SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

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1 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER 7. FOR SOLICITATION INFORMATION CALL: 9. ISSUED BY NAVAL MEDICAL LOGISTICS COMMAND 693 NEIMAN STREET FORT DETRICK MD TEL: FAX: 11. DELIVERY FOR FOB DESTINA- TION UNLESS BLOCK IS MARKED SEE SCHEDULE a. NAME ERIK PRZYGOCKI CODE N DISCOUNT TERMS 10. THIS ACQUISITION IS X SMALL BUSINESS HUBZONE SMALL BUSINESS SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS 1. REQUISITION NUMBER 13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700) 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE N R-0009 b. TELEPHONE NUMBER UNRESTRICTED OR 13b. RATING (No Collect Calls) X SET ASIDE: WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM NAICS: EDWOSB (A) PAGE 1 OF Mar OFFER DUE DATE/LOCAL TIME 01:00 PM 01 Apr % FOR: SIZE STANDARD: $15,000, METHOD OF SOLICITATION RFQ IFB X RFP 15. DELIVER TO CODE N ADMINISTERED BY BUREAU OF MEDICINE & SURGERY 7700 ARLINGTON BOULEVARD FALLS CHURCH VA TEL: FAX: CODE 17a.CONTRACTOR/ CODE FACILITY OFFEROR CODE 18a. PAYMENT WILL BE MADE BY CODE TELEPHONE NO. 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK BELOW IS CHECKED SEE ADDENDUM ITEM NO. SCHEDULE OF SUPPLIES/ SERVICES QUANTITY UNIT UNIT PRICE AMOUNT SEE SCHEDULE 25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Gov t. Use Only ) 1X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR FAR ARE ATTACHED. ADDENDA X ARE ARE NOT ATTACHED 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR FAR IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED X 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1 COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED. 29. AWARD OF CONTRACT: REF. OFFER DATED. YOUR OFFER ON SOLICITATION (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS: 30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) TEL: (TYPE OR PRINT) 31c. DATE SIGNED AUTHORIZED FOR LOCAL REPRODUCTION PREVIOUS EDITION IS NOT USABLE STANDARD FORM 1449 (REV. 2/2012) Prescribed by GSA FAR (48 CFR)

2 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS (CONTINUED) 19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES 21. QUANTITY UNIT UNIT PRICE PAGE 2 OF AMOUNT SEE SCHEDULE 32a. QUANTITY IN COLUMN 21 HAS BEEN RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: 32b. SIGNATURE OF AUTHORIZED GOVERNMENT 32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE REPRESENTATIVE 32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32g. OF AUTHORIZED GOVERNMENT REPRESENTATIVE 33. SHIP NUMBER PARTIAL FINAL 34. VOUCHER NUMBER 35. AMOUNT VERIFIED CORRECT FOR 36. PAYMENT COMPLETE PARTIAL FINAL 37. CHECK NUMBER 38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY 41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE 42a. RECEIVED BY (Print) 42b. RECEIVED AT (Location) 42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS AUTHORIZED FOR LOCAL REPRODUCTION PREVIOUS EDITION IS NOT USABLE STANDARD FORM 1449 (REV. 2/2012) BACK Prescribed by GSA FAR (48 CFR)

3 Page 3 of 179 Section SF CONTINUATION SHEET ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,977,363 Data Records Outpatient Coding Services: On-site FFP The contractor shall provide On-Site Medical Outpatient Coding services in accordance with the Performance Work Statement (PWS). Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,684 Data Records Outpatient Coding Services: Remote FFP The contractor shall provide Remote Medical Outpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

4 Page 4 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,930 Data Records Inpatient Coding Services: On-site FFP The contractor shall provide On-site Medical Inpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,527 Data Records Inpatient Coding Services: Remote FFP The contractor shall provide Remote Medical Inpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

5 Page 5 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,620 Data Records Outpatient Auditing Services: On-site FFP The contractor shall provide On-site Medical Outpatient Auditing services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,410 Data Records Outpatient Auditing Services: Remote FFP The contractor shall provide Remote Medical Outpatient Auditing services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

6 Page 6 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,615 Data Records Inpatient Auditing Services: Remote FFP The contractor shall provide Remote Medical Inpatient Auditing services in accordance with the PWS. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,038 Session Coding and Auditing Training Services FFP The contractor shall provide Medical Coding and Auditing services in accordance with the PWS. Each session is equal to one hour. FOB: Destination NET AMT

7 Page 7 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT Months CDIS Services FFP The contractor shall provide Clinical Documentation Improvement Specialist (CDIS) services in accordance with the PWS. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT Lot Travel COST FOB: Destination ESTIMATED COST ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,845,539 Data Records OPTION Outpatient Coding Services: On-site FFP The contractor shall provide On-Site Medical Outpatient Coding services in accordance with the Performance Work Statement (PWS). Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

8 Page 8 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,238 Data Records OPTION Outpatient Coding Services: Remote FFP The contractor shall provide Remote Medical Outpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,930 Data Records OPTION Inpatient Coding Services: On-site FFP The contractor shall provide On-site Medical Inpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

9 Page 9 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,527 Data Records OPTION Inpatient Coding Services: Remote FFP The contractor shall provide Remote Medical Inpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,712 Data Records OPTION Outpatient Auditing Services: On-site FFP The contractor shall provide On-site Medical Outpatient Auditing services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

10 Page 10 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,316 Data Records OPTION Outpatient Auditing Services: Remote FFP The contractor shall provide Remote Medical Outpatient Auditing services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,615 Data Records OPTION Inpatient Auditing Services: Remote FFP The contractor shall provide Remote Medical Inpatient Auditing services in accordance with the PWS. FOB: Destination NET AMT

11 Page 11 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,379 Session OPTION Coding and Auditing Training Services FFP The contractor shall provide Medical Coding and Auditing services in accordance with the PWS. Each session is equal to one hour. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT Months OPTION CDIS Services FFP The contractor shall provide CDIS services in accordance with the PWS. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT Lot OPTION Travel COST FOB: Destination ESTIMATED COST

12 Page 12 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,713,715 Data Records OPTION Outpatient Coding Services: On-site FFP The contractor shall provide On-Site Medical Outpatient Coding services in accordance with the Performance Work Statement (PWS). Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,793 Data Records OPTION Outpatient Coding Services: Remote FFP The contractor shall provide Remote Medical Outpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

13 Page 13 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,930 Data Records OPTION Inpatient Coding Services: On-site FFP The contractor shall provide On-site Medical Inpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,527 Data Records OPTION Inpatient Coding Services: Remote FFP The contractor shall provide Remote Medical Inpatient Coding services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

14 Page 14 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,804 Data Records OPTION Outpatient Auditing Services: On-site FFP The contractor shall provide On-site Medical Outpatient Auditing services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,222 Data Records OPTION Outpatient Auditing Services: Remote FFP The contractor shall provide Remote Medical Outpatient Auditing services in accordance with the PWS. Data Record is defined by the completion of the record with no errors. FOB: Destination NET AMT

15 Page 15 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,615 Data Records OPTION Inpatient Auditing Services: Remote FFP The contractor shall provide Remote Medical Inpatient Auditing services in accordance with the PWS. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT ,726 Session OPTION Coding and Auditing Training Services FFP The contractor shall provide Medical Coding and Auditing services in accordance with the PWS. Each session is equal to one hour. FOB: Destination NET AMT

16 Page 16 of 179 ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT Months OPTION CDIS Services FFP The contractor shall provide CDIS services in accordance with the PWS. FOB: Destination NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT Lot OPTION Travel COST FOB: Destination ESTIMATED COST PERFORMANCE WORK STATEMENT Performance Work Statement Medical Coding Services Enterprise-wide SECTION C SECTION 1 - INTRODUCTION 1.1. BACKGROUND In order to improve military health care, it is essential to have a robust coding and auditing program within Navy Medicine. With future International Classification of Disease (ICD) versions becoming more detailed, it is imperative that health care providers learn to improve medical record documentation. The focus of this contract is to augment Navy Medical Treatment Facility (MTF) coding resources and provide education to Navy health care providers to improve documentation and coding accuracy. The ongoing requirement of the contract is improving health care provider documentation, coding and auditing practices and achieving outcomes such as reductions in claims denials and relative values of care SCOPE The scope of this contract includes inpatient and outpatient medical record coding services, inpatient and outpatient medical record auditing services, medical coding and auditing training services, and Clinical Documentation Improvement Specialist (CDIS) services. In this contract, Armed Forces Health Longitudinal Technology Application (AHLTA), Ambulatory Procedure Visit (APV), Emergency Room (ER) and Inpatient Professional Services (IPS) (also referred to as rounds) records are all considered outpatient records. The services incorporated

17 Page 17 of 179 under this contract are inherently associated with coding and auditing processes. All services provided under this contract shall be provided either on-site or remotely for Navy MTFs as specified in the individual task orders. SECTION 2 - DUTIES 2.1. SPECIFIC DUTIES The contractor shall provide a monthly report of the services rendered during the previous month at each MTF identified in the task order to the task order primary Government Point of Contact (POC), the Regional Patient Administration Department (PAD) Officer and the Contracting Officer Representative (COR) by the 5 th business day of the month. Also, the contractor shall identify any issues regarding the services provided or any government issues that may affect their performance (i.e., inability to gain access to the Automated Information System (AIS) for new employees). The report shall contain a place for the task order primary Government POC to digitally sign to verify receipt of the deliverable and attesting that the information contained within it is accurate. The documents produced in accordance with paragraphs and below shall be embedded into the document. This shall be submitted as an Excel spreadsheet with a separate tab for each MTF, but only one spreadsheet per task order MEDICAL RECORD CODING SERVICES The contractor shall code billable care including Medical Services Accounts (MSA), all Other Health Insurance (OHI) and encounters in clinic specialties requiring expertise in a specific area of medicine The contractor shall research/resolve problematic coding practices identified by the MTFs to include data quality discrepancy items The contractor shall code encounters in clinic specialties where a high level of coding expertise in a particular specialty is required The contractor shall resolve medical record documentation deficiencies through healthcare provider query and provide routine feedback to health care providers to correct future deficiencies The contractor shall work as part of a team interacting with the health care providers, government personnel and contract employees to perform medical record coding and research errors or missing documentation The contractor shall comply with the following turnaround times which begin upon receipt of the record. All outpatient non-apv records shall be coded within 3 business days. APVs shall be coded within 15 calendar days. Inpatient medical records shall be coded within 30 calendar days The contractor shall perform a quality assessment of records, including verification of medical record documentation (both electronic and hand written) and provide the department head and individual health care providers with feedback The contractor shall recode records on the Data Quality (DQ) discrepancy list as stated in the task order. The level of effort associated with these records is approximately 3 times that of a standard Outpatient record. Records on the DQ discrepancy list are records that have a logic error between the provider documentation and the codes in the system such as a pediatric code in an adult record. If the contractor initially coded the record incorrectly, the government will not be charged for recoding the record If the government does not agree with a code assigned to a medical record by the contractor, the MTF will notify the contractor of the discrepancy. The contractor shall respond with the action to be taken within 48 hours of notification. If the contractor and MTF continue to disagree, the Navy Medicine Region (East or West) will review and make the final decision on the appropriate code(s). The Region s decision will be sent to the contractor and the code shall be changed at no cost to the government.

18 Page 18 of The contractor shall obtain physician documentation for any clinical condition or procedure to support the appropriate severity of illness, expected risk of mortality and complexity of care of the patient prior to coding the medical record The contractor shall advise members of the patient care team, to include the attending physicians, allied health practitioners, nurses and case managers, regarding documentation guidelines The contractor shall work with the MTF clinical champions, AHLTA Sustainment Trainers/Consultants, directors and department heads to develop best practices for outpatient and inpatient coding to provide educational services The contractor shall follow the MTF Standard Operating Procedures (SOPs) when the government systems are unavailable due to system issues MEDICAL RECORD AUDIT SERVICES The contractor shall conduct audits of government coded medical records as stated in the individual task orders. The audit shall assess compliance with Department of Defense (DoD) requirements and industry standards, such as the use of modifiers, procedure sequencing and linkage of procedures to diagnosis codes to support medical necessity of services. The contractor shall perform the audits in accordance with the Bureau of Medicine and Surgery Instruction A (BUMEDINST A) (or current version); a copy is provided as PWS Attachment II. In addition, the contractor shall use the government s auditing tool of choice which is currently the Auditing Prototype (an Access database) The contractor s audit shall identify inaccurate/non-specific code assignments, document improvement opportunities and make recommendations for staff training. Improved documentation accurately reflects the patient/health care provider s interaction, the chief complaint/reason for admission (including pertinent patient/family health and social histories) and co-morbidities affecting the specificity of final code assignment. The audit report (See paragraph ) shall describe the gap between the medical record documentation and the required baseline clinical documentation. This information shall be used to improve clinical documentation through provider training For MTFs with on-site services, the contractor shall pull the records for the audit based on the list provided by the task order primary Government POC. For those MTFs purchasing remote services, the government will provide the contractor electronic copies of the patient record and the auditing tool loaded with the data. The quantity and frequency of the audits will be stated in the task order. The task order primary Government POC will coordinate specific audit dates and provide a list of the records to be audited The contractor shall verify patient identification and demographic information, reason for admission, disposition date, assignment of diagnoses, procedure documentation and provider s signature for all inpatient record audits. The inpatient audit includes a comparison of the auditor s coded record against the original coded record and a comparison of Relative Weighted Products (RWPs) The contractor shall verify patient identification and demographic information, chief complaint/reason for visit, encounter date, assignment of diagnoses, procedures documentation and provider s signature for all outpatient record audits. The audit shall include a comparison of the auditor s coded record against the original coded record and a comparison of Relative Value Unit (RVUs) The contractor shall provide random data quality (DQ) audit results to the task order primary Government POC on a monthly basis adhering to the Data Quality Management Control (DQMC) policy (or current version) which can be found at The contractor shall maintain compliance with the due dates consistent with current and future DQMC guidance. The report shall include the process for the audit, aggregate positive and negative trends, comparisons stated in paragraphs and above and recommendations for corrective action, including training topics. The contractor shall be prepared to complete the DQ audit in 5 business days or less once the records have been received from the government. The

19 Page 19 of 179 completed DQ audit shall be returned to the task order Government POC in the audit tool no later than 5 business days prior to sending the results to the Region. The contractor shall follow guidance received from the MTF for focused audits. The information from the DQMC Control Review List contains the same information that is used in the audit tool The contractor shall recode records at no additional cost, if the government determines a contractoraudited record is incorrect. The government will assess accuracy by conducting shadow audits of randomly selected contractor-audited records. See PWS Attachment III - Coding Program Management and Training Guidelines regarding government surveillance of performance The contractor shall the task order primary Government POC within three business days of completion of the audit. The shall include the following information: date conducted; dates of services; guidelines used (95 or 97); summary of the audit data including common errors, trends; a compare/contrast of audit results for previously audited providers and recommendations for future training sessions. The Audit Prototype summary report(s) defined in the task order shall be included as an attachment to the report. Other information required will be identified in the task order TRAINING SERVICES The contractor shall provide training as stated in the individual task orders. The task order Government POC is responsible for scheduling and confirming the training session with the providers at least two weeks in advance consistent with the Navy Medicine Training Guidelines (refer to PWS Attachment III, Coding Program Management and Training Guidelines). The primary focus of training is to increase the accuracy of medical encounter coding by improving code assignment and clinical documentation The contractor shall work with the government to develop training that is specific to the clinical services provided by the MTF and shall incorporate standardized Bureau of Medicine and Surgery (BUMED) training guidance provided in the Coding Program Management and Training Guidelines (PWS Attachment III) to facilitate evolving requirements. The contractor shall work with the MTF personnel and the AHLTA sustainment trainers in the performance of these services. Training topics shall include the current ICD version; Current Procedural Terminology (CPT) codes and conventions; inpatient and outpatient documentation; RVU/RWP documentation and coding; residency specific issues (as applicable); use of Healthcare Common Procedural Coding System (HCPCS) and CPT codes; inpatient and outpatient query processes; Medicare Severity-Diagnosis Related Group (MS-DRG) validation and industry coding classification updates The contractor shall ensure training materials are continuously updated to relay the most current and relevant information. The curriculum shall include specific information and examples relevant to the clinical area for which the training is provided The contractor shall not include instruction on how to use the government systems such as AHLTA, Composite Health Care System (CHCS), or Coding Compliance Editor (CCE) in their curriculum. The contractor shall inform the task order Government POC in writing of system related issues brought up during training The contractor shall participate in continuous process improvement with AHLTA sustainment trainer and aid the health care providers in determining the best process for entering information into the system The contractor shall incorporate audit findings and feedback from health care providers (to include residents and interns), clinical staff and government coders into their training The contractor shall provide updates and revisions to any templates or tools used by the health care providers related to coding The contractor shall use a variety of methods to provide training, which may include, group training, oneon-one training, webinars, web-based training, power point presentations, Defense Collaboration Services (DCS) and/or instructional videos. The government reserves the right to record any training session or copy any of the training materials provided by the contractor for educational purposes.

20 Page 20 of The contractor shall identify and provide a list of teaching tools/equipment required from the government at least two weeks in advance of training The contractor shall advise the task order Government POC in advance of developing the training schedule if any provider requires immediate training based on the audit results The contractor shall the task order primary Government POC within three (3) business days of each training session. The shall include the following information: date and number of training hours; name of trainee(s) and their specialty area; training location; documentation used for training; number of records reviewed (if applicable); summary of overall findings; recommendations provided to trainees; feedback from trainees; recommended timeframe to meet again (if applicable). Any follow-up training shall not commence prior to COR approval and modification to the contract. Any other information required will be stated in the task order CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST (CDIS) SERVICES The contractor shall perform initial and follow-up assessments regarding the inpatient provider s documentation skills. With each assessment, inpatient record reviews shall include verification of patient identification and demographics; reason for admission; disposition date; assignment of diagnoses; procedures documentation and health care provider s signature. The contractor shall also identify opportunities for improvement to ensure documentation used for measuring and reporting physician and hospital outcomes is accurate and complete The contractor shall perform a baseline review of all inpatient health care providers to determine if CDIS are impacting documentation. The sample size for the review shall be between 2-5% per health care provider. The review shall start within 30 calendar days of contract startup and the results of the review shall be provided in a report to the Task Order Government POC per the following schedule: Number of Providers Up to 350 Between 350 and 700 Greater than 700 Report Due After Start of Review Within 5 business days Within 10 business days Within 15 business days The contractor shall perform a baseline review of all new health care providers within 30 days of seeing patients to determine the current level of documentation detail. The sample size for the review shall be 2% per provider. A report of findings shall be provided to the Task Order Government POC within 5 business days of starting the review The contractor shall concurrently review all medical records identified in the task order(s) to identify documentation deficiencies. For an inpatient stay, the CDIS shall review the provider documentation daily and recommend an addendum to the record if necessary. If the CDIS determines a provider s documentation is not improving, the CDIS shall recommend to the Task Order Government POC a corrective action plan to identify specific areas of improvement, a remediation plan that includes a timeline in which to achieve positive results and a follow-up plan. The corrective action plan shall be approved by the Task Order Government POC prior to implementation. A summary of all providers placed on a corrective action shall be included in the monthly report of services rendered The contractor shall perform focused inpatient medical record reviews. The initial review is performed within hours of patient admission The contractor shall communicate with physicians, case managers, coders and other health care team members to obtain comprehensive medical record documentation to support the severity of illness, expected risk of mortality, and complexity of care provided to the patient. Documentation obtained shall include clinical treatment and procedures, medical decisions and diagnoses for inpatients.

21 Page 21 of The contractor shall initiate a query to the health care provider to clarify and explain any documentation that does not clearly and consistently describe the patient s medical condition and hospital stay to assign the correct MS-DRG. Clarification includes obtaining accurate and complete documentation based on current clinical findings, prescribed treatment, medical interventions and/or processes. The contractor s medical record review methodology shall comply with BUMEDINST A (or current version) (See PWS Attachment II) The contractor shall conduct routine (non-query) follow-up reviews of the medical record every 3 days until the issue is resolved The contractor shall review outstanding queries daily for provider responses and follow-up as needed to facilitate timely and accurate documentation The contractor shall provide education to physicians and other members of the health care team regarding compliant documentation responsibilities, coding and reimbursement issues and documentation guidelines The contractor shall investigate and analyze documentation issues/questions to generate and recommend solutions to the Task Order Government POC. The contractor shall prepare formal reports for the government with findings and recommendations regarding documentation, revenue and reimbursement issues. Formal reports shall be submitted to the Task Order Government POC by the 5 th business day of each month The contractor shall provide medical record documentation education to residents and interns in the MTFs Family Practice graduate medical education (GME) program The contractor shall implement coding documentation improvement processes and disseminate new/updated information to improve documentation, RWP and Prospective Payment System (PPS) capture within five (5) business days after receiving approval from the government The contractor shall educate the health care provider on the most efficient process for capturing data in the applicable system The contractor shall evaluate Present on Admission (POA) indicators for each diagnosis that could potentially affect the principal diagnosis, quality indicators or MS-DRG assignment The contractor shall validate data using government AIS and identify data capture trends, variations in coding practices and perform management analysis. The contractor shall use this data to provide feedback to taskers or queries from customers such as the MTFs or the Navy Medicine Region (East or West) in a variety of formats The contractor shall monitor compliance with policies and procedures relevant to the clinical data management program, make recommendations to improve compliance, obtain government approval for implementation and take action The contractor shall collect and analyze data to correct identified complex coding deficiencies and improve reimbursement capture The contractor shall utilize enterprise-prescribed tools to monitor the completeness of clinical documentation and accuracy of code assignments The contractor shall make daily rounds and interact with health care team members to ensure consistent documentation practices. The contractor shall work closely with any department impacting admissions to include, Scheduling, Insurance Verification, Operating Room (OR), Post-Anesthesia Care Unit (PACU), Emergency Department (ED) and the Admitting Office for direct admits. The contractor shall seek clarification from physicians regarding proper documentation as it relates to reimbursement The contractor shall achieve minimum departmental productivity standards of reviews per day, inclusive of initial and follow-up reviews.

22 Page 22 of APPLICABLE DIRECTIVES AND REFERENCES The following legal, regulatory, policy, and security documents are relevant to the performance of contract services. The contractor shall comply with all mandatory documents listed below and referenced throughout Section 2.1. Mandatory Compliance Document No./Version/Location Source BUMED memo 6000 Ser M3/ HCO3 AT dtd 2 Feb 12, (See PWS Attachment I) BUMEDINST Department of Defense (DOD) TRICARE Operations A (or current version) (See PWS Attachment II) Administrative Instruction No. 15 (DOD AI-15), May 3, TRICARE Operations Manual M, Chapter 2, dtd Feb 1, =TO08&Change=153&Type=AsOf&Filename=C2TOC.PDF DOD DODI dtd June 6, BUMED Version 2.0 dtd 6 December 2010 (see PWS Attachment III, Coding Program Management and Training Guidelines) Navy Medicine (NAVMED) DOD Policy dtd 06 July Copy.pdf R dtd May 14, Title Subj: Requirement to Correct Codes When Reviewed By Coder/Auditor and Found To Be Inaccurate (or current version) Coding Program Standard Business Practices, Proceses, and Reporting Guidelines OSD Records and Information Management Program Records Management Security of Unclassified DoD Information on Non- DoD Information Systems (or current version) Coding Program Management and Training Guidelines PII Incident Reporting Requirements DoD Privacy Program Department of the Navy (DON) Secretary of the Navy (SECNAV) CIO Message DTG Z FEB 08 SECNAVINST Loss of Personally Identifiable Information Reporting Process DON Computer Network Incident Response and Reporting

23 Page 23 of 179 Military Health System United States Code (USC) United States Code (USC) Code of Federal Regulations (CFR) American Health Information Management Association (AHIMA) Health Topics/Technology/Support Areas/MHS Specific Coding Guidelines?type=Training+Booklets+%26+Toolkits USC Title 41 USC Title 44 title44/html/uscode-2008-title44.htm 36 CFR, Chapter XII, National Archives and Records Administration, Subchapter B vol3/pdf/cfr-2011-title36-vol3-chapxii-subchapb.pdf /bok1_ hcsp?ddocname=bok1_ DOD DOD dtd Nov 29, pdf DOD Department of Defense Instruction (DODI) R dtd Dec 2, DOD Department of Defense Directive (DODD) R dtd October 29, DOD DODI dtd Feb 6, DOD DOD dtd. Aug 12, odi.pdf DOD DODI dtd Jan 23, Joint Travel Regulation SECNAV SECNAV E dtd Dec 28, agement%20security%20and%20safety%20services/05-200%20management%20program%20and%20techniques%20 Requirements MHS Coding Guidelines Public Contracts Public Printing and Documents Records Management American Health Information Management Association Code of Ethics Standards of Conduct Privacy of Individually Identifiable Health Information in DoD Health Care Programs DOD Privacy Program Information Assurance (IA) Implementation Security of Individually Identifiable Health Information in DoD Healthcare Programs Identification (ID) Cards for Members of the Uniformed Services, Their Dependents, and Other Eligible Individuals Per Diem Rates DON Privacy Program

24 Page 24 of 179 BUMED Services/5211.5E.pdf gapiiphiincident.aspx PII Incident Response SECTION 3 HOURS OF OPERATION 3.1. Specific days and hours of operation are defined in the individual task orders for on-site services. The contractor s employees may work outside the duty hours stated in the task order, at no additional cost to the government, to manage any backlog with coordination and written approval from the task order Government POC. Services are not required on the observance of federal holidays at any Navy MTF All closings for severe weather or other emergency shall be at the sole discretion of the government for on-site services. The contractor shall provide services unless notified by the task order primary Government POC that a closing due to weather conditions or other emergency is authorized. The contractor will receive guidance from the Government task order primary Government POC of the MTF protocol for closings Remote services are not bound by defined service hours, however some facilities do not have 24/7 Information Technology (IT) support. It is the contractor s responsibility to ensure that individuals providing remote coding services are informed of the operating hours for the IT department of the MTF they are servicing in the event IT support is required. The hours of operation and contact information for the IT department will be included in the task orders. SECTION 4 DELIVERABLES 4.1. Contract Data Requirements List (PWS Attachment IV) 4.2. Schedule of Deliverables Deliverable Referenced Due Date Quality Control Plan 9.5. No later than the start of the contract and 60 days prior to each option exercise Confidentiality Agreement Prior to start of services Health Examination and Immunization/Screening Requirement Form (on-site services only) days prior to contract performance Random DQ Audit Results Monthly Monthly Report of Services th business day of each month Rendered Audit Report Within 3 business days after completing the audit Training Report Within 3 business days following each training session Baseline Review of Inpatient Healthcare Providers Number of Providers Up to 350 Report Due After Start of Review Within 5 business days Number of Providers Between 350 and 700 Report Due After Start of Review Within 10 business days Number of Providers

25 Page 25 of 179 Greater than 700 Report Due After Start of Review Within 15 business days Baseline Review of All New Healthcare Providers Report due within 5 business days after starting the review CDIS Formal Reports th business day of each month Personnel Roster days prior to performance of services Command Orientation Within 30 days of contract start SECTION 5 QUALITY ASSURANCE SURVEILLENCE PLAN (QASP) 5.1. QASP Matrix Performance Element Performance Reference Surveillance Method Frequency Acceptable Quality Level Coding Turn Inspection Monthly 95% Around Time Coding Accuracy Inspection Monthly 95% Audit Accuracy Inspection Monthly 95% Training Quality Inspection & Random Observation Monthly Inspection: 90% of the reports are accurate. Feedback: 80% of students rated the quality of the training CDIS Reporting Inspection& Observation effective. Bi-annual Inspection: 90% of the reports are accurate. CDIS Productivity Inspection Monthly 95% Contractor Quality Control Plan 9.5. Inspection Annually for overall QC activities; as required for corrective 100% Invoicing Monthly invoices are timely and accurate. SECTION 6 - QUALIFICATIONS Inspection/ Acceptance actions Monthly 100% 6.1. GENERAL QUALIFICATIONS The contractor shall ensure their staff is fully trained to provide services consistent with ICD-10 and future mandated coding changes.

26 Page 26 of Be a U.S. Citizen per PWS Attachment V, Citizenship Requirements CODING, AUDITING, TRAINING AND CODING CONSULTATION SERVICES The contractor s professional staff shall possess and maintain certifications issued by a nationally recognized certifying professional body for coding professionals. An apprenticeship certification is not considered acceptable under this contract The contractor s professional staff shall possess a minimum of 2 years of experience working in their discipline CLINICAL DOCUMENTATION IMPROVEMENT SERVICES Bachelor s degree in a health-related field with a minimum of 5 years clinical experience including but not limited to; acute patient care, health services, public health, long-term care administration, hospital organization and management, strategic planning and health systems Two years in the last five years focused on inpatient coding, healthcare and coding regulations including code structure, clinical documentation, MS-DRG experience, criteria-based chart reviews (ex. Utilization Management or Case Management), and quality improvement experience working with a physician s group. SECTION 7 RESUME 7.1. Thirty (30) days after contract award, the contractor shall submit a resume to the COR for each contract employee. Prior to contract employees providing services under this contract, the COR will verify the compliance of each contract employee with the qualification requirements applicable to the labor category required to perform the work The contractor shall maintain a personnel roster for all individuals who are providing services under this contract. The contractor shall provide a copy of the list to the COR within 30 days prior to performance of services under this contract and as required to maintain currency of the information The contractor shall inform the COR of any terminations of employment within 24 hours of the action. SECTION 8 - GOVERNMENT AND CONTRACTOR FURNISHED ITEMS GOVERNMENT FURNISHED ITEMS The government will provide the auditing tool of choice, which is currently the Auditing Prototype (Access database). This includes the tool, directions for usage and a maximum of 2 training sessions not to exceed a total of 4 hours per year for contractor personnel. The task order primary Government POC or their designee will provide the training on how to use the audit prototype AUTOMATED INFORMATION SYSTEMS (AIS) The government will provide access to the AIS required for the performance of services on the contract and will maintain all hardware and systems. Access to sensitive data will be at a level appropriate to the performance of services ON-SITE SERVICES The government will provide, without cost, the facilities, materials, consumable supplies, equipment and/or services required to perform the on-site duties, with the exception of the services specified under this contract. The government will provide routine scheduled maintenance and repair of government-provided equipment according to MTF Instructions. Upon contractor s request, through the task order Government POC, the government will provide repairs of government provided equipment in accordance with MTF Instructions.

27 Page 27 of The contractor shall coordinate with the Material Management Department to order department supplies. The contractor shall research products, make recommendations for purchase, enter new item requests, and create replenishment requests to be submitted by the appropriate government official. The contractor is liable for loss of or damage to supplies and equipment if such loss or damage is due to negligence or willful misuse. The contractor shall ensure efficient and economical use of supplies At no time during the term of this contract shall the contractor remove government furnished supplies or equipment from the MTF for on-site services The contract employees shall comply with the military base policies and instructions for gaining access to the military base for on-site services. The identification badge shall be worn during performance of work and anytime the contractor is on the premises. The contractor shall ensure all government furnished items are returned during a proper check-out with the task order Government POC when the contract employee is no longer providing services under this contract The Government task order primary Government POC will provide written confirmation to the contractor for training sessions, which includes the audit dates, the MTF name and contact information (See ) The government will provide any teaching tools/equipment identified by the contractor as being required for training. The government will notify the contractor if the materials are unavailable (See ) REMOTE SERVICES Unless otherwise stated in the task order, the government will issue laptops to the contractor in support of remote services. The laptops will be issued to the contract employee(s) who shall exchange the laptop at the MTF every 60 days starting from issuance, unless the task order states otherwise. The contractor s employee shall possess and maintain a National Agency Check with Law and Credit (NACLC) security clearance before being eligible to receive and use the government furnished laptop. Persons issued Government Furnished Property shall be within commuting distance of an MTF. Refer to Section 10 for additional information CONTRACTOR FURNISHED ITEMS The contractor shall supply current resources and references (e.g. ICD (current version), CPT, and HCPCS) for each contract employee. Specific requirements will be identified in the individual task orders The contractor s headquarters personnel shall use Microsoft-compatible programs possessing Health Insurance Portability and Accountability Act (HIPAA) compliant encryption capabilities to receive encrypted e- mails from government accounts. SECTION 9 QUALITY CONTROL 9.1. The services specified in this contract and the task orders shall be performed in accordance with established principles and ethics of the medical record coding profession. The quality of services shall meet or exceed the current recognized standards established by American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), the MTF, BUMED, DON, the DoD Health Affairs (HA), and those other professional associations and government agencies which specify standards of performance for the medical record coding profession. The contractor shall adhere to and comply with all DoD, DON, BUMED, and Regional and local MTF instructions, notices, Coding Compliance Plans and Coding SOPs as well as BUMED policy letters, notes/notices and memorandums which may be in effect during the term of the contract The contractor shall comply with applicable laws and DoD regulations for disposing of copies of patient care records that are in the contractor s possession.

