Performance Work Statement
Non-personal Services/Medical Gas Products and Services/ Fort Polk, LA
1. GENERAL
1.1. This is a non-personal services contract (as defined by Federal Acquisition Regulation (FAR) Subpart 37.104) and is intended to create an
employer- employee relationship between the Government and the Medical Gas provider only to the extent necessary for providing the medical gas
services required under the contract. The performance of the medical gas provider under a non-personal services contract are subject to oversight by
the Logistics Department. Any personal injury claims alleging negligence by representatives of the medical gas provider will be the responsibility of
the medical gas provider. The authority for this contract is 10 United States Code 1089 and 10 United States Code 1091.
1.2. Background. Bayne-Jones Army Community Hospital is a general medical and surgical community hospital site at building 285 in Fort Polk, LA
and is part of the Defense Health Agency (DHA). It is accredited by The Joint Commission (TJC). The mission of Bayne-Jones Army Community
Hospital (BJACH) is to provide world-class medicine to the military personnel and their families in a safe, clean, and aesthetically pleasing Medical
Treatment Facility MTF. BJACH is located on a 10-acre wooded site bordered by 3rd Street to the south, HWY 467 to the north, Louisiana Ave to the
east and BLDG 350 to the west.
1.3. Scope of Work. The contractor shall provide medical gas products and services to include refilling government owned oxygen tanks of various
sizes, providing filled cylinders of nitrous oxide, nitrogen, various sizes of carbon dioxide, oxygen, lung diffusion mix, medical air, filling bulk liquid
oxygen tank, and associated service such as hydrostatic testing of cylinders, cylinder and bulk oxygen tank maintenance, delivery, and removal of
empty tanks at the MTF BJACH, Fort Polk, Louisiana as required by this Performance Work Statement (PWS) and in accordance with the terms and
conditions of this contract.
1.4. Period of Performance (POP). The POP shall be a 12-month Base Year (BY) with four (4) 12-month Option Year (OY) periods. A six (6) month
extension period will be available at the end of the 4th OY.
1.5. HOURS OF PERFORMANCE
The Contractor shall ensure routine orders are delivered within 5 business days of being requested. The Contractor shall adhere to routine delivery
hours of 0800 to 1630, Monday through Friday, excluding federal holidays, scheduled installation closures, or unexpected post closure due to threat,
weather conditions, etc. The Contractor shall fulfil emergency orders within 24 hours of being requested. Contractor shall contact a member of the
receiving department to coordinate delivery times.
Holidays. The following is a list of legal federal holidays as referred to elsewhere in the contract and PWS:
New Year's Day January 1st
Martin Luther King's Birthday 3rd Monday in January
Presidents' Day 3rd Monday in February
Memorial Day Last Monday in May
Juneteenth Day 19-Jun
Independence Day 4-Jul
Labor Day 1st Monday in September
Columbus Day 2nd Monday in October
Veteran's Day 11-Nov
Thanksgiving Day 4th Thursday in November
Christmas 25-Dec
1.6. Standards. The Contractor shall ensure routine orders are delivered within five (5) business days of request. The Contractor shall ensure
emergency orders are delivered within 24 hours of request. The Contractor shall perform hydrostatic testing on cylinders when they reach the 5-year
expiration from the previous hydrostatic testing date. The Contractor shall maintain cylinders at industrial standards according to the cylinder
contents. The Contractor shall return cylinders after hydrostatic testing within 30 days of receiving them. The contractor shall maintain the bulk
oxygen tank at industrial standards and perform maintenance at least once each year of the contract award. The Contractor shall ensure liquid oxygen
is delivered with a minimum 99% purity. The Contractor shall adhere to routine delivery hours of 0800 to 1630, Monday through Friday, excluding
federal holidays, scheduled installation closures, or unexpected post closure due to threat, weather conditions, etc. The Contractor shall ensure
delivered medical gas always matches the label on the cylinder 100% of the time. The Contractor shall ensure compressed gas cylinder safety
protocols are followed 100% of the time by ensuring caps or other safety device are in place, and cylinders are properly secured upon delivery. The
Contractor shall ensure cylinders are delivered at least 3/4 full.
1.7. QUALITY CONTROL (QC). Quality Control is the responsibility of the Contractor. The Contractor is responsible for the delivery of quality
services/supplies to the Government (see FAR 52.246-1, Contractor Inspection Requirements). The Contractor shall develop, implement and maintain
an effective Quality Control System which includes a written Quality Control Plan (QCP). The QCP shall implement standardized procedure
/methodology for monitoring and documenting contract performance to ensure all contract requirements are met. The Contractors' QCP shall contain
a systematic approach to monitor operations to ensure acceptable services/products are provided to the Government. The QCP, as a minimum, shall
address continuous process improvement; procedures for scheduling, conducting and documentation of inspection; discrepancy identification and
correction; corrective action procedures to include procedures for addressing Government discovered non-conformances; procedures for root cause
analysis to identify the root cause and root cause corrective action to prevent re-occurrence of discrepancies; procedures for trend analysis; procedures
for collecting and addressing customer feedback/complaints. The Contractor shall, upon request, provide to the Government their quality control
documentation. A comprehensive QCP shall be submitted to the KO and COR within ten (10) days after contract award and within five (5) working
days when changes are made thereafter (see Section J Exhibit B Deliverable #1). After acceptance of the quality control plan the Contractor shall
receive the Contracting Officer (KO) acceptance in writing of any proposed change to their QC system prior to implementation.
1.8. QUALITY ASSURANCE (QA). The Government will evaluate the Contractor's performance under this contract in accordance with the Quality
Assurance Surveillance Plan (QASP). This plan is a Government only document primarily focused on what the Government must do to assure that the
Contractor has performed in accordance with the requirements of the contract.
