to maintain access to required IT systems or networks, the contractor shall ensure that all employees requiring access complete annual Information Assurance (IA) training, and maintain a current requisite background investigation. The Contractor’s Security Representative shall contact the Command Security Manager for guidance when reinvestigations are required. Security Approval Process The Contractor’s Security Representative shall ensure that each individual employee pending assignment shall accurately complete the required forms for submission to the Navy Command’s Security Manager. The Contractor’s Security Representative shall screen the investigative questionnaires for completeness and accuracy and for potential suitability/security issues prior to submitting the request to the Navy Command’s Security Manager. Forms and fingerprint cards may be obtained from the Navy Command’s Security Manager. These required items, shall be forwarded to the Navy Command's Security Manager for processing at least 30 days prior to the individual employee’s anticipated date for reporting for duty. The Navy Command’s Security Manager will review the submitted documentation for completeness prior to submitting it to the Office of Personnel Management (OPM). Suitability/security issues identified by the Navy Command’s Security Manager may render the contract employee ineligible for the assignment. A favorable review of the questionnaire and advance fingerprint results are required as an interim measure prior to the contract employee start date. An unfavorable determination made by the Navy Command’s Security Manager is final and such a determination does not relieve the contractor from meeting any contractual obligation under the contract. If contractor employees already possess a current favorably adjudicated investigation, the Navy Command’s Security Manager will use the Visit Authorization Request (VAR) via the Joint Personnel Adjudication System (JPAS). The contractor shall include the IT Position Category per SECNAV M-5510.30 for each employee designated on a VAR. The VAR requires annual renewal for the duration of the employee’s performance under the contract. The Navy Command’s Security Manager will forward the required forms to OPM for processing. Once the investigation is complete, the results will be forwarded by OPM to the DON Central Adjudication Facility (CAF) for a position of trust determination. When a favorable determination is not made, contractor employees shall not be permitted to work on this contract effort and if already working on the contract shall be removed immediately. N62645-11-R-0012 Page 63 of 118 The potential consequences of any requirements under this clause including denial of access for a proposed contractor employee who fails to obtain a favorable trustworthiness determination in no way relieves the contractor from the requirement to execute performance under the contract within the timeframes specified in the contract. Contractors shall plan ahead in processing their employees and subcontractor employees for working in non-sensitive positions, with sensitive information, and/or on Government IT systems. The contractor shall insert this clause in all subcontracts when the subcontractor is permitted to have physical access to a federally controlled facility and/or access to a federally-controlled information system/network and/or access to government information. N62645-11-R-0012 Page 64 of 118 Section I - Contract Clauses CLAUSES INCORPORATED BY REFERENCE 52.202-1 Definitions JUL 2004 52.203-5 Covenant Against Contingent Fees APR 1984 52.203-6 Restrictions On Subcontractor Sales To The Government SEP 2006 52.203-7 Anti-Kickback Procedures OCT 2010 52.203-8 Cancellation, Rescission, and Recovery of Funds for Illegal or JAN 1997 Improper Activity 52.203-10 Price Or Fee Adjustment For Illegal Or Improper Activity JAN 1997 52.203-12 Limitation On Payments To Influence Certain Federal OCT 2010 Transactions 52.203-13 Contractor Code of Business Ethics and Conduct APR 2010 52.204-4 Printed or Copied Double-Sided on Recycled Paper AUG 2000 52.204-7 Central Contractor Registration APR 2008 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.204-10 Reporting Executive Compensation and First-Tier SubcontractJUL 2010 Awards 52.209-6 Protecting the Government's Interest When Subcontracting DEC 2010 With Contractors Debarred, Suspended, or Proposed for Debarment 52.215-2 Audit and Records--Negotiation OCT 2010 52.215-8 Order of Precedence--Uniform Contract Format OCT 1997 52.219-6 Notice Of Total Small Business Set-Aside JUN 2003 52.219-14 Limitations On Subcontracting DEC 1996 52.222-3 Convict Labor JUN 2003 52.222-21 Prohibition Of Segregated Facilities FEB 1999 52.222-25 Affirmative Action Compliance APR 1984 52.222-26 Equal Opportunity MAR 2007 52.222-35 Equal Opportunity for Veterans SEP 2010 52.222-36 Affirmative Action For Workers With Disabilities OCT 2010 52.222-37 Employment Reports on Veterans SEP 2010 52.222-41 Service Contract Act Of 1965 NOV 2007 52.222-43 Fair Labor Standards Act And Service Contract Act - Price SEP 2009 Adjustment (Multiple Year And Option) 52.222-50 Combating Trafficking in Persons FEB 2009 52.222-54 Employment Eligibility Verification JAN 2009 52.223-5 Pollution Prevention and Right-to-Know Information AUG 2003 52.223-6 Drug-Free Workplace MAY 2001 52.223-14 Toxic Chemical Release Reporting AUG 2003 52.223-18 Contractor Policy to Ban Text Messaging While Driving SEP 2010 52.224-1 Privacy Act Notification APR 1984 52.224-2 Privacy Act APR 1984 52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.227-1 Authorization and Consent DEC 2007 52.227-2 Notice And Assistance Regarding Patent And Copyright DEC 2007 Infringement 52.228-5 Insurance - Work On A Government Installation JAN 1997 52.229-3 Federal, State And Local Taxes APR 2003 52.232-1 Payments APR 1984 52.232-3 Payments under Personal Services Contracts APR 1984 52.232-8 Discounts For Prompt Payment FEB 2002 N62645-11-R-0012 Page 65 of 118 52.232-11 Extras APR 1984 52.232-17 Interest OCT 2010 52.232-18 Availability Of Funds APR 1984 52.232-23 Assignment Of Claims JAN 1986 52.232-25 Prompt Payment OCT 2008 52.232-33 Payment by Electronic Funds Transfer--Central Contractor OCT 2003 Registration 52.233-1 Disputes JUL 2002 52.233-1 Alt I Disputes (Jul 2002) - Alternate I DEC 1991 52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.237-2 Protection Of Government Buildings, Equipment, And APR 1984 Vegetation 52.237-3 Continuity Of Services JAN 1991 52.242-13 Bankruptcy JUL 1995 52.243-1 Changes--Fixed Price AUG 1987 52.243-1 Alt I Changes--Fixed Price (Aug 1987) - Alternate I APR 1984 52.244-2 Subcontracts OCT 2010 52.244-6 Subcontracts for Commercial Items DEC 2010 52.245-1 Government Property AUG 2010 52.245-1 Alt I Government Property (Aug 2010) Alternate I AUG 2010 52.246-25 Limitation Of Liability--Services FEB 1997 52.249-8 Default (Fixed-Price Supply & Service) APR 1984 52.253-1 Computer Generated Forms JAN 1991 252.201-7000 Contracting Officer's Representative DEC 1991 252.203-7001 Prohibition On Persons Convicted of Fraud or Other Defense- DEC 2008 Contract-Related Felonies 252.203-7002 Requirement to Inform Employees of Whistleblower Rights JAN 2009 252.204-7000 Disclosure Of Information DEC 1991 252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7004 Alt A Central Contractor Registration (52.204-7) Alternate A SEP 2007 252.204-7006 Billing Instructions OCT 2005 252.205-7000 Provision Of Information To Cooperative Agreement Holders DEC 1991 252.209-7001 Disclosure of Ownership or Control by the Government of a JAN 2009 Terrorist Country 252.209-7004 Subcontracting With Firms That Are Owned or Controlled By DEC 2006 The Government of a Terrorist Country 252.223-7004 Drug Free Work Force SEP 1988 252.223-7006 Prohibition On Storage And Disposal Of Toxic And APR 1993 Hazardous Materials 252.225-7003 Report of Intended Performance Outside the United States and OCT 2010 Canada--Submission with Offer 252.225-7004 Report of Intended Performance Outside the United States and OCT 2010 Canada--Submission after Award 252.225-7006 Quarterly Reporting of Actual Contract Performance Outside OCT 2010 the United States 252.225-7012 Preference For Certain Domestic Commodities JUN 2010 252.232-7010 Levies on Contract Payments DEC 2006 252.243-7001 Pricing Of Contract Modifications DEC 1991 252.243-7002 Requests for Equitable Adjustment MAR 1998 252.247-7023 Transportation of Supplies by Sea MAY 2002 CLAUSES INCORPORATED BY FULL TEXT N62645-11-R-0012 Page 66 of 118 52.203-14 DISPLAY OF HOTLINE POSTER(S) (DEC 2007) (a) Definition. United States, as used in this clause, means the 50 States, the District of Columbia, and outlying areas. (b) Display of fraud hotline poster(s). Except as provided in paragraph (c)-- (1) During contract performance in the United States, the Contractor shall prominently display in common work areas within business segments performing work under this contract and at contract work sites-- (i) Any agency fraud hotline poster or Department of Homeland Security (DHS) fraud hotline poster identified in paragraph (b)(3) of this clause; and (ii) Any DHS fraud hotline poster subsequently identified by the Contracting Officer. (2) Additionally, if the Contractor maintains a company website as a method of providing information to employees, the Contractor shall display an electronic version of the poster(s) at the website. (3) Any required posters may be obtained as follows: Poster(s) Obtain from: DOD Inspector General ATTN: Defense Hotline 400 Army Navy Drive Washington, DC 22202-2884 (i) Appropriate agency name(s) and/or title of applicable Department of Homeland Security fraud hotline poster); and (ii) The website(s) or other contact information for obtaining the poster(s).) (c) If the Contractor has implemented a business ethics and conduct awareness program, including a reporting mechanism, such as a hotline poster, then the Contractor need not display any agency fraud hotline posters as required in paragraph (b) of this clause, other than any required DHS posters. (d) Subcontracts. The Contractor shall include the substance of this clause, including this paragraph (d), in all subcontracts that exceed $5,000,000, except when the subcontract-- (1) Is for the acquisition of a commercial item; or (2) Is performed entirely outside the United States. (End of clause) 52.209-9 Updates of Publicly Available Information Regarding Responsibility Matters (JAN 2011) N62645-11-R-0012 Page 67 of 118 (a) The Contractor shall update the information in the Federal Awardee Performance and Integrity Information System (FAPIIS) on a semi-annual basis, throughout the life of the contract, by posting the required information in the Central Contractor Registration database at http://www.ccr.gov. (b)(1) The Contractor will receive notification when the Government posts new information to the Contractor's record. (2) The Contractor will have an opportunity to post comments regarding information that has been posted by the Government. The comments will be retained as long as the associated information is retained, i.e., for a total period of 6 years. Contractor comments will remain a part of the record unless the Contractor revises them. (3)(i) Public requests for system information posted prior to April 15, 2011, will be handled under Freedom of Information Act procedures, including, where appropriate, procedures promulgated under E.O. 12600. (ii) As required by section 3010 of Public Law 111-212, all information posted in FAPIIS on or after April 15, 2011, except past performance reviews, will be publicly available. (End of clause) 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 01 October 2012 through 30 September 2017. (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) 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 $1,000.00, 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 100,000 hours; (2) Any order for a combination of items in excess of 100,000 hours; or (3) A series of orders from the same ordering office within 30 days that together call for quantities exceeding the limitation in subparagraph (1) or (2) above. (c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal N62645-11-R-0012 Page 68 of 118 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) above. (d) Notwithstanding paragraphs (b) and (c) above, 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 30 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) 52.216-22 INDEFINITE QUANTITY. (OCT 1995) (a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract. (b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the "maximum". The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum". (c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations. (d) 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 30 September 2017. (End of clause) 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 7 days; 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 60 months. (End of clause) 52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (APR 2009) (a) Definitions. As used in this clause-- N62645-11-R-0012 Page 69 of 118 Long-term contract means a contract of more than five years in duration, including options. However, the term does not include contracts that exceed five years in duration because the period of performance has been extended for a cumulative period not to exceed six months under the clause at 52.217-8, Option to Extend Services, or other appropriate authority. 