PRESOL | Q | Physical Evaluation Board Liaison Officer (PEBLO) - PEBLO COMBO Solicitation

FBO DAILY ISSUE OF JANUARY 29, 2012 FBO #3718
SOLICITATION NOTICE

Q -- Physical Evaluation Board Liaison Officer (PEBLO) - PEBLO COMBO Solicitation

Notice Date: 1/27/2012
Notice Type: Combined Synopsis/Solicitation
NAICS: 524114 — Direct Health and Medical Insurance Carriers
Contracting Office: Department of the Air Force, United States Air Force Europe, 48 CONS/LGC - Lakenheath, RAF Lakenheath, Unit 5070 Box 270, RAF Lakenheath, 09461-0270
ZIP Code: 09461-0270
Solicitation Number: FA5587-11-T-0098
Archive Date: 2/28/2012
Point of Contact: Sarah Gordon, Phone: +44 01638 52 2234, Darian L. Vomund, Phone: 001441638522398
E-Mail Address: sarah.gordon@lakenheath.af.mil, darian.vomund@lakenheath.af.mil
(sarah.gordon@lakenheath.af.mil, darian.vomund@lakenheath.af.mil)
Small Business Set-Aside: N/A
Description: PEBLO COMBO Solicitation I. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotations are being requested and a written solicitation will not be issued. II. FA5587-11-T-0098 is issued as a request for quotation. III. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-48. IV. The Small Business Competitiveness Demonstration Program is not applicable. V. CLIN ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 1,960 Hours FULL TIME PEBLO BASIC YEAR FFP SERVICES FOR ONE FULL TIME PHYSICAL EVALUATION BOARD LIAISON OFFICER (PEBLO) FOR PERIOD OF PERFORMACE: 1 FEBRUARY 2012 - 30 SEPTEMBER 2012. FOB: Destination NSN: Q401-P1-PEB-LOLN PURCHASE REQUEST NUMBER: F2P4MD1228A001 SIGNAL CODE: A ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1001 1,960 Hours OPTION FULL TIME PEBLO OPTION YEAR ONE FFP SERVICES FOR ONE FULL TIME PHYSICAL EVALUATION BOARD LIAISON OFFICER (PEBLO) FOR PERIOD OF PERFORMACE: 1 OCTOBER 2012 - 30 SEPTEMBER 2013. FOB: Destination NSN: Q401-P1-PEB-LOLN SIGNAL CODE: A ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1002 1 Lot OPTION TRAVEL EXPENSES FFP TRAVEL EXPENSES WILL INCLUDE AVERAGE PER DIEM RATE, FLIGHT AND CAR EXPENSES. FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2001 1,960 Hours OPTION FULL TIME PEBLO OPTION YEAR TWO FFP SERVICES FOR ONE FULL TIME PHYSICAL EVALUATION BOARD LIAISON OFFICER (PEBLO) FOR PERIOD OF PERFORMACE: 1 OCTOBER 2013 - 30 SEPTEMBER 2014. FOB: Destination NSN: Q401-P1-PEB-LOLN SIGNAL CODE: A ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2002 1 Lot OPTION TRAVEL EXPENSES FFP TRAVEL EXPENSES WILL INCLUDE AVERAGE PER DIEM RATE, FLIGHT AND CAR EXPENSES. FOB: Destination INSPECTION AND ACCEPTANCE TERMS Supplies/services will be inspected/accepted at: CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY 0001 Destination Government Destination Government 1001 Destination Government Destination Government 1002 N/A N/A N/A Government 2001 Destination Government Destination Government 2002 N/A N/A N/A Government VI. The 48th Medical Group at RAF Lakenheath, UK requires one full time Pysical Evaluation Board Liaison Officer (PEBLO) for a period of performance: 1 October 2012- 30 september 2013 to include 2 option years. VII. Delivery: 30 Days ADC; FOB Destination; Inspection/Acceptance by Government at Destination; 48 MDSS/SGSM MEDICAL LOGISTICS BOSTON DRIVE, RAF LAKENHEATH BRANDON, SUFFOLK IP27 9PN UNITED KINGDOM VIII. The provision at 52.212-1, Instructions to Offerors - Commercial Items applies to this acquisition. IX. Evaluation will be based on technical acceptability and price. X. Offerors are advised to include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications - Commercial Items, with their quotation. XI. The clause at 52.212-4, Contract Terms and Conditions - Commercial Items, applies to this acquisition. XII. The clause at 52.212-5, Contract Terms and Conditions Required To Implement Statutes Or Executive Orders - Commercial Items (July 2010) (DEVIATION), applies to this acquisition. XIII. The following provisions and clauses are also applicable to this acquisition: CLAUSES INCORPORATED BY REFERENCE 52.204-7 Central Contractor Registration APR 2008 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.209-5 Certification Regarding Responsibility Matters APR 2010 52.212-1 Instructions to Offerors--Commercial Items JUN 2008 52.212-4 Contract Terms and Conditions--Commercial Items JUN 2010 52.224-1 Privacy Act Notification APR 1984 52.224-2 Privacy Act APR 1984 52.229-6 Taxes--Foreign Fixed-Price Contracts JUN 2003 52.232-8 Discounts For Prompt Payment FEB 2002 52.232-33 Payment by Electronic Funds Transfer--Central Contractor Registration OCT 2003 52.237-2 Protection Of Government Buildings, Equipment, And Vegetation APR 1984 52.253-1 Computer Generated Forms JAN 1991 252.204-7004 Alt A Central Contractor Registration (52.204-7) Alternate A SEP 2007 252.222-7002 Compliance With Local Labor Laws (Overseas) JUN 1997 252.229-7000 Invoices Exclusive of Taxes or Duties JUN 1997 252.229-7006 Value Added Tax Exclusion (United Kingdom) JUN 1997 252.229-7007 Verification of United States Receipt of Goods JUN 1997 252.229-7008 Relief From Import Duty (United Kingdom) JUN 1997 252.233-7001 Choice of Law (Overseas) JUN 1997 CLAUSES INCORPORATED BY FULL TEXT 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (MAY 2011) An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically at http://orca.bpn.gov. If an offeror has not completed the annual representations and certifications electronically at the ORCA website, the offeror shall complete only paragraphs (c) through (o) of this provision. (a) Definitions. As used in this provision -- "Economically disadvantaged women-owned small business (EDWOSB) Concern" means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program. "Forced or indentured child labor" means all work or service- (1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or (2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties. Inverted domestic corporation, as used in this section, means a foreign incorporated entity which is treated as an inverted domestic corporation under 6 U.S.C. 395(b), i.e., a corporation that used to be incorporated in the United States, or used to be a partnership in the United States, but now is incorporated in a foreign country, or is a subsidiary whose parent corporation is incorporated in a foreign country, that meets the criteria specified in 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue Code at 26 U.S.C. 7874. Manufactured end product means any end product in Federal Supply Classes (FSC) 1000-9999, except-- (1) FSC 5510, Lumber and Related Basic Wood Materials; (2) Federal Supply Group (FSG) 87, Agricultural Supplies; (3) FSG 88, Live Animals; (4) FSG 89, Food and Related Consumables; (5) FSC 9410, Crude Grades of Plant Materials; (6) FSC 9430, Miscellaneous Crude Animal Products, Inedible; (7) FSC 9440, Miscellaneous Crude Agricultural and Forestry Products; (8) FSC 9610, Ores; (9) FSC 9620, Minerals, Natural and Synthetic; and (10) FSC 9630, Additive Metal Materials. Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture. Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate-- (1) Are conducted under contract directly and exclusively with the regional government of southern Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization; (3) Consist of providing goods or services to marginalized populations of Sudan; (4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization; (5) Consist of providing goods or services that are used only to promote health or education; or (6) Have been voluntarily suspended. Service-disabled veteran-owned small business concern-- (1) Means a small business concern-- (i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and (ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran. (2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16). "Small business concern" means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation. Subsidiary means an entity in which more than 50 percent of the entity is owned-- (1) Directly by a parent corporation; or (2) Through another subsidiary of a parent corporation. Veteran-owned small business concern means a small business concern-- (1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and (2) The management and daily business operations of which are controlled by one or more veterans. "Women-owned business concern" means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and whose management and daily business operations are controlled by one or more women. "Women-owned small business concern" means a small business concern-- (1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; or (2) Whose management and daily business operations are controlled by one or more women. Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127)", means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States. (b) (1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted on the Online Representations and Certifications Application (ORCA) website. (2) The offeror has completed the annual representations and certifications electronically via the ORCA website at http://orca.bpn.gov. After reviewing the ORCA database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications--Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ----------. [Offeror to identify the applicable paragraphs at (c) through (o) of this provision that the offeror has completed for the purposes of this solicitation only, if any.) These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer. Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted on ORCA.] (c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply. (1) Small business concern. The offeror represents as part of its offer that it ( ) is, ( ) is not a small business concern. (2) Veteran-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents as part of its offer that it ( ) is, ( ) is not a veteran-owned small business concern. (3) Service-disabled veteran-owned small business concern. (Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.) The offeror represents as part of its offer that it ( ) is, ( ) is not a service-disabled veteran-owned small business concern. (4) Small disadvantaged business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents, for general statistical purposes, that it ( ) is, ( ) is not a small disadvantaged business concern as defined in 13 CFR 124.1002. (5) Women-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ) is, ( ) is not a women-owned small business concern. Note to paragraphs (c)(8) and (9): Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold. (6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that-- (i) It [ ] is, [ ] is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and (ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate in reference to the WOSB concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern or concerns that are participating in the joint venture:__________.] Each WOSB concern participating in the joint venture shall submit a separate signed copy of the WOSB representation. (7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that-- (i) It [ ] is, [ ] is not an EDWOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and (ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate in reference to the EDWOSB concern or concerns that are participating in the joint venture. The offeror shall enter the name or names of the EDWOSB concern or concerns that are participating in the joint venture: __________. Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation. (8) Women-owned business concern (other than small business concern). (Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ) is, a women-owned business concern. (9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price: _____________________________________________ (10) (Complete only if the solicitation contains the clause at FAR 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns or FAR 52.219-25, Small Disadvantaged Business Participation Program-Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.) (i) General. The offeror represents that either-- (A) It ( ) is, ( ) is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged business concern in the CCR Dynamic Small Business Search database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); or (B) It ( ) has, ( ) has not submitted a completed application to the Small Business Administration or a Private Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted. (ii) Joint Ventures under the Price Evaluation Adjustment for Small Disadvantaged Business Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR 124.1002(f) and that the representation in paragraph (c)(10)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. (The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture: ____________.) (11) HUBZone small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents, as part of its offer, that-- (i) It [ ] is, [ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR Part 126; and (ii) It [ ] is, [ ] is not a HUBZone joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(11)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: _______.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation. (d) Certifications and representations required to implement provisions of Executive Order 11246-- (1) Previous Contracts and Compliance. The offeror represents that-- (i) It ( ) has, ( ) has not, participated in a previous contract or subcontract subject either to the Equal Opportunity clause of this solicitation, the and (ii) It ( ) has, ( ) has not, filed all required compliance reports. (2) Affirmative Action Compliance. The offeror represents that-- (i) It ( ) has developed and has on file, ( ) has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR Subparts 60-1 and 60-2), or (ii) It ( ) has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor. (e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made. (f) Buy American Act Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act --Supplies, is included in this solicitation.) (1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of "domestic end product." The terms "commercially available off-the-shelf (COTS) item," "component," "domestic end product," "end product," "foreign end product," and "United States" are defined in the clause of this solicitation entitled "Buy American Act--Supplies." (2) Foreign End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________ (List as necessary) (3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. (g)(1) Buy American Act-Free Trade Agreements-Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American Act-Free Trade Agreements-Israeli Trade Act, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms "Bahrainian, Moroccan, Omani, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American Act-Free Trade Agreements-Israeli Trade Act." (ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled ``Buy American Act--Free Trade Agreements--Israeli Trade Act'': Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, or Peruvian End Products) or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________ [List as necessary] (iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American Act-Free Trade Agreements-Israeli Trade Act." The offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of "domestic end product." Other Foreign End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________ [List as necessary] (iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. (2) Buy American Act-Free Trade Agreements-Israeli Trade Act Certificate, Alternate I (Jan 2004). If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled "Buy American Act-Free Trade Agreements-Israeli Trade Act": Canadian End Products: Line Item No. _______________________________________ _______________________________________ _______________________________________ [List as necessary] (3) Buy American Act-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II (Jan 2004). If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled "Buy American Act-Free Trade Agreements-Israeli Trade Act": Canadian or Israeli End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________ [List as necessary] (4) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(4)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled "Trade Agreements." (ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products. Other End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________ (List as necessary) (iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American Act. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation. (h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that -- (1) The offeror and/or any of its principals ( ) are, ( ) are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency, (2) ( ) Have, ( ) have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; and (3) ( ) are, ( ) are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and (4) ( ) Have, ( ) have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied. (i) Taxes are considered delinquent if both of the following criteria apply: (A) The tax liabilityis finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted. (B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded. (ii) Examples. (A) The taxpayer has received a statutory notice of deficiency, under I.R.C. Sec. 6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights. (B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights. (C) The taxpayer has entered into an installment agreement pursuant to I.R.C. Sec. 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment. (D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code). (i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). [The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).] (1) Listed end products. Listed End Product Listed Countriesof Origin (2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.] [ ] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. [ ] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor. (j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly- (1) ( ) In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or (2) ( ) Outside the United States. (j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly-- (1) ( ) In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or (2) ( ) Outside the United States. (k) Certificates regarding exemptions from the application of the Service Contract Act. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.] [ ] (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror ( ) does ( ) does not certify that- (i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations; (ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and (iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers. [ ] (2) Certain services as described in FAR 22.1003-4(d)(1). The offeror ( ) does ( ) does not certify that- (i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial quantities in the course of normal business operations; (ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii)); (iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a month) servicing the Government contract; and (iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers. (3) If paragraph (k)(1) or (k)(2) of this clause applies- (i) If the offeror does not certify to the conditions in paragraph (k)(1) or (k)(2) and the Contracting Officer did not attach a Service Contract Act wage determination to the solicitation, the offeror shall notify the Contracting Officer as soon as possible; and (ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause. (l) Taxpayer Identification Number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to a central contractor registration database to be eligible for award.) (1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS). (2) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN. (3) Taxpayer Identification Number (TIN). ( ) TIN: --------------------. ( ) TIN has been applied for. ( ) TIN is not required because: ( ) Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States; ( ) Offeror is an agency or instrumentality of a foreign government; ( ) Offeror is an agency or instrumentality of the Federal Government. (4) Type of organization. ( ) Sole proprietorship; ( ) Partnership; ( ) Corporate entity (not tax-exempt); ( ) Corporate entity (tax-exempt); ( ) Government entity (Federal, State, or local); ( ) Foreign government; ( ) International organization per 