NOTICE TO VENDORS REQUEST FOR PROPOSAL RFP HCF-01. IRHTP site to IRHTP Network Ethernet Bandwidth Connectivity (two locations)

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1 NOTICE TO VENDORS REQUEST FOR PROPOSAL IRHTP site to IRHTP Network Ethernet Bandwidth Connectivity (two locations) IRHTP Consortium site Internet Service Healthcare Connect Fund Network Expansion Project Ethernet Connectivity Mr. Art Spies Senior Vice President Iowa Hospital Association 100 East Grand Avenue, Suite 100 Des Moines, IA The Iowa Rural Health Telecommunications Program (IRHTP) will be receiving sealed bid proposals for HCF-01 until 3:00 p.m. CDST, On the 30th day after the posting of the RFP. 0

2 RFP HCP-01 INDEX IRHTP Site to IRHTP Network Connectivity (Two locations) Including build-out services if applicable. - IRHTP Consortium IRHTP hospital site Internet Service - Healthcare Connect Fund Network Expansion Project - Ethernet Connectivity to hospital owned sites. THIS REQUEST FOR PROPOSAL CONSISTS OF SEVEN (7) CHAPTERS, FOUR (4) ANNEXES, AND NINE (9) ATTACHMENTS. CHAPTER TITLE 1 Administrative Issues 2 Contractual Terms 3 IRHTP Hospital Ethernet Connections to IRHTP Network Attachment 1 List of HCP owned Link-Segments and Their Locations Attachment 2 List of HCP owned Switches and Their Locations Attachment 3 Vendor s Response to Chapter 3- IRHTP Hospital To IRHTP Network Connectivity 4 Internet Services For IRHTP Hospitals And Other Sites Attachment 4 IRHTP Hospital Locations Internet Pricing Attachment 5 Future Sites Internet Pricing 5 Ethernet Connectivity Attachment 6 Low and High Speed Internet Service Future Sites Attachment 7 List of Examples of Current Levels of Clinic Ethernet Connectivity Attachment 8 Vendor Response Sheet for Ethernet Connectivity Future Sites Attachment 9 Leased Lit or Dark Fiber Vendor Response Sheet 6 Testing Process and Procedures 7 Evaluation Process and Criteria Annex A Annex B Annex C Annex D Bid Proposal Compliance Form Authorization to Release Information Certification Letter Format IRHTP Participating Sites Listing 1

3 General Information Iowa Rural Health Telecommunications Program This RFP is divided into seven (7) Chapters: Chapter One; is dedicated to RFP administrative issues. Chapter Two: describes Contractual Terms and Conditions. Chapter Three is the first of three technical specification chapters. Its purpose is to secure pricing for a 1 GBs Ethernet platform and connection to two Iowa hospitals, one located in Grinnell, Iowa, and one located in Sigourney, Iowa. While initial bandwidths on these connections may only start out with 20 or 30 Mbs applications, the new healthcare electronic records system as well as future things such as radiology and Internet distribution will cause significant growth in the near future. By having a 1 GBs platform initially installed, the hospital will not have to experience outages while modifications are made to a smaller platform. Chapter Four is to secure pricing for various increments of Internet capacity for the 89 IRHTP member hospitals. The hospital will, in turn, disseminate this Internet over the Ethernet links being asked for in Chapter Five. Chapter Five asks for various increments of Ethernet capacity from the 89 aforementioned IRHTP member hospitals to their hospital owned and operated sites. In each case the A- Location is a member hospital and the Z-Location is one of their owned sites. Chapter Six is the Test and Acceptance specification. Chapter Seven is the Evaluation process. Responsible Party for This Project. The Iowa Rural Telecommunications Program, has submitted an application to become a non-profit 501(c) (6) organization. IRHTP is the consortium of record for this project. IRHTP is incorporated in the State of Iowa pursuant to section of the Revised Iowa Nonprofit Corporation Act. 2

4 CHAPTER 1 ADMINISTRATIVE ISSUES 1.0 General. The Rural Health Care Program of the Universal Service Fund (USF), administered by the Universal Service Administrative Company (USAC), is a support program authorized by Congress and designed by the Federal Communications Commission (FCC) to provide reduced rates to rural health care providers (HCPs) for telecommunications services and internet access charges related to the use of telemedicine & telehealth. The Iowa Rural Health Telecommunications Program (IRHTP) is a joint effort consisting of a consortium of 86 Iowa rural and urban hospitals, two South Dakota hospitals, and the Iowa Hospital Association (IHA). The IHA is functioning as the project coordinator and administrator for the Iowa Rural Health Telecommunications Program. The project coordinator is Arthur J. Spies, Senior Vice President with the Iowa Hospital Association; contact at or [email protected]. The Iowa Hospital Association (IHA) was asked by the workgroup in December of 2006 to facilitate the development of a proposal to the FCC Rural Health Care Pilot Program. IHA facilitated the process and submitted the IRHTP proposal on behalf of participating Iowa hospitals. The Iowa Hospital Association has and will continue to have responsibility for the general project administration / management that includes: Meeting logistics for the IRHTP steering committee (face to face and conference calls) Communication with IHA Board and participating hospitals Serving as IRHTP project coordinator which Manages the administrative aspects of the build-out of the approved network Completes and submits program forms and supporting documentation; sign off on certifications, invoices, etc USAC payment management Serve as primary point of contact for the project Communicates any requirements/requests to participating entities Assures administrative project documentation Maintains project files Prepares for any audits. The Iowa Rural Health Telecommunications Program (IRHTP) and the Iowa IRHTP Association (IHA) received approval to proceed with the connection of 89 consortium IRHTP sites to the Iowa Communications Network using newly constructed or existing fiber optic cable facilities. IRHTP is now seeking bid proposals for Ethernet bandwidth and connectivity at various health care locations throughout the State of Iowa and surrounding states. The bid response pricing and methodology will be applied to unidentified future IRHTP site locations, as they desire to join the IRHTP consortium. 1.1 Notice. This project is subject to the USAC procurement rules. The IRHTP will submit a USAC Form 465, RFP, and supporting documentation to USAC which will review the 3

5 documentation and will post the RFP on the USAC website. All RFPs will be open for response and bidding for 30 calendar days after the posting. After documents are posted to the USAC website, the following process will commence. 1.2 Schedule and Submission of Proposal Questions and Answers. Vendors are invited to submit written questions and/or requests for interpretation/consideration/acceptance concerning this RFP within five (5) business days from the posting of this RFP. Vendors with questions concerning this RFP may submit questions in writing via to Art Spies at IRHTP will reply to all questions received within four (4) business days following the initial five (5) business day period. Oral questions will not be accepted, and verbal communications shall not override written communications. Only written communications are binding on IRHTP. If the questions, requests for clarifications, or suggestions pertain to a specific section of the RFP, the page and section number(s) must be referenced. IRHTP will prepare a written response to all pertinent questions submitted by Vendors and will post questions and responses on the USAC website; as well as the Iowa IRHTP website, within four (4) business days following the initial five (5) business day period. The IRHTP s written responses will be considered part of the RFP. If the IRHTP decides to adopt a suggestion, the IRHTP will issue an amendment to the RFP Verbal Representations. The IRHTP assumes no responsibility for verbal representations made by its consortium members and representatives unless such representations are confirmed in writing by the IRHTP and incorporated into this RFP Changes and Amendments. In the event it becomes necessary for IRHTP to amend, add to or delete any part of this RFP, the amendment will be posted on the IHA and USAC websites after approval by USAC. Vendor s bid proposal must include acknowledgment of all addenda issued by IRHTP Receipt of Bid Proposals. Bid Proposals must be received at IHA s office no later than 3:00 P.M. CST on the 30th calendar day after the posting of the RFP. This requirement is a mandatory requirement and is not a minor deficiency subject to waiver by the IRHTP. No bid proposals will be accepted after the date and time specified. A late bid proposal shall be returned unopened to the Vendor. Additionally, no bid proposal will be accepted by telephone, electronic mail or facsimile. The bid proposals must be mailed (with mailing in sufficient time to arrive on or before this deadline requirement) or be delivered as follows: Mailing Address: 4 Delivery To: Iowa Hospital Association Iowa Hospital Association Attn: Mr. Art Spies Attn: Mr. Art Spies IRHTP Project Coordinator IRHTP Project Coordinator 100 East Grand Ave. Suite East Grand Ave. Suite 100 Des Moines, Iowa Des Moines, Iowa If bid proposals are delivered by mail service, express courier, delivery service or company, or in person, it shall be the sole responsibility of the Vendor submitting the proposal to insure that such delivery takes place prior to the aforementioned deadline. There shall be no waiving of the deadline due to missed deliveries on the part of the

6 Vendor, Vendor s delivery staff or Vendor s choice of delivery service(s). Deliveries made directly to IHA must be received by an IHA staff person able to accept such delivery Bid Proposal Opening. Successful Vendors will be notified of selection for contract award within 30 calendar days after the end of the RFP posting period (30 calendar days). The bid proposals and the evaluation documents created by the IRHTP will remain confidential until the evaluation committee has evaluated all bid proposals submitted in response to this RFP and the IRHTP has issued a notice of award. The bid proposals submitted and the evaluation documents created by the IRHTP may be available for inspection subject to FCC and USAC guidelines or other applicable law only after the selection process is complete Failure to comply with or supply any and all information requested to accompany bid proposals may be cause for rejection of the proposal as noncompliant All bid proposals shall be firm for a period of 90 days to allow the evaluation committee to fully evaluate all proposals and make an award deemed to be in the best interest of IRHTP By submitting a bid proposal the Vendor agrees to the terms and conditions contained within this RFP. 1.3 Proposal Submission & Format Bid Proposals shall be printed on 8.5 x 11 paper. The proposals should be in 3- ring binders with appropriate tabs for reference. The original bid proposal must be in a package CLEARLY MARKED HCF-01 Proposal on the outer envelope or wrapping. This is necessary to insure that the response package is handled properly for verification of the RFP deadline. Lack of notation of the RFP number may affect the receipt timing and the evaluation process. Vendor should consider this item as a critical factor when submitting a response To achieve a uniform review process and the maximum degree of comparability, proposals shall be organized in the following manner: Title page that includes the subject of the bid proposal, the RFP number being responded to (IRHTP RFP HCF- 01), name of Vendor, address, name of designated contact person, telephone number, facsimile telephone number, address for Vendor s contact person (and, if applicable, the cellular telephone number of contact person) and the date Completed Bid Proposal Compliance Form (Annex A) Completed Authorization to Release Information Form (Annex B) Completed Certification Letter format (Annex C) Number of Copies. Vendors shall submit one (1) with original blue-ink signatures and three (3) copies; in addition four (4) soft copies of the bid proposal shall be provided on (4) CDs using Microsoft Word and Excel, if proposal contains spreadsheets. 1.4 Clarification of Proposals and Obtaining Information. IRHTP reserves the right to contact a Vendor after submission of bid proposals for the purpose of clarifying a bid proposal to ensure mutual understanding. This contact may include written questions, interviews, site visits, a review of past performance. This information may be used to evaluate the Vendor s bid proposal. However, the information received from the Vendor shall not be considered in the 5

7 evaluation of a Vendor s bid proposal if the information materially alters the content of the bid proposal. IRHTP reserves the right to obtain information concerning any Vendor or any proposal from any source and to consider such information in evaluating the Vendor s bid proposal. 1.5 Cost of Bid Proposal. IRHTP is not responsible for any costs incurred by a Vendor, which are related to the preparation or delivery of the bid proposal, or with any other activities carried out by the Vendor as it relates to this RFP. The costs of preparation and delivery of the bid proposal are solely the responsibility of the Vendor. 1.6 Bid Proposal Obligations. The contents of the bid proposal and any clarification thereto submitted by the successful Vendor shall become part of the contractual obligation and incorporated by reference into the ensuing Contract. 1.7 Bid Proposals Property of IRHTP. Except as otherwise stated herein, all bid proposals become the property of the IRHTP and shall not be returned to the Vendor unless all bid proposals are rejected. In the event all bid proposals are rejected, Vendors will be asked to send prepaid shipping instruments to the IRHTP for return of the bid proposals submitted. In the event no shipping instruments are received by the IRHTP, the bid proposals will be destroyed by the IRHTP. Additionally, the evaluation documents created by the IRHTP will be destroyed in the event all bid proposals are rejected. Otherwise, at the conclusion of the selection process, the contents of all bid proposals may be placed in the public domain and be opened to inspection by interested parties subject to appropriate FCC, USAC, and federal procurement regulations. 1.8 Rejection and Disqualification of Bid Proposals IRHTP reserves the right to reject any and all bid proposals, in whole or in part, received in response to this RFP at any time prior to the execution of a written Contract. Issuance of this RFP in no way constitutes a commitment by IRHTP to award the Contract. This RFP is designed to provide Vendors with the information necessary for the preparation of competitive bid proposals. This RFP process is for IRHTP s benefit and is intended to provide IRHTP with competitive information to assist in the selection of goods and services The IRHTP may reject a bid proposal outright and not evaluate the proposal for any one (1) of the following reasons: Failure of Vendor to deliver the bid proposal by the due date and time Failure to include the Bid Proposal Compliance Form signed by an officer of the Vendor submitting the bid proposal (Annex A) Failure to include the Authorization to Release Information Form (Annex B) Failure to include the Certification Letter (Annex C) Failure to submit completed Bid Proposal Submittal Forms (Attachment 3, Attachment 4, Attachment 5, Attachment 6, Attachment 8, and Attachment 9). Vendors should mark the attachments they are not bidding as No Bid The Vendor states that a technical requirement cannot be met The Vendor's response materially changes a technical requirement. 6

8 The Vendor s response limits the rights of the IRHTP The Vendor fails to respond to the IRHTP s request for information, documents, or references The Vendor s exceptions to the contract terms and conditions described in Chapter 2 and Annex A (Bid Proposal Compliance Form) materially changes the terms and conditions of that section or the requirements of this RFP The Vendor provides misleading or inaccurate responses The Vendor s proposal is materially unbalanced The Vendor cannot certify operational readiness by February 1, 2014 or a mutually negotiated contractual date. 1.9 Public Records and Requests for Confidentiality All information submitted by a Vendor may be treated as public information by IRHTP unless the Vendor properly requests that information be treated as confidential at the time of submitting the bid proposal. In the event the Vendor marks each page of its bid proposal as proprietary or confidential without adhering to the requirements of this Section, the IRHTP may reject the bid proposal as noncompliant Any requests for confidential treatment of information must be included in a cover letter with the Vendor s bid proposal and must enumerate the specific grounds which support treatment of the material as confidential and must indicate why disclosure is not in the best interests of the public. The request must also include the name, address and telephone number of the person authorized by the Vendor to respond to any inquiries by IRHTP concerning the confidential status of the materials Any documents submitted which contain confidential information must be marked on the outside as containing confidential information, and each page upon which confidential information appears must be marked as containing confidential information. The confidential information must be clearly identifiable to the reader wherever it appears. All copies of the proposal submitted, as well as the original proposal, must be marked in this manner. Failure to properly mark information as confidential shall relieve the IRHTP from any responsibility if the information is viewed by the public, a competitor, or is any way accidentally released In addition to marking the material as confidential material where it appears, the Vendor must submit one (1) hard copy (printed) of the bid proposal from which the confidential information has been excised. This hard copy of the proposal MUST be clearly marked as Excluding Confidential Materials. In addition to a hard copy, the Vendor must also include an electronic copy of the non-confidential portions of the proposal on CD-ROM using Microsoft Word and Excel as appropriate. The confidential material must be excised in such a way as to allow the public to determine the general nature of the material removed and to retain as much of the document as possible. The excised version must be submitted with the cover letter and may be made available for public inspection. This submittal is a mandatory requirement and is not subject to waiver. Failure to mark the confidential items and to provide the required one (1) copy with confidential information excised shall be defined as allowance for the entire proposal to be treated as a public record. 7

