January 4, 2006

Dear Prospective Offeror:

 

SUBJECT: **Solicitation Number SOUP300-06-R-0001**

** **

The Embassy of the United States of America invites you to submit a
proposal for customized Medical Insurance Services for Ukrainian
employees of US Embassy in Ukraine.

**The Embassy intends to conduct a pre-proposal conference, and all
prospective offerors who have received a solicitation package will be
invited to attend. See Section L of the attached Request for Proposals
(RFP).**

 

Your proposal must be submitted in a sealed envelope marked \"Proposal
Enclosed\" to the Contracting Officer, Edith Backman at Artem Business
Center, Glybochytska 4, Kiev, Ukraine **on or before February 9, 2006,
17:00. No proposal will be accepted after this time.**

 

In order for a proposal to be considered, you must also complete and
submit the following:

 

> 1\. SF-33

2.  Section B, Pricing Schedule

3.  Section B, Retention Amounts in B.3 and B.7

4.  Section K, Representations and Certifications;

5.  Additional information as required in Section L.

 

Direct any questions regarding this solicitation to Contracting Officer,
Edith Backman or Contracting Specialist Olena Stavnycha; by letter or by
telephone 490-4551, 490-4113 or by fax 490-4085 during regular business
hours.

 

**Please note: proposals that contain more benefits (even if there is no
increase in cost) or fewer benefits than those stated in the
solicitation may be deemed technically unacceptable.**

 

The U.S. Government intends to award a contract to the responsible
company submitting an acceptable offer at the lowest price. We intend to
award a contract based on initial proposals, without holding
discussions, although we may hold discussions with companies in the
competitive range if there is a need to do so.

 

 

Sincerely,

*** ***

*** ***

***Edith Backman***

Contracting Officer

Of US Embassy Kiev, Ukraine

 

 

### SECTION B

**PART I PRICE - HEALTH INSURANCE**

B.1. [Health Insurance Services]{.underline}.

 

The Contractor shall provide the Health Insurance services to employees
of the Government of the United States of America in Ukraine as
described in Section C and the Exhibits in Section J. The groups of
employees who shall be provided this insurance are listed in C.1.2. This
insurance shall be provided in accordance with Section C and the
Exhibits in Section J.

 

B.1.1. Official Residence Expense (ORE) Staff and Embassy Association
Employees (EAE) are included under this contract only as a rider; the
Contractor shall bill the Chief of Mission and Deputy Chief of Mission
(for ORE Staff) and the Embassy Association (for EAEs) separately, at
the rates specified below. See Section G for billing procedures.

 

B.2. [Prices]{.underline}.

 

This is a fixed price with economic price adjustment requirements type
contract under which will be issued firm, fixed-price task orders. The
fixed prices/premium rates (calculated in US dollars) for the health
insurance services as specified in Section C and Exhibit A of Section J
are as follows:

 

B.2.1. BASE YEAR OF CONTRACT:

***Bi-Weekly Rates per Employee:***

+------------+--------+---------------+---------+------------+-------+
| Category   | Est    | Rate per      | Es      | Rate per   | Total |
|            | imated |               | timated | employee   |       |
|            | Number | Employee      | Number  | (not in    |       |
|            | of     |               | of      | Kyiv)      |       |
|            | Emp    |               | Em      |            |       |
|            | loyees |               | ployees |            |       |
|            |        |               | that    |            |       |
|            |        |               | are     |            |       |
|            |        |               | located |            |       |
|            |        |               | not in  |            |       |
|            |        |               | Kyiv    |            |       |
+------------+--------+---------------+---------+------------+-------+
| Single     | 168    |               | 1       |            |       |
| employees  |        |               |         |            |       |
| (Self      |        |               |         |            |       |
| only)      |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 116    |               |         |            |       |
| employee   |        |               |         |            |       |
| and one    |        |               |         |            |       |
| dependent  |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 194    |               | 4       |            |       |
| employee   |        |               |         |            |       |
| and two    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 69     |               |         |            |       |
| employee   |        |               |         |            |       |
| and three  |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 2      |               |         |            |       |
| employee   |        |               |         |            |       |
| and four   |        |               |         |            |       |
| dependents |        |               |         |            |       |
| and/or up  |        |               |         |            |       |
| to 7       |        |               |         |            |       |
| (seven)    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| SUBTOTAL   |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+