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 the size standard in paragraph (c) of this clause. Such a concern is ``not dominant in its field of operation'' when it does not exercise a controlling or major influence on a national basis in a kind of business activity in which a number of business concerns are primarily engaged. In determining whether dominance exists, consideration shall be given to all appropriate factors, including volume of business, number of employees, financial resources, competitive status or position, ownership or control of materials, processes, patents, license agreements, facilities, sales territory, and nature of business activity. (b) If the Contractor represented that it was a small business concern prior to award of this contract, the Contractor shall rerepresent its size status according to paragraph (e) of this clause or, if applicable, paragraph (g) of this clause, upon the occurrence of any of the following: (1) Within 30 days after execution of a novation agreement or within 30 days after modification of the contract to include this clause, if the novation agreement was executed prior to inclusion of this clause in the contract. (2) Within 30 days after a merger or acquisition that does not require a novation or within 30 days after modification of the contract to include this clause, if the merger or acquisition occurred prior to inclusion of this clause in the contract. (3) For long-term contracts-- (i) Within 60 to 120 days prior to the end of the fifth year of the contract; and (ii) Within 60 to 120 days prior to the date specified in the contract for exercising any option thereafter. (c) The Contractor shall rerepresent its size status in accordance with the size standard in effect at the time of this rerepresentation that corresponds to the North American Industry Classification System (NAICS) code assigned to this contract. The small business size standard corresponding to this NAICS code can be found at http://www.sba.gov/services/contractingopportunities/sizestandardstopics/. (d) The small business size standard for a Contractor providing a product which it does not manufacture itself, for a contract other than a construction or service contract, is 500 employees. (e) Except as provided in paragraph (g) of this clause, the Contractor shall make the rerepresentation required by paragraph (b) of this clause by validating or updating all its representations in the Online Representations and Certifications Application and its data in the Central Contractor Registration, as necessary, to ensure that they reflect the Contractor's current status. The Contractor shall notify the contracting office in writing within the timeframes specified in paragraph (b) of this clause that the data have been validated or updated, and provide the date of the validation or update. (f) If the Contractor represented that it was other than a small business concern prior to award of this contract, the Contractor may, but is not required to, take the actions required by paragraphs (e) or (g) of this clause. (g) If the Contractor does not have representations and certifications in ORCA, or does not have a representation in ORCA for the NAICS code applicable to this contract, the Contractor is required to complete the following rerepresentation and submit it to the contracting office, along with the contract number and the date on which the rerepresentation was completed: N62645-11-R-0012 Page 70 of 118 The Contractor represents that it (X ) is, ( ) is not a small business concern under NAICS Code 622110- assigned to solicitation number N62645-11-R-0012. (Contractor to sign and date and insert authorized signer's name and title). (End of clause) 52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES (MAY 1989) In compliance with the Service Contract Act of 1965, as amended, and the regulations of the Secretary of Labor (29 CFR Part 4), this clause identifies the classes of service employees expected to be employed under the contract and states the wages and fringe benefits payable to each if they were employed by the contracting agency subject to the provisions of 5 U.S.C. 5341 or 5332. THIS STATEMENT IS FOR INFORMATION ONLY: IT IS NOT A WAGE DETERMINATION Employee Class GS Equivalency Licensed Vocational Nurse (Naval Medical Center San Diego, CA) GS/5 Nurse Practitioner (Naval Medical Center San Diego, CA) GS/12 Certified Nurse Midwife (Naval Hospital Lemoore, CA) GS/12 Registered Nurse (Branch Medical Clinic Barstow, CA) GS/11 Licensed Vocational Nurse (Naval Hospital Twentynine Palms, CA) GS/6 Registered Nurse Case Manager (Naval Hospital Camp Pendleton, CA) GS/12 (End of clause) 52.249-12 TERMINATION (PERSONAL SERVICES) (APR 1984) The Government may terminate this contract at any time upon at least 15 days' written notice by the Contracting Officer to the Contractor. The Contractor, with the written consent of the Contracting Officer, may terminate this contract upon at least 15 days' written notice to the Contracting Officer. (End of clause) 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): http://farsite.hill.af.mil (End of clause) N62645-11-R-0012 Page 71 of 118 Section J - List of Documents, Exhibits and Other Attachments ATTACHMENT TABLE OF CONTENTS Attachment AA Lists of Acceptable Documents to establish U.S. Citizenship Attachment AB Contract Administration Plan (CAP) with 3 Enclosures Attachment AC Letter of Identification – Travel (Example) Attachment AD Health Care Worker Certificate Of Availability Attachment AE Offeror’s Technical Proposal (Incorporated By Reference) Attachment AF Computer Skills Competency Form Attachment AG Current Task Order Prices for MATO Contract Task Orders Attachment AH Format for Contractor’s Fill Rate Report to NMLC Attachment AI Supplemental Pricing Worksheet (Sample) Attachment AJ CLIN Explanation Attachment AK Wage Determinations N62645-11-R-0012 Page 72 of 118 ATTACHMENT AA Lists of Acceptable Documents to Establish U.S. Citizenship Excerpt from SECNAV M-5510.30 of June 2006, Appendix F 4. All documents submitted as evidence of U. S. citizenship must be original documents or certified copies. Uncertified copies are not acceptable. The following documents are acceptable proof of citizenship: a. The original U. S. birth certificate with a raised seal issued at the time of birth from one of the 50 states, or outlying territories or possessions. b. A hospital birth certification (clinic and commercial birth center certification is not permitted) with an authenticating raised seal or signature provided all vital information is given. c. A delayed birth certificate provided it shows the birth record was filed within one year after birth, it bears the registrar's seal and signature, and cites secondary evidence such as a baptismal certificate, certificate of circumcision, affidavits of persons having personal knowledge of the facts of the birth or other official records such as early census, school or insurance. d. U.S. Passport (current or expired) or U.S. passport issued to individual’s parent in which the individual is included. e. FS-240 Report of Birth Abroad of a Citizen of the United States of America/Consular Report of Birth. f. FS-545 Certification of Birth issued by a U.S. Consulate or DS-1350 the Department of State Certification. g. INS N-550/570 U.S. Immigration and Naturalization Service Naturalization Certificate. h. INS N-560/561 U.S. Immigration and Naturalization Service Certificate of Citizenship. If the individual does not have a Certificate of Citizenship, the original Certificate of Naturalization of the parent(s) may be accepted if the naturalization occurred while the individual was under 18 years of age (or under 16 years of age before 5 October 1978) and residing permanently in the U.S. i. Certificate of birth issued by the Canal Zone government indicating U.S citizenship is only acceptable if verified by direct government inquiry to: Vital Records Section, Passport Services, 1111 19th Street NW, Suite 510, Washington, D.C. 20522-1705. j. DD 372, Verification of Birth is acceptable for military members (officer and enlisted) provided the birth data is listed and verified by the Department of Vital Statistics. k. DD 1966, Application for Enlistment into the Armed Forces of the United States are acceptable provided the documents sighted are listed and attested to by a recruiting official. 5. If none of the above forms of evidence are obtainable, a notice from the registrar issued by the state with the individual’s name, date of birth, which years were searched for a birth record and that there is no birth certificate on file for the applicant should be presented. *The registrar's notice must be accompanied by the best combination of the following secondary evidence: a. Baptismal certificate N62645-11-R-0012 Page 73 of 118 b. Census record c. Certificate of circumcision d. Early school record e. Family Bible record f. Doctor’s record of post-natal care g. Newspaper files and insurance papers * NOTE: These documents must be early public records showing the date and place of birth, created within the first five years of life. The individual may also submit an Affidavit of Birth, Form DSP-10A, from an older blood relative, i.e., a parent, aunt, uncle, sibling, who has personal knowledge of the birth. It must be notarized or have the seal and signature of the acceptance agent. N62645-11-R-0012 Page 74 of 118 ATTACHMENT AB CONTRACT ADMINISTRATION PLAN (CAP) 1. Definitions. 1.1 Administrative Contracting Officer (ACO). To the extent that the Procuring Contracting Officer (PCO) has delegated contract administration, the Government official responsible for administering the contract. 1.2 Alternate Contracting Officer’s Representative (ACOR). In the absence of the Contracting Officer’s Representative (COR), the Government official appointed in writing by the PCO who functions as the technical representative of the PCO for a specific contract, for a specified period of time. 1.3 Bureau of Medicine and Surgery (BUMED). The Department of the Navy command responsible for all Navy health and dental contracting initiatives. 1.4 Commanding Officer. The medical department officer that has ultimate responsibility for the operation of a Medical Treatment Facility (MTF). 1.5 Contracting Officer’s Representative (COR). The Government official appointed in writing by the PCO who functions as the technical representative of the PCO. 1.6 Contractor. The offeror identified in block 15A of the Standard Form 33 or block 7 of the Standard Form 26 and its health care workers who are providing services under the contract. 1.7 Health Care Program Analyst. The Naval Medical Logistics Command (NAVMEDLOGCOM) contract administration advisory resource for the COR/Technical Assistant (TA)/supervisor. 1.8 Medical Treatment Facility (MTF). A Department of Defense (DoD) hospital or medical center that may require services under this contract. The abbreviation, “MTF” includes all the Branch Medical Clinics, Medical Administrative Units, Branch Medical Annexes and other subordinate clinical activities specified in this contract. The abbreviation, “MTF” also refers to any military treatment facility within the scope of this contract. 1.9 Naval Medical Logistics Command (NAVMEDLOGCOM). The Department of the Navy command responsible for implementation of the Bureau of Medicine and Surgery health care contracting initiatives. 1.10 Procuring Contracting Officer (PCO). The Government official within NAVMEDLOGCOM authorized by warrant to enter into this contract for the Government. 1.11 Supervisor. The Government official whose duty it is to provide day-to-day direction to, and oversight of, contractor personnel, including supervisory functions such as time and attendance. 1.12 Technical Assistant (TA). The MTF representative who may be assigned by the COR to provide technical or administrative assistance to the COR. TAs may be assigned to assist and support the COR but shall not be given the authority to provide any technical direction or clarification directly to the Contractor. 2. Responsibilities. 2.1 The Navy's ASSISTANT CHIEF FOR HEALTH CARE OPERATIONS, BUREAU OF MEDICINE AND SURGERY (BUMED Code M3) as Program Manager shall: 2.1.1 Establish medical contract policy guidance. N62645-11-R-0012 Page 75 of 118 2.1.2 Provide overall direction for the planning, development, and operation of all Navy MTFs. 2.1.3 Monitor the progress and achievement of medical contract within the Navy’s health care delivery system. 2.1.4 Serve as subject matter expert for all technical aspects of medical contracting efforts. 2.2 The PCO, ACQUISITION MANAGEMENT DIRECTORATE (Code 02), Naval Medical Logistics Command shall: 2.2.1 Perform all required pre-award actions including providing information or answering questions that arise during the solicitation period and as a result of Freedom of Information Act (FOIA) inquiries. 2.2.2 Review the Contract Administration Plan (CAP). The PCO shall furnish sample COR and TA nomination letters to the MTF in accordance with NAVSUPINST 4205.3C. 2.2.3 Verify that the individual(s) nominated to act as COR have had the required training and the necessary experience. If the PCO determines that a nominee does not meet experience and training requirements, the PCO shall request that the MTF nominate another individual. 2.2.4 Review the CAP prior to incorporation into the solicitation. This review shall ensure that all contract administration functions are assigned, suit the specific circumstances of the contract and give due consideration to the type of contract, the place of performance, period of performance, and inspection and acceptance criteria stated in the solicitation/contract. 2.2.5 Include the COR duties contained in this master CAP in the resultant solicitation/contract. Additional duties shall be separately delineated within the contract, as appropriate. 2.2.6 Designate the paying office in the contract. 2.2.7 Appoint the COR and ACOR. 2.2.8 Perform all contract administration duties of a Contracting Officer. Regular meetings between the PCO, the COR or the MTF Commanding Officer (or representative) will be held to discuss the status of and the performance under individual contract. The format and frequency of these meetings will depend upon the size and complexity of the contract. NOTE: All parties are specifically reminded that only the Contracting Officer has the authority to modify the terms of the contract. Therefore, in no event will any understanding, agreement, modification, change order, or other matter deviating from the terms of the basic contract between the Contractor and any other person be effective or binding on the Government. When/if, in the opinion of the Contractor, any direction affecting the terms of the basic contract has been given by the COR or any other person, the Contractor shall promptly notify the PCO. 2.2.9 Evaluate reports of Contractor non-compliance and take appropriate action within 30 days of receipt. Copies of any correspondence regarding the results of such analyses shall be provided to the MTF and the COR simultaneously with the action taken. Immediately sign and return acknowledgement of CDR’s to the COR, including a final KO acknowledgement and recommendation to the COR on how to proceed. 2.2.10 Arrange the post-award conference, if required. Invite necessary attendees. Ensure that the requirements of the contract and the COR’s duties are thoroughly discussed and understood. Ensure that all personnel involved understand current DoD Standards of Conduct policies. 2.2.11 Oversee the performance of CORs under the contract. Prompt action shall be taken when COR (or alternate) is not performing properly. N62645-11-R-0012 Page 76 of 118 2.2.12 Maintain the official contract file including modifications (and all back-up documentation). 2.2.13 Maintain the accuracy of this Master CAP throughout the life of these contract. 2.2.14 Maintain a list of all CORs under their authority. Periodically review the files and performance of these CORs in accordance with NAVSUPINST 4205.3C and local policies. 2.2.15 Review the existing annual Contractor performance reports prior to negotiating under this contract. Enter data into the Contractor Performance Assessment Reporting System (CPARS). 2.2.16 Maintain a log of total hours for each Contract Line Item Number (CLIN) to guarantee quantities are not exceeded. Notify the Health Care Program Analyst (NAVMEDLOGCOM Code 07) and the MTF when 75% of the quantity of any CLIN has been reached. 2.3 The HEALTH CARE PROGRAM ANALYST, HEALTH CARE SERVICES SUPPORT DIRECTORATE (Code 07), Naval Medical Logistics Command shall: 2.3.1 Submit a completed and signed CAP Documentation Form with answers to questions that pertain to this acquisition. 2.3.2 As appropriate, submit the Contract Data Requirements List (DD Form 1423 or CDRL) providing a description of all reports/outputs required from the Contractor. 2.3.3 Act as the health care contracting technical manager for BUMED. Ensure consistency among health care contract, providing coordination and technical liaison between MTFs, BUMED, CORs, and the PCO. 2.3.4 Coordinate/develop the procurement technical requirements including a performance work statement (Section C); draft input to Sections B, H, L and M; a draft Source Selection Plan; a draft CAP; potential sources for the procurement; draft quality assurance plan; surveillance plan and other related documents required for the acquisition. 2.3.5 Monitor and manage reports of Contractor non-compliance, evaluate reports submitted by the individual CORs, and recommend PCO disposition on all noted discrepancies. 