1.9. CRIMINAL HISTORY BACKGROUND CHECKS.
No performance under this contract will be allowed without full compliance with the Crime Control Act of 1990, as implemented by Department of
Defense Instruction 1402.5, Enclosure 5 (Healthcare Workers), dated 19 January 1993. All contract providers under this PWS must undergo a
criminal history background check IAW the DoDI 1402.5 procedures. Background checks will be based on the procedures in Enclosure 6 to DoDI
1402.5.
Providers also must comply with DoD 5200.2R, DoD Personnel Security Program, to obtain access to government computer systems based on the
information provided on Standard Form 85P completed by the contract provider. This may also include fingerprints of individuals obtained by a law
enforcement officer and inquiries will be made through the Federal Bureau of Investigation (FBI) and state criminal history repositories.
1.10. COMPLIANCE WITH CRIME CONTROL ACT OF 1990. This position requires the contractor to comply with Public Law 101-647 (Crime
Control Act) and submit to a criminal history background check performed by the government. The contractor shall schedule an appointment with the
Security & Intelligence Office at the MTF within 3 working days after start of performance under this contract. The contractor will be fingerprinted
and complete a Standard Form SF 85. If the contract employee is in a position that requires access to Critical Sensitive or Classified Information the
contract agency Facility Security Office (FSO) is responsible for ensuring that the employee has the required SECURITY clearance to include
submitting a SF86 EPSQ questionnaire to DSS and obtaining the necessary SECURITY clearance level through DISCO as prescribed by the National
Industrial Security Program Operating Manual (NISPOM) The contractor shall be advised that a FAVORABLE report is needed as a condition of
employment under Army Contracts. Until the final background checks are completed, line of sight restriction shall apply and access to classified or
Critical Sensitive information will be denied until a final SECURITY clearance or an interim SECURITY clearance has been granted by DISCO and
the appropriate security verification and visitation letter has been received by the MTF Security and Intelligence office. Security will notify each
department head when line of sight requirement can be lifted.
1.10.1. Contract employees who previously received a background check and do not have a two-year break in service must get verification from
Security and Intelligence Office at the MTF. All employees are required to have a record re-verification and internal record check at a minimum of
every five years.
1.11. SECURITY REQUIREMENTS. Security clearances are not required. The Contractor shall provide an up-to-date access roster, electronically to
the COR within 30 calendar days after performance start date and yearly thereafter. (see Section J Exhibit B Deliverable #2). The COR will forward
the access rosters to the Security and Intelligence Division (S&ID), the Directorate of Plans, Training, Mobilization and Security (DPTMS) and
visitors center yearly or upon request.
1.11.1. Contractor personnel performing work under this contract shall be able to read, write, speak, and understand the English language to
effectively carry out all contract requirements. They shall have a command of both the written and spoken English language to properly, clearly and
effectively communicate in person or via electronic devices (telephone and/or computer) with co-workers, customers and the general public.
1.11.2. Contractor personnel performing work under this contract shall be U.S. citizens unless the provisions of AR 25-2, Army Cybersecurity have
been fully completed and approval has been granted by the Government for a non-U.S. citizen to perform the required support.
1.11.3. Access and General Protection/Security Policy and Procedures. This standard language text is for contractor employees with an area of
performance within an Army controlled installation, facility or area. Contractor and all associated sub-contractor's employees shall comply with
applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government
representative). The contractor shall also provide all information required for background checks to meet installation access requirements to be
accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all
personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the
changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may
require changes in contractor security matters or processes.
1.11.4. OPSEC Training: All Contractor employees must complete annual Operational Security (OPSEC) awareness training. In accordance with
DODM 5205.02-M (DOD Operations Security (OPSEC) Program Manual), Contractor employees shall complete initial OPSEC Level I training no
later than (NLT) 30 calendar days after performance start date. New Contractor employees must complete Level I OPSEC training within 30 calendar
days of reporting for duty and submit certificates to COR upon completion. OPSEC training is available at the following website:
https://securityawareness.usalearning/gov/opsec/. OPSEC Awareness Training attendance and compliance may be documented as a performance
metric and be part of past performance information in support of future source selections. Neither the Contractor nor any of its contract service
providers shall disclose or cause to disseminate any information concerning operations of military activities. All inquiries, comments, or complaints
arising from any matter observed, experienced, or learned as a result of, or in connection with, the performance of this contract, the resolution of
which may require the dissemination of official information, shall be directed to the COR and KO. The Contractor shall only conduct business with
KO, COR or Alternate COR (ACOR). Names of authorized personnel shall be provided to the Contractor by the COR, in writing, and updated as
necessary throughout the contract period. The Contractor shall develop an OPSEC Standard Operating Procedure (SOP)/Plan to be reviewed and
approved by the responsible government OPSEC officer, per AR 530-1 (Operations Security) and COR NLT 30 calendar days after performance start
date and annually thereafter (see Section J Exhibit B Deliverable #3). This SOP/Plan will include the Government's critical information list, why it
needs to be protected, where it is located, who is responsible for it and how to protect it. The plan shall also address how the Contractor shall conduct
a rotation at the JRTC utilizing SECRET material and identify an individual who will be the Contractor's OPSEC Coordinator. This SOP shall
identify an individual who will be the Contractor's OPSEC Coordinator. The Contractor shall ensure this individual becomes OPSEC Level II
certified per AR 530-1.