28 Page 28 of The contractor shall utilize the BUMED Coding Program Management and Training Guidelines, Military Health Systems (MHS) coding guidelines and MTF processes to monitor and evaluate the completeness of clinical documentation and accuracy of code assignments. For additional information refer to the link in Section The contractor shall become acquainted with and obey all MTF regulations. In addition, the contractor shall comply with DoD and MTF instructions, Standard Operating Procedures (SOPs) and policies applicable to data quality, ethics and services rendered in a federal facility The contractor shall comply with federal, state, local, and Joint Commission health, fire and safety regulations The contractor shall establish, submit for government approval and implement a Quality Control Plan (QCP) that is consistent with the applicable MTFs Quality Improvement Plan at the task order level for the specific MTFs The contractor shall submit a Quality Control Plan to the COR and the Contracting Officer for review no later than the start of the contract. The QCP shall include (a) a plan for providing services by appropriately qualified personnel; (b) a plan to ensure maintenance and enforcement of the other requirements for contractor employees as specified in Section 11.1.; and (c) procedures the contractor shall implement to ensure the successful completion of tasks identified in this Performance Work Statement (PWS) Upon receipt of the contractor's QCP, the COR will review and provide comments to the contractor. If the COR finds deficiencies in any portion of the proposed QCP, the contractor shall have five (5) working days to correct the deficiencies. The COR will provide final approval of the QCP Sixty (60) days prior to exercising any option year under this contract, the contractor shall submit to the COR an updated QCP that is consistent with updated Joint Commission standards and updated MTF Quality Control Program. The revised QCP shall be subject to the same review process as that required at the time of contract award INDEPENDENT CONTRACTOR The services provided by the contractor are provided 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 Commanding Officer 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 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. SECTION 10 - START OF SERVICES BACKGROUND INVESTIGATION The MTF is responsible for assistance with the security processes involved with on-site services. The COR is responsible for all security processes for remote services The Contractor Appointing Personnel shall report to the COR on the first day of contract performance. The COR shall provide direction for a proper check-in and any additional documentation or instructions that may be

29 Page 29 of 179 necessary for contract performance. The Contractor Appointing Personnel shall return the completed check-in sheet to the COR within ten business days Upon receipt of an adjudicated Federal background investigation or at a minimum advanced fingerprint results, the Command Trusted Agent will enter contract employee into the Contractor Verification System (CVS). The contractor employee is responsible for completing the CVS application for requesting issuance of a Common Access Card (CAC) Fourteen days prior to performance of services under this contract, the contractor s Security Representative shall submit to the MTF Security Manager, via the COR, the necessary documents to obtain the appropriate Federal background investigation ORIENTATION The contractor employees shall complete command and information systems orientation within thirty days of the beginning of services. Command Orientation will take place during normal business hours All on-site contractor employees shall complete approximately 16 hours of orientation regarding MTF information systems required for performance of services All contractor employees shall be required to attend systems training, unless they have previous experience using the information systems utilized under this contract. On-site employees will receive training during the MTF orientation. Remote employees shall attend classes onboard the MTF at the contractor s expense or request training via video conference from the region in which the remote services are being provided. Contractor employees must pass a systems test or attend training before access to the system(s) will be granted The contractor employees shall participate in periodic training as systems are upgraded in order to provide services required by the contract. The government will use modalities that allow remote staff to stay current The task order primary Government POC may waive training for individuals who have previously worked at the MTF on a case-by-case basis The contractor employees shall complete mandatory Navy and DoD on-line training as indicated above. Online training may require the contractor s employees to enter their Social Security Number to document and track compliance with training requirements OCCUPATIONAL HEALTH REQUIREMENTS FOR ON-SITE SERVICES Within 30 days prior to performance of services, the contractor s employees shall obtain, at the contractor expense, documentation of required immunizations and physical testing, and a statement from the contractor employee s licensed medical practitioner or a report of a physical examination. The physical examination and immunization documentation shall be submitted to the COR prior to the start of services. The requirements are provided on the HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM, the current version of which is available at: The MTF will identify any contract employees who are not required to complete this documentation after contract award. Declinations shall only be permitted based on either the contract employee s religious convictions or medical contraindications (as documented by a qualified health care provider) EMERGENCY PREPAREDNESS PLAN The contractor shall participate in executing the Emergency Preparedness Plan (drills and actual emergencies) as scheduled by the MTF (typically semiannually) for on-site services. The MTF maintains a personnel re-call list with personal contact information for all military, civil service and contractor employees which are required to prepare in advance for an actual emergency. Upon commencement of performance, the contractor

30 Page 30 of 179 shall provide the task order primary Government POC with a list of personal contact information for a designated contractor representative. Should an emergency occur that will affect the contractor, the designated representative will be contacted. SECTION 11 STANDARDS OTHER REQUIREMENTS All financial, statistical, personnel, and technical data which are furnished, produced, or otherwise available to the contractor during the performance of this contract are considered confidential business information and shall not be used for purposes other than performance of work under this contract. Such data shall not be released by the contractor without prior written consent of the COR. Any presentation of any statistical or analytical materials, or any reports based on information obtained from studies covered by this contract, will be subject to review and approval by the COR before publication or dissemination. All inquiries from the media shall be forwarded to the Command Public Affairs Officer via the MTF COR All records produced in the performance of this contract and all evaluations of patients are the property of, and subject to the exclusive control of, the government. The contractor may retain a copy of all such records or evaluations, but may not provide further copies or disclose the information from such records or evaluations to third parties. All requests from other treatment facilities or other individuals for patient records shall be handled in accordance with procedures specified by applicable MTF instructions When creating and maintaining official government records, the contractor shall comply with all federal requirements established by 44 United States Code (USC), 41 USC, 36 Code of Federal Regulations (CFR), Department of Defense (DOD) Administrative Instruction No. 15 (DOD AI-15), OSD Records and Information Management Program May 3, 2013 and Chapter 2 of the TRICARE Operations Manual. For additional information refer to the links in Section Unclassified DoD information provided to or developed by non-dod entities in support of DoD activities is to be protected according to the information safeguards described in DoDI dtd Jun 12, Security of Unclassified DoD Information on Non-DoD Information Systems (or current version) CONTRACT EMPLOYEE STANDARDS Eating by contract employees is prohibited in patient care areas/clinics and is restricted to designated areas. Smoking is prohibited in all clinic facilities The contractor and all contract employees shall comply with all MTF checkout processes. These processes include returning government property, i.e., identification badges, laptops, etc., to the MTF upon a contract employees last day of service. Failure to do so promptly may result in delay of payment to the contractor Confidentiality Agreement. All contract employees shall sign a confidentiality form (See PWS Attachment VI) stating they have read and agree to conform to the confidentiality requirements of the government and their profession regarding the protection and confidentiality of personal health information. The contract employee shall sign the form prior to start of services. The signed agreement will be maintained at the MTF CODING ETHICS. Contract employees shall follow the standards of ethical coding developed by AHIMA's Coding Policy and Strategy Committee. For additional information refer to the link in Section CONFLICT OF INTEREST The contractor shall not, while performing services under this contract, advise, recommend, or suggest to persons eligible to receive medical care at the government s expense that such persons should receive care from the contractor at any place other than a government facility.

31 Page 31 of The contractor shall not hire any employee for performance under this contract whose employment would result in a conflict with government or DoD Standards of Conduct, DoD (see link in 2.2. for additional information) The contractor is not prohibited by reason of their performance under this contract from outside employment if there is no conflict with the performance of services The contractor shall not use any government facilities or other government property in connection with outside employment. SECTION 12 REMOTE SERVICES Remote Service Options. The government acknowledges that this is a non-personal services contract and the contractor is to determine the method for delivering services remotely; however, because of the limitations imposed by the government systems and the variance between MTFs, only the two options below may be used. The options for providing remote services will be identified in the task order and a summary of the methods are described below. The contractor shall be aware that more than one method of remote services may be used during the performance period to ensure continuous performance. The contractor shall ensure their approved Data Sharing Agreement (DSA) will accommodate all of the options listed below. The contractor s remote staff must possess and maintain the appropriate clearance to obtain a CAC. The contractor may provide remote services via: Option 1: Scan Technician. The contractor shall be responsible for the entire process with no government involvement. The contractor shall provide personnel on-site at the MTF to obtain the medical records, transmit the records and enter the codes into the government s AIS. The contractor shall also provide remote medical coders to code the records and return them to the on-site personnel. Onsite personnel shall input all codes into the AIS. Onsite contractor personnel shall have access to government computer systems required for the performance of their duties. The onsite personnel shall have at least 1 year of experience in the last 3 years working with medical records. The government may provide personnel within the MTF to perform on-site responsibilities for retrieving, scanning, and transmitting medical record documentation. Any government resources available to relieve the contractor of this responsibility will be identified in the task order. Option 2: Government Furnished Equipment (GFE). The MTF Information Technology (IT) department will issue a laptop to contract employees performing remote coding services. The contract employees shall possess and maintain the appropriate security clearance to be issued a CAC. The remote coder is required to return the laptop in person to the MTF every 60 days to obtain the required updates The governent will determine at the task order level if remote services will be required. The contractor shall select one of the above options prior to the submission of pricing. SECTION 13 TRAVEL The government may require the contract worker to travel to the MTF as indicated in the PWS. The contractor shall be reimbursed for actual allowable, allocable, and reasonable travel costs incurred during performance of services in accordance with the Joint Federal Travel Regulations currently in effect on date of travel unless otherwise specified in the PWS or individual task order. The contractor shall travel in a manner that is the most economical to the government. No travel shall occur prior to the allocation of funding to the Travel Contract Line Item Number (CLIN). See the individual task orders for additional information Government contract air carriers and the government's contract airfares are not available to contractor employees. Airfare will be paid at the coach rate with a minimum of seven days advance purchase, non-refundable ticket price; unless the government grants prior written approval. The government shall reimburse the fee charges to reschedule the non-refundable ticket only if the government reschedules the trip.

32 Page 32 of The Joint Travel Regulation (JTR) shall serve as the basis for the cost limits for lodging, per diem, miscellaneous expenses and mileage reimbursement if use of privately owned vehicle is authorized. The contractor shall utilize discount hotel/motel and car rental practices. For additional information regard Per Diem rates refer to the link in Section 2.2. SECTION 14 - MISCELLANEOUS PROVISIONS Breach Response. DoDD R, DoD Privacy Program, October 29, 2014, defines a breach as the actual or possible loss of control, unauthorized disclosure, or unauthorized access of personal information where persons other than authorized users gain access or potential access to such information for other than authorized purposes where one or more individuals will be adversely affected. Within one hour of discovery, the breach must be reported to the US Computer Emergency Readiness Team (US CERT) and BUMED M-6 Privacy Officer. The contractor shall adhere to the reporting and response requirements set forth in the following: Safeguarding Against and Responding to the Breach of Personally Identifiable Information, June 5, 2009; DoDD , "DoD Privacy Program," Oct 29, 2014; DoD R, DoD Privacy Program dtd 14 May 07; NAVMED Policy : PII Incident Reporting Requirements, 06 July 2009; DON CIO MSG DTG Z FEB 08: Loss of Personally Identifiable Information Reporting Process, Feb 2008; PII Incident Response ; SECNAV E, DoN Privacy Program, Dec 28, 2005; SECNAVINST , DON Computer Network Incident Response and Reporting Requirement. For additional information refer to the links in Section A Data Sharing Agreement (DSA) is currently used to request and control the disclosure, use, storage and/or destruction of Military Health System (MHS) data that is owned and/or managed by Navy Medicine or the Defense Health Agency (DHA) to ensure that applicable privacy and security requirements are followed. In addition, research requests for MHS data that include protected health information (PHI) must be reviewed for HIPAA compliance by the DHA Privacy Board Under DoDI , Privacy of Individually Identifiable Health Information in DoD Health Care Programs, December 2, 2009, reasonable steps must be taken to implement appropriate procedural, administrative, technical and physical safeguards to prevent the unauthorized use and/or disclosure of any personally identifiable information (PII) or PHI. Likewise, all uses, disclosures, and destruction of PII and PHI data are generally subject to DoD R, DoD Privacy Program, May 14, 2007, as well as DoDI , Information Assurance (IA) Implementation, Feb. 6, 2003, and DoDI , Security of Individually Identifiable Health Information in DoD Health Care Programs August 12, For additional information refer to links in Section To begin the Data Service Agreement (DSA) request process, the contractor shall contact the Office of the Navy Medicine CIO at [email protected]. After receiving DSA approval, anyone needing access to information system applications or data sources must contact the responsible system program office. DSAs are active for one year, or until the end of the current option year, whichever comes first. If the DSA will not be renewed, the contractor must provide a Certificate of Data Destruction (CDD) to the Office of the Navy Medicine Chief Information Officer (CIO) or the Defense Health Agency (DHA) Privacy and Civil Liberties Office for DHA owned and managed data. SECTION 15 DEFINITIONS AMBULATORY PROCEDURE UNIT (APU): A location or organization within an MTF (or freestanding outpatient clinic) that is specially equipped, staffed and designated for the purpose of providing the intensive level of care associated with ambulatory procedure visits. AMBULATORY PROCEDURE VISIT (APV): provides pre-procedure and post-procedure care, observation, and assistance for patients requiring short-term care of less than 24 hours. Same Day Surgeries, also known as Ambulatory Procedure Visits, are performed in a specialized area such as an APU, surgical suite, or extended care area. ARMED FORCES HEALTH LONGITUDINAL TECHNOLOGY APPLICATION (AHLTA): The electronic medical record used in the Military Healthcare System.

33 Page 33 of 179 COMMANDING OFFICER: The senior Officer who is responsible for the operation of the medical treatment facility (MTF) for which the contract services are provided. COMPOSITE HEALTH CARE SYSTEM (CHCS): A medical Automated Information System that provides patient and facility data management and communications capabilities. CONTRACTING OFFICER: The government employee with the authority to enter into, administer, negotiate terms, conditions and/or amounts, and/or terminate contracts, and make related determinations and findings. The term includes certain authorized representatives of the Contracting Officer acting within the limits of their authority as delegated by the Contracting Officer. CONTRACTING OFFICER S REPRESENTATIVE (COR): The government employee responsible for assuring the Contractor s performance through surveillance and documentation, and provides liaison to the Contracting Officer. The Contracting Officer will designate a COR in writing and authorize the individual to act as the Contracting Officer s Representative (COR). The COR has no authority to resolve disputes or obligate funds. 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 modifications or adjustment. CONTRACTOR: That entity or its representative responsible for the delivery of the services or materials specified in this contract, as designated by contract award. CURRENT PROCEDURAL TERMINOLOGY (CPT)-4: Coding system maintained by the American Medical Association consisting of descriptive terms and codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. DIAGNOSIS RELATED GROUP (DRG): is a system to classify hospital cases into one of approximately 500 groups, also referred to as DRGs, expected to have similar hospital resource use, developed for Medicare as part of the prospective payment system. DRGs are assigned by a "grouper" program based on ICD diagnoses, procedures, age, sex, discharge status, and the presence of complications or co-morbidities. DRGs have been used in the US since 1983 to determine how much Medicare pays the hospital, since patients within each category are similar clinically and are expected to use the same level of hospital resources. DRGs may be further grouped into Major Diagnostic Categories (MDCs). HEALTH CARE PROVIDER: A healthcare professional who provides health services to patients; examples include a physician, dentist, nurse, or allied health professional. HEALTH INFORMATION: Any information, whether oral or recorded in any form or medium, that is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual. INPATIENT TREATMENT RECORD: The medical record that is used by hospitals to document inpatient medical or dental care. This record applies to all beneficiaries. INPATIENT CODING: The assignment of codes for care and services provided to patients admitted to an acute care hospital. INPATIENT PROFESSIONAL SERVICES (IPS): Professional services provided to a patient during an inpatient admission that are captured by ambulatory coding classification systems. INTERNATIONAL CLASSIFICATION OF DISEASES (ICD) ICD: is the official classification system used by the United States (U.S.) to assign codes to diagnoses and procedures associated with hospital utilization.

34 Page 34 of 179 KEY PERSON: Experienced contractor professional or technical person who is essential for successful Contractor management. MEDICARE SEVERITY - DIAGNOSIS RELATED GROUP (MS-DRG): A numeric classification system effective October 1, 2007 used by Medicare to pay for hospital inpatient services. MEDICAL TREATMENT FACILITY (MTF): Military hospitals or clinics, including all activities providing outpatient and/or inpatient health services for eligible beneficiaries. MILITARY HEALTH SYSTEM (MHS): America s Military Health System (MHS) is a unique partnership of health care educators, researchers, and providers and their support personnel worldwide. This DoD enterprise consists of the Office of the Assistant Secretary of Defense for Health Affairs; the medical departments of the Army, Navy, Marine Corps, Air Force, Coast Guard, and Joint Chiefs of Staff; the Combatant Command surgeons; and TRICARE providers (including private sector healthcare providers, hospitals and pharmacies). OTHER HEALTH INSURANCE (OHI): Health insurance policy, other than TRICARE, held by MHS beneficiaries. OUTPATIENT: An individual receiving healthcare services for an actual or potential disease, injury, or life stylerelated problem that does not require admission to a medical treatment facility for inpatient care. PROSPECTIVE PAYMENT SYSTEM: a payment mechanism for reimbursing hospitals for inpatient health care services in which a predetermined rate is set for treatment of specific illnesses. The system was originally developed by the U.S. federal government for use in treatment of Medicare recipients. PROTECTED HEALTH INFORMATION (PHI): Under the Health Insurance Portability and Accountability Act (HIPAA), PHI includes any individually identifiable health information. Identifiable refers not only to data that is explicitly linked to a particular individual; it also includes data items which reasonably could be expected to allow individual identification. See the guidance on ``protected health information'' in 45 CFR , which is limited to the information created or received by the Contractor from or on behalf of the Government. QUALITY ASSURANCE (CONTRACT): Government surveillance or monitoring actions to check goods or services to determine if they meet the requirements of the Performance Work Statement. QUALITY CONTROL: Actions taken to control the provision of services to ensure they meet the requirements of the contract. QUALITY IMPROVEMENT/RISK MANAGEMENT: An ongoing program designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, pursue opportunities to improve patient care, and resolve identified problems. QUALITY OF SERVICE: The quality of services shall meet or exceed the current recognized standards established by American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), the MTF, Bureau of Medicine and Surgery (BUMED) of the DON, DoD Health Affairs (HA), and those other professional associations which specify standards of performance for the coding profession. RELATIVE VALUE UNIT (RVU): Quantification of the relative resource consumption related to an ambulatory encounter. RELATIVE WEIGHTED PRODUCT (RWP): Quantification of the relative resource consumption related to an inpatient stay. REGION: Navy Medicine is broken into two regions, Navy Medicine East (NME) and Navy Medicine West (NMW). For additional information on which MTFs are located in each region, please see

35 for Navy Medicine East Area of Responsibility and for Navy Medicine West Area of Responsibility. TRICARE: The health care program serving MHS beneficiaries and enrollees. Page 35 of 179 LIST OF ATTACHMENTS AND EXHIBITS PWS Attachment I BUMED Memo 6000 Ser M3 HCO3 AT (Code Correction Guidelines) PWS Attachment II BUMEDINST A PWS Attachment III Coding Program Management and Training Guidelines PWS Attachment IV DD Contract Data Requirements List PWS Attachment V Citizenship Requirements PWS Attachment VI Confidentiality Form PWS Attachment VII Personally Identifiable Information (PII), Protected Health Information (PHI) and Federal Information Requirements CONTRACT ADMINISTRATION PLAN CONTRACT ADMINISTRATION PLAN (CAP) Non-Personal Services 1. Definitions Alternate Contracting Officer s Representative (ACOR). In the absence of the Contracting Officer s Representative (COR), the Government official appointed in writing by the Contracting Officer who functions as the technical representative of the Contracting Officer for a specific contract, for a specified period of time Bureau of Medicine and Surgery (BUMED). The Department of the Navy command responsible for all Navy medicine healthcare and research initiatives Commanding Officer. The senior Officer that has ultimate responsibility for the operation of the local activity Contracting Officer. The Government official at the Naval Medical Logistics Command with the actual authority to enter into, administer, and/or terminate contracts and make related determinations and findings on the behalf of the Government Contracting Officer s Representative (COR). The Government official appointed in writing by the Contracting Officer who functions as the technical representative of the Contracting Officer under the contract. For Indefinite Delivery and Indefinite Quantity contracts, CORs will be appointed for each task order in addition to an overall contract COR Contractor. The organization identified as the contractor/offeror on the Standard Form 1449 and its employees who are providing services under the contract Defense Contract Audit Agency (DCAA). The Government office responsible for performing all necessary contract audits for the Department of Defense. DCAA also provides accounting and financial advisory services regarding contracts and subcontracts Department Head. The Government official responsible for managing the operation of a distinct organizational division, office, or unit. The Department Head is subordinate to the Commanding Officer of the local activity Local Activity. The Military Treatment Facility (MTF), research activity, or other organization that falls under the cognizance of BUMED.

36 Page 36 of Military Treatment Facility (MTF). A Department of Defense (DoD) hospital or medical or health center where services may be required to be performed under this contract. The abbreviation, MTF includes all Branch Medical or Health Clinics, Medical Administrative Units, Branch Medical or Health Annexes and other subordinate clinical activities Naval Medical Logistics Command (NMLC). The Department of the Navy command responsible for providing contract support for BUMED Reserved Technical Assistant (TA). The local activity representative who may be appointed by the Commanding Officer (or designated representative) to provide technical or administrative assistance to the COR. TAs may be assigned to assist and support the COR but will not be given the authority to provide any technical direction or clarification directly to the Contractor. 2. Responsibilities The Contracting Officer, Acquisition Management and Analytics Directorate (Code 05), Naval Medical Logistics Command will: Perform all required pre-award actions including providing information or answering questions that arise during the solicitation period and as a result of Freedom of Information Act (FOIA) inquiries Review the Contract Administration Plan (CAP) Verify that the individual(s) nominated to act as COR and/or ACOR have had the required training and the necessary experience. If the Contracting Officer determines that a nominee does not meet experience and training requirements, the Contracting Officer will request that the local activity nominate another individual Review the CAP prior to incorporation into the solicitation. This review will ensure that all contract administration functions are assigned, suit the specific circumstances of the contract and give due consideration to the type of contract, the place of performance, period of performance, and inspection and acceptance criteria stated in the solicitation/contract Include the COR duties contained in this Master CAP in the resultant solicitation/contract. Additional duties will be separately delineated within the contract, as appropriate Designate the paying office in the contract Appoint the COR and ACOR. COR and ACOR appointments will be completed through the DoD Contracting Officer s Representative Tracking (CORT) Tool at: Perform all contract administration duties of a Contracting Officer. Regular meetings between the Contracting Officer, the COR or the local activity Commanding Officer (or representative) will be held to discuss the status of and the performance under individual contracts. The format and frequency of these meetings will depend upon the size and complexity of the contract. NOTE: All parties are specifically reminded that only the Contracting Officer has the authority to modify the terms of the contract. Therefore, in no event will any understanding, agreement, modification, change order, or other matter deviating from the terms of the contract between the Contractor and any other person be effective or binding on the Government. When/if, in the opinion of the Contractor, any direction affecting the terms of the contract has been given by the COR or any other person, the Contractor shall promptly notify the Contracting Officer.

37 Page 37 of Evaluate reports of Contractor non-compliance and take appropriate action within 30 days of receipt. Copies of any correspondence regarding the results of such analyses will be provided to the local activity and the COR simultaneously with the action taken Arrange the post-award conference, if required. Invite necessary attendees. Ensure that the requirements of the contract and the COR s duties are thoroughly discussed and understood. Ensure that all personnel involved understand current DoD Standards of Conduct policies Oversee the performance of CORs under the contract. Prompt action will be taken when COR (or alternate) is not performing properly Maintain the official contract file including modifications (and all back-up documentation) Maintain the accuracy of this Master CAP throughout the life of the contract Maintain a list of all CORs under their authority. Periodically review the files and performance of these CORs in accordance with NAVSUPINST (series) and local policies Review the existing annual Contractor performance report prior to negotiating (if applicable) any task orders under the contract, extending the contract, or exercising any options under the contract Maintain a log of total quantity ordered under the contract by Contract Line Item Number (CLIN)/Sub Contract Line Item Number (SLIN) to guarantee that maximum order quantities are not exceeded. Notify the local activity when 75% of the maximum order quantity of any CLIN/SLIN has been reached The Commanding Officer of the Local Activity (or designated representative) will: Establish policy guidance for the performance of services Provide overall direction for services at the activity Budget and provide funding for the contract Nominate (to the Contracting Officer) an individual to be appointed as COR (by name, title, organizational code and telephone number). This individual (augmented by the activity Department Heads) will also be the contract quality assurance monitor and lead technical advisor to the Contracting Officer and will be responsible for the technical interface needed during contract performance. An ACOR can be nominated to act in the absence of the COR, when needed, or to provide additional expertise. COR and ACOR nominations will be made through the DoD CORT Tool at: The local activity approval authority for the COR or ACOR nomination may be the nominee s supervisor. NOTE: COR duties cannot be delegated. The COR will be accountable for the actions of ACORs. NOTE: Nomination of a new COR or ACOR as a result of reassignment, termination of employment, etc., will be made in accordance with the procedures outlined herein Ensure all individuals nominated as COR or ACOR have the necessary qualifications to satisfactorily perform the required duties and hold a position of responsibility commensurate with the complexity of the contract. All CORs must complete DAU CLC 106. In addition CORs should complete a Naval Supply System Command (NAVSUP) or BUMED approved COR training course (or DAU/DoD equivalents) prior to appointment under complex contracts Support and supervise the COR in the performance of his/her duties. If the Commanding Officer determines that assigned duties are not being performed in a satisfactory manner, immediate corrective action will be taken (including the recommendation to replace the COR if required). The Contracting Officer will be promptly notified

38 Page 38 of 179 of all actions taken. The local activity should consider COR performance in rating all individuals assigned COR functions Ensure that appropriate timely action is taken on all contract related correspondence received from either the Contracting Officer or COR. This includes the timely submission (to the Contracting Officer) of any requests for changes to the contract, deviations or waivers. An Independent Government Cost Estimate of the impact on contract price and the availability of additional funding (if required) must accompany all requests for changes to the contract. The Contractor s price quote and the rationale for requesting the change shall accompany any changes proposed by the Contractor. The Contractor s price quote serves as a budgetary estimate of the cost impact. The local activity will also provide input as to technical acceptability of proposed contract language changes The local activity Commanding Officer may appoint a TA to assist the COR in executing routine contract administration, monitoring and, surveillance duties. The appointment of all TAs must be in writing and must include the TA's responsibilities and limitations. A copy of this appointment letter will be provided to the Contracting Officer. Before appointment, the local activity will assure that all TAs have the appropriate training and experience. TAs must complete DAU CLC 106 prior to appointment. A sample TA appointment letter is located on the NAVSUP Contracting Knowledge Site (CKS) at: The Contracting Officer's Representative (COR) will: Notify the Contracting Officer in writing of any organizational or personnel changes affecting the CAP Attend both the pre-proposal and post-award conferences, if held Upon receipt of the contract from the Contracting Officer, forward copies of documents to staff having administrative responsibilities for the contract Attend periodic meetings (as necessary) among the Contracting Officer, local activity and Contractor to discuss the status of and performance under the contract Avoid issuing any instructions that would constitute a change to the contract. The COR and Contractor shall not enter into any understanding, agreement, modification, or change order deviating from the terms of the contract which shall be effective or binding on the Government. If in the opinion of the Contractor, an effort outside the scope of the contract is requested, the Contractor shall promptly notify the Contracting Officer in writing. The Contractor shall not act unless the Contracting Officer has issued a written change to the contract. The COR will include, on all correspondence to the Contractor, a declination of authority statement as follows: I have neither the authority nor the intent to change the terms or conditions of this contract. This contract can only be changed by a written modification issued by the Contracting Officer. If you believe that I am requesting an effort outside the scope of this contract, promptly notify the Contracting Officer. Additionally, this shall not be construed as an authorization for new work or additional work not already contained in the contract Perform as the technical interface between the Government and the Contractor for this contract. The COR will provide technical advice or clarification regarding the performance work statement and terms of the contract; milestones to be met within the general terms of the contract or specific subtasks of the contract. The COR is the point of contact through whom the Contractor can relay technical questions and problems to the Contracting Officer. The Contractor may also contact the Contracting Officer directly Coordinate/facilitate complete and timely approvals for work at Government facilities between the local activity and the Contractor. The COR will inspect the qualifications of each contract employee prior to submission to the local activity if required by the contract Monitor Contractor performance and progress under the contract. If potentially inefficient or wasteful methods are being used, the COR will take reasonable and timely action to alert the Contractor and the Contracting Officer. Furthermore, the COR will promptly advise the Contracting Officer of any observed continuous and/or

39 Page 39 of 179 substantial deficiencies in the Contractor's performance or other noncompliance with the terms and conditions of the contract. Section C or the Performance Work Statement of the contract includes the Quality Assurance Surveillance Plan to be used by the COR to monitor Contractor performance. Deviation from this surveillance plan is only permitted with the prospective approval of the Contracting Officer In accordance with procedures given in this CAP, promptly issue Contract Discrepancy Reports (CDRs) (Enclosure (1)) to the Contractor to document discrepant performance. The COR will always obtain the Contractor's response/rebuttal to the CDR, evaluate, with the affected Department Head, the acceptability of the response and promptly forward the CDR, Contractor response/rebuttal, and their recommendation to the Contracting Officer The COR will recognize that CDRs become official records within the contract file and that they have serious implications for overall contract management and relationships. CDRs will not be the first and only choice for communicating contract issues with the contractor and shall be implemented in accordance with the procedures given below within this CAP For serious contract performance deficiencies, or when less formal communications fail to resolve minor performance deficiencies, the COR will issue a CDR to the Contractor The COR will ensure that all inspection data is attached to the CDR. The Contractor cannot be expected to respond to performance deficiencies that are not clearly and specifically identified. A cover memorandum on the CDR should specify that the Contractor has three working days, or other appropriate deadline, to respond in writing to the COR. At the time the CDR is issued to the Contractor, the COR will provide a copy of the CDR to the Contracting Officer Upon return of the CDR package from the Contractor, the COR will review the Contractor s comments and give careful, objective consideration to the facts and mitigating circumstances documented in the response. The COR will then make a final written determination and recommendation to the Contracting Officer on the acceptability of Contractor performance and note it on the CDR. The COR will state why the Contractor s response does or does not have merit. The COR will prepare the determination, recommendation, and other statements as appropriate along with actions being requested of the Contracting Officer and as much additional documentation as required to support their conclusions and recommendations The COR will provide the above documentation along with actions being requested of the Contracting Officer and as much additional documentation as required to support their conclusions and recommendations to (1) the Contractor, and (2) the Contracting Officer The Contracting Officer will review CDRs and will advise the COR of the need for any further documentation Monitor and verify that services are provided in accordance with the performance work statement and terms of the contract. Keep accurate records of Contractor performance and compare these records with the Wide Area Work Flow (WAWF) invoice submitted by the Contractor. The COR will always use this information as a tool when evaluating Contractor invoices. Monthly Progress Reports should be compared with their corresponding contractor invoices to verify consistency between the two. The COR should review the acceptability of invoices by consideration of the following: (a) Are there any performance issues? (b) Are costs appropriate considering current progress of work? (c) Are required reports up to date? For cost reimbursement contracts or task orders, the COR s review of invoices will be documented by completion of a Contractor Invoice Review Form (Enclosure (2)) Notify the Contracting Officer of questioned costs or issues. As required, assist the Contracting Officer in resolving questioned costs or issues with the contractor.

40 Page 40 of Accept the services as the official Government representative Use appropriate methods for contract surveillance Understand contract invoicing requirements. The COR will ensure that all WAWF Invoices are processed in a timely manner so that prompt payment due dates are met. Prior to acceptance of a WAWF invoice, the processing official will obtain approval from the cognizant activity Department Head that the payment request is appropriate. This can be done by having the activity Department Head sign a DD250 (or provide an to the contractor) for uploading into WAWF with the invoice. When the WAWF invoice comes up in the WAWF system, the processing official can then see that approval has already been given by the activity Department Head Immediately alert the Contracting Officer of any unusual performance problems. If a corrective action plan is approved by the Contracting Officer, the COR will monitor the implementation and effectiveness of that corrective action plan. In uncertain situations, the COR will always seek advice from the Contracting Officer, as prudent, before acting Continually monitor the quantity of services provided under each CLIN/SLIN and (if applicable) task order. Advise the Contracting Officer if it appears that service quantities may be exhausted before the end of the performance period, or if quantities for services have been ordered but will not be received by the end of the performance period Perform administrative duties including maintaining files which support the actions performed as a COR. The COR will respond to all contract correspondence in a timely manner. Contract files will include a conforming copy of the contract, all modifications, a conforming copy of the Contractor s Technical Proposal, all surveillance reports, each CDR (including the Contractor s response/rebuttal), any contract-related correspondence, a contract log or COR diary, all telephone conversation and records, meeting minutes, reports from Government subject matter experts, and Independent Government Cost Estimates If applicable, take the necessary steps to ensure that Government property furnished to the Contractor is provided in a timely manner and in proper condition for use. The COR will maintain both inventory and disposition records for all Government furnished property. This inventory/disposition file is coordinated with the Contracting Officer. The COR will ensure that the Contractor returns all Government furnished property or that Government furnished material has been reasonably consumed in the performance of work Read and comply with all applicable Standards of Conduct and Conflict of Interest instructions and procedures including annual financial interest filings Ensure that the Contractor receives copies of all regulations and/or directives considered appropriate to the services being provided Submit information detailing the Contractor's performance to the Contracting Officer. A statement indicating performance has been satisfactory along with your request to continue performance is required prior to exercising options under the contract. An annual report on the Contractor's performance will be required 30 days after the end of each performance period. A final report will be sent to the Contracting Officer within 60 days after completion of the contract. The final report will contain a conclusive statement describing the Contractor's overall performance and an evaluation on the accountability of Government property furnished to the Contractor. An addendum report may also be required. Format for the report will be in consonance with the Contractor Performance Assessment Reporting System (CPARS) and is provided at Enclosure (3). If the COR is responsible as the assessing official to complete the CPARS assessment, then that assessment may take the place of the annual report on contractor performance. These reports are to be submitted to the Contracting Officer through the DoD CORT Tool at: Perform other duties, particular to the contract, as may be incorporated into the contract document or as required by the Contracting Officer.