2.3.6 Perform health care trend analyses and provide feedback to the PCO and CORs. 2.3.7 Provide any other technical assistance to the MTF, PCO/ACO, CORs, and other customers. 2.3.8 Through coordination with the PCO, participate in periodic COR meetings and inspections to discuss status and performance under the contract emphasizing problem identification, problem solving and contract familiarity. 2.3.9 Ensure that the MTF, PCO/ACO, CORs, and BUMED are appropriately informed of related dental health care issues. 2.3.10 Provide periodic statistical and financial reports to BUMED. 2.4. The COMMANDING OFFICER OF THE MTF shall: 2.4.1 Budget and provide funding for the contract. 2.4.2 Nominate (to the PCO) individual(s) to be appointed as COR (by name, title, organizational code and telephone number). This individual(s) shall also be the contract quality assurance monitor and lead technical advisor to the ACO and shall be responsible for the technical interface needed during contract performance. An ACOR can be nominated to act in the absence of the COR, when needed, or to provide additional expertise. N62645-11-R-0012 Page 77 of 118 NOTE: COR duties cannot be delegated. The COR shall be accountable for the actions of ACORS or TAs. NOTE: Nomination of new CORs as a result of reassignment, termination of employment, etc., shall be made in accordance with the procedures outlined herein. 2.4.3 Ensure all individuals nominated as COR or ACOR have the necessary qualifications to satisfactorily perform the required duties and hold a position of responsibility commensurate with the complexity of the contract. All CORs shall have graduated from a Naval Supply System Command (NAVSUP) approved/BUMED provided medical COR training course prior to their appointment. 2.4.4 Upon receipt of the contract from the PCO, forward copies of documents to staff having administrative responsibilities for these contract. 2.4.5 Support and supervise the COR in the performance of their duties. If the Commanding Officer determines that assigned duties are not being performed in a satisfactory manner, immediate corrective action shall be taken (including the recommendation to replace the COR if required). The PCO shall be promptly notified of all actions taken. The MTF should consider COR performance in rating all individuals assigned COR functions. 2.4.6 Notify the PCO in writing of any organizational or personnel changes affecting the CAP. 2.4.7 Ensure that appropriate timely action is taken on all contract related correspondence received from either the PCO or COR. This includes the timely submission (to the PCO) of any requests for changes to the performance work statement, deviations or waivers. An Independent Government Cost Estimate of the impact on contract price and the availability of additional funding (if required) must accompany all requests for changes to the performance work statement/contract. The Contractor’s price quote and the rationale for requesting the change shall accompany any changes proposed by the Contractor. The Contractor’s price quote serves as a budgetary estimate of the cost impact. The MTF shall also provide input as to technical acceptability of proposed contract language changes. 2.4.8 The MTF Commanding Officer may appoint a TA to assist the COR in executing routine contract administration, monitoring and, surveillance duties. The appointment of all TAs must be in writing and must include the TA's responsibilities and limitations. A copy of this appointment letter shall be provided to the PCO. Before appointment, the MTF shall assure that all TAs have the appropriate training and experience. 2.5 The CONTRACTING OFFICER'S REPRESENTATIVE (COR) shall: 2.5.1 Attend both the pre-proposal and post-award conferences, if held. 2.5.2 Attend periodic meetings (as necessary) among the PCO, MTF and Contractor(s) to discuss the status of and performance under the contract. 2.5.3 Avoid issuing any instructions that would constitute a change to the contract. The COR and Contractor shall not enter into any understanding, agreement, modification, or change order deviating from the terms of the contract which shall be effective or binding on the Government. If in the opinion of the Contractor, an effort outside the scope of the contract is requested, the Contractor shall promptly notify the PCO in writing. The Contractor shall not act unless the PCO or ACO has issued a written change to the contract. The COR will include, on all correspondence to the Contractor, a declination of authority statement as follows: “I have neither the authority nor the intent to change the terms or conditions of this contract. This contract can only be changed by a written modification issued by the Contracting Officer. If you believe that I am requesting an effort outside the scope of this contract, promptly notify the Contracting Officer. Additionally, this shall not be construed as an authorization for new work or additional work not already contained in the contract.” 2.5.4 Perform as the technical interface between the Government and the Contractor(s) for this contract. The COR shall provide technical advice or clarification regarding the performance work statement; milestones to be met within N62645-11-R-0012 Page 78 of 118 the general terms of the contract or specific subtasks of the contract. The COR is the point of contact through whom the Contractor can relay technical questions and problems to the Contracting Officer. The Contractor may also contact the Contracting Officer directly. 2.5.5 Coordinate/facilitate complete and timely credentials submissions between the MTF and the Contractor using the applicable Professional Affairs Coordinator (PAC) staff at the MTF. The COR shall provide technical advice or clarification regarding the performance work statement, milestones to be met within the general terms of the contract or specific subtasks of the contract, maintain a method for tracking expiring credentials, and maintain shift schedules. The COR shall inspect the credentials of each contract employee prior to submission to the PAC. 2.5.6 Monitor Contractor performance and progress under the contract. If potentially inefficient or wasteful methods are being used, the COR shall take reasonable and timely action to alert the Contractor and the PCO. Furthermore, the COR shall promptly advise the PCO of any observed continuous and/or substantial deficiencies in the Contractor's performance or other noncompliance with the terms or conditions of the contract. Enclosure (1) is the surveillance plan to be used by the COR to monitor Contractor performance. Deviation from this surveillance plan is only permitted with the prospective approval of the PCO. 2.5.7 In accordance with procedures given in Enclosure 1, Surveillance Plan, promptly issue Contract Discrepancy Reports (CDRs) (Enclosure (2)) to the Contractor to document discrepant performance. The COR shall always obtain the Contractor's response/rebuttal to the CDR, evaluate, with the affected Department Head/OIC, the acceptability of the response and promptly forward the CDR, Contractor response/rebuttal, and their recommendation to the NAVMEDLOGCOM PCO and Health Care Program Analyst. 2.5.8 Monitor and verify services provided in accordance with Section B of the contract. Keep accurate records of Contractor performance and compare these records with the Wide Area Work Flow (WAWF) invoice or time sheet submitted by the Contractor. The COR shall always use this information as a tool when evaluating Contractor invoices. 2.5.9 Inspect and/or accept the services as the official Government representative. 2.5.10 Use appropriate, contract-specific sampling methods for contract surveillance. 2.5.11 Completely understand contract invoicing requirements. The COR shall process all WAWF Invoices in a timely manner to ensure that prompt payment due dates are met. 2.5.12 Immediately alert the PCO and the ACO of any unusual performance problems. If a corrective action plan is approved by the Contracting Officer, the COR shall monitor the implementation and effectiveness of that corrective action plan. In uncertain situations, the COR shall always seek advice from the PCO and/or ACO, as prudent, before acting. 2.5.13 Continually monitor the quantity of services provided under each CLIN. Advise the PCO if it appears that service quantities may be exhausted before the end of the performance period, or if quantities of unused hours for services have been ordered but will not be received by the end of the performance period. 2.5.14 Perform administrative duties including all files which support the actions performed as a COR. The COR shall respond to all contract correspondence in a timely manner. Contract files shall include a conforming copy of the contract, all modifications, a conforming copy of the Contractor’s Technical Proposal (Management Planning and Market Research), all surveillance reports, each CDR (including the Contractor’s response/rebuttal), any contract-related correspondence, a contract log or COR diary, all telephone conversation and email records, meeting minutes, reports from Government subject matter experts, and Independent Government Cost Estimates. 2.5.15 Take the necessary steps to ensure that Government property furnished to the Contractor is provided in a timely manner and in proper condition for use. The COR shall maintain both inventory and disposition records for all Government furnished property. This inventory/disposition file is coordinated with the ACO. The COR shall N62645-11-R-0012 Page 79 of 118 ensure that the Contractor returns all Government furnished property or that Government furnished material has been reasonably consumed in the performance of work. 2.5.16 Read and comply with all applicable Standards of Conduct and Conflict of Interest instructions and procedures including annual financial interest filings. 2.5.17 Ensure that the Contractor receives copies of all regulations and/or directives considered appropriate to the services being provided. 2.5.18 Submit information detailing the Contractor's performance to the PCO. A statement indicating performance has been satisfactory along with your request to continue performance would be required prior to the issuance of any Logical Follow On. An annual report on the Contractor's performance will be required 30 days after the end of each performance period. A final report shall be sent to the PCO within 60 days after completion of the contract. The final report shall contain a conclusive statement describing the Contractor's overall performance and an evaluation on the accountability of Government property furnished to the Contractor. Enclosure (3) contains the format for the reports. 2.5.19 Perform other duties, particular to the contract, as may be incorporated into the contract document or as required by the Contracting Officer. 2.6. TECHNICAL ASSISTANT (TA). All requirements for TA duties are reported directly to the COR. At the direction of the COR, the TA shall: 2.6.1 Perform surveillance and identify Contractor deficiencies. 2.6.2 Review contract deliverables, recommending acceptance/rejection, and providing the COR with the documentation to support all recommendations. 2.6.3 Assist the COR in the preparation of the final Contractor performance report using the format and procedures prescribed by the Contracting Officer. 2.6.4 Identify Contractor non-compliance with reporting requirements. 2.6.5 Evaluate Contractor proposals, identifying potential problem areas. 2.6.6 Provide (a) timely input for technical clarifications to the performance work statement, (b) technical direction for the Contractor, and (c) recommendations for CAPs. 2.6.7 Provide detailed written reports of any trip, meeting, correspondence, telephone conversation, email or, anecdotal conversation after any contact between the TA and the Contractor. Enclosures: Enclosure 1 - Surveillance Plan Enclosure 2 - Contract Discrepancy Report Enclosure 3 - Report on Contract Performance N62645-11-R-0012 Page 80 of 118 Enclosure 1 SURVEILLANCE PLAN 1. INTRODUCTION 1.1 Purpose. This surveillance plan has been developed to aid the Contracting Officer’s Representative (COR) in providing effective and systematic surveillance of all aspects of this contract. 1.2 Objective. To ensure that the Contractor is complying with the specifications of the contract by providing quality health care services to eligible beneficiaries. 1.3 Scope. This plan applies to the Medical contract services. This is a personal services contract. Contract performance will be monitored chiefly through prospective supervision by Navy personnel. Some elements of performance will be monitored by the COR through retrospective surveillance. 2. RESPONSIBILITIES 2.1 The Contracting Officer (KO) at NAVMEDLOGCOM is responsible for negotiating all modifications to contract terms, conditions or amounts. 2.2 The Health Care Program Analyst at NAVMEDLOGCOM serves as the technical agent for coordinating issues among the KO, the MTF and the COR. The Health Care Program Analyst reviews the COR’s contract surveillance and provides feedback to the COR and recommendations to the KO. The Health Care Program Analyst provides technical support to the COR and the KO in preparing modifications. The Health Care Program Analyst also tabulates statistical data. 2.3 The MTF commanding officer is responsible for establishing and maintaining a system for reviewing and approving correspondence submitted by the COR to NAVMEDLOGCOM. 2.4 The COR is responsible for assuring Contractor performance through audit, documentation and liaison with the KO. The COR shall ensure that copies of all Contractor correspondence and MTF COR responses are provided to the KO. The COR must observe the following cautions and limitations: 2.4.1 Do not request or direct the Contractor to do anything that is not expressly stated in the contract. 2.4.2 Do not attempt to control Contractor efforts except as specifically authorized in the contract. 2.4.3 Do not make suggestions or comments that the Contractor could construe as authority to proceed on work not specified in the contract. 2.4.4 Do not request changes that add work or objectives not within the scope of the contract. Seek the advice of the KO. 2.4.5 Do not accidentally generate a basis for a Contractor claim. Communicate with the Contractor in a timely manner. 2.4.6 Exercise diligence in monitoring and documenting the Contractor’s performance. When in doubt about any aspect of the contract specifications or the Contractor’s performance, seek the advice of the KO or the NAVMEDLOGCOM Health Care Program Analyst. 2.4.7 Bring to the attention of the KO any extraordinary action on the part of the Contractor, i.e., any performance outside the scope of the contract. N62645-11-R-0012 Page 81 of 118 2.5 The Government supervisory personnel specified in the contract are responsible for providing day-to-day supervision and control of contract personnel. This includes provision of technical guidance, direction, and approval of tasks performed to satisfy requirements of the contract. 3. INSPECTION METHODS. Several methods serve as means for inspecting Contractor performance. Some methods are more appropriate than others are. The COR may use any or all of these inspection methods. Inspection, along with documentation, is vital to ensuring Contractor compliance with contract requirements. 3.1 100% Inspection. This method of surveillance is time consuming, expensive and unrealistic for services performed frequently. However, it is appropriate in critical areas where health and safety are involved and each occurrence of a particular requirement must be examined to determine compliance. 