RESPONSIBILITY OF LOUIS STOKES CLEVELAND VA MEDICAL CENTER

RESPONSIBILITY OF LOUIS STOKES CLEVELAND VA MEDICAL CENTER

The Contractor shall provide all required labor, material, equipment and supervision of contractor personnel necessary to perform Basic Life Support (BLS), ambulance services for eight (8) facilities at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center CBOCs, located at:

1. 
   55 W Waterloo Rd, Akron, OH 44319 (Akron VA facility); 733 Market Ave S, Canton, OH 44702 (Canton VA facility)
   
2. 
   6751 N Chestnut St, Ravenna, OH 44266 (Ravenna VA facility)
   
3. 
   1260 Monroe St NW #1A, New Philadelphia, OH 44663 (New Philadelphia VA facility)
   
4. 
   1025 S Trimble Rd, Mansfield, OH 44906 (Mansfield VA facility)
   
5. 
   205 W 20th St, Lorain, OH 44052 (Lorain VA facility)
   
6. 
   7 W Jackson St, Painesville, OH 44077 (Painesville VA facility)
   
7. 
   3416 Columbus Ave, Sandusky, OH 44870 (Sandusky VA facility).
   

The VA requires Medical Transportation Service to transport beneficiaries including physically or mentally handicapped individuals, aged and infirm persons, their attendants and personal belongings between points in Ohio. Contractor shall provide all labor, materials and equipment necessary to transport VA beneficiaries by Basic Life Support (BLS), ambulance services. Contractor shall provide all BLS Ambulance services as stated in the scope of work for veteran beneficiaries, when requested by the VA.

(a) The services of this contract will be utilized primarily for trips starting at a veteran’s location (residence, nursing home, and other medical facilities) with the trip terminating at the Louis Stokes Cleveland VA Medical Center, at Akron, Canton, Ravenna, New Philadelphia, Mansfield, Lorain, Painesville, & Sandusky. These transports will primarily take place three (3) days per week for approximately three to five patients at a time for scheduled appointments via a standing order. This number of patients is subject to change at any time. Some trips may start at the Louis Stokes Cleveland VA at Wade Park division and end at other medical facilities and vice versa. The company awarded the contract is responsible for bringing all eligible patients to and from the facility in which the contract was awarded. In this particular contract, the facility will be for the Louis Stokes Cleveland VA Medical Center in Akron, Canton, Ravenna, New Philadelphia, Mansfield, Lorain, Painesville, Sandusky, East Liverpool, Warren and Youngstown. For example, if a patient resides in Canton and is referred to the Canton VA division for treatment, the Contractor awarded the Akron, Canton, Ravenna, New Philadelphia, Mansfield, Lorain, Painesville, Sandusky, East Liverpool, Warren and Youngstown contract will be responsible for the roundtrip transportation of the patient. There are also circumstances in which the VA outsources patients to other facilities to receive medical treatment. The VA is responsible for providing transportation for these veterans who meet the eligibility requirements for travel. The Contractor awarded the contract to the closest VA facility to the outsourced site is responsible for the transportation of this patient. For example, if a patient who resides in Akron is outsourced to a dialysis unit located near Akron, the contractor who is awarded the contract for the Akron VA Outpatient Clinic is responsible for the roundtrip travel of this patient. If a patient requires transportation to a facility that is near two separately contracted VA facilities, it is the VA’s discretion to decide which Contractor to choose from. For example, if a patient is being transported to the City of Richfield (half way between the Akron Outpatient Clinic and the Parma Outpatient Clinic), the VA will determine which Contractor will be used.

(b) Emergency transport requirements at the above stated facilities will be addressed by utilizing local 911 Emergency Services.

(c) Should the VA determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation, other services may be procured without referral to the Ambulance Contractor. However, in these rare cases, no charge shall be levied against the Contractor.

(d) In order for beneficiaries to receive the best possible treatment, it is essential that the COR be notified as soon as possible by the Contractor in instances when it is known that the required services cannot be fulfilled by the Contractor or any of its hired subcontractors. This notice will enable the VA to secure the service elsewhere to meet the requirements.