41 Page 41 of Generate monthly COR reports to the Contracting Officer and COR file. The report will address the status of contractor deliverables. Format for the monthly COR report is provided at Enclosure (4). The report is to be submitted to the Contracting Officer through the DoD CORT Tool at: The COR and ACOR will self-nominate themselves through the DoD CORT Tool at: The CORT Tool should also be utilized to assist in the performance of the COR responsibilities Technical Assistant (TA). All requirements for TA duties are reported directly to the COR. At the direction of the COR, the TA will: Perform surveillance and identify Contractor deficiencies Review contract deliverables, recommending acceptance/rejection, and providing the COR with the documentation to support all recommendations Assist the COR in the preparation of the final Contractor performance report using the format and procedures prescribed by the Contracting Officer Identify Contractor non-compliance with reporting requirements Evaluate Contractor proposals, identifying potential problem areas Provide to the COR (a) recommendations for revisions or clarifications to the performance work statement and terms of the contract and (b) recommendations for revisions to the CAP Provide detailed written reports of any trip, meeting, correspondence, telephone conversation, or anecdotal conversation after any contact between the TA and the Contractor For cost reimbursement contracts or task orders - the Defense Contract Audit Agency (DCAA) will be responsible for audit verification/provisional approval of invoices and final audit of the contract prior to final payment to the contractor. 3. Contractor Performance Assessment Reporting System (CPARS) 3.1. A Contractor Performance Assessment Report (CPAR) is required annually and after contract completion. An addendum report may be used to record contractor performance relative to contract closeout or other administrative requirements The COR will provide an assessment of the contractor s performance in CPARS The Contracting Officer will review the COR s assessment in CPARS The contractor will have a 30-day period to respond to each CPAR. Enclosures: Enclosure 1 - Contract Discrepancy Report Enclosure 2 - Contractor Invoice Review Form Enclosure 3 - Contractor Performance Assessment Report Enclosure Enclosure 4 - COR Monthly Report to the Contracting Officer

42 Page 42 of 179 Enclosure 1 - Contract Discrepancy Report CONTRACT DISCREPANCY REPORT Contract Number: Contract Clause: Date: COR Findings: COR (sign and date): Contractor Response: Contractor Project Manager (sign and date): COR Determination/Recommendation: COR (sign and date): Contracting Officer Acknowledgement and Recommendation (sign and date):

43 Page 43 of 179 Enclosure 2 - Contractor Invoice Review Form CONTRACTOR INVOICE REVIEW From: (Applicable COR) To: (Applicable Contracting Officer and DCAA) Subj: INVOICE REVIEW OF CONTRACT NO. (also identify delivery/task order number(s) as applicable) Encl: (1) Invoice No. Check Appropriate Statement: 1. Enclosure (1) submitted under the subject contract (delivery/task order) has been reviewed and the labor hours, labor mix, material (if any), travel, and other direct costs identified therein appear consistent and reasonable for the effort performed during the period covered by the invoice. 2. Enclosure (1) submitted under the subject contract (delivery/task order) has been reviewed and the following discrepancies/deficiencies are noted: Contracting Officer s Representative (signature and date)

44 Page 44 of 179 Enclosure 3 Contractor Performance Assessment Report CONTRACTOR PERFORMANCE ASSESSMENT REPORT Contractor Name and Address: Company Name: Street Address: Report Type: {Annual or Final or Addendum} Period of Performance Being Assessed: Contract Number: Order Number: Location of Contract Performance: Program Title: Contract Effort Description: Key Subcontractor(s): Contractor Name: Effort Performed: Contractor Name: Effort Performed:

45 Exceptional Very Good Satisfactory Marginal Unsatisfactory Evaluation Ratings Definitions (Excluding Utilization of Small Business) Rating Definition Note Performance meets contractual requirements and exceeds many to the Government s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective. weaknesses identified. Performance meets contractual requirements and exceeds some to the Government s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective. Performance meets contractual requirements. The contractual performance of the element or subelement contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor s proposed actions appear only marginally effective or were not fully implemented. Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or subelement contains a serious problem(s) for which the contractor s corrective actions appear or were ineffective. N R-0009 Page 45 of 179 To justify an Exceptional rating, identify multiple significant events and state how they were of benefit to the Government. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified. To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract. To justify Marginal performance, identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter). To justify an Unsatisfactory rating, identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing

46 Page 46 of 179 the management tools used to notify the contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters). Exceptional Very Good Evaluation Ratings Definitions (Utilization of Small Business) Rating Definition Note Exceeded all negotiated subcontracting goals or exceeded at least one goal and met all of the other negotiated subcontracting goals for the current period. Had exceptional success with initiatives to assist, promote, and utilize small business (SB), small disadvantaged business (SDB), women-owned small business (WOSB), HUBZone small business, veteran-owned small business (VOSB) and service disabled veteran owned small business (SDVOSB). Complied with FAR , Utilization of Small Business Concerns. Exceeded any other small business participation requirements incorporated in the contract, including the use of small businesses in mission critical aspects of the program. Went above and beyond the required elements of the subcontracting plan and other small business requirements of the contract. Completed and submitted Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate and timely manner. Met all of the negotiated subcontracting goals in the traditional socio-economic categories (SB, SDB and WOSB) and met at least one of the other socio-economic goals (HUBZone, VOSB, SDVOSB) for the current period. Had significant success with initiatives to assist, promote and utilize SB, SDB, WOSB, HUBZone, VOSB, and SDVOSB. Complied with FAR , Utilization of Small Business Concerns. Met or exceeded any other small business participation requirements incorporated in the contract, including the use of small businesses in mission critical aspects of the To justify an Exceptional rating, identify multiple significant events and state how they were a benefit to small business utilization. A singular benefit, however, could be of such magnitude that it constitutes an Exceptional rating. Ensure that small businesses are given meaningful, innovative work directly related to the project, rather than peripheral work, such as cleaning offices, supplies, landscaping, etc. Also, there should have been no significant weaknesses identified. To justify a Very Good rating, identify a significant event and state how they were a benefit to small business utilization. Ensure that small businesses are given meaningful, innovative work directly related to the project, rather than peripheral work, such as cleaning offices, supplies, landscaping, etc. There should be no significant weaknesses identified.

47 Page 47 of 179 program. Endeavored to go above and beyond the required elements of the subcontracting plan. Completed and submitted Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate and timely manner. Satisfactory Demonstrated a good faith effort to meet all of the negotiated subcontracting goals in the various socio-economic categories for the current period. Complied with FAR , Utilization of Small Business Concerns. Met any other small business participation requirements included in the contract. Fulfilled the requirements of the subcontracting plan included in the contract. Completed and submitted Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate and timely manner. Marginal Deficient in meeting key subcontracting plan elements. Deficient in complying with FAR , Utilization of Small Business Concerns, and any other small business participation requirements in the contract. Did not submit Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate or timely manner. Failed to satisfy one or more requirements of a corrective action plan currently in place; however, does show an interest in bringing performance to a satisfactory level and has demonstrated a commitment to apply the necessary resources to do so. Required a corrective action plan. Unsatisfactory Noncompliant with FAR and , and any other small business participation requirements in the contract. Did not submit Individual Subcontract Reports and/or Summary Subcontract Reports in an accurate or timely manner. Showed little interest in bringing performance to a satisfactory level or is generally uncooperative. Required a corrective action plan. To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor has addressed or taken corrective action. There should have been no significant weaknesses identified. A fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract. To justify Marginal performance, identify a significant event that the contractor had trouble overcoming and how it impacted small business utilization. A Marginal rating should be supported by referencing the actions taken by the government that notified the contractor of the contractual deficiency. To justify an Unsatisfactory rating, identify multiple significant events that the contractor had trouble overcoming and state how it impacted small business utilization. A singular problem, however, could be of such serious magnitude that it alone constitutes an Unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the actions taken by the government to notify the contractor of the

48 Page 48 of 179 deficiencies. When an Unsatisfactory rating is justified, the contracting officer must consider whether the contractor made a good faith effort to comply with the requirements of the subcontracting plan required by FAR and follow the procedures outlined in FAR , Liquidated Damages-Subcontracting Plan. NOTE 1: Generally, zero percent is not a goal unless the Contracting Officer determined when negotiating the subcontracting plan that no subcontracting opportunities exist in a particular socio-economic category. In such cases, the contractor shall be considered to have met the goal for any socio-economic category where the goal negotiated in the plan was zero. Assigned Rating Evaluation Area Past Rating Current Rating Quality Schedule Cost Control (Not required for Firm-Fixed Price or Firm-Fixed Price with Economic Price Adjustment) Management Utilization of Small Business Assessed by Contracting Officer Assessed by Contracting Officer Regulatory Compliance Other Areas: (1) {list} (2) {list} (3) {list} Rating Support Note: A factual narrative is required for all assessments regardless of rating. Each narrative statement in support of the area assessment must contain objective data. Quality Narrative: Schedule Narrative: Cost Control Narrative (if applicable): Management Narrative: Regulatory Compliance Narrative:

49 Page 49 of 179 Other Areas (1) Narrative: Other Areas (2) Narrative: Other Areas (3) Narrative: COR Name: Signature: Date:

50 Page 50 of 179 Enclosure 4 COR Monthly Report to the Contracting Officer COR Monthly Report to the Contracting Officer 1. Contract No. (also include Task Order No. if applicable): 2. Description of Services: 3. Period of Performance list month report covers: 4. Contractor: 5. Method(s) of Surveillance Used: 6. This document is in accordance with the inspection of services clause, the Contract Administration Plan (CAP), and the Quality Assurance Surveillance Plan (QASP) requirements. 7. Complete each of the following and provide detailed explanation when required. Attach additional documents if explanation is long or requires supporting evidence. a. Quality of Work: ( ) Exceptional ( ) Very Good ( ) Satisfactory If Marginal or Unsatisfactory, explain: ( ) Marginal ( ) Unsatisfactory b. Was the contractor s performance timely? ( ) Yes ( ) No If No, explain: c. Are there any significant issues that should be brought to the Contracting Officer s attention? ( ) Yes ( ) No If Yes, explain: d. Is action being taken by contractor to correct discrepancies? ( ) Yes ( ) No Discrepancies this month If Yes, explain: 8. Customer Complaints: a. Number of customer complaints: b. Number of VALID customer complaints: Discuss VALID complaints: 9. Status of Contract/Delivery/Task Order Deliverables for month report covers: Date Deliverable Deliverable Deliverable Due Date Submitted Comments 10. Additional COR Comments: 11. I hereby certify that services have been received and accepted. Contracting Officer s Representative Name: Signature: Date:

51 Page 51 of 179 INSPECTION AND ACCEPTANCE TERMS Supplies/services will be inspected/accepted at: CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY 0001 Destination Government Destination Government 0002 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 Destination Government Destination Government 0006 Destination Government Destination Government 0007 Destination Government Destination Government 0008 Destination Government Destination Government 0009 Destination Government Destination Government 0010 Destination Government Destination Government 0011 Destination Government Destination Government 1001 Destination Government Destination Government 1002 Destination Government Destination Government 1003 Destination Government Destination Government 1004 Destination Government Destination Government 1005 Destination Government Destination Government 1006 Destination Government Destination Government 1007 Destination Government Destination Government 1008 Destination Government Destination Government 1009 Destination Government Destination Government 1010 Destination Government Destination Government 1011 Destination Government Destination Government 2001 Destination Government Destination Government 2002 Destination Government Destination Government 2003 Destination Government Destination Government 2004 Destination Government Destination Government 2005 Destination Government Destination Government 2006 Destination Government Destination Government 2007 Destination Government Destination Government 2008 Destination Government Destination Government 2009 Destination Government Destination Government 2010 Destination Government Destination Government 2011 Destination Government Destination Government DELIVERY INFORMATION CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

52 Page 52 of POP 01-SEP-2016 TO 31-AUG-2017 N/A BUREAU OF MEDICINE & SURGERY 7700 ARLINGTON BOULEVARD FALLS CHURCH VA FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2016 TO 31-AUG-2017 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N00018

53 Page 53 of POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2017 TO 31-AUG-2018 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N POP 01-SEP-2018 TO 31-AUG-2019 N/A (SAME AS PREVIOUS LOCATION) FOB: Destination N00018 CLAUSES INCORPORATED BY REFERENCE Inspection Of Services--Fixed Price AUG Electronic Submission of Payment Requests and Receiving JUN 2012 Reports

54 Page 54 of 179 CLAUSES INCORPORATED BY FULL TEXT WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013) (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. (b) Electronic invoicing. The WAWF system is the method to electronically process vendor payment requests and receiving reports, as authorized by DFARS , 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 and (2) Be registered to use WAWF at 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 (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 must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order: (1) Document type. The Contractor shall use the following document type(s). 2-in-1 Invoice (2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WAWF, as specified by the contracting officer. See individual task orders. (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

55 Page 55 of Pay Official DoDAAC HQ0248 Issue By DoDAAC N62645 Admin DoDAAC N62645 Inspect By DoDAAC N00018 Ship To Code N/A Ship From Code N/A Mark For Code N/A Service Approver (DoDAAC) N/A Service Acceptor (DoDAAC) N00018 Accept at Other DoDAAC N/A LPO DoDAAC N62645 DCAA Auditor DoDAAC N/A Other DoDAAC(s) N/A (4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request. (5) WAWF notifications. The Contractor shall enter the address identified below in the Send Additional Notifications field of WAWF once a document is submitted in the system. [email protected] (g) WAWF point of contact. (1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact. [email protected] (2) For technical WAWF help, contact the WAWF helpdesk at (End of clause) CONTRACT MINIMUM/MAXIMUM QUANTITY AND CONTRACT VALUE The minimum quantity and contract value for all orders issued against this contract shall not be less than the minimum quantity and contract value stated in the following table. The maximum quantity and contract value for all orders issued against this contract shall not exceed the maximum quantity and contract value stated in the following table.

56 Page 56 of 179 MINIMUM QUANTITY MINIMUM MAXIMUM MAXIMUM AMOUNT QUANTITY AMOUNT $3, $84,615, CLIN DELIVERY/TASK ORDER MINIMUM/MAXIMUM QUANTITY AND CLIN ORDER VALUE The minimum quantity and order value for the given Delivery/Task Order issued for this CLIN shall not be less than the minimum quantity and order value stated in the following table. The maximum quantity and order value for the given Delivery/Task Order issued for this CLIN shall not exceed the maximum quantity and order value stated in the following table. MINIMUM MINIMUM MAXIMUM MAXIMUM CLIN QUANTITY AMOUNT QUANTITY AMOUNT 0001 $ $ 0002 $ $ 0003 $ $ 0004 $ $ 0005 $ $ 0006 $ $ 0007 $ $ 0008 $ $ 0009 $ $ 0010 $ $ 1001 $ $ 1002 $ $ 1003 $ $ 1004 $ $ 1005 $ $ 1006 $ $ 1007 $ $ 1008 $ $ 1009 $ $

57 Page 57 of $ $ 2001 $ $ 2002 $ $ 2003 $ $ 2004 $ $ 2005 $ $ 2006 $ $ 2007 $ $ 2008 $ $ 2009 $ $ 2010 $ $ SPECIAL CONTRACT REQUIREMENTS PERFORMANCE BY FOREIGN NATIONALS OR FOREIGN OWNERSHIP, CONTROL OR INFLUENCE (FOCI) ORGANIZATIONS In accordance with 8 U.S.C.1324a, it is unlawful to hire for employment in the U.S. an individual without verifying that individual s employment authorization. 8 CFR 274a.2 VERIFICATION OF EMPLOYMENT ELIGIBILITY identifies the official documents that establish employment eligibility. Prior to performance of work by a foreign national as a result of this contract, the employer shall provide the Contracting Officer the name of the foreign national and identify the type of form(s) produced for verification of employment status. Should the foreign national s performance require access to DoD facilities, the employer shall coordinate with the sponsor providing access, in order to submit the following: 1. Individual s Name 2. Date/place of birth 3. Citizenship 4. Date and Location of the Visit 5. Purpose of the Visit 6. Passport Number 7. Employer s Verification of Work Authorization This information shall be forwarded to the Contracting Officer at least thirty days prior to the visit taking place. Failure to provide this information within this time frame may prevent the individual(s) from entry into the DoD facilities. The offeror shall disclose if the company (or individual) is a FOCI organization. A FOCI organization includes sole proprietorships, partnerships, and corporations, and the divisions and subsidiaries of the corporation where: (a) 51% or more of the controlling (voting) stock is foreign-owned; or (b) parent organization is incorporated or otherwise charted in a country foreign to the U.S.; and (c) the organization is not performing a state function (any organization

58 Page 58 of 179 performing a state function falls under IPO authority). A division or subsidiary of an organization having a location in the U.S. is still considered a FOCI organization if the parent corporation is a FOCI organization. A university, college, or not-for-profit organization that is chartered, incorporated, or otherwise called into being in a country foreign to the U.S. and not performing a state function is a FOCI organization. A FOCI person is a non-u.s. citizen. Resident aliens are considered FOCI persons for licensing and technology transfer purposes. Approval by the U.S. Trade Representative may be required prior to executing a contract with a FOCI organization or person. PRIVACY ACT AND HIPAA The contractor shall ensure that all Protected Health Information (PHI) is protected in accordance with the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated safeguards to ensure confidentiality of health information. All contractor personnel are required to complete HIPAA training within one (1) year prior to the provision of services under this contract. Contractor personnel must complete HIPAA refresher training annually. AUTHORIZED CHANGES ONLY BY THE CONTRACTING OFFICER (a) Except as specified in paragraph (b) below, no order, statement, or conduct of Government personnel who visit the contractor s facilities or in any other manner communicates with contractor personnel during the performance of this contract shall constitute a change under the Changes clause of this contract. (b) The contractor shall not comply with any order, direction or request of Government personnel unless it is issued in writing and signed by the Contracting Officer, or is pursuant to specific authority otherwise included as a part of this contract. (c) The Contracting Officer is the only person authorized to approve changes in any of the requirements of this contract and notwithstanding provisions contained elsewhere in this contract, the said authority remains solely the Contracting Officer s. In the event the contractor effects any change at the direction of any person other than the Contracting Officer, the change will be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in charges incurred as a result thereof. CONTRACTOR'S PROPOSAL Performance of this contract by the contractor shall be conducted and performed in accordance with detailed obligations to which the contractor committed itself in Proposal dated (To be filled in at contract award) in response to NMLC Solicitation No. N R ENVIRONMENTAL AND ENERGY CONSERVATION OBJECTIVES If performance of any work under this contract is required at a Government facility, the Contractor shall contact the appropriate office and code with cognizance over safety and environmental requirement prior to performance of ANY work under this contract. The office having overall governance concerning safety is as follows: Bureau of Medicine & Surgery 7700 Arlington Blvd #5113 Falls Church, VA Contractors are responsible for following all safety and health related State and Federal statutes and corresponding State, Federal and/or Department of Defense regulations protecting the environment, contractor employees, and persons who live and work in and around contractor and/or federal facilities. STANDARD LIABILITY INSURANCE The following types of insurance are required in accordance with the clause entitled, FAR , Insurance-- Work on a Government Installation and shall be maintained in the minimum amounts shown:

59 Page 59 of 179 (a) Comprehensive General Liability: $ N/A per person and $500,000 per accident for bodily injury. (b) Automobile Insurance: $200,000 per person and $500,000 per accident for bodily injury and $20,000 per accident for property damage. (c) Standard Workman s Compensation and Employer s Liability Insurance (or, where maritime employment is involved, Longshoremen s and Harbor Worker s Compensation Insurance) in the minimum amount of $100,000. (d) Aircraft public and passenger liability: $N/A per person and $ N/A per occurrence for bodily injury, other than passenger liability; $ N/A per occurrence for property damage. Passenger bodily injury liability limits of $N/A per passenger, multiplied by the number of seats or number of passengers, whichever is greater. WORKERS' COMPENSATION INSURANCE OVERSEAS is required for all service contracts in Japan. FAR (a) applies if the Contractor employs any person who, but for a waiver granted by the Secretary of Labor, would be subject to workers compensation insurance under the Defense Base Act (42 U.S.C. 1651, et. Seq). In accordance with FAR (a) the Contractor shall (1) provide, before commencing performance under this contract, at least that workers compensation insurance or the equivalent as the laws of the country of which these employees are national may require, and (2) continue to maintain it until performance is completed. The Contractor shall insert, in all subcontracts under this contract to which the Defense Base Act would apply but for the waiver, a clause similar to this paragraph (a) (including this sentence) imposing those subcontractors this requirement to provide such workers compensation insurance coverage. REIMBURSEMENT OF TRAVEL, PER DIEM, AND SPECIAL MATERIAL COSTS (a) Area of Travel. Performance under this contract may require travel by contractor personnel. If travel, domestic or overseas, is required, the contractor is responsible for making all necessary arrangements for its personnel. These include but are not limited to: medical examinations, immunizations, passports/visas/etc., and security clearances. (b) Travel Policy. The Government will reimburse the contractor for allowable travel costs incurred by the contractor in performance of the contract in accordance with FAR Travel required for tasks assigned under this contract shall be governed in accordance with: Federal Travel Regulations, prescribed by the General Services Administration for travel in the conterminous 48 United States, (hereinafter the FTR); Joint Travel Regulation, Volume 2, DoD Civilian Personnel, Appendix A, prescribed by the Department of Defense, for travel in Alaska, Hawaii, The Commonwealth of Puerto Rico, and territories and possessions of the United States (hereinafter JTR); and Standardized Regulations (Government Civilians, Foreign Areas), Section 925, "Maximum Travel Per Diem Allowances for Foreign Areas," prescribed by the Department of State, for travel in areas not covered in the FTR or JTR (hereinafter the SR). (c) Travel. Travel and subsistence are authorized for travel beyond a fifty-mile radius of the contractor s office whenever a task assignment requires work to be accomplished at a temporary alternate worksite. No travel or subsistence shall be charged for work performed within a fifty-mile radius of the contractor s office. The contractor shall not be paid for travel or subsistence for contractor personnel who reside in the metropolitan area in which the tasks are being performed. Travel performed for personal convenience, in conjunction with personal recreation, or daily travel to and from work at the contractor s facility will not be reimbursed. (1) For travel costs other than described in paragraph (c) above, the contractor shall be paid on the basis of actual amount paid to the extent that such travel is necessary for the performance of services under the contract and is authorized by the COR in writing. (2) When transportation by privately owned conveyance is authorized, the contractor shall be paid on a mileage basis not to exceed the applicable Government transportation rate as contained in the FTR, JTR or SR. Authorization for the use of privately owned conveyance shall be indicated in the basic contract. Distances traveled between points shall be shown on invoices as listed in standard highway mileage guides. Reimbursement will not exceed the mileage shown in the standard highway mileage guides.

60 Page 60 of 179 (3) The contractor agrees, in the performance of necessary travel, to use the lowest cost mode commensurate with the requirements of the mission as set forth in the basic contract and in accordance with good traffic management principles. When it is necessary to use air or rail travel, the contractor agrees to use coach, tourist class, or similar accommodations to the extent consistent with the successful and economical accomplishment of the mission for which the travel is being performed. (4) The contractor s invoices shall include receipts or other evidence substantiating actual costs incurred for authorized travel. In no event will such payments exceed the rates of common carriers. (d) Vehicle and/or Truck Rentals. The contractor shall be reimbursed for actual rental/lease of special vehicles and/or trucks (i.e., of a type not normally used by the contractor in the conduct of its business) only if authorized in the basic contract and upon approval by the COR. Reimbursement of such rental shall be made based on actual amounts paid by the contractor. Use of rental/lease costs of vehicles and/or trucks that are of a type normally used by the contractor in the conduct of its business are not subject to reimbursement. (e) Car Rental. The contractor shall be reimbursed for car rental, exclusive of mileage charges, as authorized in the basic contract and upon approval by the COR, when the services are required to be performed beyond the normal commuting distance from the contractor s facilities. Car rental for a team on Temporary Duty (TDY) at one site will be allowed for a minimum of four (4) persons per car, provided that such number or greater comprise the TDY team. (f) Per Diem. The contractor shall not be paid for per diem for contractor personnel who reside in the metropolitan areas in which the tasks are being performed. Per Diem shall not be paid on services performed within a fifty-mile radius of the contractor s home office or the contractor s local office. Per Diem is authorized for contractor personnel beyond a fifty-mile radius of the contractor s home or local offices whenever a task assigned requires work to be done at a temporary alternate worksite. Per Diem shall be paid to the contractor only to the extent that overnight stay is necessary and authorized under this contract. The authorized per diem rate shall be the same as the prevailing per diem in the worksite locality. These rates will be based on rates contained in the FTR, JTR or SR. The applicable rate is authorized at a flat seventy-five (75%) percent on the day of departure from contractor s home or local office, and on the day of return. Reimbursement to the contractor for per diem shall be limited to actual payments to per diem defined herein. The contractor shall provide actual payments of per diem defined herein. The contractor shall provide supporting documentation (e.g., signed travel expense reports) for per diem expenses as evidence of actual payment. (g) Shipboard Stays. Whenever work assignments require temporary duty aboard a Government ship, the contractor will be reimbursed at the per diem rates identified in paragraph C8101.2C or C B(6) of the Department of Defense Joint Travel Regulations, Volume II. (h) Special Material. Special material includes only the costs of material, supplies, or services which is peculiar to the ordered services and which is not suitable for use in the course of the contractor s normal business. It shall be furnished pursuant to specific authorization approved by the COR. The contractor will be required to support all material costs claimed by its costs less any applicable discounts. Special materials include, but are not limited to, graphic reproduction expenses, or technical illustrative or design requirements needing special processing. The Contractor shall ensure that the requested travel costs will not exceed what the Government has pre-authorized. Contractor personnel must follow established Government travel requirements, complete all forms, and obtain the required signatures prior to any travel. The Contractor may be required to coordinate with other DOD and industry for travel. Trip reports will be required at the direction of the Government. The Contractor may be required to attend various meetings and reviews or to participate in Government projects. Travel may be CONUS as well as OCONUS. Reimbursements for travel will be in accordance with JTR and will in no case exceed those travel costs allowed by the JTR unless approved by the Government. No surcharges shall be authorized for travel costs other than the Contractor s G&A rate approved by the Defense Contract Audit Agency (DCAA). No fee or profit shall be applied to travel costs.

61 Page 61 of 179 Any OCONUS/FOREIGN travel by contractor personnel shall be in accordance with procedures for entering into the Area of Responsibility (e.g., CENTCOM). Refer to the Foreign Clearance Guide at RELOCATION COSTS As specified in each task order, relocation costs will be reimbursed in accordance with the JTR current at the time. All reimbursements will be retrospective, payable only upon presentation of a properly prepared invoice (as specified by the facility) to the COR. The Government will reimburse the contractor only for authorized relocation expenses deemed reasonable as stated in the current JTR. The contractor will be compensated for travel per Contract Line Item Number 0010, 1010 and 2010 in Section B of the contract. The Government reserves the right to require additional documentation, including memoranda from the contract worker performing the relocation. If a contract is terminated at the Government s convenience, relocations costs may be negotiated. (a) The Government will pay the contractor to relocate contract workers from the United States to OCONUS locations. The contractor shall send the COR an with the entire amount of relocation costs incurred upon the contract worker s start of services. The COR will divide the total authorized amount into four increments, payable upon completion of services on a quarterly basis. For example, after three months of services, the contractor shall submit an invoice for the first quarter of funds for relocation costs and the Government will certify the invoice. Should the contract worker remain for a 12-month period, all of the funds for the relocation costs will be released to the contractor. (b) The Government will pay the contractor to relocate contract workers (who relocated from the United States to OCONUS locations for performance under this contract) back to the United States. Relocation costs may only be considered upon the successful completion of at least 12 months of performance. (c) Exclusions. The Government will not provide repayment of relocation costs for contract workers who do not perform at least three months of services. This includes contract workers that terminate employment early, whether voluntarily or involuntarily, or those who receive unfavorable background checks. The contractor is cautioned against relocating a contract worker prior to their approval to begin services. CONTRACTS TO BE PERFORMED IN JAPAN The Status of Forces Agreement between the United States and Japan (SOFA) governs the rights and obligations of the United States armed forces in Japan. Unless a contractor is present in Japan solely to perform under a contract with the United States for the sole benefit of the United States armed forces in Japan and is accorded privileges under SOFA Article XIV, it and its employees shall be subject to all the laws and regulations of Japan, including the US-Japan SOFA. Certain contractor employees and their dependents not accorded privileges under SOFA Article XIV may be accorded status under SOFA Article I(b) with potential eligibility for logistic support. Dependents of contractors or of contractor employees who receive SOFA Article XIV status do not receive SOFA status under SOFA Article XIV or SOFA Article I(b) based on their status as dependents. The Contractor shall comply with the instruction of the Contracting Officer concerning the entry of its employees, equipment, and supplies into Japan, and shall comply with all applicable Japanese laws and regulations as well as United States Forces Japan (USFJ) and USFJ component policies and regulations during the performance of this contract. SOFA ARTICLE XIV STATUS (a) Awardee may apply for Article XIV status under the United States Japan Status of Forces Agreement (SOFA). Offers shall be prepared based on the assumption that SOFA Article XIV status will be granted by Government in consultation with the Government of Japan. If the Government determines that Awardee does not qualify for SOFA Article XIV status or that SOFA Article XIV status is otherwise inappropriate, an equitable adjustment shall be made to the cost/price and other appropriate terms of the contract. Persons, including corporations organized under the laws of the United States, and their employees who are ordinarily a resident in the United States and whose presence in Japan is solely for the purpose of executing contracts with the United States for the benefit of the United

62 Page 62 of 179 States armed forces may acquire privileged status under SOFA Article XIV. Such contractors and contractor employees are eligible for agency privileges and benefits under the SOFA but otherwise remain subject to the laws and regulations of Japan. Neither SOFA Article XIV nor SOFA Article I(b) status and privileges extend to dependents of SOFA Article XIV contractors or contractor employees. (b) Procedures. (1) Formal application for SOFA Article XIV status shall be made to HQ USFJ only after the contract has been awarded and the contractor s place of operation in Japan has been determined. (2) A contractor seeking SOFA Article XIV status for itself and its employees shall submit the following to the Contracting Officer as part of its offer: (i) Proof that the contractor is a person ordinarily resident in the United States or a corporation organized under the laws of the United States and that its presence in Japan is solely for the purpose of executing contracts with the United States for the benefit of the United States armed forces; and (ii) Proof that the contractor s employees are persons ordinarily a resident in the United States and that their presence in Japan is solely for the purpose of performing work under contracts with the United States for the benefit of the United States armed forces. (3) The Contracting Officer shall make the initial determination whether the contractor qualifies for SOFA Article XIV status. Upon a determination of qualification, the Contracting Officer shall forward a request for designation through component channels to Commander, United States Forces, Japan, ATTN: USFJ/J5, Unit 5068, APO AP The request shall include the items requested in subparagraph (b)(2), a full explanation of the necessity of using a United States contractor, and relevant documentation. See USFJ Instruction for further details. (4) HQ USFJ shall make the final determination on the contractor s SOFA Article XIV status upon consultation with the Government of Japan. (5) Upon receipt of HQ USFJ approval, the Contracting Officer shall issue Letters of Identification indicating SOFA Article XIV status has been granted to the contractor and contractor employees. (6) Once a contractor has been designated under SOFA Article XIV, it is not necessary that it be redesignated if a follow-on contract is awarded to that contractor; provided the new contract does not involve a material change from the work under which the SOFA Article XIV designation was originally granted and there is no significant delay between completion of the existing contract and initiation of performance under the follow-on contract. (c) SOFA Article XIV privileges and benefits. In accordance with SOFA Article XIV, paragraphs 3 through 8, upon certification by appropriate United States authorities as to their identity, such persons and their employees shall be accorded the following benefits of the SOFA. Note: Privileges and benefits afforded under SOFA Article XIV do not extend to dependents/family members. (1) Access to and movement between facilities and areas in use by the United States armed forces and between such facilities and areas and the ports or airports of Japan as provided for in SOFA Article V, paragraph 2; (2) Entry into Japan and exemption from Japanese laws and regulations on the registration and control of aliens as provided for in SOFA Article IX; (3) Exemption from customs duties and other such charges on furniture and household goods for private use imported by person when they first arrive to work in Japan, vehicles and parts imported for private use, and reasonable quantities of clothing and household goods for everyday private use which are mailed into Japan through United States military post offices as provided for in SOFA Article XI, paragraph 3;

63 Page 63 of 179 (4) If authorized by the installation commander or designee, the right to use Navy exchanges, post exchanges, base exchanges, commissaries, messes, social clubs, theaters, newspapers and other nonappropriated fund organizations regulated by United States military authorities as provided for in SOFA Article XV; (5) The transmission into or outside of Japan of United States dollar or dollar instruments realized as a result of contract performance as provided for in SOFA Article XIX, paragraph 2; (6) The use of postal facilities as provided for in SOFA Article XXI; (7) Exemption from the laws and regulations of Japan with respect to terms and conditions of employment except that such exemption shall not apply to the employment of local nationals in Japan; (8) Exemption from taxes and similar charges of Japan on depreciable assets except houses, held, used, or transferred for the execution of contracts referenced in subparagraph (a); (9) Exemption from taxation in Japan on the holding, use transfer by death, or transfer to person or agencies entitled to tax exemption under the SOFA, of movable property, tangible or intangible, the presence of which in Japan is due solely to the temporary presence of these persons in Japan, provided such exemption shall not apply to property held for the purpose of investment or the conduct of other business in Japan or to any intangible property registered in Japan. No exemption from taxes payable for the use of roads by private vehicles is provided under SOFA Article XIV; (10) Exemption from income or corporation taxes of the Government of Japan or any other taxing agency in Japan on any income derived under a contract made in the United States with the Government of the United States in connection with the construction, maintenance or operation of any of the facilities or area covered by the SOFA. The provisions of this paragraph do not exempt such persons from payment of income or corporation taxes on income derived from Japanese sources; (11) Japan authorities have the right to exercise jurisdiction over SOFA personnel in relation to offenses committed in Japan and punishable by the law of Japan. In those cases in which the Japanese authorities have the primary right to exercise jurisdiction but decide not to do so, the United States shall have the right to exercise such jurisdiction as is conferred on it by the law of the United States. SOFA ARTICLE I(b) STATUS (a) SOFA Article I(b) status. Individuals including, but not limited to, technical advisors, consultants, entertainers serving under contracts with the United States for the provision of services in support of U.S. armed forces in Japan, and whose presence is required in Japan to provide such services, may acquire SOFA status in Japan as part of the civilian component under Article I(b) of the SOFA. Note SOFA Article I(b) does not create a lawful status in Japan for any entity other than individuals (e.g., the corporation employing the individual). To qualify for SOFA status under SOFA Article I(b), such individuals must be: (1) United States nationals, (2) not ordinarily resident in Japan (or if ordinarily resident in Japan, receive permission from the GOJ to change status following the procedures set out in USFJI , Changes of Status by Person in Japan to One of the Categories (3) present in Japan at the invitation of the United States, and solely for the purpose of executing contracts for the benefit of the United States armed forces (including Foreign Military Sales contracts), and, Authorized by the Status of Forces Agreement), (4) not contractors, employees of a contractor whose presence in Japan is solely for the purpose of executing contracts within the definition of SOFA Article XIV.