TOTAL PRICE FOR OPTION YEAR ONE: (Subtotal x 26): \_\_\_\_\_\_\_

 

B.2.2. FIRST OPTION YEAR OF THE CONTRACT:

  

***Bi-Weekly Rates per Employee:***

+------------+--------+---------------+---------+------------+-------+
| Category   | Est    | Rate per      | Es      | Rate per   | Total |
|            | imated |               | timated | employee   |       |
|            | Number | Employee      | Number  | (not in    |       |
|            | of     |               | of      | Kyiv)      |       |
|            | Emp    |               | Em      |            |       |
|            | loyees |               | ployees |            |       |
|            |        |               | that    |            |       |
|            |        |               | are     |            |       |
|            |        |               | located |            |       |
|            |        |               | not in  |            |       |
|            |        |               | Kyiv    |            |       |
+------------+--------+---------------+---------+------------+-------+
| Single     | 168    |               | 1       |            |       |
| employees  |        |               |         |            |       |
| (Self      |        |               |         |            |       |
| only)      |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 116    |               |         |            |       |
| employee   |        |               |         |            |       |
| and one    |        |               |         |            |       |
| dependent  |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 194    |               | 4       |            |       |
| employee   |        |               |         |            |       |
| and two    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 69     |               |         |            |       |
| employee   |        |               |         |            |       |
| and three  |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 2      |               |         |            |       |
| employee   |        |               |         |            |       |
| and four   |        |               |         |            |       |
| dependents |        |               |         |            |       |
| and/or up  |        |               |         |            |       |
| to 7       |        |               |         |            |       |
| (seven)    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| SUBTOTAL   |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+

Total Price for Option Year 1 (Subtotal x 26): \_\_\_\_\_\_\_

 

B.2.3. SECOND OPTION YEAR OF THE CONTRACT:

***Bi-Weekly Rates per Employee:***

+------------+--------+---------------+---------+------------+-------+
| Category   | Est    | Rate per      | Es      | Rate per   | Total |
|            | imated |               | timated | employee   |       |
|            | Number | Employee      | Number  | (not in    |       |
|            | of     |               | of      | Kyiv)      |       |
|            | Emp    |               | Em      |            |       |
|            | loyees |               | ployees |            |       |
|            |        |               | that    |            |       |
|            |        |               | are     |            |       |
|            |        |               | located |            |       |
|            |        |               | not in  |            |       |
|            |        |               | Kyiv    |            |       |
+------------+--------+---------------+---------+------------+-------+
| Single     | 168    |               | 1       |            |       |
| employees  |        |               |         |            |       |
| (Self      |        |               |         |            |       |
| only)      |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 116    |               |         |            |       |
| employee   |        |               |         |            |       |
| and one    |        |               |         |            |       |
| dependent  |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 194    |               | 4       |            |       |
| employee   |        |               |         |            |       |
| and two    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 69     |               |         |            |       |
| employee   |        |               |         |            |       |
| and three  |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 2      |               |         |            |       |
| employee   |        |               |         |            |       |
| and four   |        |               |         |            |       |
| dependents |        |               |         |            |       |
| and/or up  |        |               |         |            |       |
| to 7       |        |               |         |            |       |
| (seven)    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| SUBTOTAL   |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+

 

 

 

Total Price for Option Year 2 (Subtotal x 26): \_\_\_\_\_\_\_

 

B.2.4. THIRD OPTION YEAR OF THE CONTRACT:

***Bi-Weekly Rates per Employee:***

+------------+--------+---------------+---------+------------+-------+
| Category   | Est    | Rate per      | Es      | Rate per   | Total |
|            | imated |               | timated | employee   |       |
|            | Number | Employee      | Number  | (not in    |       |
|            | of     |               | of      | Kyiv)      |       |
|            | Emp    |               | Em      |            |       |
|            | loyees |               | ployees |            |       |
|            |        |               | that    |            |       |
|            |        |               | are     |            |       |
|            |        |               | located |            |       |
|            |        |               | not in  |            |       |
|            |        |               | Kyiv    |            |       |
+------------+--------+---------------+---------+------------+-------+
| Single     | 168    |               | 1       |            |       |
| employees  |        |               |         |            |       |
| (Self      |        |               |         |            |       |
| only)      |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 116    |               |         |            |       |
| employee   |        |               |         |            |       |
| and one    |        |               |         |            |       |
| dependent  |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 194    |               | 4       |            |       |
| employee   |        |               |         |            |       |
| and two    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 69     |               |         |            |       |
| employee   |        |               |         |            |       |
| and three  |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 2      |               |         |            |       |
| employee   |        |               |         |            |       |
| and four   |        |               |         |            |       |
| dependents |        |               |         |            |       |
| and/or up  |        |               |         |            |       |
| to 7       |        |               |         |            |       |
| (seven)    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| SUBTOTAL   |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+

Total Price for Option Year 3 (Subtotal x 26): \_\_\_\_\_\_\_

 

B.2.5. FOURTH OPTION YEAR OF THE CONTRACT:

 ***Bi-Weekly Rates per Employee:***

+------------+--------+---------------+---------+------------+-------+
| Category   | Est    | Rate per      | Es      | Rate per   | Total |
|            | imated |               | timated | employee   |       |
|            | Number | Employee      | Number  | (not in    |       |
|            | of     |               | of      | Kyiv)      |       |
|            | Emp    |               | Em      |            |       |
|            | loyees |               | ployees |            |       |
|            |        |               | that    |            |       |
|            |        |               | are     |            |       |
|            |        |               | located |            |       |
|            |        |               | not in  |            |       |
|            |        |               | Kyiv    |            |       |
+------------+--------+---------------+---------+------------+-------+
| Single     | 168    |               | 1       |            |       |
| employees  |        |               |         |            |       |
| (Self      |        |               |         |            |       |
| only)      |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 116    |               |         |            |       |
| employee   |        |               |         |            |       |
| and one    |        |               |         |            |       |
| dependent  |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 194    |               | 4       |            |       |
| employee   |        |               |         |            |       |
| and two    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 69     |               |         |            |       |
| employee   |        |               |         |            |       |
| and three  |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| One        | 2      |               |         |            |       |
| employee   |        |               |         |            |       |
| and four   |        |               |         |            |       |
| dependents |        |               |         |            |       |
| and/or up  |        |               |         |            |       |
| to 7       |        |               |         |            |       |
| (seven)    |        |               |         |            |       |
| dependents |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+
| SUBTOTAL   |        |               |         |            |       |
+------------+--------+---------------+---------+------------+-------+

Total Price for Option Year 4: (Subtotal x 26): \_\_\_\_\_\_\_

 

GRAND TOTAL BASE PERIOD PLUS OPTION YEARS:
USD\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

 

B.3 [Administrative Retention Amounts]{.underline}

 

B.3.1 If the Contractor requests a price adjustment under B.4 below, the
Contractor must present cost experience data that includes the retention
amount. For purposes of any economic price adjustment, this retention
amount is a fixed amount that is a part of the premium amounts in B.2.
This retention amount will not be adjusted for any reason.

 

The retention amount is part of the premium and may include, but not be
limited to, such costs as overhead and general and administrative costs.
It will also include any profit. Essentially, it includes all costs
except the actual portion of the premium intended to fund claims paid to
the health care provider/claimant.

 

B.3.2 sets forth the retention amounts per premium paid for each
category of premium and for each period of performance.

