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Q -- Cheyenne CNH Multi Award - Attachment

Notice Date
Notice Type
623110 — Nursing Care Facilities (Skilled Nursing Facilities)
Contracting Office
Department of Veterans Affairs;Network Contracting Office;NCO 19;6162 South Willow Drive, Suite 300;Greenwood Village CO 80111
ZIP Code
Solicitation Number
Response Due
Archive Date
Point of Contact
Joshua Gallegos
Small Business Set-Aside
PAGE 1 OF 1. REQUISITION NO. 2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL TIME 9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR: SMALL BUSINESS HUBZONE SMALL BUSINESS SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM EDWOSB 8(A) NAICS: SIZE STANDARD: 11. DELIVERY FOR FOB DESTINA- TION UNLESS BLOCK IS MARKED SEE SCHEDULE 12. DISCOUNT TERMS 13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700) 13b. RATING 14. METHOD OF SOLICITATION RFQ IFB RFP 15. DELIVER TO CODE 16. ADMINISTERED BY CODE 17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE TELEPHONE NO. DUNS: DUNS+4: PHONE: FAX: 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED SEE ADDENDUM 19. 20. 21. 22. 23. 24. ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT (Use Reverse and/or Attach Additional Sheets as Necessary) 25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED. 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS: 30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012) PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212 7. FOR SOLICITATION INFORMATION CALL: STANDARD FORM 1449 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 87 00001 36C25918Q9796 09-13-2018 Joshua Gallegos 303-712-5775 10-15-2018 5:00 MST 36C259 Department of Veterans Affairs Network Contracting Office NCO 19 6162 South Willow Drive, Suite 300 Greenwood Village CO 80111 X 623110 $27.5 Million X N/A X Department of Veterans Affairs Cheyenne Healthcare System 2360 E. Pershing Blvd Cheyenne WY 82001 36C259 Department of Veterans Affairs Network Contracting Office NCO 19 6162 South Willow Drive, Suite 300 Greenwood Village CO 80111 Department of Veterans Affairs VA Community Care Payment Center P.O. Box 1004 Invoices shall be mailed or FAX'd Fort Harrison MT 59636 888-795-0773 406-841-8986 Indefinite-Quantity Contract (IDC) for Community Nursing Homes (CNH) for VA Cheyenne Health Care System in accordance with the Performance Work Statement. The period of performance for the IDC is a base year and four (4) 12-months option periods. The total estimated cost of the contract will not exceed a total cost of $1,700,000. There is a guaranteed minimum of: The cost of one (1) room for one (1) veteran for one (1) day of care at the VA base rate. Period of Performance is: Base: 11/01/2018 - 10/31/2019 OY1: 11/01/2019 - 10/31/2020 OY2: 11/01/2020 - 10/31/2021 OY3: 11/01/2021 - 10/31/2022 OY4: 11/01/2022 - 10/31/2023 X X X 1
Web Link
FBO.gov Permalink
File Name: 36C25918Q9796 36C25918Q9796_2.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591242&FileName=36C25918Q9796-010.docx)
Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591242&FileName=36C25918Q9796-010.docx

File Name: 36C25918Q9796 Attachment 1, RUGs IV Descriptions.pdf (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591244&FileName=36C25918Q9796-011.pdf)
Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591244&FileName=36C25918Q9796-011.pdf

File Name: 36C25918Q9796 Attachment 2, Exclusion Review Form.pdf (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591245&FileName=36C25918Q9796-012.pdf)
Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591245&FileName=36C25918Q9796-012.pdf

File Name: 36C25918Q9796 Attachment 3, WAGE DETERMINATIONS UNDER THE SERVICE CONTRACT ACT.pdf (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591246&FileName=36C25918Q9796-013.pdf)
Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591246&FileName=36C25918Q9796-013.pdf

File Name: 36C25918Q9796 Attachment 4, Wyoming County Map.pdf (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591247&FileName=36C25918Q9796-014.pdf)
Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4591247&FileName=36C25918Q9796-014.pdf

Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
SN05087573-W 20180915/180913231153-ef7dd30031719405f9ee66b863a0c751 (fbodaily.com)
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