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FBO DAILY - FEDBIZOPPS ISSUE OF SEPTEMBER 06, 2019 FBO #6494
MODIFICATION

Q -- Radiology, X-Rays (AMSP) B-Readings - Solicitation 1

Notice Date

9/4/2019
 

Notice Type

Modification/Amendment
 

NAICS

621512 — Diagnostic Imaging Centers
 

Contracting Office

Department of the Navy, Bureau of Medicine and Surgery, Naval Medical Logistics Command, 693 Neiman Street, FT Detrick, Maryland, 21702-9203, United States
 

ZIP Code

21702-9203
 

Solicitation Number

N6264519Q0029
 

Archive Date

9/25/2019
 

Point of Contact

Curtis E. Cardoza, Phone: 3016193020, Andrea L. Giuliano,
 

E-Mail Address

curtis.e.cardoza.civ@mail.mil, andrea.l.giuliano.civ@mail.mil
(curtis.e.cardoza.civ@mail.mil, andrea.l.giuliano.civ@mail.mil)
 

Small Business Set-Aside

N/A
 

Description

Please see the attachment. Solicitation N6264519Q0029 __________________________________________________________________________________ This is a combined synopsis/solicitation for commercial items prepared in accordance with FAR 12.6, Streamlined Procedures for Commercial Items, and FAR 13.5 Simplified procedures for certain commercial items. This announcement constitutes the only solicitation. A written Combined /Synopsis solicitation on an SF1449 will not be issued. The solicitation number is N6264519Q0029. The solicitation is issued as a request for quotes (RFQ). Provisions and clauses in effect through Federal Acquisition Circular 2005-98 are incorporated. It is the contractor's responsibility to be familiar with the applicable clauses and provisions. The clauses may be accessed in full text at these addresses: http://acquisition.gov/far. The NAICS code is 621512, with a small business size of $15.0 mil. The services will be posted on the GPE as a Full and Open requirement. This is a solicitation for quotes. The Naval Medical Logistics Command intends on awarding a single Stand Alone contract as a result of this solicitation in support of the Philadelphia Navy Yard Occupational Health Clinic (PNY-OHC) Philadelphia, PA. PERFORMANCE WORK STATEMENT RADIOLOGY - X-RAY SERVICES AND INTERPRETATION FOR PHILADELPHIA NAVY YARD - OCCUPATIONAL HEALTH CLINIC (PNY - OHC) 1. DESCRIPTION OF SERVICES. 1.1. SCOPE OF WORK. The contractor shall provide non-digital, chest x-ray services, to include interpretation of films at the contractor's facility, in support of the Philadelphia Navy Yard - Occupational Health Clinic (PNY-OHC), Building 615, Philadelphia, PA. The contractor's x-ray facility shall be within a 10-mile radius from 4898 Broad St, Building 615, PNY-OHC, Philadelphia, PA. 1.1.1. The contractor shall provide chest x-rays as follows: a 14x17 posterior/anterior (P/A) chest x-ray. Additional views (14x17 Lateral and /or Oblique) may be required for follow-up purposes. The PNY-OHC will also accommodate mobile x-ray units to provide the services. 1.1.2. The chest x-rays and interpretation of films are for use in medical surveillance programs, including the Navy Asbestos Medical Surveillance Program (AMSP). Chest x-rays taken for the Navy AMSP must be submitted for B readings. The PNY-OHC clinic will be responsible for mailing the films to the B readers. Pre-labeled x-ray jackets with previous films provided to the contractor for comparison purposes shall be returned to the PNY-OHC Occupational Medicine Clinic in a separate package with the AMSP x-rays. 1.1.3. Contractor services shall include the following: 1.1.3.1. Provide x-rays and perform interpretation via written report of x-ray films. 1.2. The contractor shall provide services between the hours of 0730 and 1530, Monday through Friday, excluding Federal holidays, on a scheduled basis. The contractor shall also provide services for a group of employees approximately once per week, not to exceed eight times per month. The PNY-OHC will schedule visits at least four weeks in advance. 1.3. INDEPENDENT CONTRACTOR. The services rendered by the Contractor are rendered in the capacity of an independent Contractor. The Government will evaluate the quality of services for purposes of contract inspection and acceptance. The Contractor shall be solely responsible for any and all liability caused by the acts or omissions of its agents or employees. The Contractor shall not in any manner represent or infer that it is an instrumentality or agent of the United States Government. The Contractor shall recognize that the Commander maintains administrative and operational responsibility for all activities within the Command and may take such actions as necessary to preserve and maintain the integrity of the Command, subject to the limitations prescribed by law and U.S. Navy Regulations. The Government may evaluate the quality of professional services provided, but retains no control over the medical, professional aspects of services rendered (e.g. professional judgements, diagnosis for a specific medical treatment). The vendor indemnifies the Government for any liability producing act or omission by the contractor, its employees and agents during contract performance. 1.4. MODIFICATIONS. The Contracting Officer will designate and authorize an individual to act as the Contracting Officer's Representative (COR). Any such representative appointed will be specifically designated by letter from the Contracting Officer. The COR exclusively represents the Contracting Officer in all technical phases of the work, but is not authorized to issue Change Orders, Supplemental Agreements, or direct any contract performance requiring contractual modification or adjustment. Changes in the scope of work can only be made by modification properly executed by the Contracting Officer. All observations made by persons other than the Contracting Officer or the COR are strictly advisory and shall not influence the Contractor's operations except for administrative requirements and responsibilities specified herein. 1.5. BACKGROUND INFORMATION. This is a non-personal services contract covering a professional discipline. Contracting has been chosen as a strategy to permit expansion of the capacity of DOD facilities by overcoming shortfalls in the numbers of and support personnel. 1.6. QUALITY OF SERVICE. The services specified in this work statement shall be performed in accordance with established principles and ethics of the healthcare profession. The Contractor shall comply with applicable provisions of law and the rules and regulations of any and all Governmental authorities and the regulations and standards of the MTF. The Contractor shall adhere to and comply with all Department of Navy (DON), Bureau of Medicine and Surgery (BUMED) and MTF Instructions and notices which may be in effect during the term of the contract. 2. GOVERNMENT FURNISHED ITEMS. 2.1. Publications and Forms. The Government will furnish all forms and publications required for the contract. The Contractor is required to comply with various instructions, directives and regulations covering routine administrative, safety and security matters in the same manner as other members of the staff. Such compliance does not constitute a material expense to the contract. 3. CONTRACTOR FURNISHED ITEMS. 3.1. Supplies. The Contractor shall furnish all supplies, equipment, and personnel, except those listed as Government-furnished, required to perform the services described in this contract. 3.2. Insurance. The Contractor shall comply with applicable provisions of the Federal Acquisition Regulations (FAR) 52.237-7, Indemnification and Medical Liability Insurance. 3.2.1. The Contractor shall comply with applicable State workers' compensation insurance laws. 3.2.2. The contractor is required to ensure that its subcontracts for provisions of the services herein contain the requirements of FAR 52.237-7 3.3. The Contractor shall provide a completed Malpractice Insurance Certification Form, see Attachment 4 to the COR annually during the term of this contract. 4. RESERVED 4.1. RESERVED 5. SPECIFIC DUTIES. 5.1. General. The contractor shall provide non-digital, chest x-ray services, to include interpretation of films at the contractor's facility, in support of the PNY-OHC. The chest x-rays and interpretation of films are for use in medical surveillance programs, including the Navy Asbestos Medical Surveillance Program (AMSP). 5.2. The Government will provide the contractor with a request form. Each employee will return to the clinic with verification of completed procedures (signed/initialed by contractor representative); see Attachment 3. The clinic will also provide the contractor with x-ray jackets for each employee (patient) with pre-labeled patient information and any past x-rays for purposes of comparison. 5.3. The Contractor shall provide a package containing final written x-ray interpretation to the PNY-OHC within five (5) working days. 5.4. The contractor shall file chest x-rays performed for physical exams (non-asbestos program) in a provided labeled jacket. The contractor will also record the date and type of x-ray on the outside of the jacket, and place a copy of the x-ray interpretation into the x-ray jacket. The jackets (with films) will be returned to the PNY-OHC clinic within 5 working days. 5.5. REPORTING REQUIREMENTS. 5.5.1. The contractor shall comply with reporting requirements as outlined in Attachment I. 6. PERSONNEL QUALIFICATIONS. Personnel performing services under this contract shall possess the minimum personnel requirements, as follows: 6.1. Be a graduate from a medical school approved by the Liaison Committee on Medical Education of the American Medical Association or the American Osteopathic Association or certification by the Educational Council for Foreign Medical Graduates (ECFMG). 6.2. Have successful completion of a residency program in radiology which has been approved by the Accreditation Council for Graduate Medical Education or the Committee on Postdoctoral Training of the American Osteopathic Association or those Canadian training programs approved by the Royal College of Physicians and Surgeons of Canada or other appropriate Canadian medical authority. 6.3. Possess a current, valid, and unrestricted medical license in the State of Pennsylvania. 6.4. Possess current board certification in Radiology. 6.5 Credentialing. The Contractor shall demonstrate and provide documentary evidence annually that radiologists performing under this contract are fully credentialed and privileged in accordance with Joint Commission standards. The contract radiologists are performing services off-site at the contactor's facility and are credentialed and privileged "by proxy". 6.6 STANDARDS AND CONFLICT OF INTEREST. 6.6.1. The Contractor shall provide adequate oversight and supervision of contractor staff activities. 6.6.2. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel and/or technical data which is furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract nor be released by the Contractor without prior written consent of the Government, via the COR. Any presentation of any statistical or analytical materials, or any reports based on information obtained from the studies covered by this contract, will be subject to review and approval by the Government, via the COR, before publication or dissemination. 6.6.3. The Contractor shall not hire any employee for performance under this contract whose employment would result in a conflict with Government or Navy Standards of Conduct (SECNAVINST 5370.2 (latest revision)). Except in very limited cases, the federal criminal statutes at 18 USC 203 and 18 USC 205 bar Government personnel, both active duty and civil service, from working as a contractor employee in a Government workplace, including a medical treatment facility, either as a second job ("moonlighting") or while on terminal leave. The contractor agrees that, before making an employment offer to an active duty member or a civil servant, it shall inform the individual of the potential applicability of these statutes and further agrees to encourage that individual to seek an advisory opinion from his/her local ethics counsel before accepting an employment offer. In addition, without the prior written approval of the contracting officer, the contractor shall not use in the performance of this contract any persons currently performing medical or dental services under other Navy contracts. 6.6.4. The Contractor or Contractor employees shall not bill personnel entitled to care for services rendered. 6.6.5. The Contractor or Contractor employees shall not, while performing services under this contract, advice, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the Contractor or Contractor employees. 7. MISCELLANEOUS PROVISIONS. 7.1. The Contractor shall be responsible for payment of all wages and salaries, taxes, withholding payments, penalties, fees, fringe benefits, professional liability insurance premiums, contributions to insurance and pension or other deferred compensation plans including, but not limited to, Workers' Compensation and Social Security obligations, licensing fees, etc., and the filing of all necessary documents, forms and returns pertinent to all of the foregoing. The Contractor shall indemnify and hold the Government harmless from and against any and all claims by Contractor employees for the payment or filing of any of the foregoing compensation. The Contractor agrees to pay all applicable federal, State, and local income taxes, including any and all other Governmental fees, taxes, or expenses levied against it. 7.2. Government Access to Patients. For the purpose of gathering data relative to satisfaction of the goals and objectives of contracting for health services within the Navy Medical Department (for example, containment of TRICARE/CHAMPUS costs, gathering patient demographic data, etc.), the Government may exercise its right to conduct brief exit interviews with patients. These interviews are separate and distinct from the Government's responsibilities for quality assurance is strictly informational, and are referenced in Section E, "Inspection and Acceptance." The Government will make every attempt to prospectively inform the Contractor of these interviews. 7.3. Government quality assurance. Contract performance will be surveyed to determine if it meets the contract standards. A variety of surveillance methods may be used. The method of surveillance may be modified to meet the needs of the customers and the performance if the contractor. See the Performance Requirements Summary at Attachment 1. 7.4. Electronic data security. The contractor shall ensure that all data transmitted via disk or e-mail is virus free. Deliverables submitted is electronic format, shall have the contract number and type identified in the subject field of the e-mail. 7.5. HIPAA. The Contractor shall comply with the Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations as specified in Attachment II (a). 7. 6. Government ownership of deliverables. The government obtains the rights to all documentation, reports, forms, or other electronic or paper records developed under this contract. 7.7 ECMRA The contractor shall report contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Radiology Services via a secure data collection site. Contracted services excluded from reporting are based on Product Service Codes (PSCs). The excluded PSCs are: (1) W, Lease/Rental of Equipment; (2) X, Lease/Rental of Facilities; (3) Y, Construction of Structures and Facilities; (4) S, Utilities ONLY; (5) V, Freight and Shipping ONLY. The contractor is required to completely fill in all required data fields using the following web address https://doncmra.nmci.navy.mil. Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. Contractors may direct questions to the help desk, linked at https://www.ecmra.mil/Default.aspx ADMINISTRATIVE INFORMATION The point of contact for administrative concerns for this requirement at Naval Medical Logistics Command, 693 Neiman Street, Fort Detrick, MD 21702 is Curtis E. Cardoza curtis.e.cardoza.civ@mail.mil. The Contracting Officer hereby designates the following individual as Contracting Officer's Representative(s) (COR) for this contract: NAME (To Be Determined) TBD MAIL ADDRESS Naval Health Clinic Annapolis 250 Wood Rd Annapolis, MD E-MAIL TBD TELEPHONE NUMBER TBD SERVICES All services are included in contract price. LIST OF SERVICES AND PRICING SHEET: ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001AA 300 Each Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001AB 40 Each Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001AC 10 Each Posterior/Anterior AND Obliques Three Views, 14X17 ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1001AA 330 Each OPTION Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1001AB 44 Each OPTION Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1001AC 11 Each OPTION Posterior/Anterior AND Obliques Three Views, 14X17 ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2001AA 363 Each OPTION Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2001AB 48 Each OPTION Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2001AC 12 Each OPTION Posterior/Anterior AND Obliques Three Views, 14X17 ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 3001AA 399 Each OPTION Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 3001AB 53 Each OPTION Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 3001AC 13 Each OPTION Posterior/Anterior AND Obliques Three Views, 14X17 LIST OF ATTACHMENTS ATTACHMENT I - Quality Assurance Surveillance Plan (QASP) ATTACHMENT I (a) - Contractor Discrepancy Report (CDR) ATTACHMENT II - HIPAA ATTACHMENT II (a) - HIPPA Business Associate Agreement ATTACHMENT III - Sample Patient Form ATTACHMENT IV - Malpractice Insurance Form ATTACHMENT V - Contract Administration Plan ATTACHMENT VI - Corporate Experience and Past Performance Form ATTACHMENT VII - FAR Part 52.209-11 ( Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law) ATTACHMENT VIII - Pricing Sheet ATTACHMENT I - Quality Assurance Surveillance Plan (QASP) P u rpo s e : T o e nsu r e t h at t h e G o v e r n m e n t h as an e ff ecti v e a n d s y ste m atic m et h o d o f s u r v eilla n ce f o r t h e s e r v ices in t h e PW S. T h e Q A SP w ill b e us ed pr i m a r ily as a t oo l to v e r i f y t h at t h e c o n t r act o r is p e r f or m i n g all s e r v ices r e q u i r ed by t h e PW S in a ti m el y, acc u rate a n d co m plete f a sh io n. 1. C ritical per f or m a n ce proce ss es a n d req u ire m e n t s. C r iti ca l to t h e per f or m a n c e o f x -r ay s e r v i ce s in su pport o f P N B C is t h e ti m el y, acc u rate a n d t h o r o ug h c o m p leti o n o f all c o n tract/task ord er r e q u ire m e n ts. 2. Per f or m a n ce Sta n dards a. Sc h ed u le - T h e d u e d ates f o r d eli v erables a n d t h e act u al acco m p li sh m e n t o f t h e s c h ed u le w ill be assessed a g ai n st or i g i n al d u e d ates a n d m ilest o n es esta b lis h ed f o r t h e c o n t r act o r task ord e r( s ). b. Deli v e r a b les - T h e d eli v e r a b les r e q u i r ed to b e su b m itted w ill b e assessed a g ai n st t h e s p eci f icati o n s f o r t h e d eli v e r a b les d etailed in t h e c o n t r act/task ord e r( s) a n d t h e Contract Administrative P lan ( CAP ), if r e q u i r ed b y t h e c o n tract, f o r t h e r e q u ired c o n te n t, q u alit y, ti m eli n ess, a n d acc u rac y. c. P a s t P e r f o r m a n ce - I n a dd iti o n to a n y sc h e d u le, d eli v e r a b les, a n d c o s t as p ects o f p e r f or m a n ce d i s c uss ed a bo v e, p u r su a n t to F A R 42.15, t h e G o v er n m e n t w ill a ss e s s t h e c o n t rac t or ' s recor d o f co n f or m i n g to co n t rac t req u ire m e n t s a n d to s ta n dard s o f g oo d w or k m a nsh i p, t h e c o n tractor ' s ad h e re n ce to c o n trac t s c h e d u les i n c l u d i n g t h e ad m i n i s t ra ti v e a s pec ts o f per f or m a n ce, t h e c o n t rac t or ' s h i s t or y o f rea s o n ab le a n d c oopera ti v e be h a v i o r a n d co mm it m e n t to c us to m er s ati s f actio n, a n d t h e co n tractor ' s b us i n e ss - li k e co n cern f or t h e i n tere s t o f t h e c us to m er. 3. S u r v eilla n ce m et h od s : T h e pr i m a r y m et h od s o f s u r v eilla n ce u sed to m o n it o r p e r f or m a n ce o f t h is c o n t r act w ill i n c l u de, b u t n o t b e li m ited t o, ra n do m o r p l a nn ed s a m p li ng, per i od ic o r i ns pec ti o n, a n d v a li da t e d c us t o m er c o m p lai n ts. 4. P e r f or m a n ce Mea su re m e n t : P er f o r m a n ce w ill be m ea su r ed in accorda n ce w ith t h e f ollo w i n g table: Per f or m a n c e Ele m e n t Per f or m a n c e R e qu ire m e n t Su r v eilla n c e M e th o d F re qu e n c y A cce pt a b l e Q u ali t y Le v el C o nt r act o r Q ua l ity C o nt ro l Pl a n Q C acti v iti e s, in s p e cti o n s, an d c orr e cti v e acti o ns c o m p l e t e d a s r e qui r e d b y th e (CAP) I n s p e cti o n b y th e C O R Q ua r t e rl y fo r over a ll Q C acti v iti e s; A s R e qui r e d fo r c orr e cti v e acti o n s. 100 % C o m p l iance w it h th e c o nt r act o r p l an. C o nt r act D e l i v e r ab l e s C o nt r ac t d e l i v e r ab l e s f u r ni s h e d a s p r e s c r ib e d i n th e P W S, CAP, attach m e nt s, C D R L s, T a sk Or d e r s, e tc., a s app l icab l e. I n s p e cti o n b y th e C O R 100 % in s p e cti o n o f a l l c o nt r ac t d e l i v e r ab l e s. >95 % o f d e l i v e r ab l e s s ub m itt e d ti m e l y an d w ith o u t re w ork r e qui r e d. Ov e r a l l C o nt r act P e rform anc e Ov e r a l l c o nt r act p e rform anc e o f s u ff ici e n t qua l it y t o e a r n a S ati s f act or y (o r hi g h er) r atin g i n th e C O R ' s annual r e p or t o n C o nt r act or P e rform anc e A ss e ssm e n t b y th e C O R A nnual A l l p e rfor m ance ele m e nt s r at e d S ati s f act or y (or hi g h e r ) I n vo icing M o nth l y in vo ic e s p e r c o nt r ac t p ro c e du r e s a r e ti m el y an d accu r at e. R e v i e w & acc e ptanc e o f th e in vo ic e M o nth l y 100 % accu r acy If per f or m a n ce is w it h in acceptable le v el s, it w ill be co ns idered to be s ati s f actor y. If n o t, o v erall p er f o r m a n ce m ay be co ns idered uns ati s f actor y. I n ce n ti v es/Disi n ce n ti v es: T h e C O R s m a k es an a nnu al r e por t o n C o n t r act o r P e r f or m a n ce ( C P A R S o r o t h er a nnu al r e por t ). T h e c o n t r act or 's f a ilu r e t o ac hi e v e s a tisf act or y p e r f or m a n ce un d er th e c o nt r ac t/t a s k ord e r, r e fl ected i n th e COR' s a nnu al r e por t, m ay r es u lt in te r m i n ati o n o f t h e c o n t r act/task ord er a n d m ay also r es u lt in t h e l o ss o f f u t u r e G o v e r n m e n t c o n t r acts/task ord e r s. T h e c o n t r act or ' s f ail u r e to ac h ie v e satis f act or y p e r f or m a n ce un d er t h e c o n t r act/task ord er m ay r es u lt in t h e n o n - e x erci s e of a v ailable optio n s For each item t h at does n ot m eet acceptable le v el s, t h e Go v er n m e n t m ay i ssu e a C o n tract Di s crepa n cy R eport ( C DR ). CDRs w ill b e f or w a rd ed to t h e C o n t r acti n g O ff icer w ith a c op y se n t to t h e c o n t r act or. T h e c o n t r act o r m u st re p ly in w riti n g w it h in 5 d a y s o f r ecei p t i d e n ti f y i n g h o w f u t u r e o cc u rre n ces o f t h e p r ob lem w ill b e pr e v e n te d. B ased u po n t h e c o n t rac t or ' s pa s t per f or m a n ce a n d p l a n to s o l v e t h e prob l e m, t h e C o n t rac ti n g O ff i ce r w ill de te r m i n e if a n y f u r t h er acti o n w ill b e ta k e n. In accorda n ce w ith t h e i ns pection o f s er v ices pro v i s io n s of t h e co n tract, t h e co n tractor w ill be i n ce n ti v ized to pro v ide q u ality prod u cts in a ti m ely m a nn er s i n ce t h e G o v e r n m e n t can r e q u i r e t h e C o n t r act or, at n o a dd iti o n al c o s t, to replace or correct w o rk t h at f ails to m eet co n tract req u ire m e n t s. CONTRACT DISCREPANCY REPORT 1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY 3. TO (Contractor and Manager's Name) 4. FROM (Name of QAE) 5. DATES (YYYYMMDD) a. PREPARED b. RETURNED BY CONTRACTOR c. ACTION COMPLETE 6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.) 7. SIGNATURE OF CONTRACTING OFFICER 8a. TO (Contracting Officer) b. FROM (Contractor) 9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable Q.C. program procedures or new Q.C. procedures. Attach continuation sheet(s) if necessary.) 10. SIGNATURE OF CONTRACTOR REPRESENTATIVE b. DATE (YYYYMMDD) 11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary) 12. GOVERNMENT ACTIONS (Reduced payment, cure notice, show cause, other) 13. CLOSE OUT NAME (1) TITLE (2) SIGNATURE (3) DATE (YYYYMMDD) (4) a. CONTRACTOR NOTIFIED b. QAE c. ACO ATTACHMENT I (a) - CONTRACTOR DISCREPANCY REPORT (CDR) ATTACHMENT II - HIPAA P R I V A C Y A ND S E C U R I T Y OF P R O T E C T E D H E AL T H I NFO R M A T I ON (Ma y 2005) (a) De f i n itio ns. A s us ed in t h is cla us e: I n di v id u al h as t h e s a m e m ea n i n g as t h e term '' i n d i v id u al ' ' in 45 C FR 164.501 a n d 164.103 a n d sh all i n cl u d e a p er s o n w h o q u ali f ies as a per s o n al repre s e n tati v e in accorda n ce w ith 45 C FR 164.502( g ).Pr i v ac y Ru le m ea n s t h e St a n dard s f o r Pr i v ac y o f I n d i v i d u a lly Ide n ti f ia b le H ea lth I n f or m a ti o n at 4 5 C FR par t 16 0 a n d par t 164, su bpar ts A a n d E. P ro t ec t e d H ea lth I n f or m a ti o n h a s t h e s a m e m ea n i n g as t h e te r m '' pro t ec t ed h ealt h i n f or m atio n ' ' in 4 5 C FR 164.501, li m ite d to t h e i n f or m atio n c reate d o r recei v ed b y T h e C o n t racto r f ro m o r on be h alf of T h e Go v er n m e n t. R eq u ired by L aw h as t h e s a m e m ea n i n g as t h e term '' r eq u ired b y la w ' ' in 45 C FR 164.50 1 a n d 164.103. S ecre t ar y m ea n s t h e S ecre t ar y o f t h e De par t m e n t o f H ea lth a n d H u m a n Se r v i ce s o r h i s / h er de s i gn ee. S ec u r ity Ru le m ea n s t h e H ea lth I nsu ra n ce R e f or m : S ec u r ity St a n dard s at 4 5 C FR par t 160, 16 2 a n d part 164, su bpar t C. T e r m s us e d, b u t n o t o t h e r w i s e de f i n ed, in t h is A g ree m e n t sh all h a v e t h e s a m e m ea n i n g as t h o s e te r m s in 4 5 C FR 160.103, 164.50 1 a n d 164.304. (b ) T h e C o n t r act o r a g r ees to n o t u se o r f u r t h er d iscl o s e P ro tected Health I n f or m ati o n o t h er t h an as p e r m itted o r req u i re d b y t h e C o n t rac t o r a s R e q u i re d b y L a w. ( c) T h e C o n t r act o r a g r ees to us e a ppropr iate s a f e gu a rd s to pr e v e n t us e o r d i s cl o su r e o f t h e P ro tected Health I n f o r m ation o t h er t h an as pro v ided f o r b y t h is C o n tract. (d) T h e C o n tractor a g rees to us e ad m i n i s trati v e, p h y s ical, a n d tec hn ical s a f e gu ards t h at r ea s o n ably a n d appropriately pro tect t h e c o n f i d e n tialit y, i n te g r it y, a n d a v aila b ility o f t h e elect ro n ic pro tected h ealth i n f or m ati o n t h at it c r eates, recei v e s, m ai n tai ns, or tra ns m its in t h e e x ec u tion o f t h is C o n tract. ( e) T h e C o n t r act o r a g r ees to m iti g ate, to t h e e x te n t pr actica b le, a n y h a r m f u l e ff ect t h at is kn o w n to t h e C o n t r act o r o f a u se o r d iscl o s u r e o f P ro tected Health I n f or m ati o n b y t h e C o n t r act o r in v i o lati o n o f t h e r e q u i r e m e n ts o f t h is C o n tract. ( f ) T h e C o n tractor a g rees to report to t h e Go v er n m e n t a n y s ec u rity i n cide n t i nv o l v i n g p rotected h ealth i n f o r m ation o f w h ich it b ec o m es a w a r e. ( g ) T h e C o n t racto r a g ree s t o repor t to t h e Go v e r n m e n t a n y us e o r di s c lo su r e o f t h e P rotecte d Healt h I n f or m atio n n ot pro v i de d f o r b y t h is C o n t rac t. ( h ) T h e C o n tractor a g rees to e nsu re t h at a n y a g e n t, i n cl u di n g a su b co n tractor, to w h o m it p ro v ides P rotected Health I n f or m atio n recei v ed f ro m, o r create d o r recei v ed b y t h e C o n t racto r o n be h a l f o f t h e G o v er n m e n t a g ree s t o t h e s a m e r est r icti o n s a n d c o n d iti o n s t h at a pp ly t h ro ug h t h is C o n t r act to t h e C o n t r act o r w ith r es p ect to s u ch i n f or m ati o n. (i) T h e C o n tractor a g rees to e nsu re t h at a n y a g e n t, i n cl u di n g a su b co n tractor, to w h o m it p ro v ides electro n ic P r otected Health I n f o r m atio n, a g rees to i m ple m e n t r ea s o n able a n d appropriate s a f e gu ards to p rotect it. ( j ) T h e C o n tractor a g rees to pro v ide acce ss, at t h e r eq u e s t of t h e Go v er n m e n t, a n d in t h e ti m e a n d m a nn er d e s i gn ated by t h e Go v er n m e n t to P rotected Health I n f o r m ation in a De s i gn ated R ecord Set, to t h e Go v er n m e n t o r, as directed by t h e Go v er n m e n t, to an I n di v id u al in order to m eet t h e r eq u ire m e n ts un de r 4 5 C FR 164.524. ( k ) T h eC o n tractor a g rees to m a k e a n y a m e n d m e n t( s ) to P rotected Health I n f o r m ation in a De s i gn ated R ecord Set t h a t t h e G o v er n m e n t d i rec ts o r a g ree s to p u r su a n t to 4 5 C FR 164.52 6 a t t h e req u e s t o f t h e G o v er n m e n t o r an I n d i v i d u al, a n d in t h e ti m e a n d m a nn er d e s i gn ated b y t h e G o v e r n m e n t. ( l) T h e C o n t rac t o r a g ree s to m a k e i n te r n a l prac ti ce s, boo ks, a n d record s re l a ti n g to t h e us e a n d d i s cl o su r e of P rotecte d Healt h I n f or m atio n recei v ed f ro m, o r create d o r recei v ed b y t h e C o n t racto r o n be h a l f o f, t h e Go v e r n m e n t, a v aila b le to t h e G o v e r n m e n t, o r at t h e r e q u e s t o f t h e G o v e r n m e n t to t h e Sec r eta r y, in a ti m e a n d m a nn er d e s i gn ated b y t h e Go v er n m e n t or t h e Secretar y, f o r p u r po s es of t h e Secretary d eter m i n i n g t h e G o v e r n m e n t ' s c o m p lia n ce w ith t h e P r i v acy R u le. ( m ) T h e C o n tractor a g rees to doc u m e n t su ch d i s clo