The minimum numbers of BLS capable Ambulance vehicles are outlined below:

(e) In the event that all Contractor vehicles are utilized on service runs for this Medical Center and additional vehicles are needed, it is the Contractor’s responsibility to arrange transportation through a subcontractor. If this circumstance were to arise, the Contractor will still bill the VA according to the details of this contract. In addition, the Contractor is required to notify the COR of this inability to provide the service and the Contractor shall pay any difference in costs. Failure to notify the VA may reflect upon the Contractor’s ability to perform under this contract and may constitute sufficient cause for termination of the existing contract.

(f) It is preferred that the awarded Contractor bill the Cleveland VA Medical Center by utilizing a secured means of Electronic Data Interchange (EDI). When billing, the VA requires that each trip is disclosed with the individual cost, exact mileage utilized point of pick-up and point of drop-off, along with the date of transport and associated patient identification.

4. VEHICLES AND EQUIPMENT:

(a) Ambulance vehicles and equipment with which the Contractor renders all services must meet Federal and State of Ohio (or Equal) requirements for insurance, licensing, registration, and equipment and are to include, but not be limited to the following:

1. 
   An emergency safety kit.
   
2. 
   Portable oxygen unit(s).
   
3. 
   Fire suppression equipment.
   
4. 
   Appropriate road emergency warning equipment.
   
5. 
   Written emergency procedures.
   
6. 
   Protective clothing required for the protection of contractor employees, such as gowns, gloves, masks, etc.
   
7. 
   Approved system for patient and/or wheel chair securement devices and a tool designed for cutting securement straps in case of emergency.
   
8. 
   Safety requirements for seat belts and handling of motorized or electric wheelchair. Contractor must furnish shoulder/chest harness for double amputee patients when applicable.
   

(c) The Contractor shall not be permitted to borrow medical equipment from the Medical Center. The Contractor shall provide all medications required while in transport, sheets and blankets, and other equipment and supplies required for use while in transport. Contractor shall at no time and under any circumstances exchange supplies, equipment and/or medications with VA. The prices quoted by the Contractor shall be inclusive of consumables used in transport. Vehicles shall have equipment for critical patient care, which shall include, but not limited to, monitors, defibrillator with external pacemaker, intubation equipment, intravenous equipment, medications, patient compartment facilities, oxygen and suction system equipment including portable oxygen suction and accessories. Contractor shall be responsible for sharps disposal.

(d) Contractor shall provide non-emergency vehicles with safe entry for non-ambulatory patients requiring BLS transportation.

(e) All additional items such as first aid kits, flashlights, warning triangles, ice scrapers, blankets, etc. shall be secured and stored below the level of seat backs.

(f) Dry chemical fire extinguishers shall be securely mounted in a bracket and readily accessible to the driver in an emergency. Extinguishers shall be serviced annually and bear a tag indicating the dates of all inspections.

(g) Heater(s) are to be of sufficient capacity to maintain patient’s warmth during winter months. All vehicles are to be air conditioned. Blowers must be operational.

(h) VA reserves the right to inspect contractor's equipment and vehicles or require documentation of compliance with contract specifications, and State laws, rules, regulations and guidelines governing transport vehicles. VA inspections of Contractor facilities shall in no way constitute a warranty by VA that the Contractor's vehicles and equipment are properly maintained. VA reserves the right to restrict the Contractor’s use of equipment and vehicles in need of repair, unclean, unsafe, damaged on the interior or exterior body, and not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the Contractor of performing in accordance with the strict intent and meaning of the contract.

(i) Ambulance vehicles and equipment shall adhere to all requirements listed herein as well as those set forth by The Ohio Medical Transportation Board Administrative Code, Chapter 4766-2 Ambulance (See Attached).

(a) Contractor shall maintain all vehicles in a clean and orderly condition, free from debris and any accumulations which may create an accident, injury, or fire hazard.

(b) Contractor shall maintain vehicles in accordance with manufacturer’s recommended maintenance schedule or an improved schedule based on actual vehicle operating conditions.