64 Page 64 of 179 (b) SOFA Article I(b) procedures. Contractor personnel must obtain a Letter of Identification from Contracting Officer to authorize entry into Japan under SOFA Article I(b) and to identify which Article I(b) privileges and benefits will be provided to each employee/dependent. Contractor shall, in writing, identify all contractor personnel and accompanying dependents eligible for SOFA Article I(b) status to the Contracting Officer. c) SOFA Article 1(b) privileges and benefits. Persons granted authority to enter Japan under SOFA Article I(b) and their dependents (defined as spouse, children under 21, and, if dependent for over half their support upon an individual having SOFA Article I(b) status, parents and children over 21) shall be accorded the following benefits of the SOFA. These privileges are personal to the employee/dependent and to not inure to the employer. (1) Access to and movement between facilities and areas in use by the United States armed forces and between such facilities and areas and the ports or airports of Japan as provided for in SOFA Article V, paragraph 2; (2) Entry into Japan and exemption from Japanese laws and regulations on the registration and control of aliens as provided for in SOFA Article IX; (3) Acceptance as valid by Japan, without a driving test or fee, a U.S. Forces, Japan Operator s Permit for Civilian Vehicle as provided for in SOFA Article X. Issuance of such permit shall be subject to applicable military regulation; (4) Exemption from customs duties and other such charges on materials, supplies, and equipment which are to be incorporated into articles or facilities used by the United States armed forces furniture, household goods for private use imported by person when they first arrive to work in Japan, vehicles and parts imported for private use, and reasonable quantities of clothing and household goods for everyday private use which are mailed into Japan through United States military post offices as provided for in SOFA Article XI, paragraphs 2 and 3; (5) Exemption from the laws and regulations of Japan with respect to terms and conditions of employment as provided for in SOFA Article XII, paragraph 7, except that such exemption shall not apply to the employment of local nationals in Japan; (6) Exemption from Japanese taxes to the Government of Japan or to any other taxing agency in Japan on income received as a result of their service with the United States armed forces as provided for in SOFA Article XIII. The provisions of Article XIII do not exempt such persons from payment of Japanese taxes on income derived from Japanese sources; (7) If authorized by the installation commander or designee, the right to use Navy exchanges, post exchanges, base exchanges, commissaries, messes, social clubs, theaters, newspapers and other nonappropriated fund organizations regulated by United States military authorities as provided for in SOFA Article XV; (8) The transmission into or outside of Japan of United States dollar or dollar instruments realized as a result of contract performance as provided for in SOFA Article XIX, paragraph 2; (9) The use of postal facilities as provided for in SOFA Article XXI; (10) Exemption from taxation in Japan on the holding, use transfer by death, or transfer to person or agencies entitled to tax exemption under the SOFA, of movable property, tangible or intangible, the presence of which in Japan is due solely to the temporary presence of these persons in Japan, provided such exemption shall not apply to property held for the purpose of investment or the conduct of other business in Japan or to any intangible property registered in Japan.

65 Page 65 of 179 (11) Japan authorities have the right to exercise jurisdiction over SOFA personnel in relation to offenses committed in Japan and punishable by the law of Japan. In those cases in which the Japanese authorities have the primary right to exercise jurisdiction but decide not to do so, the United States shall have the right to exercise such jurisdiction as is conferred on it by the law of the United States. LOGISTIC SUPPORT Contractor (if awarded Article XIV status), contractor personnel, and in the case of contractor personnel granted SOFA Article I(b) status, dependents, shall, subject to availability as determined by the installation commander or designee, be provided logistic support including, but not limited to, the items below (a) Navy, Base or Post Exchange, exchange service stations, theaters, and commissary (Article I(b) personnel/dependents and Article XIV personnel only); (b) Laundry and dry cleaning; (c) Military banking facilities (Article I(b) personnel/dependents and Article XIV personnel only); (d) Transient billeting facilities; (e) Open mess (club) membership, as determined by each respective club (Article I(b) personnel/dependents and Article XIV personnel only); (f) Casualty assistance (mortuary services) on a reimbursable basis; (g) Routine medical care on a reimbursable basis for U.S. citizens and emergency medical care on a reimbursable basis for non-u.s. citizens; (h) Dental care, limited to relief of emergencies on a reimbursable basis; (i) Department of Defense Dependent Schools on a space-available and tuition-paying basis; (j) Postal support, as authorized by military postal regulations (Article I(b) personnel/dependents and Article XIV personnel only); (k) Local recreation services on a space-available basis; (l) Issuance of U.S. Forces, Japan Operator s Permit (Article I(b) personnel/dependents and Article XIV personnel only); (m) Issuance of vehicle license plates (Article I(b) personnel/dependents and Article XIV personnel only). ORGANIZATIONAL CONFLICT OF INTEREST (JAN 1992) (NAVSUP) This clause provides examples of certain organizational conflicts of interest which are prescribed by Federal Acquisition Regulation Subpart 9.5. The two (2) underlying principles which this clause seeks to avoid are preventing the existence of conflicting roles that might bias a contractor's judgment and preventing unfair competitive advantage. The following subsections prescribe certain limitations on contracting as the means of avoiding, neutralizing or mitigating organizational conflicts of interest. If, under this contract, the contractor will provide systems engineering and technical direction for a system, but does not have overall contractual responsibility for its development, integration, assembly, checkout or production, the contractor shall not be awarded a subsequent contract to supply the system or any of its major components, or to act as consultant to a supplier of any system, subsystem, or major component utilized for or in connection with any item or other matter that is (directly or indirectly) the subject of the systems engineering and technical direction. The term of this prohibition shall endure for the entire period of this contract and for two (2) years thereafter. If, under this contract, the contractor will prepare and furnish complete specifications covering nondevelopmental items, to be used in a competitive acquisition, the contractor shall not be permitted to furnish these items, either as a prime or subcontractor. The term of this prohibition shall endure for the entire period of this contract performance and for either two (2) years thereafter or the duration of the initial production contract whichever is longer. This rule shall not apply to contractors who furnish specifications or data at Government request or to situations in which contractors act as Government representatives to help Government agencies prepare, refine or coordinate specifications, provided this assistance is supervised and controlled by Government representatives. If, under this contract, the contractor will prepare or assist in preparing a work statement to be used in competitively acquiring a system or services, the contractor shall not supply the system, its major components, or the service

66 Page 66 of 179 unless the contractor is the sole source, the contractor has participated in the development and design work, or more than one contractor has been involved in preparing the work statement. The term of this prohibition shall endure for the life of the contract. If, under this contract, the contractor will provide technical evaluation of products or advisory and assistance services, the contractor shall not provide such services if the services relate to the contractor's own or a competitor's products or services unless proper safeguards are established to ensure objectivity. If, under this contract, the contractor gains access to proprietary or source selection information of other companies in performing advisory assistance services for the Government, the contractor agrees to protect this information from unauthorized use or disclosure and to refrain from using the information for any purpose other than that for which it was furnished. A separate agreement shall be entered into between the contractor and the company whose proprietary information is the subject of this restriction. A copy of this agreement shall be provided to the Contracting Officer. Any OCI Mitigation Plan between the contractor and the Government does not give authorization for a contractor being in possession of another company s proprietary or sensitive information. STATION/BASE REGULATIONS The contractor and its employees and subcontractors shall become familiar with and obey station/base regulations, including fire, traffic, and security regulations. Personnel working at the station/base shall keep within the limits of the work (and avenues of ingress and egress), and shall not enter restricted areas unless required to do so and are cleared for such entry. Any contractor s equipment shall be marked for identification. PRIVATELY-OWNED VEHICLE OPERATION (a) Privately-Owned Vehicle (POV) Permits: Contractor personnel using POVs on DoD installations shall have proper operating licenses and permits for entry onto the installations. All vehicles, private or contractor-owned, shall comply with the vehicle operation regulations that govern installations. All vehicles are subject to search while on DoD installations. Only licensed contractor personnel shall operate vehicles on DoD installations. Vehicles shall be operated in accordance with local and state laws as well as installation specific traffic regulations. (b) Privately-Owned Vehicle (POV) Parking: The contractor shall utilize on-station POV parking in authorized areas. The Government reserves the right to change parking arrangements at any time. (c) Traffic Accident Report Requirements: The contractor shall report to Base Security, within one hour, any traffic accident involving contractor personnel that occurs on base, whether in the performance of this PWS or commuting in their POVs, IAW OPNAVINST series, OPNAVINST series, and other applicable local instructions. The contractor shall supply a copy of any on-base traffic accident report to the COR within five workdays after occurrence. The contractor shall also provide the COR a copy of any report of an off-base traffic accident that involves contractor personnel in the performance of this PWS within five workdays after occurrence. (d) Fines, Fees, Point Assessment and Other Costs: The contractor shall pay all fines, fees, point assessment, and other costs associated with traffic violations, parking violations, or accidents that occur in the performance of work under this contract. NOTICE TO CONTRACTOR OF CERTAIN DRUG DETECTION PROCEDURES Pursuant to Department of Defense and Military Service policy applicable to both Government and contractor personnel, measures will be taken to prevent the introduction and utilization of illegal drugs and related paraphernalia into Government Work areas. In furtherance of these drug control policies, unannounced periodic inspections of the following nature may be conducted by installation security authorities:

67 Page 67 of 179 a. Routine inspections of contractor occupied work spaces. b. Random inspections of vehicles on entry or exit from the installation, with drug detection dog teams as available, to eliminate them as a safe haven for storage of or trafficking in illegal drugs. c. Random inspections of personal possessions on entry or exit from the installation. When there is a probable cause to believe that a contractor employee working at a Government installation has been engaged in use, possession or trafficking of drugs, the installation authorities may detain the employee until the employee can be removed from the installation, or can be released to the local authorities having jurisdiction. When the Government discovers illegal drugs and related paraphernalia in the course of an inspection of a vehicle operated by a contractor employee, the vehicle may be detained until it can be turned over to local authorities having jurisdiction and the employee s installation driving privileges may be suspended, revoked, or denied. Trafficking in illegal drug and related paraphernalia by a contract employee while on a Government vessel or installation may lead to possible withdrawal or downgrading of security clearance, suspension or revocation of clinical privileges for employees working at an MTF, and/or referral for prosecution by appropriate law enforcement authorities. The contractor is responsible for the conduct of employees performing work under this contract and is, therefore, responsible to assure that employees are notified of these provisions prior to assignment. The removal of contractor personnel from a Government vessel or installation as a result of drug offenses shall not be a cause for excusable delay, nor shall such action be deemed a basis for an equitable adjustment to price, delivery or other provisions of this contract. OCCUPATIONAL SAFETY AND HEALTH REQUIREMENTS (a) If performance of any work under this contract is required at a Government facility, the contractor shall contact the appropriate office and code with cognizance over safety and environmental requirement prior to performance of any work under this contract. (b) Contractors are responsible for following all safety and health related State and Federal statutes and corresponding State, Federal and/or Department of Defense regulations (e.g., NOSCINST C, Occupational Safety and Health Manual) protecting the environment, contractor employees, and persons who live and work in and around contractor and/or federal facilities. (c) Contractors shall monitor its employees and ensure that they are following safety regulations particular to the work areas. Contractors shall ensure that its employees: (1) Wear appropriate safety equipment and clothing; (2) Are familiar with all relevant emergency procedures should an accident occur; and (3) Have access to a telephone and telephone numbers for the Government facility where the work is performed. (d) This contract may require the contractor to handle hazardous materials, which material safety data sheets will be provided. (e) Accidents: The contractor is solely responsible for compliance of all safety regulations of employees while working on Government facilities. All accidents which may arise out of, or in connection with, performance of services required hereunder which result in injury, death, or property damage, shall be reported in writing to the Contracting Officer and COR within twenty-four hours of such occurrence. Reports shall provide full details of the accident, including statements from witnesses. The fore-going procedures shall also apply to any claim made by a

68 Page 68 of 179 third party against the contractor as a result of any accident that occurs in connection with performance under this contract. GOVERNMENT INSTALLATION WORK SCHEDULE (a) Please refer to each task order for facility hours of operation. (b) The Federal Holidays applicable to this contract are: New Year s Day, Martin Luther King s Birthday, President s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veteran s Day, Thanksgiving Day, and Christmas Day. (c) In the event that the contractor is prevented from performance as the result of an Executive Order or an administrative leave determination (e.g., weather related closing, delayed opening or early closure) that applies to the Government facility, such time may be charged to the contract as a direct cost provided such charges are consistent with the contractor s accounting practices. In the event that any of the above holidays occur on a Saturday or Sunday, then such holiday shall be observed as they are by the assigned Government employees at the Government facility. (d) If the Government facility allows a flexible workweek for its Government employees, applicable on-site contractor personnel shall perform in consonance with those flexible workweek arrangements for the department(s) supported. (e) Telework is permitted for offsite services and will be addressed at the Task Order Level. If telework is authorized on Task Order for contractor personnel on an ad-hoc or non-routine basis the telework must be approved in advance by the COR. Mission needs shall be considered in the approval or denial of telework. ELECTRONIC TRANSMISSION OF PROPRIETARY DATA The contractor shall be fully capable and willing to electronically transmit proprietary data to the Government. This data may consist of contract deliverables or pricing data required for proposal evaluation. Any software required by the Government to receive the contractor-transmitted proprietary data that the Government does not already possess shall be provided by the contractor at no cost to the Government. Instructions regarding the handling of classified information will be defined at the task order level if a clearance is required. GOVERNMENT FURNISHED PROPERTY Government furnished property will be identified in orders issued under the contract. TASK ORDER ORDERING PROCEDURES a. Government requirements for task orders to be issued under this ID/IQ contract vehicle will be solicited using the fair opportunity process described at FAR (b)(1) unless one of the exceptions listed at FAR (b)(2) applies. b. Information regarding the type of task order, award basis and selection criteria shall be provided with each Task Order Proposal Request (TOPR). c. The Government at its sole discretion may issue task orders with a base period of performance and that also include option periods that provide for continued performance of the task order. Task orders issued with option periods will include FAR clause Option to Extend the Term of the Contract. Option periods will be exercised in writing by the issuance of task order modifications. 1. Task order modifications will be issued unilaterally by the Contracting Officer when the written notices required by FAR have been provided within the timeframes listed therein.

69 Page 69 of Task order modifications may be issued bilaterally as agreed upon by the Contracting Officer and the contractor in cases where the written notices or timeframes required by FAR have not been met. d. No protest under FAR Subpart 33.1 is authorized in connection with the issuance or proposed issuance of a task order except for in accordance with FAR (a)(10)(i). e. The Naval Medical Logistics Command, Code 05, is the designated ordering office for the contract. ON-RAMP/OFF-RAMP ON-RAMP Consistent with FAR (c)(1)(ii)(A), the Naval Medical Logistics Command (NMLC) has determined that it is in the Government s best interest that during the term of the MATO base contracts, there remains an adequate level of competition for task orders. The degree of competition is impacted by the number and quality of contractors. Over time, competition may decrease due to contractor attrition. Services provided by a contractor or multiple contractors may be of a lower quality than expected, which would limit competition. Additionally, a contractor or multiple contractors may not be able to provide services at competitive prices. Unresponsiveness to Task Order Proposal Requests (TOPRs) also impacts competition. Recognizing the possibility of inadequate competition, NMLC intends to annually review the number and quality of contractors and determine whether it would be in the Government s best interest to initiate a new solicitation in order to award additional base contracts. If NMLC determines that it would be in the Government s best interest to open a new solicitation to add new contractor(s) to the MATO, the Contracting Officer may do so at any time provided that: (a) The solicitation is issued under then-applicable federal procurement law; (b) The solicitation identifies the total approximate number of new awards that the Contracting Officer intends to make. The Contracting Officer may decide to award more or fewer contracts than the number anticipated in the solicitation depending upon the overall quality of the offers received; (c) Any contractor that meets the eligibility requirements set forth in the new solicitation submits a proposal in response to the solicitation; however, existing contractors may not hold more than one base contract at any time; (d) The award decision under any solicitation is based upon the same evaluation factors/sub-factors as the original Solicitation N R-0009; (e) The terms and conditions of any resulting awards from a new solicitation are materially identical to the existing version of the base contracts; (f) The term for any such new awards from a solicitation is co-terminus with the existing term for all other contractors, including the option periods (if applicable); (g) If awarded a contract, a new contractor is eligible to submit a proposal in response to each TOPR and receive task order awards with the same rights and obligations as any other contractor; and (h) The award of any new contract(s) does not increase the overall ceiling value of the MATO. OFF-RAMP Each contractor is expected to submit proposals in response to TOPRs, successfully perform the terms of awarded task orders, and promptly improve performance when it does not meet the terms of the task orders. If a contractor does not meet these expectations, it is the Government s intent to off-ramp the contractor by:

70 Page 70 of 179 (a) Implementing a termination for convenience, if applicable and if such action is in the Government s best interest; or (b) Implementing a termination for default, if applicable; or (c) Taking any other action which may be permitted under the contract terms and conditions. NONDISPLACEMENT OF QUALIFIED WORKERS The requirements of FAR clause (Nondisplacement of Qualified Workers) shall be applied at the task order level. CONTRACT DELIVERY/TASK ORDER OMBUDSMAN The Ombudsman will review complaints from contractors regarding the award of Task Orders and ensure that all contractors are afforded a fair opportunity to be considered, consistent with the procedures in the contract. The Task Order contract Ombudsman for this contract is the Navy Competition Advocate General. Contractors are encouraged to settle their complaints through the Competition Advocate chain of command, seeking review by the Command Competition Advocate at the Naval Medical Logistics Command before taking their complaints to the Navy Competition Advocate General. The Naval Medical Logistics Command's Competition Advocate can be reached at the following address: Naval Medical Logistics Command ATTN: Competition Advocate 693 Neiman St. Fort Detrick, MD CONTRACTOR PERSONNEL IDENTIFICATION Contractor employees shall identify themselves as contractor personnel by introducing themselves or being introduced as contractor personnel and displaying distinguishing badges or other visible identification for meetings with Government personnel. Contractor personnel shall also appropriately identify themselves as contractor employees in telephone conversations and in formal and informal written correspondence. When working at Government facilities, distinguishing badges or other visible identification shall be displayed by contractor personnel. Contractor personnel, while performing in a Contractor capacity, are prohibited from using their retired or reserve component military rank or title in written or verbal communications associated with the contract under which they provide services. STANDARDS OF CONDUCT Contractor employees providing support to the Government shall conduct themselves in a professional, businesslike manner adhering to high ethical standards. Contractor employees must follow the Standards of Ethical Conduct for Employees of the Executive Branch (Codified in 5 C.F.R. Part 2635 and as amended at 76 FR 38547) and local command policy in addition to the standards of conduct policies of the contractor. The Government will not tolerate unethical behavior and behavior that reflects poorly upon the Government, its mission, and its operations. If a contractor employee is uncertain whether contemplated acts or conduct may violate the Standards of Ethical Conduct for Employees of the Executive Branch or local command policy, the contractor employee must contact the Contracting Officer Representative (COR) before engaging in such acts or conduct. CORs will seek advice on ethics issues from their ethics counselor. BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (BAA) incorporates HIPAA/HITECH Act requirements under the HHS Final

71 Omnibus Rule (78 FR 5566, published 25 Jan 2013), effective 23 Sep This BAA is for use by MHS components outside of DHA. Business Associate Agreement Introduction N R-0009 Page 71 of 179 In accordance with 45 CFR (e)(2) and (e) and paragraph C of DoD 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 R, paragraph C ) 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 R (2003), DoDI (2009), and DoD R (2007). DoD Privacy Act Issuances means the DoD issuances implementing the Privacy Act, which are DoDD (2007) and DoD R (2007). HHS Breach means a breach that satisfies the HIPAA Breach Rule definition of breach in 45 CFR 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

72 Page 72 of modifications to those Rules, implementing the HITECH Act provisions of Pub. L See 78 FR (Jan. 25, 2013) (with corrections at 78 FR (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 (e)(1)(ii)) and (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 (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 , or take other measures as necessary to satisfy Covered Entity s obligations under 45 CFR (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 (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 (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

73 Page 73 of 179 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 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 , 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.

74 Page 74 of 179 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 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 updated information as it is obtained, following the instructions at 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 ing 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 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 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

75 Page 75 of 179 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: ID- THEFT ( ); TTY: 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 tollfree, 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, 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

76 Page 76 of 179 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 forthhere. 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. NAVY ENTERPRISE-WIDE CONTRACTOR MANPOWER REPORTING APPLICATION (ECMRA)

77 Page 77 of 179 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the Bureau of Medicine & Surgery via a secure data collection site. The contractor is required to completely fill in all required data fields using the following web address 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 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, Inc. from Baltimore, 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. Naval Medical Logistics Command 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 its proposal that was accepted by the Government, the contractor 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 closeout services. CLAUSES INCORPORATED BY FULL TEXT SUP Contractor Unclassified Access to Federally Controlled Facilities, Sensitive Information, Information Technology (IT) Systems or Protected Health Information (July 2013) Homeland Security Presidential Directive (HSPD)-12, requires government agencies to develop and implement Federal security standards for Federal employees and contractors. The Deputy Secretary of Defense Directive-Type Memorandum (DTM) "DoD Implementation of Homeland Security Presidential Directive - 12 (HSPD-12)" dated November 26, 2008 (or its subsequent DoD instruction) directs implementation of HSPD-12. This clause is in accordance with HSPD-12 and its implementing directives. APPLICABILITY This clause applies to contractor employees requiring physical access to any area of a federally controlled base, facility or activity and/or requiring access to a DoN or DoD computer/network/system to perform certain unclassified sensitive duties. This clause also applies to contractor employees who access Privacy Act and Protected Health Information, provide support associated with fiduciary duties, or perform duties that have been identified by

78 Page 78 of 179 DON as National Security Position, as advised by the command security manager. It is the responsibility of the responsible security officer of the command/facility where the work is performed to ensure compliance. Each contractor employee providing services at a Navy Command under this contract is required to obtain a Department of Defense Common Access Card (DoD CAC). Additionally, depending on the level of computer/network access, the contract employee will require a successful investigation as detailed below. ACCESS TO FEDERAL FACILITIES Per HSPD-12 and implementing guidance, all contractor employees working at a federally controlled base, facility or activity under this clause will require a DoD CAC. When access to a base, facility or activity is required contractor employees shall in-process with the Navy Command's Security Manager upon arrival to the Navy Command and shall out-process prior to their departure at the completion of the individual's performance under the contract. ACCESS TO DOD IT SYSTEMS In accordance with SECNAV M , contractor employees who require access to DoN or DoD networks are categorized as IT-I, IT-II, or IT-III. The IT-II level, defined in detail in SECNAV M , includes positions which require access to information protected under the Privacy Act, to include Protected Health Information (PHI). All contractor employees under this contract who require access to Privacy Act protected information are therefore categorized no lower than IT-II. IT Levels are determined by the requiring activity's Command Information Assurance Manager. Contractor employees requiring privileged or IT-I level access, (when specified by the terms of the contract) require a Single Scope Background Investigation (SSBI) which is a higher level investigation than the National Agency Check with Law and Credit (NACLC) described below. Due to the privileged system access, a SSBI suitable for High Risk public trusts positions is required. Individuals who have access to system control, monitoring, or administration functions (e.g. system administrator, database administrator) require training and certification to Information Assurance Technical Level 1, and must be trained and certified on the Operating System or Computing Environment they are required to maintain. Access to sensitive IT systems is contingent upon a favorably adjudicated background investigation. When access to IT systems is required for performance of the contractor employee's duties, such employees shall in-process with the Navy Command's Security Manager and Information Assurance Manager upon arrival to the Navy command and shall out-process prior to their departure at the completion of the individual's performance under the contract. Completion and approval of a System Authorization Access Request Navy (SAAR-N) form is required for all individuals accessing Navy Information Technology resources. The decision to authorize access to a government IT system/network is inherently governmental. The contractor supervisor is not authorized to sign the SAAR-Ni therefore, the government employee with knowledge of the system/network access required or the COR shall sign the SAAR-N as the "supervisor". The SAAR-N shall be forwarded to the Navy Command's Security Manager at least 30 days prior to the individual's start date. Failure to provide the required documentation at least 30 days prior to the individual's start date may result in delaying the individual's start date. When required to maintain access to required IT systems or networks, the contractor shall ensure that all employees requiring access complete annual Information Assurance (IA) training, and maintain a current requisite background investigation. The Contractor's Security Representative shall contact the Command Security Manager for guidance when reinvestigations are required. INTERIM ACCESS The Navy Command' s Security Manager may authorize issuance of a DoD CAC and interim access to a DoN or DoD unclassified computer/network upon a favorable review of the investigative questionnaire and advance favorable fingerprint results. When the results of the investigation are received and a favorable determination is not made, the contractor employee working on the contract under interim access will be denied access to the computer network and this denial will not relieve the contractor of his/her responsibility to perform. DENIAL OR TERMINATION OF ACCESS

79 Page 79 of 179 The potential consequences of any requirement under this clause including denial or termination of physical or system access in no way relieves the contractor from the requirement to execute performance under the contract within the timeframes specified in the contract. Contractors shall plan ahead in processing their employees and subcontractor employees. The contractor shall insert this clause in all subcontracts when the subcontractor is permitted to have unclassified access to a federally controlled facility, federally-controlled information system/network and/or to government information, meaning information not authorized for public release. CONTRACTOR'S SECURITY REPRESENTATIVE The contractor shall designate an employee to serve as the Contractor's Security Representative. Within three work days after contract award, the contractor shall provide to the requiring activity's Security Manager and the Contracting Officer, in writing, the name, title, address and phone number for the Contractor's Security Representative. The Contractor's Security Representative shall be the primary point of contact on any security matter. The Contractor's Security Representative shall not be replaced or removed without prior notice to the Contracting Officer and Command Security Manager. BACKGROUND INVESTIGATION REQUIREMENTS AND SECURITY APPROVAL PROCESS FOR CONTRACTORS ASSIGNED TO NATIONAL SECURITY POSITIONS OR PERFORMING SENSITIVE DUTIES Navy security policy requires that all positions be given a sensitivity value based on level of risk factors to ensure appropriate protective measures are applied. Navy recognizes contractor employees under this contract as Non- Critical Sensitive [ADP/IT-II] when the contract scope of work require physical access to a federally controlled base, facility or activity and/or requiring access to a DoD computer/network, to perform unclassified sensitive duties. This designation is also applied to contractor employees who access Privacy Act and Protected Health Information (PHI), provide support associated with fiduciary duties, or perform duties that have been identified by DON as National Security Positions. At a minimum, each contractor employee must be a US citizen and have a favorably completed NACLC to obtain a favorable determination for assignment to a non-critical sensitive or IT-II position. The NACLC consists of a standard NAC and a FBI fingerprint check plus law enforcement checks and credit check. Each contractor employee filling a non-critical sensitive or IT-II position is required to complete: * SF-86 Questionnaire for National Security Positions (or equivalent OPM investigative product) * Two FD-258 Applicant Fingerprint Cards (or an electronic fingerprint submission) * Original Signed Release Statements Failure to provide the required documentation at least 30 days prior to the individual's start date shall result in delaying the individual's start date. Background investigations shall be reinitiated as required to ensure investigations remain current (not older than 10 years) throughout the contract performance period. The Contractor's Security Representative shall contact the Command Security Manager for guidance when reinvestigations are required. Regardless of their duties or IT access requirements ALL contractor employees shall in-process with the Navy Command's Security Manager upon arrival to the Navy command and shall out-process prior to their departure at the completion of the individual's performance under the contract. Employees requiring IT access shall also check-in and check-out with the Navy Command's Information Assurance Manager. Completion and approval of a System Authorization Access Request Navy (SAAR-N) form is required for all individuals accessing Navy Information Technology resources. The SAAR-N shall be forwarded to the Navy Command's Security Manager at least 30 days prior to the individual's start date. Failure to provide the required documentation at least 30 days prior to the individual's start date shall result in delaying the individual's start date. The contractor shall ensure that each contract employee requiring access to IT systems or networks complete annual Information Assurance (IA) training, and maintain a current requisite background investigation. Contractor employees shall accurately complete the required investigative forms prior to submission to the Navy Command Security Manager. The Navy Command's Security Manager will review the submitted documentation for completeness prior to submitting it to the Office of Personnel Management (OPM). Suitability/security issues identified by the Navy may render the contractor employee ineligible for the assignment. An unfavorable determination made by the Navy is final (subject to SF-86 appeal procedures) and such a determination does not

80 Page 80 of 179 relieve the contractor from meeting any contractual obligation under the contract. The Navy Command's Security Manager will forward the required forms to OPM for processing. Once the investigation is complete, the results will be forwarded by OPM to the DON Central Adjudication Facility (CAF) for a determination. If the contractor employee already possesses a current favorably adjudicated investigation, the contractor shall submit a Visit Authorization Request (VAR) via the Joint Personnel Adjudication System (JPAS) or a hard copy VAR directly from the contractor's Security Representative. Although the contractor will take JPAS "Owning" role over the contractor employee, the Navy Command will take JPAS "Servicing" role over the contractor employee during the hiring process and for the duration of assignment under that contract. The contractor shall include the IT Position Category per SECNAV M for each employee designated on a VAR. The VAR requires annual renewal for the duration of the employee's performance under the contract. BACKGROUND INVESTIGATION REQUIREMENTS AND SECURITY APPROVAL PROCESS FOR CONTRACTORS ASSIGNED TO OR PERFORMING NON-SENSITIVE DUTIES Contractor employee whose work is unclassified and non-sensitive (e.g., performing certain duties such as lawn maintenance, vendor services, etc...) and who require physical access to publicly accessible areas to perform those duties shall meet the following minimum requirements: * Must be either a US citizen or a US permanent resident with a minimum of 3 years legal residency in the United States (as required by The Deputy Secretary of Defense DTM or its subsequent DoD instruction) and * Must have a favorably completed National Agency Check with Written Inquiries (NACI) including a FBI fingerprint check prior to installation access. To be considered for a favorable trustworthiness determination, the Contractor's Security Representative must submit for all employees each of the following: * SF-85 Questionnaire for Non-Sensitive Positions * Two FD-258 Applicant Fingerprint Cards (or an electronic fingerprint submission) * Original Signed Release Statements The contractor shall ensure each individual employee has a current favorably completed National Agency Check with Written Inquiries (NACI) or ensure successful FBI fingerprint results have been gained and investigation has been processed with OPM. Failure to provide the required documentation at least 30 days prior to the individual's start date may result in delaying the individual's start date. * Consult with your Command Security Manager and Information Assurance Manager for local policy when IT-III (non-sensitive) access is required for non-us citizens outside the United States. CLAUSES INCORPORATED BY REFERENCE Gratuities APR Printed or Copied Double-Sided on Postconsumer Fiber MAY 2011 Content Paper Personal Identity Verification of Contractor Personnel JAN System for Award Management JUL System for Award Management Maintenance JUL Commercial and Government Entity Code Maintenance JUL Incorporation by Reference of Representations and DEC 2014 Certifications Contract Terms and Conditions--Commercial Items MAY (Dev) Small Business Subcontracting Plan (Deviation 2013-O0014) OCT 2015

81 Page 81 of Workers' Compensation and War-Hazard Insurance Overseas APR Insurance - Work On A Government Installation JAN Interest MAY Availability Of Funds APR Unenforceability of Unauthorized Obligations JUN Providing Accelerated Payments to Small Business DEC 2013 Subcontractors Protection Of Government Buildings, Equipment, And APR 1984 Vegetation Alt I Government Property (Apr 2012) Alternate I APR Use And Charges APR Default (Fixed-Price Supply & Service) APR Contracting Officer's Representative DEC Requirements Relating to Compensation of Former DoD SEP 2011 Officials Agency Office of the Inspector General DEC Line Item Specific: Single Funding SEP Alt A System for Award Management Alternate A FEB Limitations on the Use or Disclosure of Third-Party DEC 2015 Contractor Reported Cyber Incident Information (Dev) Safeguarding Covered Defense Information and Cyber OCT 2015 Incident Reporting Disclosure of Information to Litigation Support Contractors FEB Provision Of Information To Cooperative Agreement Holders DEC Reporting of Government-Furnished Property AUG Representation Regarding Combating Trafficking in Persons JAN Preference For Certain Domestic Commodities FEB Antiterrorism/Force Protection Policy for Defense JUN 2015 Contractors Outside the United States Utilization of Indian Organizations and Indian-Owned SEP 2004 Economic Enterprises, and Native Hawaiian Small Business Concerns Technical Data--Commercial Items FEB Validation of Restrictive Markings on Technical Data JUN Levies on Contract Payments DEC Prohibition on Interrogation of Detainees by Contractor JUN 2013 Personnel Requests for Equitable Adjustment DEC Subcontracts for Commercial Items JUN Tagging, Labeling, and Marking of Government-Furnished APR 2012 Property Reporting Loss of Government Property APR Contractor Property Management System Administration APR Reporting, Reutilization, and Disposal MAR 2015 CLAUSES INCORPORATED BY FULL TEXT ANTITERRORISM/FORCE PROTECTION POLICY FOR DEFENSE CONTRACTORS OUTSIDE THE UNITED STATES (JUN 2015) (a) Definition. United States, as used in this clause, means, the 50 States, the District of Columbia, and outlying areas.