26 CFR 1.6049-4; ( ) Other ----------. (5) Common parent. ( ) Offeror is not owned or controlled by a common parent; ( ) Name and TIN of common parent: Name --------------------. TIN --------------------. (m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan. (n) Prohibition on Contracting with Inverted Domestic Corporations- (1) Relation to Internal Revenue Code. An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue Code 25 U.S.C. 7874. (2) Representation. By submission of its offer, the offeror represents that-- (i) It is not an inverted domestic corporation; and (ii) It is not a subsidiary of an inverted domestic corporation. (o) Sanctioned activities relating to Iran. (1) Unless a waiver is granted or an exception applies as provided in paragraph (o)(2) of this provision, by submission of its offer, the offeror certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act of 1996. (2) The certification requirement of paragraph (o)(1) of this provision does not apply if- (i) This solicitation includes a trade agreements certification (e.g., 52.212-3(g) or a comparable agency provision); and (ii) The offeror has certified that all the offered products to be supplied are designated country end products. (End of provision) 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS--COMMERCIAL ITEMS (AUG 2011) (DEVIATION) (a) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (a) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records-Negotiation. (1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract. (2) The Contractor shall make available at its offices at all reasonable times, the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved. (3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law. (b)(1) Notwithstanding the requirements of any other clause in this contract, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (b)(i) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause- (i) 52.203-13, Contractor Code of Business Ethics and Conduct (APR 2010) (Pub. L. 110-252, Title VI, Chapter 1 (41 U.S.C. 251 note). (ii) 52.219-8, Utilization of Small Business Concerns (DEC 2010) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $650,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities. (iii) Reserved. (iv) 52.222-26, Equal Opportunity (MAR 2007) (E.O. 11246). (v) 52.222-35, Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans (SEP 2006) (38 U.S.C. 4212). (vi) 52.222-36, Affirmative Action for Workers with Disabilities (JUN 1998) (29 U.S.C. 793). (vii) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222-40. (viii) 52.222-41, Service Contract Act of 1965 (Nov 2007) (41 U.S.C. 351, et seq.). (ix) 52.222-50, Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g)). None. (x) 52.222-51, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (Nov 2007) (41 U.S.C. 351, et seq.). (xi) 52.222-53, Exemption from Application of the Service Contract Act to Contracts for Certain Services--Requirements (FEB 2009) (41 U.S.C. 351, et seq.). (xii) 52.222-54, Employment Eligibility Verification (JAN 2009). (xiii) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (MAR 2009) (Pub. L. 110-247). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6. (xiv) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (FEB 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64. (2) While not required, the contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations. (End of clause) CLAUSES INCORPORATED BY FULL TEXT 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 30 days. (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 30days; 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 3 years and 6 months. (End of clause) CLAUSES INCORPORATED BY FULL TEXT 52.232-18 AVAILABILITY OF FUNDS (APR 1984) Funds are not presently available for this contract. The Government's obligation under this contract 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 this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer. (End of clause) CLAUSES INCORPORATED BY FULL TEXT 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 CLAUSES INCORPORATED BY FULL TEXT 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) CLAUSES INCORPORATED BY FULL TEXT 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (APR 1984) (a) The use in this solicitation of any Federal Acquisition Regulation (48 CFR Chapter 1) provision with an authorized deviation is indicated by the addition of"(DEVIATION)" after the date of the provision. (b) The use in this solicitation of any Defense Federal Acquisition Regulation Supplement (48 CFR Chapter 2) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation. (End of provision) 52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (APR 1984) (a) The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause. (b) The use in this solicitation or contract of any Defense Federal Acquisition Regulation Supplement (48 CFR Chapter 2) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation. (End of clause) 252.212-7001 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS APPLICABLE TO DEFENSE ACQUISITIONS OF COMMERCIAL ITEMS (DEC 2010) (DEVIATION) (a) In addition to the clauses listed in paragraph (b) of the Contract Terms and Conditions Required to Implement Statutes or Executive Orders--Commercial Items clause of this contract (FAR 52.212-5) (OCT 2010) (DEVIATION), the Contractor shall include the terms of the following clause, if applicable, in subcontracts for commercial items or commercial components, awarded at any tier under this contract: 252.237-7010 252.237-7019 Prohibition on Interrogation of Detainees by Contractor Personnel (NOV 2010) (Section 1038 of Pub. L. 111-84). Training for Contractor Personnel Interacting with Detainees (SEP 2006) (Section 1092 of Pub. L. 108-375). 252.247-7003 Pass-Through of Motor Carrier Fuel Surcharge Adjustment to the Cost Bearer (JUL 2009) (Section 884 of Public Law 110-417) 252.247-7023 Transportation of Supplies by Sea (MAY 2002) (10 U.S.C. 2631) 252.247-7024 Notification of Transportation of Supplies by Sea (MAR 2000) (10 U.S.C. 2631) (End of clause) 252.225-7042 AUTHORIZATION TO PERFORM (APR 2003) The offeror represents that it has been duly authorized to operate and to do business in the country or countries in which the contract is to be performed. (End of provision) 252.225-7043 ANTITERRORISM/FORCE PROTECTION POLICY FOR DEFENSE CONTRACTORS OUTSIDE THE UNITED STATES (MAR 2006) (a) Definition. United States, as used in this clause, means, the 50 States, the District of Columbia, and outlying areas. (b) Except as provided in paragraph (c) of this clause, the Contractor and its subcontractors, if performing or traveling outside the United States under this contract, shall-- (1) Affiliate with the Overseas Security Advisory Council, if the Contractor or subcontractor is a U.S. entity; (2) Ensure that Contractor and subcontractor personnel who are U.S. nationals and are in-country on a non-transitory basis, register with the U.S. Embassy, and that Contractor and subcontractor personnel who are third country nationals comply with any security related requirements of the Embassy of their nationality; (3) Provide, to Contractor and subcontractor personnel, antiterrorism/force protection awareness information commensurate with that which the Department of Defense (DoD) provides to its military and civilian personnel and their families, to the extent such information can be made available prior to travel outside the United States; and (4) Obtain and comply with the most current antiterrorism/force protection guidance for Contractor and subcontractor personnel. (c) The requirements of this clause do not apply to any subcontractor that is-- (1) A foreign government; (2) A representative of a foreign government; or (3) A foreign corporation wholly owned by a foreign government. (d) Information and guidance pertaining to DoD antiterrorism/force protection can be obtained from [Contracting Officer to insert applicable information cited in PGI 225.7403-1]. (End of clause) 252.225-7043 Antiterrorism/Force Protection for Defense Contractors Outside the United States As prescribed in 225.7403-2, use the following clause: ANTITERRORISM/FORCE PROTECTION POLICY FOR DEFENSE CONTRACTORS OUTSIDE THE UNITED STATES (MAR 2006) (a) Definition. "United States," as used in this clause, means, the 50 States, the District of Columbia, and outlying areas. (b) Except as provided in paragraph (c) of this clause, the Contractor and its subcontractors, if performing or traveling outside the United States under this contract, shall (1) Affiliate with the Overseas Security Advisory Council, if the Contractor or subcontractor is a U.S. entity; (2) Ensure that Contractor and subcontractor personnel who are U.S. nationals and are in-country on a non-transitory basis, register with the U.S. Embassy, and that Contractor and subcontractor personnel who are third country nationals comply with any security related requirements of the Embassy of their nationality; (3) Provide, to Contractor and subcontractor personnel, antiterrorism/force protection awareness information commensurate with that which the Department of Defense (DoD) provides to its military and civilian personnel and their families, to the extent such information can be made available prior to travel outside the United States; and (4) Obtain and comply with the most current antiterrorism/force protection guidance for Contractor and subcontractor personnel. (c) The requirements of this clause do not apply to any subcontractor that is (1) A foreign government; (2) A representative of a foreign government; or (3) A foreign corporation wholly owned by a foreign government. (d) Information and guidance pertaining to DoD antiterrorism/force protection can be obtained from 48th Fighter Wing Anti-Terrorism Office DSN 226-1242, Commercial: 01638-52-1242.. 