su r es of P r otected Health I n f o r m ation a n d i n f o r m ation r elated to su c h di s c lo su re s as w o u l d b e req u ire d f o r t h e Go v e r n m e n t t o re s po n d to a req u e s t b y an I n di v id u al f o r a n acco un ti n g of di s clo su res o f P rotected Health I n f o r m ation in accorda n ce w ith 45 C FR 164.528. ( n ) T h e C o n t r act o r a g r ees to pro v i d e to t h e G o v e r n m e n t o r an I n d i v i d u al, in ti m e a n d m a nn er d e s i gn ated b y t he Go v er n m e n t, i n f or m ation collected in accorda n ce w ith t h is C la us e of t h e C o n tract, to p er m it t h e Go v er n m e n t to re s po n d to a req u e s t b y an I n d i v id u al f or an acco un ti n g o f d i s clo su r es of P r otected Health I n f or m atio n in accorda n c e w it h 4 5 C FR 164.528. Ge n e r al U s e a n d Di s cl o su r e P ro v i s i o n s E x ce p t as o t h e r w ise li m ited in t h is A g r ee m e n t, t h e C o n t r act o r m ay u se o r d iscl o se P ro tected Health I n f or m ati o n o n be h alf o f, o r to pro v i d e s e r v i ce s t o, t h e G o v e r n m e n t f o r t h e f o ll o w i n g p u rpo s e s, if su ch us e o r d i s cl o su r e o f Pro t ec t ed Health I n f or m ati o n w o u ld n o t v i o late t h e P r i v acy R u le, t h e Sec u r ity R u le o r t h e De p a r t m e n t o f De f e ns e Health I nf or m ati o n P r i v acy R e gu lati o n if do n e b y t h e G o v e r n m e n t: [ L i s t P u rpo s e s ]. Speci f ic U s e a n d D i s clo su r e P ro v i s i o n s: ( a) E x ce p t as o t h e r w ise li m ited in t h is A g r ee m e n t, t h e C o n t r act o r m ay u se P ro tected Health I n f or m ati o n f o r t h e prop er m a n a g e m e n t a n d a d m i n ist r ati o n o f t h e C o n t r act o r o r to ca rr y o u t t h e le g al r es po n si b ilities o f t h e C o n t r act or. (b ) E x ce p t as o t h e r w ise li m ited in t h is A g r ee m e n t, t h e C o n t r act o r m ay d iscl o s e P ro tected Health I n f or m ati o n f o r t h e prope r m a n a g e m e n t a n d ad m i n i s t ratio n o f t h e C o n t ractor, pro v i de d t h at di s clo su re s ar e req u i re d b y l a w, o r t h e C o n t racto r obtai n s rea s o n abl e a ssu ra n ce s f ro m t h e per s o n to w h o m t h e i n f or m ati o n is d iscl o s ed t h at it w ill r e m ain c o n f i d e n tial a n d us ed o r f u r t h er d iscl o s ed o n ly as r e q u i r ed b y law o r f o r t h e p u rpo s e f o r w h ich it w a s d i s cl o s ed to t h e per s o n, a n d t h e per s o n n o ti f ies t h e C o n t rac t o r o f a n y i ns ta n ce s o f w h ich it is a w are in w h ich t h e c o n f i d e n tiality o f t h e i n f or m ati o n h as b een br eac h e d. (c) E x cept as o t h er w i s e li m ited in t h is A g r ee m e n t, t h e C o n tractor m ay us e P r otected Health I n f o r m ation to p ro v ide data A gg r e g ation s er v ices to t h e Go v er n m e n t as p er m itted b y 4 5 C FR 164.504(e)(2)(i)( B ). (d ) C o n t r act o r m ay u se P ro tected Health I n f or m ati o n to r e por t v i o lati o n s o f law to a ppropr iate Fe d e r al a n d State a u t h oritie s, co ns i s te n t w it h 4 5 C FR 164.502( j ) (1). O b li g ati o n s o f t h e G o v e r n m e n t, P ro v isi o n s f o r t h e G o v e r n m e n t to I n f or m t h e C o n t r act o r o f P r i v acy P r actices a n d R est r icti o n s ( a) U po n r e q u est t h e G o v e r n m e n t s h all pro v i d e t h e C o n t r act o r w ith t h e n o tice o f pr i v acy pr actices t h at t h e Go v e r n m e n t prod u ce s i n accorda n c e w it h 4 5 C FR 164.520, a s w e l l a s a n y c h a ng es to su ch n otice. (b ) T h e G o v e r n m e n t sh all pro v i d e t h e C o n t r act o r w ith a n y c h a ng es i n, o r r e v o cati o n o f, p e r m i ss i o n b y I n d i v i d u al to us e o r d iscl o s e P ro tected Health I n f or m ati o n, if s u ch c h a ng es a ff ect t h e C o n t r act or ' s p e r m itted o r r e q u i r ed u ses a n d d i s c l o su r e s. (c) T h e Go v er n m e n t sh all n oti f y t h e C o n tractor of a n y r e s triction to t h e us e o r d i s clo su r e o f P rotected Health I n f or m atio n t h at t h e Go v e r n m e n t h as a g ree d t o i n accorda n c e w it h 4 5 C FR 164.522. P e r m i ss i b le R e q u e s ts b y t h e G o v e r n m e nt. T h e Go v er n m e n t sh all n o t r eq u e s t t h e C o n tractor to us e o r d i s clo s e P rotected Health I n f o r m ation in a n y m a nn er t h at w o u ld n o t b e per m i ss i b le un de r t h e P r i v ac y Ru le if do n e b y t h e G o v e r n m e n t, e x cep t f o r pro v i d i n g D a ta A gg re g a ti o n s er v ices to t h e Go v er n m e n t a n d f o r m a n a g e m e n t a n d ad m i n i s trati v e acti v ities o f t h e C o n t r act o r as o t h e r w ise p e r m itted b y t h is cla us e. T e r m i n ati o n. (a) T er m i n atio n. A b reach by t h e C o n tractor of t h is cla us e, m ay su b j ect t h e C o n tractor to ter m i n ation un d er a n y a pp lica b le d e f a u lt o r te r m i n ati o n pro v isi o n o f t h is C o n t r act. (b ) E ff ect o f T e r m i n ati o n. (1) I f t h is co n tract h as r ecords m a n a g e m e n t r eq u ire m e n t s, t h e r ecords su b j ect to t h e C la us e sh o u ld b e h a n dled in accorda n ce w ith t h e r ecords m a n a g e m e n t r eq u ire m e n t s. If t h is co n tract does n ot h a v e records m a n a g e m e n t req u ire m e n t s, t h e record s sh o u ld b e h a n dle d i n accorda n c e w it h para g rap h s (2) a n d (3 ) be l o w (2 ) I f t h is c o n trac t doe s n o t h a v e record s m a n a g e m e n t req u i re m e n t s, e x cep t as pro v i de d in para g rap h (3 ) o f t h is s ectio n, u po n ter m i n atio n o f t h is C o n tract, f o r a n y rea s o n, t h e C o n t racto r sh al l ret u r n o r de s troy all P rotected Health I n f o r m ation r ecei v ed f rom t h e Go v er n m e n t, o r created or recei v ed b y t h e C o n tractor on be h alf o f t h e G o v e r n m e n t. T h is pro v isi o n sh all a pp ly to P ro tected Health I n f or m ati o n t h at is in t h e po ssessi o n o f su bco n tractors o r a g e n ts o f t h e C o n tractor. T h e C o n tractor sh all r etain n o copies of t h e P rotected Health I n f o r m atio n. (3 ) I f t h is c o n trac t doe s n o t h a v e record s m a n a g e m e n t pro v i s i o n s a n d t h e C o n tracto r deter m i n e s t h a t ret u r n i n g o r de s tro y i n g t h e P rotected Health I n f o r m ation is i n f ea s ible, t h e C o n tractor sh all p ro v ide to t h e Go v er n m e n t n o ti f icati o n o f t h e c o n d iti o n s t h at m a k e r et u r n o r d est r u cti o n i n f easi b le. U po n m u t u al a g ree m e n t o f t h e Go v er n m e n t a n d t h e C o n tractor t h at ret u rn or de s tr u ction o f P rotected Health I n f o r m ation is i n f easi b le, t h e C o n t r act o r s h all e x te n d t h e pro tecti o n s o f t h is C o n t r act to s u ch P ro tected Health I n f or m ati o n a n d li m it f u rt h er us es a n d di s clo su res o f su ch P rotected Health I n f o r m ation to t h o s e p u rpo s es t h at m a k e t h e r et u r n o r d est r u cti o n i n f easi b le, f o r so l o n g as t h e C o n t r act o r m ai n tai n s su ch P r otected Health I n f o r m atio n. Miscella n e o u s. (a) R e gu latory R e f ere n ce s. A re f ere n ce in t h is C la us e to a s ection in t h e P r i v acy Ru le or Sec u rity Ru le m ea n s t h e s ectio n as in e ff ec t o r a s a m e n ded, a n d f o r w h ic h c o m plia n ce is req u i red. (b ) S u r v i v al. T h e r e s p ecti v e r i gh ts a n d ob li g ati o n s o f B us i n e s s A ss o ciate un d er t h e '' E ff ect o f T e r m i n ati o n ' ' pro v isi o n o f t h is C la us e sh all s u r v i v e t h e te r m i n ati o n o f t h is C o n t r act. (c) I n terpretatio n. A n y a m b i gu ity in t h is C la us e sh all b e r e s ol v ed in f a v or of a m ea n i n g t h at p er m its t h e Go v er n m e n t to c o m p ly w ith t h e P r i v acy R u le o r Sec u r ity R u le. ATTACHMENT II (a) - HIPAA BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (BAA) incorporates HIPAA/HITECH Act requirements under the HHS Final Omnibus Rule (78 FR 5566, published 25 Jan 2013), effective 23 Sep 2013. This BAA is for use by MHS components outside of DHA. Business Associate Agreement Introduction In accordance with 45 CFR 164.502(e) (2) and 164.504(e) and paragraph C.3.4.1.3 of DoD 6025.18-R, "DoD Health Information Privacy Regulation," January 24, 2003, this document serves as a business associate agreement (BAA) between the signatory parties for purposes of the Health Insurance Portability and Accountability Act (HIPAA) and the "HITECH Act" amendments thereof, as implemented by the HIPAA Rules and DoD HIPAA Issuances (both defined below). The parties are a DoD Military Health System (MHS) component, acting as a HIPAA covered entity, and a DoD contractor, acting as a HIPAA business associate. The HIPAA Rules require BAAs between covered entities and business associates. Implementing this BAA requirement, the applicable DoD HIPAA Issuance (DoD 6025.18-R, paragraph C3.4.1.3) provides that requirements applicable to business associates must be incorporated (or incorporated by reference) into the contract or agreement between the parties. (a) Catchall Definition. Except as provided otherwise in this BAA, the following terms used in this BAA shall have the same meaning as those terms in the DoD HIPAA Rules: Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices (NoPP), Protected Health Information (PHI), Required By Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use. Breach means actual or possible loss of control, unauthorized disclosure of or unauthorized access to PHI or other PII (which may include, but is not limited to PHI), where 12 Nov 2013 Page 2 of 10 persons other than authorized users gain access or potential access to such information for any purpose other than authorized purposes, where one or more individuals will be adversely affected. The foregoing definition is based on the definition of breach in DoD Privacy Act Issuances as defined herein. Business Associate shall generally have the same meaning as the term "business associate" in the DoD HIPAA Issuances, and in reference to this BAA, shall mean the contractor. Agreement means this BAA together with the documents and/or other arrangements under which the Business Associate signatory performs services involving access to PHI on behalf of the MHS component signatory to this BAA. Covered Entity shall generally have the same meaning as the term "covered entity" in the DoD HIPAA Issuances, and in reference to this BAA, shall mean the Government facility(s) and office(s) that are supported under this contract. DHA Privacy Office means the DHA Privacy and Civil Liberties Office. The DHA Privacy Office Director is the HIPAA Privacy and Security Officer for DHA, including the National Capital Region Medical Directorate (NCRMD). DoD HIPAA Issuances means the DoD issuances implementing the HIPAA Rules in the DoD Military Health System (MHS). These issuances are DoD 6025.18-R (2003), DoDI 6025.18 (2009), and DoD 8580.02-R (2007). DoD Privacy Act Issuances means the DoD issuances implementing the Privacy Act, which are DoDD 5400.11 (2007) and DoD 5400.11-R (2007). HHS Breach means a breach that satisfies the HIPAA Breach Rule definition of breach in 45 CFR 164.402. HIPAA Rules means, collectively, the HIPAA Privacy, Security, Breach and Enforcement Rules, issued by the U.S. Department of Health and Human Services (HHS) and codified at 45 CFR Part 160 and Part 164, Subpart E (Privacy), Subpart C (Security), Subpart D (Breach) and Part 160, Subparts C-D (Enforcement), as amended by the 2013 modifications to those Rules, implementing the "HITECH Act" provisions of Pub. L. 111-5. See 78 FR 5566-5702 (Jan. 25, 2013) (with corrections at 78 FR 32464 (June 7, 2013)). Additional HIPAA rules regarding electronic transactions and code sets (45 CFR Part 162) are not addressed in this BAA and are not included in the term HIPAA Rules. Service-Level Privacy Office means one or more offices within the military services (Army, Navy, or Air Force) with oversight authority over Privacy Act and HIPAA privacy compliance. I. Obligations and Activities of Business Associate (a) The Business Associate shall not use or disclose PHI other than as permitted or required by the Agreement or as required by law. (b) The Business Associate shall use appropriate safeguards, and comply with the DoD HIPAA Rules with respect to electronic PHI, to prevent use or disclosure of PHI other than as provided for by the Agreement. (c) The Business Associate shall report to Covered Entity any Breach of which it becomes aware, and shall proceed with breach response steps as required by Part V of this BAA. With respect to electronic PHI, the Business Associate shall also respond to any security incident of which it becomes aware in accordance with any Information Assurance provisions of the Agreement. If at any point the Business Associate becomes aware that a security incident involves a Breach, the Business Associate shall immediately initiate breach response as required by part V of this BAA. (d) In accordance with 45 CFR 164.502(e)(1)(ii)) and 164.308(b)(2), respectively), as applicable, the Business Associate shall ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of the Business Associate agree to the same restrictions, conditions, and requirements that apply to the Business Associate with respect to such PHI. (e) The Business Associate shall make available PHI in a Designated Record Set, to the Covered Entity or, as directed by the Covered Entity, to an Individual, as necessary to satisfy the Covered Entity obligations under 45 CFR 164.524. (f) The Business Associate shall make any amendment(s) to PHI in a Designated Record Set as directed or agreed to by the Covered Entity pursuant to 45 CFR 164.526, or take other measures as necessary to satisfy Covered Entity's obligations under 45 CFR 164.526. (g) The Business Associate shall maintain and make available the information required to provide an accounting of disclosures to the Covered Entity or an individual as necessary to satisfy the Covered Entity's obligations under 45 CFR 164.528. (h) To the extent the Business Associate is to carry out one or more of Covered Entity's obligation(s) under the HIPAA Privacy Rule, the Business Associate shall comply with the requirements of HIPAA Privacy Rule that apply to the Covered Entity in the performance of such obligation(s); and (i) The Business Associate shall make its internal practices, books, and records available to the Secretary for purposes of determining compliance with the HIPAA Rules. II. Permitted Uses and Disclosures by Business Associate (a) The Business Associate may only use or disclose PHI as necessary to perform the services set forth in the Agreement or as required by law. The Business Associate is not permitted to de-identify PHI under DoD HIPAA issuances or the corresponding 45 CFR 164.514(a)-(c), nor is it permitted to use or disclose de-identified PHI, except as provided by the Agreement or directed by the Covered Entity. (b) The Business Associate agrees to use, disclose and request PHI only in accordance with the HIPAA Privacy Rule "minimum necessary" standard and corresponding DHA policies and procedures as stated in the DoD HIPAA Issuances. (c) The Business Associate shall not use or disclose PHI in a manner that would violate the DoD HIPAA Issuances or HIPAA Privacy Rules if done by the Covered Entity, except uses and disclosures for the Business Associate's own management and administration and legal responsibilities or for data aggregation services as set forth in the following three paragraphs. (d) Except as otherwise limited in the Agreement, the Business Associate may use PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate. The foregoing authority to use PHI does not apply to disclosure of PHI, which is covered in the next paragraph. (e) Except as otherwise limited in the Agreement, the Business Associate may disclose PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate, provided that disclosures are required by law, or the Business Associate obtains reasonable assurances from the person to whom the PHI is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached. (f) Except as otherwise limited in the Agreement, the Business Associate may use PHI to provide Data Aggregation services relating to the Covered Entity's health care operations. III. Provisions for Covered Entity to Inform Business Associate of Privacy Practices and Restrictions (a) The Covered Entity shall provide the Business Associate with the notice of privacy practices that the Covered Entity produces in accordance with 45 CFR 164.520 and the corresponding provision of the DoD HIPAA Issuances. (b) The Covered Entity shall notify the Business Associate of any changes in, or revocation of, the permission by an Individual to use or disclose his or her PHI, to the extent that such changes affect the Business Associate's use or disclosure of PHI. (c) The Covered Entity shall notify the Business Associate of any restriction on the use or disclosure of PHI that the Covered Entity has agreed to or is required to abide by under 45 CFR 164.522, to the extent that such changes may affect the Business Associate's use or disclosure of PHI. IV. Permissible Requests by Covered Entity The Covered Entity shall not request the Business Associate to use or disclose PHI in any manner that would not be permissible under the HIPAA Privacy Rule or any applicable Government regulations (including without limitation, DoD HIPAA Issuances) if done by the Covered Entity, except for providing Data Aggregation services to the Covered Entity and for management and administrative activities of the Business Associate as otherwise permitted by this BAA. V. Breach Response (a) In general. In the event of a breach of PII/PHI held by the Business Associate, the Business Associate shall follow the breach response requirements set forth in this Part V, which is designed to satisfy both the Privacy Act and HIPAA as applicable. If a breach involves PII without PHI, then the Business Associate shall comply with DoD Privacy Act Issuance breach response requirements only; if a breach involves PHI (a subset of PII), then the Business Associate shall comply with both Privacy Act and HIPAA breach response requirements. A breach involving PHI may or may not constitute an HHS Breach. If a breach is not an HHS Breach, then the Business Associate has no HIPAA breach response obligations. In such cases, the Business Associate must still comply with breach response requirements under the DoD Privacy Act Issuances. If the DHA Privacy Office determines that a breach is an HHS Breach, then the Business Associate shall comply with both the HIPAA Breach Rule and DoD Privacy Act Issuances, as directed by the DHA Privacy Office, regardless of whether the breach occurs at DHA or at one of the Service components. If the DHA Privacy Office determines that the breach does not constitute an HHS Breach, then the Business Associate shall comply with DoD Privacy Act Issuances, as directed by the applicable Service-Level Privacy Office. The following provisions of Part V set forth the Business Associate's Privacy Act and HIPAA breach response requirements for all breaches, including but not limited to HHS breaches. This Part V is designed to satisfy the DoD Privacy Act Issuances and the HIPAA Breach Rule as implemented by the DoD HIPAA Issuances. In general, for breach response, the Business Associate shall report the breach to the Covered Entity, assess the breach incident, notify affected individuals, and take mitigation actions as applicable. Because DoD defines "breach" to include possible (suspected) as well as actual (confirmed) breaches, the Business Associate shall implement these breach response requirements immediately upon the Business Associate's discovery of a possible breach. (b) Government Reporting Provisions The Business Associate shall report the breach within one hour of discovery to the US Computer Emergency Readiness Team (US CERT), and, within 24 hours of discovery, to the DHA Privacy Office and the other parties set forth below. The Business Associate is deemed to have discovered a breach as of the time a breach (suspected or confirmed) is known, or by exercising reasonable diligence would have been known, to any person (other than the person committing it) who is an employee, officer or other agent of the Business Associate. The Business Associate shall submit the US-CERT report using the online form at https://forms.us-cert.gov/report/. Before submission to US-CERT, the Business Associate shall save a copy of the on-line report. After submission, the Business Associate shall record the US-CERT Reporting Number. Although only limited information about the breach may be available as of the one hour deadline for submission, the Business Associate shall submit the US-CERT report by the deadline. The Business Associate shall e-mail updated information as it is obtained, following the instructions at http://www.us-cert.gov/pgp/email.html. The Business Associate shall provide a copy of the initial or updated US-CERT report to the DHA Privacy Office and the applicable Service-Level Privacy Office, if requested by either. Business Associate questions about US-CERT reporting shall be directed to the DHA or Service-Level Privacy Office, not the US-CERT office. The Business Associate report due within 24 hours shall be submitted by completing the New Breach Reporting Form DD 2959 at the Breach Response page on the DHA Privacy Office web site and emailing that form to, as applicable, the DHA Privacy Office, the Service-Level Privacy Office, the Contracting Officer (CO) and Contracting Officer's Representative (COR) and the Business Associate's DoD point of contact (POC) unless the POC specifies another addressee for breach reporting. Encryption is not required, because Breach Report Forms should not contain PII/PHI. The email address for notices to the DHA Privacy Office is provided at the Privacy Office website breach response page. If electronic mail is not available, telephone notification is also acceptable, but all notifications and reports delivered telephonically must be confirmed by email as soon as technically feasible. If multiple beneficiaries are affected by a single event or related set of events, then a single reportable breach may be deemed to have occurred, depending on the circumstances. The Business Associate shall inform the DHA Privacy Office as soon as possible if it believes that "single event" breach response is appropriate; the DHA Privacy Office will determine how the Business Associate shall proceed and, if appropriate, consolidate separately reported breaches for purposes of Business Associate report updates, beneficiary notification, and mitigation. When a Breach Report Form initially submitted is incomplete or incorrect due to unavailable information, or when significant developments require an update, the Business Associate shall submit a revised form or forms, stating the updated status and previous report date(s) and showing any revisions or additions in red text. Examples of updated information the Business Associate shall report include, but are not limited to: confirmation on the exact data elements involved, the root cause of the incident, and any mitigation actions to include, sanctions, training, incident containment, follow-up, etc. The Business Associate shall submit these report updates promptly after the new information becomes available. Prompt reporting of updates is required to allow the DHA Privacy Office to make timely final determinations on any subsequent notifications or reports. The Business Associate shall provide updates to the same parties as required for the initial Breach Reporting Form. The Business Associate is responsible for reporting all information needed by the DHA Privacy Office to make timely and accurate determinations on reports to HHS as required by the HHS Breach Rule and reports to the Defense Privacy and Civil Liberties Office as required by DoD Privacy Act Issuances. In the event the Business Associate is uncertain on how to apply the above requirements, the Business Associate shall consult with the DHA Privacy Office (or the Service-Level Privacy Office, which will consult with the Privacy Office as appropriate) when determinations on applying the above requirements are needed. (c) Individual Notification Provisions: If the DHA Privacy Office determines that individual notification is required, the Business Associate shall provide written notification to individuals affected by the breach as soon as possible, but no later than 10 working days after the breach is discovered and the identities of the individuals are ascertained. The 10 day period begins when the Business Associate is able to determine the identities (including addresses) of the individuals whose records were impacted. The Business Associate's proposed notification to be issued to the affected individuals shall be submitted to the parties to which reports are submitted under paragraph V (a) for their review, and for approval by the DHA Privacy Office. Upon request, the Business Associate shall provide the DHA Privacy Office with the final text of the notification letter sent to the affected individuals. If different groups of affected individuals receive different notification letters, then the Business Associate shall provide the text of the letter for each group. (PII shall not be included with the text of the letter(s) provided.) Copies of further correspondence with affected individuals need not be provided unless requested by the Privacy Office. The Business Associate's notification to the individuals, at a minimum, shall include the following: -The individual(s) must be advised of what specific data was involved. It is insufficient to simply state that PII has been lost. Where names, Social Security Numbers (SSNs) or truncated SSNs, and Dates of Birth (DOBs) are involved, it is critical to advise the individual that these data elements potentially have been breached. -The individual(s) must be informed of the facts and circumstances surrounding the breach. The description should be sufficiently detailed so that the individual clearly understands how the breach occurred. -The individual(s) must be informed of what protective actions the Business Associate is taking or the individual can take to mitigate against potential future harm. The notice must refer the individual to the current Federal Trade Commission (FTC) web site pages on identity theft and the FTC's Identity Theft Hotline, toll-free: 1-877-ID-THEFT (438-4338); TTY: 1-866-653-4261. -The individual(s) must also be informed of any mitigation support services (e.g., one year of free credit monitoring, identification of fraud expense coverage for affected individuals, provision of credit freezes, etc.) that the Business Associate may offer affected individuals, the process to follow to obtain those services and the period of time the services will be made available, and contact information (including a phone number, either direct or toll-free, e-mail address and postal address) for obtaining more information. Business Associates shall ensure any envelope containing written notifications to affected individuals are clearly labeled to alert the recipient to the importance of its contents, e.g., "Data Breach Information Enclosed," and that the envelope is marked with the identity of the Business Associate and/or subcontractor organization that suffered the breach. The letter must also include contact information for a designated POC to include, phone number, email address, and postal address. If the Business Associate determines that it cannot readily identify, or will be unable to reach, some affected individuals within the 10 day period after discovering the breach, the Business Associate shall so indicate in the initial or updated Breach Report Form. Within the 10 day period, the Business Associate shall provide the approved notification to those individuals who can be reached. Other individuals must be notified within 10 days after their identities and addresses are ascertained. The Business Associate shall consult with the DHA Privacy Office, which will determine which media notice is most likely to reach the population not otherwise identified or reached. The Business Associate shall issue a generalized media notice(s) to that population in accordance with Privacy Office approval. The Business Associate shall, at no cost to the government, bear any costs associated with a breach of PII/PHI that the Business Associate has caused or is otherwise responsible for addressing. Breaches are not to be confused with security incidents (often referred to as cyber security incidents when electronic information is involved), which may or may not involve a breach of PII/PHI. In the event of a security incident not involving a PII/PHI breach, the Business Associate shall follow applicable DoD Information Assurance requirements under its Agreement. If at any point the Business Associate finds that a cyber security incident involves a PII/PHI breach (suspected or confirmed), the Business Associate shall immediately initiate the breach response procedures set forth here. The Business Associate shall also continue to follow any required cyber security incident response procedures to the extent needed to address security issues, as determined by DoD/DHA. VI. Termination (a) Termination. Noncompliance by the Business Associate (or any of its staff, agents, or subcontractors) with any requirement in this BAA may subject the Business Associate to termination under any applicable default or other termination provision of the Agreement. (b) Effect of Termination. (1) If the Agreement has records management requirements, the Business Associate shall handle such records in accordance with the records management requirements. If the Agreement does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below. If the Agreement has provisions for transfer of records and PII/PHI to a successor Business Associate, or if DHA gives directions for such transfer, the Business Associate shall handle such records and information in accordance with such Agreement provisions or DHA direction. (2) If the Agreement does not have records management requirements, except as provided in the following paragraph (3), upon termination of the Agreement, for any reason, the Business Associate shall return or destroy all PHI received from the Covered Entity, or created or received by the Business Associate on behalf of the Covered Entity that the Business Associate still maintains in any form. This provision shall apply to PHI that is in the possession of subcontractors or agents of the Business Associate. The Business Associate shall retain no copies of the PHI. (3) If the Agreement does not have records management provisions and the Business Associate determines that returning or destroying the PHI is infeasible, the Business Associate shall provide to the Covered Entity notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Covered Entity and the Business Associate that return or destruction of PHI is infeasible, the Business Associate shall extend the protections of the Agreement to such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or destruction infeasible, for so long as the Business Associate maintains such PHI. VII. Miscellaneous (a) Survival. The obligations of Business Associate under the "Effect of Termination" provision of this BAA shall survive the termination of the Agreement. (b) Interpretation. Any ambiguity in the Agreement shall be resolved in favor of a meaning that permits the Covered Entity and the Business Associate to comply with the HIPAA Rules and the DoD HIPAA Rules. ATTACHMENT III - Sample Patient Form BRANCH HEALTH CLINIC, PNY 4898 S. BROAD STREET BLDG. 615, 1 ST FLOOR PHILADELPHIA, PA 19112 (215) 897-8148/48 DATE: __________________ PATIENT NAME: _________________________________________________ (Last, First, MI) SS# (last 4): ________________ DOB: ______________ (M/F) ______ EXAM TYPE: CHEST X-RAY REASON FOR REQUEST: □ AMSP □ PRE-EMPLOYMENT □ OTHER DATE OF EXAM: ______________________________ COMPLETED BY: ______________________________ TECHNICIAN INITIALS *EMPLOYEE: PLEASE RETURN TO BRANCH HEALTH CLINIC, PNY BLDG. 615 ATTACHMENT IV - Malpractice Insurance Form MALPRACTICE CERTIFICATION INFORMATION Contractors shall complete the following and submit it with their offer. Contractor has or will maintain(ed) malpractice insurance in compliance with the terms and conditions of this solicitation (including FAR Clause 52.237‑7, Indemnification and Medical Liability Insurance, located in Section I of the solicitation). ______ Yes _____ No Reasons: 2. Insurer: ____________________ Insure: ____________________ Address ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ Phone ____________________ ____________________ 3. Is or will yours be a group plan or are proposed physicians individually insured? _______ Group ________ by individual 4. Is malpractice coverage ______ occurrence or ______ claims made? 5. If claims made, is extended reporting endorsement (tail) provided? ______ (Yes/No/NA) for how long a period? ______ Years Can the tail be invoked within 90 days of notification by the Government? _____ (Yes/No) 6. What is the extent of coverage? $_____________ per incident $_____________ aggregate Do these limits apply to each individual practitioner? _____ (Yes/No) If no, explain. _________________________________________________ 7. Will your malpractice insurance coverage be in effect immediately upon award? _______ (Yes/No) If "no," when will coverage begin? ______________________________________________ If yes, attach proof of malpractice coverage to this form and include as required. _________________________ Signature of Authorized Insurance Company Agent Title: _________________ Date: _________________ ATTACHMENT V - Contract Administration Plan CONTRACT ADMINISTRATION PLAN (CAP) FOR FIXED PRICE CONTRACTS In order to expedite the administration of this contract, the following delineation of duties is provided. The names, addresses and phone numbers for these offices or individuals are included elsewhere in the contract award document. The office or individual designated as having responsibility should be contacted for any questions, clarifications, or information regarding the administration function assigned. 