1.11.5. Threat Awareness and Reporting Program (TARP). The Contractor shall comply with the Threat Awareness and Reporting Program (TARP)
and ensure all employees complete annual Level I Antiterrorism Awareness Training requirements prescribed by DOD regulations and Defense
Federal Acquisition Regulation Supplement (DFARS), Section 252.225- 7043 (Level I Antiterrorism Awareness Training). All Contractor employees,
to include subcontractor employees, requiring access to Army installations, facilities and controlled areas shall complete AT Level I training and
submit employee certificates of completion to the COR NLT 30 calendar days after performance start date and annually thereafter (see Section J
Exhibit B Deliverable #4). AT level I awareness training is available at the following website: https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf. In
the event that the automated system is not available (e.g., server problems), AT Level I Awareness Training can be provided by a qualified instructor.
Contact the installation AT/FP Office for guidance. If the training is not completed online, the Level I AT Awareness instructor qualification shall be
coordinated with the installation Antiterrorism Officer or (installation security equivalent) and the resultant name(s) of approved instructors shall be
provided to the contracting officer or designee along with all associated cost or schedule impacts to the contract. Antiterrorism performance (AT
Level I Awareness Training attendance and compliance) may be documented as a performance metric under the resultant contract and be part of past
performance information in support of future source selections. IAW DoDI 2000.12, all DoD and non-DoD Tenants will comply with the installation
AT Program. The Contractor shall attend TARP training at least annually IAW DoDM 5205.02, Enclosure 7, paragraph 3. d. The Contractor shall
report threat-related incidents, behavioral indicators and/or other matters of counterintelligence interest specified in AR 381-12, paragraph 3 to the
Contractor's Facility Security Officer, nearest military CI office, Federal Bureau of Investigation and/or the Defense Security Service. Methods of
reporting include online at https://www.inscom.army.lmil/isalute and by phone 1- 800-CALL-SPY (1-800-225-5779).
1.11.6. "iWATCH Training. The contractor and all associated sub-contractors shall brief all CSPs on the local iWATCH program (training standards
provided by the MTF antiterrorism officer). This local developed training will be used to inform CSPs of the types of behavior to watch for and
instruct CSPs to report suspicious activity to the COR. This training shall be completed within 14 calendar days of contract award and within 14
calendar days of new CSPs commencing performance with the results reported to the COR NLT 30 calendar days after contract award (see Section J
Exhibit B Deliverable #5)."
1.11.7. Sponsoring organizations, activities whose personnel do not need access to multiple Installations or access to the government information
systems will submit a completed access control roster to the Visitor Control Center (VCC) (see Section J Exhibit B Deliverable #6). They may receive
a MOBILISA visitor card for the terms of their contract (until contract end date, not to exceed 3 years) when sponsored on an access roster. If not
sponsored they will only receive a pass for up to 7 days.
1.11.8. MOBILISA card expirations may be updated to reflect a new contract period by submitting an updated access control roster to the VCC.
1.11.9. Access rosters may only be submitted via e-mail to the VCC by a .mil, .gov, .AAFES, address by the COR or security activity, all others will
be returned without action.
1.11.10. Installation Access. All unescorted visitors to Fort Polk must be vetted at the Visitors Center, located adjacent to the main gate on Louisiana
Avenue (building 5903). Personnel requiring unescorted access will present a state issued Real ID Act compliant driver's license (check status of your
state at: https://www.dhs.gov/real-id- enforcement-brief ). Visitors who do not have a Real ID act compliant driver's license may use alternate forms
of ID to prove their identity. Contact the Fort Polk Visitor's Center at (337) 531-7907 to obtain a listing of authorized alternate forms of identity. Each
visitor with acceptable screening results will be issued an access control credential for unescorted access to the installation. Personnel with
unfavorable screening results may be denied unescorted access to Fort Polk. Law enforcement data obtained during the vetting process will not be
released by personnel at the Visitors Center. A waiver process has been established for personnel who are denied unescorted access. Generally,
waivers will be processed within five days of completion.
1.11.11. Escorted visitors who are accompanied by Department of Defense-affiliated personnel (active- duty Soldiers, civilian common access card
holders, retiree ID card holders, DoD dependent ID card holders, and civilian contractor Common Access Card (CAC) holders) will not require
vetting for access and will only need to produce a valid ID card; these visitors must be in the immediate vehicle of the escorting card holder. DoD
affiliated personnel will be responsible for their escorted visitors on the installation. Personnel who are enrolled and vetted through the Rapid Gate
program or possess an installation issued ID/Pass do not have escorting privileges.
1.11.12. The Fort Polk Visitors Center is open Monday to Friday 0500 to 2100 and Saturday and Sunday 0800 to 1600. For additional information
concerning access control please contact the Visitors Center at (337) 531-0380/4978/7186.
1.11.13. Contractors shall provide an access roster to Directorate of Emergency Services (DES), Visitors Center of all employees monthly or when
any personnel change occurs for access to Fort Polk. Access rosters must be forwarded by the COR to the visitors control center using a specific
format electronically from a government computer (see Section J Exhibit B Deliverable #6). All personnel employed under this contract will adhere to
all Fort Polk access control policies which include, weapons registration, transportation of weapons on the installation, access control policies, use of
installation passes and ID cards and the operation of motor vehicles.
1.11.14. Installation AT/FP. Pursuant to DoD Instruction Number 2000.16, "DoD Antiterrorism (AT) Standards," dated October 2, 2006, each
Contractor employee requiring access to a Federally-Controlled Installation, facility and/or federally-controlled information system(s) shall complete
Level I AT Awareness Training on an annual basis and receive a certificate of completion. The training is accessible from any computer and is
available at http://jko.jten.mil/courses/atl1/launch.html The contractor is responsible for ensuring that all applicable employees have completed
antiterrorism awareness training and shall certify that their workforce has completed the training through the submission of completion certificate(s)
to the Contracting Officer and the Contracting Officer's Representative (if appointed) within five working days after contract award or prior to access
to a federally- controlled installation or information system.