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) 5352.201-9101 Ombudsman. OMBUDSMAN (APR 2010) (a) An ombudsman has been appointed to hear and facilitate the resolution of concerns from offerors, potential offerors, and others for this acquisition. When requested, the ombudsman will maintain strict confidentiality as to the source of the concern. The existence of the ombudsman does not affect the authority of the program manager, contracting officer, or source selection official. Further, the ombudsman does not participate in the evaluation of proposals, the source selection process, or the adjudication of protests or formal contract disputes. The ombudsman may refer the party to another official who can resolve the concern. (b) Before consulting with an ombudsman, interested parties must first address their concerns, issues, disagreements, and/or recommendations to the contracting officer for resolution. Consulting an ombudsman does not alter or postpone the timelines for any other processes (e.g., agency level bid protests, GAO bid protests, requests for debriefings, employee-employer actions, contests of OMB Circular A-76 <http://www.whitehouse.gov/omb/circulars/a076/a76_rev2003.pdf> competition performance decisions). (c) If resolution cannot be made by the contracting officer, concerned parties may contact the Center/MAJCOM ombudsmen: Primary Command Ombudsman: Ms. Tara Petersen HQ USAFE/A7K, UNIT 3050, Box 10, APO AE 09094-0110 HQ USAFE/A7K, Flugplatz Ramstein, 66877 Ramstein Germany E-mail: tara.petersen@ramstein.af.mil Tel: (49)-6371-47-2209, Fax: (49)-6731-47-2025 Alternate Command Ombudsman: Ms. Heidi Hoehn HQ USAFE/A7K, UNIT 3050, Box 10, APO AE 09094-0110 HQ USAFE/A7K, Flugplatz Ramstein, 66877 Ramstein Germany E-mail: heidi.hoehn@ramstein.af.mil Tel: (49)-6371-47-9330, Fax: (49)-6731-47-2025 Concerns, issues, disagreements, and recommendations that cannot be resolved at the MAJCOM/DRU or ARISRA level, may be brought by the concerned party for further consideration to the Air Force ombudsman, Associate Deputy Assistant Secretary (ADAS) (Contracting), SAF/AQC, 1060 Air Force Pentagon, Washington DC 20330-1060, phone number (703) 588-7004, facsimile number (703) 588-1067. (d) The ombudsman has no authority to render a decision that binds the agency. (e) Do not contact the ombudsman to request copies of the solicitation, verify offer due date, or clarify technical requirements. Such inquiries shall be directed to the Contracting Officer. (End of clause) 5352.223-9000 Elimination of Use of Class I Ozone Depleting Substances (ODS). ELIMINATION OF USE OF CLASS I OZONE DEPLETING SUBSTANCES (ODSs) (APR 2003) (a) Unless the requiring activity has obtained prior Senior Acquisition Official (SAO) approval, contractors may not: (1) Provide any service or product with any specification, standard, drawing, or other document that requires the use of a Class I ODS in the test, operation, or maintenance of any system, subsystem, item, component, or process; or (2) Provide any specification, standard, drawing, or other document that establishes a test, operation, or maintenance requirement that can only be met by use of a Class I ODS. [Note: This prohibition does not apply to manufacturing.] (b) For the purposes of Air Force policy, the following products that are pure (i.e., they meet the relevant product specification identified in AFI 32-7086) are Class I ODSs: (1) Halons: 1011, 1202, 1211, 1301, and 2402; (2) Chlorofluorocarbons (CFCs): CFC-11, CFC-12, CFC-13, CFC-111, CFC-112, CFC-113, CFC-114, CFC-115, CFC-211, CFC-212, CFC-213, CFC-214, CFC-215, CFC-216, and CFC-217, and the blends R-500, R-501, R-502, and R-503; and (3) Carbon Tetrachloride, Methyl Chloroform, and Methyl Bromide. [NOTE: Material that uses one or more of these Class I ODSs as minor constituents do not meet the Air Force definition of a Class I ODS.] (c) The requiring activity has obtained SAO approval to permit the contractor to use the following Class I ODS(s): Class I ODS/ Application or Use/Quantity (lbs.) per contract period of performance [List each Class I ODS, its applications or use and the approved quantities for use throughout the length of the contract. If "None," so state.] (d) The offeror/contractor is required to notify the contracting officer if any Class I ODS that is not specifically listed above is required in the test, operation, or maintenance of any system, subsystem, item, component, or process. (End of clause) 5352.223-9001 Health and Safety on Government Installations. HEALTH AND SAFETY ON GOVERNMENT INSTALLATIONS (JUN 1997) (a) In performing work under this contract on a Government installation, the contractor shall: (1) Comply with the specific health and safety requirements established by this contract; (2) Comply with the health and safety rules of the Government installation that concern related activities not directly addressed in this contract; (3) Take all reasonable steps and precautions to prevent accidents and preserve the health and safety of contractor and Government personnel performing or in any way coming in contact with the performance of this contract; and (4) Take such additional immediate precautions as the contracting officer may reasonably require for health and safety purposes. (b) The contracting officer may, by written order, direct Air Force Occupational Safety and Health (AFOSH) Standards and/or health/safety standards as may be required in the performance of this contract and any adjustments resulting from such direction will be in accordance with the Changes clause of this contract. (c) Any violation of these health and safety rules and requirements, unless promptly corrected as directed by the contracting officer, shall be grounds for termination of this contract in accordance with the Default clause of this contract. (End of clause) 5352.225-9004 Submission of Offers in Other than United States Currency. SUBMISSION OF OFFERS IN OTHER THAN UNITED STATES CURRENCY (JUNE 2006) (a) Offers may be submitted in United States dollars or the currency accepted at the place of performance. (b) All offers shall be evaluated for determination of contract award by converting all foreign currencies to equivalent United States dollars by using the Foreign Currency Fluctuation Defense (FCFD) budget rate for the applicable currency in affect on the date set for the receipt of initial proposals. (c) When a "Final Proposal Revision" is requested and received, in accordance with the applicable solicitation's terms and conditions, offers shall be evaluated by converting all foreign currencies to equivalent United States dollars by using the Foreign Currency Fluctuation Defense (FCFD) budget rate for the applicable currency in affect on the date set for the receipt of initial proposals. (End of Provision) 5352.242-9000 Contractor access to Air Force installations. CONTRACTOR ACCESS TO AIR FORCE INSTALLATIONS (JUN 2002) (a) The contractor shall obtain base identification and vehicle passes for all contractor personnel who make frequent visits to or perform work on the Air Force installation(s) cited in the contract. Contractor personnel are required to wear or prominently display installation identification badges or contractor-furnished, contractor identification badges while visiting or performing work on the installation. (b) The contractor shall submit a written request on company letterhead to the contracting officer listing the following: contract number, location of work site, start and stop dates, and names of employees and subcontractor employees needing access to the base. The letter will also specify the individual(s) authorized to sign for a request for base identification credentials or vehicle passes. The contracting officer will endorse the request and forward it to the issuing base pass and registration office or security police for processing. When reporting to the registration office, the authorized contractor individual(s) should provide a valid driver's license, current vehicle registration, valid vehicle insurance certificate, and, current vehicle registration, valid vehicle insurance certificate, current MOT, and current road tax disc to obtain a vehicle pass to obtain a vehicle pass. (c) During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel and for prompt return of credentials and vehicle passes for any employee who no longer requires access to the work site. (d) When work under this contract requires unescorted entry to controlled or restricted areas, the contractor shall comply with AFI 31-101, Volume 1, The Air Force Installation Security Program, and AFI 31-501, Personnel Security Program Management, as applicable. (e) Upon completion or termination of the contract or expiration of the identification passes, the prime contractor shall ensure that all base identification passes issued to employees and subcontractor employees are returned to the issuing office. (f) Failure to comply with these requirements may result in withholding of final payment. (End of clause) PWS PERFORMANCE WORK STATEMENT FOR PHYSICAL EVALUATION BOARD LIAISON OFFICER (PEBLO) AT RAF LAKENHEATH, UNITED KINGDOM 5 Jan 2012 PHYSICAL EVALUATION BOARD LIAISON OFFICER (PEBLO) Non-Personal Services 1 SCOPE OF WORK. The Government requires one (1) Full Time Equivalent (FTE) for this contract at the established facilities at the 48th Medical Group, RAF Lakenheath, and England, also referred to as the "Medical Treatment Facility" (MTF) herein. The contractor shall provide a representative to work as a Physical Evaluation Board Liaison Officer (PEBLO). The contractor will be responsible for the performance or management of the Medical Evaluation Board process to include organizing people and resources efficiently so as to direct activities toward common goals and objectives. In addition, the contractor will be responsible for assisting with the case management of active duty beneficiaries undergoing Physical Evaluation Board processing. Performance shall be in accordance with the requirements contained in this Performance Work Statement (PWS), and standards of the Joint Commission and Health Services Inspection (HSI). 