9 1.9.5 The Vendor s failure to request in the bid proposal confidential treatment of material pursuant to this Section and the relevant laws and administrative rules will be deemed by IRHTP as a waiver of any right to confidentiality which the Vendor may have had Restrictions on Gifts and Activities. No gifts or other items of value will be accepted by any IRHTP officer, board member, or employee 1.11 Restriction on Communication. Vendors should funnel all communications thru the Project Coordinator in order to receive the highest quality response from the consortium Nonmaterial and Material Variances. The IRHTP reserves the right to waive or permit cure of nonmaterial variances in the bid proposal if, in the judgment of the IRHTP, it is in the IRHTP s best interest to do so. Nonmaterial variances include minor informalities that do not affect responsiveness; that are merely a matter of form or format; that do not change the relative standing or otherwise prejudice other Vendors; that do not change the meaning or scope of the RFP; or that do not reflect a material change in the services. In the event the IRHTP waives or permits cure of nonmaterial variances, such waiver or cure will not modify the RFP requirements or excuse the Vendor from full compliance with RFP specifications or other contract requirements if the Vendor is awarded the contract. The determination of materiality is in the sole discretion of the IRHTP Copyrights. By submitting a bid proposal, the Vendor agrees that IRHTP may copy the bid proposal for purposes of facilitating the evaluation or to respond to requests for public records. The Vendor consents to such copying by submitting a proposal and warrants that such copying will not violate the rights of any third party. IRHTP will have the right to use ideas or adaptations of ideas, which are presented in the proposals. In the event the Vendor copyrights the bid proposal, the IRHTP may reject the bid proposal as noncompliant Conflict between Terms. IRHTP reserves the right to accept or reject any exception taken by the Vendor to the terms and conditions of this RFP. Substantial variations between the Vendor s terms and conditions and those contained in this RFP may be grounds for rejection of the Vendor s bid proposal as non-responsive and non-compliant Release of Claims. With the submission of a bid proposal, Vendor agrees that it will not bring any claim or have any cause of action against IRHTP or its consortium members based on any misunderstanding concerning the information provided herein or concerning IRHTP s failure, negligent or otherwise, to provide the Vendor with pertinent information as intended by this RFP Construction of RFP with Laws and Rules. Changes in applicable laws and rules may affect the award process or the resulting Contract. Vendors are responsible for ascertaining pertinent legal requirements and restrictions. Vendors are encouraged to visit the USAC Healthcare Connect Fund website: RFP Copy. Copies of the RFP will be available on the USAC Healthcare Connect Fund Program web site at The RFP will also be available to vendors via the Iowa IRHTP site Association web site: click on members and groups and then click on IRHTP. Vendors may also request a copy of the RFP electronic copy by contacting Mr. Art Spies at [email protected] (515) (copy requested will be issued via ). 8

10 1.18 Downloading RFP from the Internet. The RFP, Amendments, and all responses to Vendor questions will be posted on the Iowa IRHTP site Association web site at Vendors are advised to check the IHA website periodically for amendments to this RFP as Vendors will not automatically receive Amendments and responses Definition of Contract. The full execution of a written contract shall constitute the making of a contract for services and no Vendor shall acquire any legal or equitable rights relative to the contract services until the Contract has been fully executed by the successful Vendor and the IRHTP Award Notice and Acceptance Period. The IRHTP will send an Award Notice to all Vendors submitting a timely bid proposal. Negotiation and acceptance of the contracts shall be completed with the successful Vendor no later than 60 days after the Award Notice. If an apparent successful Vendor fails to negotiate and deliver the executed contract by that date, the IRHTP may, in its sole discretion, cancel the award and award the contract to the next highest ranked Vendor. The IRHTP reserves the right to continue negotiations after 60 days if, in IRHTP s sole discretion, IRHTP deems it to be in the best interests of IRHTP to do so No Minimum Guaranteed. The IRHTP anticipates that the selected Vendor will provide services as requested by the IRHTP. The IRHTP will not guarantee any minimum compensation will be paid to the Vendor or any minimum usage of the Vendor s services Criminal History and Background Investigation. The IRHTP reserves the right to conduct criminal history and other background investigations of the Vendor, its officers, directors, shareholders, or partners and personnel retained by the Vendor for the performance of the Contract. 9

11 2.0 Contractual Terms Generally. CHAPTER 2 CONTRACTUAL TERMS General Contract Terms. The Contracts, which the IRHTP expects to award, will be based upon the bid proposal submitted by successful Vendors (Vendors awarded the Contract) and this solicitation. The Contracts between the IRHTP and the Vendor shall be a combination of the specifications, terms and conditions of the Request for Proposal, the offer of the Vendor contained in its bid proposal, written clarifications or changes made in accordance with the provisions herein, and any other terms deemed necessary by the IRHTP Negotiated Terms. Vendors should plan on negotiated terms being included in any Contract awarded as a result of this RFP. All costs associated with complying with these requirements should be included in any pricing quoted by the Vendor Acceptance/Exceptions. By submitting a bid proposal, each Vendor acknowledges its acceptance of these specifications, terms and conditions without change except as otherwise expressly stated in the appropriate section of the Bid Proposal Compliance Form (Annex A). If a Vendor takes exception to a provision, it must state the reason for the exception and set forth in Annex A of its bid proposal the specific Contract language it proposes to include in place of the provision. Exceptions that materially change these terms or the requirements of the RFP may be deemed non-responsive by the IRHTP, in its sole discretion, resulting in possible disqualification of the bid proposal. The IRHTP reserves the right to either award a Contract without further negotiation with the successful Vendor or to negotiate Contract terms with the selected Vendor if the best interests of the IRHTP would be served. 2.1 Additional Cost Items Not In Contract. IRHTP is unaware of any additional Contract terms that would add cost. Notwithstanding, should any Contract items arise that would cost additional monies; those costs shall be borne by the Vendor. 2.2 Additional Vendor Information. Service providers that intend to respond to this RFP must secure a Service Providers Identification Number (SPIN) from USAC. Service providers with existing SPIN numbers must submit a FCC form 498 to renew their eligibility. See the USAC website for details on how to secure a SPIN. 2.3 Mandatory Vendor Information Mandatory Vendor requirements The purpose of this paragraph is to identify the mandatory elements of information a Vendor must supply before any consideration will be given to a proposal.. All information listed below is required or at least an indication that the Vendor meets or exceeds the mandatory requirement for the following background information: Name, address, telephone number, fax number and address of the Vendor including all d/b/as or assumed names or other operating names of the Vendor Form of business entity, i.e., corporation, partnership, proprietorship, limited Liability Company. 10

12 State of incorporation (if a corporation). If a limited liability company, state of formation. The successful Vendor will be required to register the Iowa Secretary of State to do business in Iowa. If already registered, provide the date of the Vendor s registration to do business in Iowa Local office addresses and phone number Number of employees Type of business Name, address and telephone number of the Vendor s representative to contact regarding all contractual and technical matters concerning this proposal Name, address and telephone number of the Vendor s representative to contact regarding scheduling and other arrangements Vendor must provide the following legal or administrative information During the previous five (5) years, describe any damages or penalties or anything of value traded or given up by Vendor under any of its existing or past contracts as it relates to services performed that are similar to the services contemplated by this RFP and the resulting Contract. If so, indicate the reason for the penalty or exchange of property or services and the estimated account of the cost of that incident to the Vendor During the last five (5) years, describe any order, judgment or decree of any Federal or State authority barring, suspending or otherwise limiting the right of the Vendor to engage in any business, practice or activity. 2.4 Pricing and Cost Information. IRHTP will consider the purchase or lease of circuits and/or network equipment necessary to make a broadband service functional in conjunction with providing support for the broadband service. Equipment is defined as that hardware and software necessary to manage, control, or maintain a broadband service or a dedicated health care network. 2.5 Identify All Costs. Vendors submitting proposals should identify all costs associated with the solution or subset solution that they are quoting. Not all of the costs associated with the solutions will necessarily qualify for HCF funds, and it is critical that IRHTP and participants understand the complete cost of ownership. Quotes must include the following: For telecommunications solutions: Implementation Fees, including any cost of required hardware, for end-toend connectivity Ongoing transmission fees for end-to-end connectivity Tax/surcharge rate that will apply Any other costs associated with the solution and/or description of requirements that are prerequisites for the solution that may add additional cost to IRHTP and its participants For hardware and/or software solutions: Purchase price Installation costs Maintenance costs, including subscriptions, hardware, and software. 11

13 Shipping charges Ongoing support costs and support hour limits that may add costs Tax/surcharge rate that will apply Any other costs associated with the solution and/or description of requirements that are prerequisites for the solution that may add additional cost to IRHTP and its participants For Internet Services: Implementation Fees, including any cost of required hardware, for end-toend connectivity Ongoing transmission fees for end-to-end connectivity Ongoing subscription fees Any other costs associated with the solution and/or description of requirements that are prerequisites for the solution that may add additional cost to IRHTP and its participants For Ethernet Services Implementation Fees, including any cost of required hardware, for end-toend connectivity Ongoing transmission fees for end-to-end connectivity Ongoing subscription fees Any other costs associated with the solution and/or description of requirements that are prerequisites for the solution that may add additional cost to IRHTP and its participants. 2.6 Implementation Schedule Description Vendors should include a plan with a timeline that provides a clear understanding of the vendors capacity to implement each of the various methodologies by a given time. Unless otherwise noted, the optimal date for turn-up of many of these service requests is February 1, 2014, which corresponds to the beginning of the HCF funding cycle, though IRHTP recognizes that various projects will not be implemented as of that date. The Vendors implementation timeline should allow time for testing the implemented circuits/services. Additionally, please identify any circumstances that may create potential delays. Meeting healthcare provider mission critical timing requirements will be one of the proposal evaluation criteria. 2.7 Service and Performance Level Agreements The IRHTP consortium expects that any contracts resulting from this RFP will contain guarantees to the performance of the proposed solution to the specified speeds, transaction volumes, uptime rates, etc. Please include information regarding service levels and any service level guarantees associated with the solution, including uptime and response time guarantees. Vendors are encouraged to include strong guarantees, as this will be one of the proposal evaluation criteria. Please see Chapter 6, Paragraph Contracting Provisions The Healthcare Connect Fund provides an opportunity for HCPs to receive a significant subsidy relating to a wide range of eligible telecommunications products and services. However the rules of the program demand that consortia, HCPs, and vendors adapt their standard processes and contracts to effectively take advantage of this opportunity. Based on IRHTP s review of 12

14 the Healthcare Connect Fund Order and associated FAQs, we intend to require that vendors comply with the following contracting provisions: Payment. Vendors submitting bids should be aware that the payment process for the HCF may not reflect Vendors current billing practices. Contracted vendors will bill the IRHTP consortium directly for all contracted services IRHTP will have a separate invoicing arrangement with each participating HCP through which HCPs will contribute their 35% share plus their fair share of network administration, management, and equipment costs. Vendors will be required to incorporate payment term contract language that is consistent with the above process and guarantees the vendor will comply with the requirements of the Healthcare Connect Fund Once the bill is received by IRHTP, IRHTP will send the vendor a remittance in the amount of 35% of the billed amount. In order to receive the remaining 65% of the billed amount, the vendor will need to certify to USAC that certifies that the 35% payment was received from IRHTP and that the bill accurately reflects the services the HCP is receiving and that the invoicing package is accurate, after which the vendor will choose either to receive a direct payment or to off-set the vendors USF contributions by the 65% amount Existing Connections/Services. In some cases, bids are being requested for connections/services that already have circuits in place and are under existing contract. Vendors holding these contracts should view this RFP as an opportunity to extend or expand what is already in place and are under existing contract. If existing vendors bids are deemed to be the most cost effective, the existing vendors solutions may be selected with whatever contract modifications are required to meet the new circumstances and HCF rules. Alternatively, existing contracts that were bid through the traditional program may be evergreen Existing Infrastructure. The IRHTP consortium philosophy is to contract with multiple vendors to the extent that where sufficient vendor infrastructure is already in place, vendors have opportunity to provide beneficial pricing due to the previous investment. This being said, we are open to including Master Service Agreement (MSA) language with any selected vendors that allows us to add new network participants at specified pricing. Without such an MSA, IRHTP will need to undergo a new competitive bidding process every time a new participant wishes to join the consortium. To the extent that vendors are willing and able to include MSA language for a specific service area that meets the HCF requirements for specified pricing, proposals for such contract language are encouraged and will be considered. HCF FAQ language relating to MSAs and implications for adding new facilities are end noted at the end of this chapter Future Sites. As indicated in Chapter 4 of this RFP, the current 89 participating and eligible HCPs, as well as an unknown number of future eligible HCP sites, are the first phase of what is expected to be a growing number of HCP s that will decide over time to participate in the IRHTP consortium. It is feasible that over the next 15 years, the consortium may see many sites participating. IRHTP will be requesting that language be included in the contract in order to maximize our ability to grow in every case without issuing a new RFP Evergreen Contracts. IRHTP wishes to maximize the opportunity to Evergreen contracts that results from this RFP. According to HCF FAQ language, A new contract entered into by an HCP or consortium as a result of competitive bidding will be 13