1. The Procuring Contract Office (PCO) is responsible for: a. All pre-award duties such as solicitation, negotiation and award of contracts. b. Any information or questions during the pre-award stage of the procurement. c. Freedom of Information inquiries. d. Changes in contract terms and/or conditions. e. Post award conference. 2. The Contract Administration Office (CAO) is responsible for matters specified in the FAR 42.302 and DFARS 42.302 except those areas otherwise designated as the responsibility of the Contracting Officer's Representative (COR) or someone else herein. 3. The paying office is responsible for making payment of proper invoices after acceptance is documented. 4. The Contracting Officer's Representative (COR) is responsible for interface with the contractor and performance of duties such as those set forth below. It is emphasized that only the PCO/CAO has the authority to modify the terms of the contract. In no event will any understanding, agreement, modification, change order, or other matter deviating from the terms of the basic contract between the contractor and any other person be effective or binding on the Government. If in the opinion of the contractor an effort outside the scope of the contract is requested, the contractor shall promptly notify the PCO in writing. No action may be taken by the contractor unless the PCO or CAO has issued a contractual change. The COR duties are as follows: a. Technical Interface (1) The COR is responsible for all Government technical interface concerning the contractor and furnishing technical instructions to the contractor. These instructions may include: technical advice/recommendations/clarifications of specific details relating to technical aspects of contract requirements; milestones to be met within the general terms of the contract or specific subtasks of the contract; or, any other interface of a technical nature necessary for the contractor to perform the work specified in the contract. The COR is the point of contact through whom the contractor can relay questions and problems of a technical nature to the PCO. (2) The COR is prohibited from issuing any instruction which would constitute a contractual change. The COR shall not instruct the contractor how to perform. If there is any doubt whether technical instructions contemplated fall within the scope of work, contact the PCO for guidance before transmitting the instructions to the contractor. b. Contract Surveillance (1) The COR shall monitor the contractor's performance and progress under the contract. In performing contract surveillance duties, the COR should exercise extreme care to ensure that he/she does not cross the line of personal services. The COR must be able to distinguish between surveillance (which is proper and necessary) and supervision (which is not permitted). Surveillance becomes supervision when you go beyond enforcing the terms of the contract. If the contractor is directed to perform the contract services in a specific manner, the line is being crossed. In such a situation, the COR's actions would be equivalent to using the contractor's personnel as if they were government employees and would constitute transforming the contract into one for personal services. (2) The COR shall monitor contractor performance to see that inefficient or wasteful methods are not being used. If such practices are observed, the COR is responsible for taking reasonable and timely action to alert the contractor and the PCO to the situation. (3) The COR will take timely action to alert the PCO to any potential performance problems. If performance schedule slippage is detected, the COR should determine the factors causing the delay and report them to the PCO, along with the contractor's proposed actions to eliminate or overcome these factors and recover the slippage. Once a recovery plan has been put in place, the COR is responsible for monitoring the recovery and keeping the PCO advised of progress. (4) If the Contractor Performance Assessment Reporting System (CPARS) is applicable to the contract the COR is responsible for completing a Contractor Performance Assessment Report (CPAR) in the CPARS Automated Information System (AIS). The initial CPAR, under an eligible contract, must reflect evaluation of at least 180 days of contractor performance. The completed CPAR, including contractor comments if any, (NOTE: contractors are allowed 30 days to input their comments) should be available in the CPARS AIS for reviewing official (PCO) review no later than 270 days after start of contract performance. Subsequent CPARs covering any contract option periods should be ready at 1-year intervals thereafter. c. Invoice Review and Approval/Inspection and Acceptance (1) The COR is responsible for quality assurance of services performed and acceptance of the services or deliverables. The COR shall expeditiously review copies of the contractor's invoices or vouchers, certificate of performance and all other supporting documentation to determine the reasonableness of the billing. In making this determination, the COR must take into consideration all documentary information available and any information developed from personal observations. (2) The COR must indicate either complete or partial concurrence with the contractor's invoice/voucher by executing the applicable certificate of performance furnished by the contractor. The COR must be cognizant of the invoicing procedures and prompt payment due dates detailed elsewhere in the contract. (3) The COR will provide the PCO and the CAO with copies of acceptance documents such as Certificates of Performance. (4) The COR shall work with the Contractor to obtain and execute a final invoice no more than 60 days after completion of contract performance. The COR shall ensure that the invoice is clearly marked as a "Final Invoice." d. Contract Modifications. The COR is responsible for developing the statement of work for change orders or modifications and for preparing an independent government cost estimate of the effort described in the proposed statement of work. e. Administrative Duties (1) The COR shall take appropriate action on technical correspondence pertaining to the contract and for maintaining files on each contract. This includes all modifications, government cost estimates, contractor invoices/vouchers, certificates of performance, DD 250 forms and contractor's status reports. (2) The COR shall maintain files on all correspondence relating to contractor performance, whether satisfactory or unsatisfactory, and on trip reports for all government personnel visiting the contractor's place of business for the purpose of discussing the contract. (3) The COR must take prompt action to provide the PCO with any contractor or technical code request for change, deviation or waiver, along with any supporting analysis or other required documentation. f. Government Furnished Property. When government property is to be furnished to the contractor, the COR will take the necessary steps to insure that it is furnished in a timely fashion and in proper condition for use. The COR will maintain adequate records to ensure that property furnished is returned and/or that material has been consumed in the performance of work. Enclosure (1) g. Security. The COR is responsible for ensuring that any applicable security requirements are strictly adhered to. h. Standards of Conduct. The COR is responsible for reading and complying with all applicable agency standards of conduct and conflict of interest instructions. i. Written Report/Contract Completion Statement. (1) The COR is responsible for timely preparation and submission to the PCO, of a written, annual evaluation of the contractors performance. The report shall be submitted within 30 days prior to the exercise of any contract option and 60 days after contract completion. The report shall include a written statement that services were received in accordance with the Contract terms and that the contract is now available for close-out. The report shall also include a statement as to the use made of any deliverables furnished by the contractor. (2) If the Contractor Performance Assessment Reporting System (CPARS) is applicable to the contract you are responsible for completing a final Contractor Performance Assessment Report (CPAR) in the CPARS with 30 days of contract completion. (3) The COR is responsible for providing necessary assistance to the Contracting Officer in performing Contract Close-out in accordance with FAR 4.804, Closeout of Contract Files. 5. The Technical Assistant (TA), if appointed, is responsible for providing routine administration and monitoring assistance to the COR. The TA does not have the authority to provide any technical direction or clarification to the contract. Duties that may be performed by the TA are as follows: a. Identify contractor deficiencies to the COR. b. Review contract deliverables, recommend acceptance/rejection, and provide the COR with documentation to support the recommendation. c. Assist in preparing the final report on contractor performance for the applicable contract in accordance with the format and procedures prescribed by the COR. d. Identify contract noncompliance with reporting requirements to the COR. e. Review contractor status and progress reports, identify deficiencies to the COR, and provide the COR with recommendations regarding acceptance, rejection, and/or Government technical clarification requests. f. Review invoices and provide the COR with recommendations to facilitate COR certification of the invoice. g. Provide the COR with timely input regarding technical clarifications for the statement of work, possible technical direction to provide the contractor, and recommend corrective actions. h. Provide detailed written reports of any trip, meeting, or conversation to the COR subsequent to any interface between the TA and contractor. ATTACHMENT VI - Corporate Experience and Past Performance Form CORPORATE EXPERIENCE and PAST PERFORMANCE INFORMATION FORM Form ___ of ___ Name of Offeror: Contract Number, order number, or identifier: Customer Name & Location: Customer Point of Contact (Name & Title): Telephone Number ( PLEASE VERIFY ): and e-mail address Total dollar amount for this effort during the past five (5) years: (For ordering vehicles, show both the annual estimated contract amount and the amount of orders actually performed): (Show calendar year and dollars) Number of personnel (FTE) performing per year (avg.): Period of Performance: From: To: Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the solicitation: Quality, delivery, or cost problem(s); corrective action(s) taken; and effectiveness of the corrective action(s): Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts: ATTACHMENT VII - FAR Part 52.209-11 ( Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law) Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) (a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that-- (1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or (2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government. (b) The Offeror represents that- (1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and (2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months. ATTACHMENT VIII - Pricing Sheet Description of Services SLIN Base Option 1 Option 2 Option 3 Quantity P & A One View AA 300.00 330.00 363.00 399.00 P /A and Lateral Two Views AB 40.00 44.00 48.00 53.00 P/A and Obliques Three Views AC 10.00 11.00 12.00 13.00 Description of Services SLIN Base Option 1 Option 2 Option 3 Price P & A One View AA P /A and Lateral Two Views AB P/A and Obliques Three Views AC Base Period Total: Option Period 1 Total: Option Period 2 Total: Option Period 3 Total: Task Order Total: Special Notes Addendum to 52.212-1 Instructions to Offerors - Commercial Items (Oct 2018) ADDRESS FOR THE PHILADELPHIA NAVY YARD: Philadelphia Navy Yard - Occupational Health Clinic (PNY-OHC) 4898 Broad Street, Building 615 Philadelphia, PA 19112 (a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code and small business size standard for this acquisition is 621512 and $15 mil. Quoters shall submit their quotes on two (2) separate volumes/documents: Volume I: Price Quote for Base and All Option Periods (Attachment VIII) Volume II: Non-Price Factors As a minimum quotes must show: Volume I (1) The solicitation number; (2) Evidence of insurability in regard to medical liability in the amounts prescribed in FAR 52.237-7; (3) The name, address, and telephone number of the offeror; (4) Price Information: (a) Quoters shall provide unit prices and amounts for the Base year and all Option periods on the pricing sheet above (Attachment VIII). (b) Price discount terms; if any. (5) "Remit to" address, if different than mailing address; (6) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically); (7) Acknowledgment of Solicitation Amendments; (8) Completed copy of provision FAR 52.209-11. Volume II The quoter shall complete a Corporate Experience and Past Performance Information Form for each reference submitted in accordance with Attachment VI of the solicitation. •(a) Location: The quoter shall provide proof that they are located within a ten (10) mile radius of the PNY-OHC. •(b) Technical Capability/Experience working with Asbestos Medical Surveillance Program (AMSP). The Quoter shall provide proof of quality standards for X-Ray Imaging and interpretations. This can include technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary; detailing experience if any, working with an AMSP and experience in B-Readings/Interpretations. •(c) Credentials: The quoter shall provide proof that they are credentialed in accordance with Joint Commission standards to perform the services required herein. •(d) Past Performance: The quoter shall demonstrate relevant past performance or affirmatively state that it possesses no relevant past performance. Relevant past performance is performance under contracts or efforts (within the last three years) that is of similar scope, magnitude, and complexity to that which is described in the solicitation (as defined in Attachment VI). The Government will evaluate the relevant references submitted under Corporate Experience factor. Only a single set of up to three references shall be submitted. The quoter shall complete Attachment VI for past performance with no greater than three (3) references submitted. •(e) Period for acceptance of quotes. The quoter agrees to hold the prices in its offer firm for 90 calendar days from the date specified for receipt of quotes, unless another time period is specified in an addendum to the solicitation. •(f) Quote Submission Quotes shall be submitted via email to curtis.e.cardoza.civ@mail.mil and andrea.l.giuliano.civ@mail.mil by NLT 10:00am EST 03 September 2019 and must contain FAR Provision 52.209-11 (Attachment VII). Questions regarding this Request for Quotes (RFQ) shall be submitted before 28 August 2019 by NLT 4:00pm EST. (End of Provision) 52.212-2 Evaluation-Commercial Items (Oct 2014) The Government will conduct a Best Value source selection process using the policies and procedures of FAR part 12.203, Procedures for Solicitation, Evaluation, and Award, 13.106-2, Evaluation of Quotations or Quoters, and FAR part 13.106-3, Award and Documentation. Quote: The quoter's submission shall be in the form prescribed by, and shall contain response to each to each of the areas identified above in (The Addendum to FAR 52.212-1). The quote shall clearly indicate, with sufficient details, the vendor's capability to meet ALL of the requirements as stated above in the Performance Work Statement. Any quote which does not provide, as a minimum, that which is required in the solicitation may be determined to be substantially incomplete and not warrant any further consideration. Evaluation: Quoters will be evaluated based on location of facility, technical capability and or experience working with an Asbestos Medical Surveillance Program (AMSP), proof of being credentialed according to Joint Commission standards and past performance. BASIS OF AWARD Award will be made to the responsible quoter whose quotation conforms to all solicitation requirements, such as terms and conditions, representations and certifications, technical/quality requirements, and also provide the best value to the Government based on the results of price and non-price factors. Non Price factors are significantly more important than price factors. In addition, the Contracting Officer will determine if the proposed prices to include the base and option periods are deemed fair and reasonable and is the best value quote that can fulfill the needs of the PNY-OHC. Other Administrative Instructions: Quoters must be registered in the SAM database to be eligible for award. Registration is free and can be completed on-line at http://www.sam.gov ; provide DUNS number; Cage Code and TIN. FAR and DFARS Provisions & Clauses: Clauses Incorporated by Reference FAR 52.203-3, Gratuities FAR 52.203-17, Contractor Employee Whistleblower Rights and Requirement to Inform Employees of Whistleblower Rights FAR 52.204-7, System for Award Management FAR 52.204-9, Personal Identity Verification of Contractor Personnel FAR 52.204-13, System for Award Management Maintenance FAR 52.212-1, Instructions to Offerors--Commercial Items FAR 52.212-2 Evaluation - Commercial Items FAR 52.212-4, Contract Terms and Conditions---Commercial Items; FAR 52.203-6, Restrictions on Subcontractor Sales to the Government FAR 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards FAR 52.217-8, Option to Extend Services FAR 52.219-9 Small Business Subcontracting Plan FAR 52.219-28, Post-Award Small Business Program Representation FAR 52.222-41, Service Contract Labor Standards FAR 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran - Representation and Certifications FAR 52.232-18, Availability of Funds FAR 52.232-39, Unenforceability of Unauthorized Obligations FAR 52.233-4, Applicable Law for Breach of Contract Claim FAR 52.242-15, Stop Work Order DFARS 252.201-7000, Contracting Officer's Representative DFARS 252.203-7003, Agency Office of the Inspector General DFARS 252.225-7001, Buy American Act and Balance of Payment Program; DFARS 252.225-7012, Preference for Certain Domestic Commodities DFARS 252.225-7021, Trade Agreements; DFARS 252.227-7015, Technical Data-Commercial Items; DFARS 252.232-7003, Electronic Submission of Payment Requests; DFARS 252.237-7010, Prohibition on Interrogation of Detainees by Contractor Personnel DFARS 252.243-7002, Requests for Equitable Adjustment; DFARS 252.247-7024, Notification of Transportation of Supplies by Sea. DFARS 252.225-7000, Buy American Act-Balance of Payments Program Certificate; DFARS 252.225-7035, Buy American Act--North American Free Trade Agreement Implementation Act- Balance of Hexavalent Chromium DFARS 252.243-7001, Pricing of Contract Modifications DEC (1991) FAR Provision Clauses Incorporated by Full Text 52.209-11, Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law. (a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that-- (1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or (2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government. (b) The Offeror represents that- (1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and (2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months. (End of provision) FAR 52.212-3 ALT I, Offeror Representations and Certifications-Commercial Items The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u)) 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- (6) 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 (7) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties. "Highest-level owner" means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner. "Immediate owner" means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees. "Inverted domestic corporation," means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). "Manufactured end product" means any end product in product and service codes (PSCs) 1000-9999, except- (1) PSC 5510, Lumber and Related Basic Wood Materials; (2) Product or Service Group (PSG) 87, Agricultural Supplies; (3) PSG 88, Live Animals; (4) PSG 89, Subsistence; (5) PSC 9410, Crude Grades of Plant Materials; (6) PSC 9430, Miscellaneous Crude Animal Products, Inedible; (7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products; (8) PSC 9610, Ores; (9) PSC 9620, Minerals, Natural and Synthetic; and (10) PSC 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. "Predecessor" means an entity that is replaced by a successor and includes any predecessors of the predecessor. "Restricted business operations" means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate- (1) Are conducted under contract directly and exclusively with the regional government of southern Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization; (3) Consist of providing goods or services to marginalized populations of Sudan; (4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization; (5) Consist of providing goods or services that are used only to promote health or education; or (6) Have been voluntarily suspended. Sensitive technology- (1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically- (i) To restrict the free flow of unbiased information in Iran; or (ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and (2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)). "Service-disabled veteran-owned small business concern"- (1) Means a small business concern- (i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and (ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran. (2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16). "Small business concern" means a concern, including its affiliates that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation. "Small disadvantaged business concern, consistent with 13 CFR 124.1002," means a small business concern under the size standard applicable to the acquisition, that-- (1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by-- (i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and (ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and (2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1) (i) and (ii) of this definition. "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. "Successor" means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term "successor" does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances. "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 its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women. "Women-owned small business concern" means a small business concern -- (1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and (2) Whose management and daily business operations are controlled by one or more women. "Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127)," means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States. (b) (1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b) (2) of this provision do not automatically change the representations and certifications in SAM. (2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM 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), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs __. [Offeror to identify the applicable paragraphs at (c) through (u) 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 electronically on SAM.] (c) Offerors must complete the following representations when the resulting contract is to 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 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: 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 for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: _________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation. (7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c) (6) of this provision.] The offeror represents that- (i) It [_] is, [_] is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and (ii) It [_] is, [_] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: _____________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation. (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) HUB Zone 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 HUB Zone small business concern listed, on the date of this representation, on the List of Qualified HUB Zone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUB Zone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and (ii) It [_] is, [_] is not a HUB Zone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUB Zone small business concern participating in the HUB Zone joint venture. [ The offeror shall enter the names of each of the HUB Zone small business concerns participating in the HUB Zone joint venture : __________.] Each HUB Zone small business concern participating in the HUB Zone joint venture shall submit a separate signed copy of the HUB Zone representation. (d) Representations required to implement provisions of Executive Order 11246 -- (1) Previous contracts and compliance. The offeror represents that -- (i) It [_] has, [_] has not, participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and (ii) It [_] has, [_] has not, filed all required compliance reports. (2) Affirmative Action Compliance. The offeror represents that -- (i) It [_] has developed and has on file, [_] has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or (ii) It [_] has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor. (e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made. (f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American - 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-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 -- Free Trade Agreements -- Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms "Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American--Free Trade Agreements--Israeli Trade Act." (ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act": Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: LINE ITEM NO. COUNTRY OF ORIGIN [ List as necessary ] (iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) or