(c) Contractor shall correct a deficiency that might interfere with safe operation of vehicle before vehicle is placed in service.

(d) Contractor shall ensure vehicle windows and lights are kept clean at all times.

(e) Contractor shall keep the interior of vehicles clean and in good repair.

(f) Wheelchair lifts shall be maintained in conformance with operation/maintenance manual instructions provided by lift manufacturer. When a vehicle is serviced, the mechanic or service facility shall inspect, repair, or service the lift in accordance with the manufacturer’s instructions.

(g) Contractor shall maintain (and furnish upon request) procedures that outline preventive maintenance and/or repairs on each vehicle in an individual vehicle file and in chronological order, latest service on top. A statement from the Contractor indicating compliance of vehicle maintenance files is in place should be submitted at time of offer for evaluation purposes. Requested submission and verification of these documentation requirements will be a quality assurance procedure during the contract period.

(h) Maintenance procedures shall adhere to all requirements listed herein as well as those set forth by The Ohio Medical Transportation Board Administrative Code, Chapter 4766-2 Ambulance.

6. DRIVER QUALIFICATIONS:

(a) In order to operate a special transportation service vehicle a driver must have no current medical condition that interferes with the ability to drive safely. A medical condition includes but is not limited to issues with vision, hearing and mental capacity.

(b) It is the Contractor’s responsibility to ensure that all employees servicing the VAMC contract obtain a physician’s statement or the statement of a nurse practitioner certified by the American Nurses’ Association (or other professional nursing certifying organization having authority to certify registered nurses in advanced nursing practice) that the driver has no current medical condition that interferes with the driver’s ability to drive safely. It shall be obtained before driving a special transportation service vehicle and kept on file. It shall be made available to the VA upon request.

(c) Each driver shall be able to perform a vehicle safety inspection. Each driver and attendant, when a vehicle is staffed by both a driver and an attendant must be able to assist a passenger into and out of the vehicle and operate a wheelchair lift or ramp.

(d) Each driver shall:

1. 
   Possess a driver’s license that is valid for the class of vehicle driven and if required under Ohio Statutes (or other state Equal), evidence of a special transportation service vehicle permit or endorsement issued by the commissioner of public safety.
   
2. 
   Be at least 18 years of age and have not less than one year of experience as a licensed driver; and
   
3. 
   For the past three years:
   
4. 
   Have not had a driver’s license canceled or suspended under Ohio Statutes, (or other state Equal);
   
5. 
   Have a driving record clear of convictions for operating a motor vehicle or motorcycle without insurance as required by Ohio Statutes, (or other state Equal);
   
6. 
   Have a driving record clear of convictions for driving a motor vehicle without a valid current license for the class of vehicle driven; and
   
7. 
   Have a driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance under Ohio Statutes (or other state Equal).
   
8. 
   Have a record clear of criminal convictions of crimes or pending criminal indictments against persons, and crimes or anticipatory crimes reasonably related to providing special transportation services. This must be documented by a formal background check.
   

(f) Emergency Medical Technician (EMT) and Paramedic Qualifications: EMT’s and Paramedic’s providing services under this contract shall have the following qualifications, in addition to those required by Federal, State, and Local Government:

1. 
   Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 150 hours or equivalent including an in-hospital training period. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154, Federal Register 39:24304. (1974).
   
2. 
   Shall submit evidence of equivalent training program, which has been successfully completed, to the Contracting Officer.
   
3. 
   Shall be certified, licensed or otherwise officially recognized by the local, state or regional government or public entity where the emergency ambulance service is operated or by which it is governed.
   
4. 
   Shall attend all refresher continuing education, or advanced training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than every two (2) years. Such refresher training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration.
   

(a) Contractor employees performing services to VA beneficiaries under this contract must meet all requirements of Ohio Department of Transportation for drivers and attendants of special transportation service vehicles, including a basic First Aid Class.