15 designated as evergreen if it meets all of the following requirements: Signed by the individual HCP or consortium lead entity; Specifies the service type, bandwidth and quantity; Specifies the term of the contract; Specifies the cost of services to be provided; and Includes the physical addresses or other identifying information of the HCPs purchasing from the contract Variable Bandwidths. In those circumstances in which variable levels of bandwidth are being requested and quoted, vendors will be asked to incorporate the variable bandwidth levels and associated costs into the contract in order to allow HCPs to turn up their bandwidths without the need to engage in a new competitive bidding process Contract Extension Language. Vendors will be asked to incorporate contract language that allows HCPs to voluntarily extend their contracts beyond the first ten-year period by allowing one five-year renewal. HCF rules allow for such extensions to be executed without the need for a new competitive bidding process The following sample contract language would meet this contracting requirement: Prior to the expiration date, the customer shall have the option to voluntarily renew the initial 10-year Service Order for an additional Five (5) Year Service Period equaling a total of 15 years Another contracting consideration relates to the maximum three (3) year length of an HCF funding commitment. (See endnote #5) Even though it is anticipated that the HCF will fund connections/services for contracts resulting from this RFP for beyond the three (3) year guaranteed commitment, it s important for IRHTP and participant HCPs that cannot risk losing the subsidy after 3 years to structure contracts in a way that does not commit them beyond the three (3) year period. This can be achieved either by the vendor including term language that allows IRHTP participants to execute early termination of longer term contracts in the circumstance that HCF funding were to no longer be available after the three (3) year funding commitment Master Agreements will be between IRHTP and the vendor with HCPs signing subcontracts. The IRHTP project coordinator will facilitate and coordinate the contracting and payment process. (Refer to Chapter 1, paragraph 1.0) Each HCP participating in consortium contracting will be signing a service agreement with IRHTP that includes their vendor sub-contract as an addendum. We are in the process of considering how we propose to handle sub-contract severability language Additional contract terms, including any required by participating HCPs, will be discussed and negotiated with selected vendors. End note #3 An MSA is a contract (typically multi-year) between HCPs in a consortium and a vendor that contractually obligates the vendor to offer certain services to existing and/or future members of the consortium at specified pricing. An MSA under the Healthcare Connect Fund also may be a contract that has been negotiated by a federal, state, Tribal, or local government from which HCPs may be entitled to purchase services. Such MSAs must have been negotiated pursuant to competitive bidding. See HCF Order* at paras for more details regarding the circumstances under which HCPs may rely on MSA s 14

16 End note #4 Can consortia add new HCPs to their networks without going through the competitive bidding process? Yes, as long as adding new HCPs was contemplated in the original request for competitive bids. If adding additional HCP sites was not a part of the original bid solicitation, the applicant must conduct a new competitive bidding process. However, if adding new sites was contemplated in the original bid solicitation, applicants do not need to complete the competitive bidding process again to add new HCPs to the network. See HCF Order* at paras and for additional information. This is true even if a consortium requests more than $100,000 in funding in a year to add new sites to its network using its original bid solicitation. If either the first or the second renewal option is not exercised, this Service Order shall automatically renew for successive one-month terms unless either party terminates this Service Order by giving thirty (30) days prior written notice to the other party before the expiration of the current term. End note #5 Are applicants guaranteed a certain amount of funding through the Healthcare Connect Fund? No. Funding requests for all applicants are processed on a first-come, first-served basis, unless USAC has established a filing window, in which case all applications received within the window will be deemed to have been filed at the same time. The Commission has stated that it does not anticipate that it will reach the $400 million funding cap for all rural health care programs in the foreseeable future. However, because funding is not guaranteed, an applicant may choose to include in any contract it makes with a vendor a provision governing the effectiveness of the agreement if the applicant does not receive a funding commitment from USAC. See HCF Order* at paras for more information. Can an applicant receive support for a 36-month contract for eligible services if it covers a time period that spans more than three funding years? No. Applicants in the Healthcare Connect Fund can only receive a multi-year funding commitment that covers a period of up to three funding years. Accordingly, any months outside of the three funding years would not be covered by the commitment. For example, if an applicant requested a 36-month funding commitment for services starting on July 1, 2014, USAC could issue a 36-month funding commitment that would expire on June 30, 2017, and the applicant would receive a commitment for the full 36 month period. However, if an applicant requested a 36-month funding commitment for services that started on January 1, 2014, USAC could issue only a commitment for services for the remaining six months of funding year 2013, and all of funding years 2014 and Although the applicant s contract would also cover six months of funding year 2016, it would not be covered by the multi-year funding commitment. Accordingly, the commitment would end on June 30, See HCF Order* at paras for more information on multi-year funding commitments. 15

17 CHAPTER 3 HOSPITAL ETHERNET CONNECTIONS TO IRHTP NETWORK 3.0 Purpose of This Chapter. The Iowa Rural Health Telecommunications Program (IRHTP) is soliciting proposals from qualified fiber optic network providers to provide a 1 GBs Ethernet link-segment platform to two IRHTP hospitals. One hospital location is in Grinnell, Iowa and the other is located in Sigourney, Iowa. The connections will terminate at the nearest IRHTP aggregation point (See Attachments 1 and 2). 3.1 Evergreen Contracts. It is the intent of the IRHTP to establish Evergreen (automatically renewing) contracts with the Vendor Bandwidth Procurement. The initial bandwidth overlaid on these 1 GB Ethernet platform connections may only a 30 MBs application; however, the new healthcare electronic records system and future applications such as radiology and internet distribution will cause significant growth in the very near future. By requiring a 1 GBs Ethernet platform to be initially installed, the hospital will not have to experience outages while modifications are made to upgrade smaller bandwidth platforms. 3.3 Link-Segments A link-segment is generally defined as the fiber optic facility beginning at the health care provider s (HCP) Alcatel-Lucent 7210 edge switch and continuing on until terminated on the Alcatel-Lucent 1692 aggregation switch currently at a designated IRHTP aggregation point Each link-segment constructed or provided as part of this project is engineered and tested for a minimum of one gigabit of throughput from the local hospital to the specified IRHTP aggregation point. 3.4 Handoff. Methodology of the handoff will be negotiated with the successful vendor at contract signing. 3.5 Vendor Requirements The Vendor must submit a detailed overview of the proposed network, and how the vendor proposes to implement the installation, testing, and handoff of the new service The Vendor must detail the process on the method to accomplish the HCP incremental change of bandwidth and the respective change in billing process Vendor must fulfill all of the requirements of Chapter 6 of this RFP, Testing Process and Procedures The Vendor must detail the process for issuing reimbursements for lost service All installation charges resulting from the implementation of this Chapter 3 and all other fees and taxes or other charges must be imbedded in the monthly rate. IRHTP will pay no other costs other that the costs submitted on the Bid Submittal form Attachment 3 (Bid Response Sheet Hospital to IRHTP Network Connectivity) requires an inclusive initial 10-year term price, with one voluntary renewal term of five (5) years. All costs, installation, build out (if necessary), equipment, and maintenance must be included in the monthly rate) requires an inclusive initial 10-year term price, with one voluntary renewal term of five (5) years. All costs, installation, build out (if necessary), equipment, and maintenance must be included in the monthly rate. 16

18 3.6 Local Hospital. IRHTP has designated a local on-site coordinator at each participating hospital. The on-site coordinator has designated the location of the fiber termination within the building. Any service turn-up must be coordinated with this on-site coordinator. 3.7 Change Orders. The vendor must submit a firm fixed monthly price for each site bid for each increment listed on the Attachment 3 Bid Submittal Form. There are no funds set aside or budgeted for contingencies or change orders. 17

19 ATTACHMENT 1 LIST OF HCP OWNED LINK-SEGMENTS AND THEIR LOCATIONS Line HCP HCP Address Distance Distance Aggregation Point Address Grinnell Community Senior High School 1333 Sunset Street. Grinnell, Iowa 1 Grinnell Regional Medical Center th Avenue Grinnell, Iowa, mi 1.44 km Keokuk County Health Center Highway 149, Sigourney, IA mi Sigourney Jr/Sr High School 907 East.85 km Pleasant Valley ATTACHMENT 2 LIST of HCP OWNED SWITCHES AND THEIR LOCATIONS Line HCP HCP Address Aggregation Point Address MPLS Switch Location Grinnell Community Senior High Iowa Valley Comm College, 3700 School 1333 Sunset Street. South Center Street Marshalltown, 1 Grinnell Regional Medical Center Grinnell, Iowa Iowa Keokuk County Health Center th Avenue Grinnell, Iowa Highway 149, Sigourney, IA Sigourney Jr/Sr High School 907 East Pleasant Valley Indian Hills Comm College, 525 Grandview Ave. Ottumwa, IA

20 ATTACHMENT 3 VENDOR S RESPONSE TO CHAPTER 3 - HOSPITAL TO IRHTP NETWORK CONNECTIVITY BID SUBMITTAL FORM Note: The Bid Submittal Form consists of one (1) page. This page must be signed by an officer of the company and dated: Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 1 Gb/s > 1 Gb/s 1 Grinnell Regional Medical Center th Avenue, Grinnell, Iowa Keokuk County Health Center Highway 149, Sigourney, IA Officer Signature Date 19

21 CHAPTER 4 INTERNET SERVICES FOR IRHTP HOSPITALS AND OTHER SITES 4.0 General Information: A consortium of Iowa hospitals, belonging to the Iowa Rural Health Telecommunication Program (IRHTP), is requesting proposals for Internet service to existing and future sites IRHTP is a FCC Pilot Program participant and therefore qualifies to submit this RFP and other documentation to receive funding through the newly created FCC Healthcare Connect Fund (HCF) as early as February 1, IRHTP is seeking proposals, which will receive partial funding through the Healthcare Connect Fund (HCF), for the non-recurring costs (NRC) associated with provisioning the leased service in addition to 10 years of monthly recurring costs (MRC) for all 89 of the IRHTP Consortium locations. The proposal should also include a voluntary renewal option for an additional five (5) years In the Pilot Program, IRHTP coordinated the installation of broadband access to 89 IRHTP hospital sites and other healthcare providers (HCPs). With the addition of the Healthcare Connect Fund and this RFP, IRHTP is expanding its focus to fund a wide range of healthcare-related broadband use locations for the 89 currently eligible Iowa HCPs that have signed Letters of Agency to allow IRHTP to request bids on their behalf Once the bids are received, these HCPs will determine their intention to proceed to the contracting phase of the process Those HCPs that proceed to contracting will authorize IRHTP to submit forms and process payments on their behalf for any accepted bids issued as a result of this RFP process Note that the current 89 participating HCPs listed in Attachment 4 are the first phase of what is expected to be a growing number of HCPs that decide over time to participate in the IRHTP consortium. It is feasible that over the next 15 years there will be additional sites participating. These sites are not identified in this RFP, but the Vendor must be willing to accept these future sites into the same pricing scenario as the initial 89 sites. 4.1 Bidding Instructions specific to this section Unless otherwise noted, bids for Internet service should be for an initial 10-year contract period beginning as early as February 1, USAC rules provide for one voluntary five-(5) year renewal Additionally, it should be noted that reasonable and customary installation charges up to $5,000 and upfront charges for service provider deployment of new or upgraded facilities up to an average of $50,000 per consortium member are eligible for funding through the HCF consortia program (unlike the traditional USAC program). Any requirements for upfront charges should be clearly stated in all proposals. All costs must be included in the vendor s response Upfront payments. Upfront payments include all non-recurring costs for services, equipment, or facilities, other than reasonable and customary installation charges of up to $5, Limitations. The following limitations apply to all upfront payments: 20

22 Upfront payment associated with services providing a bandwidth of less than 1.5 Mbps (symmetrical) are not eligible for support Only consortium applicants are eligible for support for upfront payments The following limitations apply if a consortium makes a request for support for upfront payments that exceeds, on average, $50,000 per eligible site in the consortium The support for the upfront payments must be prorated over at least three (3) years The upfront payments must be part of a multi-year contract Quotes are being requested for variable levels of service. This will enable the HCP to weigh the pros and cons of higher levels of Internet service against the additional cost incurred. However, it is recognized that for a variety of reasons different service providers will have different increments of service that they can provide. Vendors should feel free to quote the increments of Internet service (even if not identical to what is in our request) they are in a position to deploy Vendors submitting bids are again reminded that the payment process for the HCF may not reflect vendor s current billing processes. Vendors are directed to see Chapter 2 of this RFP for billing process details First-time applicants will be assigned a SPIN by USAC. See ( The FCC Form 498 collects the following information: service provider name, address, phone numbers, addresses, contact names, and billing and collection information. Those vendors with existing SPIN must file FCC form 498 to renew that number for this project Cost Effectiveness It is anticipated that several vendors may be required to provide all of the components requested by the HCP. For the purposes of the Healthcare Connect Fund, cost-effective is defined as the method which costs the least after consideration of the features, quality of transmission, reliability, and other factors that the health care provider deems relevant to choosing a method of providing the required health care services Vendors are encouraged to make proposals on those parts of the project where they feel they can effectively provide a solution. Vendor proposals will be evaluated based on the IRHTP determination, in collaboration with the affected HCPs, to be the most cost effective solution In some cases, bids are being requested for services that are already in place and are under existing contract. Both new and existing vendors are welcome to bid on these service requests. Whichever proposals are deemed to be the most cost effective will be selected Leaving existing vendor solutions in place may be deemed to be the most cost effective solution. If so, some contract modification may be required to meet HCF rules Vendors must, in all cases, clearly indicate when solutions either require or are dependent upon additional hardware, systems and/or vendors, in order to account for all costs of the functionality requested/promised services. If the vendor is unable to provide the costs for a dependent vendor system, this must be indicated in the response. 21

23 If the Vendor is aware of a required component that is not specifically requested but is needed to deploy a fully functional system in this RFP, the vendor must identify that component and include that cost in the RFP response. 4.2 Specific Internet Service Specifications: Vendors shall respond with their public Internet pricing as specified on Attachments 4 and 5. Vendor shall provide pricing for each speed increment shown on Attachments 4 and 5 for each of the 89 IRHTP hospital locations. If the Vendor cannot provide a specific increment of service, Vendor should list what can be provided for that location. Vendors must provide a single full-duplex connection to the Public Internet Vendor must state how many static IP addresses will be provided each location at no additional charge, as part of an enhanced service offering List the industry standards that the Vendor will use for this project. Describe how the equipment could support IPv6 when that becomes a de facto standard Describe the process that new IRHTP sites will use to sign up for service at a future date IRHTP Consortium members must be able to originate and terminate virtual private network (VPN) connections on their own equipment located behind the Vendors connection to the HCP meet point(s) shown in Attachments 4 and 5. IRHTP Consortium members must be able to configure these types of VPN connections (i.e.: those that originate and terminate behind the Vendor s network interface) at will and without any assistance or permission of the Vendor. It is understood that any VPN capable equipment is owned and provided by the Consortium members and is not included in this RFP. 4.3 Bandwidth Change IRHTP is seeking the ability to increase or decrease Internet bandwidth speeds for the members participating in its network. Vendors should describe how a level of service can be upgraded to provide a higher level of service in the future for the customers who sign up initially for a particular level of service, but need to increase speeds during the contract period Explain how a Consortium member location can terminate service without incurring penalties. 4.4 Power Requirements Vendor must identify the specific power requirements (AC or DC) for its equipment located at a HCP Meet Point. 4.5 Continuing Services HCPs cannot experience an interruption of Internet service due to administrative process dates or documents. This RFP is to enable the existence of three years of network services delivery (based on a funding commitment date contained in the Funding Commitment Letter) allowing current participating entities and new eligible entities the option to continue services at the same pricing or less for an additional seven years, plus one voluntary renewal of five (5) years. 4.6 Start-up Date Actual service startup must be within 90 calendar days of contract award. Include a timeline for each location specified in Attachments 4 and 5 with date service could be available to the HCP if beyond 90 days. 4.7 Testing Include a timeline and a description of the process the Vendor will use to conduct testing of the Internet connections to and through the HCP Meet Point. (See Chapter 6 of this RFP.) 4.8. Management Reports Describe Management Reports that are available at no additional cost. 22