1.11.15. Special Instructions.
a. Using an internet search engine, search JKO (Joint Knowledge Online) to begin the process.
Clicks:
No DOD CAC
I am a US mil, government civil servant, or contract employee I've been directed to take required training on JKO
Click on Courses
I do not have a .MIL, .GOV, or .NDU.EDU address or I am a Multi-National Student Fill out the contact sheet and email to sponsor (This is the COR)
Sponsor will email to the JKO help desk. (This is the COR)
Approval
Help desk sends non-CAC user an email with User ID
Help desk will send a separate email with electronic token to register a new password (token is good for 24 hrs)
New User follows the instructions in the email and enters a new password
User will need to enroll in Course # JS-US007-14 (User has up to 30 days to complete the course)
In the event that the automated system at https://jkodirect.jten.mil not available (e.g., server problems), Level I AT Awareness Training can be
provided by a qualified instructor. However, if the training is not completed online, the Level I AT Awareness instructor qualification must be
coordinated with the installation Antiterrorism Officer or (installation security equivalent) and the resultant name(s) of approved instructors shall be
provided the contracting officer or designee along with all associated cost or schedule impacts to the contract.
Antiterrorism performance (Level I AT Awareness Training attendance and compliance) may be documented as a performance metric under the
resultant contract and be part of past performance information in support of future source selections.
1.12. POST AWARD CONFERENCE/PERIODIC PROGRESS MEETINGS. The Contractor shall attend, participate in and furnish input to
scheduled and unscheduled meetings, conferences and/or briefings that relate to the contracted functions and services as required to provide effective
communication and impart necessary information. These meetings include both on-site and off-site meetings, and the frequency may be weekly,
monthly or as otherwise required. These meetings shall be at no additional cost to the Government.
1.13. CONTRACTING OFFICER REPRESENTATIVE (COR). The COR will be identified by separate letter. The COR monitors all technical
aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure Contractor performs
technical requirements of the contract, perform inspections necessary in connection with contract performance, maintain written and oral
communications with the Contractor concerning technical aspects of the contract, issue written interpretations of technical requirements, including
government drawings, designs, specifications, monitor Contractor's performance, notifies both the KO and Contractor of any deficiencies, coordinates
availability of government furnished property and provide site entry of Contractor personnel. The COR will also prepare Contractor Performance
Assessment Reports System (CPARS) reports based on documented Contractor performance evaluations. A letter of designation is issued to the COR
with a copy furnished to the Contractor stating the responsibilities and limitations of the COR, especially with regard to changes in cost or price,
estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting contract.
1.14. CONTRACTOR PERSONNEL. The Government has the right to issue a barred from installation letter to any Contractor employee, or
prospective Contractor employee, who is identified as a potential threat to the health, safety, security, general well-being or operational mission of the
installation and its population. The Contractor shall furnish all personnel required for efficient operation of all phases of work incidental to performing
the services required by this PWS. The Contractor shall provide qualified and trained personnel with the required technical, educational, and cultural
experience to accomplish all requirements as specified in this PWS. The Contractor shall be responsible for ensuring all personnel performing work
under this contract possess and maintain current certifications required by the PWS during the execution of this contract.
1.15. IDENTIFICATION OF CONTRACTOR EMPLOYEES. All Contractor personnel shall be identifiable by visibly wearing on the front exterior
clothing, above the waist, a readable identification badge furnished by the Contractor and made of durable plastic. All Contractor identification shall
comply with the standards established by Homeland Security Presidential Directive 12 (HSPD-12). The badge format is subject to approval by the
COR. Badges shall be laminated and include the company's name (prime Contractor or sub-Contractor), ID number, issue and expiration dates,
employee name, job title and a color photograph of the recipient. A list of badges issued shall be provided to the KO and COR no later than 10
calendar days after performance start date and updated as changes occur (see Section J Attachment 2 Deliverable #7). The list shall include the badge
ID number, issue and expiration dates, and the employee's name for each badge issued.
1.16. Contractor shall only conduct business with the KO and COR. The names of the KO, COR and Alternate COR (if appointed) shall be provided
to the Contractor by the Government, in writing, and updated as necessary throughout the contract period.
1.17. Contractor shall comply with all applicable federal, state and local laws and ensure equipment is secure while protecting material, equipment,
and supplies from damage and loss. Government security personnel shall have the express right to inspect for security violations at any time during
the term of the contract.
1.18. The Contractor shall be responsible for the performance and conduct of Contractor and subcontractor employees at all times. It is essential that
all Contractor personnel meet the highest standards of professionalism and personal integrity. The Contractor shall ensure their personnel do not
perform work under the influence of alcohol, illegal prescribed drugs or any other incapacitating agents. Personnel employed by the Contractor in the
performance of this contract, or any representative of the Contractor entering Fort Polk and any other performance locations supported under this
contract, shall abide by the applicable installation security regulations. Violation of such rules, regulations, laws, directives, or requirements shall be
grounds for removal (permanently or temporarily as the Government determines) from the work site. Removal of employees does not relieve the
Contractor from the responsibility for the work defined in this contract. The Contractor shall not employ for performance under this contract any
person whose employment would result in a conflict of interest with the Government's standards of conduct.
1.19. All Contractor personnel shall conform to standards of conduct and code of ethics, which are consistent with those applicable to Government
employees as provided in the Joint Ethics Regulation 5500.7.R. Contractor personnel shall present a neat professional appearance and be easily
identified. This shall be accomplished by wearing distinctive clothing bearing the company name and by wearing appropriate badges that contain the
company name and employee's name.