this provision) as defined in the clause of this solicitation entitled "Buy American-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-Free Trade Agreements-Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g) (1) (ii) for paragraph (g) (1) (ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act": Canadian End Products: Line Item No.: ___________________________________________ [List as necessary] (3) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g) (1) (ii) for paragraph (g) (1) (ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled "Buy American--Free Trade Agreements--Israeli Trade Act'': Canadian or Israeli End Products: Line Item No.: Country of Origin: [ List as necessary ] (4) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 52.225-3 is included in this solicitation, substitute the following paragraph (g) (1) (ii) for paragraph (g) (1) (ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act": Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: Line Item No.: Country of Origin: [ List as necessary ] (5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product as defined in the clause of this solicitation entitled "Trade Agreements." (ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products. Other End Products Line Item No.: Country of Origin: [ List as necessary ] (iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation. (h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals-- (1) [_] Are, [_] are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; (2) [_] Have, [_] have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; 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 $3,500 for which the liability remains unsatisfied. (i) Taxes are considered delinquent if both of the following criteria apply: (A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted. (B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded. (ii) Examples. (A) The taxpayer has received a statutory notice of deficiency, under I.R.C. §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 appear 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. §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. §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 Product Listed End Product: Listed Countries of Origin: (2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.] [_] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. [_] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that is has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor. (j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly- (1) [_] In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or (2) [_] Outside the United States. (k) Certificates regarding exemptions from the application of the Service Contract Labor Standards. (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 Labor Standards wage determination to the solicitation, the offeror shall notify the Contracting Officer as soon as possible; and (ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k) (1) or (k) (2) of this clause or to contact the Contracting Officer as required in paragraph (k) (3) (i) of this clause. (l) Taxpayer identification number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to the SAM database to be eligible for award.) (1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS). (2) The TIN may be used by the government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c) (3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN. (3) Taxpayer Identification Number (TIN). [_] TIN: _____________________. [_] TIN has been applied for. [_] TIN is not required because: [_] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States; [_] Offeror is an agency or instrumentality of a foreign government; [_] Offeror is an agency or instrumentality of the Federal Government; (4) Type of organization. [_] Sole proprietorship; [_] Partnership; [_] Corporate entity (not tax-exempt); [_] Corporate entity (tax-exempt); [_] Government entity (Federal, State, or local); [_] Foreign government; [_] International organization per 26 CFR 1.6049-4; [_] Other ____________________. (5) Common parent. [_] Offeror is not owned or controlled by a common parent: [_] Name and TIN of common parent: Name ____________________________________ TIN ______________________________________ (m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan. (n) Prohibition on Contracting with Inverted Domestic Corporations- (1) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4. (2) Representation. The offeror represents that- (i) It [ ] is, [ ] is not an inverted domestic corporation; and (ii) It [ ] is, [ ] is not a subsidiary of an inverted domestic corporation. (o) Prohibition on contracting with entities engaging in certain activities or transactions relating to Iran. (1) The offeror shall email questions concerning sensitive technology to the Department of State at CISADA106@state.gov. (2) Representation and Certification. Unless a waiver is granted or an exception applies as provided in paragraph (o) (3) of this provision, by submission of its offer, the offeror- (i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran; (ii) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act; and (iii) Certifies that the offeror, and any person owned or controlled by the offeror, does not knowingly engage in any transaction that exceeds $3,500 with Iran's Revolutionary Guard Corps or any of its officials, agents, or affiliates, the property and interests in property of which are blocked pursuant to the International Emergency Economic Powers Act (50(U.S.C. 1701 et seq.) (see OFAC's Specially Designated Nationals and Blocked Persons List at https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx ). (3) The representation and certification requirements of paragraph (o) (2) of this provision do not apply if- (i) This solicitation includes a trade agreements certification (e.g., 52.212-3(g) or a comparable agency provision); and (ii) The offeror has certified that all the offered products to be supplied are designated country end products. (p) Ownership or Control of Offeror. (Applies in all solicitations when there is a requirement to be registered in SAM or a requirement to have a unique entity identifier in the solicitation. (1) The Offeror represents that it [ ] has or [ ] does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond to paragraph (2) and if applicable, paragraph (3) of this provision for each participant in the joint venture. (2) If the Offeror indicates "has" in paragraph (p) (1) of this provision, enter the following information: Immediate owner CAGE code: _____________________________________________ Immediate owner legal name: ______________________________________________ (Do not use a "doing business as" name) Is the immediate owner owned or controlled by another entity: [ ] Yes or [ ] No. (3) If the Offeror indicates "yes" in paragraph (p) (2) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information: Highest level owner CAGE code: _____________________________________________ Highest level owner legal name: ______________________________________________ (Do not use a "doing business as" name) (q) Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law. (1) As required by section 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that- (i) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless and agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or (ii) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government. (2) The Offeror represents that-- (i) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and (ii) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months. (r) Predecessor of Offeror. (Applies in all solicitations that include the provision at 52.204-16, Commercial and Government Entity Code Reporting.) (1) The Offeror represents that it [ ] is or [ ] is not a successor to a predecessor that held a Federal contract or grant within the last three years. (2) If the Offeror has indicated "is" in paragraph (r) (1) of this provision, enter the following information for all predecessors that held a Federal contract or grant within the last three years (if more than one predecessor, list in reverse chronological order): Predecessor CAGE code ______ (or mark "Unknown). Predecessor legal name: _________________________. (Do not use a "doing business as" name). (s) Reserved. (t) Public Disclosure of Greenhouse Gas Emissions and Reduction Goals. Applies in all solicitations that require offerors to register in SAM (52.212-1(k)). (1) This representation shall be completed if the Offeror received $7.5 million or more in contract awards in the prior Federal fiscal year. The representation is optional if the Offeror received less than $7.5 million in Federal contract awards in the prior Federal fiscal year. (2) Representation. [ Offeror to check applicable block(s) in paragraph (t) (2) (i) and (ii) ]. (i) The Offeror (itself or through its immediate owner or highest-level owner) [ ] does, [ ] does not publicly disclose greenhouse gas emissions, i.e., makes available on a publicly accessible Web site the results of a greenhouse gas inventory, performed in accordance with an accounting standard with publicly available and consistently applied criteria, such as the Greenhouse Gas Protocol Corporate Standard. (ii) The Offeror (itself or through its immediate owner or highest-level owner) [ ] does, [ ] does not publicly disclose a quantitative greenhouse gas emissions reduction goal, i.e., make available on a publicly accessible Web site a target to reduce absolute emissions or emissions intensity by a specific quantity or percentage. (iii) A publicly accessible Web site includes the Offeror's own Web site or a recognized, third-party greenhouse gas emissions reporting program. (3) If the Offeror checked ''does'' in paragraphs (t) (2) (i) or (t) (2) (ii) of this provision, respectively, the Offeror shall provide the publicly accessible Web site(s) where greenhouse gas emissions and/or reduction goals are reported: _____. (u) (1) In accordance with section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions), Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with an entity that requires employees or subcontractors of such entity seeking to report waste, fraud, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information. (2) The prohibition in paragraph (u) (1) of this provision does not contravene requirements applicable to Standard Form 312 (Classified Information Nondisclosure Agreement), Form 4414 (Sensitive Compartmented Information Nondisclosure Agreement), or any other form issued by a Federal department or agency governing the nondisclosure of classified information. (3) Representation. By submission of its offer, the Offeror represents that it will not require its employees or subcontractors to sign or comply with internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting waste, fraud, or abuse related to the performance of a Government contract to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information (e.g., agency Office of the Inspector General). (End of Provision) FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders- Commercial Items. (a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items: (1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)). (2) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115-91). (3) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (Nov 2015) (4) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553). (5) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Public Laws 108-77, 108-78 (19 U.S.C. 3805 note)). (b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the contracting officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: __X_ (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 4704 and 10 U.S.C. 2402). ___ (2) 52.203-13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509). __X_ (3) 52.203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (Jun 2010) (Section 1553 of Pub L. 111-5) (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009). __X_ (4) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Oct 2018) (Pub. L. 109-282) (31 U.S.C. 6101 note). ___ (5) [Reserved] ___ (6) 52.204-14, Service Contract Reporting Requirements (Oct 2016) (Pub. L. 111-117, section 743 of Div. C). ___ (7) 52.204-15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (Oct 2016) (Pub. L. 111-117, section 743 of Div. C). __X_ (8) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Oct 2015) (31 U.S.C. 6101 note). __X_ (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) (41 U.S.C. 2313). ___ (10) [Reserved] ___ (11) (i) 52.219-3, Notice of HUB Zone Set-Aside or Sole-Source Award (Nov 2011) (15 U.S.C. 657a). ___ (ii) Alternate I (Nov 2011) of 52.219-3. __X_ (12) (i) 52.219-4, Notice of Price Evaluation Preference for HUB Zone Small Business Concerns (Oct 2014) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a). ___ (ii) Alternate I (Jan 2011) of 52.219-4. ___ (13) [Reserved] ___ (14) (i) 52.219-6, Notice of Total Small Business Aside (Nov 2011) (15 U.S.C. 644). ___ (ii) Alternate I (Nov 2011). ___ (iii) Alternate II (Nov 2011). ___ (15) (i) 52.219-7, Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644). ___ (ii) Alternate I (Oct 1995) of 52.219-7. ___ (iii) Alternate II (Mar 2004) of 52.219-7. __X_ (16) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (15 U.S.C. 637(d) (2) and (3)). ___ (17) (i) 52.219-9, Small Business Subcontracting Plan (Aug 2018) (15 U.S.C. 637 (d) (4)). ___ (ii) Alternate I (Nov 2016) of 52.219-9. ___ (iii) Alternate II (Nov 2016) of 52.219-9. ___ (IV) Alternate III (Nov 2016) of 52.219-9. ___ (v) Alternate IV (Aug 2018) of 52.219-9. ___ (18) 52.219-13, Notice of Set-Aside of Orders (Nov 2011) (15 U.S.C. 644(r)). ___ (19) 52.219-14, Limitations on Subcontracting (Jan 2017) (15 U.S.C. 637(a) (14)). __X_ (20) 52.219-16, Liquidated Damages-Subcontracting Plan (Jan 1999) (15 U.S.C. 637(d) (4) (F) (i)). ___ (21) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (Nov 2011) (15 U.S.C.657f). __X_ (22) 52.219-28, Post Award Small Business Program Re-representation (Jul 2013) (15 U.S.C. 632(a) (2)). ___ (23) 52.219-29, Notice of Set-Aside for, or Sole Source Award to, Economically Disadvantaged Women-Owned Small Business Concerns (Dec 2015) (15 U.S.C. 637(m)). ___ (24) 52.219-30, Notice of Set-Aside for, or Sole Source Award to, Women-Owned Small Business Concerns Eligible Under the Women-Owned Small Business Program (Dec 2015) (15 U.S.C. 637(m)). __X_ (25) 52.222-3, Convict Labor (June 2003) (E.O. 11755). __X_ (26) 52.222-19, Child Labor-Cooperation with Authorities and Remedies (Jan 2018) (E.O. 13126). __X_ (27) 52.222-21, Prohibition of Segregated Facilities (Apr 2015). __X_ (28) (i) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246). ___ (ii) Alternate I (Feb 1999) of 52.222-26. __X_ (29) (i) 52.222-35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212). ___ (ii) Alternate I (July 2014) of 52.222-35. __X_ (30) (i) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793). ___ (ii) Alternate I (July 2014) of 52.222-36. __X_ (31) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212). ___ (32) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496). __X_ (33) (i) 52.222-50, Combating Trafficking in Persons (JAN 2019) (22 U.S.C. chapter 78 and E.O. 13627). ___ (ii) Alternate I (Mar 2015) of 52.222-50, (22 U.S.C. chapter 78 and E.O. 13627). __X_ (34) 52.222-54, Employment Eligibility Verification (Oct 2015). (E. O. 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.) ___ (35) (i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C. 6962(c) (3) (A) (ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.) ___ (ii) Alternate I (May 2008) of 52.223-9 (42 U.S.C. 6962(i) (2) (C)). (Not applicable to the acquisition of commercially available off-the-shelf items.) ___ (36) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (Jun 2016) (E.O.13693). ___ (37) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (Jun 2016) (E.O. 13693). ___ (38) (i) 52.223-13, Acquisition of EPEAT® -Registered Imaging Equipment (Jun 2014) (E.O.s 13423 and 13514 ___ (ii) Alternate I (Oct 2015) of 52.223-13. ___ (39) (i) 52.223-14, Acquisition of EPEAT® -Registered Television (Jun 2014) (E.O.s 13423 and 13514). ___ (ii) Alternate I (Jun 2014) of 52.223-14. __X_ (40) 52.223-15, Energy Efficiency in Energy-Consuming Products (Dec 2007) (42 U.S.C. 8259b). ___ (41) (i) 52.223-16, Acquisition of EPEAT® -Registered Personal Computer Products (Oct 2015) (E.O.s 13423 and 13514). ___ (ii) Alternate I (Jun 2014) of 52.223-16. __X_ (42) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging while Driving (Aug 2011) (E.O. 13513). ___ (43) 52.223-20, Aerosols (Jun 2016) (E.O. 13693). ___ (44) 52.223-21, Foams (Jun 2016) (E.O. 13696). ___ (45) (i) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a). ___ (ii) Alternate I (Jan 2017) of 52.224-3. ___ (46) 52.225-1, Buy American--Supplies (May 2014) (41 U.S.C. chapter 83). ___ (47) (i) 52.225-3, Buy American--Free Trade Agreements--Israeli Trade Act (May 2014) (41 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41, 112-42, and 112-43). ___ (ii) Alternate I (May 2014) of 52.225-3. ___ (iii) Alternate II (May 2014) of 52.225-3. ___ (iv) Alternate III (May 2014) of 52.225-3. ___ (48) 52.225-5, Trade Agreements (Aug 2018) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note). __X_ (49) 52.225-13, Restrictions on Certain Foreign Purchases (June 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury). ___ (50) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). ___ (51) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150). ___ (52) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150). ___ (53) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 4505), 10 U.S.C. 2307(f)). ___ (54) 52.232-30, Installment Payments for Commercial Items (Jan 2017) (41 U.S.C. 4505, 10 U.S.C. 2307(f)). __X_ (55) 52.232-33, Payment by Electronic Funds Transfer--System for Award Management (Oct 2018) (31 U.S.C. 3332). ___ (56) 52.232-34, Payment by Electronic Funds Transfer-Other Than System for Award Management (Jul 2013) (31 U.S.C. 3332). ___ (57) 52.232-36, Payment by Third Party (May 2014) (31 U.S.C. 3332). ___ (58) 52.239-1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a). ___ (59) 52.242-5, Payments to Small Business Subcontractors (Jan 2017) (15 U.S.C. 637(d) (13)). ___ (60) (i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631). ___ (ii) Alternate I (Apr 2003) of 52.247-64. ___ (iii) Alternate II (Feb 2006) of 52.247-64. (c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or executive orders applicable to acquisitions of commercial items: [ Contracting Officer check as appropriate.] __X_ (1) 52.222-17, Non-displacement of Qualified Workers (May 2014) (E.O. 13495) __X_ (2) 52.222-41, Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67. ). __X_ (3) 52.222-42, Statement of Equivalent Rates for Federal Hires (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). __X_ (4) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (Multiple Year and Option Contracts) (Aug 2018) (29 U.S.C.206 and 41 U.S.C. chapter 67). ___ (5) 52.222-44, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). ___ (6) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67). ___ (7) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67). __X_ (8) 52.222-55, Minimum Wages under Executive Order 13658 (Dec 2015) (E.O. 13658). __X_ (9) 52.222-62, Paid Sick Leave under Executive Order 13706 (JAN 2017) (E.O. 13706). ___ (10) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792). (d) Comptroller General Examination of Record The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records -- Negotiation. (1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract. (2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved. (3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law. (e) (1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c) and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause- (i) 52.203-13, Contractor Code of Business Ethics and Conduct (Jan 2019) (41 U.S.C. 3509). (ii) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)). (iii) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115-91). (iv) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (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 $700,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities. (v) 52.222-17, Non-displacement of Qualified Workers (May 2014) (E.O. 13495). Flow down required in accordance with paragraph (1) of FAR clause 52.222-17. (vi) 52.222-21, Prohibition of Segregated Facilities (Apr 2015). (vii) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246). (viii) 52.222-35, Equal Opportunity for Veterans (Oct 2019) (38 U.S.C. 4212). (ix) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793). (x) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212). (xi) 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. (xii) 52.222-41, Service Contract Labor Standards (Aug 2018), (41 U.S.C. chapter 67). (xiii) (A) 52.222-50, Combating Trafficking in Persons (Jan 2019) (22 U.S.C. chapter 78 and E.O. 13627). (B) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 E.O. 13627). (xiv) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67.) (xv) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67) (xvi) 52.222-54, Employment Eligibility Verification (Oct 2015) (E. O. 12989). (xvii) 52.222-55, Minimum Wages under Executive Order 13658 (Dec 2015). (xviii) 52.222-62, Paid sick Leave under Executive Order 13706 (JAN 2017) (E.O. 13706). (xix) (A) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a). (B) Alternate I (Jan 2017) of 52.224-3. (xx) 52.225-26, Contractors Performing Private Security Functions outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). (xxi) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6. (xxii) 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) FAR 52.217-9, Option to Extend the Term of the Contract (a) The Government may extend the term of this contract by written notice to the Contractor within 30 days provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension. (b) If the Government exercises this option, the extended contract shall be considered to include this option clause. (c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 48 (months). (End of Clause) FAR 52.237-7, Indemnification and Medical Liability Insurance. (a) It is expressly agreed and understood that this is a non-personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor's professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence: *_________________. (b) An apparently successful offeror, upon request by the Contracting Officer, shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (a) of this clause. (c) Liability insurance may be on either an occurrences basis or on a claims-made basis. If the policy is on a claims-made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided. (d) Evidence of insurance documenting the required coverage for each health care provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims-made basis and evidence of an extended reporting endorsement is not provided prior to the commencement of services, evidence of such endorsement shall be provided to the Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended reporting endorsement is provided to the Contracting Officer. (e) The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the Government's interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If, during the performance period of the contract the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause, for the entire period of the contract, either under the new policy, or a combination of old and new policies. (f) The Contractor shall insert the substance of this clause, including this paragraph (f), in all subcontracts under this contract for health care services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer evidence of such insurance. (End of Clause) FAR 52.252-1 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/ DFARS 252.232-7006, Wide Area Workflow Payment Instructions (a) Definitions. As used in this clause- "Department of Defense Activity Address Code (DoDAAC)" is a six position code that uniquely identifies a unit, activity, or organization. "Document type" means the type of payment request or receiving report available for creation in Wide Area Workflow (WAWF). "Local processing office (LPO)" is the office responsible for payment certification when payment certification is done external to the entitlement system. "Payment request" and "receiving report" are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports. (b) Electronic invoicing. The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (DFARS) 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports. (c) WAWF access. To access WAWF, the Contractor shall- (1) Have a designated electronic business point of contact in the System for Award Management at https://www.sam.gov ; and (2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site. (d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the "Web Based Training" link on the WAWF home page at https://wawf.eb.mil/ (e) WAWF methods of document submission. Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol. (f) WAWF payment instructions. The Contractor shall use the following information when submitting payment requests and receiving reports in WAWF for this contract or task or delivery order: (1) Document type. The Contractor shall submit payment requests using the following document type(s): (i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher. (ii) For fixed price line items- (A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer. ___________________________________________________________ (Contracting Officer: Insert applicable invoice and receiving report document type(s) for fixed price line items that require shipment of a deliverable.) (B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer. ___________________________________________________________ (Contracting Officer: Insert either "Invoice 2in1" or the applicable invoice and receiving report document type(s) for fixed price line items for services.) (iii) For customary progress payments based on costs incurred, submit a progress payment request. (iv) For performance based payments, submit a performance based payment request. (v) For commercial item financing, submit a commercial item financing request. (2) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract. (f) [Note: The Contractor may use a WAWF "combo" document type to create some combinations of invoice and receiving report in one step.] (3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system. Routing Data Table* Field Name in WAWF Data to be entered in WAWF Pay Official DoDAAC HQ0248 Issue By DoDAAC N62645 Admin DoDAAC N62645 Inspect By DoDAAC N/A Ship To Code N/A Ship From Code N/A Mark For Code N/A Service Approver (DoDAAC) N/A Service Acceptor (DoDAAC) N32626 Accept at Other DoDAAC N/A LPO DoDAAC N32626 DCAA Auditor DoDAAC N/A Other DoDAAC(s) N/A (*Contracting Officer: Insert applicable DoDAAC information. If multiple ship to/acceptance locations apply, insert "See Schedule" or "Not applicable.") (**Contracting Officer: If the contract provides for progress payments or performance-based payments, insert the DoDAAC for the contract administration office assigned the functions under FAR 42.302(a) (13).) (4) Payment request. The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable. (5) Receiving report. The Contractor shall ensure a receiving report meets the requirements of DFARS Appendix F. WAWF Acceptor/COR email address: lee.m.digiovanni.civ@mail.mil WAWF point of contact: UNS.detrick.navmedlogcomftdmd.list.nmlc-wawf@mail.mil (1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact. N/A___________________________________________________________ (Contracting Officer: Insert applicable information or "Not applicable.") (2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed. (End of clause) CONTRACTOR SUPPORT NOTICE: NAVY USE OF SUPPORT CONTRACTOR FOR CONTRACT CLOSEOUT FUNCTIONS: Naval Medical Logistics Command uses two private contractors in support of the contract closeout process. Those companies are Contracting Resources Group (CRG) of Federal Hill, MD, doing business under the authority of the Small Business Administration's 8(a) program, and the Ability One Program, doing business under the authority of the Javits-Wagner O'Day Act (41 U.S.C. § 47). The contract closeout process includes activities such as processing DE obligation modifications, obtaining contractor and requiring activity concurrence, preparing the DD-Form 1594 (Contract Completion Statement), and preparing closed files for archiving. Support contractors may perform additional administrative duties, including filing and processing simple administrative modifications. Performing these functions require the contractor employees to have access to the contract file. Therefore, information you provide to the Government or information already in the possession of the Government may be viewed by these support contractors in the course of performing contract close-out functions. The information that may be made available to the contractor may include pricing and technical proposals and performance information. NMLC has signed Non-Disclosure Agreements with each support contractor employee and has required both contractors to provide a Conflict of interest Mitigation Plan to ensure these employees are firewalled from all business development activity. By submission of a proposal in response to this solicitation, the offeror and its subcontractors consent to access of their business sensitive/confidential or proprietary data by the Government's support contractor personnel in order to perform close out services. Added: <input type="hidden" name="dnf_class_values[procurement_notice][description][1][added_on]" value="2019-08-19 09:03:40">Aug 19, 2019 9:03 am Modified: <input type="hidden" name="dnf_class_values[procurement_notice][description][1][modified_on]" value="2019-09-04 16:03:27">Sep 04, 2019 4:03 pm Track Changes Amendment to the Solicitation: 1 - The mileage in Section 1.1 of the PWS was increased from 10 miles to 20 miles. 