(b) Driver shall have successfully completed training in the techniques of transporting and assisting elderly and physically handicapped passengers which shall include instruction in the following elements:

1. 
   Discussion of characteristics of the aging process and major disabling conditions;
   
2. 
   Discussion of common assistance devices used by elderly and handicapped persons;
   
3. 
   Discussion of attitudes toward elderly and handicapped persons, which includes the participation of handicapped and elderly persons;
   
4. 
   Instruction in methods of handling wheelchairs;
   
5. 
   Instruction in moving, lifting and transferring passengers;
   
6. 
   Guidelines for transporting handicapped persons;
   
7. 
   Instruction in the operation of lifts, ramps and securing wheelchairs; Instruction in handling and securing wheelchairs that are equipped with Oxygen.
   

(d) Each employee shall complete four (4) hours of training in first aid (or show evidence of possessing American Red Cross First Aid Certificate).

(e) Each employee shall complete four (4) hours of classroom instruction in defensive driving and abuse-prevention training.

(f) Each employee shall successfully complete a refresher first aid course every two (2) years.

(g) The Contractor must have on file satisfactory evidence of above training, evidence that the instructor is qualified to teach the above, and First Aid certificates for instructor and trainee/driver available for review and inspection by the VA Contracting Officer and inspection team.

(h) A record of each employee as to character and physical capability of performing the duties of a driver must be maintained and made available for inspection upon request.

(j) The Contractor shall furnish qualified personnel as required by contract specifications to accomplish all services under this contract. During the contract period of performance, if the Contractor proposes to add-on or replace personnel to perform contract services, the Contractor shall ensure the employee meets contract requirements as stated and upon request by the VAMC provide required evidence of training, certifications, licensing and any other qualifications to the designated COR. At no time shall the Contractor utilize add-on or replacement personnel to perform contract services who do not meet the qualifications under the terms and conditions of this contract.

(k) Contractor personnel performing services to the Government shall at all times conduct themselves in a professional manner, maintain personal hygiene, maintain a clean, neat appearance, and be identified by a badge or license. The Contractor shall be responsible for furnishing all vehicles, personnel, equipment, supplies, vehicle fuel, name tags and/or badges for performance of services under this contract. Employee identifications shall be available at all times. Contractor personnel shall not smoke in vehicles while transporting VA patients.

(l) Driver training shall adhere to all requirements listed herein as well as those set forth by The Ohio Medical Transportation Board Administrative Code, Chapter 4766-2 Ambulance (See Attached).

(a) It is understood that the patient plus one (1) additional passenger to be transported on a trip will be based on the size of the vehicle and authorization by VAMC.

(b) Drivers and passengers shall use seat belts/securement devices at all times.

(c) There shall be no smoking by the driver, attendants, or passenger.

(d) Contractor is required to provide “through the door service” for patients to and from their designated appointments. “Through the door service” is defined as patients being picked up either on the ward, in their homes, in their clinic or at other stated areas and taken to their stated destination or appointment. On the return trip the contractor will return the patient to either the ward, inside his/her home, or to other stated areas.

(e) The Contractor shall be required to transport non-ambulatory veterans on gurneys and litters who are not in need of emergency transportation or medical attention.

(f) Upon delivery or pick-up of a patient, the Contractor shall log in the patient on a log sheet at the location designated at the facility. Contractor shall provide the following information on the log sheet:

1. 
   Patient Name
   
2. 
   Last four of the patient’s Social Security Number
   
3. 
   Time of delivery or pick-up
   
4. 
   Point of origin or destination
   
5. 
   Name of Contractor personnel picking up or delivering patient
   

(h) An authorized official of the VA Medical Center (usually the COR) may, in the best interest of the patient, allow one (1) relative or concerned other to accompany the patient at no additional cost to the Government. The relative or concerned other is to only be transported home with the beneficiary unless approved by an official of the VA Medical Center. The beneficiary will also be allowed to carry with her or him at least 1 bag of luggage during her or his transport. Prior to contract performance, the COR shall provide the Contractor with a list of names (or position titles) and phone numbers of authorized Government personnel who may request services. This list will be updated and submitted to the Contractor as changes occur. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

(i) Contractor is required to notify the COR of any unusual events, including but not limited to accidents, safety problems and deviations in transportation that occur and involve any VA beneficiary being transported under this contract. This notification will be made immediately by telephone to the COR or AOD during other than normal working hours. A written report of the event will be delivered to the COR within 24 hours. Failure to comply with this provision may be grounds for default.