2 GENERAL CONTRACTOR REQUIREMENTS AND RESPONSIBILITIES 2.1 HOURS OF WORK. The contractor's work schedule will be determined by the Patient Administration Officer based on the needs of the clinic or floor in which the contractor is to provide the service. The Contractor will be required to work 8-hour shifts Monday through Friday 0730-1630 hours, excluding Federal holidays. The contractor may be required to work more than 8 hrs in a single day or 40 hours in a week and holidays. However, under no circumstances will the contractor earn premium pay. All overtime, weekend or night shift hours will be paid at the same hourly rate as regular hours of work. If additional hours are worked, the Government may reduce future scheduled hours to maintain a 40 hour work week average. All hours worked will be recorded accurately on the work schedules. Under no circumstances are the work schedules to reflect hours worked when the contractor was absent or vice versa. 2.1.1 On occasion, services may be required to support an activation or exercise of contingency plans outside the normal duty hours for a crisis declared by the national command authority or overseas combatant commander. Emergency situations (i.e., accident and rescue operations, civil disturbances, natural disasters, military contingency operations, and exercises) may necessitate the contractor provide increased or reduced support as determined by the contracting officer. If necessary, the Government will negotiate an equitable adjustment for the cost of these emergency requirements. 2.1.2 As directed by the MTF, the contractor may be required to attend Government provided additional training in patient care aspects and procedures. 2.2 INDIVIDUAL LOGISTICAL SUPPORT. Individual logistical support is provided under this contract in accordance with FAR 25.802, DFARS 225.802, and the policies and procedures of DoD 4525.6-M and AFI 36-3026. Policies and procedures are subject to change. Examples of support are: DOD Common Access Card (CAC); Commissary (including rationed items); Base Exchange (including rationed items); MWR Facilities (e.g. chapels, clubs, cinema, fitness center); Military Banking Facilities; Military Postal Service (APO/FPO); Mortuary Services (on reimbursable basis); POV (Privately-Owned Vehicle license); Purchase of POL (Petroleum and Oil products); Transient Billets or Visiting Officers Quarters (VOQ) on space-available and reimbursable basis when travel is performed on Official Government Orders; Department of Defense Dependent Schools (DODDS) on a space guaranteed and tuition paying basis; Medical services on a reimbursable basis; Dental care only for emergency conditions on a reimbursable basis; Pet/Firearm Registration and Control and Housing Referral. Logistical support is not authorized for Local National hires as it is forbidden by the Status of Forces Agreement (SOFA). Local National hires may be authorized a CAC if their duties require access to Government computer programs. 2.3 ABSENCE. Contractor is permitted to request approval of unpaid absences for holiday, vacation, sick, and family leave from the Patient Administration Officer. Scheduled absences are to be coordinated a minimum of 2 weeks in advance, and are at the discretion of the Patient Administration Officer. Notify the Patient Administration Officer as early as possible of unscheduled absences to allow for planning of service coverage and workload distribution. 2.4 DRESS AND APPEARANCE. Contractor personnel shall present a professional, conservative, and neat appearance. Contractor personnel shall report for duty in a professional manner, in appropriate attire befitting a health care setting, and having complied with socially acceptable standards of personal hygiene expected of health care workers. 2.4.1 While on duty, Contractor personnel shall be neat and clean (free from visible dirt and stains), well groomed and appropriately dressed. The personnel's clothing shall fit correctly to provide a professional, modest appearance, in keeping with normally accepted community standards of dress for the work being performed. 2.4.2 Contractor personnel shall display legible MTF-provided identification media on their outer clothing. 2.4.3 Facial hair (including beards, mustaches, and sideburns) shall be controlled (restrained) or trimmed. It shall not interfere with safe work practices, look unkempt, or be unclean. 2.4.4 When required and supplied by the Government, wear special protective clothing and shoe covers. When duties will be performed in specified areas, a disposable protective hood shall be worn to ensure infection control standards are met. These items shall remain the property of the Government and shall not be removed from the MTF. After use, protective clothing shall be turned in or destroyed as directed by the Chief of Service. 2.5 OFFICE SKILLS. Contractor shall possess working knowledge of computers, specifically the internet, Microsoft Word, Microsoft Access, Microsoft Excel, and Windows Operating System. 2.6 SECURITY. 2.6.1 See Appendix 1 for information regarding Host Agency Checks (HAC) and National Agency Checks (NAC). 2.6.2 During performance, report any information or circumstances observed that may pose a threat to the security of DoD personnel, contractor personnel, resources, and defense information to the Security Forces. The Patient Administration Officer will brief the contractor upon initial on-base assignment and as required thereafter. Comply with the requirements of Volume 1, AFI 71-101, Criminal Investigations, and paragraph 1.1 of Volume 2, Protective Service Matters. 2.6.3 Adhere to local base procedures for entry to Air Force controlled/restricted areas. 2.6.4 Ensure keys issued by the government are properly safeguarded and not used by unauthorized personnel. Do not duplicate keys issued by the government. 2.6.5 Lost keys shall be reported immediately to the facility manager. The government replaces lost keys or performs re-keying. 3. HEALTHCARE REQUIREMENTS. 3.1 In accordance with Federal Acquisition Regulation 37.401 with regard to Non-Personal Services for health care services, the following information is provided: 3.1.1 This is a NON-PERSONAL health care services contract, as defined in FAR 37.101, under which the contractor is an independent contractor. 3.1.2 The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis, for specific medical treatment). 3.1.3 The contractor hereby indemnifies the Government for any liability producing act or omission by the contractor, its employees and agents occurring during contract performance. 3.2 Contractor staff must comply with 48th Medical Group and unit standards of care as well as the healthcare practices of their specific profession. See Appendix 2 for a list of applicable publications and forms; this list is not exhaustive. 3.2.1 Recognize adverse signs and symptoms and react quickly in emergency situations. 3.2.2 Provide patients with the utmost care and undivided attention. 3.2.3 Ensure a safe work environment and employee safe work habits. 3.2.4 Participate in Quality Inspection and Risk Management activities to the extent that falls within the scope of this PWS. 3.3 HIPAA. All patients shall be assured of their privacy and personal dignity. Follow guidelines for confidentiality and privacy based on the Health Insurance Portability and Accountability Act (HIPAA). See Appendix 3 for more information. 3.4 RELEASE OF INFORMATION AND RECORDS MANAGEMENT. 3.4.1 Only release medical information obtained during the course of this contract to MTF staff involved in the care and treatment of that individual patient. 3.4.2 Lists and/or names of patients shall not be disclosed or revealed in any way for any use outside the MTF without prior written permission by the Chief of Hospital Services. 3.4.3 Refer all other requests for records to the Outpatient records center. 3.4.4 Prepare all documentation/records to meet or exceed established standards of the MTF, to include, but not limited to, timeliness, accuracy, content and signature. Only MTF and Air Force-approved abbreviations shall be used for documentation of the patient health record. For unapproved abbreviation list see MDGI 44-116, attch 2 and 3. 3.4.5 Generate and manage IAW DoD 5400-7R, DoD Freedom of Information Act Program, Chapter 4; AFI 33-129, Web Management and Internet Use, paragraphs 7.4, 8.2.3, 16 and 17; and AFI 33-201, Communications Security (COMSEC), Table 1. 3.4.6 Mark IAW instructions identified in DoD 5400-7R paragraph C4.2.1. Safeguard all sensitive data IAW DoD Regulation 5400.7/Air Force Supplement, paragraph C4.4. 3.4.7 When authorized for destruction, shred the records so that the pieces cannot be reconstructed. Degauss or overwrite magnetic tapes or other magnetic media. 3.4.8 Patient lists, no matter how developed are FOUO and shall be marked: "FOR OFFICIAL USE ONLY. This document contains information exempt from mandatory disclosure under the Freedom of Information Act (FOIA), Title 5 U.S.C. 552(b) (2) High and (b) (6) apply." 3.5 CREDENTIAL MAINTENANCE. 3.5.1 Contractors shall have and provide a current certification in Basic Life Support (BLS) by the American Heart Association or UK equivalent. 3.5.2 An annual physical examination is required. The contractor must provide proof of the medical examination by a qualified medical practitioner and required immunizations prescribed by the MTF for continued employment within the facility. Report all information necessary to assure hospital records can be maintained correctly, and therefore comply with the Joint Commission, Operational Safety and Health Administration (OSHA), and Center for Disease Control (CDC) health record requirements. 4 POSITION QUALIFICATION REQUIREMENTS. 4.1 FORMAL EDUCATION/: Candidate must have knowledge of the entire military healthcare delivery system practices and DES processing regulations, instructions, procedures and policies. Candidate must have understanding of TRICARE contract language, regional healthcare issue and initiatives, and other federal health benefits programs. Proficient in Microsoft Office programs, Outlook (email), and Internet familiarity desired. Position requires an Associate Degree in business administration, management or healthcare organizations from an accredited college/university. Position also requires two (2) years relevant work experience. Work is primarily sedentary. Ability to obtain a government security clearance required 4.2 EXPERIENCE: Experience in Health Care Administration and or one or more of the following: case management, social work or family advocacy for a minimum of 24 months with the past 60 months required. 