2- Volume IIF was amended to extend the proposal due date to 27 August 2019 NLT 10:00 AM Est. In addition, Qustions about this RFQ should be submitted before 22 August 2019 by NLT 4:00 PM Est. 3- Volume IIA was also amended to reflect that the government will look favorably at vendors with close proximity to the Navy Yard. Please see the Amendment/changes below: Solicitation N6264519Q0029 __________________________________________________________________________________ This is a combined synopsis/solicitation for commercial items prepared in accordance with FAR 12.6, Streamlined Procedures for Commercial Items, and FAR 13.5 Simplified procedures for certain commercial items. This announcement constitutes the only solicitation. A written Combined /Synopsis solicitation on an SF1449 will not be issued. The solicitation number is N6264519Q0029. The solicitation is issued as a request for quotes (RFQ). Provisions and clauses in effect through Federal Acquisition Circular 2005-98 are incorporated. It is the contractor's responsibility to be familiar with the applicable clauses and provisions. The clauses may be accessed in full text at these addresses: http://acquisition.gov/far. The NAICS code is 621512, with a small business size of $15.0 mil. The services will be posted on the GPE as a Full and Open requirement. This is a solicitation for quotes. The Naval Medical Logistics Command intends on awarding a single Stand Alone contract as a result of this solicitation in support of the Philadelphia Navy Yard Occupational Health Clinic (PNY-OHC) Philadelphia, PA. PERFORMANCE WORK STATEMENT RADIOLOGY - X-RAY SERVICES AND INTERPRETATION FOR PHILADELPHIA NAVY YARD - OCCUPATIONAL HEALTH CLINIC (PNY - OHC) 1. DESCRIPTION OF SERVICES. 1.1. SCOPE OF WORK. The contractor shall provide non-digital, chest x-ray services, to include interpretation of films at the contractor's facility, in support of the Philadelphia Navy Yard - Occupational Health Clinic (PNY-OHC), Building 615, Philadelphia, PA. The contractor's x-ray facility shall be within a 20-mile radius from 4898 Broad St, Building 615, PNY-OHC, Philadelphia, PA. 1.1.1. The contractor shall provide chest x-rays as follows: a 14x17 posterior/anterior (P/A) chest x-ray. Additional views (14x17 Lateral and /or Oblique) may be required for follow-up purposes. PNY-OHC currently has no accommodation for mobile x-ray trailers. 1.1.2. The chest x-rays and interpretation of films are for use in medical surveillance programs, including the Navy Asbestos Medical Surveillance Program (AMSP). Chest x-rays taken for the Navy AMSP must be submitted for B readings. The PNY-OHC clinic will be responsible for mailing the films to the B readers. Pre-labeled x-ray jackets with previous films provided to the contractor for comparison purposes shall be returned to the PNY-OHC Occupational Medicine Clinic in a separate package with the AMSP x-rays. 1.1.3. Contractor services shall include the following: 1.1.3.1. Provide x-rays and perform interpretation via written report of x-ray films. 1.2. The contractor shall provide services between the hours of 0730 and 1530, Monday through Friday, excluding Federal holidays, on a scheduled basis. The contractor shall also provide services for a group of employees approximately once per week, not to exceed eight times per month. The PNY-OHC will schedule visits at least four weeks in advance. 1.3. INDEPENDENT CONTRACTOR. The services rendered by the Contractor are rendered in the capacity of an independent Contractor. The Government will evaluate the quality of services for purposes of contract inspection and acceptance. The Contractor shall be solely responsible for any and all liability caused by the acts or omissions of its agents or employees. The Contractor shall not in any manner represent or infer that it is an instrumentality or agent of the United States Government. The Contractor shall recognize that the Commander maintains administrative and operational responsibility for all activities within the Command and may take such actions as necessary to preserve and maintain the integrity of the Command, subject to the limitations prescribed by law and U.S. Navy Regulations. The Government may evaluate the quality of professional services provided, but retains no control over the medical, professional aspects of services rendered (e.g. professional judgements, diagnosis for a specific medical treatment). The vendor indemnifies the Government for any liability producing act or omission by the contractor, its employees and agents during contract performance. 1.4. MODIFICATIONS. The Contracting Officer will designate and authorize an individual to act as the Contracting Officer's Representative (COR). Any such representative appointed will be specifically designated by letter from the Contracting Officer. The COR exclusively represents the Contracting Officer in all technical phases of the work, but is not authorized to issue Change Orders, Supplemental Agreements, or direct any contract performance requiring contractual modification or adjustment. Changes in the scope of work can only be made by modification properly executed by the Contracting Officer. All observations made by persons other than the Contracting Officer or the COR are strictly advisory and shall not influence the Contractor's operations except for administrative requirements and responsibilities specified herein. 1.5. BACKGROUND INFORMATION. This is a non-personal services contract covering a professional discipline. Contracting has been chosen as a strategy to permit expansion of the capacity of DOD facilities by overcoming shortfalls in the numbers of and support personnel. 1.6. QUALITY OF SERVICE. The services specified in this work statement shall be performed in accordance with established principles and ethics of the healthcare profession. The Contractor shall comply with applicable provisions of law and the rules and regulations of any and all Governmental authorities and the regulations and standards of the MTF. The Contractor shall adhere to and comply with all Department of Navy (DON), Bureau of Medicine and Surgery (BUMED) and MTF Instructions and notices which may be in effect during the term of the contract. 2. GOVERNMENT FURNISHED ITEMS. 2.1. Publications and Forms. The Government will furnish all forms and publications required for the contract. The Contractor is required to comply with various instructions, directives and regulations covering routine administrative, safety and security matters in the same manner as other members of the staff. Such compliance does not constitute a material expense to the contract. 3. CONTRACTOR FURNISHED ITEMS. 3.1. Supplies. The Contractor shall furnish all supplies, equipment, and personnel, except those listed as Government-furnished, required to perform the services described in this contract. 3.2. Insurance. The Contractor shall comply with applicable provisions of the Federal Acquisition Regulations (FAR) 52.237-7, Indemnification and Medical Liability Insurance. 3.2.1. The Contractor shall comply with applicable State workers' compensation insurance laws. 3.2.2. The contractor is required to ensure that its subcontracts for provisions of the services herein contain the requirements of FAR 52.237-7 3.3. The Contractor shall provide a completed Malpractice Insurance Certification Form, see Attachment 4 to the COR annually during the term of this contract. 4. RESERVED 4.1. RESERVED 5. SPECIFIC DUTIES. 5.1. General. The contractor shall provide non-digital, chest x-ray services, to include interpretation of films at the contractor's facility, in support of the PNY-OHC. The chest x-rays and interpretation of films are for use in medical surveillance programs, including the Navy Asbestos Medical Surveillance Program (AMSP). 5.2. The Government will provide the contractor with a request form. Each employee will return to the clinic with verification of completed procedures (signed/initialed by contractor representative); see Attachment 3. The clinic will also provide the contractor with x-ray jackets for each employee (patient) with pre-labeled patient information and any past x-rays for purposes of comparison. 5.3. The Contractor shall provide a package containing final written x-ray interpretation to the PNY-OHC within five (5) working days. 5.4. The contractor shall file chest x-rays performed for physical exams (non-asbestos program) in a provided labeled jacket. The contractor will also record the date and type of x-ray on the outside of the jacket, and place a copy of the x-ray interpretation into the x-ray jacket. The jackets (with films) will be returned to the PNY-OHC clinic within 5 working days. 5.5. REPORTING REQUIREMENTS. 5.5.1. The contractor shall comply with reporting requirements as outlined in Attachment I. 6. PERSONNEL QUALIFICATIONS. Personnel performing services under this contract shall possess the minimum personnel requirements, as follows: 6.1. Be a graduate from a medical school approved by the Liaison Committee on Medical Education of the American Medical Association or the American Osteopathic Association or certification by the Educational Council for Foreign Medical Graduates (ECFMG). 6.2. Have successful completion of a residency program in radiology which has been approved by the Accreditation Council for Graduate Medical Education or the Committee on Postdoctoral Training of the American Osteopathic Association or those Canadian training programs approved by the Royal College of Physicians and Surgeons of Canada or other appropriate Canadian medical authority. 6.3. Possess a current, valid, and unrestricted medical license in the State of Pennsylvania. 6.4. Possess current board certification in Radiology. 6.5 Credentialing. The Contractor shall demonstrate and provide documentary evidence annually that radiologists performing under this contract are fully credentialed and privileged in accordance with Joint Commission standards. The contract radiologists are performing services off-site at the contactor's facility and are credentialed and privileged "by proxy". 6.6 STANDARDS AND CONFLICT OF INTEREST. 6.6.1. The Contractor shall provide adequate oversight and supervision of contractor staff activities. 6.6.2. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel and/or technical data which is furnished, produced or otherwise available to the Contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract nor be released by the Contractor without prior written consent of the Government, via the COR. Any presentation of any statistical or analytical materials, or any reports based on information obtained from the studies covered by this contract, will be subject to review and approval by the Government, via the COR, before publication or dissemination. 6.6.3. The Contractor shall not hire any employee for performance under this contract whose employment would result in a conflict with Government or Navy Standards of Conduct (SECNAVINST 5370.2 (latest revision)). Except in very limited cases, the federal criminal statutes at 18 USC 203 and 18 USC 205 bar Government personnel, both active duty and civil service, from working as a contractor employee in a Government workplace, including a medical treatment facility, either as a second job ("moonlighting") or while on terminal leave. The contractor agrees that, before making an employment offer to an active duty member or a civil servant, it shall inform the individual of the potential applicability of these statutes and further agrees to encourage that individual to seek an advisory opinion from his/her local ethics counsel before accepting an employment offer. In addition, without the prior written approval of the contracting officer, the contractor shall not use in the performance of this contract any persons currently performing medical or dental services under other Navy contracts. 6.6.4. The Contractor or Contractor employees shall not bill personnel entitled to care for services rendered. 6.6.5. The Contractor or Contractor employees shall not, while performing services under this contract, advice, recommend, or suggest to persons eligible to receive medical care at Government expense that such persons should receive care from the Contractor or Contractor employees. 7. MISCELLANEOUS PROVISIONS. 7.1. The Contractor shall be responsible for payment of all wages and salaries, taxes, withholding payments, penalties, fees, fringe benefits, professional liability insurance premiums, contributions to insurance and pension or other deferred compensation plans including, but not limited to, Workers' Compensation and Social Security obligations, licensing fees, etc., and the filing of all necessary documents, forms and returns pertinent to all of the foregoing. The Contractor shall indemnify and hold the Government harmless from and against any and all claims by Contractor employees for the payment or filing of any of the foregoing compensation. The Contractor agrees to pay all applicable federal, State, and local income taxes, including any and all other Governmental fees, taxes, or expenses levied against it. 7.2. Government Access to Patients. For the purpose of gathering data relative to satisfaction of the goals and objectives of contracting for health services within the Navy Medical Department (for example, containment of TRICARE/CHAMPUS costs, gathering patient demographic data, etc.), the Government may exercise its right to conduct brief exit interviews with patients. These interviews are separate and distinct from the Government's responsibilities for quality assurance is strictly informational, and are referenced in Section E, "Inspection and Acceptance." The Government will make every attempt to prospectively inform the Contractor of these interviews. 7.3. Government quality assurance. Contract performance will be surveyed to determine if it meets the contract standards. A variety of surveillance methods may be used. The method of surveillance may be modified to meet the needs of the customers and the performance if the contractor. See the Performance Requirements Summary at Attachment 1. 7.4. Electronic data security. The contractor shall ensure that all data transmitted via disk or e-mail is virus free. Deliverables submitted is electronic format, shall have the contract number and type identified in the subject field of the e-mail. 7.5. HIPAA. The Contractor shall comply with the Health Insurance Portability and Accountability Act (HIPAA) privacy and security regulations as specified in Attachment II (a). 7. 6. Government ownership of deliverables. The government obtains the rights to all documentation, reports, forms, or other electronic or paper records developed under this contract. 7.7 ECMRA The contractor shall report contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Radiology Services via a secure data collection site. Contracted services excluded from reporting are based on Product Service Codes (PSCs). The excluded PSCs are: (1) W, Lease/Rental of Equipment; (2) X, Lease/Rental of Facilities; (3) Y, Construction of Structures and Facilities; (4) S, Utilities ONLY; (5) V, Freight and Shipping ONLY. The contractor is required to completely fill in all required data fields using the following web address https://doncmra.nmci.navy.mil. Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. Contractors may direct questions to the help desk, linked at https://www.ecmra.mil/Default.aspx ADMINISTRATIVE INFORMATION The point of contact for administrative concerns for this requirement at Naval Medical Logistics Command, 693 Neiman Street, Fort Detrick, MD 21702 is Curtis E. Cardoza curtis.e.cardoza.civ@mail.mil. The Contracting Officer hereby designates the following individual as Contracting Officer's Representative(s) (COR) for this contract: NAME (To Be Determined) TBD MAIL ADDRESS Naval Health Clinic Annapolis 250 Wood Rd Annapolis, MD E-MAIL TBD TELEPHONE NUMBER TBD SERVICES All services are included in contractprice. LIST OF SERVICES AND PRICING SHEET: ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001AA 300 Each Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001AB 40 Each Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001AC 10 Each Posterior/Anterior AND Obliques Three Views, 14X17 ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1001AA 330 Each OPTION Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1001AB 44 Each OPTION Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 1001AC 11 Each OPTION Posterior/Anterior AND Obliques Three Views, 14X17 ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2001AA 363 Each OPTION Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2001AB 48 Each OPTION Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 2001AC 12 Each OPTION Posterior/Anterior AND Obliques Three Views, 14X17 ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 3001AA 399 Each OPTION Posterior AND Anterior One View, 14X17 P/A Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 3001AB 53 Each OPTION Posterior/Anterior AND Lateral Two Views, 14X17 Chest X-ray ITEM NO SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 3001AC 13 Each OPTION Posterior/Anterior AND Obliques Three Views, 14X17 LIST OF ATTACHMENTS ATTACHMENT I - Quality Assurance Surveillance Plan (QASP) ATTACHMENT I (a) - Contractor Discrepancy Report (CDR) ATTACHMENT II - HIPAA ATTACHMENT II (a) - HIPPA Business Associate Agreement ATTACHMENT III - Sample Patient Form ATTACHMENT IV - Malpractice Insurance Form ATTACHMENT V - Contract Administration Plan ATTACHMENT VI - Corporate Experience and Past Performance Form ATTACHMENT VII - FAR Part 52.209-11 ( Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law) ATTACHMENT VIII - Pricing Sheet ATTACHMENT I - Quality Assurance Surveillance Plan (QASP) P u rpo s e : T o e nsu r e t h at t h e G o v e r n m e n t h as an e ff ecti v e a n d s y ste m atic m et h o d o f s u r v eilla n ce f o r t h e s e r v ices in t h e PW S. T h e Q A SP w ill b e us ed pr i m a r ily as a t oo l to v e r i f y t h at t h e c o n t r act o r is p e r f or m i n g all s e r v ices r e q u i r ed by t h e PW S in a ti m el y, acc u rate a n d co m plete f a sh io n. 1. C ritical per f or m a n ce proce ss es a n d req u ire m e n t s. C r iti ca l to t h e per f or m a n c e o f x -r ay s e r v i ce s in su pport o f P N B C is t h e ti m el y, acc u rate a n d t h o r o ug h c o m p leti o n o f all c o n tract/task ord er r e q u ire m e n ts. 2. Per f or m a n ce Sta n dards a. Sc h ed u le - T h e d u e d ates f o r d eli v erables a n d t h e act u al acco m p li sh m e n t o f t h e s c h ed u le w ill be assessed a g ai n st or i g i n al d u e d ates a n d m ilest o n es esta b lis h ed f o r t h e c o n t r act o r task ord e r( s ). b. Deli v e r a b les - T h e d eli v e r a b les r e q u i r ed to b e su b m itted w ill b e assessed a g ai n st t h e s p eci f icati o n s f o r t h e d eli v e r a b les d etailed in t h e c o n t r act/task ord e r( s) a n d t h e Contract Administrative P lan ( CAP ), if r e q u i r ed b y t h e c o n tract, f o r t h e r e q u ired c o n te n t, q u alit y, ti m eli n ess, a n d acc u rac y. c. P a s t P e r f o r m a n ce - I n a dd iti o n to a n y sc h e d u le, d eli v e r a b les, a n d c o s t as p ects o f p e r f or m a n ce d i s c uss ed a bo v e, p u r su a n t to F A R 42.15, t h e G o v er n m e n t w ill a ss e s s t h e c o n t rac t or ' s recor d o f co n f or m i n g to co n t rac t req u ire m e n t s a n d to s ta n dard s o f g oo d w or k m a nsh i p, t h e c o n tractor ' s ad h e re n ce to c o n trac t s c h e d u les i n c l u d i n g t h e ad m i n i s t ra ti v e a s pec ts o f per f or m a n ce, t h e c o n t rac t or ' s h i s t or y o f rea s o n ab le a n d c oopera ti v e be h a v i o r a n d co mm it m e n t to c us to m er s ati s f actio n, a n d t h e co n tractor ' s b us i n e ss - li k e co n cern f or t h e i n tere s t o f t h e c us to m er. 3. S u r v eilla n ce m et h od s : T h e pr i m a r y m et h od s o f s u r v eilla n ce u sed to m o n it o r p e r f or m a n ce o f t h is c o n t r act w ill i n c l u de, b u t n o t b e li m ited t o, ra n do m o r p l a nn ed s a m p li ng, per i od ic o r i ns pec ti o n, a n d v a li da t e d c us t o m er c o m p lai n ts. 4. P e r f or m a n ce Mea su re m e n t : P er f o r m a n ce w ill be m ea su r ed in accorda n ce w ith t h e f ollo w i n g table: Per f or m a n c e Ele m e n t Per f or m a n c e R e qu ire m e n t Su r v eilla n c e M e th o d F re qu e n c y A cce pt a b l e Q u ali t y Le v el C o nt r act o r Q ua l ity C o nt ro l Pl a n Q C acti v iti e s, in s p e cti o n s, an d c orr e cti v e acti o ns c o m p l e t e d a s r e qui r e d b y th e (CAP) I n s p e cti o n b y th e C O R Q ua r t e rl y fo r over a ll Q C acti v iti e s; A s R e qui r e d fo r c orr e cti v e acti o n s. 100 % C o m p l iance w it h th e c o nt r act o r p l an. C o nt r act D e l i v e r ab l e s C o nt r ac t d e l i v e r ab l e s f u r ni s h e d a s p r e s c r ib e d i n th e P W S, CAP, attach m e nt s, C D R L s, T a sk Or d e r s, e tc., a s app l icab l e. I n s p e cti o n b y th e C O R 100 % in s p e cti o n o f a l l c o nt r ac t d e l i v e r ab l e s. >95 % o f d e l i v e r ab l e s s ub m itt e d ti m e l y an d w ith o u t re w ork r e qui r e d. Ov e r a l l C o nt r act P e rform anc e Ov e r a l l c o nt r act p e rform anc e o f s u ff ici e n t qua l it y t o e a r n a S ati s f act or y (o r hi g h er) r atin g i n th e C O R ' s annual r e p or t o n C o nt r act or P e rform anc e A ss e ssm e n t b y th e C O R A nnual A l l p e rfor m ance ele m e nt s r at e d S ati s f act or y (or hi g h e r ) I n vo icing M o nth l y in vo ic e s p e r c o nt r ac t p ro c e du r e s a r e ti m el y an d accu r at e. R e v i e w & acc e ptanc e o f th e in vo ic e M o nth l y 100 % accu r acy If per f or m a n ce is w it h in acceptable le v el s, it w ill be co ns idered to be s ati s f actor y. If n o t, o v erall p er f o r m a n ce m ay be co ns idered uns ati s f actor y. I n ce n ti v es/Disi n ce n ti v es: T h e C O R s m a k es an a nnu al r e por t o n C o n t r act o r P e r f or m a n ce ( C P A R S o r o t h er a nnu al r e por t ). T h e c o n t r act or 's f a ilu r e t o ac hi e v e s a tisf act or y p e r f or m a n ce un d er th e c o nt r ac t/t a s k ord e r, r e fl ected i n th e COR' s a nnu al r e por t, m ay r es u lt in te r m i n ati o n o f t h e c o n t r act/task ord er a n d m ay also r es u lt in t h e l o ss o f f u t u r e G o v e r n m e n t c o n t r acts/task ord e r s. T h e c o n t r act or ' s f ail u r e to ac h ie v e satis f act or y p e r f or m a n ce un d er t h e c o n t r act/task ord er m ay r es u lt in t h e n o n - e x erci s e of a v ailable optio n s For each item t h at does n ot m eet acceptable le v el s, t h e Go v er n m e n t m ay i ssu e a C o n tract Di s crepa n cy R eport ( C DR ). CDRs w ill b e f or w a rd ed to t h e C o n t r acti n g O ff icer w ith a c op y se n t to t h e c o n t r act or. T h e c o n t r act o r m u st re p ly in w riti n g w it h in 5 d a y s o f r ecei p t i d e n ti f y i n g h o w f u t u r e o cc u rre n ces o f t h e p r ob lem w ill b e pr e v e n te d. B ased u po n t h e c o n t rac t or ' s pa s t per f or m a n ce a n d p l a n to s o l v e t h e prob l e m, t h e C o n t rac ti n g O ff i ce r w ill de te r m i n e if a n y f u r t h er acti o n w ill b e ta k e n. In accorda n ce w ith t h e i ns pection o f s er v ices pro v i s io n s of t h e co n tract, t h e co n tractor w ill be i n ce n ti v ized to pro v ide q u ality prod u cts in a ti m ely m a nn er s i n ce t h e G o v e r n m e n t can r e q u i r e t h e C o n t r act or, at n o a dd iti o n al c o s t, to replace or correct w o rk t h at f ails to m eet co n tract req u ire m e n t s. CONTRACT DISCREPANCY REPORT 1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY 3. TO (Contractor and Manager's Name) 4. FROM (Name of QAE) 5. DATES (YYYYMMDD) a. PREPARED b. RETURNED BY CONTRACTOR c. ACTION COMPLETE 6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.) 7. SIGNATURE OF CONTRACTING OFFICER 8a. TO (Contracting Officer) b. FROM (Contractor) 9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable Q.C. program procedures or new Q.C. procedures. Attach continuation sheet(s) if necessary.) 10. SIGNATURE OF CONTRACTOR REPRESENTATIVE b. DATE (YYYYMMDD) 11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary) 12. GOVERNMENT ACTIONS (Reduced payment, cure notice, show cause, other) 13. CLOSE OUT NAME (1) TITLE (2) SIGNATURE (3) DATE (YYYYMMDD) (4) a. CONTRACTOR NOTIFIED b. QAE c. ACO ATTACHMENT I (a) - CONTRACTOR DISCREPANCY REPORT (CDR) ATTACHMENT II - HIPAA P R I V A C Y A ND S E C U R I T Y OF P R O T E C T E D H E AL T H I NFO R M A T I ON (Ma y 2005) (a) De f i n itio ns. A s us ed in t h is cla us e: I n di v id u al h as t h e s a m e m ea n i n g as t h e term '' i n d i v id u al ' ' in 45 C FR 164.501 a n d 164.103 a n d sh all i n cl u d e a p er s o n w h o q u ali f ies as a per s o n al repre s e n tati v e in accorda n ce w ith 45 C FR 164.502( g ).Pr i v ac y Ru le m ea n s t h e St a n dard s f o r Pr i v ac y o f I n d i v i d u a lly Ide n ti f ia b le H ea lth I n f or m a ti o n at 4 5 C FR par t 16 0 a n d par t 164, su bpar ts A a n d E. P ro t ec t e d H ea lth I n f or m a ti o n h a s t h e s a m e m ea n i n g as t h e te r m '' pro t ec t ed h ealt h i n f or m atio n ' ' in 4 5 C FR 164.501, li m ite d to t h e i n f or m atio n c reate d o r recei v ed b y T h e C o n t racto r f ro m o r on be h alf of T h e Go v er n m e n t. R eq u ired by L aw h as t h e s a m e m ea n i n g as t h e term '' r eq u ired b y la w ' ' in 45 C FR 164.50 1 a n d 164.103. S ecre t ar y m ea n s t h e S ecre t ar y o f t h e De par t m e n t o f H ea lth a n d H u m a n Se r v i ce s o r h i s / h er de s i gn ee. S ec u r ity Ru le m ea n s t h e H ea lth I nsu ra n ce R e f or m : S ec u r ity St a n dard s at 4 5 C FR par t 160, 16 2 a n d part 164, su bpar t C. T e r m s us e d, b u t n o t o t h e r w i s e de f i n ed, in t h is A g ree m e n t sh all h a v e t h e s a m e m ea n i n g as t h o s e te r m s in 4 5 C FR 160.103, 164.50 1 a n d 164.304. (b ) T h e C o n t r act o r a g r ees to n o t u se o r f u r t h er d iscl o s e P ro tected Health I n f or m ati o n o t h er t h an as p e r m itted o r req u i re d b y t h e C o n t rac t o r a s R e q u i re d b y L a w. ( c) T h e C o n t r act o r a g r ees to us e a ppropr iate s a f e gu a rd s to pr e v e n t us e o r d i s cl o su r e o f t h e P ro tected Health I n f o r m ation o t h er t h an as pro v ided f o r b y t h is C o n tract. (d) T h e C o n tractor a g rees to us e ad m i n i s trati v e, p h y s ical, a n d tec hn ical s a f e gu ards t h at r ea s o n ably a n d appropriately pro tect t h e c o n f i d e n tialit y, i n te g r it y, a n d a v aila b ility o f t h e elect ro n ic pro tected h ealth i n f or m ati o n t h at it c r eates, recei v e s, m ai n tai ns, or tra ns m its in t h e e x ec u tion o f t h is C o n tract. ( e) T h e C o n t r act o r a g r ees to m iti g ate, to t h e e x te n t pr actica b le, a n y h a r m f u l e ff ect t h at is kn o w n to t h e C o n t r act o r o f a u se o r d iscl o s u r e o f P ro tected Health I n f or m ati o n b y t h e C o n t r act o r in v i o lati o n o f t h e r e q u i r e m e n ts o f t h is C o n tract. ( f ) T h e C o n tractor a g rees to report to t h e Go v er n m e n t a n y s ec u rity i n cide n t i nv o l v i n g p rotected h ealth i n f o r m ation o f w h ich it b ec o m es a w a r e. ( g ) T h e C o n t racto r a g ree s t o repor t to t h e Go v e r n m e n t a n y us e o r di s c lo su r e o f t h e P rotecte d Healt h I n f or m atio n n ot pro v i de d f o r b y t h is C o n t rac t. ( h ) T h e C o n tractor a g rees to e nsu re t h at a n y a g e n t, i n cl u di n g a su b co n tractor, to w h o m it p ro v ides P rotected Health I n f or m atio n recei v ed f ro m, o r create d o r recei v ed b y t h e C o n t racto r o n be h a l f o f t h e G o v er n m e n t a g ree s t o t h e s a m e r est r icti o n s a n d c o n d iti o n s t h at a pp ly t h ro ug h t h is C o n t r act to t h e C o n t r act o r w ith r es p ect to s u ch i n f or m ati o n. (i) T h e C o n tractor a g rees to e nsu re t h at a n y a g e n t, i n cl u di n g a su b co n tractor, to w h o m it p ro v ides electro n ic P r otected Health I n f o r m atio n, a g rees to i m ple m e n t r ea s o n able a n d appropriate s a f e gu ards to p rotect it. ( j ) T h e C o n tractor a g rees to pro v ide acce ss, at t h e r eq u e s t of t h e Go v er n m e n t, a n d in t h e ti m e a n d m a nn er d e s i gn ated by t h e Go v er n m e n t to P rotected Health I n f o r m ation in a De s i gn ated R ecord Set, to t h e Go v er n m e n t o r, as directed by t h e Go v er n m e n t, to an I n di v id u al in order to m eet t h e r eq u ire m e n ts un de r 4 5 C FR 164.524. ( k ) T h e C o n tractor a g rees to m a k e a n y a m e n d m e n t( s ) to P rotected Health I n f o r m ation in a De s i gn ated R ecord Set t h a t t h e G o v er n m e n t d i rec ts o r a g ree s to p u r su a n t to 4 5 C FR 164.52 6 a t t h e req u e s t o f t h e G o v er n m e n t o r an I n d i v i d u al, a n d in t h e ti m e a n d m a nn er d e s i gn ated b y t h e G o v e r n m e n t. ( l) T h e C o n t rac t o r a g ree s to m a k e i n te r n a l prac ti ce s, boo ks, a n d record s re l a ti n g to t h e us e a n d d i s cl o su r e of P rotecte d Healt h I n f or m atio n recei v ed f ro m, o r create d o r recei v ed b y t h e C o n t racto r o n be h a l f o f, t h e Go v e r n m e n t, a v aila b le to t h e G o v e r n m e n t, o r at t h e r e q u e s t o f t h e G o v e r n m e n t to t h e Sec r eta r y, in a ti m e a n d m a nn er d e s i gn ated b y t h e Go v er n m e n t or t h e Secretar y, f o r p u r po s es of t h e Secretary d eter m i n i n g t h e G o v e r n m e n t ' s c o m p lia n ce w ith t h e P r i v acy R u le. ( m ) T h e C o n tractor a g rees to doc u m e n t su ch d i s clo su r es of P r otected Health I n f o r m ation a n d i n f o r m ation r elated to su c h di s c lo su re s as w o u l d b e req u ire d f o r t h e Go v e r n m e n t t o re s po n d to a req u e s t b y an I n di v id u al f o r a n acco un ti n g of di s clo su res o f P rotected Health I n f o r m ation in accorda n ce w ith 45 C FR 