(j) At no time shall the Contractor’s vehicle use the VA Medical Center’s Ambulance Entrance unless the drop off or pick up is for a medical emergency. If waiting time is necessary, vehicle must park in appropriate designated general parking lot areas.

(k) The patient may bring with her or him up to 3 liters of oxygen. The contractor shall be responsible for providing adequate and safe storage of the oxygen tanks during transport.

(l) If or when patient’s medical records are transported, Contractor will ensure that Privacy Act guidelines are followed.

(m) Patients will be entitled to transport one certified trained service animal. No pets are to be transported at any time.

9. ORDERS

(a) When ordering services, the VA shall provide the Contractor with the following type of information:

1. 
   Mode of transportation required,
   
2. 
   Required time of arrival and/or within 30 minute timeframe,
   
3. 
   Name of beneficiary,
   
4. 
   Pickup and delivery point,
   
5. 
   Type and number of additional medical care specialists required,
   
6. 
   Type of equipment required,
   
7. 
   Last four of the patient’s Social Security Number, and
   
8. 
   Any other special instructions.
   

(c) A schedule in as far advance as possible shall be provided to the contractor. However, unscheduled requests for services during off business hours (4:31p.m. to 7:59am) will be made by telephone, encrypted email, or in writing by a secured facsimile machine or other secured electronic means by the COR and/or designated VAMC personnel. It is the responsibility of the Contractor to obtain formal documentation, of all transport requests made during off business hours, in order to be used to as validation during billing and invoicing of services. The preferred means of documentation is a copy of the provider’s Consult request for transport.

(d) The contractor shall, at all times during the contract period, have on his/her premises a functioning secured fax machine or secured network to communicate requirements with the VA (i.e., requests for service, patient incidents, special correspondence, etc).

(e) Contractor must notify the COR at least eight (8) hours in advance of need when Contractor believes he/she may be unable to meet the number of scheduled trips required.

(f) The awarded contractor should establish a system to remind patients that they are scheduled for transportation with the said Contractor, with at least one (1) day advance notice.

(g) Any requests to upgrade current transport services to services that are not specified in this contract must first be approved by the COR or a designated appointee.

(h) In the case of inclement weather, the decision as to whether or not a VA beneficiary will be transported will be made mutually by the COR or designee and the Contractor.

10. RESPONSE TIME

(a) The Contractor shall respond to all calls for ambulance transport service by being on-site at the designated VA facility or point of pick up within thirty (30) minutes of notification. Should the time period for pick-up, stated herein, be physically impossible due to location of veteran beneficiary, the Contractor shall contact the appropriate individual at the VA (from a list of extensions which shall be provided to the Contractor from the PCAS department and the CBOC locations) and proceed to inform him/her of the anticipated time required for pick-up and delivery of said patient.

(b) The Contractor shall maintain a 100% monthly compliance rate on response time to pick-up during the contract year. Failure of the Contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the contract for “cause.”

11. CONFORMITY TO REGULATIONS

(a) The Contractor and his/her operators shall conform to all Federal, State and local regulations governing the performance of contracted services.

(b) VAMC facilities have been designated NO SMOKING areas in their entirety. Individuals found in violation of this no smoking policy may be subject to a $50 federal citation for disregarding posted safety rules and regulations. Furthermore, Contractor may be directed to stop work. Contractor is to notify all of his/her employees and/or sub-contractors of this strict enforcement policy.

(c) The Contractor must have the appropriate permits/licenses to perform services in the state of Ohio.

(d) All services provided by the Contractor shall comply with applicable current laws, regulations and standards of the appropriate regulatory body.

12. EVIDENCE OF COVERAGE

Before commencing work under the contract, the Contractor shall furnish the Contracting Officer with a certification from his/her insurance company indicating that the coverage outlined in this contract has been obtained and that it may not be changed or canceled during the term of the contract.