4.3 HEALTH REQUIREMENTS: 4.3.1 Public Health clearance is required and the contractor shall submit immunization records and physical health certification with their proposal. The records must show proof of immunization against Hepatitis A and B, Measles, Mumps, Rubella, Varicella, and Influenza. The offeror shall also provide proof of negative TB skin test taken within the past 12 months. If the TB test was positive, submit proof of negative chest x-ray within the past 12 months. After start of work, the government will provide post blood borne exposure protocols according to applicable AFIs. The health certification shall state the date on which the physical examination was completed, the name of the doctor who performed the examination, and a statement concerning the physical health of the individual. The certification shall also contain the following statement: "(Name of contractor personnel) is suffering from no contagious diseases to include, but not limited to, Tuberculosis, Hepatitis A and B and HIV." 4.4 SPECIFIC TASKS. The contractor shall perform or shall know how to perform the tasks listed below. The contractor shall at no point receive additional payment for performing tasks outside of this list or outside of the scope of this contract. If additional tasks are required, the contractor and customer shall contact the contracting officer prior to performance in order to increase the scope of the contract and complete negotiations for equitable adjustment. 4.4.1 Administrative duties: Provides administrative support/oversight of the 48th Medical Evaluation Board (MEB) program for the active duty beneficiaries of RAF Lakenheath and RAF Mildenhall. Upon need and/or request will advise Limited Scope Military Treatment Facilities (LSMTF) staff within United Kingdom of appropriate MEB and Fast Track MEB processing procedures. Shall work productively with minimal supervision and provide reccomendation in a positive and professional manner with patients, case managers, providers, and co-workers. Shall not supervise or evaluate any other staff members. Provides support/management of MEB office day to day operations, to include the collection, collaboration and coordination of fast track/MEB necessary patient documentation. Will assist in the coordination of deployment waiver packages and Review in Lue Of (RILO)/Temporary Duty Retirement Listing (TDRL) Medical appointments. 4.4.2 Business Operations: Ensures consistency with 48th MDG's Strategic Plan. Identifies and follows up on opportunities to increase efficiency and reduce cost; displays and shares knowledge of professional developments and current trends related to Medical Evaluation Board case management. 4.4.3 Marketing: Provides contact reports, and all other required reporting to supervisor on a timely basis. Provides referring providers information on new and/or existing programs. Conducts training on the MEB process to patients, staff or referred to facilities as needed and/or appropriate. 4.4.4 Coordination of Services Assistance: Communicates regularly with the patient and care giver(s)/support systems, promotes efficient and coordinated care. Conducts conferences with patient and care giver(s) and involved professionals, and identifies needs for additional/ancillary services/equipment. 5 CONTRACT PERFORMANCE 5.1 If contractor fails to perform IAW the PWS the contractor will be notified in writing by the Contracting Office of all non-compliance issues and given an opportunity to correct non-conforming work. It is encouraged to resolve minor infractions at the lowest level possible, but ensuring the Contracting Office is in the chain. At no time may a contractor be instructed not to contact the Contracting Office. This is a non-personal service and the contractor's recourse is always with the Contracting Office. 6 CONTRACTOR SUPPORT 6.1 Support includes Government-controlled working space, material, equipment, services (including automatic data processing), or other support which the Government determines can be made available. 6.2 TRAINING AND TRAVEL 6.2.1 The Government will provide training on Government provided forms and equipment, initial orientation and annual training requirements specific to the MTF. The Government will provide training to the Contractor's trainers that include appointing, Medical Evaluation Board process, HIPAA, and Government IT systems requirements. All Contractor staff that access Government IT systems shall be trained in security awareness, protection of Government sensitive and privacy information, and their responsibility and consequences before access is authorized. 6.2.2 Travel. At the direction of the Government, contract personnel may be required to travel either to San Antonio, Texas or Ramstein, Germany. This is required for IDES/VA training lasting up to 1 week in the designated location. All travel must be coordinated with and approved by the Medical Logistics Section in advance and in writing. The contractor is solely responsible for their own travel for day to day management and operations, to include any trips to address site or personnel issues. This paragraph only applies if the Government requires or directs attendance at a conference, meeting, or other location/event. 6.2.3 Travel costs shall be reimbursed in accordance with Federal Travel Regulations, Joint Travel Regulations and Standardized Regulations Section 925, FAR 31.205-46 for locality per diem rates. All travel shall be pre-approved and travel invoices shall be supported by receipts. Actual modes of transportation and costs shall be agreed to in advance and reimbursed on a cost basis upon receipt of the invoice in Wide Area Work Flow and submittal of receipts to the Medial Logistics Section. Allowable travel costs not specifically covered in FAR 31.205-46 may be addressed on an as-needed basis. The Joint Travel Regulation (JTR) does not apply to contractors; however, it may be used to aid the contracting officer in making individual decisions regarding travel rules. Travel requirements will be identified on a cost-reimbursement basis. Billable travel costs are airfare, ground transportation, and per diem costs. APPENDIX 1 NATIONAL AGENCY CHECK (NAC)/HOST AGENCY CHECK (HAC). The government will submit an investigation request for the awardee on AF Form 2583, "Request for Personnel Security Action", at no additional cost to the contractor. The contractor must successfully pass a National Agency Check (NAC) US or Host Agency Check (HAC) UK to be eligible for contract award. Any contractor receiving an unfavorable NAC/HAC shall be terminated for the Default. UNESCORTED ENTRY - CAC: 1. Those personnel requiring CAC cards are issued one because they are either authorized Logistical Support (i.e. Commissary, BX, and Gas Station) and/or computer access. US personnel shall have a NAC initiated by the gaining units Security Manager or for UK personnel the gaining units HAC POC. It is the Trusted Agents (TA) responsibility to ensure these checks are initiated. 2. The contract award document contains the information whether or not an individual is authorized Logistical Support or requires computer access in performance of their job. This has to be verified by the contractors TA. 3. TA's are individuals assigned by their unit to "sponsor" contractors in Contractor Verification System (CVS) allowing them to be issued a CAC. The TA will initially load the contractor in CVS which prompts the contractor to go into CVS and verify the information. The TA will provide instructions on how this is accomplished. 4. DD Form 1172-2, Application for Department of Defense Common Access Card DEERS Enrollment, must be completed and submitted with the DD Form 557, Appointment/Termination Record- Authorized Signature. The TA must fill out the DD Form 1172-2, all typed, if there is any hand written information on the form (other than signatures) the MPF office will reject the form. The TA must fill in Section I, Employee Information; Section II, Employee Declaration and Remarks, here is where the contractor's security clearance information (NAC or HAC) goes and all authorized Logistical Support, the contractor signs and dates boxes 37 and 38; and Section III, Authorized/Verified By, is where the TA fills in their information. They verify the contractors' signature in Section II and then the TA signs Section III. The DD Form 577, Appointment/Termination Record- Authorized Signature, and as the name implies, verifies the TA's name and signature. This is used to compare the name and signature in Section III of the DD Form 1172-2. MPF will not accept the DD Form 1172-2 or process the contractor in DEERS without a DD Form 577 indicating the TA. 5. Occasionally, a contractor may arrive at RAF Lakenheath assigned to a TA from another base, this is not a problem. In this instance the contractor must ensure they bring with them the completed and signed DD Form 1172-2 and a copy of the TA's DD Form 577. 6. If the contractor has dependents accompanying them the DD Form 1172, Application for Uniformed Services Identification Card/DEERS Enrollment, may be required. The completed form is required if the dependents have never been issued a DoD identification card. The TA is required to fill out and sign the DD Form 1172 and the form must accompany the contractor. If the dependents have a current card then the DD Form 1172 is not required to accompany the contractor as MPF will be able to pull the DD Form 1172 off of the system since the individuals will already be in DEERS. IMPORTANT: Contractors must report to MPF with their passport and Social Security Card and those of their family members as well. 7. The ORIGINAL DD Form 1172-2 and DD Form 1172 must accompany the contractor. This is per the Status of Forces Agreement (SOFA); the original is required because MPF must send it to DMDC. If the contractor is assigned a TA from RAF Lakenheath the same information is required. 