1.20. ORGANIZATIONAL CONFLICT OF INTEREST (OCI).
1.20.1. Purpose. The primary purpose of this section of the PWS is to aid in ensuring the following:
a. The Contractor does not obtain an unfair competitive advantage by establishing the ground rules for a future competition;
b. The Contractor's objectivity and judgment are not biased because of its present or future interests (financial, contractual, organizational or
otherwise) which relate to work performed under this contract; and
c. The Contractor does not obtain an unfair competitive advantage by virtue of its access to non- public or proprietary information belonging to others.
1.20.2. Definitions:
1.20.2.1. The term "Contractor" herein used means: (a) the organization (hereinafter referred to as "it" or "its") entering into this agreement with the
Government; (b) all business organizations with which it may merge, join or affiliate now or in the future and in any manner whatsoever, or which
hold or may obtain, by purchase or otherwise, direct or indirect control of it; (c) its parent organization if any and any of its present or future
subsidiaries, associates, affiliates or holding companies and; (d) any organization or enterprise over which it has direct or indirect control now or in
the future.
1.20.2.2. The term "proprietary information" for purposes of this clause means any information considered so valuable by its owners that it is held
secret by them and their licensees. Information furnished voluntarily by the owner without limitations on its use, or which is available without
restrictions from other sources, is not considered proprietary.
1.20.3. Biased Ground Rules. This type of conflict may arise in situations where a company sets the ground rules for a future competition. For
example, when a Contractor develops requirements then competes to provide products or services to satisfy those requirements, thus obtaining a
competitive advantage. Impaired Objectivity. This type of conflict may exist where a Contractor's obligations under a contract require objectivity, but
another role of the Contractor casts doubt on its ability to be truly objective. An example of this type of conflict is where a Contractor's work under
one contract entails evaluating itself, its affiliates, or its competitors under a separate contract.
1.20.4. Unequal Access to Information. This type of conflict may arise when a Contractor has access to nonpublic or proprietary information as part
of its performance under a contract that gives it an unfair advantage in a competition for a later contract.
1.20.5. General Constraints. The provisions of FAR Subpart 9.5, Organizational and Consultant Conflicts of Interest, concerning organizational
conflicts of interest govern this contract. Potential conflicts may exist in accordance with FAR 9.505-1, Providing Systems Engineering and Technical
Direction, through 9.505-4, Obtaining Access to Proprietary Information. In this regard, the Contractor is responsible for identifying any actual or
potential organizational conflicts of interest to the KO that arise as the result of performance under this contract. To avoid or mitigate a potential
conflict related to performance under this contract, the KO will impose appropriate constraints such as the constraints discussed below. Since it is
impossible to foresee all the circumstances that might give rise to organizational conflicts of interest, the constraints discussed below are not all
inclusive and the KO may impose constraints other than, or in addition to, the constraints listed below.
1.20.5.1. The Contractor agrees that if it provides, under a contract or task order or delivery order, systems engineering and technical guidance for
systems and programs, but does not have overall contractual responsibility, it will not be allowed to be awarded a contract or task or delivery order to
supply the system or any of its major components or be a subcontractor or consultant to a supplier of the system or any of its major components (FAR
9.505-1).
1.20.5.2. The Contractor agrees that if it prepares complete specifications for non-developmental items or assists in the preparation of work statements
for a system or services under a contract, task order or delivery order, it will not be allowed to furnish these items, either as a prime Contractor, a
subcontractor or as a consultant (FAR 9.505-2).
1.20.5.3. The Contractor agrees that it will neither evaluate nor advise the Government about its own products or activities. The Contractor will
objectively evaluate or advise the Government concerning products or activities of any prospective competitors (FAR 9.505-3).
1.20.5.4. The Contractor agrees that if it gains access to proprietary information of other companies, it will exercise diligent effort to protect such
proprietary information from unauthorized use or disclosure (FAR 9.505-4). In addition, the Contractor agrees to protect the proprietary information
of other organizations disclosed to the Contractor during performance of this contract with the same caution that a reasonably prudent Contractor
would use to safeguard highly valuable property. The Contractor also agrees that if it gains access to the proprietary information of other companies it
will enter into written agreements with the other companies to protect their information from unauthorized use or disclosure for as long as it remains
proprietary and to refrain from using the information for any purpose other than that for which it was furnished. Contractor shall provide copies of
such agreements to the KO.
1.20.5.5. If the Contractor, in the performance of this contract, obtains access to plans, policies, reports, studies, financial plans, data or other
information of any nature which has not been released or otherwise made available to the public, the Contractor agrees that without prior written
approval of the KO, it shall not: (a) use such information for any private purpose unless the information has been released or otherwise made available
to the public, or (b) release such information unless release is otherwise authorized under the contract or such information has previously been
released or otherwise made available to the public by the Government.
1.20.6. Non-Disclosure Agreements. Contractor shall obtain from each employee who has access to proprietary information under this contract, a
written agreement which shall in substance provide that such employee shall not, during his/her employment by the Contractor or thereafter, disclose
to others or use for their benefit, proprietary information received in connection with the work under this contract. The Contractor will educate its
employees regarding the restrictions imposed by FAR 9.505-4, so that they will not use or disclose proprietary information or data generated or
acquired in the performance of this contract, except as provided herein.
1.20.7. Conflicts Involving Future Procurements: The award of this contract or acquiescence in the Contractor's performance of services here under
shall not constitute or be interpreted as a determination that the Contractor is eligible to participate in future procurements, developmental efforts,
implementation efforts, or related activities. Only the KOs for such efforts, applying the rules, principles, and procedures of FAR Subpart 9.5, have
the authority to determine whether a conflict exists in connection with such procurements.