24 4.8.1 Vendor must describe the routing to the various Internet switches throughout the country. Description is to include the specific route bandwidth size of the connections and state how many hops are required between the Vendor s equipment and the above mentioned locations Vendor shall provide a bandwidth guarantee for the IRHTP s contracted bandwidth amount Vendor must route all current and future ARIN registered /24 or greater IP block owned by IRHTP or its users Vendor shall certify that all one-time and recurring costs associated with the service are included in the Vendor s bid proposal Vendor must provide an IP backbone map of the Vendor s network showing total bandwidth between Vendor Router locations that are currently operational (listing IP addresses of the routers is not required or desired) Vendor must describe current ability of its network to carry the additional traffic from IRHTP while at the same time meeting all current and future requirements of Vendor s existing and future customers Vendor must describe how secondary DNS for the current and future domains for which IRHTP is the primary provider could be provided Vendor must include information about the number and speed of the peering arrangements Vendor has with other ISPs Vendor must specify any routing policy on Vendor s network for IP route prefix lengths Vendor must describe any statistical reports available to the IRHTP about the Vendor s POP, to which the IRHTP would be connected Vendor must specify whether there is or is not a route server available on the Vendor s network that will show the Vendor s current routing tables and that would be available for use by the IRHTP. 4.9 IP Address Allocation: IRHTP sites must be able to obtain additional IP addresses if required. Designate the number of routable addresses available for each IRHTP site circuit Domain Name Service: Designate whether the vendor will provide primary and secondary Domain Name Service (DNS) Online Reporting: If available, state whether the Vendor will provide the IRHTP site with a password-protected web portal to access online reports containing their historical network traffic information Network Monitoring: Vendor must describe its Network Monitoring process Technical Support: Vendor must provide IRHTP sites a toll-free trouble reporting telephone number to the Vendor s Network Operations Center (NOC) that operates on a 24x7x365 basis. Vendor must provide technical support for service-related inquiries Maintenance IRHTP Site s Responsibilities: Vendor must describe the IRHTP site s maintenance responsibilities, if any BGP Policies: Vendor must detail its BGP policies. Vendor must list all terms and conditions and/or requirements that the IRHTP would be required to meet to establish a BGP (Non Transit) 23

25 peering connection. Vendor will provide the upgrade options currently in place for this level of service Service-level Agreements (SLA). Vendor shall submit their proposed SLA information for this service and detail their ability to meet the IRHTP requirements, where applicable. The submitted SLA shall reference the following minimal elements and corresponding requirements Up Time: The IRHTP requests guaranteed uptime of %. State the guaranteed uptime vendor can offer Latency: The measured latency within IRHTP and Vendors Network must be less than 60 Milliseconds Port-to-Port Response Time: IRHTP desires a minimum of 30-minute initial response time and two hour on-site time, if required. State the standard initial response time and on-site time for reported troubles Mean Time To Repair: - Three (3) hours Planned Network Maintenance: IRHTP requires 72 hours or more advance notice prior to planned network maintenance. State the standard notification Vendor provides to customers for Planned Network Maintenance. Vendor must describe its standard maintenance window Scheduled Network Outages: Specify when and how often there are scheduled network outages in order to perform maintenance and/or upgrades Escalation: List Vendor s trouble escalation procedures Security Incidents: List any programs in place specifically for monitoring and resolving security incidents Credit Allowances: Vendor must provide a listing of the credit allowances and/or refunds that may be assessed based upon service outages. Example: If service were unavailable for 5 minutes, state the refund amount. If the service were unavailable for 30 minutes state that refund amount Pricing Methodology: IRTHP requires a pricing methodology based on pricing that can be extrapolated across the State of Iowa and surrounding states Some locations will only require Internet service levels of 1 Mbs, 3 Mbs, 4.5 Mbs, 6 Mbs or 10 Mbs. Other locations will require increments of 30 Mbs, 60 Mbs, 100 Mbs, 200 Mbs, 500 Mbs. IRTHP is fully aware that not all vendors will be able to serve all locations. Vendor responses should state which bandwidths and services requested by this section are available in areas they can service The Internet service pricing secured as a result of this RFP will also be applicable to future IRHTP sites joining the IRHTP network Vendor Response Sheets -Attachment 4 and 5 (Vendor Response Sheets IRHTP site Internet Service) requires an all inclusive initial 10-year term price, with one voluntary renewal term of five (5) years. All costs, installation, carrier build out (if necessary), equipment, and maintenance must be included in the monthly rate. If a Vendor cannot serve all locations, the vendor should attach a map, diagram, or narrative describing the area(s) that can be served per the indicated pricing. If a Vendor is using a correspondent carrier or LEC to deliver service, all of the costs associated with the delivery of that service to a site must be included in one monthly total. 24

26 25

27 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 4 IRHTP LOW SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 1 of 7 Line # HCP name HCP Address Adair County Memorial Hospital 609 SE Kent, Greenfield, IA Alegent Health Community Memorial 631 North 8th St., Missouri Valley, IA Hospital 3 Alegent Health Mercy Hospital 800 Mercy Drive, Council Bluffs, IA Council Bluffs 4 Alegent Health Mercy Hospital 603 Rosary Drive, Corning, IA Corning 5 Audubon County Memorial Hospital 515 Pacific St, Audubon, IA Avera Holy Family Health 826 N. 8th St., Estherville, IA Avera McKennan 2920 West 10 th Street., Sioux Falls, SD Baum Harmon Mercy Hospital 255 N. Welch Ave., Primghar, IA., Iowa Specialty Hospital 403 1st St. SE, Belmond, IA Boone County Hospital 1015 Union St., Boone, IA Buchanan County Health Center st St. E, Independence, IA, Signature of Officer Date 26

28 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 4 IRHTP LOW SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 2 of 7 Line # HCP name HCP Address Burgess Health Center 1600 Diamond St., Onawa, IA, Central Community Hospital 901 Davidson St. NW, Elkader, IA Cherokee Regional Health Center 300 Sioux Valley Dr., Cherokee, IA Clarinda Regional Health Center 823 S. 17th St., Clarinda, IA Crawford County Memorial Hospital st Ave S., Denison, IA Davis County Hospital 509 N. Madison, Bloomfield, IA Dallas County Hospital th St., Perry, IA Ellsworth Municipal Hospital 110 Rocksylvania Ave, Iowa Falls, IA Floyd County Medical Center th St., Charles City, IA Floyd Valley Hospital 714 Lincoln St NE, Hwy 3 East, LeMars, IA Fort Madison Community Hospital 5445 Ave. O #174, Fort Madison, IA Franklin General Hospital 1720 Central Ave E, Hampton, IA Signature of Officer Date 27

29 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 4 IRHTP LOW SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 3 of 7 Line # HCP name HCP Address Genesis Health System 1227 E. Rusholme St., Davenport, IA Genesis Health System DeWitt th St., DeWitt, IA, Genesis Plaza 2535 Maplecrest Rd., Bettendorf, IA, Genesis Bettendorf Imaging Center 4017 Devils Glen Rd., Bettendorf, IA Grape Community Hospital 2959 US Hwy 275, Hamburg, IA Great River Medical Center 1221 S. Gear Ave, W. Burlington, IA Grinnell Regional Medical Center th Avenue, Grinnell, Iowa Hancock County Memorial Hospital st St NW, Britt, IA Hawarden Community Hospital th St., Hawarden, IA Hegg Memorial Health Center st. Ave., Rock Valley, IA Henry County Health Center 407 S. White St., Mt Pleasant, IA Horn Memorial Hospital 701 E. 2nd St, Ida Grove, IA Jefferson County Hospital 400 Highland St., Fairfield, IA Jennie Edmundson Hospital 933 E. Pierce St., #2C, Council Bluffs, IA Signature of Officer Date 28

30 ATTACHMENT 4 IRHTP LOW SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 4 of 7 Note: Each page must be signed by an officer of the company and dated. Line # HCP name HCP Address Keokuk Area Hospital 1600 Morgan St., Keokuk, IA Keokuk County Health Center Highway 149, Sigourney, IA Knoxville Hospital & Clinics 1002 S. Lincoln St., Knoxville, IA Kossuth Regional Health Center 1515 S. Phillips St., Algona, IA Lakes Regional Healthcare 2301 Hwy 71, Spirit Lake, IA Lucas County Health Center 1200 N 7th St, Chariton, IA Madison County Health Care System 300 W. Hutchings St., Winterset, IA Mahaska Health Partnership 1229 C Ave. East, Oskaloosa, IA Manning Regional Healthcare Center 410 Main St., Manning, IA Marengo Memorial Hospital 300 W. May St., Marengo, IA Marshalltown Medical and Surgical Center Three S. 4th Ave, Marshalltown, IA Mercy Medical Center, West Lakes th St, West Des Moines, IA Mercy Iowa City 500 E. Market St., Iowa City, IA Mercy Medical Center Cedar Rapids th St. SE, Cedar Rapids, IA Signature of Officer Date 29

31 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 4 IRHTP LOW SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 5 of 7 Line # HCP name HCP Address Mercy Medical Center Centerville St., St Josephs Dr., Centerville, IA Mercy Medical Center Clinton 1410 N 4th St., Clinton, IA Mercy Medical Center Des Moines th Ave, Des Moines, IA Mercy Medical Center Dubuque 250 Mercy Dr., Dubuque, IA Mercy Medical Center Dyersville rd St SW, Dyersville, IA Mercy Medical Center New Hampton 308 N Maple Ave, New Hampton, IA Mercy Medical Center N. Iowa East th St SW, Mason City, IA Campus 59 Mercy Medical Center Sioux City 801 5th St., Sioux City, IA Mitchell County Regional Health 616 N 8th St., Osage, IA Center 61 Monroe County Hospital th St, Albia, IA Orange City Area Health System 1000 Lincoln Circle SE, Orange City, IA Osceola Community Hospital, Inc. 9th Ave N., Sibley, IA Palmer Lutheran Health Center, Inc. 112 Jefferson St., West Union, IA Palo Alto County Health System st St., Emmetsburg, IA Signature of Officer Date 30

32 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 4 IRHTP LOW SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 6 of 7 Line # HCP name HCP Address Pella Regional Health Center 404 Jefferson St., Pella, IA Regional Health Services of Howard 235 8th Ave W., Cresco, IA Co. 68 Regional Medical Center 709 W. Main St., #359. Manchester, IA Ringgold County Hospital 504 N. Cleveland, Mt. Ayr, IA Sanford Health 1305 West 18 th St, Sioux Fall, SD Sanford Hospital Rock Rapids 801 Greene St., Rock Rapids, IA Sanford Sheldon Medical Center 118 N. 7th Ave, Sheldon, IA Shenandoah Medical Center 300 Pershing Ave., Shenandoah, IA Sioux Center Community Hospital/Health Center 605 S. Main Ave., Sioux Center, IA Skiff Medical Center 204 N. 4th Ave. E, Newton, IA Spencer Hospital st Ave. E., Spencer, IA St. Anthony Regional Hospital 311 S. Clark St., Carroll, IA Stewart Memorial Community Hospital 1301 W. Main St., Lake City, IA Signature of Officer Date 31

33 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 4 IRHTP LOW SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 7 of 7 Line # HCP name HCP Address Story County Medical Center 630 6th St., Nevada, IA University of Iowa Hospitals & Clinics 200 Hawkins Dr., Iowa City, IA Van Buren County Hospital 304 Franklin St., Keosauqua, IA Van Diest Hospital 800 Ohio St., Webster City, IA Veterans Memorial Hospital 40 1st Ave SE., Waukon, IA Virginia Gay Hospital 502 N 9th Ave., Vinton, IA Waverly Health Center 312 9th St. SW, Waverly, IA Wayne County Hospital 417 S. East Street, Corydon, IA Winneshiek Medical Center 901 Montgomery St., Decorah, IA Washington County Hospital 400 E. Polk St., Washington, IA Iowa Specialty Hospital 1316 S. Main St., Clarion, IA Signature of Officer Date 32

34 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 5 IRHTP HIGH SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 1 of 7 Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 1 Adair County Memorial Hospital 609 SE Kent, Greenfield, IA Alegent Health Community Memorial 631 North 8th St., Missouri Valley, IA Hospital 3 Alegent Health Mercy Hospital 800 Mercy Drive, Council Bluffs, IA Council Bluffs 4 Alegent Health Mercy Hospital 603 Rosary Drive, Corning, IA Corning 5 Audubon County Memorial Hospital 515 Pacific St, Audubon, IA Avera Holy Family Health 826 N. 8th St., Estherville, IA Avera McKennan 2920 West 10 th Street., Sioux Falls, SD Baum Harmon Mercy Hospital 255 N. Welch Ave., Primghar, IA., Iowa Specialty Hospital 403 1st St. SE, Belmond, IA Boone County Hospital 1015 Union St., Boone, IA Buchanan County Health Center st St. E, Independence, IA, Burgess Health Center 1600 Diamond St., Onawa, IA, Signature of Officer Date 33

35 ATTACHMENT 5 IRHTP HIGH SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 2 of 7 Note: Each page must be signed by an officer of the company and dated. Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 13 Central Community Hospital 901 Davidson St. NW, Elkader, IA Cherokee Regional Health Center 300 Sioux Valley Dr., Cherokee, IA Clarinda Regional Health Center 823 S. 17th St., Clarinda, IA Crawford County Memorial Hospital st Ave S., Denison, IA Davis County Hospital 509 N. Madison, Bloomfield, IA Dallas County Hospital th St., Perry, IA Ellsworth Municipal Hospital 110 Rocksylvania Ave, Iowa Falls, IA Floyd County Medical Center th St., Charles City, IA Floyd Valley Hospital 714 Lincoln St NE, Hwy 3 East, LeMars, IA Fort Madison Community Hospital 5445 Ave. O #174, Fort Madison, IA Franklin General Hospital 1720 Central Ave E, Hampton, IA Genesis Health System 1227 E. Rusholme St., Davenport, IA Genesis Health System DeWitt th St., DeWitt, IA, Signature of Officer Date 34

36 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 5 IRHTP HIGH SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 3 of 7 Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 26 Genesis Plaza 2535 Maplecrest Rd., Bettendorf, IA, Genesis Bettendorf Imaging Center 4017 Devils Glen Rd., Bettendorf, IA Grape Community Hospital 2959 US Hwy 275, Hamburg, IA Great River Medical Center 1221 S. Gear Ave, W. Burlington, IA Grinnell Regional Medical Center th Avenue, Grinnell, Iowa Hancock County Memorial Hospital st St NW, Britt, IA Hawarden Community Hospital th St., Hawarden, IA Hegg Memorial Health Center st. Ave., Rock Valley, IA Henry County Health Center 407 S. White St., Mt Pleasant, IA Horn Memorial Hospital 701 E. 2nd St, Ida Grove, IA Jefferson County Hospital 400 Highland St., Fairfield, IA Jennie Edmundson Hospital 933 E. Pierce St., #2C, Council Bluffs, IA Keokuk Area Hospital 1600 Morgan St., Keokuk, IA Keokuk County Health Center Highway 149, Sigourney, IA Signature of Officer Date 35