164.528. ( n ) T h e C o n t r act o r a g r ees to pro v i d e to t h e G o v e r n m e n t o r an I n d i v i d u al, in ti m e a n d m a nn er d e s i gn ated b y t he Go v er n m e n t, i n f or m ation collected in accorda n ce w ith t h is C la us e of t h e C o n tract, to p er m it t h e Go v er n m e n t to re s po n d to a req u e s t b y an I n d i v id u al f or an acco un ti n g o f d i s clo su r es of P r otected Health I n f or m atio n in accorda n c e w it h 4 5 C FR 164.528. Ge n e r al U s e a n d Di s cl o su r e P ro v i s i o n s E x ce p t as o t h e r w ise li m ited in t h is A g r ee m e n t, t h e C o n t r act o r m ay u se o r d iscl o se P ro tected Health I n f or m ati o n o n be h alf o f, o r to pro v i d e s e r v i ce s t o, t h e G o v e r n m e n t f o r t h e f o ll o w i n g p u rpo s e s, if su ch us e o r d i s cl o su r e o f Pro t ec t ed Health I n f or m ati o n w o u ld n o t v i o late t h e P r i v acy R u le, t h e Sec u r ity R u le o r t h e De p a r t m e n t o f De f e ns e Health I nf or m ati o n P r i v acy R e gu lati o n if do n e b y t h e G o v e r n m e n t: [ L i s t P u rpo s e s ]. Speci f ic U s e a n d D i s clo su r e P ro v i s i o n s: ( a) E x ce p t as o t h e r w ise li m ited in t h is A g r ee m e n t, t h e C o n t r act o r m ay u se P ro tected Health I n f or m ati o n f o r t h e prop er m a n a g e m e n t a n d a d m i n ist r ati o n o f t h e C o n t r act o r o r to ca rr y o u t t h e le g al r es po n si b ilities o f t h e C o n t r act or. (b ) E x ce p t as o t h e r w ise li m ited in t h is A g r ee m e n t, t h e C o n t r act o r m ay d iscl o s e P ro tected Health I n f or m ati o n f o r t h e prope r m a n a g e m e n t a n d ad m i n i s t ratio n o f t h e C o n t ractor, pro v i de d t h at di s clo su re s ar e req u i re d b y l a w, o r t h e C o n t racto r obtai n s rea s o n abl e a ssu ra n ce s f ro m t h e per s o n to w h o m t h e i n f or m ati o n is d iscl o s ed t h at it w ill r e m ain c o n f i d e n tial a n d us ed o r f u r t h er d iscl o s ed o n ly as r e q u i r ed b y law o r f o r t h e p u rpo s e f o r w h ich it w a s d i s cl o s ed to t h e per s o n, a n d t h e per s o n n o ti f ies t h e C o n t rac t o r o f a n y i ns ta n ce s o f w h ich it is a w are in w h ich t h e c o n f i d e n tiality o f t h e i n f or m ati o n h as b een br eac h e d. (c) E x cept as o t h er w i s e li m ited in t h is A g r ee m e n t, t h e C o n tractor m ay us e P r otected Health I n f o r m ation to p ro v ide data A gg r e g ation s er v ices to t h e Go v er n m e n t as p er m itted b y 4 5 C FR 164.504(e)(2)(i)( B ). (d ) C o n t r act o r m ay u se P ro tected Health I n f or m ati o n to r e por t v i o lati o n s o f law to a ppropr iate Fe d e r al a n d State a u t h oritie s, co ns i s te n t w it h 4 5 C FR 164.502( j ) (1). O b li g ati o n s o f t h e G o v e r n m e n t, P ro v isi o n s f o r t h e G o v e r n m e n t to I n f or m t h e C o n t r act o r o f P r i v acy P r actices a n d R est r icti o n s ( a) U po n r e q u est t h e G o v e r n m e n t s h all pro v i d e t h e C o n t r act o r w ith t h e n o tice o f pr i v acy pr actices t h at t h e Go v e r n m e n t prod u ce s i n accorda n c e w it h 4 5 C FR 164.520, a s w e l l a s a n y c h a ng es to su ch n otice. (b ) T h e G o v e r n m e n t sh all pro v i d e t h e C o n t r act o r w ith a n y c h a ng es i n, o r r e v o cati o n o f, p e r m i ss i o n b y I n d i v i d u al to us e o r d iscl o s e P ro tected Health I n f or m ati o n, if s u ch c h a ng es a ff ect t h e C o n t r act or ' s p e r m itted o r r e q u i r ed u ses a n d d i s c l o su r e s. (c) T h e Go v er n m e n t sh all n oti f y t h e C o n tractor of a n y r e s triction to t h e us e o r d i s clo su r e o f P rotected Health I n f or m atio n t h at t h e Go v e r n m e n t h as a g ree d t o i n accorda n c e w it h 4 5 C FR 164.522. P e r m i ss i b le R e q u e s ts b y t h e G o v e r n m e nt. T h e Go v er n m e n t sh all n o t r eq u e s t t h e C o n tractor to us e o r d i s clo s e P rotected Health I n f o r m ation in a n y m a nn er t h at w o u ld n o t b e per m i ss i b le un de r t h e P r i v ac y Ru le if do n e b y t h e G o v e r n m e n t, e x cep t f o r pro v i d i n g D a ta A gg re g a ti o n s er v ices to t h e Go v er n m e n t a n d f o r m a n a g e m e n t a n d ad m i n i s trati v e acti v ities o f t h e C o n t r act o r as o t h e r w ise p e r m itted b y t h is cla us e. T e r m i n ati o n. (a) T er m i n atio n. A b reach by t h e C o n tractor of t h is cla us e, m ay su b j ect t h e C o n tractor to ter m i n ation un d er a n y a pp lica b le d e f a u lt o r te r m i n ati o n pro v isi o n o f t h is C o n t r act. (b ) E ff ect o f T e r m i n ati o n. (1) I f t h is co n tract h as r ecords m a n a g e m e n t r eq u ire m e n t s, t h e r ecords su b j ect to t h e C la us e sh o u ld b e h a n dled in accorda n ce w ith t h e r ecords m a n a g e m e n t r eq u ire m e n t s. If t h is co n tract does n ot h a v e records m a n a g e m e n t req u ire m e n t s, t h e record s sh o u ld b e h a n dle d i n accorda n c e w it h para g rap h s (2) a n d (3 ) be l o w (2 ) I f t h is c o n trac t doe s n o t h a v e record s m a n a g e m e n t req u i re m e n t s, e x cep t as pro v i de d in para g rap h (3 ) o f t h is s ectio n, u po n ter m i n atio n o f t h is C o n tract, f o r a n y rea s o n, t h e C o n t racto r sh al l ret u r n o r de s troy all P rotected Health I n f o r m ation r ecei v ed f rom t h e Go v er n m e n t, o r created or recei v ed b y t h e C o n tractor on be h alf o f t h e G o v e r n m e n t. T h is pro v isi o n sh all a pp ly to P ro tected Health I n f or m ati o n t h at is in t h e po ssessi o n o f su bco n tractors o r a g e n ts o f t h e C o n tractor. T h e C o n tractor sh all r etain n o copies of t h e P rotected Health I n f o r m atio n. (3 ) I f t h is c o n trac t doe s n o t h a v e record s m a n a g e m e n t pro v i s i o n s a n d t h e C o n tracto r deter m i n e s t h a t ret u r n i n g o r de s tro y i n g t h e P rotected Health I n f o r m ation is i n f ea s ible, t h e C o n tractor sh all p ro v ide to t h e Go v er n m e n t n o ti f icati o n o f t h e c o n d iti o n s t h at m a k e r et u r n o r d est r u cti o n i n f easi b le. U po n m u t u al a g ree m e n t o f t h e Go v er n m e n t a n d t h e C o n tractor t h at ret u rn or de s tr u ction o f P rotected Health I n f o r m ation is i n f easi b le, t h e C o n t r act o r s h all e x te n d t h e pro tecti o n s o f t h is C o n t r act to s u ch P ro tected Health I n f or m ati o n a n d li m it f u rt h er us es a n d di s clo su res o f su ch P rotected Health I n f o r m ation to t h o s e p u rpo s es t h at m a k e t h e r et u r n o r d est r u cti o n i n f easi b le, f o r so l o n g as t h e C o n t r act o r m ai n tai n s su ch P r otected Health I n f o r m atio n. Miscella n e o u s. (a) R e gu latory R e f ere n ce s. A re f ere n ce in t h is C la us e to a s ection in t h e P r i v acy Ru le or Sec u rity Ru le m ea n s t h e s ectio n as in e ff ec t o r a s a m e n ded, a n d f o r w h ic h c o m plia n ce is req u i red. (b ) S u r v i v al. T h e r e s p ecti v e r i gh ts a n d ob li g ati o n s o f B us i n e s s A ss o ciate un d er t h e '' E ff ect o f T e r m i n ati o n ' ' pro v isi o n o f t h is C la us e sh all s u r v i v e t h e te r m i n ati o n o f t h is C o n t r act. (c) I n terpretatio n. A n y a m b i gu ity in t h is C la us e sh all b e r e s ol v ed in f a v or of a m ea n i n g t h at p er m its t h e Go v er n m e n t to c o m p ly w ith t h e P r i v acy R u le o r Sec u r ity R u le. ATTACHMENT II (a) - HIPAA BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (BAA) incorporates HIPAA/HITECH Act requirements under the HHS Final Omnibus Rule (78 FR 5566, published 25 Jan 2013), effective 23 Sep 2013. This BAA is for use by MHS components outside of DHA. Business Associate Agreement Introduction In accordance with 45 CFR 164.502(e) (2) and 164.504(e) and paragraph C.3.4.1.3 of DoD 6025.18-R, "DoD Health Information Privacy Regulation," January 24, 2003, this document serves as a business associate agreement (BAA) between the signatory parties for purposes of the Health Insurance Portability and Accountability Act (HIPAA) and the "HITECH Act" amendments thereof, as implemented by the HIPAA Rules and DoD HIPAA Issuances (both defined below). The parties are a DoD Military Health System (MHS) component, acting as a HIPAA covered entity, and a DoD contractor, acting as a HIPAA business associate. The HIPAA Rules require BAAs between covered entities and business associates. Implementing this BAA requirement, the applicable DoD HIPAA Issuance (DoD 6025.18-R, paragraph C3.4.1.3) provides that requirements applicable to business associates must be incorporated (or incorporated by reference) into the contract or agreement between the parties. (a) Catchall Definition. Except as provided otherwise in this BAA, the following terms used in this BAA shall have the same meaning as those terms in the DoD HIPAA Rules: Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices (NoPP), Protected Health Information (PHI), Required By Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use. Breach means actual or possible loss of control, unauthorized disclosure of or unauthorized access to PHI or other PII (which may include, but is not limited to PHI), where 12 Nov 2013 Page 2 of 10 persons other than authorized users gain access or potential access to such information for any purpose other than authorized purposes, where one or more individuals will be adversely affected. The foregoing definition is based on the definition of breach in DoD Privacy Act Issuances as defined herein. Business Associate shall generally have the same meaning as the term "business associate" in the DoD HIPAA Issuances, and in reference to this BAA, shall mean the contractor. Agreement means this BAA together with the documents and/or other arrangements under which the Business Associate signatory performs services involving access to PHI on behalf of the MHS component signatory to this BAA. Covered Entity shall generally have the same meaning as the term "covered entity" in the DoD HIPAA Issuances, and in reference to this BAA, shall mean the Government facility(s) and office(s) that are supported under this contract. DHA Privacy Office means the DHA Privacy and Civil Liberties Office. The DHA Privacy Office Director is the HIPAA Privacy and Security Officer for DHA, including the National Capital Region Medical Directorate (NCRMD). DoD HIPAA Issuances means the DoD issuances implementing the HIPAA Rules in the DoD Military Health System (MHS). These issuances are DoD 6025.18-R (2003), DoDI 6025.18 (2009), and DoD 8580.02-R (2007). DoD Privacy Act Issuances means the DoD issuances implementing the Privacy Act, which are DoDD 5400.11 (2007) and DoD 5400.11-R (2007). HHS Breach means a breach that satisfies the HIPAA Breach Rule definition of breach in 45 CFR 164.402. HIPAA Rules means, collectively, the HIPAA Privacy, Security, Breach and Enforcement Rules, issued by the U.S. Department of Health and Human Services (HHS) and codified at 45 CFR Part 160 and Part 164, Subpart E (Privacy), Subpart C (Security), Subpart D (Breach) and Part 160, Subparts C-D (Enforcement), as amended by the 2013 modifications to those Rules, implementing the "HITECH Act" provisions of Pub. L. 111-5. See 78 FR 5566-5702 (Jan. 25, 2013) (with corrections at 78 FR 32464 (June 7, 2013)). Additional HIPAA rules regarding electronic transactions and code sets (45 CFR Part 162) are not addressed in this BAA and are not included in the term HIPAA Rules. Service-Level Privacy Office means one or more offices within the military services (Army, Navy, or Air Force) with oversight authority over Privacy Act and HIPAA privacy compliance. I. Obligations and Activities of Business Associate (a) The Business Associate shall not use or disclose PHI other than as permitted or required by the Agreement or as required by law. (b) The Business Associate shall use appropriate safeguards, and comply with the DoD HIPAA Rules with respect to electronic PHI, to prevent use or disclosure of PHI other than as provided for by the Agreement. (c) The Business Associate shall report to Covered Entity any Breach of which it becomes aware, and shall proceed with breach response steps as required by Part V of this BAA. With respect to electronic PHI, the Business Associate shall also respond to any security incident of which it becomes aware in accordance with any Information Assurance provisions of the Agreement. If at any point the Business Associate becomes aware that a security incident involves a Breach, the Business Associate shall immediately initiate breach response as required by part V of this BAA. (d) In accordance with 45 CFR 164.502(e)(1)(ii)) and 164.308(b)(2), respectively), as applicable, the Business Associate shall ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of the Business Associate agree to the same restrictions, conditions, and requirements that apply to the Business Associate with respect to such PHI. (e) The Business Associate shall make available PHI in a Designated Record Set, to the Covered Entity or, as directed by the Covered Entity, to an Individual, as necessary to satisfy the Covered Entity obligations under 45 CFR 164.524. (f) The Business Associate shall make any amendment(s) to PHI in a Designated Record Set as directed or agreed to by the Covered Entity pursuant to 45 CFR 164.526, or take other measures as necessary to satisfy Covered Entity's obligations under 45 CFR 164.526. (g) The Business Associate shall maintain and make available the information required to provide an accounting of disclosures to the Covered Entity or an individual as necessary to satisfy the Covered Entity's obligations under 45 CFR 164.528. (h) To the extent the Business Associate is to carry out one or more of Covered Entity's obligation(s) under the HIPAA Privacy Rule, the Business Associate shall comply with the requirements of HIPAA Privacy Rule that apply to the Covered Entity in the performance of such obligation(s); and (i) The Business Associate shall make its internal practices, books, and records available to the Secretary for purposes of determining compliance with the HIPAA Rules. II. Permitted Uses and Disclosures by Business Associate (a) The Business Associate may only use or disclose PHI as necessary to perform the services set forth in the Agreement or as required by law. The Business Associate is not permitted to de-identify PHI under DoD HIPAA issuances or the corresponding 45 CFR 164.514(a)-(c), nor is it permitted to use or disclose de-identified PHI, except as provided by the Agreement or directed by the Covered Entity. (b) The Business Associate agrees to use, disclose and request PHI only in accordance with the HIPAA Privacy Rule "minimum necessary" standard and corresponding DHA policies and procedures as stated in the DoD HIPAA Issuances. (c) The Business Associate shall not use or disclose PHI in a manner that would violate the DoD HIPAA Issuances or HIPAA Privacy Rules if done by the Covered Entity, except uses and disclosures for the Business Associate's own management and administration and legal responsibilities or for data aggregation services as set forth in the following three paragraphs. (d) Except as otherwise limited in the Agreement, the Business Associate may use PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate. The foregoing authority to use PHI does not apply to disclosure of PHI, which is covered in the next paragraph. (e) Except as otherwise limited in the Agreement, the Business Associate may disclose PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate, provided that disclosures are required by law, or the Business Associate obtains reasonable assurances from the person to whom the PHI is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached. (f) Except as otherwise limited in the Agreement, the Business Associate may use PHI to provide Data Aggregation services relating to the Covered Entity's health care operations. III. Provisions for Covered Entity to Inform Business Associate of Privacy Practices and Restrictions (a) The Covered Entity shall provide the Business Associate with the notice of privacy practices that the Covered Entity produces in accordance with 45 CFR 164.520 and the corresponding provision of the DoD HIPAA Issuances. (b) The Covered Entity shall notify the Business Associate of any changes in, or revocation of, the permission by an Individual to use or disclose his or her PHI, to the extent that such changes affect the Business Associate's use or disclosure of PHI. (c) The Covered Entity shall notify the Business Associate of any restriction on the use or disclosure of PHI that the Covered Entity has agreed to or is required to abide by under 45 CFR 164.522, to the extent that such changes may affect the Business Associate's use or disclosure of PHI. IV. Permissible Requests by Covered Entity The Covered Entity shall not request the Business Associate to use or disclose PHI in any manner that would not be permissible under the HIPAA Privacy Rule or any applicable Government regulations (including without limitation, DoD HIPAA Issuances) if done by the Covered Entity, except for providing Data Aggregation services to the Covered Entity and for management and administrative activities of the Business Associate as otherwise permitted by this BAA. V. Breach Response (a) In general. In the event of a breach of PII/PHI held by the Business Associate, the Business Associate shall follow the breach response requirements set forth in this Part V, which is designed to satisfy both the Privacy Act and HIPAA as applicable. If a breach involves PII without PHI, then the Business Associate shall comply with DoD Privacy Act Issuance breach response requirements only; if a breach involves PHI (a subset of PII), then the Business Associate shall comply with both Privacy Act and HIPAA breach response requirements. A breach involving PHI may or may not constitute an HHS Breach. If a breach is not an HHS Breach, then the Business Associate has no HIPAA breach response obligations. In such cases, the Business Associate must still comply with breach response requirements under the DoD Privacy Act Issuances. If the DHA Privacy Office determines that a breach is an HHS Breach, then the Business Associate shall comply with both the HIPAA Breach Rule and DoD Privacy Act Issuances, as directed by the DHA Privacy Office, regardless of whether the breach occurs at DHA or at one of the Service components. If the DHA Privacy Office determines that the breach does not constitute an HHS Breach, then the Business Associate shall comply with DoD Privacy Act Issuances, as directed by the applicable Service-Level Privacy Office. The following provisions of Part V set forth the Business Associate's Privacy Act and HIPAA breach response requirements for all breaches, including but not limited to HHS breaches. This Part V is designed to satisfy the DoD Privacy Act Issuances and the HIPAA Breach Rule as implemented by the DoD HIPAA Issuances. In general, for breach response, the Business Associate shall report the breach to the Covered Entity, assess the breach incident, notify affected individuals, and take mitigation actions as applicable. Because DoD defines "breach" to include possible (suspected) as well as actual (confirmed) breaches, the Business Associate shall implement these breach response requirements immediately upon the Business Associate's discovery of a possible breach. (b) Government Reporting Provisions The Business Associate shall report the breach within one hour of discovery to the US Computer Emergency Readiness Team (US CERT), and, within 24 hours of discovery, to the DHA Privacy Office and the other parties set forth below. The Business Associate is deemed to have discovered a breach as of the time a breach (suspected or confirmed) is known, or by exercising reasonable diligence would have been known, to any person (other than the person committing it) who is an employee, officer or other agent of the Business Associate. The Business Associate shall submit the US-CERT report using the online form at https://forms.us-cert.gov/report/. Before submission to US-CERT, the Business Associate shall save a copy of the on-line report. After submission, the Business Associate shall record the US-CERT Reporting Number. Although only limited information about the breach may be available as of the one hour deadline for submission, the Business Associate shall submit the US-CERT report by the deadline. The Business Associate shall e-mail updated information as it is obtained, following the instructions at http://www.us-cert.gov/pgp/email.html. The Business Associate shall provide a copy of the initial or updated US-CERT report to the DHA Privacy Office and the applicable Service-Level Privacy Office, if requested by either. Business Associate questions about US-CERT reporting shall be directed to the DHA or Service-Level Privacy Office, not the US-CERT office. The Business Associate report due within 24 hours shall be submitted by completing the New Breach Reporting Form DD 2959 at the Breach Response page on the DHA Privacy Office web site and emailing that form to, as applicable, the DHA Privacy Office, the Service-Level Privacy Office, the Contracting Officer (CO) and Contracting Officer's Representative (COR) and the Business Associate's DoD point of contact (POC) unless the POC specifies another addressee for breach reporting. Encryption is not required, because Breach Report Forms should not contain PII/PHI. The email address for notices to the DHA Privacy Office is provided at the Privacy Office website breach response page. If electronic mail is not available, telephone notification is also acceptable, but all notifications and reports delivered telephonically must be confirmed by email as soon as technically feasible. If multiple beneficiaries are affected by a single event or related set of events, then a single reportable breach may be deemed to have occurred, depending on the circumstances. The Business Associate shall inform the DHA Privacy Office as soon as possible if it believes that "single event" breach response is appropriate; the DHA Privacy Office will determine how the Business Associate shall proceed and, if appropriate, consolidate separately reported breaches for purposes of Business Associate report updates, beneficiary notification, and mitigation. When a Breach Report Form initially submitted is incomplete or incorrect due to unavailable information, or when significant developments require an update, the Business Associate shall submit a revised form or forms, stating the updated status and previous report date(s) and showing any revisions or additions in red text. Examples of updated information the Business Associate shall report include, but are not limited to: confirmation on the exact data elements involved, the root cause of the incident, and any mitigation actions to include, sanctions, training, incident containment, follow-up, etc. The Business Associate shall submit these report updates promptly after the new information becomes available. Prompt reporting of updates is required to allow the DHA Privacy Office to make timely final determinations on any subsequent notifications or reports. The Business Associate shall provide updates to the same parties as required for the initial Breach Reporting Form. The Business Associate is responsible for reporting all information needed by the DHA Privacy Office to make timely and accurate determinations on reports to HHS as required by the HHS Breach Rule and reports to the Defense Privacy and Civil Liberties Office as required by DoD Privacy Act Issuances. In the event the Business Associate is uncertain on how to apply the above requirements, the Business Associate shall consult with the DHA Privacy Office (or the Service-Level Privacy Office, which will consult with the Privacy Office as appropriate) when determinations on applying the above requirements are needed. (c) Individual Notification Provisions: If the DHA Privacy Office determines that individual notification is required, the Business Associate shall provide written notification to individuals affected by the breach as soon as possible, but no later than 10 working days after the breach is discovered and the identities of the individuals are ascertained. The 10 day period begins when the Business Associate is able to determine the identities (including addresses) of the individuals whose records were impacted. The Business Associate's proposed notification to be issued to the affected individuals shall be submitted to the parties to which reports are submitted under paragraph V (a) for their review, and for approval by the DHA Privacy Office. Upon request, the Business Associate shall provide the DHA Privacy Office with the final text of the notification letter sent to the affected individuals. If different groups of affected individuals receive different notification letters, then the Business Associate shall provide the text of the letter for each group. (PII shall not be included with the text of the letter(s) provided.) Copies of further correspondence with affected individuals need not be provided unless requested by the Privacy Office. The Business Associate's notification to the individuals, at a minimum, shall include the following: -The individual(s) must be advised of what specific data was involved. It is insufficient to simply state that PII has been lost. Where names, Social Security Numbers (SSNs) or truncated SSNs, and Dates of Birth (DOBs) are involved, it is critical to advise the individual that these data elements potentially have been breached. -The individual(s) must be informed of the facts and circumstances surrounding the breach. The description should be sufficiently detailed so that the individual clearly understands how the breach occurred. -The individual(s) must be informed of what protective actions the Business Associate is taking or the individual can take to mitigate against potential future harm. The notice must refer the individual to the current Federal Trade Commission (FTC) web site pages on identity theft and the FTC's Identity Theft Hotline, toll-free: 1-877-ID-THEFT (438-4338); TTY: 1-866-653-4261. -The individual(s) must also be informed of any mitigation support services (e.g., one year of free credit monitoring, identification of fraud expense coverage for affected individuals, provision of credit freezes, etc.) that the Business Associate may offer affected individuals, the process to follow to obtain those services and the period of time the services will be made available, and contact information (including a phone number, either direct or toll-free, e-mail address and postal address) for obtaining more information. Business Associates shall ensure any envelope containing written notifications to affected individuals are clearly labeled to alert the recipient to the importance of its contents, e.g., "Data Breach Information Enclosed," and that the envelope is marked with the identity of the Business Associate and/or subcontractor organization that suffered the breach. The letter must also include contact information for a designated POC to include, phone number, email address, and postal address. If the Business Associate determines that it cannot readily identify, or will be unable to reach, some affected individuals within the 10 day period after discovering the breach, the Business Associate shall so indicate in the initial or updated Breach Report Form. Within the 10 day period, the Business Associate shall provide the approved notification to those individuals who can be reached. Other individuals must be notified within 10 days after their identities and addresses are ascertained. The Business Associate shall consult with the DHA Privacy Office, which will determine which media notice is most likely to reach the population not otherwise identified or reached. The Business Associate shall issue a generalized media notice(s) to that population in accordance with Privacy Office approval. The Business Associate shall, at no cost to the government, bear any costs associated with a breach of PII/PHI that the Business Associate has caused or is otherwise responsible for addressing. Breaches are not to be confused with security incidents (often referred to as cyber security incidents when electronic information is involved), which may or may not involve a breach of PII/PHI. In the event of a security incident not involving a PII/PHI breach, the Business Associate shall follow applicable DoD Information Assurance requirements under its Agreement. If at any point the Business Associate finds that a cyber security incident involves a PII/PHI breach (suspected or confirmed), the Business Associate shall immediately initiate the breach response procedures set forth here. The Business Associate shall also continue to follow any required cyber security incident response procedures to the extent needed to address security issues, as determined by DoD/DHA. VI. Termination (a) Termination. Noncompliance by the Business Associate (or any of its staff, agents, or subcontractors) with any requirement in this BAA may subject the Business Associate to termination under any applicable default or other termination provision of the Agreement. (b) Effect of Termination. (1) If the Agreement has records management requirements, the Business Associate shall handle such records in accordance with the records management requirements. If the Agreement does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below. If the Agreement has provisions for transfer of records and PII/PHI to a successor Business Associate, or if DHA gives directions for such transfer, the Business Associate shall handle such records and information in accordance with such Agreement provisions or DHA direction. (2) If the Agreement does not have records management requirements, except as provided in the following paragraph (3), upon termination of the Agreement, for any reason, the Business Associate shall return or destroy all PHI received from the Covered Entity, or created or received by the Business Associate on behalf of the Covered Entity that the Business Associate still maintains in any form. This provision shall apply to PHI that is in the possession of subcontractors or agents of the Business Associate. The Business Associate shall retain no copies of the PHI. (3) If the Agreement does not have records management provisions and the Business Associate determines that returning or destroying the PHI is infeasible, the Business Associate shall provide to the Covered Entity notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Covered Entity and the Business Associate that return or destruction of PHI is infeasible, the Business Associate shall extend the protections of the Agreement to such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or destruction infeasible, for so long as the Business Associate maintains such PHI. VII. Miscellaneous (a) Survival. The obligations of Business Associate under the "Effect of Termination" provision of this BAA shall survive the termination of the Agreement. (b) Interpretation. Any ambiguity in the Agreement shall be resolved in favor of a meaning that permits the Covered Entity and the Business Associate to comply with the HIPAA Rules and the DoD HIPAA Rules. ATTACHMENT III - Sample Patient Form BRANCH HEALTH CLINIC, PNY 4898 S. BROAD STREET BLDG. 615, 1 ST FLOOR PHILADELPHIA, PA 19112 (215) 897-8148/48 DATE: __________________ PATIENT NAME: _________________________________________________ (Last, First, MI) SS# (last 4): ________________ DOB: ______________ (M/F) ______ EXAM TYPE: CHEST X-RAY REASON FOR REQUEST: □ AMSP □ PRE-EMPLOYMENT □ OTHER DATE OF EXAM: ______________________________ COMPLETED BY: ______________________________ TECHNICIAN INITIALS *EMPLOYEE: PLEASE RETURN TO BRANCH HEALTH CLINIC, PNY BLDG. 615 ATTACHMENT IV - Malpractice Insurance Form MALPRACTICE CERTIFICATION INFORMATION Contractors shall complete the following and submit it with their offer. Contractor has or will maintain(ed) malpractice insurance in compliance with the terms and conditions of this solicitation (including FAR Clause 52.237‑7, Indemnification and Medical Liability Insurance, located in Section I of the solicitation). ______ Yes _____ No Reasons: 2. Insurer: ____________________ Insure: ____________________ Address ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ Phone ____________________ ____________________ 3. Is or will yours be a group plan or are proposed physicians individually insured? _______ Group ________ by individual 4. Is malpractice coverage ______ occurrence or ______ claims made? 5. If claims made, is extended reporting endorsement (tail) provided? ______ (Yes/No/NA) for how long a period? ______ Years Can the tail be invoked within 90 days of notification by the Government? _____ (Yes/No) 6. What is the extent of coverage? $_____________ per incident $_____________ aggregate Do these limits apply to each individual practitioner? _____ (Yes/No) If no, explain. _________________________________________________ 7. Will your malpractice insurance coverage be in effect immediately upon award? _______ (Yes/No) If "no," when will coverage begin? ______________________________________________ If yes, attach proof of malpractice coverage to this form and include as required. _________________________ Signature of Authorized Insurance Company Agent Title: _________________ Date: _________________ ATTACHMENT V - Contract Administration Plan CONTRACT ADMINISTRATION PLAN (CAP) FOR FIXED PRICE CONTRACTS In order to expedite the administration of this contract, the following delineation of duties is provided. The names, addresses and phone numbers for these offices or individuals are included elsewhere in the contract award document. The office or individual designated as having responsibility should be contacted for any questions, clarifications, or information regarding the administration function assigned. 