82 (b) Except as provided in paragraph (c) of this clause, the Contractor and its subcontractors, if performing or traveling outside the United States under this contract, shall-- (1) Affiliate with the Overseas Security Advisory Council, if the Contractor or subcontractor is a U.S. entity; Page 82 of 179 (2) Ensure that Contractor and subcontractor personnel who are U.S. nationals and are in-country on a non-transitory basis, register with the U.S. Embassy, and that Contractor and subcontractor personnel who are third country nationals comply with any security related requirements of the Embassy of their nationality; (3) Provide, to Contractor and subcontractor personnel, antiterrorism/force protection awareness information commensurate with that which the Department of Defense (DoD) provides to its military and civilian personnel and their families, to the extent such information can be made available prior to travel outside the United States; and (4) Obtain and comply with the most current antiterrorism/force protection guidance for Contractor and subcontractor personnel. (c) The requirements of this clause do not apply to any subcontractor that is-- (1) A foreign government; (2) A representative of a foreign government; or (3) A foreign corporation wholly owned by a foreign government. (d) Information and guidance pertaining to DoD antiterrorism/force protection can be obtained from Naval Criminal Investigative Service (NCIS), Code 21; telephone, DSN or commercial (202) (End of clause) CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS--COMMERCIAL ITEMS (NOV 2015) (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) , Prohibition on Contracting with Inverted Domestic Corporations (Nov 2015). (2) , Protest After Award (AUG 1996) (31 U.S.C. 3553). (3) , Applicable Law for Breach of Contract Claim (OCT 2004) (Public Laws and (19 U.S.C 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: (Contracting Officer check as appropriate.) X (1) , Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C and 10 U.S.C. 2402). X (2) , Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

83 Page 83 of 179 (3) , Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (June 2010) (Section 1553 of Pub. L ). (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009.) X (4) , Reporting Executive Compensation and First-Tier Subcontract Awards (Oct 2015) (Pub. L ) (31 U.S.C note). (5) [Reserved] (6) , Service Contract Reporting Requirements (JAN 2014) (Pub. L , section 743 of Div. C). (7) , Service Contract Reporting Requirements for Indefinite-Delivery Contracts (JAN 2014) (Pub. L , section 743 of Div. C). X (8) , Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. (Oct 2015) (31 U.S.C note). X (9) , Updates of Publicly Available Information Regarding Responsibility Matters (July 2013) (41 U.S.C. 2313). (10) [Reserved] (11)(i) , Notice of HUBZone Set-Aside or Sole-Source Award (NOV 2011) (15 U.S.C. 657a). (ii) Alternate I (NOV 2011) of (12) (i) , Notice of Price Evaluation Preference for HUBZone 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 (13) [Reserved] X (14)(i) , Notice of Total Small Business Set-Aside (NOV 2011) (15 U.S.C. 644). (ii) Alternate I (NOV 2011). (iii) Alternate II (NOV 2011). (15)(i) , Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644). (ii) Alternate I (Oct 1995) of (iii) Alternate II (Mar 2004) of X (16) , Utilization of Small Business Concerns (OCT 2014) (15 U.S.C. 637(d)(2) and (3)). (17)(i) , Small Business Subcontracting Plan (Oct 2015) (15 U.S.C. 637(d)(4)). (ii) Alternate I (Oct 2001) of (iii) Alternate II (Oct 2001) of (iv) Alternate III (Oct 2015) of

84 Page 84 of 179 X (18) , Notice of Set-Aside of Orders (NOV 2011) (15 U.S.C. 644(r)). X (19) , Limitations on Subcontracting (NOV 2011) (15 U.S.C. 637(a)(14)). (20) , Liquidated Damages Subcon-tracting Plan (Jan 1999) (15 U.S.C. 637(d)(4)(F)(i)). (21) , Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (NOV 2011) (15 U.S.C. 657f). X (22) , Post Award Small Business Program Rerepresentation (July 2013) (15 U.S.C. 632(a)(2)). (23) , Notice of Set-Aside for Economically Disadvantaged Women-Owned Small Business (EDWOSB) Concerns (July 2013) (15 U.S.C. 637(m)). (24) , Notice of Set-Aside for Women-Owned Small Business (WOSB) Concerns Eligible Under the WOSB Program (July 2013) (15 U.S.C. 637(m)). X (25) , Convict Labor (June 2003) (E.O ). (26) , Child Labor Cooperation with Authorities and Remedies (JAN 2014) (E.O. 3126). X (27) , Prohibition of Segregated Facilities (Apr 2015). X (28) , Equal Opportunity (Apr 2015) (E.O ). X (29) , Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212). X (30) , Equal Opportunity for Workers with Disabilities (July 2014) (29 U.S.C. 793). X (31) , Employment Reports on Veterans (Oct 2015) (38 U.S.C. 4212). X (32) , Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O ). X (33)(i) , Combating Trafficking in Persons (March 2, 2015) (22 U.S.C. chapter 78 and E.O ). X (ii) Alternate I (March 2, 2015) of (22 U.S.C. chapter 78 and E.O ). X (34) , Employment Eligibility Verification (Oct 2015). (E. O ). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in ) (35)(i) , 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 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off-the-shelf items.) (36) (i) , Acquisition of EPEAT Registered Imaging Equipment (Jun 2014) (E.O.s and 13514). (ii) Alternate I (OCT 2015) of (37)(i) , Acquisition of EPEAT Registered Televisions (Jun 2014) (E.O.s and 13514).

85 Page 85 of 179 (ii) Alternate I (Jun 2014) of (38) , Energy Efficiency in Energy-Consuming Products (Dec 2007) (42 U.S.C. 8259b). (39)(i) , Acquisition of EPEAT[supreg]-Registered Personal Computer Products (OCT 2015) (E.O.s and 13514). (ii) Alternate I (Jun 2014) of X (40) , Encouraging Contractor Policies to Ban Text Messaging While Driving (Aug 2011) (E.O ). (41) , Buy American--Supplies (May 2014) (41 U.S.C. chapter 83). (42) (i) , Buy American--Free Trade Agreements--Israeli Trade Act (May 2014) (41 U.S.C. chapter 83, 19 U.S.C note, 19 U.S.C note, 19 U.S.C note, 19 U.S.C note, Pub. L , , , , , , , , , , , and (ii) Alternate I (May 2014) of (iii) Alternate II (May 2014) of (iv) Alternate III (May 2014) of (43) , Trade Agreements (Nov 2013) (19 U.S.C. 2501, et seq., 19 U.S.C note). X (44) , 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). (45) , Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C Note). (46) , Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C (47) , Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150). (48) , Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 4505, 10 U.S.C. 2307(f)). (49) , Installment Payments for Commercial Items (Oct 1995) (41 U.S.C. 4505, 10 U.S.C. 2307(f)). X (50) , Payment by Electronic Funds Transfer System for Award Management (July 2013) (31 U.S.C. 3332). (51) , Payment by Electronic Funds Transfer Other than System for Award Management (July 2013) (31 U.S.C. 3332). (52) , Payment by Third Party (MAY 2014) (31 U.S.C. 3332). X (53) , Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a). (54)(i) , Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631).

86 Page 86 of 179 (ii) Alternate I (Apr 2003) of (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) , Nondisplacement of Qualified Workers (May 2014) (E.O ). X (2) , Service Contract Labor Standards (MAY 2014) (41 U.S.C. chapter 67). (3) , Statement of Equivalent Rates for Federal Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). X (4) , Fair Labor Standards Act and Service Contract Labor Standards--Price Adjustment (Multiple Year and Option Contracts) (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67). (5) , 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) , 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) , 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) , Minimum Wages Under Executive Order (Dec 2014) (E.O ). ` (9) , Promoting Excess Food Donation to Nonprofit Organizations (MAY 2014) (42 U.S.C. 1792). (10) , Accepting and Dispensing of $1 Coin (Sept 2008) (31 U.S.C. 5112(p)(1)). (d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at , 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

87 commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause (i) , Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509). Page 87 of 179 (ii) , Utilization of Small Business Concerns (OCT 2014) (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 in lower tier subcontracts that offer subcontracting opportunities. (iii) , Nondisplacement of Qualified Workers (MAY 2014) (E.O ). Flow down required in accordance with paragraph (l) of FAR clause (iv) , Prohibition of Segregated Facilities (Apr 2015). (v) , Equal Opportunity (APR 2015) (E.O ). (vi) , Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212). (vii) , Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793). (viii) , Employment Reports on Veterans (Oct 2015) (38 U.S.C. 4212). (ix) , Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O ). Flow down required in accordance with paragraph (f) of FAR clause (x) , Service Contract Labor Standards (May 2014), (41 U.S.C. chapter 67). (xi) (A) , Combating Trafficking in Persons (March 2, 2015) (22 U.S.C. chapter 78 and E.O ). (B) Alternate I (March 2, 2015) of (22 U.S.C. chapter 78 and E.O ). (xii) , 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.) (xiii) , Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67) (xiv) , Employment Eligibility Verification (Oct 2015) (E. O ). (xv) , Minimum Wages Under Executive Order (Dec 2014) (E.O ).

88 Page 88 of 179 (xvi) , Contractors Performing Private Security Functions Outside the United States (Jul 2013) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C Note). (xvii) , 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 (xviii) , 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 (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) ALLOWABLE COST AND PAYMENT (JUN 2013) (a) Invoicing. (1) The Government will make payments to the Contractor when requested as work progresses, but (except for small business concerns) not more often than once every 2 weeks, in amounts determined to be allowable by the Contracting Officer in accordance with Federal Acquisition Regulation (FAR) subpart 31.2 in effect on the date of this contract and the terms of this contract. The Contractor may submit to an authorized representative of the Contracting Officer, in such form and reasonable detail as the representative may require, an invoice or voucher supported by a statement of the claimed allowable cost for performing this contract. (2) Contract financing payments are not subject to the interest penalty provisions of the Prompt Payment Act. Interim payments made prior to the final payment under the contract are contract financing payments, except interim payments if this contract contains Alternate I to the clause at (3) The designated payment office will make interim payments for contract financing on the 30 th day after the designated billing office receives a proper payment request. In the event that the Government requires an audit or other review of a specific payment request to ensure compliance with the terms and conditions of the contract, the designated payment office is not compelled to make payment by the specified due date. (b) Reimbursing costs. (1) For the purpose of reimbursing allowable costs (except as provided in subparagraph (b)(2) of the clause, with respect to pension, deferred profit sharing, and employee stock ownership plan contributions), the term "costs" includes only-- (i) Those recorded costs that, at the time of the request for reimbursement, the Contractor has paid by cash, check, or other form of actual payment for items or services purchased directly for the contract;

89 Page 89 of 179 (ii) When the Contractor is not delinquent in paying costs of contract performance in the ordinary course of business, costs incurred, but not necessarily paid, for-- (A) Supplies and services purchased directly for the contract and associated financing payments to subcontractors, provided payments determined due will be made-- (1) In accordance with the terms and conditions of a subcontract or invoice; and (2) Ordinarily within 30 days of the submission of the Contractor's payment request to the Government; (B) Materials issued from the Contractor's inventory and placed in the production process for use on the contract; (C) Direct labor; (D) Direct travel; (E) Other direct in-house costs; and (F) Properly allocable and allowable indirect costs, as shown in the records maintained by the Contractor for purposes of obtaining reimbursement under Government contracts; and (iii) The amount of financing payments that have been paid by cash, check, or other forms of payment to subcontractors. (2) Accrued costs of Contractor contributions under employee pension plans shall be excluded until actually paid unless-- (i) The Contractor's practice is to make contributions to the retirement fund quarterly or more frequently; and (ii) The contribution does not remain unpaid 30 days after the end of the applicable quarter or shorter payment period (any contribution remaining unpaid shall be excluded from the Contractor's indirect costs for payment purposes). (3) Notwithstanding the audit and adjustment of invoices or vouchers under paragraph (g) of this clause, allowable indirect costs under this contract shall be obtained by applying indirect cost rates established in accordance with paragraph (d) of this clause. (4) Any statements in specifications or other documents incorporated in this contract by reference designating performance of services or furnishing of materials at the Contractor's expense or at no cost to the Government shall be disregarded for purposes of cost-reimbursement under this clause. (c) Small business concerns. A small business concern may receive more frequent payments than every 2 weeks. (d) Final indirect cost rates. (1) Final annual indirect cost rates and the appropriate bases shall be established in accordance with Subpart 42.7 of the Federal Acquisition Regulation (FAR) in effect for the period covered by the indirect cost rate proposal. (2)(i) The Contractor shall submit an adequate final indirect cost rate proposal to the Contracting Officer (or cognizant Federal agency official) and auditor within the 6-month period following the expiration of each of its fiscal years. Reasonable extensions, for exceptional circumstances only, may be requested in writing by the Contractor and granted in writing by the Contracting Officer. The Contractor shall support its proposal with adequate supporting data.

90 Page 90 of 179 (ii) The proposed rates shall be based on the Contractor's actual cost experience for that period. The appropriate Government representative and the Contractor shall establish the final indirect cost rates as promptly as practical after receipt of the Contractor's proposal. (iii) An adequate indirect cost rate proposal shall include the following data unless otherwise specified by the cognizant Federal agency official: (A) Summary of all claimed indirect expense rates, including pool, base, and calculated indirect rate. (B) General and Administrative expenses (final indirect cost pool). Schedule of claimed expenses by element of cost as identified in accounting records (Chart of Accounts). (C) Overhead expenses (final indirect cost pool). Schedule of claimed expenses by element of cost as identified in accounting records (Chart of Accounts) for each final indirect cost pool. (D) Occupancy expenses (intermediate indirect cost pool). Schedule of claimed expenses by element of cost as identified in accounting records (Chart of Accounts) and expense reallocation to final indirect cost pools. (E) Claimed allocation bases, by element of cost, used to distribute indirect costs. (F) Facilities capital cost of money factors computation. (G) Reconciliation of books of account (i.e., General Ledger) and claimed direct costs by major cost element. (H) Schedule of direct costs by contract and subcontract and indirect expense applied at claimed rates, as well as a subsidiary schedule of Government participation percentages in each of the allocation base amounts. (I) Schedule of cumulative direct and indirect costs claimed and billed by contract and subcontract. (J) Subcontract information. Listing of subcontracts awarded to companies for which the contractor is the prime or upper-tier contractor (include prime and subcontract numbers; subcontract value and award type; amount claimed during the fiscal year; and the subcontractor name, address, and point of contact information). (K) Summary of each time-and-materials and labor-hour contract information, including labor categories, labor rates, hours, and amounts; direct materials; other direct costs; and, indirect expense applied at claimed rates. (L) Reconciliation of total payroll per IRS form 941 to total labor costs distribution. (M) Listing of decisions/agreements/approvals and description of accounting/organizational changes. (N) Certificate of final indirect costs (see , Certification of Final Indirect Costs). (O) Contract closing information for contracts physically completed in this fiscal year (include contract number, period of performance, contract ceiling amounts, contract fee computations, level of effort, and indicate if the contract is ready to close). (iv) The following supplemental information is not required to determine if a proposal is adequate, but may be required during the audit process: (A) Comparative analysis of indirect expense pools detailed by account to prior fiscal year and budgetary data. (B) General organizational information and limitation on allowability of compensation for certain contractor personnel. See (p). Additional salary reference information is available at

91 Page 91 of 179 (C) Identification of prime contracts under which the contractor performs as a subcontractor. (D) Description of accounting system (excludes contractors required to submit a CAS Disclosure Statement or contractors where the description of the accounting system has not changed from the previous year's submission). (E) Procedures for identifying and excluding unallowable costs from the costs claimed and billed (excludes contractors where the procedures have not changed from the previous year's submission). (F) Certified financial statements and other financial data (e.g., trial balance, compilation, review, etc.). (G) Management letter from outside CPAs concerning any internal control weaknesses. (H) Actions that have been and/or will be implemented to correct the weaknesses described in the management letter from subparagraph G) of this section. (I) List of all internal audit reports issued since the last disclosure of internal audit reports to the Government. (J) Annual internal audit plan of scheduled audits to be performed in the fiscal year when the final indirect cost rate submission is made. (K) Federal and State income tax returns. (L) Securities and Exchange Commission 10-K annual report. (M) Minutes from board of directors meetings. (N) Listing of delay claims and termination claims submitted which contain costs relating to the subject fiscal year. (O) Contract briefings, which generally include a synopsis of all pertinent contract provisions, such as: Contract type, contract amount, product or service(s) to be provided, contract performance period, rate ceilings, advance approval requirements, pre-contract cost allowability limitations, and billing limitations. (v) The Contractor shall update the billings on all contracts to reflect the final settled rates and update the schedule of cumulative direct and indirect costs claimed and billed, as required in paragraph (d)(2)(iii)(i) of this section, within 60 days after settlement of final indirect cost rates. (3) The Contractor and the appropriate Government representative shall execute a written understanding setting forth the final indirect cost rates. The understanding shall specify (i) the agreed-upon final annual indirect cost rates, (ii) the bases to which the rates apply, (iii) the periods for which the rates apply, (iv) any specific indirect cost items treated as direct costs in the settlement, and (v) the affected contract and/or subcontract, identifying any with advance agreements or special terms and the applicable rates. The understanding shall not change any monetary ceiling, contract obligation, or specific cost allowance or disallowance provided for in this contract. The understanding is incorporated into this contract upon execution. (4) Failure by the parties to agree on a final annual indirect cost rate shall be a dispute within the meaning of the Disputes clause. (5) Within 120 days (or longer period if approved in writing by the Contracting Officer) after settlement of the final annual indirect cost rates for all years of a physically complete contract, the Contractor shall submit a completion invoice or voucher to reflect the settled amounts and rates. The completion invoice or voucher shall include settled subcontract amounts and rates. The prime contractor is responsible for settling subcontractor amounts and rates included in the completion invoice or voucher and providing status of subcontractor audits to the contracting officer upon request.

92 Page 92 of 179 (6)(i) If the Contractor fails to submit a completion invoice or voucher within the time specified in paragraph (d)(5) of this clause, the Contracting Officer may-- (A) Determine the amounts due to the Contractor under the contract; and (B) Record this determination in a unilateral modification to the contract. (ii) This determination constitutes the final decision of the Contracting Officer in accordance with the Disputes clause. (e) Billing rates. Until final annual indirect cost rates are established for any period, the Government shall reimburse the Contractor at billing rates established by the Contracting Officer or by an authorized representative (the cognizant auditor), subject to adjustment when the final rates are established. These billing rates-- (1) Shall be the anticipated final rates; and (2) May be prospectively or retroactively revised by mutual agreement, at either party's request, to prevent substantial overpayment or underpayment. (f) Quick-closeout procedures. Quick-closeout procedures are applicable when the conditions in FAR (a) are satisfied. (g) Audit. At any time or times before final payment, the Contracting Officer may have the Contractor's invoices or vouchers and statements of cost audited. Any payment may be (1) Reduced by amounts found by the Contracting Officer not to constitute allowable costs or (2) Adjusted for prior overpayments or underpayments. (h) Final payment. (1) Upon approval of a completion invoice or voucher submitted by the Contractor in accordance with paragraph (d)(5) of this clause, and upon the Contractor's compliance with all terms of this contract, the Government shall promptly pay any balance of allowable costs and that part of the fee (if any) not previously paid. (2) The Contractor shall pay to the Government any refunds, rebates, credits, or other amounts (including interest, if any) accruing to or received by the Contractor or any assignee under this contract, to the extent that those amounts are properly allocable to costs for which the Contractor has been reimbursed by the Government. Reasonable expenses incurred by the Contractor for securing refunds, rebates, credits, or other amounts shall be allowable costs if approved by the Contracting Officer. Before final payment under this contract, the Contractor and each assignee whose assignment is in effect at the time of final payment shall execute and deliver-- (i) An assignment to the Government, in form and substance satisfactory to the Contracting Officer, of refunds, rebates, credits, or other amounts (including interest, if any) properly allocable to costs for which the Contractor has been reimbursed by the Government under this contract; and (ii) A release discharging the Government, its officers, agents, and employees from all liabilities, obligations, and claims arising out of or under this contract, except-- (A) Specified claims stated in exact amounts, or in estimated amounts when the exact amounts are not known; (B) Claims (including reasonable incidental expenses) based upon liabilities of the Contractor to third parties arising out of the performance of this contract; provided, that the claims are not known to the Contractor on the date of the execution of the release, and that the Contractor gives notice of the claims in writing to the Contracting Officer within 6 years following the release date or notice of final payment date, whichever is earlier; and (C) Claims for reimbursement of costs, including reasonable incidental expenses, incurred by the Contractor under the patent clauses of this contract, excluding, however, any expenses arising from the Contractor's indemnification of the Government against patent liability.

93 Page 93 of 179 (End of clause) ORDER LIMITATIONS. (OCT 1995) (a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than $3,000.00, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract. (b) Maximum order. The Contractor is not obligated to honor: (1) Any order for a single item with a price in excess of $84,615,718.38; or (2) A series of orders from the same ordering office within 30 days that together exceeds the price limitation in paragraph (b)(1) above. (c) If this is a requirements contract (i.e., includes the Requirements clause at subsection of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) above. (d) Notwithstanding paragraphs (b) and (c) above, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 7 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source. (End of clause) CLAUSES INCORPORATED BY REFERENCE Indefinite Quantity OCT 1995 CLAUSES INCORPORATED BY FULL TEXT OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) (a) The Government may extend the term of this contract by written notice to the Contractor within 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 60 months. ***This clause applies to task orders ONLY.*** (End of clause)

94 Page 94 of STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES (MAY 2014) In compliance with the Service Contract Labor Standards statute and the regulations of the Secretary of Labor (29 CFR part 4), this clause identifies the classes of service employees expected to be employed under the contract and states the wages and fringe benefits payable to each if they were employed by the contracting agency subject to the provisions of 5 U.S.C or THIS STATEMENT IS FOR INFORMATION ONLY: IT IS NOT A WAGE DETERMINATION Labor Category Medical Record Clerk Medical Record Technician Projected Federal Equivalent GS-7 GS-9 The GS rates can be obtained at (End of clause) CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): (End of clause) CLAUSES INCORPORATED BY REFERENCE Authorized Deviations In Clauses APR 1984 CLAUSES INCORPORATED BY FULL TEXT PROHIBITION ON CONTRACTING WITH ENTITIES THAT REQUIRE CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS (DEVIATION 2016-O0003)(OCT 2015) (a) The Contractor shall not require employees or subcontractors seeking to report fraud, waste, or abuse to sign or comply with internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or contactors 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. (b) The Contractor shall notify employees that the prohibitions and restrictions of any internal confidentiality agreements covered by this clause are no longer in effect. (c) The prohibition in paragraph (a) of this clause does not contravene requirements applicable to Standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information.

95 Page 95 of 179 (d)(1) Use of funds appropriated (or otherwise made available) by the Continuing Appropriations Act, 2016 (Pub. L ) or any other FY 2016 appropriations act that extends to FY 2016 funds the same prohibitions as contained in sections 743 of division E, title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L ) may be prohibited, if the Government determines that the Contractor is not in compliance with the provisions of this clause. (2) The Government may seek any available remedies in the event the Contractor fails to perform in accordance with the terms and conditions of the contract as a result of Government action under this clause. (End of clause) ORDERING (MAY 2011) (a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the contract schedule. Such orders may be issued from September 1, 2016 through 31 August (b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control. (c)(1) If issued electronically, the order is considered ``issued'' when a copy has been posted to the Electronic Document Access system, and notice has been sent to the Contractor. (2) If mailed or transmitted by facsimile, a delivery order or task order is considered ``issued'' when the Government deposits the order in the mail or transmits by facsimile. Mailing includes transmittal by U.S. mail or private delivery services. (End of Clause) TRANSPORTATION OF SUPPLIES BY SEA (APR 2014) (a) Definitions. As used in this clause -- "Components" means articles, materials, and supplies incorporated directly into end products at any level of manufacture, fabrication, or assembly by the Contractor or any subcontractor. "Department of Defense" (DoD) means the Army, Navy, Air Force, Marine Corps, and defense agencies. "Foreign-flag vessel" means any vessel that is not a U.S.-flag vessel. "Ocean transportation" means any transportation aboard a ship, vessel, boat, barge, or ferry through international waters. "Subcontractor" means a supplier, materialman, distributor, or vendor at any level below the prime contractor whose contractual obligation to perform results from, or is conditioned upon, award of the prime contract and who is performing any part of the work or other requirement of the prime contract. "Supplies" means all property, except land and interests in land, that is clearly identifiable for eventual use by or owned by the DoD at the time of transportation by sea.

96 Page 96 of 179 (i) An item is clearly identifiable for eventual use by the DoD if, for example, the contract documentation contains a reference to a DoD contract number or a military destination. (ii) "Supplies" includes (but is not limited to) public works; buildings and facilities; ships; floating equipment and vessels of every character, type, and description, with parts, subassemblies, accessories, and equipment; machine tools; material; equipment; stores of all kinds; end items; construction materials; and components of the foregoing. "U.S.-flag vessel" means a vessel of the United States or belonging to the United States, including any vessel registered or having national status under the laws of the United States. (b)(1) The Contractor shall use U.S.-flag vessels when transporting any supplies by sea under this contract. (2) A subcontractor transporting supplies by sea under this contract shall use U.S.-flag vessels if-- (i) This contract is a construction contract; or (ii) The supplies being transported are-- (A) Noncommercial items; or (B) Commercial items that-- (1) The Contractor is reselling or distributing to the Government without adding value (generally, the Contractor does not add value to items that it contracts for f.o.b. destination shipment); (2) Are shipped in direct support of U.S. military contingency operations, exercises, or forces deployed in humanitarian or peacekeeping operations; or (3) Are commissary or exchange cargoes transported outside of the Defense Transportation System in accordance with 10 U.S.C (c) The Contractor and its subcontractors may request that the Contracting Officer authorize shipment in foreign-flag vessels, or designate available U.S.-flag vessels, if the Contractor or a subcontractor believes that -- (1) U.S.-flag vessels are not available for timely shipment; (2) The freight charges are inordinately excessive or unreasonable; or (3) Freight charges are higher than charges to private persons for transportation of like goods. (d) The Contractor must submit any request for use of foreign-flag vessels in writing to the Contracting Officer at least 45 days prior to the sailing date necessary to meet its delivery schedules. The Contracting Officer will process requests submitted after such date(s) as expeditiously as possible, but the Contracting Officer's failure to grant approvals to meet the shipper's sailing date will not of itself constitute a compensable delay under this or any other clause of this contract. Requests shall contain at a minimum -- (1) Type, weight, and cube of cargo; (2) Required shipping date; (3) Special handling and discharge requirements; (4) Loading and discharge points;

97 Page 97 of 179 (5) Name of shipper and consignee; (6) Prime contract number; and (7) A documented description of efforts made to secure U.S.-flag vessels, including points of contact (with names and telephone numbers) with at least two U.S.-flag carriers contacted. Copies of telephone notes, telegraphic and facsimile message or letters will be sufficient for this purpose. (e) The Contractor shall, within 30 days after each shipment covered by this clause, provide the Contracting Officer and the Maritime Administration, Office of Cargo Preference, U.S. Department of Transportation, 400 Seventh Street SW., Washington, DC 20590, one copy of the rated on board vessel operating carrier's ocean bill of lading, which shall contain the following information: (1) Prime contract number; (2) Name of vessel; (3) Vessel flag of registry; (4) Date of loading; (5) Port of loading; (6) Port of final discharge; (7) Description of commodity; (8) Gross weight in pounds and cubic feet if available; (9) Total ocean freight in U.S. dollars; and (10) Name of the steamship company. (f) If this contract exceeds the simplified acquisition threshold, the Contractor shall provide with its final invoice under this contract a representation that to the best of its knowledge and belief-- (1) No ocean transportation was used in the performance of this contract; (2) Ocean transportation was used and only U.S.-flag vessels were used for all ocean shipments under the contract; (3) Ocean transportation was used, and the Contractor had the written consent of the Contracting Officer for all foreign-flag ocean transportation; or (4) Ocean transportation was used and some or all of the shipments were made on foreign-flag vessels without the written consent of the Contracting Officer. The Contractor shall describe these shipments in the following format: ITEM CONTRACT QUANTITY DESCRIPTION LINE ITEMS TOTAL

98 Page 98 of 179 (g) If this contract exceeds the simplified acquisition threshold and the final invoice does not include the required representation, the Government will reject and return it to the Contractor as an improper invoice for the purposes of the Prompt Payment clause of this contract. In the event there has been unauthorized use of foreign-flag vessels in the performance of this contract, the Contracting Officer is entitled to equitably adjust the contract, based on the unauthorized use. (h) In the award of subcontracts for the types of supplies described in paragraph (b)(2) of this clause, including subcontracts for commercial items, the Contractor shall flow down the requirements of this clause as follows: (1) The Contractor shall insert the substance of this clause, including this paragraph (h), in subcontracts that exceed the simplified acquisition threshold in part 2 of the Federal Acquisition Regulation. (2) The Contractor shall insert the substance of paragraphs (a) through (e) of this clause, and this paragraph (h), in subcontracts that are at or below the simplified acquisition threshold in part 2 of the Federal Acquisition Regulation. (End of clause) CLAUSES INCORPORATED BY REFERENCE Instructions to Offerors--Commercial Items OCT 2015 ADDENDUM TO ADDENDUM TO INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS THIS SECTION IS FOR SOLICITATION PURPOSES ONLY. THIS SECTION WILL BE PHYSICALLY REMOVED FROM ANY RESULTANT AWARD, BUT WILL BE DEEMED INCORPORATED BY REFERENCE. THIS ADDENDUM SUPPLEMENTS FAR Failure to comply with any of the instructions may result in the proposal being removed from further consideration. 1. SUBMISSION OF COST OR PRICING DATA It is expected that this contract will be awarded based upon a determination that there is adequate price competition; therefore, the offeror is not required to submit additional cost or pricing data (beyond that required by the solicitation) or to certify cost or pricing data with its proposal If, after receipt of the proposals, the Contracting Officer determines that adequate price competition does not exist in accordance with FAR and FAR , the offeror shall provide other information requested to be submitted to determine fairness and reasonableness of price, or certified cost or pricing data as requested by the Contracting Officer. 2. PROPOSAL CONTENT AND INSTRUCTIONS FOR PREPARATION OF PROPOSALS 2.1. The instructions provided specify the format and content that Contractors shall use in response to this Request for Proposal (RFP). The intent is not to restrict the Contractors in the manner in which they will perform their work but rather to ensure a certain degree of uniformity in the format of the responses for evaluation purposes. This requirement is a 100% set-aside for small business concerns under NAICS , Administrative Management and General Management Consulting. The size standard for NAICS is $15 million. Proposals will only be accepted from contractors who are registered in System for Award Management (SAM) under the NAICS code Contractors must submit a proposal that is legible and comprehensive enough to provide the basis for a sound evaluation by the Government. Information provided should be precise, factual, and complete. Legibility, clarity, completeness, and responsiveness are important. Proposals shall be in the form prescribed by, and shall

99 Page 99 of 179 contain a response to, each of the areas identified in the RFP. Any proposal that does not meet the requirements of the solicitation may be determined to be substantially incomplete and may result in rejection of the contractor s entire proposal from further consideration The Contractor shall include four separate volumes in response to the RFP: 1. Technical 2. Past Performance 3. Business 4. Price Complete Technical, Past Performance, Business and Pricing volumes shall be received at the same time via one electronic mail ( ) to [email protected] by 1:00 pm local time on 1 April Any questions regarding this RFP shall also be submitted to this address. Questions should be presented in writing to NMLC no later than ten (10) calendar days after the issue date of this solicitation. Questions shall be listed chronologically and reference the corresponding solicitation section and paragraph. NMLC s responses to questions will be presented in the form of an amendment. The source of the questions will not be disclosed No hard copies of proposals will be accepted. Please note only 1 per contractor will be accepted. The ed proposal (to include all four volumes) shall not be larger than 10 megabytes and shall be in Microsoft Office for Windows format (2007), either.docx or.xlsx files, as specified herein. If the is larger than 10 megabytes, it will not be accepted. Consent letters and forms that require signatures may be submitted as a.pdf file. The contractor is responsible for ensuring that proposals do not contain corrupted files such that they are not readable by the Government Each ed proposal shall have the name of the contractor and the RFP number in the subject line. Any requests for hand delivery will not be honored. It is the Contractor s responsibility to ensure that proposals are received by the due date and time required. The Government will acknowledge receipt of all proposals. If an acknowledgement is not received, it is the Contractor s responsibility to follow-up with NMLC to guarantee receipt The Technical, Past Performance and Business volumes shall be in Microsoft Word for Windows (2007)(.docx), on 8 ½ X 11 inch size, with 1 inch margins all around, Times New Roman font of not less than 10 point font size inclusive of tables, charts, graphs, graphics, etc. Text, tables, charts, graphs, graphics, etc. that are not in compliance will not be considered by the Government in its evaluation. Each page of each document shall have a footer indicating the name of the contractor and page X of Y Technical. In accordance with electronic submission requirements given in this section, the contractor shall include the following: The offeror shall address how its proposed management approach will be beneficial to the Government and how it reduces the risk of unsuccessful contract performance The offeror must submit a plan to describe any techniques, methods and actions that will be used by the offeror to mitigate anticipated risks to include 1) provision of Common Access Card (CAC) and security clearance for their contract coders/staff, 2) provision of support for coding backlog- a plan to be able to assist MTFs for government generated backlog and contractor generated backlog and 3) provide strategic plans to mitigate disruption of schedule, increased costs, degradation of performance, the need for increased Government oversight, or the likelihood of unsuccessful contract performance The offeror must describe how its specific hypothesis, methodologies, processes, and capabilities reflect their ability to effectively and efficiently manage the task order requirement detailed in the PWS. The offeror must demonstrate that adequate procedures are in place to ensure overall contract performance is achieved at an acceptable quality level. The offeror shall describe its ability to meet the challenges of managing this requirement.