1.20.8. Representations and Disclosures:
1.20.8.1. The Contractor represents that it has disclosed to the KO, prior to award of this contract, all facts relevant to the existence or potential
existence of OCI as that term is used in FAR Subpart 9.5.
1.20.8.2. The Contractor represents that if it discovers an OCI or potential conflict of interest after award of this contract, a prompt and full disclosure
shall be made in writing to the KO. This disclosure shall include a description of the action the Contractor has taken or proposes to take to avoid or
mitigate such conflict.
1.20.9. Remedies and Waiver:
1.20.9.1. For breach of any of the above restrictions or for non-disclosure or misrepresentation of any relevant facts required to be disclosed
concerning this contract, the Government may terminate this contract for default, disqualify the Contractor for subsequent related contractual efforts,
and pursue such other remedies as may be permitted by law or this contract. If, however, in compliance with this PWS, the Contractor discovers and
promptly reports an OCI (or the potential thereof) subsequent to contract award, the KO may terminate this contract for convenience if such
termination is deemed to be in the best interest of the Government.
1.20.9.2. The parties recognize that this clause has potential effects, which will survive the performance of this contract, and that it is impossible to
foresee each circumstance to which it might be applied in the future. Accordingly, the Contractor may at any time seek a waiver from the cognizant
KO by submitting a full written description of the requested waiver and the reasons in support thereof (FAR 9.503).
1.21. CONTRACTOR PHOTOGRAPHY. IAW USC Title 18 and in the interest of National Defense, it is unlawful to take any photographs, render
sketches, drawings, maps, or geographical representation or other media of JRTC and Fort Polk military installation or training areas without first
obtaining approval from the Directorate of Plans, Training, Mobility and Security: Chief, S&ID; AT/FP Officer; Visual Information; and Directorate
of Emergency Services, Physical Security Office.
1.21.1. IAW Garrison Policy Memorandum #6, (July 18, 2013), Installation Photography and Other Media, paragraph 5c, as well as any subsequent
memorandums on the subject, Contractors must have prior approval for any activity that involves photographs, video or drawings of installation
infrastructure. This policy does not apply to Government Quality Assurance personnel and the COR performing inspections or contract surveillance.
1.21.2. Personnel taking photographs, videos, sketches, drawings, maps or other presentations of JRTC and Fort Polk must be in possession of an
approved photo request and present it to law enforcement or competent authority upon demand.
1.21.3. Report all unauthorized photographic activity to the DES 911 Center or the Installation Operations Center.
2. DEFINITIONS & ACRONYMS
2.1. Definitions
2.1.1. Contractor: A supplier or vendor having a contract to provide specific supplies or service to the government. The term used in this contract
refers to the prime.
2.1.2. Contracting Officer (KO): A person with authority to enter into, administer, and or terminate contracts, and make related determinations and
findings on behalf of the Government. Note: The only individual who can legally bind the Government.
2.1.3. Contracting Officer's Representative (COR): An employee of the U.S. Government appointed by the contracting officer to administer the
contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical
direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications.
This individual does NOT have authority to change the terms and conditions of the contract.
2.1.4. Defective Service: A service output that does not meet the standard of performance associated with the Performance Work Statement.
2.1.5. Deliverable: Anything that can be physically delivered but may include non-physical things such as meeting minutes, accident reports, any
employee changes, and screening checks of new employees.
2.1.6. Physical Security: Actions that prevent the loss or damage of Government property.
2.1.7. Quality Assurance (QA): The Government procedures to verify that services being performed by the Contractor are performed according to
acceptable standards.
2.1.8. Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for
surveillance of contractor performance.
2.1.9. Quality Control (QC): All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract
requirements.
2.1.10. Subcontractor: One that enters into a contract with a prime Contractor. The Government does not have privity of contract with the
subcontractor.
2.1.11. Workday: Number of hours per day the Contractor provides services shall be IAW the contract.
2.1.12. Performance Requirement Summary (PRS): A listing of the service outputs under the contract that are to be evaluated by the COR on a regular
basis, the surveillance methods to be used for these outputs, and the performance requirement of the listed outputs.
2.2. Acronyms
Acronym Definition
ACOR Alternate Contracting Officer Representative
BJACH Bayne-Jones Army Community Hospital
BLDG Building
BY Base Year
CAC Common Access Card
COR Contracting Officer's Representative
CPARS Contractor Performance Assessment Reports System
CSP Contract Service Provider
DES Directorate of Emergency Services
DFARS Defense Federal Acquisition Regulation Supplement
DHA Defense Health Agency
DISCO Division Information Systems Control Officer
DoD Department of Defense
DoD Department of Defense
DPTMS Directorate of Plans, Training, Mobilization and Security
DSS Defense Security Service
FAR Federal Acquisition Regulation
FSO Facility Security Officer
HCP Health Care Provider
HQDA Head Quarters Department of the Army
HSPD Homeland Security Presidential Directive
IAW In Accordance With
ID Identification
JKO Joint Knowledge Online
KO Contracting Officer
MTF Medical Treatment Facility
NISPOM National Industrial Security Program Operating
NLT No Later Than
OCI Organizational Conflict of Interest
OPSEC Operational Security
OY Option Year
PoP Period of Performance
PWS Performance Work Statement
QA Quality Assurance
QASP Quality Assurance Surveillance Plan
QC Quality Control
QCP Quality Control Plan
SOP Standard Operating Procedure
TARP Threat Awareness and Reporting Program
TJC The Joint Commission
USC United States Code
VCC Visitor Control Center
3. GOVERNMENT FURNISHED ITEMS AND SERVICES.
3.1. Supplies/Materials.
3.1.1. The MTF will provide hand trucks for moving compressed gas cylinders from the delivery truck to their storage location.