37 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 5 IRHTP HIGH SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 4 of 7 Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 40 Knoxville Hospital & Clinics 1002 S. Lincoln St., Knoxville, IA Kossuth Regional Health Center 1515 S. Phillips St., Algona, IA Lakes Regional Healthcare 2301 Hwy 71, Spirit Lake, IA Lucas County Health Center 1200 N 7th St, Chariton, IA Madison County Health Care System 300 W. Hutchings St., Winterset, IA Mahaska Health Partnership 1229 C Ave. East, Oskaloosa, IA Manning Regional Healthcare Center 410 Main St., Manning, IA Marengo Memorial Hospital 300 W. May St., Marengo, IA Marshalltown Medical and Surgical Center Three S. 4th Ave, Marshalltown, IA Mercy Medical Center, West Lakes th St, West Des Moines, IA Mercy Iowa City 500 E. Market St., Iowa City, IA Mercy Medical Center Cedar Rapids th St. SE, Cedar Rapids, IA Mercy Medical Center Centerville St., St Josephs Dr., Centerville, IA Signature of Officer Date 36

38 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 5 IRHTP HIGH SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 5 of 7 Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 53 Mercy Medical Center Clinton 1410 N 4th St., Clinton, IA Mercy Medical Center Des Moines th Ave, Des Moines, IA Mercy Medical Center Dubuque 250 Mercy Dr., Dubuque, IA Mercy Medical Center Dyersville rd St SW, Dyersville, IA Mercy Medical Center New Hampton 308 N Maple Ave, New Hampton, IA Mercy Medical Center N. Iowa East th St SW, Mason City, IA Campus 59 Mercy Medical Center Sioux City 801 5th St., Sioux City, IA Mitchell County Regional Health 616 N 8th St., Osage, IA Center 61 Monroe County Hospital th St, Albia, IA Orange City Area Health System 1000 Lincoln Circle SE, Orange City, IA Osceola Community Hospital, Inc. 9th Ave N., Sibley, IA Palmer Lutheran Health Center, Inc. 112 Jefferson St., West Union, IA Palo Alto County Health System st St., Emmetsburg, IA Signature of Officer Date 37

39 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 5 IRHTP HIGH SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 6 of 7 Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 66 Pella Regional Health Center 404 Jefferson St., Pella, IA Regional Health Services of Howard 235 8th Ave W., Cresco, IA Co. 68 Regional Medical Center 709 W. Main St., #359. Manchester, IA Ringgold County Hospital 504 N. Cleveland, Mt. Ayr, IA Sanford Health 1305 West 18 th St, Sioux Fall, SD Sanford Hospital Rock Rapids 801 Greene St., Rock Rapids, IA Sanford Sheldon Medical Center 118 N. 7th Ave, Sheldon, IA Shenandoah Medical Center 300 Pershing Ave., Shenandoah, IA Sioux Center Community Hospital/Health Center 605 S. Main Ave., Sioux Center, IA Skiff Medical Center 204 N. 4th Ave. E, Newton, IA Spencer Hospital st Ave. E., Spencer, IA St. Anthony Regional Hospital 311 S. Clark St., Carroll, IA Stewart Memorial Community Hospital 1301 W. Main St., Lake City, IA Signature of Officer Date 38

40 Note: Each page must be signed by an officer of the company and dated. ATTACHMENT 5 IRHTP HIGH SPEED INTERNET SERVICE BID SUBMITTAL FORM Page 7 of 7 Line # HCP name HCP Address 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs 79 Story County Medical Center 630 6th St., Nevada, IA University of Iowa Hospitals & Clinics 200 Hawkins Dr., Iowa City, IA Van Buren County Hospital 304 Franklin St., Keosauqua, IA Van Diest Hospital 800 Ohio St., Webster City, IA Veterans Memorial Hospital 40 1st Ave SE., Waukon, IA Virginia Gay Hospital 502 N 9th Ave., Vinton, IA Waverly Health Center 312 9th St. SW, Waverly, IA Wayne County Hospital 417 S. East Street, Corydon, IA Winneshiek Medical Center 901 Montgomery St., Decorah, IA Washington County Hospital 400 E. Polk St., Washington, IA Iowa Specialty Hospital 1316 S. Main St., Clarion, IA Signature of Officer Date 39

41 CHAPTER 5 HEALTHCARE CONNECT FUND NETWORK EXPANSION PROJECT ETHERNET CONNECTIVITY 5.0 Background: A consortium of Iowa IRHTP Hospitals, belonging to the Iowa Rural Health Telecommunication Program (IRHTP), is requesting proposals for broadband Ethernet services IRHTP is a FCC Pilot Program participant and therefore qualifies to submit this RFP and other documentation to receive funding through the newly created FCC Healthcare Connect Fund (HCF) as early as February 1, With the addition of the Healthcare Connect Fund and this RFP, IRHTP is expanding its focus to fund a wide range of healthcare-related broadband use locations for the Iowa healthcare providers (HCPs) that have signed Letters of Agency to allow IRHTP to request bids on their behalf. See Annex D for the list of these sites Once the bids are received, these HCPs will determine their intention to proceed to the contracting phase of the process Those HCPs that proceed to contracting will be authorizing IRHTP submit forms and process payments on their behalf for any accepted bids issued as a result of this RFP process Note: there are 28 HCP owned sites that are listed in Attachment 7 that are the first phase of what is expected to be a growing number of HCPs that decide over time to participate in the IRHTP consortium. These 28 owned HCP site are sites that very likely will the first sites to order services from this RFP. This Attachment is provided to give the Vendor an example of the initial bandwidths being used at these types of sites. Over the next 15 years we will see additional sites participating. These future sites are not identified in this RFP, but the Vendor must be willing to accept these future sites into the same pricing scenario as the initial 28 sites Unless otherwise noted, bids for broadband service requests should be for an initial ten-year contract period beginning as early as February 1, 2014, USAC rules provide for one voluntary five (5)-year renewal Additionally, it should be noted that reasonable and customary installation charges up to $5,000 and vendor build-out charges for service provider deployment of new or upgraded facilities up to an average of $50,000 per consortium member are eligible for funding through the HCF consortia program (unlike the traditional USAC program). Any requirements for Vendor build-out charges should be clearly stated in all proposals. All costs must be included in the vendor s response Quotes will be requested for specific levels of bandwidth. However, the HCP will weigh the costs of the other increments of bandwidth stated in 40

42 Attachment 8. This will enable the HCP to weigh the pros and cons of higher bandwidth levels against the additional cost incurred. However, it is recognized that for a variety of reasons different service providers will have different increments of bandwidth that they can provision. Vendors should feel free to quote the increments of bandwidth (even if not identical to what is in our request) they are in a position to deploy Vendors submitting bids are again reminded that the payment process for the HCF may not reflect vendor s current billing processes. Vendors are directed to Chapter 2 of this RFP Vendors should also be aware that they will need to obtain a SPIN in order to participate in this program ( Vendors who currently have a SPIN number assigned, must file a FCC form 498 to renew their number for this project Cost Effectiveness Vendor proposals will be evaluated based on what the IRHTP and the affected HCPs determine to be the most cost effective solution. It is anticipated that several vendors may be required to provide all of the components requested by the HCP. For the purposes of the Healthcare Connect Fund, costeffective is defined as the method which costs the least after consideration of the features, quality of transmission, reliability, and other factors that the health care provider deems relevant to choosing a method of providing the required health care services Vendors are encouraged to make proposals on those parts of the project where they feel they can effectively provide a solution. Vendor proposals will be evaluated based on the IRHTP determination, in collaboration with the affected HCPs, to be the most cost effective solution The IRHTP and participating HCPs will evaluate Cost effectiveness, see Chapter 7 of this document In some cases, bids are being requested for connections and services that already have circuits in place and are under existing contract. Both new and existing vendors are welcome to bid on these service requests. Whichever proposals are deemed to be the most cost effective will be selected Leaving existing vendor solutions in place may be deemed to be the most cost effective solution. If so, some contract modification may be required to meet HCF rules Vendors must in all cases clearly indicate when solutions either require or are dependent upon additional hardware, systems and/or vendors, so that all costs of the functionality requested/promised are accounted for. If the vendor is unable to provide the costs for a dependent vendor system, this must be indicated in the response If the Vendor knows of a required item that is required to deploy a fully functional system that is not specified in this RFP, the vendor must identify that item and include that cost in the RFP response. 41

43 5.1 Specific Requirements: As part of the Healthcare Connect Fund opportunity, IRHTP desires to secure pricing and a methodology from Vendors to connect eligible IRHTP site owned HCP satellite locations to the owning IRHTP site via Ethernet. This section of this RFP is for private Ethernet service only. If Ethernet is not available or is not cost effective other options will be considered. HCP satellite locations will receive their respective Internet capacity from the owning IRHTP site via this connectivity being requested by Chapter 4 of this RFP. 5.2 Locations Currently the sites listed in Attachment 7 are the only sites that will be requesting service at this time. HCP s are weighing many factors to determine where, when, and which satellite locations may be attached. Some of those considerations are, but are not limited to: The term of existing connectivity contracts The length of lease at a particular location Near term relocation plans Viability of the business plan at a particular location The determination of bandwidth needs and the implementation schedule of new electronic healthcare records packages. 5.3 Pricing Methodology. IRTHP is asking for a pricing methodology based on valid examples shown in Attachment 7 that can be extrapolated across the State of Iowa and surrounding states. To view examples of clinic bandwidth being requested, see Attachment Some locations will only require bandwidths of 1Mbs, 3Mbs, 4.5 Mbs, 6 Mbs or 10 Mbs. Other locations will require increments of 30Mbs, 60Mbs, 100 Mbs, 200 Mbs, 500 Mbs or 1 Gb/s. IRTHP is fully aware not all vendors will be able to serve all locations. Vendor responses should state what bandwidths and services requested by this section are available in areas they can service. 5.4 Vendor response sheet. Attachment 8 (Bid Response Sheet HCP Site Connectivity) asks for an inclusive initial 10-year term price, with one voluntary renewal term of five (5) years to continue services at the same pricing, or less.. All costs, installation, build out (if necessary), equipment, and maintenance must be included in the monthly rate. Future sites are not identified in this RFP, but the Vendor must be willing to accept these future sites into the same pricing scenario as the initial 28 sites The Vendor response sheet is comprised of two parts: Page One for Low Bandwidth Ethernet connectivity and Page Two is for High Bandwidth Connectivity Not all of the Low Bandwidth or High Bandwidth increments are requested for the initial 28 sites in Attachment 8. However, for the Vendor to be considered when additional sites are added, the Vendor must have responded to this RFP with pricing for all of the increments the Vendor can provide. If the Vendor has different bandwidth increments other than the ones listed in Attachment 8, the Vendor may submit them for consideration. 42

44 5.4.3 If the Vendor offers router or firewall management service please include the monthly rate on the appropriate lines in Attachment 8, Bid Response Sheet, 5.5 Lease of fiber. In the current network design, there are a few sites on leased dark fiber. Vendors are invited to submit pricing proposals for leased dark fiber or lit fiber service. The monthly pricing must include all costs (fiber installation, terminating, and multiplexing equipment). See Attachment 9 for more information. 43

45 ATTACHMENT 6 Low Speed Internet Service Future Sites Low Bandwidth Bidders Response Sheet page 1 of 2 A LOCATION Any eligible IRHTP hospital in the State of Iowa and surrounding states Z LOCATION Any eligible IRHTP HCP-owned site in the State of Iowa and surrounding states 1.5 Mbs 3.0 Mbs 4.5 Mbs 6.0 Mbs 10 Mbs 15 Mbs 20 Mbs Vendor Response assumes an initial 10 year contract with one 5-yr voluntary renewal. All costs are included: installation, equipment, maintenance, taxes (if applicable). Optional monthly router management fee $ Optional monthly firewall management fee $ Signature Date 44

46 ATTACHMENT 6 High Speed Internet Service Future Sites High Bandwidth Bidders Response Sheet page 2 of 2 A LOCATION Any eligible IRHTP hospital in the State of Iowa and surrounding states Z LOCATION Any eligible IRHTP HCP-owned site in the State of Iowa and surrounding states 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs Vendor Response assumes an initial 10 year contract with one five (5)-year voluntary renewal. All costs are included: installation, equipment, maintenance, taxes (if applicable). Optional monthly router management fee $ Optional monthly firewall management fee $ Signature Date 45

47 ATTACHMENT 7 CURRENT LEVELS OF CLINIC CONNECTIVITY page 1 of 3 A Location HCP Name Address City ZIP Z Location Parent Hospital Address City Zip Mbs FAIL OVER OR REDUNDANT SERVICE Mercy Clinics Prairie Trails Mercy Clinics East 2605 SW White Birch Drive 5900 E University Ave Ankeny, Iowa Pleasant Hill, IA Mercy Clinics South 6601 SW 9th St. Des Moines, IA Mercy Clinics East Village 1350 Des Moines St., Suite 110. Des Moines, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Mercy Clinics Perry th St Perry, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Mercy Clinics Franklin th St Des Moines, Z1 location Mercy Medical th Ave. Des Moines, IA IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Mercy Clinics Johnston 5615 NW 86th St Johnston, IA Z1 location Mercy Medical th Ave. Des Moines, IA (86th Street) Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Mercy Clinics Urbandale (Plum) 8421 Plum Drive, Urbandale, IA Z1 location Mercy Medical Center th Ave. Des Moines, IA

48 ATTACHMENT 7 CURRENT LEVELS OF CLINIC CONNECTIVITY page 2 of 3 A Location HCP Name Address City ZIP Z Location Parent Hospital Address City Zip Mbs FAIL OVER OR REDUNDANT SERVICE Mercy Clinics Mercy Sports Medicine Mercy Clinics Jordan Creek Mercy Clinics Panora Mercy Clinics Indianola Mercy Clinics Ingersoll Mercy Clinics Hickman Mercy Ambulance Knoxville Mercy Clinics Urbandale Family Medicine 3310 SW 9th St Des Moines, Z1 location Mercy Medical th Ave. Des Moines, IA IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Jordan W Des Z1 location Mercy Medical th Ave. Des Moines, IA Creek Parkway Moines. IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA 319 East Main Panora, IA Z1 location Mercy Medical th Ave. Des Moines, IA Street Center Z2 location Mercy West Lakes th Pl West Des Moines, IA 307 East Scenic Indianola, IA Z1 location Mercy Medical th Ave. Des Moines, IA Valley Ave. Center Z2 location Mercy West Lakes th Pl West Des Moines, IA 3425 Ingersoll Des Moines, Z1 location Mercy Medical th Ave. Des Moines, IA Ave IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA 25 West Hickman Waukee, IA Z1 location Mercy Medical th Ave. Des Moines, IA Road Center Z2 location Mercy West Lakes th Pl West Des Moines, IA 1545 Iowa 14 Knoxville, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA 4005 NW Urbandale Dr Urbandale, IA Z1 location Mercy Medical Center th Ave. Des Moines, IA