(a) The Government reserves the right to thoroughly inspect and investigate the establishment, vehicles, driver qualifications/training, facilities, business reputation and other qualifications of any Contractor and to reject any offer, irrespective of price, if it shall be administratively determined lacking any of the essentials necessary to ensure acceptable standards of performance. The Government may inspect Contractor’s establishment at least annually, and may inspect any element any time, and especially upon receipt of a complaint about the condition of the vehicle or its equipment, the driver or attendant, or service provided.

(b) Inspection by VA inspection team may be made of said vehicles and maintenance records of vehicles prior to award and at any time during the term of any resulting contract(s).The Contracting Officer will be notified in writing of any vehicle equipment added, changed or deleted after award of contract.

14. PATIENT RIGHTS:

1. 
   The Contractor shall be courteous to VA beneficiaries. Patients may bring a reasonable amount of equipment, such as any manual wheelchair, or prosthetic devices, consumable medical supplies, and one (1) personal suitcase during her or his transport.
   

2. 
   The Contractor shall immediately notify the VA by telephone of any incidents or accidents involving injury to VA patients during transport. The contractor shall promptly (within 24 hours of the occurrence) complete and submit to the COR, a detailed “Incident Report” with all information necessary to conduct a full review (Who, What, When, Where and How). Accidents must be reported even if there is no apparent injury to the patient(s) being transported. Failure to advise the Government of any incident or accident within the specified time above may be cause for termination of the contract.
   
3. 
   The Contractor shall notify the COR in writing within 24 hours of any patient complaints about Contractor’s service. The Contractor may provide recommendations for improved services along with the patient complaints for the VA’s review. No recommendation shall be construed as being effective until and unless it is provided as a written modification to the contract from the Contracting Officer.
   

(a) Within seven (7) days after contract award, the Contractor shall provide the following:

1. 
   Contractor Personnel Roster. Contractor shall identify all employees by name and position and provide training documentation with date and location of such training.
   
2. 
   Contractor shall include Contractor’s project manager with telephone and fax numbers.
   
3. 
   Contractor shall include telephone and fax numbers through which scheduling transport requests will be made.
   
4. 
   Listing of all vehicles with VINs and documentation of insurance coverage and a statement indicating all have been fully maintained and are currently safe to operate.
   
5. 
   Any personnel or vehicle changes shall be submitted within two (2) business days after changes occur.
   

1. 
   Patient’s name
   
2. 
   Last four of Social Security number
   
3. 
   Trip date,
   
4. 
   Pick-up point,
   
5. 
   Drop-off point,
   
6. 
   Identify as round trip or one way
   
7. 
   Mode of transportation (i.e. ALS, BLS)
   
8. 
   Number of miles traveled
   
9. 
   Base charge plus an itemization of additional charges if applicable, and
   
10. 
    Name of VA Official who authorized trip.
    

The Contractor shall not exceed vehicle capacity for the patient and one (1) passenger transported in vehicles.

The awarded Contractor is required to wait at either end of transport up to 30 minutes from the pick-up time. If the Contractor waits any longer than 15 minutes at either end of the transport, the Contractor is to contact the COR or appointed designee and the COR will attempt to contact the patient and get the patient ready for transport. If at any point the Contractor waits beyond a total of 30 minutes from the requested pick-up time, the VA Medical Center will approve a cancelled on site transport and pay the contracted base rate amount for a cancelled on site charge. If the VA still needs the patient to be picked up after the 30 minutes, the VA will incur the cancelled on site charge as well as the contracted rate for the subsequent transport.

1. 
   All trips, from point of pick up to point of drop off will be charged an agreed upon base rate, as well as a mileage rate.
   

2. 
   The base rate will be applied at the point of pick up and will only be paid if the awarded Contractor has arrived at the initial point of pickup. The base rate will also serve as the amount of payment towards a cancelled on site charge.
   