3.2 Surveillance Checklists. Checklists are used for services performed on an infrequent but predictable schedule (e.g., monthly, quarterly, annually, etc.) Any scheduled service that is provided on less than a daily basis can be considered for inclusion on a checklist. 3.3 Random Sampling. Sampling can be an unbiased, comprehensive evaluation of the Contractor’s performance while efficiently using limited inspection time. The basis for doing random sampling is MIL-STD-105D, “Sampling Procedures and Tables for Inspection by Attributes”. It is based on the statistical concept that an evaluation of randomly chosen occurrences may allow the evaluator to draw conclusions (acceptable/not acceptable) about the universe of occurrences. 3.4 Validated Customer Complaints. Validated customer complaints are the customer’s method of documenting problems. The COR will coordinate efforts to acquire, document and validate these complaints. Customer complaints are not used to reject a service, but can be used as further evidence of unsatisfactory performance (e.g. if random sampling shows the specific service is unsatisfactory). When other surveillance continues to show unsatisfactory performance, validated customer complaints can indicate a need to increase surveillance. The COR must have a written validation process for all customer complaints (much like the CDR process). Only validated customer complaints should be forwarded to the Contracting Officer for action. Customer complaints cannot be used in conjunction with other surveillance methods (i.e., partial random sampling plus certain customer complaints) because their occurrences are not truly random. 4. TIME FRAMES FOR MONITORING PERFORMANCE REQUIREMENTS. There are several different time frames for monitoring performance requirements of the contract. Depending upon the specific performance requirement, the COR will monitor activities on a one-time basis, a per occurrence basis, or an ongoing basis. 4.1 One-time Activities. This performance requirement is generally monitored for initial or start-up activities, such as submission and verification of the credentials files. 4.2 Per Occurrence Activities. This activity is one that is monitored at each occurrence. It is often an activity could place a patient at unnecessary risk for which the COR will investigate. Examples of these would include medication errors, impaired providers, or any incidents that resulted in disciplinary action against a Contractor employee. 4.3 Ongoing Activities. This performance requirement is one that must be continually monitored throughout the life of the contract because the requirement itself is ongoing. Examples include a requirement for shift coverage, schedule submissions, meeting attendance, maintenance of personnel qualifications and, documentation of annual training. 5. DOCUMENTATION. 5.1 The need to document each contact between the COR and the Contractor cannot be overemphasized. CORs should understand the procedures that are described in FAR Part 33.2. CORs should remember that the documentation prepared by the COR will be the primary evidence presented by the Government in any litigation, with the Government bearing the burden of proof. This documentation must be thorough, accurate and complete. N62645-11-R-0012 Page 82 of 118 5.2 It is important to maintain a record of all other contacts between the COR and the Contractor which reflect normal clinic operations or the services required in the contract. Examples may include schedule submissions, feedback on Contractor credentialing actions, substitution procedures for health care workers, etc. These examples may or may not be a part of routine surveillance, but the COR’s ability to reconstruct events will be important if the Government rejects the quality or timeliness of contract services. 5.3 Documentation may include Contract Discrepancy Reports (CDRs), meeting minutes, annotations on surveillance checklists, letters, email, telephone conversation records, memoranda, etc. Results of inspections identifying unsatisfactory Contractor performance must be given to the Contractor for review, comment, and corrective action as appropriate. 5.4 All performance related inspection documentation is an integral part of the contract file and must be stored and maintained accordingly. The COR should maintain a reading file of all correspondence and pertinent documentation. 6. INVOICING PROCEDURES 6.1 At the end of each bi-weekly period of contract performance, the contractor will present the COR with an invoice via Wide Area Work Flow. The COR will inspect the invoice to ensure that it accurately reflects the amount of service provided by the contractor, but will not accept (sign) the invoice if there are any substantial inaccuracies. 6.2 The COR shall coordinate with the supervisor of each clinical area represented on the invoice to determine the accuracy of the service totals included on the invoice. Additional tools which may be available to the COR to confirm invoice amounts are contract employee time clock cards and sign-in/sign-out sheets. Time which is not in some way confirmed through coordination with the applicable supervisor, documented by time clock, documented by time sheet, or confirmed through some other appropriate method available to the COR will not be considered to have been provided. 6.3 If the COR identifies any discrepancies with the invoice, the COR shall reject the invoice per WAWF procedures. The contractor will re-invoice so that it can be certified correctly. 6.4 CORs may NOT note changes directly on the contractor’s invoice, as it will be rejected by DFAS as improper. 6.5 Failure of the contractor to submit invoices in a timely manner, significant or recurring discrepancies on submitted invoices, or failure of the contractor to submit a revised invoice for a billing period, shall be brought to the attention of the KO and the NAVMEDLOGCOM Health Care Program Analyst. 7. CONTRACT DISCREPANCY REPORTS (CDRs) 7.1 The COR shall recognize that CDRs become official records within the contract file and that they have serious implications for overall contract management and relationships. CDRs shall not be the first and only choice for communicating contract issues with the contractor and shall be implemented in accordance with the procedures given below within this Surveillance Plan. 7.2 For serious contract performance deficiencies, or when less formal communications fail to resolve minor performance deficiencies, the COR will issue a CDR to the Contractor. 7.3 The COR shall ensure that all inspection data is attached to the CDR. The Contractor cannot be expected to respond to performance deficiencies that are not clearly and specifically identified. A cover memorandum on the CDR should specify that the Contractor has three working days, or other appropriate deadline, to respond in writing to the COR. At the time the CDR is issued to the Contractor, the COR shall provide a copy of the CDR to the Contracting Officer and to the Health Care Program Analyst. N62645-11-R-0012 Page 83 of 118 7.4 Upon return of the CDR package from the Contractor, the COR shall review the Contractor’s comments and give careful, objective consideration to the facts and mitigating circumstances documented in the response. The COR shall then make a final written determination and recommendation to the Contracting Officer on the acceptability of Contractor performance and note it on the CDR. The COR shall state why the Contractor’s response does or does not have merit. The COR shall prepare the determination, recommendation, and other statements as appropriate along with actions being requested of the Contracting Officer and as much additional documentation as required to support their conclusions and recommendations. 7.5 The COR shall provide the above documentation along with actions being requested of the Contracting Officer and as much additional documentation as required to support their conclusions and recommendations to (1) the Contractor, (2) the PCO, and (3) the Health Care Program Analyst. 7.6 The PCO and Health Care Program Analyst will review CDRs and will advise the COR of the need for any further documentation. 8. COR SURVEILLANCE REQUIREMENTS 8.1 Submission of Credentials. The COR shall inspect the credentials of each contract employee. 8.1.1 The contractor shall submit Individual Credentials Files (ICFs), Individual Professional Files (IPFs), and qualifications packages (for non-credentialed/non-licensed personnel) in accordance with requirements of the contract and BUMEDINST 6320.66 (latest revision). 8.1.2 ICFs and IPFs. The COR will inspect each ICF/IPF for completeness and compliance with contract qualification requirements. Incomplete/incorrect packages will be returned to the contractor under a memo documenting the deficiencies. Complete/correct packages will be forwarded to the Professional Affairs Coordinator (PAC) for formal credentialing action. The PAC will inform the contractor by letter or email upon approval of a package. 8.1.3 Non-credentialed/non-licensed personnel. The contractor shall submit to the COR a package of documents demonstrating the individual’s compliance with contract requirements. The COR will review each package and return to the contractor under a memo stating approval or reason(s) for disapproval. 8.2 Orientation. In coordination with the supervisors for whom services are being provided, the COR shall coordinate the availability of appropriate orientation sessions and shall track and maintain records of orientation completed by contractor personnel. The COR shall ensure that all orientation is completed within the timeframes specified in the contract and notify the contractor of deficiencies. 8.3 Background checks for childcare workers. The COR shall ensure the completion by contractor personnel of background check forms, coordinate with appropriate security service to obtain requisite fingerprinting and forwarding of forms to the required law enforcement agencies, and shall maintain a file of completed background checks. The COR shall notify the MTF chain of command and the contracting officer immediately upon the receipt of an unfavorable background check. 8.4 Maintenance of Credentials. 8.4.1 The COR shall maintain a method for tracking expiring credentials, such as a database or spreadsheet. The method chosen should include at least the guidelines in this paragraph, as best implemented in accordance with MTF policy. Not less than once per month, the COR shall review the tracking file and identify any credentials due to expire within 2 months. The COR shall notify the contractor of those expiring credentials and shall advise the contractor that the affected individual will not be permitted on the staffing schedule or to provide service under the contract following expiration of credentials. N62645-11-R-0012 Page 84 of 118 8.4.2 The COR shall maintain a record of contractor personnel compliance with health certification requirements of the contract. The COR shall notify the contractor of expired health certifications. 8.5 Contractor Shift Schedules for Personnel For Which Replacement Coverage is Required. The COR will inspect the Contractor submitted schedule for those positions for which coverage is required. The COR shall compare the schedule to the contract requirements, note deficiencies, and inform the contractor of those deficiencies. The contractor shall be required to submit an updated schedule. 8.6 Full-time versus part-time staff. The COR shall ensure that the contractor utilizes only full-time individuals when required by the contract. The COR shall also ensure that the contractor does not utilize part-time personnel in excess of any restrictions imposed thereon by the contract. The COR shall coordinate with the respective supervisors to monitor these requirements. 8.7 Personnel substitution. The COR shall monitor contractor compliance with Section H restricting substitution of approved personnel. 8.8 Contract Discrepancy Reports (CDRs). The COR’s responsibilities for documentation of contractor performance problems using the CDR (provided by Enclosure 2) are given in paragraph 2.5.7 of the Contract Administration Plan. The COR shall maintain close communication with the supervisor(s) of contractor personnel as they will be most aware of day-to-day performance issues which may arise. CDRs shall be completed by the COR, not the supervisor. A CDR shall be completed by the COR in accordance with the Contract Administration Plan whenever there exist unresolved COR surveillance deficiencies or unresolved supervisory issues. Remember that the CDR is presented to the contractor firm’s designated representative, not the contractor employee who failed to perform in accordance with the contract. That is not to say that a CDR must be completed every time there is a deviation from contract requirements. The COR or supervisor is better served by attempting to solve performance problems at the lowest level possible and in the least threatening manner possible., not by producing a CDR for every minor infraction. It is best to seek cooperative resolution, and then resort to formal documentation via a CDR if resolution cannot be reached. This approach is not intended as a license to avoid documentation of performance problems; if a problem cannot be expeditiously resolved cooperatively, the CDR process should be invoked. The CDR form is designed to produce a record of both Government and contractor positions. There is no requirement that this form be reduced to hard copy; an electronic copy attached to emails transmitted between representatives is acceptable. 9. SUPERVISOR RESPONSIBILITES 9.1 The supervisor is the individual Government employee who is responsible for providing the day-to-day direction and control of the activities of the personal services health care worker. The supervisor(s) of contract personnel shall read and retain a copy of the contract under which the supervisor is receiving services. The supervisor shall recognize that the contract protects the interests of both the Government and the contractor/contract personnel and that the contract prescribes duties and responsibilities for both parties. 9.2 This is a personal services contract and provides the supervisor with the ability to direct and control the day-to- day activities of the contract personnel. However, the supervisor shall be cognizant of the overall scope of the contract and the particular duties defined by the contract as being within that scope. The supervisor shall ensure that duties assigned to contract personnel are consistent with the duties prescribed by the contract. 9.3 The supervisor shall be cognizant of their responsibilities for supervision of contract personnel which may differ from their responsibilities regarding supervision of government personnel. This includes assignment of specific work hours; the contract may impose this responsibility on the supervisor or it may reserve work scheduling as a function for the contractor. The same may apply to the administration of leave for contract personnel. The contract will provide specific information regarding these functions and the supervisor shall become familiar with these provisions. 