49 ATTACHMENT 7 CURRENT LEVELS OF CLINIC CONNECTIVITY page 3 of 3 A Location HCP Name Address City ZIP Z Location Parent Hospital Address City Zip Mbs FAIL OVER OR REDUNDANT SERVICE Z2 location Mercy West Lakes th Pl West Des Moines, IA Mercy Clinics W Des Moines Mercy Ambulance Center Mercy Physicians Building Office Mercy Clinics Rehab (SW 7th St DSM) Great River Medical Center th St. Suite 106 W Des Moines. IA th Street W Des Moines. IA 1200 University Ave. 501 S.W. Seventh St South Gear Avenue Des Moines, IA Des Moines, IA West Burlington, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Z1 location Mercy Medical C th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Z1 location Mercy Medical th Ave. Des Moines, IA Center Z2 location Mercy West Lakes th Pl West Des Moines, IA Z location St Luke's 100 NE Saint Lee's Summit, Mo Luke's BLVD Virginia Gay Hospital Clinic 401 Cardinal Ave Adkins, IA Z location Virginia Gay Hospital 502 N 9th Ave, Van Buren County 735 N Highway 1 Birmingham, Z location Van Buren County 502 N 9th Hospital Clinic IA Hospital Ave, Van Buren County 604 1st Street Bonaparte, Z location Van Buren County 502 N 9th Hospital Clinic IA Hospital Ave, Van Buren County th Cantril, IA Z location Van Buren County 502 N 9th Hospital Clinic Street Hospital Ave, Van Buren County Highway Douds, IA Z location Van Buren County 502 N 9th Hospital Clinic 98 Hospital Ave, Van Buren County 206 S. 4th Street Farmington, Z location Van Buren County 502 N 9th Hospital Clinic IA Hospital Ave, Wayne County Hospital 417 S East Street Corydon, IA Z location St Luke's 100 NE Saint Luke's BLVD Vinton, IA Vinton, IA Vinton, I IA Vinton, IA Vinton, IA Vinton, IA Lees Summit, Mo

50 ATTACHMENT 8 ETHERNET CONNECTIVITY Low Bandwidth Bidders Response Sheet page 1 of 2 A LOCATION Any eligible IRHTP hospital in the State of Iowa and surrounding states Z LOCATION Any eligible IRHTP HCP-owned site in the State of Iowa and surrounding states. 1.5 Mbs 3.0 Mbs 4.5 Mbs 6.0 Mbs 10 Mbs 15 Mbs 20 Mbs Vendor Response assumes an initial 10 year contract with one 5-yr voluntary renewal. All costs are included: installation, equipment, maintenance, taxes (if applicable). Optional monthly router management fee $ Optional monthly firewall management fee $ Signature Date 49

51 ATTACHMENT 8 ETHERNET CONNECTIVITY High Bandwidth Bidders Response Sheet page 2 of 2 A LOCATION Any eligible IRHTP hospital in the State of Iowa and surrounding states Z LOCATION Any eligible IRHTP HCP-owned site in the State of Iowa and surrounding states. 30 Mbs 60 Mbs 100 Mbs 200 Mbs 500 Mbs Vendor Response assumes an initial 10 year contract with one five (5)-year voluntary renewal. All costs are included: installation, equipment, maintenance, taxes (if applicable). Optional monthly router management fee $ Optional monthly firewall management fee $ Signature Date 50

52 ATTACHMENT 9 ETHERNET CONNECTIVITY Vendor Response Sheet - Page 1 of 2 LIT OR DARK FIBER LEASE Request for Dark Fiber Service Pricing: A Location: Mercy IRHTP site th Ave Des Moines, Iowa Z1 Location: Mercy West Lakes TH Pl West Des Moines, Iowa Z2 Location: Mercy North 801 E 1st St Ankeny, Iowa Monthly Fee:$ Monthly Fee:$ A Location: Mercy West Lakes TH Pl Des Moines, Iowa Z2 Location: Mercy Clinics Clive, IA 1601 NW 114 th St, Monthly Fee: $ Dark Fiber Response assumes an initial 10-year contract with one 5 year renewal. All costs are included: installation, equipment, maintenance, taxes (if applicable). Proposed Lit Fiber Service Pricing: 1GBs Ethernet Platform A Location: Mercy IRHTP site th Ave Des Moines, Iowa Z1 Location: Mercy West Lakes TH Pl West Des Moines, Iowa Monthly Fee: $ Z2 Location: Mercy North 801 E 1st St Ankeny, Iowa Monthly Fee: $ A Location: Mercy West Lakes TH Pl Des Moines, Iowa Z2 Location: Mercy Clinics Clive, IA 1601 NW 114 th St Monthly Fee: $ 51

53 ATTACHMENT 9 ETHERNET CONNECTIVITY Vendor Response Sheet - Page 2 of 2 LIT OR DARK FIBER LEASE Lit Fiber Response assumes an initial 10-year contract with one five (5) year renewal. All costs are included: installation, equipment, maintenance, taxes (if applicable). Signature Date 52

54 CHAPTER 6 TESTING PROCESS AND PROCEDURES 6.0 Access Network The existing IRHTP network is a combination of physical Layer 0 and 1 fiber backbone and wavelengths, Layer 2/3 carrier Ethernet transport and IP/MPLS switches, and Layer 3 logical (IP services) core routers. As the first mile extension of the IRHTP network, this access network must adhere to established architectural parameters and services frameworks. In particular, to provide consistent access to the IRHTP network, access circuits must be a combination of these same elements of Layer 0 and 1 connectivity and Layer 2 transport capabilities. Without all of these elements, the access circuit will not function correctly with the IRHTP network The IRHTP network is configured to provide sufficient throughput and gateway routing capabilities. Ethernet traffic may enter the network at any authorized transport switch and be carried through the IRHTP network for delivery to the destination In addition to adequate physical space, conditioned power, environmental control, and controlled security the HCP end points will also provide (at its expense and not a part of this RFP) an Alcatel Lucent 7210 edge switch The transport connection itself must provide a minimum of 1Gbs of bandwidth. Each individual HCP will order a specified amount of symmetrical Ethernet service they desire in increments of 1.5, 3.0, 4.5, , 30Mbs, 60Mbs, 100 Mbs, 200 Mbs, or 500 Mbs. Any transport technology chosen must be capable of passing 802.1Q VLAN tags through the access connections and the IRHTP network The customer interface from the AL 7210 edge switch at the HCP end points shall be a copper cable connected to a 10/100/1000 Ethernet port with a minimum bandwidth throughput configuration of 1 Gb/s Switching decisions at the edge switch will be made based on currently configured VLAN s. 6.1 Test and Acceptance. Vendor will be required to coordinate all testing of circuits with the appropriate parties Vendors are required to fully describe their service/performance level agreements in their bid submissions. These service/performance agreements must minimally meet the criteria explicitly defined in the RFP requirements. Service and performance level details will be considered material criteria for awarding contracts As specific contracts are awarded under this program, a testing and acceptance process as outlined below will be performed for each specific contract awarded based on the information provided in the proposal of the winning Vendor(s). 53

55 6.1.3 This testing and acceptance process will be consistent with customary and normal industry procedures and practices used to validate and verify the technology used to deliver the required bandwidth and the needs of the users of the access connections Upon the successful verification of service/performance criteria as outlined in the bid via completion of the testing and acceptance process, a formal acceptance document will be issued to the bidder by the IRHTP If the vendor has already tested a link segment that is in operation, he need not retest said link segment The RFC 2544 standard, established by the Internet Engineering Task Force (IETF) standards body, is the de facto methodology that outlines the tests required to measure and prove performance criteria for carrier Ethernet networks. The standard provides an out-of-service benchmarking methodology to evaluate the performance of network devices using throughput, back-to-back, packet loss and latency tests, with each test validating a specific part of an SLA. This methodology defines the frame size, test duration and number of test iterations. Once completed, these tests will provide performance metrics of the Ethernet network under test In order to ensure that an Ethernet network is capable of supporting a variety of services (such as VoIP, video, etc.), the RFC 2544 test suite supports seven predefined frame sizes (64, 128, 256, 512, 1024, 1280 and 1518 bytes) to simulate various traffic conditions. Each frame size will be tested. 6.2 Test and Accept Documentation Process: Notification of circuit availability will be sent by Vendor to IRHTP test and accept resource IRHTP Ticket Number will be issued Within 3 business days, IRHTP will arrange for a circuit test date. Notification will be sent via to Vendor contact provided in RFP response After a formal notification has been sent to the IRHTP, the IRHTP test and accept technician will be dispatched to verify circuit compliance to RFC 2544 testing criteria IRHTP will have 10 business days to test and accept or deny the above test findings The Vender tester shall have two additional attempts to correct any noncompliance issues with the circuit before IRHTP will decline the circuit all together without any obligations Upon acceptance or denial of any circuit the IRHTP will notify the Vendor contact listed in RFP response of the results via e mail within five (5) business days of test results. 54

56 6.3 Service Capabilities and Configurations Service Availability, Packet Loss and Latency. Availability shall be defined as the percentage of total time that service is operative when measured over 30 day calendar month (720 hour) period Ethernet service will be considered inoperative when service is degraded to a level in which the packets are not passed between the customer side of the layer 2 switch located at the HCP end point and the IRHTP side of the layer 2 switch at the selected ICN POP The end-to-end availability test standard for Ethernet service specified for the connection is 99.5%. 6.4 Response Time The response time by the Vendor shall be no greater than three (3) hours from notification by the network operator or the end point IT department of a service interruption Vendor shall provide proactive notification and update the network managers hourly on progress attempts to fix the incident. Vendor shall also provide IRHTP with an escalation contact list. 6.5 Packet Loss Ratio Performance is noted in terms of packet loss and latency Packet Loss Ratio is defined as the percentage of in-profile Ethernet frames not reliably delivered between the HCP layer 2 edge switch to the ingress/egress point of the IRHTP Network layer 2 switch over a given measurement interval Packet Loss Ratio shall be no more than 0.5% when tested end to end. 6.6 Latency Latency is defined as the average time it takes a packet to travel from the customer layer 2 edge switch to the ingress/egress point of the IRHTP network layer 2 switch over a given measurement interval Latency shall be no more than 60 micro seconds when tested end to end These requirements will be explicitly included in the contract with the successful vendor(s). 6.7 Regulatory Approval. Vendor acknowledges that it has all relevant local, state, and federal regulatory approval for all services, features, equipment, discounts, and promotions proposed. 6.8 Disaster Recovery. Vendor shall provide in their RFP response a detailed written outline of relevant infrastructure, systems and contingency processes in place to provide disaster recovery capabilities for the Services offered in their bid response. 55

57 6.9 Installation Intervals Vendor shall state the installation timeline for each location where Ethernet connections are proposed IRHTP requires that the installation interval for connectivity not exceed 30 days from contract signature Vendors shall indicate guarantees and/or remedies provided to IRHTP if the installation intervals are exceeded In the event a fiber optic cable must be extended into an HCP end point, vendor shall incorporate the estimated time required to extend fiber optic service to the Vendor s location within the required 30 day period All HCP Meet Points will provide a minimum 2 inner duct already in place to the public ROW at no charge to the Vendor Maintenance and Monitoring. Maintenance and monitoring shall be provided on a 7 x24 x 365 bases Network Operations Center (NOC). Vendor shall describe in detail their NOC capabilities that will be utilized in providing support for the Ethernet connections they are bidding. Included in this information shall be: Hours of operation Skill levels and responsibilities of staff Trouble ticket system Level of proactive monitoring End user notification capabilities Any other relevant information deemed appropriate for the analysis of the Vendor s bid Out of Service Credits A service outage is defined as an outage of service of thirty minutes or more for any twenty four-hour periods. Issuance of credit process should be described in detail by Vendor in the RFP response Vendor agrees to credit the HCP in the amount of three times the prorated monthly charge (based on hours of non-compliance down time not to include advance notice planned outages for maintenance) for service outages calculated on a thirty-day month (720 hours) Service Level Agreements. Vendor shall include their written SLA for the service proposed. As a minimum, describe the guaranteed layer 2 circuit loss, jitter, and latency allowances within the Service Level Agreement and how that level of service explicitly complies with the specification criteria outlined in the RFP. Service and performance level details will be considered material criteria for awarding contracts. 56

58 6.14 Scalability. IRHTP requires the ability to scale up or down the bandwidth, without penalty during the entire 15-year Agreement contract period For bid evaluation purposes, the period for any changes in bandwidth, either up or down, will be in periods of not less than 30 days, for each increment. The base level bandwidth however shall not decrease below 30Mbps during the 15-year contract period If the bandwidth is temporarily increased above 30 Mbps, it may be decreased back to the 30 Mbps base level within the required timeline window stated above, at the discretion of each HCP or IRHTP Vendor shall include in their response whether or not their implementation and billing system can accommodate this flexibility and if so what a) Non Recurring Charges (NRC) may apply and b) what the order and implementation timelines are to accommodate incremental bandwidth changes (both up and down). The Vendor must be capable of billing for the incremental bandwidth changes (both up and down) over the 30 Mbps base level increment on a 30-day billing cycle Failure To Meet Standards. Failure to meet the aforementioned testing and installations standards will result in an immediate termination of the contract Vendor Support. To assure each location receives appropriate levels of service and account leadership, describe how you will support each location IRHTP requires an account team committed to providing quality service and prompt response at all times Provide the roles and responsibilities of each account team member, pre and post sale, in a hierarchical format including their management staff Phone numbers, pager numbers, fax numbers, and postal addresses should be included on the hierarchy for escalation purposes Account team members should include, at a minimum, a billing representative, an order representative, a technical support representative and a management level representative Vendors Project Manager. Vendor will assign a Project Manager to the project that will act as the Single Point of Contact for IRHTP. The Project Manager will manage the overall project ordering, provisioning, installation, testing, turn-up, trouble-shooting, and bill reconciliation. Project Manager should have a minimum of one (1) year experience managing projects of this type Vendor agrees. Vendor must make a positive statement agreeing to meet all of the aforementioned testing process and procedures. 57