100 Page 100 of 179 The offeror shall describe its management lines of authority and responsibilities and identify the span of control for its managers The offeror shall demonstrate in sufficient detail a technical approach that will successfully accomplish the solicitation requirements. The offeror should describe the risks associated with the solicitation requirements and any risks associated with the offeror s proposed technical approach and should describe any techniques, methods and actions that will be used by the offeror to mitigate the risk(s) identified The technical volume shall include a discussion of the methods that will be used by the offeror to recruit and retain qualified, educated personnel with appropriate qualifications/skill levels and knowledge to meet the solicitation requirements. The offeror shall describe the labor mix and number of personnel required for each labor category to fulfill the task order requirements detailed in the PWS The offeror shall identify individuals and provide resumes for the primary personnel, who will be considered key personnel. If any proposed personnel are not currently employed with the offeror, the offeror shall submit letters of commitment along with the person s resume The offeror shall provide the measures of employing the key personnel based on the following criteria: competency of proposed personnel in the areas of responsibilities, relevant work experience, and certification in the main program areas by reviewing resumes of the offeror's employees which must be included as part of the proposal. Likewise the offeror shall include the rationale used in the selection of the key personnel considering the benefit, the overall team performance and efficiency The offeror shall include a description of activities for timely, effective, and complete management of personnel during the life of the contract The offeror shall include a description of activities for timely, effective, and complete start of services to meet the solicitation requirements. The offeror shall describe its approach for tracking the timeliness, accuracy, and quality of deliverables. The offeror shall present a plan to describe its ability to manage the contractors work schedules and meet the challenges to immediately resolve the risk especially the coding backlog issues. The offeror shall provide critical path from award to startup In addition to the above evaluation factors, the offeror shall address the following: The offeror shall discuss their understanding of FAR clause and discussion shall demonstrate proper understanding of the clause If a subcontractor has been proposed, the contractor shall specifically address FAR , Limitations on Subcontracting; the contractor s Technical volume shall clearly detail the nature of the relationship between the parties, (i.e. subcontractor, partner, etc.) and shall list the responsibilities of both the offeror and proposed subcontractor. The list shall demonstrate the offeror has the majority of duties and is responsible for overall contract management If the contractor is proposing as a mentor/protégé or business relationship other than subcontracting, the contractor s Technical volume shall clearly detail the nature of the relationship between the parties, (i.e. mentor-protégé, joint venture, etc.) and shall address the responsibilities of all parties as they would relate to provision of services under the resultant contract The total number of the pages submitted for the Technical volume shall not exceed 15 pages (8 ½ X 11 inch), excluding a title page, table of contents and resumes. If the Technical volume contains more than 15 pages, only the first 15 pages will be evaluated. Cover letters are not required; any information contained in a cover letter will not be evaluated Past Performance. In accordance with electronic submission requirements given in this section, the contractor shall include the following:

101 Page 101 of The offeror shall complete at least three, but no more than five Past Performance Information Sheets (PPISs) (Attachment 1). Each of the PPISs shall be completed in its entirety. The Past Performance information listed on each sheet shall be for medical coding and auditing services. Each PPIS shall not exceed one page, inclusive of a narrative. If a PPIS contains more than one page, only the first page will be considered. The offeror shall complete Section I of the Past Performance Information Sheet and submit it to the customer Point of Contact (POC) for completion of Section II. The customer POC shall submit the entire completed Past Performance Information Sheet directly to the Contracting Officer via to [email protected] no later than the closing date and time of the solicitation. The Government will not consider Past Performance Information Sheets submitted after the closing date and time of the solicitation. The Government will provide acknowledgement of the Past Performance Information Sheets; however, evaluation will not occur until after the solicitation closes. Receipt of the Past Performance Information Sheet shall not be mistaken for evaluation. If more than five Past Performance Information sheets are submitted, only the first five Past Performance Information Sheets will be considered. The Government reserves the right to contact the customer POCs for verification or additional information For each of the Past Performance Information Sheet submitted the offeror shall describe the objectives achieved detailing how the effort is similar to the requirements of this solicitation (referencing PWS). For any contracts which did not/do not meet the original requirements with regard to original cost, schedule, or technical performance, the offeror shall provide a brief explanation of the reason(s) for such shortcomings and any demonstrated corrective actions taken to avoid recurrence. The offeror shall list each time the delivery schedule was revised and provide an explanation of why the revision was necessary. The offeror shall also provide a copy of any cure notices or show cause letters received on each contract listed and description of any corrective action taken. For any terminated contracts, the offeror shall indicate the type and reasons for the termination It is important that the offeror include a statement reflecting an annual account of records coded per type (Outpatient (OP) and Inpatient (IP)) Each Past Performance Information Sheet may include multiple contracts or orders for the same contractor. Contracts cited must be current, or have ended not more than three years prior to the closing date of the solicitation. If the contract performance ended more than three years prior to the closing date of the solicitation the contract performance will be determined not relevant The offeror may submit past performance that demonstrates prior experience of key personnel. The past performance submission shall identify, by name, the key personnel and clearly identify their previous roles and responsibilities and their proposed roles and responsibilities under the resultant contract. The offeror shall discuss how the key personnel s previous roles and responsibilities will contribute to successful contract operations under the resultant contract. If the submission does not clearly describe the roles and responsibilities of the key personnel and the how the key personnel will contribute to the performance under the resultant contract, it will be determined not relevant The offeror may submit past performance that demonstrates prior experience by teaming partners (e.g. proposed subcontractor, partner, mentor, protégé, parent company, sister company, etc.) ONLY if they will be performing in support of the contract resulting from this solicitation. Such past performance submissions shall clearly identify the relationship of the teaming partners to the offeror and the how they will contribute to the performance under the resultant contract. If the submission does not clearly describe the relationship of teaming partners to the offeror and the how the teaming partners will contribute to the performance under the resultant contract, it will be determined not relevant. A maximum of two Past Performance Information Sheets shall be for services provided by entities other than the offeror, members of SBA approved Joint Ventures, and key personnel. If more than two Past Performance Information Sheets are submitted for services provided by entities other than the offeror, members of SBA approved Joint Ventures, and key personnel, only the first two Past Performance Information Sheets will be considered relevant If Past Performance is submitted for a contract under which the offeror or teaming partner provided services as a subcontractor, partner, mentor, protégé, parent company, sister company, etc., the Past Performance Information Sheet shall clearly describe the corporate relationships among those who provided the services, citing key

102 Page 102 of 179 responsibilities for each, to include identifying the specific services provided (in terms of numbers and types of personnel, locations, etc) and nature of services provided (e.g., recruitment, payroll, benefits administration, etc). If the submission does not clearly detail the specific responsibilities and relationship under a contract, it will be determined not relevant If a teaming partner is proposed, the offeror shall submit written consent from that teaming partner to disclose their Past Performance information to the contractor. If such consent is not provided as part of the submission, the Past Performance of that teaming partner will be determined not relevant. The offeror shall submit the written consent as a separate document with the submission of their Technical, Pricing, and Business Volumes. The written consent shall not be submitted by the customer POC with the submission of the completed Past Performance Information Sheets If neither the offeror nor its teaming partner possesses relevant past performance, the offeror shall submit a statement affirming that it possesses no relevant Past Performance. The offeror shall submit the statement affirming that is possesses no relevant Past Performance as a separate document with the submission of their Technical, Pricing, and Business Volumes The Government may contact the POCs listed on the Past Performance Information Sheets. POCs shall be either Government personnel (civil service or military) or employees of private sector dental/medical facilities for which the contractor has provided services. Due to a potential conflict of interest, Past Performance Information Sheets that list POCs that work for, or have worked for, the offeror or with a teaming partner(s) directly or indirectly will be determined not relevant The total number of the pages submitted for Past Performance shall not exceed 5 pages (8 ½ X 11 inch), (one page for each PPIS), excluding a title page. If the Past Performance volume contains more than 5 pages, only the first 5 pages will be evaluated Business. In accordance with the requirements given in this section, the contractor shall complete the following: This requirement is 100% set-aside for small businesses. The offeror shall be registered in SAM as a small business under the applicable NAICS code for this solicitation, The small business size standard is $7.5M. The offeror shall complete and submit FAR OFFEROR REPRESENTATIONS AND CERTIFICATIONS- -COMMERCIAL ITEMS (OCT 2015) ALTERNATE I (OCT 2014). The offeror shall also complete and submit the SAM Certification Sheet (Attachment 2) Offeror s Information Form located in Attachment 3 shall be completed and submitted. Two points of contact shall be provided. Please note that all communication regarding this solicitation and proposals will be directed to the designated contacts on the form The offeror shall complete and submit DFARS clause (Attachment 4) REPRESENTATION BY CORPORATIONS REGARDING AN UNPAID DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW FISCAL YEAR 2016 APPROPRIATIONS (DEVIATION 2016-O0002) (OCT 2015) 2.5. Pricing. The offeror shall provide a complete and detailed price proposal to perform the prospective contract successfully. The offeror s price proposal shall support the offeror s technical proposal. The contractor shall consider the information provided in the PWS included in this RFP in the development of its price. Proposed prices should be inclusive of any discounts provided. Pricing shall be valid for a period of 180 days Pricing for this solicitation represents initial quantities and two option years. All quantities are divided into lots. Lots for this requirement are outlined in the Addendum to Enclosures Pricing for travel is not required as it will be reimbursed in accordance with the Joint Travel Regulations.

103 Page 103 of The information contained in Addendum to Enclosures 1-27 is provided to assist in the development of pricing for the CLINs. These enclosures shall not be submitted with the offeror s pricing proposal; they are for informational purposes only. Pricing shall be completed in accordance with this section Offerors shall propose on all Lots provided in the Pricing Workbook provided with the solicitation All pricing information shall be completed in the Pricing Workbook The pricing workbook shall be submitted as the Price portion of the proposal. 3.0 Miscellaneous 3.1. Contractors shall not contact any incumbent workers during their official duty hours In accordance with the Naval Marine Corps Acquisition Regulation Supplement (NMCARS) , for Prompt Payment Act purposes, contracts will be subject to the 7 calendar day constructive acceptance period Performance under the resulting contract is to begin on 01 September 2016 and go through 31 August 2019, if all options are exercised. It is to continue services currently being provided under contracts N D-5044 with Caban Resources, LLC, N D-5045 with Peak Government Services, Inc., and N D-5046 with Diamond Solutions, Inc In accordance with FAR , funds are not presently available for the resulting contracts. The Government s obligation under this solicitation is contingent upon the availability of appropriated funds from which payment for performance can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for the resulting contracts and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer via the award of a task order Business to Business (B2B) Gateway All Department of the Navy (DON) information systems as defined in Department of Defense Directive (DoDD) shall be certified and accredited (C&A) for operation. C&A is attained via the Defense Information Assurance Certification and Accreditation Process (DIACAP) and is applicable to all DON- owned or controlled information systems that receive, process, store, display or transmit Department of Defense (DoD) information, regardless of Mission Assurance Category (MAC) classification or sensitivity, except, per DoDD Paragraph 2.3; IT that is considered Platform Information Technology (PIT). Regardless of whether the system or device is considered PIT or whether it is determined that it requires a full accreditation, the following DIACAP artifacts shall be included with your proposal; System Identification Profile (SIP), DIACAP Implementation Plan (DIP), and Plan of Actions and Milestones (POA&M). A template has been included with this solicitation as B2B Attachment 6, MDS2F Form and Instructions. Completion of this form in its entirety will satisfy the requirement for the SIP, DIP and POA&M Navy PIT Designation Certain medical technologies may be designated as PIT by the Navy Operational Designated Accrediting Authority (ODAA); however the PIT designation itself does not constitute an Approval to Operate (ATO). The PIT system will require a PIT Risk Analysis (PRA). The DIACAP SIP, DIP, POA&M and Risk Analysis documents are required in order to complete a PRA. Contractors will be required to scan the PIT system for vulnerabilities prior to delivery According to DoDD 85001, Paragraph E ; PIT refers to computer resources, both hardware and software, that are physically part of, dedicated to, or essential in real time to the mission performance of special-purpose systems. Medical technologies, and specifically medical imaging and monitoring systems are considered special-purpose mission technologies according to this definition.

104 Page 104 of The PIT designation issued by the ODAA may be used by the Program Manager (PM) to complete a PRA in order to prove compliance with C&A requirements, but is cautioned that the appropriate IA controls must still be built into the IT to comply with acquisition requirements. The contractor shall work with Navy Program Managers to ensure their systems meet these requirements The contractor shall establish appropriate administrative, technical, and physical safeguards to protect all government data, to ensure the confidentiality, integrity, and availability of government data under their control. At a minimum, this shall include provisions for personnel, electronic, and physical security The contractor shall propose an acceptable approach to selecting Information Awareness (I/A) controls starting from the baseline set on DoD Instruction B, commensurate with the system s Mission Assurance Category (MAC) and Confidentiality Level. For medical systems, the MAC level assigned is typically MAC III sensitive The contractor shall comply with DIACAP requirements as specified by the DoD that meet appropriate DoD and Navy IA requirements. The contractor shall initiate the process by providing the required documentation necessary to receive an ATO. The contractor shall make their device or system delivered against this contract available for C&A testing and initiates the process well in advance of a contract delivery order. The requirements shall be met before the contractor's system is authorized to access DoD data or interconnect with any DoD network that receives, processes, stores, displays or transmits DoD data. An ATO, at a minimum, will be required before a device or system is installed. The contractor shall ensure that the proper contractor support staff is available to participate in all phases of the DIACAP process. They include but are not limited to; Completing and maintaining all documentation necessary to obtain an ATO Attending and supporting DIACAP and C&A meetings with Navy IA representatives Supporting/conducting the vulnerability mitigation process to comply with IA controls listed in DoD Instruction Supporting the C&A Team during system security testing Contractors must confirm that their systems are locked down prior to initiating C&A testing Post-Accreditation Review An annual IA review shall be conducted that comprehensively evaluates existing policies and processes to ensure procedural consistency and that the IS continues to operate in the manner to which it was accredited. The annual review process should account for the analysis of projected policy needs, and produce a plan for development or implementation of new policies or processes Personnel Security and User Access Control The contractor shall comply with DoDD , Information Assurance (IA), DoD Instruction (DODI) Information Assurance (IA) Implementation, DoDD , DoD Privacy Program, DoD R, DoD Health Information Privacy Regulation and DoD R, Personnel Security Program Requirements. Contractor responsibilities for ensuring personnel security include, but are not limited to meeting the following requirements: Follow the Privacy Office guidelines for submittal of IT security clearances and ensure all contractor personnel are designated as IT-I, IT-II or IT-III where their duties meet the criteria of the position sensitivity designations Because of the unique circumstances presented by DoD and DON networks, personnel security requirements shall be followed to ensure appropriate precautions are taken prior to allowing vendor personnel

105 Page 105 of 179 access to the network. Any vendor personnel that will be accessing the medical device/system while installed on the hospital network will be required to have a National Agency Check (NAC) completed. Typically, this requires an investigation to support a Public Trust Position and requires the person(s) to complete and submit a Standard Form 85P (SF85P), Questionnaire for Public Trust Positions, via the Electronic Personnel Security Questionnaire (EPSQ). Questions relating to SF85Ps and the EPSQ process may be directed to or online at Contractor personnel accessing equipment connected to the hospital network will be required to complete a System Authorization Access Request-Navy (SAAR-N) (form OPNAV 5239/14). Copies of this form can be obtained from the Navy PACS Office. Additionally, contractor personnel are required to complete the annual DoD IA training requirements The contractor shall initiate, maintain and document personnel security investigations appropriate to the individual s responsibilities and required access to Sensitive Information (SI) Immediately report to the appropriate Navy POC and deny access to any automated information system (AIS), network, or information if a contractor employee filling a sensitive position receives an unfavorable adjudication, if information that would result in an unfavorable adjudication becomes available, or if directed to do so by the appropriate Navy representative for security reasons Ensure that all contractor personnel receive IA training before being granted access to DoD AIS s Access to the medical devices will be limited to authorized users as determined by local policy. Vendors whose systems do not yet meet the requirement for CAC authentication must indicate their willingness to do so, and offer a timeline for compliance Operating Systems To ensure that medical systems attain data confidentiality, integrity, and availability levels consistent with best industry practices, the use of current Operating Systems (OS) is highly recommended. Preference shall be given to systems that employ modern operating systems, including closed source, open source, or proprietary. Medical systems will employ whenever possible, operating systems that are fully supported by the manufacturer and are commercially available Domain Name System Realm/Directory Services Contractor will be required to demonstrate, if applicable whether client/server topology based medical systems can integrate with Directory Services and support LDAP authentication. 3.8 Local Privileged and Administrative User/Local System Accounts Contractor shall create a single local user account with administrative/root level privileges for purposes of conducting system repairs and maintenance only. This account shall be separate and distinct from the built-in local administrative/root account provided by the Operating System and shall comply with DoD policy. All factors required to complete successful identification, authentication and authorization against the built-in local Administrative/Root level account shall be provided to the Medical Treatment Facility (MTF) Biomedical Engineering Department. In addition, the MTF will be provided with access and instructions on how to change IP addresses, host names/ae titles, etc Complete administrative system rights shall be provided to the government System Administrator for the purpose of conducting device vulnerability scans as needed Antimalware Medical systems that make use of a file system under direct control of an operating system instance whether physical and/or virtual shall provide the appropriate antimalware safeguards consistent with current security practices.

106 Page 106 of 179 Exemption from this requirement is applicable to medical systems which make use of a proprietary file system and/or operating system for which no commercially available antimalware application exists. This exemption should be documented in the C&A Initial Technical Questionnaire Preference may be given to medical systems capable of supporting antimalware applications, within tolerable specifications, that support the use of DISA approved McAfee, and/or Symantec solutions. Systems shall be configured as to allow for the update of malware definition signatures on a scheduled basis. Scanning shall encompass the entire system (file system, operating system, real-time processes), by default. In cases where the scanning of the entire system may negatively affect the operation of the system, the Contractor shall provide a detailed list of exclusions with justifications as part of the C&A Initial Technical Questionnaire Malware Handling and Threat Detection The contractor shall monitor systems for malware incidents, such as viruses, spyware, and adware and prepare incident reports to include the location of the malware, severity, and course of action taken for cleanup. In cases where complete malware removal cannot be achieved, the Contractor shall re-image the system to support cleanup efforts. The contractor will provide the Government with full access to the antimalware application logs Navy Business to Business (B2B) Gateway All contractor systems that will communicate with DON systems will interconnect through the established Military Health System (MHS) Business to Business (B2B) gateway. For all Web applications, contractors will connect to the DISA-established Web DMZ The Contractor shall connect to the B2B gateway via a contractor procured Internet Service Provider (ISP) connection and assume all responsibilities for establishing and maintaining their connectivity to the B2B gateway. This will include acquiring and maintaining the circuit to the B2B gateway and acquiring a FIPS Virtual Private Network (VPN)/Firewall device compatible with the MHS VPN device. Maintenance and repair of contractor procured VPN equipment shall be the responsibility of the contractor The Contractor shall configure their network to support access to government systems (e.g., configure ports and protocols for access) The Contractor shall provide full time connections to a TIER1 or TIER2 ISP. Dial-up ISP connections are not acceptable The Contractor shall comply with DoD guidance regarding allowable ports, protocols and risk mitigation strategies Prior to accessing DON networks, all contractors shall complete a DD Form 2875 System Authorization Access Request (SAAR), included as B2B Attachment 3, and submit to NMLC, Code 03, Imaging Informatics Division for processing. The contractor shall complete applicable DoD IA training IPv6 The proposed system shall be Internet Protocol version 6 (IPv6) capable or the vendor must provide a detailed project, migration or planning documentation to show when the proposed system shall be IPv6 capable Minimum IPv6 capabilities include: Conformant with the IPv6 standards profile contained in the DoD IT Standards Registry (DISR);

107 Page 107 of Maintaining interoperability in heterogeneous environments with IPv4; Commitment to upgrade as the IPv6 standard evolves; Availability of vendor IPv6 technical support The contractor must be able to demonstrate or provide documentation to prove that their product is IPv6 capable. As described in the DISR IPv6 standards profile, application vendors are expected to scan and test their code for IPv6 compliance and provide a letter of compliance indicating to what degree they comply. The letter shall be in vendor format and describe the standards used for testing and the results of the scans. IPv6 'capable' is defined as having the capability of receiving, processing and forwarding IPv6 packets and/or interfacing with other IPv6 capable systems/devices and in a manner similar to IPv4. In order to demonstrate IPv6 compliance, the vendor should submit the following documentation: Provide a diagram showing IPv6 core configuration, to include IPv6 addressing, internal network connectivity and topology, external network connectivity, and IPv6 traffic flow; Submit a list of core components to include vendor/manufacturer IPv6 compliance; Submit a report that illustrates testing of IPv6 compliance, to include test scripting, logs and results Information Assurance Vulnerability Management (IAVM) IAVM is focused on maintaining a secure platform as new vulnerabilities and exploits are discovered and released through various software developers and security agencies. The core tool of successful IAVM is the Information Assurance Vulnerability Alert (IAVA). The DoD releases IAVAs for local action on the various platforms across the enterprise network. Each Navy Healthcare Facility is responsible for managing their local network. Most DoD IAVAs originate from a real world event such as a patch release or vulnerability notification from a software vendor (e.g. Windows or Sun patch release), or a US-CERT released from the CERT Coordination Center at Carnegie Mellon University. To have an effective IAVM program, vendors must be proactive in monitoring emerging threats. Some recommended sources for IAVM support are: General Vulnerability alerts, all platforms: Microsoft security resources: SUN Microsystems Security resources: cgi/show.pl?target=security/sec As part of the IAVM program, the contractor shall provide a primary and secondary point of contact for compliance actions. The point of contact shall provide, upon receipt of a vulnerability message, an acknowledgement of that receipt. The vendor shall thoroughly test all mitigations for the vulnerability, and upon applying the mitigation to the system, report compliance. Receipt and compliance messages shall occur within the stipulated time window, as stated in the vulnerability message or other official notification Any vendor interested in meeting this requirement shall have a documented process to demonstrate an organizational culture embracing security throughout the system lifecycle. The processes shall clearly demonstrate security s role in the product development phase, and the processes the vendor employs to react to vulnerabilities, validate required patches, communicate status and required actions to their customers, and the follow up service support to address patch implementation Health Insurance Portability and Accountability Act (HIPAA) The contractor shall comply with the HIPAA Act of 1996 (Public Law ) requirements, specifically the administrative simplification provision s of the law and the associated rules and regulations published by the

108 Secretary, Health and Human Services (HHS). This includes the Standards for Electronic Transactions, the Standards for Privacy of Individually Identifiable Health Information and the Security Standards Additional Attachments Page 108 of B2B Attachment 1 contains a list of approved products available in the commercial marketplace that are compatible with a B2B with NMLC B2B Attachment 2 is a form for vendors to complete when requesting a B2B with NMLC B2B Attachment 3 is a blank DD 2875, System Authorization Access Form B2B Attachment 4 is a B2B Implementation Briefing for additional information regarding setting up a B2B B2B Attachment 5 is a Tricare Manual. Within this manual, sections that are highlighted represent B2B requirements B2B Attachment 6 is the Manufacturer Disclosure Statement for Medical Device Security. This form must be completed in its entirety before a B2B can be implemented. List of B2B Attachments: B2B Attachment 1--Juniper Networks - Product Listings B2B Attachment 2--NMLC - Vendor Business to Business (B2B) Information Request Form B2B Attachment 3--DD2875-System Authorization Access Form B2B Attachment 4--B2B Implementation Briefing 2013 B2B Attachment 5--Tricare Manual (with B2B requirements highlighted) B2B Attachment 6--MDS2 Form and Instructions List of Enclosures to FAR Addendum: FAR Addendum Enclosure 1 Lot A Performance Work Statement FAR Addendum Enclosure 2 Lot B Performance Work Statement FAR Addendum Enclosure 3 Lot C Performance Work Statement FAR Addendum Enclosure 4 Lot D Performance Work Statement FAR Addendum Enclosure 5 Lot E Performance Work Statement FAR Addendum Enclosure 6 Lot F Performance Work Statement FAR Addendum Enclosure 7 Lot G Performance Work Statement FAR Addendum Enclosure 8 Lot H Performance Work Statement FAR Addendum Enclosure 9 Lot I Performance Work Statement ADD. ENCLOSURES FAR Addendum Enclosure 1 Lot A 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Health Clinic Annapolis, Maryland

109 Page 109 of The contractor shall provide on-site outpatient coding services, onsite outpatient auditing services, and onsite training services at the Naval Health Clinic (NHC) Annapolis, Maryland. Services shall also be provided in support of the Branch Health Clinics (BHC) Bancroft Hall Annapolis, MD; Earle, NJ; Lakehurst, NJ; Philadelphia, PA; and Mechanicsburg, PA. Coding and auditing support of the BHCs shall be accomplished at the Naval Health Clinic Annapolis. Training services shall be provided on-site at all locations listed above approximately twice per year The facility is comprised of specialties that include Orthopedic, Pediatric, Family Health, Internal Medicine, Mental Health Care, Physical Therapy, and Optometry services The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:30 AM to 6:30 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (onsite) The contractor shall provide services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract. The contractor shall code and perform quality assessment reviews for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 4,500 records Approximately 4,200 records Approximately 3,900 records 3.2. The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). 4. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 3,600 records Approximately 3,360 records Approximately 3,120 records 4.3. The contractor shall perform the audits in accordance with BUMED Instruction A to satisfy the audit requirements. In addition, the contractor shall use the government s tool of choice which is currently Global Code. The government will provide the tool, along with documentation and training on the use of the tool. The DQ audit results shall be provided to the POC by the 15th of each month. 5. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training sessions for NHC Annapolis and the BHCs identified above in paragraph 1.1. as follows: Option Period 1 Option Period 2 Approximately 163 sessions Approximately 166 sessions Approximately 170 sessions

110 Page 110 of Travel. The government will reimburse the contractor up to $2, in accordance with the Joint Travel Regulation (JTR) for reasonable travel expenses incurred while performing the duties in this task order. For mileage, the contractor will be reimbursed for roundtrip travel 7. Point of Contact Information. Primary POC: LTJG Kawika Segundo Patient Administration Department Head Phone: Secondary POC: CDR Michael Klemann Director for Administration Phone: Local Contracting Officer s Representative: Mr. Steve Rogers Phone: [email protected] Mailing address: 250 Wood Road Annapolis, MD Description of Services. Performance Work Statement Medical Records Coding Services Naval Health Clinic Patuxent River, Maryland 1.1. The contractor shall provide onsite outpatient coding services at the Naval Health Clinic Patuxent River, Maryland. Services shall also be provided in support of the Branch Health Clinics (BHCs) Naval Air Facility (NAF) Washington Joint Base Andrews, MD; Dahlgren, VA; and Indian Head, MD. Coding support of the BHCs shall be accomplished at the Naval Health Clinic Patuxent River The facility is comprised of specialties that include Family Practice; Primary Care; Internal Medicine; Physical Therapy; Occupational Health; Military Medicine; Optometry; Pediatrics; Hearing Conservation; Nutritional Medicine; Behavioral Health; Substance Abuse Rehabilitation Program; Immunization Clinic; and visiting specialists such as, but not limited to, Dermatology; Orthopedics, ENT, GYN, Neurology, Ophthalmology and Psychiatry The contractor shall perform 1/12th of the work each month. 2. Duty Hours. The hours of operation are from 6:00 AM and 6:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding Services (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract.

111 Page 111 of The contractor shall code and perform a quality assessment review for AHLTA records as follows: Option Period 1 Option Period 2 Approximately 130,140 records Approximately 121,464 records Approximately 112,788 records 4. Point of Contact Information. Primary POC: LT Sarah Brown Patient Administration Department Head Phone: [email protected] Secondary POC: Ms. Jeanette Carney Coding Supervisor Phone: [email protected] Local Contracting Representative: Mr. James Summers Contracting Officer s Representative (COR) Phone: address: [email protected] Mailing address: Buse Road Building 1370 Patuxent River, MD Description of Services. Performance Work Statement Medical Records Coding Services Naval Health Clinic Quantico, Virginia 1.1. The contractor shall provide onsite outpatient coding services and onsite training services at the Naval Health Clinic Quantico (NHCQ), Virginia. Services shall also be provided in support of the Branch Health Clinics (BHCs) The Basic School (TBS) Quantico, VA; Officer Candidate School (OCS), Quantico, VA; Washington Navy Yard (WNY), Washington, DC; and Sugar Grove, West Virginia The facility is comprised of specialties that include Sports Medicine, Military Medicine, Chiropractic and Physical Therapy at OCS; Primary Care at Sugar Gove; Chiropractic, Military Medicine and Physical Therapy at TBS; Primary Care, Optometry, and Preventive Medicine at WNY; and Dermatology, Pediatrics, Behavioral Health, Deployment Health, Primary Care, Optometry, Semper Fi Center, Occupational Health, Physical Therapy and Hearing Conservation at NHCQ The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 6:00 AM and 6:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government.

112 Page 112 of Medical Record Coding (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient records as follows: Option Period 1 Option Period 2 Approximately 130,140 records Approximately 121,464 records Approximately 112,788 records 3. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide training each month for NHC Quantico and the BHCs identified above in paragraph 1.1. as follows: Option Period 1 Option Period sessions 812 sessions 828 sessions 4. Travel. The government will reimburse the contractor up to $200 for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. The Washington Navy Yard is considered an alternate work space and the contractor will not be eligible for mileage reimbursement. 5. Point of Contact Information. Primary POC: LT Brendan Good Patient Administration Department Head Phone: [email protected] Local COR: LT Joseph Sank Phone: [email protected] Mailing address: 3259 Catlin Avenue Quantico, VA FAR Addendum Enclosure 2 Lot B 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Health Clinic Corpus Christi, Texas

113 Page 113 of The contractor shall provide onsite outpatient coding services, remote outpatient auditing services and onsite training services at the Naval Health Clinic Corpus Christi, Texas. Services shall also be provided in support of the Branch Health Clinics Kingsville, TX and Fort Worth, TX. Coding and auditing support of the BHCs shall be accomplished at the Naval Health Clinic Corpus Christi. Training shall be provided on-site at each of the locations listed above The facility is comprised of specialties that include Med Home Port Comfort, Med Home Port Mercy, Optometry, Flight Medicine, Internal Medicine, Occupational Health, Hearing Conversation, Physical Therapy, Mental Health and the Substance Abuse Rehabilitation Program (SARP) The contractor shall perform 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:30 AM and 4:30 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters annually as follows: Option Period 1 Option Period 2 Approximately 75,600 records Approximately 70,560 records Approximately 65,520 records 4. Auditing (remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The government will provide the audit list to the contractor at least 2 weeks prior to the audit and the contractor shall provide the records to their personnel. The contractor shall provide the results to the primary POC in the Audit Prototype (or BUMED tool of choice) within 2 weeks of receiving the list. The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 1,800 records Approximately 1,680 records Approximately 1,560 records 4.3. The contractor shall perform the audits in accordance with BUMED Instruction A to satisfy the audit requirements. In addition, the contractor shall use the government s tool of choice which is currently Global Code. The tool, along with documentation and training on the use of the tool will be provided to the contractor. The DQ audit results shall be provided to the POC by the 15th of each month. 5. Training (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training annually in accordance with the following schedule: The contractor shall provide training at Naval Health Clinic Corpus Christi as follows:

114 Page 114 of 179 Option Period 1 Option Period sessions 140 sessions 143 sessions The contractor shall provide training at Branch Health Clinic Kingsville as follows (inclusive of totals above in section ): Option Period 1 Option Period 2 25 sessions 25 sessions 26 sessions *Note: BHC Kingsville is considered an alternate work site and travel reimbursement is not authorized The contractor shall provide training at Branch Health Clinic Fort Worth as follows (inclusive of totals above in section ): Option Period 1 Option Period 2 24 sessions 24 sessions 25 sessions 6. Remote Services. Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started. 7. Travel. The government will reimburse the contractor up to $3, for reasonable travel expenses incurred while performing the duties in this task order. 8. Point of Contact Information. Primary POC: Ms. Valerie Waskow Medical Records Administrator Phone: [email protected] Secondary POC: LT Niesha Guidry Patient Administration Officer Phone: [email protected] Local Contracting Officer s Representative: Ms. Ezzie Garcia Phone: [email protected] 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Pensacola, Florida

115 Page 115 of The contractor shall provide remote inpatient and outpatient coding services, onsite outpatient auditing services, onsite and remote training services and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Pensacola, Florida. Services shall also be provided in support of the Branch Health Clinics (BHCs) in New Orleans, LA; Millington, TN; Naval Air Station (NAS), Pensacola, FL; Whiting Field, Milton, FL; Naval Air Tactical Training Center (NATTC), Pensacola, FL; Panama City, FL; Gulfport, MS; Meridian, MS; Crane, IN; Belle Chasse, LA and Navy Technical Training Center (NTTC) Corry Station, Pensacola, FL. Auditing support of the BHCs shall be accomplished at the Naval Hospital Pensacola. Training services shall be provided on-site or remotely at each of the locations listed above The facility is comprised of specialties that include Dermatology, Cardiology, Gastroenterology, Pulmonary, Substance Abuse, ENT, OB/GYN, Ophthalmology, Orthopedics, Allergist, Neurology, Mental Health, Audiology, General Surgery, Urology, Social Work, Physical Therapy, Occupational Therapy Optometry and Podiatry The contractor shall perform 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 4:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (remote) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient: The contractor shall code and perform a quality assessment review for inpatient records as follows: Option Period 1 Option Period 2 Approximately 3,825 records Approximately 3,825 records Approximately 3,825 records 3.3. Outpatient: The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 172,800 records Approximately 161,280 records Approximately 149,760 records By the 15th of each month, the contractor shall recode records listed on the Data Quality (DQ) discrepancy list. Records on the DQ discrepancy list were coded by the government but the system has identified a logic error (i.e. pediatric codes in an adult record or female only diagnosis in male record). On average, the government anticipates 165 records a month will be on the DQ discrepancy report and the level of effort for these records is approximately 3 times that of an AHLTA record. The quantity of records identified in paragraph 3.3. includes the DQ discrepancy list records In addition to the duties above, the contractor shall: Upload the Coding Abstract form into Essentris Follow the local practice for tracking records in the Composite Health Care System (CHCS) for accountability purposes Print RNDS (ROUNDS) summary document from CHCS not less than 24 hours after coding is completed in Coding Compliance Editor (CCE) on each inpatient record. 4. Auditing Service (onsite).