  

**NOTE TO OFFEROR - Fill in the fixed retention amounts for each period
of performance and for each category of premium. This fixed amount must
be expressed in the currency in which the premium amount is proposed.
The fixed retention amount shall NOT be expressed in terms of a
percentage of the premium.**

 

B.3.2 Retention Amounts **per separate premium paid** per single
employee and per family plan.

 

 

 

B. 4. [Economic Price Adjustment-Health Insurance Premiums.]{.underline}

 

B.4.1. [Premium Adjustment based on Experience]{.underline} - For health
insurance, prices may be adjusted upward or downward based on the
experience rating of the Mission(s) covered by this contract. No
adjustment will be allowed during the first twelve months. After such
time, the contractor or the Government may request an adjustment in
premiums on an annual basis. Before any such adjustment is made, the
contractor agrees to provide the Government a balance sheet showing two
main components for the time period: (1) receipts (premiums received)
minus the retention amount and (2) claims paid. The retention amount is
not subject to adjustment. The Government reserves the right to have an
independent third party review the balance sheet and make
recommendations regarding the appropriateness of the requested
adjustment. Any adjustment shall be subject to mutual agreement of the
parties and shall result in a written modification to the contract. Any
failure to reach agreement under this clause shall be subject to the
procedures in the Disputes clause.

 

B.4.2. [Premium Adjustment Based on Laws]{.underline} - The rates may
also be adjusted during the performance period of the contract as a
result of laws enacted by the host Government, if such change in the
laws has a direct impact on the cost to the contractor to perform this
contract at the contracted rate. In that event, the Contracting Officer
may enter into negotiations with the Contractor to modify the contract
to adjust the premium rate. The contractor agrees to provide all
documentation necessary to support any requested adjustment.

 

B. 4. 2. 1 [Employee Pool]{.underline} -- This clause is only in effect
if the contractor included details in its offer regarding a pooling
arrangement, of which this contract is a part.

 

Before any adjustment is made under this price adjustment clause, the
Contractor must include in its proposal for adjustment, details setting
forth how the pool impacts the request for equitable adjustment.

 

**SECTION C**

**DESCRIPTION/SPECIFICATION/WORK STATEMENT**

** **

**PART I - HEALTH INSURANCE**

 

C. 1. [Health Insurance Services.]{.underline}

 

The Government of the United States of America requires Health Insurance
coverage for its employees as further described in C.1.2 in Ukraine**.**
The Government has determined that the prevailing practice by employers
in Ukraine is to provide for their employees health insurance protection
and that the cost of such insurance protection is usually borne by both
the employee and the employer. For the employee's coverage the
employer's contribution is 95% and the employee's contribution is 5%.
For the dependents' coverage the employer's contribution is 60% and the
employee's contribution is 40%. The employer pays the dental services
and HIV/AIDs treatment at 100%. []{.mark}

Health insurance protection will be representative of locally prevailing
compensation practice as further described in C.1.2. The specific health
benefit coverage under this contract is set forth in Section C and the
Exhibits in Section J.

 

The Contractor shall insure that health care under this contract does
not exclude the HIV/AIDS care.

**The medical services shall be provided within the all territory of
Ukraine.**

C.1.1. [Employee and Dependent Health Services Benefits.]{.underline}

 

The health benefits under this contract are as follows. The maximum
health benefit coverage under this contract is determined not to exceed
USD 10,400.00 for medical services per eligible participant per one
contract year. **Proposals that contain more benefits (even if there is
no increase in cost) or fewer benefits than stated in the solicitation
may be deemed technically unacceptable.**

 

[Employee and Dependents]{.underline}

C. 1.1.1. [Hospitalization]{.underline}

###### Organization of planned hospitalization at the discretion of respective physician 

###### Organization of emergency hospitalization in case of acute disease or accident

###### Transportation to the hospital (emergency hospitalization only)

###### Free choice of the medical facility (in cases of emergency this choice is made by the physician of the ambulance)

###### Semi-private room and board

###### Providing all necessary tests and examinations according to the treating physician's prescriptions

###### Providing medications

-   Private nursing shall be provided when medically necessary at
    supervising physician discretion

-   Physiotherapy at treating physician's prescription (massages 10 per
    year)

###### Up to two alternative consultations upon patient's request

-   When the hospitalization cannot be provided by the private clinic
    the contractor organizes it in the specialized clinic (e.g. Oncology
    Center, Proctology Center, SRI of Orthopedic & Trauma, SRI of
    Urology & Nephrology etc.)