59 CHAPTER 7 EVALUATION PROCESS AND CRITERIA 7.0 Award Process An evaluation committee assigned by personnel within the IRHTP will review the bid proposals. The evaluation committee will consider all information provided when making its recommendations and may consider relevant information from other sources The evaluation committee will make its recommendation to the IRHTP Board indicating the committee s choice The IRHTP Board will select the Vendor(s) to receive the award. The IRHTP Board is not bound by the evaluation committee s recommendation. All Vendors submitting Bid Proposals will receive notification of the award All applicable contracting requirements imposed by this RFP and Iowa law shall be met by the Vendor. The successful Vendor must, in a timely manner, enter into a Contract with the IRHTP to implement the service contemplated by this RFP. Failure of a successful Vendor to agree to the terms of a Contract within a timely manner may be grounds for the IRHTP to award to the next compliant Vendor. 7.1 Evaluation Criteria A Bid Proposal will only be evaluated if all of the Mandatory Requirements identified in Chapter 2 are met and/or fulfilled The IRHTP may award a Contract to responsible Vendors meeting the requirements of this RFP and which, in the sole discretion of the IRHTP, provides the best value to the HCP after considering price and compliance with the provisions of this RFP. 7.2 Proposed vendor responses for broadband projects will be evaluated on the following criteria, using a ranking of 1 to 10, with 10 being highest score, multiplied times the weighted percent: Cost of Solution 30% Implementation Timeframe Suitable to Meet HCP Needs 20% Solution s Suitability to Meet Project Goals 15% Solution s Capacity to Leverage Existing Resources 15% Proposal s Compliance with RFP Requirements 20%. 58

60 Criteria Total percent of score Cost of Solution 30% Rank times percent Implementation Timeframe Suitability to Meet Project Goals Capacity to Leverage Existing Compliance with RFP Guideline 20% 15% 15% 20% TOTAL SCORE 100% The IRHTP board reserves the right to issue any resulting order with the vendors whose proposals, in the judgment of the IRHTP and the affected HCPs, most nearly conform to the specifications and needs of the HCPs as described in our evaluation criteria. IRHTP reserves the right to waive all technicalities in rejecting any or all proposals which in our judgment fail to satisfy the best interests of the IRHTP board. The IRHTP board is not obligated to accept any proposal received. It may accept proposals in whole or in part, or may reject all proposals. 59

61 ANNEX A BID PROPOSAL COMPLIANCE FORM Page 1 of 2 Vendor affirms that the information contained in the bid proposal is true and accurately portrays all aspects of the goods or services or both contemplated by this RFP. The Vendor is aware that any substantive misinformation or misrepresentation may disqualify the bid proposal from further consideration. Vendor hereby certifies total compliance with all other terms, conditions and specifications of this RFP except as expressly stated below: (Form may be reproduced if additional space is needed.) Chapter 1, Administrative Issues Chapter 2. Contractual Term s. Chapter 3 IRHTP Hospital Ethernet Connections to IRHTP Network Chapter 4 Internet Services for IRHTP Hospitals and other Sites Chapter 5 Ethernet Connectivity Chapter 6 Testing Process and Procedures Chapter 7 Evaluation Process and Criteria 60

62 ANNEX A BID PROPOSAL COMPLIANCE FORM Page 2 of 2 I certify that I have the authority to bind the Vendor indicated below to the specific terms and conditions imposed in this RFP and offered in this bid proposal, and that by my signature on this document I specifically agree to all of the waivers, restrictions and requirements of this RFP as conditions precedent to submitting this proposal. I further state that in making this bid proposal that the Vendor has not consulted with others for the purpose of restricting competition or violating State or Federal anti-trust laws and has not knowingly made any false statements in this proposal. Authorized Signature: Printed Name: Title: Telephone: Fax Number: Business Name: Address: Federal ID Number: USAC SPIN: 61

63 ANNEX B AUTHORIZATION TO RELEASE INFORMATION (Name of Vendor) hereby authorizes any person or entity, public or private, having any information concerning the Vendor s background, including but not limited to its performance history regarding its prior rendering of services similar to those detailed in this RFP, to release such information to the IRHTP. The Vendor acknowledges that it may not agree with the information and opinions given by such person or entity in response to a reference request. The Vendor acknowledges that the information and opinions given by such person or entity may hurt its chances to receive contract awards from the IRHTP or may otherwise hurt its reputation or operations. The Vendor is willing to take that risk. The Vendor agrees to release all persons, entities, and the IRHTP from any liability whatsoever that may be incurred in releasing this information or using this information. Printed Name of Vendor Signature of Authorized Representative Date 62

64 ANNEX C CERTIFICATION LETTER FORMAT (VENDOR LETTERHEAD) I, [name of corporate officer], on behalf of [Vendor name] (SPIN ) certify and swear under the penalty of perjury, that to the best of my knowledge, information and belief, all federal Healthcare Connect Fund Program support provided to us will be used only for eligible Healthcare Connect Fund Program purposes for which the support is intended, as described. (Signature) Name Title Date NOTARIZED BY Date 63

65 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Ackley Medical Center th Ave Franklin Ackley IA Ethernet Ellsworth Family Medicine 322 1/2 College Ave Hardin Iowa Falls IA Ethernet Ellsworth Municipal Hospital 110 Rocksylvania Ave Hardin Iowa Falls IA Internet Adair County Medical Clinic- Fontanelle 406 5th St Adair Fontanelle IA Ethernet Adair County Medical Clinic- Stuart 303 SW 7th St Adair Stuart IA Ethernet Adair County Memorial Hospital 609 SE Kent St Adair Greenfield IA Internet Alegent Creighton - Dunlap Clinic 707 Iowa Avenue Harrison Dunlap IA Ethernet Alegent Creighton - Logan Clinic 122 West 8th St Harrison Logan IA Ethernet Alegent Creighton - Woodbine Clinic 518 Lincoln Way Harrison Woodbine IA Ethernet Alegent Creighton Health Community Memorial Hospital 631 N 8th St Harrison Missouri Valley IA Internet Alegent Creighton -Missouri Valley Clinic 809 East Elm St Harrison Missouri Valley IA Ethernet Alegent Creighton Clinic -Bedford 618 Court Ave Taylor Bedford IA Ethernet Alegent Creighton Clinic- Lenox 201 S Main St Taylor Lenox IA Ethernet Alegent Creighton Health Mercy Hospital - Corning 603 Rosary Dr Adams Corning IA Internet Alegent Creighton Health Mercy Hospital - Council Bluffs 800 Mercy Drive Pottawattamie Council Bluffs IA Internet Alegent Health- Glenwood PMIC 359 Indian Hills Dr Mills Glenwood IA Ethernet Alegent Health - Glenwood Clinic 1203 South Locust Street Mills Glenwood IA Ethernet Alegent Health - Oakland Clinic 700 South Highway St Pottawattamie Oakland IA Ethernet Alegent Health - Onawa Clinic th St Monona Onawa IA Ethernet Atkins Family Medical Clinic 97 Main Avenue Benton Atkins IA Ethernet Audubon County Memorial Hospital 515 Pacific Ave, Ste. 1 Audubon Audubon IA Internet 64

66 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Avera Holy Family Hospital 826 N 8th St Emmet Estherville IA Internet Avera Medical Group/Spirit Lake Medical Ctr rd St Dickinson Spirit Lake IA Internet Avera Medical Group- Estherville 926 N 8th St Emmet Estherville IA Ethernet Avera McKennan Hospital & University Health Center 1325 S. Cliff Ave, Minnehaha Sioux Falls SD Ethernet Baum-Harmon Mercy Hospital 255 N. Welch Ave. O'Brien Primghar IA Internet Birmingham Medical Clinic 735 N Highway 1 Van Buren Birmingham IA Ethernet Bonaparte Medical Clinic 624 1st St Van Buren Bonaparte IA Ethernet Beckwith Adult Day Services 1111 S Linn St Boone Boone IA Ethernet Boone County Family Medicine 1115 S Marshall St Boone Boone IA Ethernet Boone County Family Medicine - Ogden 333 W Walnut St Boone Ogden IA Ethernet Boone County Hospital 1015 Union St Boone Boone IA Internet Home Health Services 105 S Marshall St Boone Boone IA Ethernet Buchanan County Health Center st St E Buchanan Independence IA internet Burgess Family Clinic - Dunlap 612 Iowa Avenue Harrison Dunlap IA Ethernet Burgess Family Clinic - Mapleton 513 S Muckey St Monona Mapleton IA Ethernet Burgess Family Clinic - Sloan 409 Evans St Woodbury Sloan IA Ethernet Burgess Family Pharmacy - Whiting 723 Whittier St Monona Whiting IA Ethernet Burgess Health Center 1600 Diamond St Monona Onawa IA Internet Burgess Physical Therapy & Mental Health - Mapleton 111 S 5th St Monona Mapleton IA Ethernet 65

67 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service CCMH Medical Clinic - City Center 115 N 14th St Crawford Denison IA Ethernet Charter Oak Medical Clinic 149 Main St Crawford Charter Oak IA Ethernet Central Community Hospital 901 Davidson St NW Clayton Elkader IA Internet Cherokee Regional Medical Center 300 Sioux Valley Dr Cherokee Cherokee IA Internet Clarinda Medical Associates- Bedford Clinic 1207 Madison Taylor Bedford IA Ethernet Clarinda Regional Health Center 220 Essie Davison Dr Page Clarinda IA Internet Community Health 545 State Street Hancock Garner IA Ethernet Crawford County Memorial Hospital 100 Medical Parkway Crawford Denison IA Internet Dallas County Hospital th St Dallas Perry IA Internet Davis County Hospital 509 N Madison St Davis Bloomfield IA Internet Deer Creek Family Care 401 First Ave Tama Toledo IA Ethernet Douds Medical Clinic Highway 98 Van Buren Douds IA Ethernet Earlham Medical Clinic 125 W 1st St Madison Earlham IA Ethernet Exira Medical Clinic 107 South Jefferson Audubon Exira IA Ethernet Family Medicine Clinic - Le Mars 194 6th Ave NE Plymouth LeMars IA Ethernet Family Medicine Clinic - Marcus 101 E. Pine St Cherokee Marcus IA Ethernet Family Medicine Clinic - Remsen 15 East 2nd St Plymouth Remsen IA Ethernet Floyd Valley Hospital - Avera 714 Lincoln Street Plymouth LeMars IA Internet Family Practice Clinic - Graettinger 109 W Robbins Palo Alto Graettinger IA Ethernet Family Practice Clinic - West Bend 107 West Division Kossuth West Bend IA Ethernet Farmington Medical Clinic 206 S 4th St Van Buren Farmington IA Ethernet Floyd County Medical Center th St Franklin Charles City IA Internet Fort Madison Community Hospital 5445 Avenue O, # 174 Lee Fort Madison IA Internet 66

68 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Fort Madison Physicians & Surgeons 5409 Avenue O Lee Fort Madison IA Ethernet Fox River Medical Clinic th St Van Buren Cantril IA Ethernet Franklin General Hospital 1720 Central Ave E, Suite A Franklin Hampton IA Internet Fremont County Medical Center 802 Illinois St Fremont Sidney IA Ethernet Garner Medical Center 730 W. 3rd St Hancock Garner IA Ethernet Garner Rehabilitation Clinic 365 W 8th St Hancock Garner IA Ethernet 4017 Devils Glen Genesis - Bettendorf Imaging Center Road Scott Bettendorf IA Ethernet Genesis Medical Center - De Witt th St, Stop 1 Clinton De Witt IA Internet Genesis Medical Center- Davenport 1227 E Rusholme St Scott Davenport IA Internet Genesis Physical Rehabilitation 170 South 4th Ave Scott Eldridge IA Ethernet Genesis Plaza 2535 Maplecrest Road Scott Bettendorf IA Ethernet George C. Grape Community Hospital 2959 US Highway 275 Fremont Hamburg IA Internet Great River Clinic - Mediapolis 410 N Orchard St Des Moines Mediapolis IA Ethernet Great River Clinic - Wapello 220 Mulberry, Suite A Louisa Wapello IA Ethernet West Great River Medical Center 1221 S Gear Ave Des Moines Burlington IA Internet Great River Quick Care 624 N. Roosevelt, # 101 Des Moines Burlington IA Ethernet The Keokuk Clinic 1603 Morgan St Lee Keokuk IA Ethernet Grinnell Regional Medical Center 210 4th Ave Poweshiek Grinnell IA Both Hancock County Health System 532 1st St NW Hancock Britt IA Internet Hartley Mercy Medical Center 231 N. 8th Ave W. O'Brien Hartley IA Ethernet 67

69 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Hawarden Regional Healthcare th St Sioux Hawarden IA Internet Hawarden Regional Healthcare Clinics - Ireton 318 Main St Sioux Ireton IA Ethernet Hawarden Regional Healthcare Clinics - Hawarden 1122 Ave L Sioux Hawarden IA Ethernet Hegg Memorial Health Center st Avenue Sioux Rock Valley IA Internet Henry County Health Center 407 S White St Henry Mount Pleasant IA Internet Home Health & Hospice of Pella 505 Union St Jasper Pella IA Ethernet Horn Memorial Hospital 701 E 2nd St Ida Ida Grove IA Internet Horn Physicians Clinic - Mapleton 412 Main St Monona Mapleton IA Ethernet Horn Physicians Clinic - Odebolt 300 South Maple Sac Odebolt IA Ethernet Hull Medical Clinic 807 Main St Sioux Hull IA Ethernet Humeston Family Medical Clinic 109 Broad Street Wayne Humeston IA Ethernet Iowa Specialty Hospital - Belmond 403 1st St SE Wright Belmond IA Internet Iowa Specialty Hospital - Clarion 1316 S Main St Wright Clarion IA Internet Jefferson County Health Center 2000 S Main St Jefferson Fairfield IA Internet Kanawha Medical Center 108 Main St Hancock Kanawha IA Ethernet Keokuk County Health Center Highway 149 Keokuk Sigourney IA Both Knoxville Hospital & Clinics 1002 S Lincoln St Marion Knoxville IA Internet Pleasantville Clinic 104 N Washington St Marion Pleasantville IA Ethernet Kossuth Regional Health Center 1515 S Phillips St Kossuth Algona IA Internet Kossuth Regional Health Center - Bancroft Clinic 122 W. Ramsey St Kossuth Bancroft IA Ethernet Kossuth Regional Health Center- Algona Clinic 1519 S Phillips St Kossuth Algona IA Ethernet Lakes Community Health Center st Street Dickinson Milford IA Ethernet Lakes Regional Healthcare 2301 U.S 71 Dickinson Spirit Lake IA Internet Lineville Medical Clinic 101 Main Street Wayne Lineville IA Ethernet 68

70 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Seymour Medical Clinic 515 W Wall St Wayne Seymour IA Ethernet Humeston Medical Clinic 123 Broad Street Wayne Humeston IA Ethernet Lucas County Health Center 1200 N 7th St Lucas Chariton IA Internet Lynnville Medical Clinic 303 East St Jasper Lynnville IA Ethernet Mercy Iowa City 500 E Market St Johnson Iowa City IA Internet Madison County Health Care System 300 W Hutchings St Madison Winterset IA Internet Madrid Family Practice 623 W North St Boone Madrid IA Ethernet Mahaska Health Partnership 1229 C Ave E Mahaska Oskaloosa IA Internet Manilla Medical Clinic 542 Main St Crawford Manilla IA Ethernet Manning Regional Healthcare Center 410 Main St Carroll Manning IA Internet Marengo Memorial Hospital 300 W May St Iowa Marengo IA Internet Marshalltown Medical & Surgical Center 3 S 4th Ave Marshall Marshalltown IA Internet Medical Clinic in Bussey 411 Merrill St Marion Bussey IA Ethernet Medical Clinic in Knoxville 1208 N Lincoln Marion Knoxville IA Ethernet Medical Clinic in Monroe 100 East Sherman Jasper Monroe IA Ethernet Medical Clinic in Ottumwa 920 N Quincy Ave Wapello Ottumwa IA Ethernet Medical Clinic in Pella 405 Monroe Marion Pella IA Ethernet Medical Clinic in Sully 704 Third St Jasper Sully IA Ethernet House of Mercy 1409 Clark St Polk Des Moines IA Ethernet CHS Home th St Polk Urbandale IA Ethernet Mercy Adel Clinic 1120 Greene St Dallas Adel IA Ethernet Mercy Ambulance Knoxville 1545 HWY 14 S Marion Knoxville IA Ethernet 69