116 Page 116 of The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 25,200 records Approximately 23,520 records Approximately 21,840 records 5. Training Services (onsite and remote) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite and remote training services for NH Pensacola and the BHCs identified above in paragraph 1.1. as follows: Option Period 1 Option Period 2 2,387 sessions 2,435 sessions 2,483 sessions 5.3. The government s preferred method to conduct remote training is via Defense Collaboration Services (DCS). There is no cost to use this site but the host must possess a valid CAC. Please refer to the DCS website for additional information: 6. CDIS Services (onsite) 6.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Pensacola as follows: Option Period 1 Option Period 2 12 months 12 months 12 months 7. The government anticipates purchasing audio conference and webinar training from an accredited Health Information Organization for education and skill set sustainment, and to keep current with local, national and government standards. Contractor personnel shall attend when requested by the government. 8. Travel. The government will reimburse the contractor up to $15,000 or reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. 9. Point of Contact Information. Primary POC: Angel Swab Phone: [email protected] Secondary POC: Sarah Martin Medical Records Administrator Phone:

117 Page 117 of Local Contracting Officer s Representative: Ms. Willie Jackson Phone: [email protected] Mailing address: 6000 West Highway 98 Pensacola, FL Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital, Jacksonville, Florida 1.1. The contractor shall provide onsite outpatient coding services, onsite outpatient auditing services, onsite training services and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital, Jacksonville, Florida. Services shall also be provided in support of the Branch Health Clinics (BHCs) Albany, Georgia; Kings Bay, Georgia; Jacksonville, Florida; Key West, Florida; and Mayport, Florida. Coding and auditing support of the BHCs will be accomplished at the Naval Hospital Jacksonville The facility is comprised of specialties that include Mental Health, ENT, Dermatology, Pediatrics, Pain Management, General Surgery, Orthopedics, Physical Therapy, Occupational Therapy, OB-GYN, Internal Medicine, Optometry, Emergency Medicine, Gastroenterology, Primary Care, Coumadin, Cardiology, Pulmonary, Neurology, Family Medicine, Urology, Substance Abuse and Rehabilitation Program, Audiology, Podiatry, Nutrition, Ophthalmology, Wellness, Chiropractic, Hearing Conservation and Allergy The Government anticipates 1/12 th of the work ordered will be performed each month. 2. Duty Hours. Contractor personnel may work between the hours of 6:30 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. Contract employees may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the Government. 4. Medical Record Coding (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs of the Performance Work Statement in the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). Medical record coders shall code and perform a quality assessment review for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 420,000 records Approximately 392,000 records Approximately 364,000 records 5. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows:

118 Page 118 of 179 Option Period 1 Option Period 2 Approximately 18,000 records Approximately 16,800 records Approximately 15,600 records 5.3. The contractor shall also research and correct coding anomalies. These anomalies could be document/coding discrepancies, write-back errors, or other issues. 6. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide 3,672 sessions of onsite training for NH Jacksonville and the BHCs identified above in paragraph 1.1. as follows: Option 1 Option 2 3,672 sessions 3,745 sessions 3,820 sessions The contractor shall provide onsite training (these sessions are included in the total number of sessions listed above in Section 6.2.) at all locations stated in paragraph 1.1. The anticipated number of training sessions at the BHCs is: Kings Bay: 192 sessions (16 sessions on-site per month) Option sessions (17 sessions on-site per month for four months and 16 sessions on-site per month for eight months) Option sessions (17 sessions on-site per month for eight months and 16 sessions on-site per month for four months) Mayport: 832 sessions (16 sessions on-site per week) Option sessions (16 sessions on-site per week for 36 weeks and 17 sessions on-site per week for 16 weeks) Option sessions (17 sessions on-site per week for 33 weeks and 16 sessions on-site per week for 19 weeks) Albany: 64 sessions (16 sessions on-site per quarter) Option 1 65 sessions (16 sessions on-site per quarter for 3 quarters and 17 sessions on-site per quarter for one quarter.) Option 2 66 sessions (17 sessions on-site per quarter for 2 quarters and 16 sessions on-site per quarter for two quarters.) Key West: 64 sessions (16 sessions on-site per quarter) Option 1 65 sessions (16 sessions on-site per quarter for 3 quarters and 17 sessions on-site per quarter for one quarter.) Option 2 66 sessions (17 sessions on-site per quarter for 2 quarters and 16 sessions on-site per quarter for two quarters.) 7. CDIS Services (onsite)

119 Page 119 of CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide 24 months of CDIS services at NH Jacksonville as follows: Option Period 1 Option Period 2 24 months 24 months 24 months 8. Trusted Agent Sponsorship System [TASS] Registration Request form. This form, which is available from the primary POC or the local COR, must be filled out completely and accurately, and submitted with each new employee. 9. Travel. The Government will reimburse the contractor up to $8, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. 10. Point of Contact Information. Primary POC: Ms. Roylanda Brooks HIM Supervisor Phone: [email protected] Secondary POCs: LT Michelle Yarbrough Patient Administration Department Head Phone: [email protected] Local Contracting Officer s Representative: Ms. Elizabeth Sargent Phone: [email protected] Mailing address: 2080 Child Street Jacksonville, FL FAR Addendum Enclosure 3 Lot C 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Camp Lejeune, North Carolina 1.1. The contractor shall provide onsite outpatient coding services, onsite outpatient auditing services, onsite training services, and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Camp Lejeune, North Carolina. Services shall also be provided in support of the Branch Health Clinics (BHCs) Camp Johnson, NC and Camp Geiger, NC. Coding support of the BHCs shall be accomplished at the Naval Hospital Camp Lejeune. Auditing and training services shall be provided onsite at each location listed above The facility is comprised of specialties that include OB/GYN, Orthopedics, Family Practice, General Surgery, Internal Medicine and Ophthalmology.

120 Page 120 of The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 142,500 records Approximately 133,000 records Approximately 123,500 records 4. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 7,200 records Approximately 6,720 records Approximately 6,240 records 4.3. The contractor shall perform the audits in accordance with BUMED Instruction A to satisfy the audit requirements. In addition, the contractor shall use the government s tool of choice which is currently Global Code. The government will provide the tool, along with documentation and training on the use of the tool. The DQ audit results shall be provided to the POC by the 15th of each month. 5. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NH Camp Lejeune and the BHCs identified above in paragraph 1.1. as follows: Option Period 1 Option Period 2 Approximately 796 sessions Approximately 812 sessions Approximately 828 sessions 6. CDIS Services (onsite) 6.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Camp Lejeune as follows:

121 Page 121 of 179 Option Period 1 Option Period 2 48 months 48 months 48 months 7. Point of Contact Information. Primary POC: Ms. Loretta Srp Coding Supervisor Phone: [email protected] Alternate POC: LT Renardis Banks Patient Administration Officer Phone: [email protected] Local Contracting Officer s Representative: Mr. Jose Rodriguez-Malave Phone: [email protected] Mailing address: 100 Brewster Blvd Camp Lejeune, NC Description of Services. Performance Work Statement Medical Records Coding Services Naval Health Clinic, Cherry Point, North Carolina 1.1. The contractor shall provide onsite and remote outpatient coding services, onsite outpatient auditing services and onsite training services at the Naval Health Clinic, Cherry Point, North Carolina The facility is comprised of specialties that include Marine Centered Care, Homeport (Family Medicine, Pediatrics), Immunizations, Women's Health, Surgical Services (General, ENT, Podiatry, Orthopedics), Optometry, Mental Health, Primary Care, Internal Medicine, Wellness, Physical Therapy, Occupational Therapy, Chiropractic Clinic and Occupational Health The Government anticipates 1/12 th of the work ordered will be performed each month. 2. Duty Hours. Contractor personnel may work between 6:00 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. Contract employees may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the Government. 3. Minimum Personnel Requirements Contract employees shall maintain current certification in American Heart Association Basic Life Support (BLS). 4. Medical Record Coding (onsite and remote).

122 Page 122 of The contractor personnel shall perform the duties prescribed in paragraph and associated subparagraphs in the Performance Work Statement of the basic contract Outpatient (onsite): The contractor shall code any outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters annually as follows: Option 1 Option 2 Approximately 77,280 records Approximately 72,128 records Approximately 66,796 records 4.3. Outpatient (remote): the contractor shall code and perform a quality assessment review for outpatient records as follows: Option 1 Option 2 Approximately 15,000 records Approximately 14,000 records Approximately 13,000 records 4.4. The contractor shall perform the following duties in addition to the basic contract: Provide advice/feedback to members of the patient care team regarding documentation and coding guidelines, including attending physicians, allied health practitioners, nursing, and case management on a daily basis. The contractor shall include information regarding this in the monthly audit report The medical records coders shall keep the Alternate POC informed when following the policy set forth in BUMED memo 6000 Ser M3/5 HCO3 AT dtd 9 Feb 12, Subj: Requirement to Correct Codes When Reviewed By Coder/Auditors and Found to be Inaccurate. 5. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option 1 Option 2 Approximately 17,820 records Approximately 16,632 records Approximately 15,444 records 5.3. The contractor shall perform the audits in accordance with BUMED Instruction A to satisfy the audit requirements. In addition, the contractor shall use the government s tool of choice which is currently Global Code. The government will provide the tool, along with documentation and training on the use of the tool. The DQ audit results shall be provided to the POC by the 15th of each month. 6. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NHC Cherry Point as follows: Option 1 Option sessions 449 sessions 458 sessions

123 Page 123 of The Government will develop an auditing schedule and provide the records to be audited. At the Government s discretion, this responsibility by be delegated to the contractor. The results of the audit shall be provided to the government primary POC. 8. Remote Services. Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started. 9. Travel. The Government will reimburse the contractor up to $7,500 for reasonable travel expenses incurred while performing the duties in this task order in accordance with the Joint Travel Regulation. 10. Point of Contact Information. Primary POC: Ms. Cindy Godley Coding Manger Phone: [email protected] Alternate POC: LT Silas Spain Patient Administration Officer Phone: [email protected] Local Contracting Officer s Representative: Ms. Theresa Barbato Phone: [email protected] Mailing address: 4389 Beaufort Road PSC Box 8023 Cherry Point, NC Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Beaufort, South Carolina 1.1. The contractor shall provide onsite Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Beaufort, SC The facility is comprised of specialties that include Behavioral Health, Family Practice, Internal Medicine, Pediatrics, Oral and Maxillo-Facial Surgery, Orthopedics, Physical Therapy, Radiology and Urgent Care The contractor shall perform 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 4:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. CDIS Services (onsite)

124 Page 124 of CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Beaufort as follows: Option Period 1 Option Period 2 12 Months 12 Months 12 Months 4. Point of Contact Information. Local Contracting Officer s Representative: Ms. Deborah Meaut Phone: (843) [email protected] Mailing address: 1 Pinckney Blvd Beaufort, SC FAR Addendum Enclosure 4 Lot D 1. Description of Services. Performance Work Statement Medical Records Coding and Auditing Services Navy Medicine Military Treatment Facilities Within the Navy Medicine East Area of Responsibility 1.1. The contractor shall provide remote inpatient and outpatient coding services and remote inpatient auditing services for any Navy Medicine Military Treatment Facility within the Navy Medicine East Area of Responsibility (AOR). For a list of commands within this AOR, please refer to The intent of this task order is to provide immediate remote coding and auditing services to the MTFs as needed Immediately upon award, the contractor shall contact the government primary POC listed in paragraph 4 below to identify the government representative who will support this effort. This individual will work with the contractor to establish accounts in the respective government systems to streamline the start of services The primary or secondary government POC will typically notify the contractor a week in advance with the details of the assignment. The details include the MTF in need of service, the quantity and type of records to be coded and/or audited and the timeframe to complete the assignment The contractor shall use contractor furnished equipment to provide remote service via an Application Virtualization Hosting Environment (AVHE) solution. The contractor shall furnish all required equipment to support this solution to include a Common Access Card (CAC) reader. 2. Medical Record Coding Services (remote) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract.

125 Page 125 of Inpatient: The average length of stay is between 3 and 4 days. The contractor shall code and perform a quality assessment review for inpatient records as follows: Option Period 1 Option Period 2 Approximately 1,050 records Approximately 1,050 records Approximately 1,050 records 2.3. Outpatient: The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient records as follows: Option Period 1 Option Period 2 Approximately 750 records Approximately 700 records Approximately 650 records 3. Auditing (remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The government will provide the audit list to the contractor at least 2 weeks prior to the audit. The contractor shall audit inpatient records as follows: Option Period 1 Option Period 2 Approximately 180 records Approximately 180 records Approximately 180 records 4. Point of Contact Information. Primary POC: LT Derek Hoffman NME Region Patient Administration Officer Phone: [email protected] Secondary POC: Ms. Camille Cunningham-West NME Region Medical Records Administrator Phone: [email protected] 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Medical Center Portsmouth, Virginia 1.1. The contractor shall provide remote inpatient coding services, onsite and remote outpatient coding services, onsite outpatient auditing services, onsite training services, and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Medical Center Portsmouth, VA. Services shall also be provided in support of Branch Health Clinics (BHCs) Boone, Virginia Beach, VA; TRICARE Prime Clinic (TPC), Chesapeake, VA; Dam Neck, Virginia Beach, VA; Portsmouth Shipyard, VA; Naval Dental Clinic, Norfolk, VA; Northwest, Chesapeake, VA; TPC Northwest, Chesapeake, VA; Oceana, Virginia Beach, VA; Naval Station Norfolk (Sewells Point), Norfolk, VA, TPC Virginia Beach, VA; and Naval Weapons Station, Yorktown, VA. All onsite services shall be performed at NMC Portsmouth.

126 Page 126 of The facility is comprised of specialties that includes, but is not limited to Internal Medicine, Dermatology, Physical Medicine, General Surgery, Ophthalmology, Optometry, ENT, Pediatrics, Orthopedics, Behavioral Health, Substance Abuse, Family Practice, Primary Care, Audiology, Occupational Therapy and Physical Therapy The contractor shall perform 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 6:00 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (onsite and remote) The contractor shall perform the duties prescribed in paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient (remote): The contractor shall code and perform a quality assessment review for inpatient encounters as follows: Option Period 1 Option Period 2 Approximately 7,500 records Approximately 7,500 records Approximately 7,500 records 3.3. Outpatient (onsite and remote): The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters as follows: Onsite: Option Period 1 Option Period 2 Approximately 114,000 records Approximately 106,400 records Approximately 98,800 records Remote: Option Period 1 Option Period 2 Approximately 66,000 records Approximately 61,600 records Approximately 57,200 records The government anticipates 50% of the AHLTA records to be for Labor and Delivery (L&D) visits that are documented in Essentris. The process to obtain the L&D documentation will increase the coding level of effort by approximately 20%. 4. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 8,100 records Approximately 7,560 records Approximately 7,020 records 5. Training Services (onsite).

127 Page 127 of Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NMC Portsmouth and the BHCs identified above in paragraph 1.1. as follows: Option Period 1 Option Period sessions 499 sessions 509 sessions 6. CDIS Services (onsite) CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NMC Portsmouth as follows: Option Period 1 Option Period 2 96 months 96 months 96 months 7. This MTF has additional health and security requirements than those stated in the contract. Please see the local Contracting Officer s Representative for more information. 8. Point of Contact Information. Primary POC: Ms. Lisa Rosenthal Outpatient Coding Supervisor Phone: [email protected] Secondary POC: LCDR Brent Casady Patient Administration Department Head Phone: [email protected] Local Contracting Officer s Representative: Bryan Butler Phone: [email protected] Mailing address: 620 John Paul Jones Circle Portsmouth, VA FAR Addendum Enclosure 5 Lot E 1. Description of Services. Performance Work Statement Outpatient Medical Records Coding Services Naval Health Clinic New England

128 Page 128 of The contractor shall provide onsite outpatient coding services, onsite outpatient auditing services and onsite training services for Naval Health Clinic New England. Services shall be provided at the following Naval Health Clinic (NHC) New England sites: NHC New England (Newport, RI); NBHC Groton, CT; Naval Branch Health Clinic (NBHC) Portsmouth, NH. The contractor shall also provide services in support of NBHC Saratoga Springs, NY. Auditing and training services shall be provided onsite at NHC New England (Newport, RI), NBHC Groton, CT and NBHC Portsmouth, NH The facility is comprised of specialties that include Internal Medicine, Dermatology, Physical Medicine, General Surgery, Ophthalmology, Optometry, ENT, Pediatrics, Orthopedics, Behavioral Health, Substance Abuse, Family Practice, Primary Care, Audiology, Occupational Therapy and Physical Therapy The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The contractor shall provide services from 6:00 AM and 6:00 PM Monday through Friday and between 7:30 AM and 4:00 PM on Saturdays. Services are not required on Sundays or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient records as follows: Option Period 1 Option Period 2 Approximately 207,692 records Approximately 193,845 records Approximately 179,999 records 4. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 6,300 records Approximately 5,880 records Approximately 5,460 records 5. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NHC New England and the NBHCs identified above in paragraph 1.1. as follows: Option Period 1 Option Period sessions 849 sessions 866 sessions

129 Page 129 of The contractor shall also provide onsite training services (included in the total sessions listed above in Section 5.2..) onsite at Groton, CT and Portsmouth, NH as indicated below. Groton, CT is considered an Alternate Work Site and mileage is not reimbursable. The contractor shall divide the sessions of training as follows: Newport, RI/Groton, CT: 59 sessions for 8 months and 60 sessions for 4 months. Option Period 1 61 sessions for 11 months and 58 sessions for one month. Option Period 2 62 sessions for 11 months and 64 sessions for one month. Portsmouth, NH: Option Period 1 Option Period 2 10 sessions monthly 10 sessions monthly 10 sessions monthly 6. Travel. The government will reimburse the contractor up to $4, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. 7. Point of Contact Information: Primary POC and Local Contracting Representative: Ms. Altamese Harley Contract Technical Liaison/Supervisor, Managed Care Phone: [email protected] Secondary POC: Mr. John Kamishlian Patient Administration Department Head Phone: [email protected] 1. Description of Services. Performance Work Statement Medical Records Coding Services James A. Lovell Federal Health Care Center, North Chicago, Illinois 1.1. The contractor shall provide onsite outpatient coding services, onsite outpatient auditing services and onsite training services at the James A. Lovell Federal Health Care Center, North Chicago, IL (JALFHCC). Services shall also be provided in support of the Branch Health Clinics (BHCs) USS Tranquility (1007); USS Red Rover (1523), Zachary & Elizabeth Fisher (237) and the USS Weeden Osborne (1017) which are all located in Great Lakes, Illinois. Coding, auditing and training support of the BHCs shall be accomplished at the JALFHCC The facility is comprised of specialties that include Internal Medicine, OB/GYN, Physical Medicine, Optometry, Pediatrics, Orthopedics, Podiatry, Behavioral Health, Substance Abuse, Family Practice, Primary Care, Audiology and Physical Therapy The contractor shall perform 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 4:00 PM Monday through Friday. Services are not required on weekends and federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Minimum Personnel Requirements.

130 Page 130 of All contract employees at this FHCC are considered essential and will receive a letter from the command assigning this designation. Refer to the primary POC noted below for additional information established by the command. 4. Medical Record Coding (onsite) The contractor shall perform the duties prescribed in paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters as follows: Option Year 1 Option Year 2 Approximately 90,000 records Approximately 84,000 records Approximately 78,000 records 5. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Year 1 Option Year 2 Approximately 14,400 records Approximately 13,440 records Approximately 12,480 records 6. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for the James A. Lovell Federal Health Care Center and the BHCs identified above in paragraph 1.1. as follows: Option Year 1 Option Year 2 1,469 sessions 1,498 sessions 1,528 sessions 6. Point of Contact Information. Primary POC: Ms. Marsha Nielsen Health Information Management Division Officer Phone: [email protected] Secondary POC: Mr. Todd Adkins Deputy Department Head Phone: [email protected] Local Contracting Officer s Representative: Ms. Vicki Bunch

131 Page 131 of 179 Phone: Mailing address: 3001 Green Bay Road North Chicago, IL FAR Addendum Enclosure 6 Lot F 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Bremerton, Washington 1.1. The contractor shall provide onsite outpatient coding services, onsite outpatient auditing services, onsite training services, and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Bremerton, Washington. Services shall also be provided in support of the Branch Health Clinics (BHC) Bangor, WA; Everett, WA and Puget Sound Naval Station, WA. Support of the BHCs shall be accomplished at the Naval Hospital Bremerton The facility is comprised of specialties that include family practice, internal medicine, ENT, pediatric care, orthopedics, physical therapy, general surgery, obstetrics/gynecology, chiropractic, mental health, substance abuse, social work, nutrition, ophthalmology/optometry, urology, audiology and anesthesia The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 4:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding Services (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code and perform a quality assessment review of AHLTA records as follows: Option Year 1 Option Year 2 Approximately 43,380 records Approximately 40,488 records Approximately 37,596 records 4. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Year 1 Option Year 2 Approximately 6,300 records Approximately 5,880 records Approximately 5,460 records

132 Page 132 of The contractor shall perform the audits in accordance with BUMED Instruction A to satisfy the audit requirements. In addition, the contractor shall use the government s tool of choice which is currently Global Code. The government will provide the tool, along with documentation and training on the use of the tool. The DQ audit results shall be provided to the POC by the 15th of each month. 5. Training Services (onsite) Training shall be provided in accordance paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training sessions for NH Bremerton and the BHCs identified above in paragraph 1.1. as follows: Option Year 1 Option Year 2 Approximately 796 sessions Approximately 812 sessions Approximately 828 sessions 6. CDIS Services (onsite) 6.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Bremerton as follows: Option Year 1 Option Year 2 24 months 24 months 24 months 7. Point of Contact Information. Primary POC: Beverly Harris Coding Supervisor Phone: [email protected] Secondary POC: LT Andrew Rutledge Patient Administration Officer Phone: [email protected] Local Contracting Officer s Representative: Dora Herman Phone: [email protected] Mailing address: 1 Boone Road Bremerton, WA Performance Work Statement Medical Records Coding, Auditing and Training Services Naval Health Clinic Hawaii

133 Page 133 of Description of Services The contractor shall provide onsite outpatient coding services, onsite outpatient auditing services and onsite training services at the Naval Health Clinic Hawaii. Services shall also be provided at the Branch Health Clinics (BHC) at Makalapa, Kaneohe Bay, Wahiawa, Camp Smith and the Occupational Health Clinic (Pearl Harbor). All facilities under this Performance Work Statement are located on the island of Oahu The facility is comprised of specialties that include Primary Care, Pediatric Care, Optometry, Occupational Health, Dermatology, Gynecology, Physical Therapy, Chiropractic and Mental Health Care. 2. Duty Hours. The hours of operation are from 05:00 AM and 4:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform quality assessment reviews for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 9,900 records Approximately 9,240 records Approximately 8,580 records 3.3. The government has a Coder Provider Feedback Session consistent with the duties identified in paragraph , particularly and of the Performance Work Statement in the basic contract. For the Coder Provider Feedback Session, the contractor shall work at an alternate work site to provide feedback and advice to providers in their clinical work space. The interaction with the providers is not on a preset schedule and involves the contractor seeking out the providers when available; thus requiring the contractor to be in the provider s work space. The workstation at the alternate work site is configured to allow the contractor to code records when not interacting with providers. These alternate work sites are within local commuting distance and do not require travel reimbursement The contractor shall print out one encounter from each provider and meet with a provider between patients to discuss. The contractor shall discuss the encounter, discuss the guidelines used to code the encounter and provide feedback to the provider on ways to improve their documentation/coding. 4. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 5,040 records Approximately 4,704 records Approximately 4,368 records 5. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract.

134 Page 134 of The contractor shall provide onsite training at the NHC Hawaii as follows: Option 1 Option sessions 499 sessions 509 sessions The contractor shall provide 32 sessions, annually, (included in the 490 sessions) of training in accordance with the following schedule: Makalapa Medical Home Clinics 8 sessions on the scheduled day and time. This alternate work site is within commuting distance of the coding office and does not require travel reimbursement. Option 1 Option 2 8 sessions 8 sessions 8 sessions Kaneohe Bay Medical Home Clinic 8 sessions on the scheduled day and time. This location is 22 miles away from the MTF. This alternate work site is within commuting distance of the coding office and does not require travel reimbursement. Option 1 Option 2 8 sessions 8 sessions 8 sessions Camp Smith Clinic 8 sessions on the scheduled day and time. This location is 15 miles away from the MTF. This alternate work site is within commuting distance of the coding office and does not require travel reimbursement. Option 1 Option 2 8 sessions 8 sessions 8 sessions Wahiawa Clinic 8 sessions on the scheduled day and time. This location is 36 miles away from the MTF. This alternate work site is within commuting distance of the coding office and does not require travel reimbursement. Option 1 Option 2 8 sessions 8 sessions 8 sessions 6. Travel. The government will reimburse the contractor up to $5, for reasonable travel expenses incurred while providing services under this contract in accordance with the JTR. 7. Point of Contact Information. Primary POC: Ms. Nemy Membrere Healthcare Business Department Head Phone: x [email protected] Secondary POC: Ms. Maria AC Valencia Coding Program Manager Phone: x 91251

135 Page 135 of Local Contracting Officer s Representative: Mr. Alan Winters Phone: x [email protected] Mailing address: 480 Central Avenue Joint Base Pearl Harbor, HI Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Lemoore, California 1.1. The contractor shall provide onsite outpatient coding services, remote outpatient auditing services and onsite training services at the Naval Hospital Lemoore, California. Services shall also be provided in support of the Branch Health Clinic (BHC) Fallon, Nevada The facility is comprised of specialties that include General Surgery, OB/GYN, Pediatric Care, Orthopedics, Chiropractic, Mental Health, Substance Abuse Rehabilitation Program (SARP), Family Practice, Deployment Health, Primary Care OPS, Occupational Health, Preventive Medicine, Flight, Physical Therapy, Same Day Surgery (SDS) General Surgery, SDS Orthopedics and SDS Obstetrics The contractor shall perform 1/12th of the work each month. 2. Duty Hours. The hours of operation are from 6:00 AM and 6:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Outpatient Medical Record Coding (on-site) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform quality assessment reviews for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 84,000 records Approximately 78,400 records Approximately 72,800 records 3.3. The contractor shall ensure the patient encounter is pushed through Coding Compliance Editor (CCE) and shows up on the CCE Productivity Report. 4. Auditing Service (remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows:

136 Page 136 of 179 Option Period 1 Option Period 2 Approximately 7,200 records Approximately 6,720 records Approximately 6,240 records 5. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NH Lemoore and the BHCs identified above in paragraph 1.1. as follows: Option Period 1 Option Period sessions 712 sessions 726 sessions 6. Remote Services. Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started. The POC will not be involved with the establishment or sustainment of remote services; therefore, the contractor shall be onboard to start and maintain this services when approved in advanced by the government. 7. Travel. The government will reimburse the contractor up to $5, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. The government anticipates the contractor traveling quarterly to BHC, Fallon, NV. 8. Point of Contact Information: Primary POC: LTMichael Sokolowski Patient Administration Department Head Phone: [email protected] Secondary POC: Hector Ramos Coding Supervisor Phone: [email protected] Local Contracting Officer s Representative: Ms. Margaret Allison Phone: [email protected] Mailing address: 937 Franklin Avenue Lemoore, Performance Work Statement Medical Records Coding Services Naval Hospital Oak Harbor, Washington

137 Page 137 of Description of Services The contractor shall provide onsite outpatient coding services, remote outpatient auditing services, onsite training services and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Oak Harbor The facility is comprised of specialties that include Internal Medicine, Orthopedics, Surgical Services, Pediatrics, Family Medicine, Mental Health, Aviation Medicine, Physical Therapy, Internal Medicine and OB/GYN The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding Services (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 56,660 records Approximately 52,882 records Approximately 49,105 records 4. Auditing Service (remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 5,040 records Approximately 4,704 records Approximately 4,368 records 5. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NH Oak Harbor as follows: Option Period 1 Option Period sessions 649 sessions 662 sessions 6. CDIS Services (onsite) 6.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide 12 months of CDIS services at NH Oak Harbor as follows:

138 Page 138 of 179 Option Period 1 Option Period 2 12 months 12 months 12 months 7. Point of Contact Information: Primary POC: LT Jesse Pendergrass Patient Administration Department Head Phone: [email protected] Alternate POC: LT Edward Macie Patient Administration Assistant Department Head Phone: [email protected] Local Contracting Representative: Mr. Robert Digirolamo Phone: [email protected] Mailing address: 3475 North Saratoga Street Building 993 Oak Harbor, WA FAR Addendum Enclosure 7 Lot G 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Camp Pendleton, California 1.1. The contractor shall provide on-site inpatient and outpatient coding services, onsite outpatient auditing services, onsite training services, and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Camp Pendleton, California. Services shall also be provided in support of the Area Branch Health Clinics (ABHCs) 13, 21, 31, and 52 on the Marine Corps Base; the Family Medicine Oceanside Clinic (FMOC); BHCs Barstow, and Yuma AZ; and BHCs Point Hueneme and Point Mugu located on Naval Base Ventura County. Auditing and training support of the BHCs shall be accomplished on-site at the facility, with the exception of BHCs Yuma, AZ and the BHCs located on Naval Base Ventura County. Auditing and training services for these locations shall be provided at Naval Hospital Camp Pendleton. All other services under this task order shall be provided at the Naval Hospital Camp Pendleton, CA The facility is comprised of specialties that include Mental Health, ENT, Dermatology, Pediatrics, Surgical Clinic, Orthopedics, Physical Therapy, Occupational Therapy, Occupational Health, OB-GYN, Internal Medicine, Optometry, Emergency Medicine, Acute Care, Gastroenterology, Primary Care, Family Medicine, Allergy, Audiology, Cardiology, Case Management, Chiropractic, Community Health, Flight Medicine, Hearing Conservation, Immunizations, Neurology, Nutrition, Ophthalmology, Periodic Health Assessment, Pharmacy Care Clinic, Pulmonary, Substance Abuse, Social Work, Sports Medicine, Traumatic Brain Injury (TBI) Pain Management, TBI Speech Pathology, TBI Vestibular, Urology, Women s Clinic and Wounded Warrior Clinic The contractor shall provide 1/12 th of the work each month.

139 Page 139 of Duty Hours. The hours of operation are from 7:00 AM and 6:00 PM Monday through Friday. Services are not required on federally observed holidays. 3. Medical Record Coding Services (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient: The contractor shall code and perform a quality assessment review of inpatient records as follows: Option 1 Option 2 Approximately 4,500 records Approximately 4,500 records Approximately 4,500 records 3.3. The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient records as follows: Option 1 Option 2 Approximately 78,804 records Approximately 73,550 records Approximately 68,297 records 4. Auditing Service (onsite) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option 1 Option 2 Approximately 6,300 records Approximately 5,880 records Approximately 5,460 records 5. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NH Camp Pendleton and the BHCs identified above in paragraph 1.1. as follows: Option 1 Option 2 Approximately 796 sessions Approximately 812 sessions Approximately 828 sessions 6. CDIS Services (onsite) 6.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Camp Pendleton as follows: 796 months Option months Option months

140 Page 140 of Point of Contact Information. Primary POC (Jan-Aug): LT April Allen Patient Administration Department Head Phone: Primary POC (Aug-Dec): LT Paul Kim Acting Patient Administration Department Head Phone: Phone: Secondary POC: Ms. Helen Drake Medical Records Administrator Phone: Local Contracting Officer s Representative: Mr. Allen Powers Phone: [email protected] 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Twenty-Nine Palms, California 1.1. The contractor shall provide remote inpatient coding services, onsite outpatient coding services, onsite outpatient auditing services, remote inpatient and outpatient auditing services, onsite and remote training and CDIS services at the Naval Hospital Twenty-Nine Palms, California. Services shall also be provided in support of the Branch Health Clinics (BHCs) Bridgeport, CA and China Lake, CA. Coding support of the BHCs shall be performed at the Naval Hospital Twenty-Nine Palms. Auditing and training services shall be provided onsite at the BHCs twice per year The facility is comprised of specialties that include OB/GYN, Pediatrics Medical Home Clinic, Internal Med, Labor and Delivery, General Surgery, Orthopedics, Chiropractic s, Adult Care Clinic, Military Physicals, Optometry (China Lake and 29 Palms), Occupational Health (China Lake and 29 Palms), Audiology (China Lake and 29 Palms), Physical Therapy (China Lake and 29 Palms), Breast Clinic, Dietetic Clinic, Hearing Conservation (China Lake and 29 Palms), Family Practice (China Lake and 29 Palms), Aviation Medicine (China Lake) Coleville Clinic (Bridgeport), Primary Care (Bridgeport and China Lake), Mental Health, Deployment Health, Audiology, Population Health, Occupational Health and Emergency Medicine The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The contractor shall provide services from 7:00 AM and 4:30 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times

141 Page 141 of 179 noted to manage any backlog at no change in price and with prospective approval from the government. The auditor/trainer services shall be flexible throughout the week to accommodate the provider's schedule. 3. Medical Record Coding (onsite and remote) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient Coding (remote): The contractor shall code and perform a quality assessment review for inpatient records as follows: Option Period 1 Option Period 2 Approximately 192 records Approximately 192 records Approximately 192 records 3.3. Outpatient Coding (onsite): The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 178,578 records Approximately 166,673 records Approximately 154,768 records 4. Auditing Service (onsite and remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Outpatient (onsite): The contractor shall audit government coded outpatient records as follows: Approximately 7,560 records Option Period 1 Approximately 7,056 records Option Period 2 Approximately 6,552 records 4.3. Outpatient (remote): The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 180 records Approximately 168 records Approximately 156 records 4.4. Inpatient (remote): The contractor shall audit government coded inpatient records as follows: Option Period 1 Option Period 2 Approximately 360 records Approximately 360 records Approximately 360 records 5. Training Services (onsite and remote) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide training for NH Twenty-Nine Palms and the BHCs identified above in paragraph 1.1. as follows: Option Period sessions (43 sessions of outpatient training and 10 sessions of inpatient training each month. 649 sessions (44 sessions of outpatient training each month and 10 sessions of inpatient

142 Page 142 of 179 Option Period 2 training each month except one month will have 11 sessions of inpatient training). 662 sessions (45 sessions of outpatient training each month and 10 sessions of inpatient training each month except two months will have 11 sessions of inpatient training) When providing training remotely, the government s preferred method is via Defense Collaboration Services (DCS). There is no cost to use this site but the host must possess a valid CAC. Please refer to the DCS website for additional information: 6. CDIS Services (onsite) 6.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Twenty-Nine Palms as follows: Option Period 1 Option Period 2 12 months 12 months 12 months 7. Remote Services. Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started. 8. Travel. The government will reimburse the contractor up to $2, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. 9. Point of Contact Information. Primary POC: LTJG Ryan Rigby Patient Administration Department Head Phone: [email protected] Secondary POC: Mr. Sheldon Trowbridge Medical Records Administrator Phone: Sheldon.R;[email protected] Local Contracting Officer s Representative: Ms. Ann Denslow Phone: [email protected] Mailing address: MAGTFTC MCAGCC Box Twenty-Nine Palms, CA Performance Work Statement Medical Records Coding Services Naval Medical Center San Diego, California

143 Page 143 of Description of Services. The contractor shall provide onsite inpatient and outpatient coding services and Clinical Documentation Improvement Specialist (CDIS) services at Naval Medical Center San Diego, CA. 2. Duty Hours. The hours of operation are from 7:00 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding Services (onsite) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient (onsite): The contractor shall code and perform a quality assessment review for inpatient records as follows: Option Period 1 Option Period 2 Approximately 7,230 records Approximately 7,230 records Approximately 7,230 records 3.3. Outpatient (onsite): The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review of outpatient records as follows: Option Period 1 Option Period 2 Approximately 50,610 records Approximately 47,236 records Approximately 43,862 records 4. CDIS Services (onsite) 4.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NMC San Diego as follows: Option Period 1 Option Period 2 60 months 60 months 60 months 5. Point of Contact Information. Primary POC: Ruth Finkelstein Medical Records Administrator Phone: [email protected] Alternate POC: Elizabeth Allen Coding Supervisor Phone: [email protected] Mailing address: Bob Wilson Drive San Diego, CA FAR Addendum Enclosure 8 Lot H

144 Page 144 of 179 Performance Work Statement Medical Records Coding Services Naval Hospital Guam 1. Description of Services The contractor shall provide remote inpatient and outpatient coding services, onsite outpatient coding services, remote inpatient and outpatient auditing services, onsite training services and Clinical Documentation Improvement services at the Naval Hospital Guam (Agana Heights, Guam). Services shall also be provided in support of the Branch Health Clinic (BHC) Santa Rita, Guam. 1.2 The facility is comprised of specialties that include Audiology, Breast Care, Case Management, Community Health, Dermatology, Emergency Medicine, Family Medicine, General Surgery, Hearing Conservation, Immunizations, Internal Medicine, Mental Health, Nutrition, OB-GYN, Orthopedics, Occupational Health, Occupational Therapy, Ophthalmology, Optometry, Pediatrics, Physical Therapy, Pulmonary, Substance Abuse and Urology. 2. Duty Hours. The hours of operation are from 7:30 AM and 5:30 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Record Coding (remote) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient: The contractor shall code and perform a quality assessment review for inpatient records as follows: Option 1 Option 2 Approximately 3,240 records Approximately 3,240 records Approximately 3,240 records 3.3. Outpatient: The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment for outpatient records as follows: Option 1 Option 2 Approximately 33,609 records Approximately 31,368 records Approximately 29,128 records 4. Medical Record Coding (onsite) 4.1. The contractor shall research/correct coding anomalies. These anomalies could be document/coding discrepancies, write-back errors, etc. The contractor shall code outpatient records as follows: Option 1 Option 2 Approximately 21,690 records Approximately 20,244 records Approximately 18,798 records 5. Auditing Service (remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows:

145 Page 145 of 179 Option 1 Option 2 Approximately 9,000 records Approximately 8,400 records Approximately 7,800 records 5.3. The contractor shall audit government coded inpatient records as follows: Approximately 315 records Option 1 Approximately 315 records Option 2 Approximately 315 records 6. Training Services (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training for NH Guam and the BHCs identified above in paragraph 1.1. as follows: 98 sessions Option sessions Option sessions 7. CDIS Services (onsite) 7.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Guam as follows: Option Period 1 Option Period 2 12 months 12 months 12 months 8. Remote Services. Remote services shall be provided in Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started. 9. Travel. The government will reimburse the contractor up to $22, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. 10. Point of Contact Information. Primary POC: LT Monique Overfield Patient Administration Department Head Phone: to [email protected] Alternante POC : Mr. Kurt Mathews Phone: [email protected] Local Contracting Officer s Representative: Ms. Jesusa Larrew Phone :

146 Page 146 of [email protected] Mailing Address : 1 Farernholt Road, Building 50 Agana Heights, Guam Performance Work Statement Medical Records Coding Services Naval Hospital Guantanamo Bay, Cuba 1. Description of Services. The contractor shall provide remote inpatient and outpatient coding services, remote outpatient auditing services and onsite training services at the Naval Hospital Guantanamo Bay, Cuba. 2. Medical Record Coding (remote) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient: The contractor shall code and perform a quality assessment review for inpatient encounters as follows: Option Period 1 Option Period 2 Approximately 180 records Approximately 180 records Approximately 180 records 2.3. Outpatient: The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 14,100 records Approximately 13,160 records Approximately 12,220 records 3. Auditing Services (remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 2,160 records Approximately 2,016 records Approximately 1,872 records 4. Training Service (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide onsite training annually as follows: Option Period 1 Option Period sessions 166 sessions 170 sessions

147 Page 147 of Remote Services. Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started. 6. Travel. The government will reimburse the contractor up to $8, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. 7. Point of Contact Information. Primary POC: LTJG Jenniffer Rajner Patient Administration Officer Phone: Secondary POC: Mr. Ray Campbell Medical Records Administrator Phone: Local Contracting Representative: LT Jenny Frasco Phone: Mailing Address: U.S. Naval Hospital Box 11 FPO AE Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Okinawa, Japan 1.1. The contractor shall provide onsite inpatient and outpatient coding services and Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Okinawa. Services shall also be provided in support of the Branch Health Clinics (BHCs) Kinser, Marine Corp Air Station (MCAS) Futenma, Evans/ Camp Foster, Camp Courtney, Camp Hansen, and Camp Lester. All onsite services shall be performed at NH Okinawa The facility is comprised of specialties that include Dermatology, Gastroenterology, Mental Health, Neurology, Obstetrics/Gynecology, Occupational Medicine, Ophthalmology, Optometry, Otorhinolaryngology, Orthopedics, Pain Clinic, Pediatrics, Physical Therapy/OT, Podiatry, Preventive Medicine, Radiology, Pulmonary and Urology The contractor shall perform 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. 3. Medical Records Coding Services (onsite).