3.1.2. The MTF will provide full/empty tags and do not oil tags for medical gases upon delivery.
3.1.3. The MTF will provide type D and H tanks for oxygen to be refilled as needed.
3.1.4. The MTF will provide Emergency healthcare for injuries occurring while on the MTF. The Contractor shall reimburse the government for such
services.
3.2. Facilities. Not Applicable
3.3. Services. Not Applicable
3.4. Government Quality Assurance (QA). The Government shall monitor the Contractor's performance under this contract using the QA procedures
established by the MTF and pursuant to addendum 52.212-4. Additionally, the Contractor's performance is subject to scheduled and unscheduled
review by QA defined in the MTF's Quality Assurance Surveillance Plan (QASP).
4. CONTRACTOR FURNISHED ITEMS, SERVICES AND RESPONSIBILITIES. The Contractor shall furnish all supplies/materials, equipment,
facilities and services required to perform work under this contract that are not listed under Section 3 of this statement.
4.1. Supplies/Materials
4.1.1. The Contractor shall provide the following gases and tank rental for each except for government owned liquid oxygen tank and government
owned oxygen cylinders:
Cylinder Gas Quantity
D and H Med Grade Oxygen 375
H Med Grade Nitrous Oxide 32
H Med Grade Nitrogen 48
H Med Grade Carbon Dioxide Siphon 60
H Med Grade Carbon Dioxide 36
E Med Grade Carbon Dioxide 35
Mobile Walk About Med Grade Oxygen 24
H Lung Diffusion Mix 2
H Medical Air 6
Liquid Oxygen 7200 cu. ft.
Food Grade Carbon Dioxide 12
Note: All cylinder types and quantities are subject to change based on MTF requirements and mission changes.
4.1.2. The Contractor shall provide cylinder maintenance for up to 200 cylinders of various types and sizes.
4.2. Facilities. Not Applicable
4.3. Equipment. Not Applicable
4.4. Personnel Qualifications. The Contractor shall ensure delivery personnel are adequately licensed and qualified to operate delivery vehicles and
handle all types of cylinders and bulk product deliveries.
5. DESCRIPTION OF WORK.
5.1. SPECIFIC TASKS: The contractor shall provide all medical gas products and services to include, but not limited, to the following:
5.1.1. MEDICAL GAS DELIVERIES:
5.1.1.1. Routine Deliveries: Contractor shall provide all routine deliveries within 5 business days of request. Contractor shall make routine deliveries
between the hours of 0800-1630 Monday through Friday to exclude federal holidays and unexpected post closures due to threats, weather conditions,
etc. This includes bulk tank deliveries which will occur at least 2-4 times monthly to maintain tank above 30 inches and at least 1-2 weekly cylinder
deliveries as requested to maintain adequate compressed gas supplies for patient care. Liquid Oxygen levels shall be monitored by the contractor and
a delivery will be scheduled with the MTF when the level is at 40 inches so that the level does not fall below 30 inches.
5.1.1.2. Emergency Deliveries: Contractor shall fulfil all emergency deliveries within 24 hours of confirmed notification. Contractor shall notify
receiver in Logistics department prior to delivery of emergency cylinder or bulk oxygen deliveries.
5.1.1.3. Contractor shall ensure compliance with all federal, state, and local regulations associated with transport and delivery of medical gases/liquids.
5.1.1.4. Contractor shall deliver medical gas cylinders to the loading dock of the MTF. Upon delivery, Contractor shall provide a list of cylinders,
content of each, number by type and product being delivered, and/or amount of bulk liquid oxygen being provided to the MTF. The Contractor shall
provide a separate list of cylinders being returned to the MTF after maintenance with status of each. The Contractor shall ensure all protective safety
devices (caps, serviceability tags, etc.) are in place at the time of delivery.
5.1.1.5. All cylinder contents will meet purity specifications prior to being delivered to the MTF. Contractor will ensure that cylinders are at least 3/4
full when delivered.
5.1.2. GOVERNMENT OWNED 500 GALLON BULK LIQUID MEDICAL OXYGEN TANK.
5.1.2.1. The Contractor shall ensure bulk oxygen tank is maintained above 30 inches telemetry track bulk tank volume and refilled as required.
5.1.2.2. The Contractor shall provide a certificate of purity showing that the delivered oxygen is a minimum 99% purity.
5.1.2.3. The Contractor shall assist the receiving Government representative to purity check the truck contents prior to product being offloaded.
5.1.2.4. The Contractor shall schedule and perform an annual bulk liquid oxygen tank inspection and maintenance.
5.1.3. MEDICAL GAS CYLINDERS
5.1.3.1. Government owned D-H Cylinders. Contractor shall refill and exchange barcoded government owned cylinders. The Contractor shall inform
the Government representative if any Government owned cylinder has a damaged or missing barcode. The Contractor will set aside improperly or
poorly identified Government cylinders for the Government to correct prior to removing the cylinders from the MTF.
5.1.3.2. Cylinder Maintenance. The Contractor shall perform cylinder maintenance to include hydrostatic testing, refurbishing cylinders, valve testing
and maintenance, and other services needed to maintain tanks in a safe and usable condition according to industry standards. The Contractor shall
provide a monthly report in a Government approved format of all cylinder maintenance for Government owned cylinders (see Exhibit B Deliverable
#7). Cylinder maintenance will be completed within 30 calendar days of turning cylinders over to the Contractor.