71 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service West Des Mercy Ambulance Service th St Polk Moines IA Ethernet Mercy Briarwood Family Medicine NW 36th & N Ankeny Blvd Polk Ankeny IA Ethernet Mercy Carlisle Family Practice 125 School St Polk Carlisle IA Ethernet 1605 SE Delaware Mercy Diagnostic Imaging Center Ave Polk Ankeny IA Ethernet Mercy East 5900 E University Ave Polk Pleasant Hill IA Ethernet Mercy East Village 1350 Des Moines St Polk Des Moines IA Ethernet Mercy Family Care -Perry th St Dallas Perry IA Ethernet Mercy Franklin th Polk Des Moines IA Ethernet 307 E Scenic Valley Mercy Indianola Ave Warren Indianola IA Ethernet Mercy Iowa Heart Center - Ames 1816 Philadelphia Story Ames IA Ethernet Mercy Iowa Heart Center - Fort Dodge 802 Kenyon Road Webster Fort Dodge IA Ethernet Mercy Iowa Heart Center - Marshalltown 3 S 4th Ave Marshall Marshalltown IA Ethernet Mercy Iowa Heart Center- Carroll 311 S Clark Street Carroll Carroll IA Ethernet Mercy Johnston th St Polk Johnston IA Ethernet Mercy Johnston Elder Care 5837 Winwood Dr Polk Johnston IA Ethernet Mercy Jordan Creek 1055 Jordan Creek Parkway Polk Mercy Medical Center - West Lakes th St Polk West Des Moines IA Ethernet West Des Moines IA Ethernet Mercy North 800 E First St Polk Ankeny IA Ethernet Mercy Ottumwa 1001 E Penn Ave Wapello Ottumwa IA Ethernet Mercy Panora Medical Clinic 319 E Main St Guthrie Panora IA Ethernet Mercy Physicians Billing Office 1200 University Ave, Suite 200 Polk Des Moines IA Ethernet 70

72 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service 2605 SW White Birch Mercy Prairie Trail Family Medicine Dr Polk Ankeny IA Ethernet Mercy Quickcare Clinic - Hickman Hickman Rd Polk Clive IA Ethernet Mercy Quickcare Clinic - Ingersoll 3425 Ingersoll Ave Polk Des Moines IA Ethernet Mercy Riverside Rehab- OP PT 501 SW 7th St, Ste Q Polk Des Moines IA Ethernet Mercy South Family Practice & Urgent Care 6601 SW 9th St Polk Des Moines IA Ethernet Mercy Urbandale 4005 NW Urbandale Drive Polk Urbandale IA Ethernet Mercy Urbandale Aurora Medical Clinic 6200 Aurora Ave Polk Urbandale IA Ethernet Mercy Warehouse - Jefferson 96 Jefferson Ave Polk Des Moines IA Ethernet Mercy Warehouse - New York 303 New York Ave Polk Des Moines IA Ethernet Mercy Waukee 25 W Hickman Rd Polk Waukee IA Ethernet Mercy West 1601 NW 114th St Polk Mercy West Grand Medical Center th St, Ste 106 Polk West Des Moines IA Ethernet West Des Moines IA Ethernet Mercy Medical Center - Des Moines th Ave Polk Des Moines IA Internet Mercy Rehabilitation Services 200 N Second St Jackson Bellevue IA Ethernet Mercy Rehabilitation Services Highway 136 Dubuque Cascade IA Ethernet Mercy Clinic - Clear Lake th Ave South Cerro Gordo Clear Lake IA Ethernet Mercy Clinic - Forest City 635 E US Highway 9 Hancock Forest City IA Ethernet Mercy Clinic - Lake Mills 505 South 1st Ave East Winnebago Lake Mills IA Ethernet Mercy Clinic - Northwood 803 9th Ave North Worth Northwood IA Ethernet Mercy Clinic - Rockford 702 E Main Ave Floyd Rockford IA Ethernet Mercy Clinic -Sheffield 203 South 2nd St Franklin Sheffield IA Ethernet Mercy Family Clinic - Charles City 1624 South Grand Floyd Charles City IA Ethernet 71

73 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Mercy Family Clinic - Greene 104 E Traer Butler Greene IA Ethernet Mercy Peds & Adolescent Clinic- Clear Lake 418 North Shore Dr Cerro Gordo Clear Lake IA Ethernet Mercy Medical Center- North Iowa -East Campus th St SW Cerro Gordo Mason City IA Internet Mercy Clinic Regency 621 S. Illinois, Ste 100 Cerro Gordo Mason City IA Ethernet Mercy Medical Center- New Hampton 308 N Maple Ave Chickasaw New Hampton IA Internet Mercy Medical Center - Clinton 1410 N 4th St Clinton Clinton IA Internet Mercy Medical Center - Clinton - South Campus 638 South Bluff Clinton Clinton IA Ethernet Mercy Medical Center - Clinton Sleep Lab 1510 N 4th St Clinton Clinton IA Ethernet Mercy Medical Center - Dubuque 250 Mercy Dr Dubuque Dubuque IA Internet Mercy Medical Center - Dyersville 1111 S 3rd St SW Dubuque Dyersville IA Internet Mercy Medical Center - Sioux City 801 5th Street Woodbury Sioux City IA Internet Mercy Medical Center - Cedar Rapids th St SE Linn Cedar Rapids IA Internet Mercy Medical Center - Centerville 1 St. Joseph's Dr Appanoose Centerville IA Internet Methodist Jennie Edmundson East 900 Woodbury Pottawattamie Council Bluffs IA Ethernet Health Center West/PACE 3434 West Broadway Pottawattamie Council Bluffs IA Ethernet Methodist Jennie Edmundson Hospital 933 E Pierce St Pottawattamie Council Bluffs IA Internet Methodist Physicians Clinic 1400 Senate Ave Montgomery Red Oak IA Ethernet Methodist Physicians Clinic 415 Main St Mills Malvern IA Ethernet 72

74 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Methodist Physicians Clinic 320 Ebaugh St Mills Glenwood IA Ethernet Mitchell County Regional Health Center 616 N 8th St Mitchell Osage IA Internet MMSC Clinic - Conrad 105 N Church St Grundy Conrad IA Ethernet MMSC Clinic - Tama Toledo 1307 S Broadway St Tama Toledo IA Ethernet MMSC Clinic -State Center 503 3rd Ave South Marshall State Center IA Ethernet MMSC Rehab 1902 S Center St Marshall Marshalltown IA Ethernet MHP Home Health, Hospital, Public Health 1225 C Avenue East Mahaska Oskaloosa IA Ethernet Monroe County Hospital th St Monroe Albia IA Internet New Sharon Medical Center 112 S Main St Mahaska New Sharon IA Ethernet Occupational Health - Newton 321 E Third St Jasper Newton IA Ethernet Orange City Area Health System 1000 Lincoln Cir SE Sioux Orange City IA Internet Osage Clinic 620 N 8 th Street Mitchell Osage IA Ethernet Osceola Community Hospital, Inc th Ave N Osceola Sibley IA Internet Palmer Lutheran Health Center, Inc. 112 Jefferson St Fayette West Union IA Internet Palo Alto County Health System st St Palo Alto Emmetsburg IA Internet Paullina Mercy Medical Clinic 108 E Groesbeck Ave O'Brien Paullina IA Ethernet Pella Regional Health Center 404 Jefferson St Marion Pella IA Internet Postels Community Health Park 807 Broad St Poweshiek Grinnell IA Ethernet Primghar Mercy Medical Clinic 240 N. Rerick Ave O'Brien Primghar IA Ethernet Regional Family Health 111 East Mission St Clayton Strawberry Point IA Ethernet Regional Family Health 702 W Union St Clayton Edgewood IA Ethernet Regional Medical Center - Manchester 709 W Main St Delaware Manchester IA Internet Regional Health Services of Howard County 235 8th Ave W Howard Cresco IA Internet Riceville Clinic 109 Westward Dr Mitchell Riceville IA Ethernet Ringgold County Hospital 504 N Cleveland St Ringgold Mount Ayr IA Internet Sanford Health - Sioux Falls, SD 1305 W 18th St Lincoln Sioux Falls SD Ethernet 73

75 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Sanford Health Boyden Clinic th St Sioux Boyden IA Ethernet Sanford Health Hartley Clinic 512 3rd St NE O'Brien Hartley IA Ethernet Sanford Clinic - George 101 N Main St Lyon George IA Ethernet Sanford Rock Rapids Clinic 803 S Greene St Lyon Rock Rapids IA Ethernet Sanford Rock Rapids Fitness Center 400 S 7th Ave Lyon Rock Rapids IA Ethernet Sanford Rock Rapids Medical Center 801 S Greene St Lyon Rock Rapids IA Internet Sanford Sheldon Clinic 800 Oak St O'Brien Sheldon IA Ethernet Sanford Sheldon Medical Center 118 N 7th Ave, O'Brien Sheldon IA Internet Sanford Sheldon Sanborn Clinic 321 Main St O'Brien Sanborn IA Ethernet Schleswig Medical Clinic 116 Cedar St Crawford Schleswig IA Ethernet Shell Rock Clinic 1001 Mason Way Butler Shell Rock IA Ethernet Shenandoah Medical Center 300 Pershing Ave Page Shenandoah IA Internet Sioux Center Community Hospital & Health Center 605 S Main Ave Sioux Sioux Center IA Internet Sioux Center Medical Clinic 645 S Main Sioux Sioux Center IA Ethernet Sioux Rapids Family Care 113 Second St Buena Vista Sioux Rapids IA Ethernet Spencer Hospital st Ave E, Suite 1 Clayton Spencer IA Internet Warner Dialysis Center of Spirit Lake th St Dickinson Spirit Lake IA Ethernet Milford Family Clinic 2004 Okoboji Ave Dickinson Milford IA Ethernet Skiff Medical Center 204 N 4th Ave E, Jasper Newton IA Internet St. Anthony Regional Hospital 311 S Clark Street Carroll Carroll IA Internet St. Ansgar Clinic 140 W 4th St, Suite 1 Mitchell St. Ansgar IA Ethernet Stacyville Clinic 411 Broad St Mitchell Stacyville IA Ethernet Stewart Memorial Community Hospital 1301 W Main St Calhoun Lake City IA Internet 74

76 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service Story County Medical Center 640 S 19th St Story Nevada IA Internet Story County Medical Center- Senior Care 630 6th St Story Nevada IA Ethernet Story Medical Clinic - Maxwell 403 1st St Story Maxwell IA Ethernet Story Medical Clinic - Nevada 519 F Ave Story Nevada IA Ethernet Story Medical Clinic - Slater 600 Linn St, Suite B Story Slater IA Ethernet Story Medical Clinic - Zearing 112 W Main St Story Zearing IA Ethernet Story Medical Clinic- Natural Health 431 South Duff Ave, Suite B Story Ames IA Ethernet Sutherland Mercy Medical Clinic 108 W 2nd St O'Brien Sutherland IA Ethernet Tri-State Medical Group 400 N. 17th St Lee Keokuk IA Ethernet Women's Health Center 1425 Morgan St Lee Keokuk IA Ethernet Keokuk Area Hospital 1600 Morgan St Lee Keokuk IA Internet Southeastern Renal Dialysis 1419 Morgan St Lee Keokuk IA Ethernet UI Health Care - Muscatine 3465 Mulberry Ave Muscatine Muscatine IA Ethernet UI Health Care - North Liberty 3 Lions Dr Johnson North Liberty IA Ethernet 3056 River Crossing UI Health Care River Crossing Court Washington Riverside IA Ethernet UI Health Care - SE Iowa City 1130 Scott Blvd Johnson Iowa City IA Ethernet UI Health Care - Sigourney 1314 S Stuart St Keokuk Sigourney IA Ethernet UI Medical Oncology Hematology 1003 Pennsylvania Ave Wapello Ottumwa IA Ethernet UI Primary Clinic North 200 Hawkins Drive Johnson Iowa City IA Ethernet UI Quick Care Coralville 2510 Corridor Way, Suite 6A Johnson Coralville IA Ethernet 75

77 ANNEX D PARTICIPATING SITES HCP Physical Address County City State ZIP Phone # Service UI Quick Care East 1843 Lower Muscatine Rd Johnson Iowa City IA Ethernet UI Quick Care Old Capitol University of Iowa Hospitals and Clinics 201 S Clinton St,,Ste 195 Johnson Iowa City IA Ethernet 200 Hawkins Drive, 1353 JCP Johnson Iowa City IA Internet Urbana Family Medical Clinic 1002 W Main St Benton Urbana IA Ethernet Van Buren County Hospital 304 Franklin St Van Buren Keosauqua IA Internet Van Diest Medical Center 2350 Hospital Dr Hamilton Webster City IA Internet Van Horne Family Medical Clinic 205 Main St Benton Atkins IA Ethernet Veterans Memorial Hospital 40 1st St SE Allamakee Waukon IA Internet Victor Health Center 709 2nd St Iowa Victor IA Ethernet Villisca Family Health Center 309 South 5th Ave Montgomery Villisca IA Ethernet Vinton Family Medical Clinic 504 N 9 th Avenue Benton Vinton IA Ethernet Virginia Gay Hospital 502 N 9th Ave Benton Vinton IA Internet Vredenburg Center 1711 Osceola Lucas Chariton IA Ethernet Washington County Hospital & Clinics 400 E Polk St, Washington Washington IA Internet Waverly Health Center 312 9th St SW Bremer Waverly IA Internet Wayne County Hospital 417 S. East St Wayne Corydon IA Internet Wesley Medical Center 103 Main Street East Kossuth Wesley IA Ethernet MMH Family Medical Clinic 255 W. Lucas St Iowa Marengo IA Ethernet Winneshiek Medical Center 901 Montgomery St Winneshiek Decorah IA Internet Winneshiek Medical Center Rehabilitation & Sports Medicine Clinic 115 North Maryville Winneshiek Calmar IA Ethernet Winneshiek Medical Center Rehabilitation & Sports Medicine Clinic 400 Hardin Drive Allamakee Postville IA Ethernet Winneshiek Medical Center Rehabilitation & Sports Medicine Clinic 107 West Main Houston Spring Grove MN Ethernet Mabel Clinic 114 Main St Fillmore Mabel MN Ethernet 76

78 77