148 Page 148 of The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient: The contractor shall code and perform a quality assessment review for inpatient records as follows: Option Period 1 Option Period 2 Approximately 5,850 records Approximately 5,850 records Approximately 5,850 records 3.3. Outpatient: The contractor shall code and perform a quality assessment review outpatient encounters as follows: Option Period 1 Option Period 2 Approximately 52,500 records Approximately 49,000 records Approximately 45,500 records 4. CDIS Services (onsite) 4.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Okinawa as follows: Option Period 1 Option Period 2 24 months 24 months 24 months 5. Relocation: The government will reimburse the contractor for relocation expenses in accordance with the JTR and as stated on page 61of this solicitation (Relocation Costs). 6. Point of Contact Information. Primary POC: LT Yen Guckeyson Patient Administration Department Head Phone: [email protected] Alternate POC: LT Marc Haines Patient Administration Assistant Department Head Phone: [email protected] Local Contracting Officer s Representative: Ms. Carolyn Matsuda Phone: [email protected] Mailing address: PSC 482, Box 250 FPO AP

149 Page 149 of 179 Performance Work Statement Medical Records Coding Services Naval Hospital Yokosuka, Japan 1. Description of Services The contractor shall provide onsite inpatient and outpatient coding services, onsite outpatient auditing services, remote inpatient auditing services, onsite inpatient and outpatient training services, and onsite Clinical Documentation Improvement Specialist (CDIS) services at the Naval Hospital Yokosuka. Services shall also be provided in support of the Branch Health Clinics (BHCs) Atsugi, BHC Chinhae, BHC Diego Garcia, BHC Iwakuni and BHC Sasebo The facility is comprised of specialties that include Family Practice, Pediatrics, Internal Medicine, General Surgery, OB/GYN, ENT, Dermatology and Orthopedics/Podiatry The contractor shall provide 1/12 th of the work each month. 2. Duty Hours. The hours of operation are from 7:00 AM and 5:00 PM Monday through Friday. Services are not required on weekends or federally observed holidays. The contractor may provide services outside the times noted to manage any backlog at no change in price and with prospective approval from the government. Training service hours may need to fluctuate to meet the needs of the providers and to travel to outlying Branch Health Clinics. 3. Medical Record Coding Services (on-site) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Inpatient: The contractor shall code and perform a quality assessment review for inpatient records as follows: Option Period 1 Option Period 2 Approximately 3,600 records Approximately 3,600 records Approximately 3,600 records Outpatient: The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient records as follows: Option Period 1 Option Period 2 Approximately 8,640 records Approximately 8,064 records Approximately 7,488 records 4. Auditing Service (on-site and remote) The audit shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Outpatient (on-site): The contractor shall code any outpatient record presented. The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 6,300 records Approximately 5,880 records Approximately 5,460 records 4.3. Inpatient (remote): The contractor shall audit government coded inpatient records as follows:

150 Page 150 of 179 Option Period 1 Option Period 2 Approximately 360 records Approximately 360 records Approximately 360 records 5. Training Services (onsite) Training services shall be provided annually, consistent with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract. Training sessions shall be provided as follows: Total Training Sessions: Option Period 1 Option Period sessions 999 sessions 1,019 sessions Outpatient Training Services (onsite). The contractor shall provide outpatient training (included in the total number of training sessions listed above in section ). Training shall be provided for NH Yokosuka and the BHCs identified above in paragraph 1.1. as follows: Outpatient Training Sessions: Option Period 1 Option Period sessions 815 sessions 831 sessions Inpatient Training Services (onsite). The contractor shall provide inpatient training (included in the total number of training sessions listed above in section ). Training shall be provided for NH Yokosuka and the BHCs identified above in paragraph 1.1. as follows: Inpatient Training Sessions: Option Period 1 Option Period sessions 184 sessions 188 sessions 6. CDIS Services (onsite) 6.1. CDIS services shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide CDIS services at NH Yokosuka as follows: Option Period 1 Option Period 2 12 months 12 months 12 months 7. Remote Services. Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started. 8. Relocation: The government will reimburse the contractor for relocation expenses in accordance with the JTR and as stated on page 61of this solicitation (Relocation Costs).

151 Page 151 of Travel. The government will reimburse the contractor up to $18, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. The contractor shall travel quarterly to the BHCs to provide training services. 10. Point of Contact Information. Primary POC: LT Tammy D Alesandro Patient Administration Department Head Tammy.L.D [email protected] Commercial Phone: Alternate POC: LCDR Rob Nevins Patient Administration Assistant Department Head [email protected] Commercial Phone: Local Contracting Officer s Representative: Mr. Michihiko Hotta Phone: [email protected] Mailing address: PSC 475 Box 1 FPO, PA FAR Addendum Enclosure 9 Lot I 1. Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Naples, Italy 1.1. The contractor shall provide remote outpatient coding services, remote inpatient and outpatient auditing services and onsite training services for the Naval Hospital Naples, Italy. Services shall also be provided in support of the Branch Health Clinic (BHC) Capodichino The facility is comprised of specialties that include Family Practice, Pediatrics, Internal Medicine, General Surgery, OB/GYN, ENT, Orthopedics, Mental Health, Dermatology, Urology, Occupational Health, Community Health, Physical Therapy and SARP. The BHC Capodichino is a Family Practice facility. 2. Medical Record Coding (remote) The contractor shall provide coding services in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient records as follows: Option Period 1 Option Period 2 Approximately 1,125 records Approximately 1,050 records Approximately 975 records 3. Auditing (remote).

152 Page 152 of The audits shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit government coded inpatient and outpatient records as follows: Inpatient: Option Period 1 Option Period 2 Outpatient: Option Period 1 Option Period 2 Approximately 180 records Approximately 180 records Approximately 180 records Approximately 1,200 records Approximately 1,120 records Approximately 1,040 records 3.3. The contractor shall be aware that the list of records to support the DQ metric may not be posted until late the first week or early the second week of the month. Given the administrative responsibilities that must be performed by the government before the records are provided to the contractor, there may only be 2-4 business days in order to complete the audit and provide the results to the MTF primary POC by the 15 th of the month The contractor shall provide detailed feedback by each month to the providers and/or coders on any discrepancies noted. 4. Training (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract. The contractor shall provide onsite training, annually, as follows: Option 1 Option sessions 216 sessions 221 sessions 4.2. Outpatient training: The contractor shall provide outpatient training (included in the total sessions listed above in Section 4.1.) to be split into 4 trips. Each training session shall also include providing services at the BHC Capodichino. Training shall be provided as follows: Option 1 Option sessions (41 sessions each trip) 167 sessions (41 sessions 3trips and 44 sessions 1 trip) 171 sessions (42 sessions three trips and 45 sessions one trip) 4.3. Inpatient training. The contractor shall provide inpatient training (included in the total sessions listed above in Section 4.1.) to be split into two trips as follows: 48 sessions (24 sessions each trip) Option 1 49 sessions (25 sessions one trip and 24 sessions the 2 nd trip) Option 2 50 sessions (25 sessions each trip) 5. Remote Services Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started.

153 Page 153 of The contractor shall recognize the time difference between the geographical areas to ensure business can be conducted in a reasonable and effective manner. Within 72 business hours of receiving the documentation from Naval Hospital Naples, the contractor shall provide a report to the government that will be used to enter the codes into government computer systems. The report shall be provided to the MTF no later than 4:00 PM local time. The report shall be in a MS Excel format and provided in a secure manner. The report shall contain, at a minimum, the following column headings; however, additional data elements may be required: The first 4 letters of the patient s last name;. The patient s family member prefix and last 4 numbers of the patient s social security number; The provider s name (last name, first name); Date of service; The ICD-9 and CPT code; Link from ICD-9 to CPT codes; and Modifiers 6. Travel. The government will reimburse the contractor up to $20, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. Travel funds are limited to one individual traveling four times to accomplish all training requirements. 7. Point of Contact Information: Primary POC Mrs. Italia Tavano Medical Records Administrator Phone: [email protected] Alternate POC: LTJG Christine Simcox Patient Administration Department Head Phone: [email protected] Mailing address: PSC 827, Box 1000 FPO AE Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Rota, Spain 1.1. The contractor shall provide remote inpatient and outpatient coding services, remote inpatient and outpatient auditing services and onsite and remote training services for Naval Hospital Rota, Spain The facility is comprised of specialties that include Primary Care, Audiology, Dermatology, Family Practice, Pediatrics, Internal Medicine, General Surgery, OB/GYN and Orthopedics. 2. Medical Record Coding (remote) The contractor shall perform the duties prescribed in paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract.

154 2.2. The contractor shall code and perform a quality assessment review for inpatient records as follows: N R-0009 Page 154 of 179 Option Period 1 Option Period 2 Approximately 540 records Approximately 540 records Approximately 540 records 2.3. The contractor shall code any type of outpatient record presented (IPS, AHLTA, ER, APV). The contractor shall code and perform a quality assessment review for outpatient records as follows: Option Period 1 Option Period 2 Approximately 3,300 records Approximately 3,080 records Approximately 2,860 records 3. Auditing (remote) The audits shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall audit inpatient and outpatient records for the Data Quality Management Control (DQMC) and focused audits as follows: Inpatient: Option Period 1 Option Period 2 Outpatient: Option Period 1 Option Period 2 Approximately 240 records Approximately 240 records Approximately 240 records Approximately 1,080 records Approximately 1,008 records Approximately 936 records 3.3. The contractor shall provide detailed feedback via for each audit to the coders on any discrepancies noted The contractor shall be aware that the list of inpatient records to support the DQ metric may not be posted until late the first week or early the second week of the month. Given the administrative responsibilities that must be performed by the government before the records are provided to the contractor, there may only be 2-4 business days in order to complete the audit and provide the results to the MTF primary POC by the 15th of the month. 4. Training (onsite and remote) The contractor shall provide training in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide inpatient training and outpatient training during two trips per year as follows: Inpatient Training: 21 sessions Option Period 1 21 sessions Option Period 2 22 sessions Outpatient Training: 61 sessions Option Period 1 62 sessions Option Period 2 63 sessions

155 Page 155 of The government s preferred method to conduct remote training is via Defense Collaboration Services (DCS). There is no cost to use this site but the host must possess a valid CAC. Please refer to the DCO website for additional information: 5. Remote Services Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started The contractor shall recognize the time difference between the geographical areas to ensure business can be conducted in a reasonable and effective manner. Within 72 business hours of receiving the documentation from Naval Hospital Rota, the contractor shall provide a report to the government that will be used to enter the codes into government computer systems. The report shall be provided to the MTF no later than 4:00 PM local time. The report shall be in MS Excel format and provided in a secure manner. The report shall contain, at a minimum, the following column headings; however, additional data elements may be required. Registration number (IPS only) Contractor s record ID Patient s last name Patient s first name FMP/SSN Provider s name (last name, first name) Date of service The ICD-9 and CPT codes Link from ICD-9 to CPT codes Modifiers 6. Travel. The government will reimburse the contractor up to $8, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR. 7. Point of Contact Information. Primary POC: LT Jason Switzer Patient Administration Department Head Phone: [email protected] Alternate POC: Javier Palacios Phone: [email protected] Local Contracting Representative: Jonathan Fowler Phone: [email protected] Mailing address: PSC 819 Box 18 FPO AE Description of Services. Performance Work Statement Medical Records Coding Services Naval Hospital Sigonella, Italy

156 Page 156 of The contractor shall provide remote outpatient and inpatient auditing services and onsite training services at the Naval Hospital Sigonella, Italy. Services shall also be provided in support of the Naval Branch Health Clinic (NBHC) Bahrain and Souda Bay The facility is comprised of specialties that include OB/GYN, Orthopedics, Family Practice and Ophthalmology. 2. Auditing (remote) The audits shall be conducted in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract Outpatient (remote): The contractor shall audit government coded outpatient records as follows: Option Period 1 Option Period 2 Approximately 3,750 records Approximately 3,500 records Approximately 3,250 records 2.2. Inpatient (remote): The contractor shall audit government coded inpatient records as follows: Option Period 1 Option Period 2 Approximately 540 records Approximately 540 records Approximately 540 records 2.3. The contractor shall be aware that the list of inpatient records to support the DQ metric may not be posted until late the first week or early the second week of the month. Given the administrative responsibilities that must be performed by the government before the records are provided to the contractor, there may only be 2-4 business days in order to complete the audit and provide the results to the MTF primary POC by the 15 th of the month The contractor shall provide detailed feedback to the coders by for each audit noting any discrepancies. 3. Training (onsite) Training shall be provided in accordance with paragraph and associated subparagraphs included in the Performance Work Statement of the basic contract The contractor shall provide outpatient training services during 4 scheduled trips to Sigonella (40 sessions each for 3 trips and 43 sessions for 1trip).The contractor shall provide onsite training as follows: Option Period 1 Option Period sessions 166 sessions 170 sessions 4. Remote Services. Remote services shall be provided in accordance with Section 12 and associated subparagraphs included in the Performance Work Statement of the basic contract. The data associated with remote services shall be provided to the MTF in an Excel spreadsheet. The data fields to be included in the Excel spreadsheet will be determined by the government at the time this service is started The contractor shall recognize the time difference between the geographical areas to ensure business can be conducted in a reasonable and effective manner. The Army Safe Site may be used in lieu of the process approved through the contractor s DSA. 5. Travel. The government will reimburse the contractor up to $20, for reasonable travel expenses incurred while performing the duties in this task order in accordance with the JTR.

157 Page 157 of Point of Contact Information. Primary POC: LT Loreli Owens Patient Administration Department Head Phone: Alternate POC: Ms. Marcella Spina Phone: Alternate POC: Ms. Silvia Spagnolo Mailing address: PSC 836 Box 2670 FPO AE CLAUSES INCORPORATED BY FULL TEXT EVALUATION--COMMERCIAL ITEMS (OCT 2014) (a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers: The Government will evaluate each factor independently of each other and each factor listed is of equal importance. 1. Technical Approach 2. Past Performance 3. Business 4. Pricing The Technical Approach evaluation factor is more important than the Past Performance evaluation factor. The Past Performance evaluation factor is more important than the Business evaluation factor. The Business evaluation factor is more important the Price evaluation factor. The combination of the Technical Approach evaluation factor, the Past Performance evaluation factor and the Business evaluation factor is significantly more important than the Price evaluation factor. (b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

158 Page 158 of 179 (End of provision) ADDENDUM TO EVALUATION--COMMERCIAL ITEMS (OCT 2014) ADDENDUM TO EVALUATION--COMMERCIAL ITEMS THIS SECTION IS FOR SOLICITATION PURPOSES ONLY. THIS SECTION WILL BE PHYSICALLY REMOVED FROM ANY RESULTANT AWARD, BUT WILL BE DEEMED INCORPORATED BY REFERENCE. THIS ADDENDUM SUPPLEMENTS FAR A Technical Evaluation Panel will evaluate all proposals based on the proposals/documentation provided. The evaluations will be based on the Evaluation Criteria for Award. Evaluations will be conducted utilizing a competitive best value basis, using tradeoff among price and non- price factors. 2. The Government intends to award a minimum of three Indefinite Delivery Indefinite Quantity (IDIQ) Multiple Award Task Order (MATO) contracts resulting from the issuance of this solicitation to the responsible offerors submitting a proposal that are determined most advantageous to the Government, price and other factors considered. The evaluation of proposals will be based on an evaluation of Technical, Past Performance, Business, and Pricing volumes submitted by each offeror. The Government intends to make multiple contract awards under this solicitation to allow for maximum competition for future task order awards. 3. In the event that two or more proposals are determined not to have any substantial non-price differences a contract award may be made to the lower priced proposal. It should be noted that a contract award may be made to other than the lowest priced offeror if the Government determines that a price premium is warranted due to the quality of Technical and/or Past Performance volume(s). A price premium may also be considered to facilitate the award of additional contracts, thus gaining the advantages associated with increased competition for future task orders. 4. The Government reserves the right to award a contract without negotiations. Offerors are cautioned that each initial offer should contain the offeror's best terms. 5. The Government is explicitly raising the prescribed file content and submission requirements from what might be argued as a matter of "form", to one that is materially substantive in that it reflects upon the offeror's ability and willingness to follow instructions and fulfill its obligations. Upon receipt of proposals, and prior to actively engaging in proposal evaluation, a compliance review will be conducted to determine if each offeror met the submission requirements for each volume as outlined in FAR Instructions to Offerors -- Commercial Items of the solicitation. In order to be eligible for award, a proposal must comply in all material respects with the terms and conditions set forth in this solicitation. Failure to properly submit any items listed in FAR Instructions to Offerors -- Commercial Items of the solicitation may result in rejection of the offeror's entire proposal. 7. EVALUATION FACTORS Technical, Past Performance, Business and Pricing volumes submitted in response to this solicitation will be evaluated in accordance with the evaluation factors The Technical evaluation factor is more important than the Past Performance evaluation factor. The Past Performance evaluation factor is more important than the Business evaluation factor. The combination of the Technical evaluation factor, the Past Performance evaluation factor and the Business evaluation factor is significantly more important than the Pricing evaluation factor The Business volume will be evaluated and determined to be either complete, incomplete, or substantially incomplete. An offeror will be eliminated from award consideration if they have submitted a Business volume that

159 Page 159 of 179 is considered to be substantially incomplete. Awards will only be made to contractors whom have submitted complete Business volumes. An incomplete Business volume may be revised during discussions (if discussions are held and the offeror is in the competitive range) and then may be considered to be complete Information will be considered for evaluation in the volume where it is provided. For example, past performance information provided in the Technical volume will be part of the Technical Evaluation. The same past performance information will only be considered in the Past Performance Evaluation if it is also provided in the past performance volume Technical. Based on the comprehensiveness, depth, and quality of the Technical volume, the Government will assess the risk to the Government of future non-performance of solicitation requirements by the offeror in accordance with the solicitation instructions for Technical volume. Failure to appropriately detail any business relationship (i.e. subcontractor, partner, mentor, protégé, parent company, sister company, etc.) as described in sections , and of Addendum to is considered a weakness in the Technical volume. Failure to address or appropriately address FAR is also considered a weakness. The Government will not assume that the contractor possesses any capability or knowledge unless it is specified in the Technical volume Past Performance. The Government will first evaluate the offeror's Past Performance Information Sheets to determine whether the company has provided relevant Past Performance. In order for services to be considered relevant they must meet the criteria in the table below. A determination of relevant or not relevant will be made for each Past Performance Information Sheet. A relevancy determination may be made based solely on the information provided on the Past Performance Information Sheet. Also, Past Performance information may be determined not relevant after obtaining additional information from the customer POC named on a Past Performance Information sheet Relevancy shall be evaluated as follows: Rating Definition Past Performance that is related to the performance and delivery of medical coding, auditing and training services outlined in the PWS;. Services must have been performed by the contractor, subcontractor, Relevant key personnel, team member, etc. submitting the quote; and Performance cited must be current, or have ended not more than three years prior to the closing date of the solicitation. Past Performance that is not related to the performance and delivery of medical coding, auditing and training services outlined in the PWS, or has been determined not relevant in accordance with Addendum to Not Relevant FAR (2.3.), Instructions to Offerors; Performance cited is not current, meaning it ended more than three years prior to the closing date of the solicitation The Government may contact the customer POCs listed on the Past Performance Information Sheets. The Government is not restricted from evaluating and considering other relevant Past Performance information in its possession and may contact references for that information. Past Performance information may be obtained from any other sources available to the Government, such as the Past Performance Information Retrieval System (PPIRS) and interviews with Contracting Officer s Representatives The Government will review relevant Past Performance information and determine the quality and usefulness as it applies to the Performance Confidence Assessment. This evaluation shall entail an examination of items such as but not limited to contract start-up, adherence to QASP, submission and maintenance of worker requirements, and performance discrepancy resolution. Greater consideration will be given to medical coding, auditing and training services closely related to those required under this solicitation as outlined in the scope of the solicitation. Greater consideration will be given to services provided by the offeror and the offeror s key personnel. Greater consideration will also be given to performance provided by an SBA approved joint venture(s) if the offeror was a

160 Page 160 of 179 member of the SBA approved joint venture(s). If the offeror is proposing as an SBA approved joint venture, greater consideration will be given to services provided by members of that joint venture. The Past Performance Confidence assessment will be evaluated as follows: Rating Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence Unknown Confidence (Neutral) Definition Based on the offeror s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort. Based on the offeror s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort. Based on the offeror s recent/relevant performance record, the Government has a low expectation that the offeror will successfully perform the required effort. Based on the offeror s recent/relevant performance record, the Government has no expectation that the offeror will successfully perform the required effort. No recent/relevant performance record is available or the offeror s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned Business. The Business volume will be evaluated for completeness. The offeror's Business volume will be examined to ensure that it has been completed in accordance with the solicitation instructions for Business proposals section Pricing. Reasonableness- The contractor s Pricing will be examined to determine the degree to which the total proposed price compares to the price a reasonable prudent person would expect to incur for the same or similar services. Unit prices may also be examined to identify unusually high or low price estimates, inconsistent pricing patterns, and/or potential misunderstandings of the solicitation requirements. The closer the merits of the Past Performance and Technical volumes are to one another, the greater will be the importance of Price in making a contract award determination. Since contract awards will be made on a best value basis, it should be noted that awards may be made to other than the lowest priced offeror if the Government determines that a price premium is warranted due to the quality of the Past Performance and/or Technical volume(s) and the proposed price is determined to be reasonable. A price premium may also be considered to facilitate the number of contract awards to meet the requirements of Instructions and Evaluation Criteria, (2). Please note that completeness of the Business volume does not warrant a price premium Lot Awards. After contract award decisions have been made, lot award determinations will be made. Only those offerors that were selected for an IDIQ contract award in accordance with the evaluation criteria stated in Instructions and Evaluation Criteria of the solicitation will be evaluated for Lot Awards. Lots consist of initial quantities to be awarded at the time basic contracts are awarded. Reasonableness will be evaluated for the total price for each lot. Proposed prices and the labor mix proposed will be evaluated to ensure understanding of the solicitation requirements. Lot awards may be made to other than the lowest priced proposal. A premium may be considered to facilitate the minimum award of lots or due to Technical Merit. Each contract awardee will be awarded a minimum of one lot. The number of lots, amount of services required, and the total dollar value of the lots awarded to each contract awardee may vary. Within the parameters established by the solicitation and the procedures described therein, the Contracting Officer has broad discretion in determining which contract awardee should receive a lot award Lot Awards will be evaluated with consideration to the following factors: Reasonableness. The offeror s Pricing volume will be examined to determine the degree to which the proposed monthly prices and total price for each lot compare to the prices a reasonable prudent person would expect

161 Page 161 of 179 to incur for the same or similar services. The Contracting Officer reserves the right to award at a premium, provided that the proposed price is determined to be reasonable Technical Merit: The offeror s proposed labor mix shall demonstrate their ability to fulfill the workload outlined in the PWS. (End of provision) CLAUSES INCORPORATED BY FULL TEXT INFORMATION REGARDING RESPONSIBILITY MATTERS (JULY 2013) (a) Definitions. As used in this provision-- Administrative proceeding means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables. Federal contracts and grants with total value greater than $10,000,000 means-- (1) The total value of all current, active contracts and grants, including all priced options; and (2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinitequantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules). Principal means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions). (b) The offeror ( ) has ( ) does not have current active Federal contracts and grants with total value greater than $10,000,000. (c) If the offeror checked has in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information: (1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions: (i) In a criminal proceeding, a conviction. (ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more. (iii) In an administrative proceeding, a finding of fault and liability that results in-- (A) The payment of a monetary fine or penalty of $5,000 or more; or

162 Page 162 of 179 (B) The payment of a reimbursement, restitution, or damages in excess of $100,000. (iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision. (2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence. (d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management database via (see ). (End of provision) CLAUSES INCORPORATED BY REFERENCE Commercial and Government Entity Code Reporting JUL Prohibition on Contracting with Inverted Domestic NOV 2015 Corporations--Representation Single or Multiple Awards OCT Evaluation Of Options JUL Prohibition on Contracting with Entities Engaging in Certain OCT 2015 Activities or Transactions Relating to Iran-- Representation and Certifications Site Visit APR 1984 CLAUSES INCORPORATED BY FULL TEXT SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): (End of provision) CLAUSES INCORPORATED BY REFERENCE Representation Relating to Compensation of Former DoD NOV 2011 Officials (Dev) Prohibition on Contracting with Entities that Require Certain OCT 2015 Internal Confidentiality Agreements - Representation (Deviation 2016-O0003)

163 Page 163 of (Dev) Compliance with Safeguarding Covered Defense Information DEC 2015 Controls Only One Offer OCT Advancing Small Business Growth MAY 2015 CLAUSES INCORPORATED BY FULL TEXT OWNERSHIP OF CONTROL OF OFFEROR (NOV 2014) (a) Definitions. As used in this provision-- Commercial and Government Entity (CAGE) code means (1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Contractor and Government Entity (CAGE) Branch to identify a commercial or government entity, or (2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Contractor and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as an NCAGE code. 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. (b) 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 (c) and if applicable, paragraph (d) of this provision for each participant in the joint venture. (c) If the Offeror indicates ``has'' in paragraph (b) 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. (d) If the Offeror indicates ``yes'' in paragraph (c) 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:

164 Page 164 of 179 (Do not use a ``doing business as'' name) (End of provision) ALTERNATIVE LINE-ITEM STRUCTURE (SEP 2011) (a) Line items are the basic structural elements in a solicitation or contract that provide for the organization of contract requirements to facilitate pricing, delivery, inspection, acceptance and payment. Line items are organized into contract line items, subline items, and exhibit line items. Separate line items should be established to account for separate pricing, identification (see section of the Defense Federal Acquisition Regulation Supplement), deliveries, or funding. The Government recognizes that the line item structure in this solicitation may not conform to every offeror's practices. Failure to correct these issues can result in difficulties in accounting for deliveries and processing payments. Therefore, offerors are invited to propose an alternative line item structure for items on which bids, proposals, or quotes are requested in this solicitation to ensure that the resulting contract structure is economically and administratively advantageous to the Government and the Contractor. (b) If an alternative line item structure is proposed, the structure must be consistent with subpart of the Defense Federal Acquisition Regulation Supplement and PGI A sample solicitation line-item structure and a corresponding offer of a proposed alternative line-item structure follow. Solicitation: Item No. Supplies/Service Quantity Unit Unit price Amount Computer, Desktop with 20 EA CPU, Monitor, Keyboard and Mouse Alternative line-item structure offer where monitors are shipped separately: Item No. Supplies/Service Quantity Unit Unit Price Amount Computer, Desktop with 20 EA CPU, Keyboard and Mouse Monitor EA (End of provision) OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV 2015) ALTERNATE I (OCT 2014)

165 Page 165 of 179 The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site accessed through If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision. (a) Definitions. As used in this provision-- Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program. Forced or indentured child labor means all work or service (1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or (2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties. 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) , 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

166 Page 166 of 179 (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. 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 ). 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.

167 Page 167 of 179 (2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is serviceconnected, 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 , 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 ) by-- (i) One or more socially disadvantaged (as defined at 13 CFR ) and economically disadvantaged (as defined at 13 CFR ) 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 (c)(2); and (2) The management and daily business operations of which are controlled (as defined at 13.CFR ) 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. 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.

168 Page 168 of 179 (b) (1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted on the SAMwebsite. (2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation and certifications currently posted electronically at FAR , Offeror Representations and Certifications Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR ), except for paragraphs. [Offeror to identify the applicable paragraphs at (c) through (p) 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 (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 womenowned 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 womenowned small business concern in paragraph (c)(5) of this provision.] The offeror represents that

169 Page 169 of 179 (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 womenowned 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) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that-- (i) It [ ] is, [ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and (ii) It [ ] is, [ ] is not a HUBZone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small

170 Page 170 of 179 business concerns participating in the HUBZone joint venture:.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation. (11) (Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) of this provision.) [The offeror shall check the category in which its ownership falls]: Black American. Hispanic American. Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians). Asian-Pacific American (persons with origins from Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China, Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines, Republic of Palau, Republic of the Marshall Islands, Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Guam, Samoa, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru). Subcontinent Asian (Asian-Indian) American (persons with origins from India, Pakistan, Bangladesh, Sri Lanka, Bhutan, the Maldives Islands, or Nepal). Individual/concern, other than one of the preceding. (d) Representations required to implement provisions of Executive Order (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) , Buy American Supplies, is included in this solicitation.)

171 Page 171 of 179 (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 , 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

172 Page 172 of 179 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 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 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]

173 Page 173 of 179 (4) Buy American Free Trade Agreements Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 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 , 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--

174 Page 174 of 179 (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 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 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).

175 Page 175 of 179 (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 (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 (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;

176 Page 176 of 179 (ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR (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 (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 (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:.

177 Page 177 of 179 [ ] 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 ; [ ] Other. (5) Common parent. [ ] Offeror is not owned or controlled by a common parent: [ ] Name and TIN of common parent: Name

178 Page 178 of 179 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 (b) applies or the requirement is waived in accordance with the procedures at (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 questions concerning sensitive technology to the Department of State at [email protected]. (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 et seq.) (see OFAC s Specially Designated Nationals and Blocked Persons List at (3) The representation and certification requirements of paragraph (o)(2) of this provision do not apply if (i) This solicitation includes a trade agreements certification (e.g., (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 DUNS Number 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.

179 (2) If the Offeror indicates has in paragraph (p)(1) of this provision, enter the following information: N R-0009 Page 179 of 179 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) (End of Provision)