9.4 Under this contract where the supervisor is responsible for administering leave, it must be noted that contract personnel do not fall under the government personnel system and that their leave balances will not be maintained by N62645-11-R-0012 Page 85 of 118 a third party. Leave balances must be maintained by the supervisor. It is recommended that the supervisor coordinate with the COR to develop and maintain an effective system (likely a spreadsheet file) to track contractor leave. Further, it is essential that a system be developed between the supervisor and the contract personnel to ensure each is aware of the current balance so to avoid disputes regarding leave amounts accrued and used. 9.5 Regardless of whether the supervisor is responsible for administering leave for contract personnel, it is essential that the supervisor track the amount (hours) of service received from contract personnel. Coordination with the COR on this point is essential. The COR is responsible for certifying contractor invoices as being correct, i.e., representing the actual services received by the government. As the COR will not have day-to-day visibility on each contract site, contract individual, shifts worked, etc., it is absolutely essential that supervisors keep meticulous records of services received and establish a convenient means to transmit accurate, complete records to the COR for use in certifying invoices. 9.6 In general, and always keeping in mind the specific requirements and limitations prescribed by the contract, the supervisor is best served by supervising the contract personnel in the same manner as they supervise the government personnel on their staff. That is, the supervisor should not impose on contractor personnel burdens or privileges which are contrary to those imposed on other staff performing the same function, always, again, keeping in mind the requirements of the contract. When in the slightest doubt regarding this general guidance, the supervisor shall contact the COR for specific guidance and interpretation. 9.7 The supervisor’s responsibility for supervision of contractor personnel extends to the normal feedback that should be provided to any employee regarding the quality of their performance. Contractor employees should be informed when they have performed well, or performed poorly (failed to meet contract requirements). Counseling sessions regarding both good performance and poor performance must be documented by the supervisor; this documentation, both positive and negative, creates a critical trail that will be used for future award decisions. When counseling sessions for poor performance do not have a positive effect on contractor employee performance, the supervisor must contact the COR. A copy of all counseling sessions must be provided to the COR. 9.8 The supervisor should schedule regular meetings with the COR to discuss contract progress and performance. Performance problems are always most easily handled with early recognition and a consistent corrective action system. Between regularly scheduled meetings, the supervisor should contact the COR immediately upon recognition of contract performance issues. The supervisor should attempt to handle normal day-to-day individual duty performance issues through the normal supervisory methods, but contact the COR when these individual performance issues continue without resolution or when there is a pattern of non-performance across the contract personnel. N62645-11-R-0012 Page 86 of 118 Enclosure 2 CONTRACT DISCREPANCY REPORT Contract Number: Contract Clause: Date: COR Findings: COR (sign and date): Contractor Response: Contractor Project Manager (sign and date): COR Determination/Recommendation: COR (sign and date): Contracting Officer Acknowledgement and Recommendation (sign and date): N62645-11-R-0012 Page 87 of 118 Enclosure 3 REPORT ON CONTRACT PERFORMANCE Company or Individual's Name: _________________________________________ (IF CONTRACT IS WITH INDIVIDUAL STATE THEIR NAME) (IF CONTRACT IS WITH A COMPANY STATE THE COMPANY’S NAME) Contract number: ____________________________________ Type of service: ____________________________________ Reporting period: ___________________________________ COR:__________ ______________________________ telephone no: ___________________________________ Supervisor of HCW: __________________________________ telephone no: ___________________________________ Report prepared by: _________________________________ telephone no: ___________________________________ Definitions: “Contractor” means the entity (business or individual) that has the legal duty to perform the contract. “HCW” means the "Health Care Worker" who is providing the service. QUALITY OF SERVICE YES NO N/A 1. Was any HCW the subject of a validated patient complaint? If yes explain: 2. Was any HCW the subject of an occurrence report? If yes explain: 3. Did the HCW(s) interact and take direction in accordance with the contract, clinical standards, and protocol? If no, explain: 4. Did the HCW maintain productivity and quality comparable to that of other HCWs assigned the same scope of services? If no, explain: 5. Were all services provided as dictated by the terms of the contract? If no, explain: N62645-11-R-0012 Page 88 of 118 6. Were there any other documented problems with the quality of the services provided by an HCW? If yes, explain: 7. Have any HCWs been cited for commendable performance? If yes, explain: 8. Have any contract HCWs performed in an exemplary manner? If yes, explain: 9. Additional comments on Quality of Service provided: SCHEDULE YES NO N/A 10. Did the Contractor submit complete credentials file/professional file information on time? If no, explain: 11. Did the health care workers begin performance on the date and time scheduled? If no, explain: 12. Did any HCW miss a shift without approved leave? If yes, explain, including number of shifts missed: 13. Did the Contractor submit invoices on time and in accordance with the contract? If no, explain: 14. Did any HCW request excessive unplanned absences during the contract year? If yes, explain. Did the absences affect work accomplishment? How many unplanned absences were there? N62645-11-R-0012 Page 89 of 118 15. Did any HCW request leave without pay (LWOP) during the performance period? If yes, what were the circumstances? Did the LWOP affect work accomplishment? 16. Was leave requested and used in accordance with the contract? If no, explain: 17. Was any HCW habitually late to work? If so, how many times? 18. Additional comments on the Schedule of services: MANAGEMENT OF KEY PERSONNEL YES NO N/A 19. Did the HCWs meet the minimum qualifications in the contract? If no, explain: 20. Did any of the HCWs exceed the minimum qualifications stated in the contract in a way that was beneficial to the Navy? If yes, explain: 21. Did the Contractor experience turnover of HCWs during the period? Was it excessive? If yes, describe the circumstances. What was the ratio of HCW turnover to total HCWs on the contract (e.g., 2 replacement hires out of a staff of 20= 2/20 = 10%)? 22. If yes to 21 above, state the average amount of time taken for substitution of personnel from the date that one HCW left contract? Number of days: N62645-11-R-0012 Page 90 of 118 23. Did the Contractor submit complete qualification packages for substitutions? If no, explain: 24. Were all HCW maintenance requirements (licensure, BLS, etc.) kept current during the reporting period? If no, explain: 25. Did any HCW experience problems obtaining pay or benefits from the Contractor during the reporting period? If yes, explain: 26. Additional comments on the Management of Key Personnel: BUSINESS RELATIONSHIPS YES NO N/A 27. Is the Contractor responsive to your questions and concerns? If no, explain: 28. Does the Contractor conduct business in a professional and courteous manner? If no, explain: 29. Additional comments on Business Relationships: N62645-11-R-0012 Page 91 of 118 ATTACHMENT AC Letter of Identification – Travel (EXAMPLE) [Date] From: Contracting Officer, Naval Medical Logistics Command (NMLC) To: [Name of Military Treatment Facility] Subj: CONTRACTOR LETTER OF PROFESSIONAL IDENTIFY (COPI) AND OFFICIAL GOVERNMENT TRAVEL – [NAME AND SSN OF CONTRACT EMPLOYEE] 1. This letter certifies [contract employee’s name] is an employee of [contractor’s name], under contract number [contract number] providing services for the Department of the Navy (DON) for the period [period of performance]. 2. The employee must have access to military installations and temporary housing areas in order to fulfill the requirements of the contract. While on a military installation, the identified employee is subject to all the rules and regulations governing civilian personnel conduct. The employee must carry an identification card or badge at all times identifying him/her has a DON contract employee. 3. The primary duty location is in [city, state or country]. During the period of employment, the named individual may be required to travel on government business to other locations. The purpose of the travel may be to [services to be provided]. This letter, accompanied by a memorandum from the supervising agency, will serve as notification of official government travel. 4. When traveling the employee must use a mode of transportation that is the most economical to accomplish the mission. Travel may be by private automobile or public conveyance such as bus, trains, or commercial airlines. The contractor will be reimbursed in accordance with the contract. 5. As a contract employee traveling on government business, the named individual may use temporary government lodging facilities, when available. The government will reimburse for the actual cost of lodging and the government established daily rate for meals at the temporary duty location. These rates are published on the world wide web at http://www.defensetravel.dod.mil/site/perdiem.cfm. 6. The undersigned is the point of contact for this matter and may be reached at DSN 343-1103 or commercial (301) 619-1103. NMLC, Code 02 Contracting Officer Copy to: Contractor Contract employee N62645-11-R-0012 Page 92 of 118 ATTACHMENT AD HEALTHCARE WORKER CERTIFICATE OF AVAILABILITY I, ________________________________________ [NAME OF HEALTH CARE WORKER/PROVIDER] hereby certify that I have agreed to provide services as a _______________________________ under this contract at (fill in the location)______________________________________ as a subcontractor/employee (CIRCLE ONE) for ______________________________________ [NAME OF PRIME CONTRACTOR] for salary of $__________ per hour ($____________ per annum). I am available to begin providing these services on (fill in date)_________________________________, should the above named prime contractor be awarded this position. ________________________________________ ____________ Health Care Worker Signature Date HEALTH CARE WORKER MUST CIRCLE EITHER SUBCONTRACTOR OR EMPLOYEE ABOVE. TO BE COMPLETED BY THE OFFEROR If my company is awarded a Task Order, I verify that the above health care worker will be: my employee, or a subcontractor Check one of the above. _________________________________________ ____________ Contractor Agent Signature and title Date N62645-11-R-0012 Page 93 of 118 ATTACHMENT AE Inorporated by reference. N62645-11-R-0012 Page 94 of 118 ATTACHMENT AF COMPUTER SKILLS COMPETENCY FORM HCW’s name:_________________________________________________________ Position:______________________________________________________________ Company:_____________________________________________________________ Date Initial Basic Knowledge Use of Mouse Ability to move about in a windows based program Ability to navigate on the desktop Ability to draft and print a short memo Locate files Open and Close files Ability to open and reply to email Ability to Name and retrieve files Ability to Save & Print Files Specific Knowledge Ability to bring system up & shut down Enter /change password COMPANY REPRESENTATIVE: The above named health care worker has been personally tested by me and I certify that he/she is competent in all the areas listed above. ___________________________________________ Printed Name ____________________________________________ Signature Date N62645-11-R-0012 Page 95 of 118 ATTACHMENT AG The table below reflects some of the current contract prices for the sites stated in the Representative CLINs. Contract Number Task Order Clinical Area Labor Category Unit Price Naval Medical Center San Diego, CA N6264506D5029 0020 Psych/Mental Hlth RN Psychiatric $74.21 N6264506D5029 0023 Women's Health LPN/LVN $36.88 N6264506D5030 0036 Emergency Dept RN Outpat $85.83 N6264506D5030 0039 Pediatrics LPN/LVN $36.06 N6264506D5030 0042 Orthopedics LPN/LVN $37.53 N6264506D5030 0047 Pediatrics RN Outpat $70.94 N6264506D5031 0031 Women's Health Nurse Midwife $76.61 N6264506D5032 0038 Pediatrics Nurse Practitioner, Pediatric $60.39 N6264506D5032 0038 Family Practice LPN/LVN $33.70 N6264506D5032 0038 Family Practice Nurse Practitioner $60.39 N6264506D5033 0037 Primary Care RN Outpat $53.42 N6264506D5033 0038 Primary Care RN Outpat $58.41 N6264506D5033 0039 Family Practice Nurse Practitioner $66.76 N6264506D5033 0041 Family Practice Nurse Practitioner $66.95 N6264506D5034 0061 Primary Care RN Outpat $51.30 N6264506D5034 0064 Family Practice LPN/LVN $37.22 N6264506D5034 0066 Primary Care LPN/LVN $36.70 N6264506D5034 0067 Family Practice LPN/LVN $36.87 N6264506D5034 0067 Family Practice Nurse Practitioner $70.36 N6264506D5034 0068 Family Practice Nurse Practitioner $72.70 N6264506D5034 0068 Family Practice LPN/LVN $37.19 N6264506D5034 0069 Family Practice LPN/LVN $36.65 N6264506D5036 0012 ICU/CCU RN Crit Care $83.94 N6264506D5036 0013 Pediatrics RN Inpat $86.64 N6264506D5038 0009 NICU Nurse Practitioner, Neonatal $116.59 N6264506D5038 0010 NICU RN Crit Care $89.18 Naval Hospital Twentynine Palms, CA N6264506D5039 0013 Women's Health LPN/LVN $33.11 N6264506D5039 0014 Primary Care LPN/LVN $32.99 N6264506D5039 0016 Family Practice Nurse Practitioner $65.79 N6264506D5041 0014 Women's Health RN BCC $60.63 N6264506D5042 0058 Primary Care LPN/LVN $31.48 N6264506D5042 0059 Managed Care RN Case Mgr $67.21 N6264506D5042 0063 Deployment Health Clinic RN Outpat $51.82 N6264506D5042 0063 Deployment Health Clinic Nurse Practitioner $66.41 N6264506D5042 0064 Managed Care RN Case Mgr $62.63 N6264506D5042 0051 Anesthesiology RN PACU $54.57 N6264506D5042 0053 Emergency Dept RN Outpat $62.31 N6264506D5042 0054 Surgery RN OR $54.57 N62645-11-R-0012 Page 96 of 118 N6264506D5042 0057 Occupational Med Nurse Practitioner $69.31 N6264506D5043 0030 Managed Care RN Case Mgr $70.81 Naval Hospital Lemoore, CA N6264506D5033 0044 Anesthesiology Nurse Anesthetist $106.19 N6264506D5033 0046 Primary Care LPN/LVN $30.19 N6264506D5033 0047 Primary Care LPN/LVN $29.12 N6264506D5039 0017 Anesthesiology RN PACU $51.78 N6264506D5039 0017 Surgery RN OR $51.78 N6264506D5040 0017 Utilization Mgmt RN Utilization Mgr $58.50 N6264506D5040 0017 Utilization Mgmt RN Utilization Mgr $55.19 N6264506D5042 0056 Psych/Mental Hlth LPN/LVN $30.32 N6264506D5042 0056 Psych/Mental Hlth LPN/LVN $30.32 N6264506D5042 0061 Pediatrics Nurse Practitioner $67.05 N6264506D5042 0061 Family Practice Nurse Practitioner $67.05 N6264506D5043 0034 Women's Health LPN/LVN $30.40 N6264506D5043 0034 Medical Surgical Unit RN Med Surg $72.99 N6264506D5043 0034 Women's Health LPN/LVN $39.52 N6264506D5043 0034 Women's Health RN Inpat $68.01 N6264506D5043 0034 Women's Health Nurse Midwife $77.12 N6264506D5043 0035 Managed Care RN Case Mgr $46.75 Naval Hospital Camp Pendleton, CA N6264506D5032 0027 Deployment Health Clinic Nurse Practitioner $64.06 N6264506D5032 0027 Deployment Health Clinic RN Outpat $53.51 N6264506D5033 0034 Family Practice Nurse Practitioner $73.28 N6264506D5033 0035 Multi-Service Unit RN Inpat $64.60 N6264506D5033 0036 Deployment Health Clinic RN Outpat $57.75 N6264506D5034 0047 