6. APPLICABLE REGULATIONS AND MANUALS (Current Editions).
6.1. Mandatory Publications.
6.1.1. Public Law 91 596 29 Dec 70 Occupational Safety and Health Administration
6.1.2. Current Edition Joint Commission (JC) Manual
6.2. Reference Publications.
6.2.1. Public Law 91-596 Occupational Safety and Health Act of 1970
6.2.2. 29 CFR Occupational Safety and Health Standards
6.2.3. DHA PM 6040.06 Medical Gas Services
6.2.4. DHA-AI 003 Physical Security Program
6.2.5. DHA-AI 034 Drug-Free Workplace Program
6.2.6. DoDD 5500.07 Standards of Conduct
6.2.7. DoDI 3020.37 Continuation of Essential DoD Contractor Services During a Crises
6.2.8. SF 30 Amendment of Solicitation/Modification of Contract
6.2.9. SF 1449 Solicitation/Contract/Order For Commercial Items
6.2.10. SF 30 Standard Form 30 - Amendment Of Solicitation/Modification Of Contract
6.2.11. Compressed Gas Association Pamphlet P-1-1965
7. LIST OF EXHIBITS/ATTACHMENTS:
7.1. Exhibit A- Performance Requirement Summary (PRS)
Performance Objectives PWS Ref. Acceptable Quality Level (AQL)
Method of Surveillance
Performance
Incentive
Routine Deliver: provide within 5 business days of request Paragraph 5.1.1.1 No more than 1 late delivery per month Periodic Inspection, Customer
Feedback Failure to comply with any of the performance
standards shall be documented in assessments of the contractor's performance. These assessments are submitted to the Federal Government's past
Performance
Information Retrieval System. If warranted,
based on the terms and conditions of the contact and Army
Regulation DHAPM 6025.13, the contract could be terminated for cause (i.e., on the part of the contractor.
Deliver emergency gas requests within 24 hours of request Paragraph 5.1.1.2 No more than 1 late delivery every 6 months Periodic Inspection,
Customer Feedback
Complete Cylinder maintenance within 30 calendar days of receipt of cylinder Paragraph 5.1.3.2 No more than 10% returned after one month of
receipt Periodic Inspection
Cylinders are properly maintained by industry standards for medical gas Paragraph 5.1.1.3 100% of tanks are received in workable order Periodic
Inspection
Liquid oxygen is delivered at a minimum of 99% purity Paragraph 5.1.2.2 Comply at least 100% of the time. Periodic Inspection
Deliver routine orders Monday through Friday 0800-1630 excluding unexpected closures and federal holidays Paragraph 5.1.1.1 No more than one
delivery every 2 months outside of business hours Periodic Inspection, Customer Feedback
Delivered cylinders are properly identified by type, product, and maintenance status upon delivery Paragraph 5.1.1.4 Comply at least 100% of the
time Customer Feedback, Periodic Inspection
Safety protocols are followed
Paragraph 5.1.3.2 Safety protocols are followed 100% of the time Periodic Inspection
Caps or other safety devices are in place when gas is delivered
Paragraph 5.1.1.4 100% compliance Periodic Inspection
Cylinders are delivered at least 3/4 full. Paragraph 5.1.1.5 100% compliance Periodic Inspection
Bulk liquid oxygen is delivered before level falls below 30 inches Paragraph 5.1.2.1 No more than 2 instances every 6 months of level falling below
40 inches Observation, Record Review
7.2. Exhibit B-Deliverables
Deliverable Frequency Medium/Format Paragraph Reference Acceptance Criteria
1. Quality Control Plan Within 10 days after contract award and within 5 working days when changes are made thereafter Gov't approved Contractor
Format 1.7 TOCO and TOCOR review and approval
2. Access Roster Within 30 calendar days after performance start date and yearly thereafter Gov't approved Contractor Format 1.11 TOCO and
TOCOR review and approval
3. OPSEC SOP No later than 30 days after performance start date and annually thereafter Gov't approved Contractor Format 1.11.4 TOCO and
TOCOR review and approval
4. TARP AT Level I training certificates for all contractor employees requiring access to Fort Polk No later than 30 calendar days after performance
start date and annually thereafter AT Level I awareness training certificates 1.11.5, 1.11.14 TOCO and TOCOR review and approval
5. iWATCH Training Within 14 calendar days of contract award and within 14 calendar days of new CSPs commencing performance Gov't approved
Contractor Format 1.11.6 TOCO and TOCOR review and approval
6. Access Control Roster Upon award and updated as new employees need access Visitor Control Center Format and Directorate of Emergency
Services Format 1.11.7, 1.11.13 VCC and DES review and approval
7. Gov't owned cylinder maintenance report Monthly Gov't approved Contractor Format 5.1.3.2 TOCO and TOCOR review and approval
7.3. Attachment 1 - Quality Assurance Surveillance Plan (QASP)
(End of Performance Work Statement)
THE PURPOSE OF AMENDMENT 1 IS TO PROVIDE A DEADLINE FOR VENDOR QUESTION(S). THE DEADLINE FOR VENDOR QUESTION(S) IS THURSDAY 21 AUGUST 2025 AT 07:00 AM CST. VENDORS SHALL SUBMIT QUESTION(S) VIA E-MAIL IN RESPONSE TO THIS SOLICITATION TO THE CONTRACT SPECIALIST KEVIN VIJAYAN AT KEVIN.VIJAYAN.CIV@HEALTH.MIL. ALL QUESTION(S) NEED TO BE RECEIVED BY THE GOVERNMENT SERVER, BY THE STATED DATE AND TIME. THE GOVERNMENT IS NOT RESPONSIBLE FOR ANY FAILURE OF TRANSMISSION OR RECEIPT OF THE QUESTION(S).