3. 
   Mileage will only be paid when a patient is being transported. There will be no payment for mileage accrued without a VA approved passenger onboard. Trip mileage shall be determined by the latest edition of Rand McNally mileage guide. Round trip transports that involve the same point of pick up and drop off location, will be calculated by multiplying the initial point of pick up and drop off by two (2). Mileage will be calculated and billed to the exact mile or fractional mile. Bills will be sent on a weekly basis to the VA for payment.
   

4. 
   Rates are all inclusive of but not limited to vehicle, qualified driver, maintenance, insurance, fuel, or any other variable costs.
   

(a) A cancelled on site (COS) charge is a payment on behalf of the Medical Center to the awarded Contractor for an attempted transport that results in a patient not showing up for pick up. A COS charges is equal to the agreed upon base rate for a single trip. For example, if the Contractor arrives at the destination before VA cancels the order, or if the Contractor is unable to perform a scheduled pick-up for reasons beyond the Contractor's control, e.g., incorrect address, or patient absence, or patient refusal, then the Contractor shall receive 100% of base rate for a one-way trip.

(b) In order to claim a COS charge, the awarded Contractor must first obtain approval from the COR or appointed designee. Each COS charge will be reviewed and approved on a case by case basis to determine responsibility for the COS.

20. TOLL CHARGES:

1. 
   The prices in the schedule include all ferry, bridge, tunnel, and road toll charges. Any toll charges incurred shall be part of the firm fixed price and shall not be part of the Contractor’s invoice.
   

2. 
   If the Contractor’s place of business is located beyond the local telephone call zone of this Medical Center, the Contractor agrees to accept telephone orders for services on a collect basis. It is estimated that approximately 250 orders will be placed by telephone.
   

(a) In the performance of this contract, the Contractor shall take additional safety precautions as determined necessary by the CO or COR. The CO or COR will notify the Contractor of any additional requirements or noncompliance issues in which the Contractor shall take corrective action as soon as possible. Such notice shall be administered in writing to the Contractor. If the Contractor fails or refuses to comply promptly, the CO may issue an order stopping all or any part of the work and hold the Contractor in default.

(b) When ambulance services are required, the Contractor shall use universal precautionary measures for the prevention and control of the spread of infectious agents to all persons.

(c) Safety practices shall adhere to all requirements listed herein as well as those set forth by The Ohio Medical Transportation Board Administrative Code, Chapter 4766-2 Ambulance.

PRICING/COST SCHEDULE

Performance Schedule: July 1, 2017 through June 30, 2018

LINE ITEM	DESCRIPTION	EST QTY	UNIT	BASIC LIFE SUPPORT (BLS)RATE	MILEAGE RATE (est. 16 miles per trip)	TOTAL PRICE
0001	SINGLE TRIPS	1152 (96 trips per month)	TRIPS

Total Price for Year: _________________________________________________

• 
  Cancellation On-Site Rate (COS) Rate is the same rate as the Basic Life Support (BLS) Rate. There is usually no Cancellation On-Site Trips.
  
• 
  There is an estimated average of 96 trips per month (or 24 trips per week) and an estimated average of 16 miles per trip
  
• 
  Each roundtrip transport was counted as 2 trips since there was a transport each way. Also, these trips are mainly comprised of Standing Orders with some miscellaneous trips so transports mainly take place 3 times a week (every other day) and there is not necessarily a trip each day.
  

Please read below regarding the formula for pricing proposals:

Average mileage per trip – 16

Average trips per month-96

Estimated BLS Trip Price: 16 x (Mileage Rate) + (BLS rate) =

Total Trip Cost (per month) = Estimated BLS Trip Price x 96 =

Total Trip Cost x 12 months = Total Price

Below are an estimated average number of BLS transports per month for each location. Please note that these numbers are strictly an estimate and can vary considerably during the life of the contract.

BLS

1. 
   Akron: 30
   
2. 
   Canton: 30
   
3. 
   Ravenna: 1
   
4. 
   New Philadelphia 1
   
5. 
   Mansfield 30
   
6. 
   Lorain 2
   
7. 
   Painesville 1
   
8. 
   Sandusky 1________
   

Totals: 96

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