8. If the contractor is a foreign national they must first complete the steps listed below for a HAC. Once the HAC is complete the contractor must go to MPF and get assigned a Foreign Identification Number (FIN); the contractor will need to coordinate with their TA and MPF. The TA needs the FIN to load the contractor into CVS and it is also required on the DD Form 1172-2. The contractor shall take the completed form to MPF and they will input the DD Form 1172-2 into DEERS and issue the CAC. 9. The contractor shall take all of the required forms and documents to MPF on the ground floor of Bldg 977 and proceed with CAC/ID issuance. HAC - Host Agency Check: 1. The Ministry of Defense (MoD), Defense Vetting Agency, conducts HAC checks on individuals who are UK nationals, US citizens without componency status (i.e. a retiree who chooses to stay in the UK) or third country nationals (TCN). If a person falls under one these categories they must reside within the UK for 4 years before a HAC will even be accomplished. 2. These individuals will be assigned a HAC POC by their gaining unit. The POC will initiate the MOD Form 1109, Host Agency Check, please keep in mind that this check can take 4 - 6 months to accomplish and is good for 5 years. In conjunction with the MOD Form 1109 the contractor will be required to complete a BCVR, Base Check Verification Record form; the AF Form 2583, Request for Personnel Security Action; and a USAFE Form 19, Residency Check. 3. After return of the security check the following will occur: the gaining units HAC POC will complete the USAFE Form 79 and submit a package with all completed forms to the HAC office for review. If there are mistakes the package is returned for correction and then resubmitted. Once a proper package is completed the HAC POC will give the contractor all required forms to bring to Pass and ID, in Building 977; the number is 01638 52 5990 or DSN 226-5990. Pass and ID will then issue the contractor either a USAFE Form 77, Base Pass, which is good for 365 days or a CAC depending on their required contractual duties. ESCORTED ENTRY: 1. Contractor personnel requiring escorted entry on to RAF Lakenheath shall provide the first name and surnames of all personnel requiring entry. Provide a list of the vehicles that will be entering the installation to include: make, model and registration number. Also, the Road Tax disc must be current. Also include the award number, location of work and start/stop dates. This shall be on company letterhead and can be either mailed or sent electronically. Bear in mind that regardless of the submittal process the contracting office must have the paperwork five days prior to start of work. 2. This information is then submitted to the requesting activity and they in turn provide the information to the Security Forces Operations branch. NOTE: All contractors must arrive at the installation with a picture ID (i.e. passport or drivers license); if they are not in possession of a picture ID they will not be allowed entry. APPENDIX 2 APPLICABLE PUBLICATIONS AND FORMS Publications and forms applicable to this Performance Work Statement (PWS) are listed below. The contractor shall follow those publications to the extent (that is, the specific procedure in a paragraph, section, chapter or volume) specified in the PWS. The Government provides all publications and forms listed, they are provided electronically at http://www.e-publishing.af.mil/. The Government may issue supplements or amendments to listed publications from any organizational level during the life of the contract. It is the contractor's responsibilities to check the website for updated supplements. The contractor shall immediately implement those changes in publications that result in a decrease or no change in the contract price. Before implementing any such revision, supplement, or amendment that will result in an increase in contract price, the contractor shall submit to the contracting officer (CO) a price proposal for approval. Price proposals shall be submitted within 30 calendar days from the revision, supplement, or amendment giving rise to the increase in cost of performance. The Government will consider changes in the contract price due to supplements and amendments shall be considered under the "Contract Terms and Conditions-Commercial Items" clause. The Government will continue to supply the Government forms needed for daily operations. Publications Code: AFI - Air Force Instruction AFMAN - Air Force Manual AFP - Air Force Pamphlet AF Form - Air Force Form DD Form - Department of Defense Form. MDGI - Medical Group Instruction DEPARTMENT OF DEFENSE (DOD) REGULATIONS/MANUALS/INSTRUCTIONS/DIRECTIVES Number Title of Directive Date DoDD 5400.11 Privacy Program Nov 04 DoDD 5500.7 Standards of Conduct Aug 93 DoD 6025.18-R Health Information Privacy Jan 03 DoDI 1402.5 Criminal History Background Checks Jan 93 on Individuals In Child Care Services DoDI 3020.37 Continuation of Essential DoD Nov 90 Contractor Services During a Crisis AIR FORCE REGULATIONS/MANUALS/INSTRUCTIONS Number Title of Directive Date AFI 33-119 AF Messaging Jan 05 AFI 33-129 Web Management and Internet Use Feb 05 AFI 33-201 Communications Security (COMSEC) May 05 AFI 33-322 Records Management Program Oct 03 AFI 41-115 Authorized Health Care and Benefits Dec 01 AFI 41-210 Patient Administration Functions Mar 06 AFI 48-123 Medical Examinations and Standards Jun 06 AFI 71-101V1 Criminal Investigations Dec 99 AFI 71-101V2 Protective Service Matters Nov 02 AIR FORCE REGULATIONS/MANUALS/INSTRUCTIONS AFI 44-119 Clinical Performance Improvement Jun 01 Publications are available electronically. DoD publications are available at http://west.dtic.mil/whs/directives/ and AF publications are available at http://www.e-publishing.af.mil/. APPENDIX 3 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996 HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the DOD health plans are specifically listed as covered by HIPAA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPAA Privacy for DOD medical facilities is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for AF MTFs are contained in DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTFs. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTFs are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates. IAW these regulations, the Contractor and its employees meet the definition of Business Associates. Therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for each MTF, whereby the Contractor and its employees agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DoD 6025-18-R, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented. Introduction (a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8520.02-R or AFI 41-217. Individual has the same meaning as the term "individual" in 45 CFR 164.50 1 and 164.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g). Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E. Protected Health Information has the same meaning as the term "protected health information" in 45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of the Government. Electronic Protected Health Information has the same meaning as the term "electronic protected health information" in 45 CFR 160.103. Required by Law has the same meaning as the term "required by law" in 45 CFR 164.501 and 164.103. Secretary means the Secretary of the Department of Health and Human Services or his/her designee. Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 and part 164, subpart C. Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 160.502, 164.103, 164.304 and 164.501. (b) The Contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law. c) The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract. (d) The Contractor agrees to use administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic protected health information that it creates, receives, maintains, or transmits in the execution of this Contract. (e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract. (f) The Contractor agrees to report to the Government any security incident involving protected health information of which it becomes aware. (g) The Contractor agrees to report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract of which the Contractor becomes aware of. (h) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor on behalf of the Government agrees to the same restrictions and conditions that apply through this Contract to the Contractor with respect to such information. (i) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it. (j) The Contractor agrees to provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524. (k) The Contractor agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government. (1) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the 'Government or the Secretary, for purposes of the Secretary determining the Government's compliance with the Privacy Rule. (m) The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528. (n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528. General Use and Disclosure Provisions Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government. Specific Use and Disclosure Provisions (a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor. (b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached. (c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B). (d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j) (1). Obligations of the Government Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions (a) Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice. (b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures. (c) The Government shall notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522. Permissible Requests by the Government The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, DOD 6025.18R, the HIPAA Security Rule, or DOD 8580.02-R, if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause. Termination (a) Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract. (b) Effect of Termination. (1) If this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below. (2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health Information. (3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information. Miscellaneous (a) Regulatory References. A reference in this Clause to a section in DOD 6025.18-R, HIPAA Privacy Regulation or DOD 8580.02-R, HIPAA Security Regulation, or any CFR or AFI provision means the section as currently in effect or as amended, and for which compliance is required. (b) Survival. The respective rights and obligations of Business Associate under the "Effect of Termination" provision of this Clause shall survive the termination of this Contract. (c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18-R, the CFR HIPAA Privacy Rule, DOD 8520.02-R, the CFR HIPAA Security Rule and AFI 41-217. 