1. The Procuring Contract Office (PCO) is responsible for: a. All pre-award duties such as solicitation, negotiation and award of contracts. b. Any information or questions during the pre-award stage of the procurement. c. Freedom of Information inquiries. d. Changes in contract terms and/or conditions. e. Post award conference. 2. The Contract Administration Office (CAO) is responsible for matters specified in the FAR 42.302 and DFARS 42.302 except those areas otherwise designated as the responsibility of the Contracting Officer's Representative (COR) or someone else herein. 3. The paying office is responsible for making payment of proper invoices after acceptance is documented. 4. The Contracting Officer's Representative (COR) is responsible for interface with the contractor and performance of duties such as those set forth below. It is emphasized that only the PCO/CAO has the authority to modify the terms of the contract. In no event will any understanding, agreement, modification, change order, or other matter deviating from the terms of the basic contract between the contractor and any other person be effective or binding on the Government. If in the opinion of the contractor an effort outside the scope of the contract is requested, the contractor shall promptly notify the PCO in writing. No action may be taken by the contractor unless the PCO or CAO has issued a contractual change. The COR duties are as follows: a. Technical Interface (1) The COR is responsible for all Government technical interface concerning the contractor and furnishing technical instructions to the contractor. These instructions may include: technical advice/recommendations/clarifications of specific details relating to technical aspects of contract requirements; milestones to be met within the general terms of the contract or specific subtasks of the contract; or, any other interface of a technical nature necessary for the contractor to perform the work specified in the contract. The COR is the point of contact through whom the contractor can relay questions and problems of a technical nature to the PCO. (2) The COR is prohibited from issuing any instruction which would constitute a contractual change. The COR shall not instruct the contractor how to perform. If there is any doubt whether technical instructions contemplated fall within the scope of work, contact the PCO for guidance before transmitting the instructions to the contractor. b. Contract Surveillance (1) The COR shall monitor the contractor's performance and progress under the contract. In performing contract surveillance duties, the COR should exercise extreme care to ensure that he/she does not cross the line of personal services. The COR must be able to distinguish between surveillance (which is proper and necessary) and supervision (which is not permitted). Surveillance becomes supervision when you go beyond enforcing the terms of the contract. If the contractor is directed to perform the contract services in a specific manner, the line is being crossed. In such a situation, the COR's actions would be equivalent to using the contractor's personnel as if they were government employees and would constitute transforming the contract into one for personal services. (2) The COR shall monitor contractor performance to see that inefficient or wasteful methods are not being used. If such practices are observed, the COR is responsible for taking reasonable and timely action to alert the contractor and the PCO to the situation. (3) The COR will take timely action to alert the PCO to any potential performance problems. If performance schedule slippage is detected, the COR should determine the factors causing the delay and report them to the PCO, along with the contractor's proposed actions to eliminate or overcome these factors and recover the slippage. Once a recovery plan has been put in place, the COR is responsible for monitoring the recovery and keeping the PCO advised of progress. (4) If the Contractor Performance Assessment Reporting System (CPARS) is applicable to the contract the COR is responsible for completing a Contractor Performance Assessment Report (CPAR) in the CPARS Automated Information System (AIS). The initial CPAR, under an eligible contract, must reflect evaluation of at least 180 days of contractor performance. The completed CPAR, including contractor comments if any, (NOTE: contractors are allowed 30 days to input their comments) should be available in the CPARS AIS for reviewing official (PCO) review no later than 270 days after start of contract performance. Subsequent CPARs covering any contract option periods should be ready at 1-year intervals thereafter. c. Invoice Review and Approval/Inspection and Acceptance (1) The COR is responsible for quality assurance of services performed and acceptance of the services or deliverables. The COR shall expeditiously review copies of the contractor's invoices or vouchers, certificate of performance and all other supporting documentation to determine the reasonableness of the billing. In making this determination, the COR must take into consideration all documentary information available and any information developed from personal observations. (2) The COR must indicate either complete or partial concurrence with the contractor's invoice/voucher by executing the applicable certificate of performance furnished by the contractor. The COR must be cognizant of the invoicing procedures and prompt payment due dates detailed elsewhere in the contract. (3) The COR will provide the PCO and the CAO with copies of acceptance documents such as Certificates of Performance. (4) The COR shall work with the Contractor to obtain and execute a final invoice no more than 60 days after completion of contract performance. The COR shall ensure that the invoice is clearly marked as a "Final Invoice." d. Contract Modifications. The COR is responsible for developing the statement of work for change orders or modifications and for preparing an independent government cost estimate of the effort described in the proposed statement of work. e. Administrative Duties (1) The COR shall take appropriate action on technical correspondence pertaining to the contract and for maintaining files on each contract. This includes all modifications, government cost estimates, contractor invoices/vouchers, certificates of performance, DD 250 forms and contractor's status reports. (2) The COR shall maintain files on all correspondence relating to contractor performance, whether satisfactory or unsatisfactory, and on trip reports for all government personnel visiting the contractor's place of business for the purpose of discussing the contract. (3) The COR must take prompt action to provide the PCO with any contractor or technical code request for change, deviation or waiver, along with any supporting analysis or other required documentation. f. Government Furnished Property. When government property is to be furnished to the contractor, the COR will take the necessary steps to insure that it is furnished in a timely fashion and in proper condition for use. The COR will maintain adequate records to ensure that property furnished is returned and/or that material has been consumed in the performance of work. Enclosure (1) g. Security. The COR is responsible for ensuring that any applicable security requirements are strictly adhered to. h. Standards of Conduct. The COR is responsible for reading and complying with all applicable agency standards of conduct and conflict of interest instructions. i. Written Report/Contract Completion Statement. (1) The COR is responsible for timely preparation and submission to the PCO, of a written, annual evaluation of the contractors performance. The report shall be submitted within 30 days prior to the exercise of any contract option and 60 days after contract completion. The report shall include a written statement that services were received in accordance with the Contract terms and that the contract is now available for close-out. The report shall also include a statement as to the use made of any deliverables furnished by the contractor. (2) If the Contractor Performance Assessment Reporting System (CPARS) is applicable to the contract you are responsible for completing a final Contractor Performance Assessment Report (CPAR) in the CPARS with 30 days of contract completion. (3) The COR is responsible for providing necessary assistance to the Contracting Officer in performing Contract Close-out in accordance with FAR 4.804, Closeout of Contract Files. 5. The Technical Assistant (TA), if appointed, is responsible for providing routine administration and monitoring assistance to the COR. The TA does not have the authority to provide any technical direction or clarification to the contract. Duties that may be performed by the TA are as follows: a. Identify contractor deficiencies to the COR. b. Review contract deliverables, recommend acceptance/rejection, and provide the COR with documentation to support the recommendation. c. Assist in preparing the final report on contractor performance for the applicable contract in accordance with the format and procedures prescribed by the COR. d. Identify contract noncompliance with reporting requirements to the COR. e. Review contractor status and progress reports, identify deficiencies to the COR, and provide the COR with recommendations regarding acceptance, rejection, and/or Government technical clarification requests. f. Review invoices and provide the COR with recommendations to facilitate COR certification of the invoice. g. Provide the COR with timely input regarding technical clarifications for the statement of work, possible technical direction to provide the contractor, and recommend corrective actions. h. Provide detailed written reports of any trip, meeting, or conversation to the COR subsequent to any interface between the TA and contractor. ATTACHMENT VI - Corporate Experience and Past Performance Form CORPORATE EXPERIENCE and PAST PERFORMANCE INFORMATION FORM Form ___ of ___ Name of Offeror: Contract Number, order number, or identifier: Customer Name & Location: Customer Point of Contact (Name & Title): Telephone Number ( PLEASE VERIFY ): and e-mail address Total dollar amount for this effort during the past five (5) years: (For ordering vehicles, show both the annual estimated contract amount and the amount of orders actually performed): (Show calendar year and dollars) Number of personnel (FTE) performing per year (avg.): Period of Performance: From: To: Detailed description of the work performed sufficient to demonstrate the relevance of the reference to the solicitation: Quality, delivery, or cost problem(s); corrective action(s) taken; and effectiveness of the corrective action(s): Subcontractor(s) Utilized in Performance of this contract, description of the extent of work performed by subcontractor(s), along with annual dollar value of all subcontracts: ATTACHMENT VII - FAR Part 52.209-11 ( Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law) Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) (a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that-- (1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or (2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government. (b) The Offeror represents that- (1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and (2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months. ATTACHMENT VIII - Pricing Sheet Description of Services SLIN Base Option 1 Option 2 Option 3 Quantity P & A One View AA 300.00 330.00 363.00 399.00 P /A and Lateral Two Views AB 40.00 44.00 48.00 53.00 P/A and Obliques Three Views AC 10.00 11.00 12.00 13.00 Description of Services SLIN Base Option 1 Option 2 Option 3 Price P & A One View AA P /A and Lateral Two Views AB P/A and Obliques Three Views AC Base Period Total: Option Period 1 Total: Option Period 2 Total: Option Period 3 Total: Task Order Total: Special Notes Addendum to 52.212-1 Instructions to Offerors - Commercial Items (Oct 2018) ADDRESS FOR THE PHILADELPHIA NAVY YARD: Philadelphia Navy Yard - Occupational Health Clinic (PNY-OHC) 4898 Broad Street, Building 615 Philadelphia, PA 19112 (a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code and small business size standard for this acquisition is 621512 and $15 mil. Quoters shall submit their quotes on two (2) separate volumes/documents: Volume I: Price Quote for Base and All Option Periods (Attachment VIII) Volume II: Non-Price Factors As a minimum quotes must show: Volume I (1) The solicitation number; (2) Evidence of insurability in regard to medical liability in the amounts prescribed in FAR 52.237-7; (3) The name, address, and telephone number of the offeror; (4) Price Information: (a) Quoters shall provide unit prices and amounts for the Base year and all Option periods on the pricing sheet above (Attachment VIII). (b) Price discount terms; if any. (5) "Remit to" address, if different than mailing address; (6) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically); (7) Acknowledgment of Solicitation Amendments; (8) Completed copy of provision FAR 52.209-11. Volume II The quoter shall complete a Corporate Experience and Past Performance Information Form for each reference submitted in accordance with Attachment VI of the solicitation. •(a) Location: The quoter shall provide proof that they are located within a twenty (20) mile radius of the PNY-OHC. The government will look favorably at Vendors with close proximity to the Philadelphia Navy Yard. •(b) Technical Capability/Experience working with Asbestos Medical Surveillance Program (AMSP). The Quoter shall provide proof of quality standards for X-Ray Imaging and interpretations. This can include technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary; detailing experience if any, working with an AMSP and experience in B-Readings/Interpretations. •(c) Credentials: The quoter shall provide proof that they are credentialed in accordance with Joint Commission standards to perform the services required herein. •(d) Past Performance: The quoter shall demonstrate relevant past performance or affirmatively state that it possesses no relevant past performance. Relevant past performance is performance under contracts or efforts (within the last three years) that is of similar scope, magnitude, and complexity to that which is described in the solicitation (as defined in Attachment VI). The Government will evaluate the relevant references submitted under Corporate Experience factor. Only a single set of up to three references shall be submitted. The quoter shall complete Attachment VI for past performance with no greater than three (3) references submitted. •(e) Period for acceptance of quotes. The quoter agrees to hold the prices in its offer firm for 90 calendar days from the date specified for receipt of quotes, unless another time period is specified in an addendum to the solicitation. •(f) Quote Submission Quotes shall be submitted via email to curtis.e.cardoza.civ@mail.mil and andrea.l.giuliano.civ@mail.mil by NLT 10:00am EST 27 August 2019 and must contain FAR Provision 52.209-11 (Attachment VII). Questions regarding this Request for Quotes (RFQ) shall be submitted before 22 August 2019 by NLT 4:00pm EST. (End of Provision) 52.212-2 Evaluation-Commercial Items (Oct 2014) The Government will conduct a Best Value source selection process using the policies and procedures of FAR part 12.203, Procedures for Solicitation, Evaluation, and Award, 13.106-2, Evaluation of Quotations or Quoters, and FAR part 13.106-3, Award and Documentation. Quote: The quoter's submission shall be in the form prescribed by, and shall contain response to each to each of the areas identified above in (The Addendum to FAR 52.212-1). The quote shall clearly indicate, with sufficient details, the vendor's capability to meet ALL of the requirements as stated above in the Performance Work Statement. Any quote which does not provide, as a minimum, that which is required in the solicitation may be determined to be substantially incomplete and not warrant any further consideration. Evaluation: Quoters will be evaluated based on location of facility, technical capability and or experience working with an Asbestos Medical Surveillance Program (AMSP), proof of being credentialed according to Joint Commission standards and past performance. BASIS OF AWARD Award will be made to the responsible quoter whose quotation conforms to all solicitation requirements, such as terms and conditions, representations and certifications, technical/quality requirements, and also provide the best value to the Government based on the results of price and non-price factors. Non Price factors are significantly more important than price factors. In addition, the Contracting Officer will determine if the proposed prices to include the base and option periods are deemed fair and reasonable and is the best value quote that can fulfill the needs of the PNY-OHC. Other Administrative Instructions: Quoters must be registered in the SAM database to be eligible for award. Registration is free and can be completed on-line at http://www.sam.gov ; provide DUNS number; Cage Code and TIN. FAR and DFARS Provisions & Clauses: Clauses Incorporated by Reference FAR 52.203-3, Gratuities FAR 52.203-17, Contractor Employee Whistleblower Rights and Requirement to Inform Employees of Whistleblower Rights FAR 52.204-7, System for Award Management FAR 52.204-9, Personal Identity Verification of Contractor Personnel FAR 52.204-13, System for Award Management Maintenance FAR 52.212-1, Instructions to Offerors--Commercial Items FAR 52.212-2 Evaluation - Commercial Items FAR 52.212-4, Contract Terms and Conditions---Commercial Items; FAR 52.203-6, Restrictions on Subcontractor Sales to the Government FAR 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards FAR 52.217-8, Option to Extend Services FAR 52.219-9 Small Business Subcontracting Plan FAR 52.219-28, Post-Award Small Business Program Representation FAR 52.222-41, Service Contract Labor Standards FAR 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran - Representation and Certifications FAR 52.232-18, Availability of Funds FAR 52.232-39, Unenforceability of Unauthorized Obligations FAR 52.233-4, Applicable Law for Breach of Contract Claim FAR 52.242-15, Stop Work Order DFARS 252.201-7000, Contracting Officer's Representative DFARS 252.203-7003, Agency Office of the Inspector General DFARS 252.225-7001, Buy American Act and Balance of Payment Program; DFARS 252.225-7012, Preference for Certain Domestic Commodities DFARS 252.225-7021, Trade Agreements; DFARS 252.227-7015, Technical Data-Commercial Items; DFARS 252.232-7003, Electronic Submission of Payment Requests; DFARS 252.237-7010, Prohibition on Interrogation of Detainees by Contractor Personnel DFARS 252.243-7002, Requests for Equitable Adjustment; DFARS 252.247-7024, Notification of Transportation of Supplies by Sea. DFARS 252.225-7000, Buy American Act-Balance of Payments Program Certificate; DFARS 252.225-7035, Buy American Act--North American Free Trade Agreement Implementation Act- Balance of Hexavalent Chromium DFARS 252.243-7001, Pricing of Contract Modifications DEC (1991) FAR Provision Clauses Incorporated by Full Text 52.209-11, Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law. (a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that-- (1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or (2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government. (b) The Offeror represents that- (1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and (2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months. (End of provision) FAR 52.212-3 ALT I, Offeror Representations and Certifications-Commercial Items The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u)) 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- (6) 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 (7) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties. "Highest-level owner" means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner. "Immediate owner" means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees. "Inverted domestic corporation," means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). "Manufactured end product" means any end product in product and service codes (PSCs) 1000-9999, except- (1) PSC 5510, Lumber and Related Basic Wood Materials; (2) Product or Service Group (PSG) 87, Agricultural Supplies; (3) PSG 88, Live Animals; (4) PSG 89, Subsistence; (5) PSC 9410, Crude Grades of Plant Materials; (6) PSC 9430, Miscellaneous Crude Animal Products, Inedible; (7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products; (8) PSC 9610, Ores; (9) PSC 9620, Minerals, Natural and Synthetic; and (10) PSC 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. "Predecessor" means an entity that is replaced by a successor and includes any predecessors of the predecessor. "Restricted business operations" means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate- (1) Are conducted under contract directly and exclusively with the regional government of southern Sudan; (2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization; (3) Consist of providing goods or services to marginalized populations of Sudan; (4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization; (5) Consist of providing goods or services that are used only to promote health or education; or (6) Have been voluntarily suspended. Sensitive technology- (1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically- (i) To restrict the free flow of unbiased information in Iran; or (ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and (2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)). "Service-disabled veteran-owned small business concern"- (1) Means a small business concern- (i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and (ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran. (2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16). "Small business concern" means a concern, including its affiliates that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation. "Small disadvantaged business concern, consistent with 13 CFR 124.1002," means a small business concern under the size standard applicable to the acquisition, that-- (1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by-- (i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and (ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and (2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1) (i) and (ii) of this definition. "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. "Successor" means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term "successor" does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances. "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 its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women. "Women-owned small business concern" means a small business concern -- (1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and (2) Whose management and daily business operations are controlled by one or more women. "Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127)," means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States. (b) (1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b) (2) of this provision do not automatically change the representations and certifications in SAM. (2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM 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), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs __. [Offeror to identify the applicable paragraphs at (c) through (u) 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 electronically on SAM.] (c) Offerors must complete the following representations when the resulting contract is to 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 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: 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 for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: _________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation. (7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c) (6) of this provision.] The offeror represents that- (i) It [_] is, [_] is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and (ii) It [_] is, [_] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: _____________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation. (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) HUB Zone 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 HUB Zone small business concern listed, on the date of this representation, on the List of Qualified HUB Zone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUB Zone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and (ii) It [_] is, [_] is not a HUB Zone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUB Zone small business concern participating in the HUB Zone joint venture. [ The offeror shall enter the names of each of the HUB Zone small business concerns participating in the HUB Zone joint venture : __________.] Each HUB Zone small business concern participating in the HUB Zone joint venture shall submit a separate signed copy of the HUB Zone representation. (d) Representations required to implement provisions of Executive Order 11246 -- (1) Previous contracts and compliance. The offeror represents that -- (i) It [_] has, [_] has not, participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and (ii) It [_] has, [_] has not, filed all required compliance reports. (2) Affirmative Action Compliance. The offeror represents that -- (i) It [_] has developed and has on file, [_] has not developed anddoes not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or (ii) It [_] has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor. (e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made. (f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American - 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-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 -- Free Trade Agreements -- Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms "Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American--Free Trade Agreements--Israeli Trade Act." (ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act": Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: LINE ITEM NO. COUNTRY OF ORIGIN [ List as necessary ] (iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) or this provision) as defined in the