Ambulatory Care RN OR $58.53 N6264506D5034 0048 Primary Care Nurse Practitioner $68.94 N6264506D5034 0070 Emergency Dept RN Outpat $83.82 N6264506D5045 0029 Managed Care RN Case Mgr $65.98 N6264506D5045 0031 Managed Care RN Case Mgr $61.32 N6264506D5046 0090 Managed Care RN Case Mgr $61.12 N6264506D5047 0047 Occupational Med RN Outpat $56.88 N6264510D5005 0004 Deployment Health Clinic RN Psychiatric $83.25 N6264510D5005 0007 Deployment Health Clinic RN Case Mgr $62.00 NOTE: The hourly rates shown reflect the actual hourly rates in the current task orders under which same or similar services are being performed at these locations. However, it should not be assumed that the task order Statements of Work (SOWs) corresponding to the hourly rates above are identical to the current solicitation requirements. N62645-11-R-0012 Page 97 of 118 ATTACHMENT AH Format for Contractor’s Fill Rate Report to NMLC N62645-11-R-0012 Page 98 of 118 ATTACHMENT AI This is a sample Supplemental Pricing Worksheet: SUPPLEMENTAL PRICING WORKSHEET This supplemental pricing worksheet will be used to evaluate realism in accordance with requirements of Section H of the basic contract. It is not considered cost or pricing data in accordance with FAR Subpart 15.402(a)(3) or other than cost and pricing data in accordance with FAR Subpart 15.402(a)(2). NOTE: If awarded this requirement, contractors will be required to pay at least the minimum compensation rate proposed below to each health care worker. DEFINITIONS/INSTRUCTIONS: Base Hourly Rate: This is the base hourly wage paid directly to the health care worker. If overtime, shift differential, or other additional direct compensation is necessary due to the nature of the requirement, it should be included as a “blended” hourly wage. An explanation of the blended rate should be cited under “Blended Rate Explanation.” Do NOT include any fringe benefits or mandated taxes in this rate. Minimum Compensation: This is the minimum compensation to be paid to each health care worker. As noted above, if awarded this requirement, contractors will be required to pay at the least the minimum compensation proposed. This amount will be evaluated in accordance with this TOPR. Average Compensation: This is the average amount of compensation estimated to be paid for the labor category, considering all health care workers to be utilized and all hours of service to be performed. This amount will be evaluated in accordance with Section H of the basic contract. Blended Rate Explanation: Explain how the hourly rate was derived if additional, direct compensation is necessary due to the nature of the requirement. For example, if a blended rate of $20.00/hour is proposed and shift differential and overtime are necessary due to the requirement, the explanation may state, “the $20.00/hour is made up of a minimum base hourly rate of $15.00/hour plus $3.00/hour for overtime and $2.00/hour for shift differential.” Mark “N/A” if a blended rate does not apply. Additional Information: Provide any additional information deemed necessary to explain HCW compensation. Option Period Supplemental Pricing Sheets: If applicable, complete a supplemental pricing sheet for each option period required under the TOPR. N62645-11-R-0012 Page 99 of 118 This is a sample Supplemental Pricing Worksheet: CLIN 0001 Labor Category: Registered Nurse (1 FTE) Location: Naval Hospital Camp Pendleton, CA Minimum Average Base Period Compensation Rate Compensation Rate Registered Nurse Naval Hospital Camp Pendleton, CA Base Hourly Rate POP: 01 Oct 2012 – 30 Sep 2013 Minimum Average Optional Period #1 Compensation Rate Compensation Rate Registered Nurse Naval Hospital Camp Pendleton, CA Base Hourly Rate POP: 01 Oct 2013 – 30 Sep 2014 Blended Rate Explanation: (if applicable) ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Additional Information: _________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ The position/s is/are subject to the Service Contract Act. The U. S. Department of Labor (DOL) mandates a minimum Health and Welfare benefit as well as a minimum hourly compensation rate. _________________________________ __________ Signature Date _________________________________ Title _________________________________ Organization N62645-11-R-0012 Page 100 of 118 ATTACHMENT AJ Naval Medical Logistics Command uses a standard CLIN structure for medical service contracts as outlined below. Each CLIN represents a labor category under which corresponding services are placed. Not all CLINs are applicable for all solicitations. Any CLINs not used for a solicitation are designated as Reserved in Section B. 0001 Physician Any specialty recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) or other Ph.D. positions such as Medical Physicist not included in another labor band. 0002 Allied Health Allied Health Personnel include, but are not limited to, Audiologist, Chiropractor, Clinical Psychologist, Clinical Social Worker, Dietitian, Marriage and Family Therapist, Occupational Therapist, Optometrist, Pharmacist, Physical Therapist, Podiatrist, Speech Pathologist, Genetic Counselor, Physician Assistant. 0003 Advanced Practice Health Any specialty recognized by the American Nurses Credentialing Center (ANCC) or American Academy of Nurse Practitioners (AANP). 0004 Nursing Any Registered Nurse specialty, Licensed Practical Nurse, RN- Health Educator. 0005 Technologist Technologist Personnel include, but are not limited to, Cardiopulmonary Technologist, Cardiovascular Technologist, Dosimetrist, Echocardiograph Technologist, Medical Technologist, Ophthalmic Technologist, Radiologic Technologist (including the various specializations), Registered Respiratory Therapist, Certified Athletic Trainer, Perfusionist, Radiation Therapist, Surgical Technologist. 0006 Technician Technician Personnel include, but are not limited to, Cardiac Technician, Central Sterile Supply Technician, Dietetic Technician, Electrocardiograph Technician, Emergency Medical Technician, Medical Laboratory Technician, Optician, Orthopedic Technician, Pharmacy Technician, Phlebotomist, Physical Therapy Technician, Psychiatric Technician, Pulmonary Technician, Certified Respiratory Therapist, and Surgical Technician. 0007 Assistant Assistant Personnel include, but are not limited to, Chiropractic Assistant, Occupational Therapy Assistant, Speech Pathology Assistant, Medical Assistant. 0008 Travel/Training Reimbursement of travel expenses in accordance with Section C.11 of the solicitation and the Task Order. 0009 On-Call Reimbursement of on-call expenses in accordance with Section C of the solicitation and the Task Order. 0010 Orientation Reimbursement of orientation expenses in accordance with Section C.7.11 of the soliciation and the Task Order. ATTACHMENT AK WAGE DETERMINATIONS N62645-11-R-0012 Page 101 of 118 Wage Determinations may be found at the following website: http://www.wdol.gov/ The following Wage Determination versions are applicable: San Diego, CA WD 05-2057 (Rev.-12) posted on 06/17/2011 Twentynine Palms, CA WD 05-2053 (Rev.-14) posted on 06/17/2011 Camp Pendleton, CA WD 05-2057 (Rev.-12) posted on 06/17/2011 Lemoore, CA WD 05-2073 (Rev.-14) posted on 06/17/2011 N62645-11-R-0012 Page 102 of 118 Section K - Representations, Certifications and Other Statements of Offerors SECTION K In accordance with FAR 52.204-8, the offeror must complete the Online Representations and Certifications Application (ORCA) to include representation as a small business concern under the North American Industry Classification System (NAICS) code applicable to this solicitation (622110) and verify that the representations and certifications are current, accurate, complete and applicable to this solicitation as of the date of this offer and are incorporated in this offer by reference. N62645-11-R-0012 Page 103 of 118 ORCA CERTIFICATION SHEET Section K - Representations, Certifications and Other Statements of Offerors of this Solicitation. The offeror shall complete the annual representations and certifications electronically through the Online Representations and Certifications Application (ORCA) at http://orca.bpn.gov. The offeror shall verify their ORCA is current, accurate, complete and applicable to this solicitation as of the date of this offer and are incorporated in this offer by reference, except for any applicable changes identified in Section K, FAR Clause 52.204-8 and DFARS 252.204-7007. The applicable NAICS code for this solicitation is 622110. In addition to submission to ORCA the offeror shall complete the ORCA Certification Sheet and submit a hard or electronic copy with its Business volume. Online Representations and Certifications Application (ORCA) I certify that all of the representations and certifications completed in ORCA are current, complete and accurate as of the date of my signature below for RFP # N62645-11-R-0012. _________________________________ __________ Signature Date _________________________________ Title _________________________________ Organization _________________________________ E-Mail Address _________________________________ Phone OR I certify that all of the representations and certifications completed in ORCA are current, complete and accurate as of the date of my signature provided on below for RFP # N62645-11-R-0012 with the exception of the following: (list any changes) _________________________________ __________ Signature Date _________________________________ Title _________________________________ Organization N62645-11-R-0012 Page 104 of 118 CLAUSES INCORPORATED BY REFERENCE 252.204-7007 Alt A (INVALID EFF_DT) Annual Representations and DEC 1900 Certifications Alternate A CLAUSES INCORPORATED BY FULL TEXT 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2011) (a)(1) The North American Industry Classification System (NAICS) code for this acquisition is 622110. (2) The small business size standard is $34.5 Million. (3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees. (b)(1) If the clause at 52.204-7, Central Contractor Registration, is included in this solicitation, paragraph (d) of this provision applies. (2) If the clause at 52.204-7 is not included in this solicitation, and the offeror is currently registered in CCR, and has completed the ORCA electronically, the offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The offeror shall indicate which option applies by checking one of the following boxes: (__) Paragraph (d) applies. (__) Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation. (c)(1) The following representations or certifications in ORCA are applicable to this solicitation as indicated: (i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm- fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless-- (A) The acquisition is to be made under the simplified acquisition procedures in Part 13; (B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or (C) The solicitation is for utility services for which rates are set by law or regulation. (ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000. (iii) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the clause at 52.204-7, Central Contractor Registration. (iv) 52.204-5, Women-Owned Business (Other Than Small Business).This provision applies to solicitations that-- (A) Are not set aside for small business concerns; N62645-11-R-0012 Page 105 of 118 (B) Exceed the simplified acquisition threshold; and (C) Are for contracts that will be performed in the United States or its outlying areas. (v) 52.209-5, Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold. (vi) 52.214-14, Place of Performance--Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government. (vii) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government. (viii) 52.219-1, Small Business Program Representations (Basic & Alternate I). This provision applies to solicitations when the contract will be performed in the United States or its outlying areas. (A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard. (B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard. (ix) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract will be performed in the United States or its outlying areas. (x) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity. (xi) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity. (xii) 52.222-38, Compliance with Veterans' Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial items. (xiii) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of USDA-designated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction Contracts. (xiv) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA-designated items. (xv) 52.225-2, Buy American Act Certificate. This provision applies to solicitations containing the clause at 52.225- 1. (xvi) 52.225-4, Buy American Act--Free Trade Agreements—Israeli Trade Act Certificate. (Basic, Alternate I, and Alternate II) This provision applies to solicitations containing the clause at 52.225-3. (A) If the acquisition value is less than $25,000, the basic provision applies. (B) If the acquisition value is $25,000 or more but is less than $50,000, the provision with its Alternate I applies. (C) If the acquisition value is $50,000 or more but is less than $67,826, the provision with its Alternate II applies. N62645-11-R-0012 Page 106 of 118 (xvii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5. (xviii) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan--Certification. This provision applies to all solicitations. (xix) 52.225-25, Prohibition on Engaging in Sanctioned Activities Relating to Iran--Certification. This provision applies to all solicitations. (xx) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to-- (A) Solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions; and (B) For DoD, NASA, and Coast Guard acquisitions, solicitations that contain the clause at 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns. (2) The following certifications are applicable as indicated by the Contracting Officer: (Contracting Officer check as appropriate.) ------(i) 52.219-22, Small Disadvantaged Business Status. ------(A) Basic. ------(B) Alternate I. ------(ii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products. ------(iii) 52.222-48, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Certification. ------(iv) 52.222-52 Exemption from Application of the Service Contract Act to Contracts for Certain Services-- Certification. ------(v) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA-Designated Products (Alternate I only). ------(vi) 52.223-13, Certification of Toxic Chemical Release Reporting. ------(vii) 52.227-6, Royalty Information. ------ (A) Basic. ------ (B) Alternate I. ------(viii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software. (d) The offeror has completed the annual representations and certifications electronically via the Online Representations and Certifications Application (ORCA) website at http://orca.bpn.gov. After reviewing the ORCA database information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation N62645-11-R-0012 Page 107 of 118 (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 the changes identified below (offeror to insert changes, identifyingchange by clause number, title, date). These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer. ------------------------------------------------------------------------ FAR Clause Title Date Change ------------------------------------------------------------------------ ------ ---------- ------ ------ ------------------------------------------------------------------------ Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted on ORCA. (End of Provision) N62645-11-R-0012 Page 108 of 118 Section L - Instructions, Conditions and Notices to Bidders SECTION L L.1. SUBMISSION OF COST OR PRICING DATA. L.1.1. It is expected that this contract will be awarded based upon a determination that there is adequate price competition; therefore, the offeror is not required to submit additional cost or price data (beyond that required by Section L.2) or to certify cost or pricing data with its proposal. L.1.2. If, after receipt of the proposals, the Contracting Officer determines that adequate price competition does not exist in accordance with FAR 15.403-3 and 15.403-4, the offeror shall provide other information requested to be submitted to determine fairness and reasonableness of price, or certified cost or pricing data as requested by the Contracting Officer. L.2. PROPOSAL CONTENT AND INSTRUCTIONS FOR PREPARATION OF PROPOSALS. L.2.1. Introduction and Purpose - This section specifies the format and content that offerors shall use in this Request for Proposal (RFP). The intent is not to restrict the offerors in the manner in which they will perform their work but rather to ensure a certain degree of uniformity in the format of the responses for evaluation purposes. Offerors must submit a proposal that is legible and comprehensive enough to provide the basis for a sound evaluation by the Government. Information provided should be precise, factual, and complete. Legibility, clarity, completeness, and responsiveness are of the utmost importance. Proposals shall be in the form prescribed by, and shall contain a response to, each of the areas identified in Section L.2. Any proposal which does not provide, as a minimum, that which is required in this solicitation may be determined to be substantially incomplete and not warrant any further consideration. L.2.1.1. The proposal shall be submitted in three separate volumes: Volume I – Past Performance Volume II – Technical Volume III – Business A complete Volume I - Past Performance; Volume II -Technical; and Volume III - Business; shall be submitted by the closing date specified in Section A of this solicitation. If any one proposal volume is received past the stated closing date specified in this solicitation, the entire proposal will be considered late. No further consideration will be given to any offeror who submits any of these volumes late IAW FAR 15.208(b). L.2.2. Volume I: Past Performance. In accordance with file submission requirements given in this section, the offeror shall complete a maximum of 6 Past Performance Information Sheets (Section L Enclosure 1) for Past Performance efforts relevant to the services required under this solicitation. Each Past Performance Information Sheet shall identify no more than one Point of Contact (POC). Each Past Performance Information Sheet may include multiple contracts or one or more task orders under single IDIQ contracts. The same contract may appear on more than one Past Performance Information Sheet if more than one POC exists. If more than one POC is provided for any Past Performance Information Sheet, only the first POC will be considered. Each Past Performance Information Sheet shall not exceed one page, inclusive of a narrative. If a Past Performance Information Sheet contains more than 1 page, only the first page will be considered. Contracts cited must be current, or have ended not more than 3 years prior to the closing date. The contractor may provide a narrative for each effort detailing such information as the range of labor categories provided, the clinical settings in which the Past Performance occurred, and the numbers of personnel provided. If provided, the narrative shall describe the relevance of the effort to the solicitation. The offeror may include contracts that demonstrate the prior experience of key personnel or subcontractors/teaming partners who will be performing in support of the contract resulting from this solicitation; such contracts shall be clearly identified to show the relationship of the past performance entry to the offeror. N62645-11-R-0012 Page 109 of 118 L.2.2.1. If Past Performance is submitted for a contract under which the offeror (or proposed subcontractor, partner, mentor, protégé, parent company, sister company, etc.) provided services as a subcontractor, partner, mentor, protégé, parent company, sister company, etc., the Past Performance Information Sheet shall clearly describe the corporate relationships among those who provided the services, citing key responsibilities for each, to include identifying the specific services provided (in terms of numbers and types of personnel, locations, etc) and nature of services provided (e.g., recruitment, payroll, benefits administration, etc). If the submission does not clearly detail the specific responsibilities under an effort, that effort may not be evaluated. L.2.2.2. If a subcontracting, teaming, partnering, mentoring or other relationship is proposed, the offeror shall submit written consent from the subcontractor, partner, etc. to disclose their Past Performance information to the contractor. If such consent is not provided as part of the submission, the Past Performance of the subcontractor, partner, etc. may not be considered by the Government in its evaluation. L.2.2.3. If neither the offeror nor its subcontractor(s), teaming partner(s), etc. possess relevant past performance, the offeror shall submit a statement affirming that they possess no relevant Past Performance. L.2.2.4. Each of the Past Performance Information Sheets (Section L Enclosure 1) shall include the following information on each effort: L.22.214.171.124. POC information: name, title, phone number, e-mail address, agency name, and address. L.126.96.36.199. Contract Number(s) and Task Order number(s), if applicable. L.188.8.131.52. Name of contractor to whom the contract was awarded/name of contractor who performed services, if different from awardee. Provide the CAGE Code and DUNS numbers of both the awardee and the contractor who performed the service(s). L.184.108.40.206. Dates when services were provided. L.220.127.116.11. List the number and type of health care workers provided, i.e., 8 FTE registered nurses, 2 licensed practical nurses, 4 advanced practice nurses, etc. Specify if services were full time, part time, temporary, or locum tenens types of services. L.18.104.22.168. Final or projected final price of the effort. L.22.214.171.124. Describe the offeror’s role – prime, subcontractor, partner, mentor, protégé, etc. L.126.96.36.199. Place(s) of performance. L.188.8.131.52. Contracting Officer’s name, phone, e-mail address, agency name, and address. L.184.108.40.206 The offeror shall provide information on problems encountered on the identified contract(s) and the offeror’s corrective actions. L.220.127.116.11. Narrative per Section L.2.2.: L.2.2.5. POCs must be either Government personnel (civil service or military) or employees of private sector clients (such as public or private sector dental/medical facilities) with whom you have provided services. Information provided by or for POCs who work directly for your company, or indirectly (i.e. in a prime/ subcontractor or mentor/protégé relationship, etc.), will NOT be considered relevant. The Government may contact the points of contact to obtain verification and rating of Past Performance information. L.2.3. Volume II: Technical. In accordance with electronic submission requirements given in this section, the offeror shall include the following: N62645-11-R-0012 Page 110 of 118 L.2.3.1. The offeror shall discuss the corporate personnel, by name and title, who will be responsible for contract start-up and the ongoing administration of all key functional areas, such as but not limited to recruitment, scheduling, human resources, program management and credentialing. The plan shall describe the range of responsibilities for each individual and should discuss how the qualifications and experience of each individual will contribute to successful contract operations. L.2.3.2. The offeror shall discuss their knowledge of the marketplaces represented in the solicitation and detail the sources and methodologies through which they will recruit and retain required health care workers. Further, the offeror shall discuss their knowledge of the marketplaces represented in the solicitation and discuss how marketplace conditions (such as, but not limited to scarce labor categories or remote locations) will impact their ability to recruit and retain required health care workers. Without revealing the prices submitted in response to this solicitation, the offeror shall demonstrate their market research and discuss how they have applied their marketplace knowledge in development of their proposal. Note that the Technical volume will be incorporated as part of any subsequent award in Section J of the contract. L.2.3.3. If a subcontractor has been proposed, the contractor shall specifically address FAR 52.219-14, Limitations on Subcontracting; the offeror’s Technical volume shall clearly detail the nature of the relationship between the parties, (i.e. subcontractor, partner, etc), and shall address the responsibilities of all parties as they would relate to provision of services under the resultant contract. L.2.3.4. If the offeror is proposing as a mentor/protégé or business relationship other than subcontracting, the offeror’s Technical volume shall clearly detail the nature of the relationship between the parties, (i.e. mentor-protégé, joint venture, etc), and shall address the responsibilities of all parties as they would relate to provision of services under the resultant contract. L.2.3.5. Offerors are cautioned not to include any pricing or cost information in any portion of their Technical volume. Note that this exclusion does not apply to presentation of the results of the offeror's recruitment market survey or price information for past contracts. L.2.4. Volume III: Business. In accordance with file submission requirements given in this section, the offeror shall submit the following: L.2.4.1. Standard Form 33. Completed in accordance with L.18.104.22.168. L.2.4.2. Amendments. Completed in accordance with L.22.214.171.124. L.2.4.3. Section K. The offeror must be registered in ORCA IAW Section K FAR 52.204-8 and DFARS 252.204- 7007. In addition to submission to ORCA the offeror shall complete the ORCA Certification Sheet and submit a hard or electronic copy with its Business volume. (Refer to ORCA Certification Sheet in Section K.) The NAICS code for this solicitation is 622110. The small business size standard is $34.5M. L.2.4.4. Section A. Completed in accordance with L.126.96.36.199. L.2.4.5. Section B. Completed in accordance with L.188.8.131.52. L.2.4.6. CCR. The offeror shall be registered and current in CCR IAW FAR 52.204-7. L.2.5. FILE SUBMISSION. Only electronic files will be accepted unless otherwise noted in the subsections of this paragraph. L.2.5.1. The Past Performance, Technical, and Business volumes shall be submitted by mail (or hand delivered as specified in Section A of this solicitation) in electronic format as files on CD-ROMs. Files shall be in Microsoft N62645-11-R-0012 Page 111 of 118 Office for Windows format (2007), either .docx or .xlsx files as specified herein. Consent letters and forms that require signatures may be submitted as a .pdf file and included with the corresponding Volume. L.2.5.2. For the mailed or hand delivered CD-ROMs; one set of CD-ROMs shall be submitted. Each CD-ROM shall be labeled as to the name of the offeror and the contents of the CD-ROM. L.2.5.3. The Past Performance and Technical volumes (Volumes I and II, respectively) shall be in Microsoft Word for Windows (2007)(.docx) with 1 inch margins all around, Times New Roman font of not less than 10 point font size inclusive of tables, charts, graphs, graphics, etc. Tables, charts, graphs, graphics, etc. that are not in compliance will not be considered. Each page of each document shall have a footer indicating the name of the offeror and “page X of Y.” L.184.108.40.206. The total number of the pages submitted for Volume I (Past Performance) SHALL NOT EXCEED 6 PAGES, excluding a cover letter and consent letters. If Volume I contains more than 6 pages, only the first 6 pages will be evaluated. The total number of the pages submitted for Volume II (Technical) SHALL NOT EXCEED 10 PAGES, excluding a cover letter. If Volume II contains more than 10 pages, only the first 10 pages will be evaluated. L.2.5.4. Business volume (Volume III). The Business volume CD-ROM shall include all of the following items: L.220.127.116.11. Standard Form (SF) 33. This form will be provided to the offeror electronically as part of the solicitation package. It shall be appropriately completed, inclusive of the offeror's name, address, and required Commercial and Government Entity (CAGE) codes, and signed. The offeror's identity will be determined by the name submitted on the SF 33. It is not necessary to submit the entire solicitation. L.18.104.22.168. Amendments. Each amendment shall be acknowledged through instructions in Block 11 of the SF 30. Signed copies of the cover page are acceptable. It is not necessary to submit the entire amendment. L.22.214.171.124. Section K - Representations, Certifications and Other Statements of Offerors of this Solicitation. The offeror shall complete the annual representations and certifications electronically through the Online Representations and Certifications Application (ORCA) at http://orca.bpn.gov. The offeror shall verify their ORCA is current, accurate, complete and applicable to this solicitation as of the date of this offer and are incorporated in this offer by reference. (Refer to ORCA Certification Sheet in Section K.) The applicable NAICS code for this solicitation is 622110. In addition to submission to ORCA the offeror shall complete the ORCA Certification Sheet and submit a hard or electronic copy with its Business volume (Refer to ORCA Certification Sheet in Section K.) L.126.96.36.199. Section A. Offeror’s Information Form located in Section A shall be completed. The offeror shall fill in every field on the form for it to be considered complete. L.188.8.131.52. Section B. An electronic file will be posted to the NAVMEDLOGCOM web site (http://www.nmlc.med.navy.mil/DBU-RFP.asp) along with the solicitation and any amendments for downloading. The file will be named “Pricing Sheet for N62645-11-R-0012.xlsx”. The offeror shall complete all pricing and supplemental pricing information required on all tabs included in the electronic file. Blue boxes designate those fields into which the offeror can enter data. The completed file shall be submitted on the Volume III – Business CD-ROM. The file shall be renamed: [name of offeror] pricing sheet.xlsx. Please note that any reformatting of the pricing worksheet or failure to follow the naming conventions provided in this section may cause serious delay in the evaluation process and may result in rejection of the offeror's entire proposal. L.2.5.5. The offeror is responsible for ensuring that submitted CD-ROMs include all complete files and are not physically damaged nor contain corrupted files such that they are not readable by the Government. L.2.5.6. Failure to properly submit any items listed in paragraph L.2.5 and its subparagraphs may result in rejection of the offeror's entire proposal. N62645-11-R-0012 Page 112 of 118 L.3. PROPOSAL EVALUATION. L.3.1. The Past Performance evaluation factor is significantly more important than the Technical evaluation factor. The combination of the