52.212-1 ADDENDUM 52.212-1 ADDENDUM FAR 52.212-1 ADDENDUM As prescribed in 12.302(d) the following addendum is provided for provision FAR 52.212-1 to establish this solicitation as a Request for Quotation compliant with FAR Part 13 solicitation, evaluation, and award procedures: INSTRUCTIONS TO VENDORS -- COMMERCIAL ITEMS (JUN 2008) (a) Reserved. (b) Submission of quotations. Submit quotations to the office specified in this solicitation on or before the date specified in this solicitation. Quotations may be submitted on the SF 1449 or on company letterhead. As a minimum, quotations must show-- (1) The Request for Quotation (RFQ) number (see Block 5 of the SF 1449); (2) The date specified in the RFQ for receipt of quotations; (3) The name, address, and telephone number of the vendor; (4) A technical description of the items being quoted in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary; (i) Offerers shall have as a minimum an Associate Degree in Business Administration, Management or Healthcare Organizations from an accredited college/university; and provide a copy of the diploma. (ii) Provide copy of current certification in Basic Life Support (BLS). (iii) Offerers shall submit a resume detailing a thorough understanding of TRICARE contract language, regional healthcare issue and initiatives, and other federal health benefits programs. (iv) Resume shall also demonstrate detailed knowledge of the entire military healthcare delivery system practices and DES processing regulations, instructions, procedures and policies. As well as a proficiency in Microsoft Office programs, Outlook (email), and Internet familiarity desired. (v) Offerers shall provide documentation that they have two (2) years revelant PEBLO work experience. (5) Terms of any express warranty; (6) Price and any discount terms; (7) "Remit to" address, if different than mailing address; (8) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the vendor shall complete electronically); (9) Acknowledgment of Solicitation Amendments (if any); (10) Reserved. (11) If the quotation is not submitted on the SF 1449, include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Vendors that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration. (c) Period for validity of quotations. The vendor agrees to establish a firm timeframe in which the proposed price is good for. (d) Reserved. (e) Multiple quotations. Vendors are encouraged to submit multiple quotations presenting alternative terms and conditions or commercial items for satisfying the requirements of this solicitation. Each quotation submitted will be evaluated separately. (f) Reserved. (g) Contract award. The Government intends to evaluate quotations as described in this solicitation and award to the vendor whose quotation represents the best value to the Government. Therefore, the vendor's initial quote should contain the vendor's best terms from a price and technical standpoint (see "Evaluation" below). (h) Reserved. (i) Reserved. (j) Data Universal Numbering System (DUNS) Number. Applies to all quotations exceeding $3,000, and quotations of $3,000 or less if the solicitation requires the Contractor to be registered in the Central Contractor Registration (CCR) database. The vendor shall enter, in the block with its name and address on the cover page of its quotation, the annotation "DUNS" or "DUNS +4" followed by the DUNS or DUNS +4 number that identifies the vendor's name and address. The DUNS +4 is the DUNS number plus a 4-character suffix that may be assigned at the discretion of the vendor to establish additional CCR records for identifying alternative Electronic Funds Transfer (EFT) accounts (see FAR Subpart 32.11) for the same concern. If the vendor does not have a DUNS number, it should contact Dun & Bradstreet directly to obtain one. An vendor within the United States may contact Dun & Bradstreet by calling 1-866-705-5711 or via the internet at: http://fedgov.dnb.com/webform. Any vendor located outside the United States must contact the local Dun and Bradstreet office for a DUNS number. The vendor should indicate that it is a vendor for a Government contract when contacting the local Dun and Bradstreet office. (k) Central Contractor Registration. Unless the vendor is exempted in accordance FAR 4.1102, by submission of an quotation, the vendor acknowledges the requirement that a prospective awardee shall be registered in the CCR database prior to award, during performance and through final payment of any contract resulting from this solicitation. If the vendor does not become registered in the CCR database in the time prescribed by the Contracting Officer, the Contracting Officer will proceed to award to the next otherwise successful registered vendor. Vendors may obtain information on registration and annual confirmation requirements via the Internet at http://www.ccr.gov or by calling 1-888-227-2423 or 269-961-5757. (End of Provision) In accordance with FAR 12.602(a) and FAR 13.106-2, the following is provided: EVALUATION (a) The Government intends to award a purchase order resulting from this Request for Quotation (RFQ) to the vendor whose quotation conforms to the solicitation and is considered most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate quotations; (i) Verification through online check that submitted degree is from an accredited College/University. (ii) Verification that date is current on offerers submitted Basic Life Support (BLS) certificate. (iii) Verification by appropriate medical group personnel that offerors demonstrates understanding of Tricare contract language, regional healthcare issue and initiatives, and other federal health benefits programs. (iv) Verification by appropriate medical group personnel that offerors demonstrate detailed knowledge of the entire military healthcare delivery system practices and DES processing regulations, instructions, procedures and policies. As well as a proficiency in Microsoft Office programs, Outlook (email), and Internet familiarity. (v) Offerers must demonstrate, at a minimum, two (2) years relevant PEBLO work experience. (vi) Price. Basis for award: The award will be made to the vendor whose quotation represents the best value to the government. As allowed by FAR 13.106-2(b)(1), the Lowest Price Technically Acceptable (LPTA) selection process shall be applied. Award will be made to the vendor who is deemed responsible and responsive, whose quotation reflects a complete understanding of the Performance Work Statement (PWS), and represents the best value to the Government based on selection of the technically acceptable quotation with the lowest evaluated price. The best value is represented by the lowest priced technically acceptable quotation. To be eligible for award, a quotation must meet all technical requirements per the Instructions to Contractors, conform to all required terms and conditions, and provide all information required. The technical area will be evaluated on an "acceptable" or "unacceptable" basis. Only those quotations determined to be technically acceptable will be evaluated on price. If the quotation received is determined to be unacceptable, the vendor will be excluded from competition and will not be considered for award. (b) Options. The Government will evaluate quotations for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an quote is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). If the vendor is a US military dependant, please disclose DEROS information. Additionally, prospective vendors shall provide pricing only on those option CLINs in which they will be available to perform in their entirety or specify their availability within the performance period of any CLIN if not available for the entire year. (c) A purchase order, mailed or otherwise furnished to the vendor shall result in a binding contract upon receipt of written acknowledgement by the vendor or commencement of performance. ______________________________________________________________________________ NOTE: In accordance with FAR 13.004, the following information regarding quotations is provided: Legal Effect of Quotations A quotation is not an offer and, consequently, cannot be accepted by the Government to form a binding contract. Therefore, issuance by the Government of an order in response to a supplier's quotation does not establish a contract. The order is an offer by the Government to the supplier to buy certain supplies or services upon specified terms and conditions. A contract is established when the supplier accepts the offer. When appropriate, the contracting officer may ask the supplier to indicate acceptance of an order by notification to the Government, preferably in writing. In other circumstances, the supplier may indicate acceptance by furnishing the supplies or services ordered or by proceeding with the work to the point where substantial performance has occurred. If the Government issues an order resulting from a quotation, the Government may (by written notice to the supplier, at any time before acceptance occurs) withdraw, amend, or cancel its offer. GOVERNMENT POC GOVERNMENT POC STATEMENT The point of contact for the U.S. Government for receipt of property, and for completion of the Receiving Reports is Michelle Hawkins at 01638-52-8959. XIV. A DPAS rating has not been assigned to this acquisition. XV. Quotations are due by 11:00 AM EST on 13 Feb 2012. Quotations must be submitted electronically by email to TSgt Sarah Gordon at sarah.gordon@lakenheath.af.mil
Web Link: FBO.gov Permalink
(https://www.fbo.gov/spg/USAF/USAFE/48CONSLGC/FA5587-11-T-0098/listing.html)
Place of Performance: Address: RAF Lakenheath, UK, RAF Lakenheath, Non-U.S., 09461, United States; Zip Code: 09461
Record: SN02662956-W 20120129/120127234732-77dd96dd71d41addff2ceacc5cf45f5e (fbodaily.com)
Source: FedBizOpps Link to This Notice
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