clause of this solicitation entitled "Buy American-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-Free Trade Agreements-Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g) (1) (ii) for paragraph (g) (1) (ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act": Canadian End Products: Line Item No.: ___________________________________________ [List as necessary] (3) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g) (1) (ii) for paragraph (g) (1) (ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled "Buy American--Free Trade Agreements--Israeli Trade Act'': Canadian or Israeli End Products: Line Item No.: Country of Origin: [ List as necessary ] (4) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 52.225-3 is included in this solicitation, substitute the following paragraph (g) (1) (ii) for paragraph (g) (1) (ii) of the basic provision: (g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act": Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products: Line Item No.: Country of Origin: [ List as necessary ] (5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.) (i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product as defined in the clause of this solicitation entitled "Trade Agreements." (ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products. Other End Products Line Item No.: Country of Origin: [ List as necessary ] (iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation. (h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals-- (1) [_] Are, [_] are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; (2) [_] Have, [_] have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; 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 $3,500 for which the liability remains unsatisfied. (i) Taxes are considered delinquent if both of the following criteria apply: (A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted. (B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded. (ii) Examples. (A) The taxpayer has received a statutory notice of deficiency, under I.R.C. §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 appear 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. §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. §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 Product Listed End Product: Listed Countries of Origin: (2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.] [_] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. [_] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that is has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor. (j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly- (1) [_] In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or (2) [_] Outside the United States. (k) Certificates regarding exemptions from the application of the Service Contract Labor Standards. (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 Labor Standards wage determination to the solicitation, the offeror shall notify the Contracting Officer as soon as possible; and (ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k) (1) or (k) (2) of this clause or to contact the Contracting Officer as required in paragraph (k) (3) (i) of this clause. (l) Taxpayer identification number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to the SAM database to be eligible for award.) (1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS). (2) The TIN may be used by the government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c) (3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN. (3) Taxpayer Identification Number (TIN). [_] TIN: _____________________. [_] TIN has been applied for. [_] TIN is not required because: [_] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States; [_] Offeror is an agency or instrumentality of a foreign government; [_] Offeror is an agency or instrumentality of the Federal Government; (4) Type of organization. [_] Sole proprietorship; [_] Partnership; [_] Corporate entity (not tax-exempt); [_] Corporate entity (tax-exempt); [_] Government entity (Federal, State, or local); [_] Foreign government; [_] International organization per 26 CFR 1.6049-4; [_] Other ____________________. (5) Common parent. [_] Offeror is not owned or controlled by a common parent: [_] Name and TIN of common parent: Name ____________________________________ TIN ______________________________________ (m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan. (n) Prohibition on Contracting with Inverted Domestic Corporations- (1) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4. (2) Representation. The offeror represents that- (i) It [ ] is, [ ] is not an inverted domestic corporation; and (ii) It [ ] is, [ ] is not a subsidiary of an inverted domestic corporation. (o) Prohibition on contracting with entities engaging in certain activities or transactions relating to Iran. (1) The offeror shall email questions concerning sensitive technology to the Department of State at CISADA106@state.gov. (2) Representation and Certification. Unless a waiver is granted or an exception applies as provided in paragraph (o) (3) of this provision, by submission of its offer, the offeror- (i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran; (ii) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act; and (iii) Certifies that the offeror, and any person owned or controlled by the offeror, does not knowingly engage in any transaction that exceeds $3,500 with Iran's Revolutionary Guard Corps or any of its officials, agents, or affiliates, the property and interests in property of which are blocked pursuant to the International Emergency Economic Powers Act (50(U.S.C. 1701 et seq.) (see OFAC's Specially Designated Nationals and Blocked Persons List at https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx ). (3) The representation and certification requirements of paragraph (o) (2) of this provision do not apply if- (i) This solicitation includes a trade agreements certification (e.g., 52.212-3(g) or a comparable agency provision); and (ii) The offeror has certified that all the offered products to be supplied are designated country end products. (p) Ownership or Control of Offeror. (Applies in all solicitations when there is a requirement to be registered in SAM or a requirement to have a unique entity identifier in the solicitation. (1) The Offeror represents that it [ ] has or [ ] does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond to paragraph (2) and if applicable, paragraph (3) of this provision for each participant in the joint venture. (2) If the Offeror indicates "has" in paragraph (p) (1) of this provision, enter the following information: Immediate owner CAGE code: _____________________________________________ Immediate owner legal name: ______________________________________________ (Do not use a "doing business as" name) Is the immediate owner owned or controlled by another entity: [ ] Yes or [ ] No. (3) If the Offeror indicates "yes" in paragraph (p) (2) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information: Highest level owner CAGE code: _____________________________________________ Highest level owner legal name: ______________________________________________ (Do not use a "doing business as" name) (q) Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law. (1) As required by section 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that- (i) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless and agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or (ii) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government. (2) The Offeror represents that-- (i) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and (ii) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months. (r) Predecessor of Offeror. (Applies in all solicitations that include the provision at 52.204-16, Commercial and Government Entity Code Reporting.) (1) The Offeror represents that it [ ] is or [ ] is not a successor to a predecessor that held a Federal contract or grant within the last three years. (2) If the Offeror has indicated "is" in paragraph (r) (1) of this provision, enter the following information for all predecessors that held a Federal contract or grant within the last three years (if more than one predecessor, list in reverse chronological order): Predecessor CAGE code ______ (or mark "Unknown). Predecessor legal name: _________________________. (Do not use a "doing business as" name). (s) Reserved. (t) Public Disclosure of Greenhouse Gas Emissions and Reduction Goals. Applies in all solicitations that require offerors to register in SAM (52.212-1(k)). (1) This representation shall be completed if the Offeror received $7.5 million or more in contract awards in the prior Federal fiscal year. The representation is optional if the Offeror received less than $7.5 million in Federal contract awards in the prior Federal fiscal year. (2) Representation. [ Offeror to check applicable block(s) in paragraph (t) (2) (i) and (ii) ]. (i) The Offeror (itself or through its immediate owner or highest-level owner) [ ] does, [ ] does not publicly disclose greenhouse gas emissions, i.e., makes available on a publicly accessible Web site the results of a greenhouse gas inventory, performed in accordance with an accounting standard with publicly available and consistently applied criteria, such as the Greenhouse Gas Protocol Corporate Standard. (ii) The Offeror (itself or through its immediate owner or highest-level owner) [ ] does, [ ] does not publicly disclose a quantitative greenhouse gas emissions reduction goal, i.e., make available on a publicly accessible Web site a target to reduce absolute emissions or emissions intensity by a specific quantity or percentage. (iii) A publicly accessible Web site includes the Offeror's own Web site or a recognized, third-party greenhouse gas emissions reporting program. (3) If the Offeror checked ''does'' in paragraphs (t) (2) (i) or (t) (2) (ii) of this provision, respectively, the Offeror shall provide the publicly accessible Web site(s) where greenhouse gas emissions and/or reduction goals are reported: _____. (u) (1) In accordance with section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions), Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with an entity that requires employees or subcontractors of such entity seeking to report waste, fraud, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information. (2) The prohibition in paragraph (u) (1) of this provision does not contravene requirements applicable to Standard Form 312 (Classified Information Nondisclosure Agreement), Form 4414 (Sensitive Compartmented Information Nondisclosure Agreement), or any other form issued by a Federal department or agency governing the nondisclosure of classified information. (3) Representation. By submission of its offer, the Offeror represents that it will not require its employees or subcontractors to sign or comply with internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting waste, fraud, or abuse related to the performance of a Government contract to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information (e.g., agency Office of the Inspector General). (End of Provision) FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders- Commercial Items. (a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items: (1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)). (2) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115-91). (3) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (Nov 2015) (4) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553). (5) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Public Laws 108-77, 108-78 (19 U.S.C. 3805 note)). (b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the contracting officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: __X_ (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 4704 and 10 U.S.C. 2402). ___ (2) 52.203-13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509). __X_ (3) 52.203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (Jun 2010) (Section 1553 of Pub L. 111-5) (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009). __X_ (4) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Oct 2018) (Pub. L. 109-282) (31 U.S.C. 6101 note). ___ (5) [Reserved] ___ (6) 52.204-14, Service Contract Reporting Requirements (Oct 2016) (Pub. L. 111-117, section 743 of Div. C). ___ (7) 52.204-15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (Oct 2016) (Pub. L. 111-117, section 743 of Div. C). __X_ (8) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Oct 2015) (31 U.S.C. 6101 note). __X_ (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) (41 U.S.C. 2313). ___ (10) [Reserved] ___ (11) (i) 52.219-3, Notice of HUB Zone Set-Aside or Sole-Source Award (Nov 2011) (15 U.S.C. 657a). ___ (ii) Alternate I (Nov 2011) of 52.219-3. __X_ (12) (i) 52.219-4, Notice of Price Evaluation Preference for HUB Zone Small Business Concerns (Oct 2014) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a). ___ (ii) Alternate I (Jan 2011) of 52.219-4. ___ (13) [Reserved] ___ (14) (i) 52.219-6, Notice of Total Small Business Aside (Nov 2011) (15 U.S.C. 644). ___ (ii) Alternate I (Nov 2011). ___ (iii) Alternate II (Nov 2011). ___ (15) (i) 52.219-7, Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644). ___ (ii) Alternate I (Oct 1995) of 52.219-7. ___ (iii) Alternate II (Mar 2004) of 52.219-7. __X_ (16) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (15 U.S.C. 637(d) (2) and (3)). ___ (17) (i) 52.219-9, Small Business Subcontracting Plan (Aug 2018) (15 U.S.C. 637 (d) (4)). ___ (ii) Alternate I (Nov 2016) of 52.219-9. ___ (iii) Alternate II (Nov 2016) of 52.219-9. ___ (IV) Alternate III (Nov 2016) of 52.219-9. ___ (v) Alternate IV (Aug 2018) of 52.219-9. ___ (18) 52.219-13, Notice of Set-Aside of Orders (Nov 2011) (15 U.S.C. 644(r)). ___ (19) 52.219-14, Limitations on Subcontracting (Jan 2017) (15 U.S.C. 637(a) (14)). __X_ (20) 52.219-16, Liquidated Damages-Subcontracting Plan (Jan 1999) (15 U.S.C. 637(d) (4) (F) (i)). ___ (21) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (Nov 2011) (15 U.S.C.657f). __X_ (22) 52.219-28, Post Award Small Business Program Re-representation (Jul 2013) (15 U.S.C. 632(a) (2)). ___ (23) 52.219-29, Notice of Set-Aside for, or Sole Source Award to, Economically Disadvantaged Women-Owned Small Business Concerns (Dec 2015) (15 U.S.C. 637(m)). ___ (24) 52.219-30, Notice of Set-Aside for, or Sole Source Award to, Women-Owned Small Business Concerns Eligible Under the Women-Owned Small Business Program (Dec 2015) (15 U.S.C. 637(m)). __X_ (25) 52.222-3, Convict Labor (June 2003) (E.O. 11755). __X_ (26) 52.222-19, Child Labor-Cooperation with Authorities and Remedies (Jan 2018) (E.O. 13126). __X_ (27) 52.222-21, Prohibition of Segregated Facilities (Apr 2015). __X_ (28) (i) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246). ___ (ii) Alternate I (Feb 1999) of 52.222-26. __X_ (29) (i) 52.222-35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212). ___ (ii) Alternate I (July 2014) of 52.222-35. __X_ (30) (i) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793). ___ (ii) Alternate I (July 2014) of 52.222-36. __X_ (31) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212). ___ (32) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496). __X_ (33) (i) 52.222-50, Combating Trafficking in Persons (JAN 2019) (22 U.S.C. chapter 78 and E.O. 13627). ___ (ii) Alternate I (Mar 2015) of 52.222-50, (22 U.S.C. chapter 78 and E.O. 13627). __X_ (34) 52.222-54, Employment Eligibility Verification (Oct 2015). (E. O. 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.) ___ (35) (i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C. 6962(c) (3) (A) (ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.) ___ (ii) Alternate I (May 2008) of 52.223-9 (42 U.S.C. 6962(i) (2) (C)). (Not applicable to the acquisition of commercially available off-the-shelf items.) ___ (36) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (Jun 2016) (E.O.13693). ___ (37) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (Jun 2016) (E.O. 13693). ___ (38) (i) 52.223-13, Acquisition of EPEAT® -Registered Imaging Equipment (Jun 2014) (E.O.s 13423 and 13514 ___ (ii) Alternate I (Oct 2015) of 52.223-13. ___ (39) (i) 52.223-14, Acquisition of EPEAT® -Registered Television (Jun 2014) (E.O.s 13423 and 13514). ___ (ii) Alternate I (Jun 2014) of 52.223-14. __X_ (40) 52.223-15, Energy Efficiency in Energy-Consuming Products (Dec 2007) (42 U.S.C. 8259b). ___ (41) (i) 52.223-16, Acquisition of EPEAT® -Registered Personal Computer Products (Oct 2015) (E.O.s 13423 and 13514). ___ (ii) Alternate I (Jun 2014) of 52.223-16. __X_ (42) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging while Driving (Aug 2011) (E.O. 13513). ___ (43) 52.223-20, Aerosols (Jun 2016) (E.O. 13693). ___ (44) 52.223-21, Foams (Jun 2016) (E.O. 13696). ___ (45) (i) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a). ___ (ii) Alternate I (Jan 2017) of 52.224-3. ___ (46) 52.225-1, Buy American--Supplies (May 2014) (41 U.S.C. chapter 83). ___ (47) (i) 52.225-3, Buy American--Free Trade Agreements--Israeli Trade Act (May 2014) (41 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41, 112-42, and 112-43). ___ (ii) Alternate I (May 2014) of 52.225-3. ___ (iii) Alternate II (May 2014) of 52.225-3. ___ (iv) Alternate III (May 2014) of 52.225-3. ___ (48) 52.225-5, Trade Agreements (Aug 2018) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note). __X_ (49) 52.225-13, Restrictions on Certain Foreign Purchases (June 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury). ___ (50) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). ___ (51) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150). ___ (52) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150). ___ (53) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 4505), 10 U.S.C. 2307(f)). ___ (54) 52.232-30, Installment Payments for Commercial Items (Jan 2017) (41 U.S.C. 4505, 10 U.S.C. 2307(f)). __X_ (55) 52.232-33, Payment by Electronic Funds Transfer--System for Award Management (Oct 2018) (31 U.S.C. 3332). ___ (56) 52.232-34, Payment by Electronic Funds Transfer-Other Than System for Award Management (Jul 2013) (31 U.S.C. 3332). ___ (57) 52.232-36, Payment by Third Party (May 2014) (31 U.S.C. 3332). ___ (58) 52.239-1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a). ___ (59) 52.242-5, Payments to Small Business Subcontractors (Jan 2017) (15 U.S.C. 637(d) (13)). ___ (60) (i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631). ___ (ii) Alternate I (Apr 2003) of 52.247-64. ___ (iii) Alternate II (Feb 2006) of 52.247-64. (c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or executive orders applicable to acquisitions of commercial items: [ Contracting Officer check as appropriate.] __X_ (1) 52.222-17, Non-displacement of Qualified Workers (May 2014) (E.O. 13495) __X_ (2) 52.222-41, Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67. ). __X_ (3) 52.222-42, Statement of Equivalent Rates for Federal Hires (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). __X_ (4) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (Multiple Year and Option Contracts) (Aug 2018) (29 U.S.C.206 and 41 U.S.C. chapter 67). ___ (5) 52.222-44, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). ___ (6) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67). ___ (7) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67). __X_ (8) 52.222-55, Minimum Wages under Executive Order 13658 (Dec 2015) (E.O. 13658). __X_ (9) 52.222-62, Paid Sick Leave under Executive Order 13706 (JAN 2017) (E.O. 13706). ___ (10) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792). (d) Comptroller General Examination of Record The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records -- Negotiation. (1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract. (2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved. (3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law. (e) (1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c) and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause- (i) 52.203-13, Contractor Code of Business Ethics and Conduct (Jan 2019) (41 U.S.C. 3509). (ii) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)). (iii) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115-91). (iv) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (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 $700,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities. (v) 52.222-17, Non-displacement of Qualified Workers (May 2014) (E.O. 13495). Flow down required in accordance with paragraph (1) of FAR clause 52.222-17. (vi) 52.222-21, Prohibition of Segregated Facilities (Apr 2015). (vii) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246). (viii) 52.222-35, Equal Opportunity for Veterans (Oct 2019) (38 U.S.C. 4212). (ix) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793). (x) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212). (xi) 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. (xii) 52.222-41, Service Contract Labor Standards (Aug 2018), (41 U.S.C. chapter 67). (xiii) (A) 52.222-50, Combating Trafficking in Persons (Jan 2019) (22 U.S.C. chapter 78 and E.O. 13627). (B) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 E.O. 13627). (xiv) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67.) (xv) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67) (xvi) 52.222-54, Employment Eligibility Verification (Oct 2015) (E. O. 12989). (xvii) 52.222-55, Minimum Wages under Executive Order 13658 (Dec 2015). (xviii) 52.222-62, Paid sick Leave under Executive Order 13706 (JAN 2017) (E.O. 13706). (xix) (A) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a). (B) Alternate I (Jan 2017) of 52.224-3. (xx) 52.225-26, Contractors Performing Private Security Functions outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). (xxi) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6. (xxii) 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) FAR 52.217-9, Option to Extend the Term of the Contract (a) The Government may extend the term of this contract by written notice to the Contractor within 30 days provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension. (b) If the Government exercises this option, the extended contract shall be considered to include this option clause. (c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 48 (months). (End of Clause) FAR 52.237-7, Indemnification and Medical Liability Insurance. (a) It is expressly agreed and understood that this is a non-personal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor's professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence: *_________________. (b) An apparently successful offeror, upon request by the Contracting Officer, shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (a) of this clause. (c) Liability insurance may be on either an occurrences basis or on a claims-made basis. If the policy is on a claims-made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided. (d) Evidence of insurance documenting the required coverage for each health care provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims-made basis and evidence of an extended reporting endorsement is not provided prior to the commencement of services, evidence of such endorsement shall be provided to the Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended reporting endorsement is provided to the Contracting Officer. (e) The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the Government's interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If, during the performance period of the contract the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause, for the entire period of the contract, either under the new policy, or a combination of old and new policies. (f) The Contractor shall insert the substance of this clause, including this paragraph (f), in all subcontracts under this contract for health care services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer evidence of such insurance. (End of Clause) FAR 52.252-1 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/ DFARS 252.232-7006, Wide Area Workflow Payment Instructions (a) Definitions. As used in this clause- "Department of Defense Activity Address Code (DoDAAC)" is a six position code that uniquely identifies a unit, activity, or organization. "Document type" means the type of payment request or receiving report available for creation in Wide Area Workflow (WAWF). "Local processing office (LPO)" is the office responsible for payment certification when payment certification is done external to the entitlement system. "Payment request" and "receiving report" are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports. (b) Electronic invoicing. The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (DFARS) 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports. (c) WAWF access. To access WAWF, the Contractor shall- (1) Have a designated electronic business point of contact in the System for Award Management at https://www.sam.gov ; and (2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site. (d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the "Web Based Training" link on the WAWF home page at https://wawf.eb.mil/ (e) WAWF methods of document submission. Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol. (f) WAWF payment instructions. The Contractor shall use the following information when submitting payment requests and receiving reports in WAWF for this contract or task or delivery order: (1) Document type. The Contractor shall submit payment requests using the following document type(s): (i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher. (ii) For fixed price line items- (A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer. ___________________________________________________________ (Contracting Officer: Insert applicable invoice and receiving report document type(s) for fixed price line items that require shipment of a deliverable.) (B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer. ___________________________________________________________ (Contracting Officer: Insert either "Invoice 2in1" or the applicable invoice and receiving report document type(s) for fixed price line items for services.) (iii) For customary progress payments based on costs incurred, submit a progress payment request. (iv) For performance based payments, submit a performance based payment request. (v) For commercial item financing, submit a commercial item financing request. (2) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract. (f) [Note: The Contractor may use a WAWF "combo" document type to create some combinations of invoice and receiving report in one step.] (3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system. Routing Data Table* Field Name in WAWF Data to be entered in WAWF Pay Official DoDAAC HQ0248 Issue By DoDAAC N62645 Admin DoDAAC N62645 Inspect By DoDAAC N/A Ship To Code N/A Ship From Code N/A Mark For Code N/A Service Approver (DoDAAC) N/A Service Acceptor (DoDAAC) N32626 Accept at Other DoDAAC N/A LPO DoDAAC N32626 DCAA Auditor DoDAAC N/A Other DoDAAC(s) N/A (*Contracting Officer: Insert applicable DoDAAC information. If multiple ship to/acceptance locations apply, insert "See Schedule" or "Not applicable.") (**Contracting Officer: If the contract provides for progress payments or performance-based payments, insert the DoDAAC for the contract administration office assigned the functions under FAR 42.302(a) (13).) (4) Payment request. The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable. (5) Receiving report. The Contractor shall ensure a receiving report meets the requirements of DFARS Appendix F. WAWF Acceptor/COR email address: lee.m.digiovanni.civ@mail.mil WAWF point of contact: UNS.detrick.navmedlogcomftdmd.list.nmlc-wawf@mail.mil (1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact. N/A___________________________________________________________ (Contracting Officer: Insert applicable information or "Not applicable.") (2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed. (End of clause) CONTRACTOR SUPPORT NOTICE: NAVY USE OF SUPPORT CONTRACTOR FOR CONTRACT CLOSEOUT FUNCTIONS: Naval Medical Logistics Command uses two private contractors in support of the contract closeout process. Those companies are Contracting Resources Group (CRG) of Federal Hill, MD, doing business under the authority of the Small Business Administration's 8(a) program, and the Ability One Program, doing business under the authority of the Javits-Wagner O'Day Act (41 U.S.C. § 47). The contract closeout process includes activities such as processing DE obligation modifications, obtaining contractor and requiring activity concurrence, preparing the DD-Form 1594 (Contract Completion Statement), and preparing closed files for archiving. Support contractors may perform additional administrative duties, including filing and processing simple administrative modifications. Performing these functions require the contractor employees to have access to the contract file. Therefore, information you provide to the Government or information already in the possession of the Government may be viewed by these support contractors in the course of performing contract close-out functions. The information that may be made available to the contractor may include pricing and technical proposals and performance information. NMLC has signed Non-Disclosure Agreements with each support contractor employee and has required both contractors to provide a Conflict of interest Mitigation Plan to ensure these employees are firewalled from all business development activity. By submission of a proposal in response to this solicitation, the offeror and its subcontractors consent to access of their business sensitive/confidential or proprietary data by the Government's support contractor personnel in order to perform close out services.
 

Web Link

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(https://www.fbo.gov/spg/DON/BUMED/N62645/N6264519Q0029/listing.html)
 

Place of Performance

Address: Philadelphia Navy Yard - Occupational Health Clinic, 4898 Broad Street, Bldg. 615, PNC-OHC, Philadelphia, Pennsylvania, 19112, United States

Zip Code: 19112
 

Record

SN05429989-W 20190906/190904230937-e6d4eeb010a81ef6f948f02303368e08 (fbodaily.com)
 

Source

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