Past Performance evaluation factor and the Technical evaluation factor is significantly more important than the combined Business evaluation factors (Completeness, Reasonableness and Realism). L.3.1.1. Information will be considered for evaluation in the volume where it is provided. For example, past performance information provided in the Technical volume will be part of the Technical Evaluation. The same past performance information will only be considered in the Past Performance Evaluation if it is also provided in the past performance volume. L.3.2. The Government reserves the right to award without discussions. It should be noted that award may be made to other than the lowest priced offer. Offerors are cautioned that each initial offer should contain the offeror's best terms. L.3.3. Contract awards will be based on an evaluation of Past Performance, Technical, and Business submissions. All task orders will be awarded via Task Order Proposal Request after contract award, within the guidelines stated in Section H. All successful contract awardees will receive, at a minimum, a task order award for $25,000 during the life of the contracts. L.3.4. Volume I. Past Performance. L.3.4.1. The Government will first evaluate the offeror's Past Performance information to determine whether the company has relevant Past Performance. In doing so the Government will examine the age of the previous/current contracts, and the scope, magnitude and complexity of those efforts. SCOPE. Refers to the labor bands provided, (Nursing and Advanced Practice Nurse) and specific labor categories provided, e.g. Operating Room Nurses, Labor and Delivery Nurses, Family Nurse Practitioners, etc. The evaluation of scope shall include an examination of clinical setting. MAGNITUDE. Refers to the number of relevant personnel provided. COMPLEXITY. Refers to concurrent administration of multiple, relevant efforts; management of complex staffing requirements such as coverage requirements, requirements over a broad geographical region or remote location(s), and maintenance of personnel in high turnover positions. L.3.4.2. Relevancy shall be evaluated as follows: Rating Definition Very Relevant Present/past performance effort involved essentially the same scope and magnitude of the effort and complexities this solicitation requires. Relevant Present/past performance effort involved similar scope and magnitude of the effort and complexities this solicitation requires. Somewhat Relevant Present/past performance effort involved some of the scope and magnitude of the effort and complexities this solicitation requires. Not Relevant Present/past performance effort involved little or none of the scope and magnitude of the effort and complexities this solicitation requires. L.3.4.3. The Government will then review this past performance information and determine the quality and usefulness as it applies to the performance confidence assessment. The Government reserves the right to contact the points of contact identified in the offeror’s proposal for the purpose of assessing the offeror’s record of Past N62645-11-R-0012 Page 113 of 118 Performance. This evaluation shall entail an examination of such items as contract start, fill rates, submission and maintenance of credentials, and performance discrepancy resolution. The performance confidence assessment shall be evaluated as follows: Substantial Confidence: Based on the offeror’s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort. Satisfactory Confidence: Based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort. Limited Confidence: Based on the offeror’s recent/relevant performance record, the Government has a low expectation that the offeror will successfully perform the required effort. No Confidence: Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort. Unknown Confidence: No recent/relevant performance record is available of the offeror’s performance record is (neutral) so sparse that no meaningful confidence assessment rating can be reasonably assigned. L.3.4.4. The Government is not restricted from evaluating and considering other relevant Past Performance information in its possession and may contact references for that information. Past performance information may be obtained from any other sources available to the government, such as Past Performance Information Retrieval system (PPIRS) and interviews with Contracting Officer’s Representatives. Information regarding any subcontractors utilized will also be considered. L.3.4.5. Based on the relevance and Performance Confidence Assessment of the offeror’s Past Performance, the Government will assess the risk to the Government of future non-performance of solicitation requirements by the offeror. The Government will not assume that the offeror possesses any Past Performance unless it is specified in the Past Performance volume. L.3.5. Volume II. Technical. L.3.5.1. Based on the comprehensiveness, depth, and quality of research demonstrated within the offeror’s Technical volume, the Government will assess the risk to the Government of future non-performance of solicitation requirements by the offeror. L.3.5.2. Failure to appropriately detail any business relationship as detailed under items L.2.3.3 and L.2.3.4 is considered a weakness in the Technical volume. L.3.5.3. The Government shall assign a combined Technical/Risk rating to the offeror’s proposal as follows Color Rating Description Blue Outstanding The proposal meets requirements and represents an exceptional approach and understanding of the requirements. Strengths far outweigh any weakness. Risk of unsuccessful performance is very low. Purple Good The proposal meets requirements and represents a thorough approach and understanding of the requirements. The proposal contains strengths which outweigh any weakness. Risk of unsuccessful performance is low. Green Acceptable The proposal meets requirements and represents an adequate approach and understanding of the requirements. Strengths and weakness are offsetting or will have little or no impact on contract performance. Risk of unsuccessful performance is no worse than moderate. N62645-11-R-0012 Page 114 of 118 Yellow Marginal The proposal does not clearly meet requirements and has not demonstrated an adequate approach and understanding of the requirements. The proposal has one or more weaknesses which are not offset by strengths. Risk of unsuccessful performance is high. Red Unacceptable Proposal does not meet requirements and contains one or more deficiencies. Proposal is unawardable. L.3.5.4. The Government will not assume that the offeror possesses any capability or knowledge unless it is specified in the Technical volume. L.3.6. Volume III. Business. L.3.6.1. Adequate price competition is expected for this acquisition. The Business volume will be evaluated with consideration to the following factors: L.184.108.40.206. COMPLETENESS. The offeror's Business volume will be examined to ensure that the following have been completed: Standard Form 33 has been completed IAW L.220.127.116.11; all amendments have been acknowledged IAW L.18.104.22.168; the offeror is registered in ORCA IAW Section K FAR 52.204-8 and DFARS 252.204-7007 and submitted the ORCA Certification Sheet (located in Section K) IAW L.22.214.171.124; Section A’s Offeror’s Information form is completed IAW L.126.96.36.199; pricing and supplemental pricing information has been submitted for each Representative CLIN in Section B IAW L.188.8.131.52; and the offeror is registered in CCR IAW FAR 52.204-7 and L.2.4.6. L.184.108.40.206. REASONABLENESS. The offeror’s Business volume will be examined to determine the degree to which the proposed prices compare to the prices a reasonable prudent person would expect to incur for the same or similar services. Since awards will be made on a best value basis, the Contracting Officer reserves the right to award at a premium, provided that the proposed prices are determined to be reasonable. L.220.127.116.11. REALISM. The offeror’s Representative CLIN prices and the Supplemental Pricing Worksheets will be examined to identify unusually low price estimates, understatements of costs, inconsistent pricing patterns, potential misunderstandings of the solicitation requirements, and the risk of personnel recruitment and retention problems during contract performance. The Contracting Officer will use the minimum compensation information to determine the price realism of the proposed compensation and may use the minimum and average compensation information for best value determinations. L.4. QUESTIONS. Offeror questions should be presented in writing to the contract specialist no later than 10 calendar days after the issue date (Block 5 of SF33) of this solicitation via email at firstname.lastname@example.org using the subject title: “Code 024R: N62645-11-R-0012.” Emails with another title may not be received. Questions should be listed chronologically and reference the corresponding solicitation section and paragraph. NAVMEDLOGCOM responses to questions will be presented in the form of an amendment. The contract specialist will not disclose the source of the questions. If you send your question via e-mail and do not receive acknowledgment of receipt by NAVMEDLOGCOM within 72 hours, you are requested to resend your question. L.5. REVIEW OF AGENCY PROTESTS. L.5.1. The contracting activity, NAVMEDLOGCOM, will process agency protests in accordance with the requirements set forth in FAR 33.103(d). L.5.2. Pursuant to FAR 33.103(d)(4), an agency protest may be filed directly with the appropriate reviewing authority; or a protester may appeal a decision rendered by a Contracting Officer to the appropriate reviewing authority. N62645-11-R-0012 Page 115 of 118 L.5.3. The reviewing authority for the Contracting Officer is the Director of Acquisition Management, NAVMEDLOGCOM, Code 02, 693 Neiman Street, Fort Detrick, MD 21702-9203. Agency procurement protests should clearly identify the initial adjudicating official, i.e., the, “Contracting Officer” or the, “Reviewing Official”. L.5.4. Offerors should note this review of the Contracting Officer’s decision will not extend GAO’s timeliness requirements. Therefore, any subsequent protest to GAO must be filed within 10 days of knowledge of initial adverse agency action. N62645-11-R-0012 Page 116 of 118 Enclosure 1 Past Performance Information Sheet 1. POC information: name, title, phone number, e-mail address, agency name, and address. 2. Contract Number and Task Order number(s), if applicable. 3. Name of contractor to whom the contract was awarded/name of contractor who performed services, if different from awardee. Provide the CAGE Code and DUNS numbers of both the awardee and the contractor who performed the service(s). 4. Dates when services were provided. 5. List the number and type of health care workers provided, i.e., 8 FTE registered nurses, 2 licensed practical nurses, 4 advanced practice nurses, etc. Specify if services were full time, part time, temporary, or locum tenens types of services. 6. Final or projected final price of the effort. 7. Describe the offeror’s role – prime, subcontractor, partner, mentor, protégé, etc. 8. Place(s) of performance. 9. Contracting Officer’s name, phone, e-mail address, agency name, and address. 10 The offeror shall provide information on problems encountered on the identified contract(s) and the offeror’s corrective actions. 11. Narrative per Section L.2.2.: N62645-11-R-0012 Page 117 of 118 CLAUSES INCORPORATED BY REFERENCE 52.215-1 Instructions to Offerors--Competitive Acquisition JAN 2004 52.222-24 Preaward On-Site Equal Opportunity Compliance Evaluation FEB 1999 52.237-1 Site Visit APR 1984 CLAUSES INCORPORATED BY FULL TEXT 52.216-1 TYPE OF CONTRACT (APR 1984) The Government contemplates award of Firm Fixed Price (FFP), Indefinite Delivery / Indefinite Quantity (IDIQ) contracts resulting from this solicitation. (End of provision) 52.233-2 SERVICE OF PROTEST (SEP 2006) (a) 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: Naval Medical Logistics Command Code 02, Attn: Contracting Officer 693 Neiman Street Fort Detrick, MD 21702 (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) 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): http://farsite.hill.af.mil (End of provision N62645-11-R-0012 Page 118 of 118 Section M - Evaluation Factors for Award SECTION M M.1. EVALUATION CRITERIA AND BASIS FOR AWARD. M.1.1. The Government intends to award a minimum of three Indefinite Delivery, Indefinite Quantity (IDIQ) contracts resultant from the issuance of this solicitation to those responsible offerors submitting proposals that are determined most advantageous to the Government, price and other factors considered. The evaluation of proposals will be based on an evaluation of Past Performance, Technical (Management Planning and Market Research), and the Business volumes submitted by each offeror. The Government intends to make multiple awards under this solicitation to allow for maximum competition for future Task Order awards. Awards under this procurement will be made to the offerors determined to be the best value to the Government. M.1.2. In the evaluation of all offerors’ proposals, Past Performance is significantly more important than Technical. Additionally, the combination of the Past Performance and Technical evaluation factors is significantly more important than the combined Business volume evaluation factors (Completeness, Reasonableness, and Realism). The closer the merits of the Past Performance and Technical volumes are to one another, the greater will be the importance of Price in making the award determination. In the event that two or more proposals are determined not to have any substantial technical differences (i.e. Past Performance and Technical are substantially equivalent), award may be made to the lower priced proposal. It should be noted that award may be made to other than the lowest priced offeror if the Government determines that a price premium is warranted due to Past Performance and/or Technical merit. A price premium may also be considered to facilitate the award of contracts to three or more offerors, thus gaining the advantages associated with increased competition for future Task Orders. M.1.3. Awards may also be made on the basis of initial offers without discussions. Offerors are therefore cautioned that their initial offer should contain the offeror’s best terms. M.2. EVALUATION FACTORS. M.2.1. Past Performance volumes submitted in response to this solicitation will be evaluated in accordance with the Past Performance factor. See Section L.3 and its subparagraphs. M.2.2. Technical volumes submitted in response to this solicitation will be evaluated in accordance with the Technical factor. See Section L.3 and its subparagraphs. M.2.3. Business volumes submitted in response to this solicitation will be evaluated in consideration of the following factors in Section L.3 and its subparagraphs. M.2.4. Competitive Range. In accordance with FAR 15.306(c), “Competitive Range”, the Government will evaluate all proposals and, if discussions are to be conducted, the Government will establish a competitive range. Based on the ratings of each proposal against all evaluation criteria, the Contracting Officer will establish a competitive range comprised of all the most highly rated proposals. The Contracting Officer may further reduce the competitive range for purposes of efficiency. Discussions may be in person, by telephone, or in writing at the discretion of the Contracting Officer.
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