###### When the hospitalization in private clinics is not possible (e.g. in cases of emergency when the state ambulance takes the patient to any available state clinic) the contractor does everything possible to move the patient to the private clinic as soon as the patient's condition allows it.

###### 

######### Clinics for hospitalization (see para. C.1.1.18.).

######### 

######### C.1.1.2. [Surgery]{.underline} 

###### Organization of planned surgery at the discretion of respective physician 

###### Organization of emergency surgery

###### Transportation to the hospital (emergencies only)

###### Free choice of the medical facility (in cases of emergency this choice is made by the physician of the ambulance)

###### Semi-private room and board

###### Providing all necessary tests and examinations according to the treating physician's prescriptions

###### Providing medications

-   Private nursing shall be provided when medically necessary at
    supervising physician discretion

-   Post surgery treatment and physiotherapy at treating physician's
    prescription

###### Up to two alternative consultations upon patient's request

-   When the surgery cannot be provided by the private clinic the
    contractor organizes it in the specialized clinic (e.g. Oncology
    Center, Proctology Center, SRI of Orthopedic & Trauma, SRI of
    Urology & Nephrology etc.)

###### When the surgery in private clinics is not possible (e.g. in cases of emergency when the state ambulance takes the patient to any available state clinic) the contractor does everything possible to move the patient to the private clinic as soon as the patient's condition allows it.

###### Clinics for surgery (see para. C.1.1.18.).

C.1.1.3. [Doctor Visits]{.underline} (see C.1.1.6. Hospital Outpatient
Services)

 

C.1.1.4. [Prescription Drugs]{.underline}

-   Prescription of all drugs and supplies

-   Organizing of drugs/supplies delivery (home/office) and/or pick up
    at the consulting medical facility or conveniently located drug
    store

-   Patient has the possibility to choose a brand of a prescribed drug

C.1.1.5. [Maternity]{.underline}

-   Pre natal care

-   Delivery of any complexity

-   Post natal care

-   Semi-private room and board

-   Free choice of medical facility and physician

-   Neonatal care -- Intensive care for premature infant

-   Monitoring of the post-natal period by the respectively assigned
    medical specialist

-   All State maternity homes all over the territory of Ukraine shall be
    available upon request.

-   All Kiev State Maternity Homes shall available upon request:

  ----------------------------------------- -----------------------------
  Maternity Home                            Address

  №1                                        вул. Арсенальна,5

  №2                                        вул. Мостицька,11

  №3                                        вул. Кучера, 7

  №4                                        пр. Героїв Сталінграда 16

  №5                                        пр. Червонозоряний, 2

  №6                                        вул. П. Запорожця, 26

  №7                                        вул. Предславінська, 9

  НІІ ПАГ                                   вул. Мануїльського, 8

  Київський Обласний Центр Охорони Здоров'я вул. Багговутівська, 1
  Матері і Дитини                           
  ----------------------------------------- -----------------------------

**(Embassy Employees live in different districts of Kiev, and cities of
Ukraine)**

 

C.1.1.6. [Hospital Outpatient Services]{.underline}

-   Physician's consultations at the clinic

-   Physician's visits to the patient's home at treating physician's
    discretion

-   Free choice of the medical facility and physician

-   Annual routine check up

-   Duty Doctor services on weekends

-   Tests at home upon treating physician's discretion

-   Medical certifications issuance (bolnichny).

-   Physiotherapy at treating physician's discretion

-   Up to two alternative consultations upon the patient's request

###### 

###### Clinics (see para. C.1.1.18.).

 

C.1.1.7. [Optical Service]{.underline}

-   Doctor's consultations, treatment and medications.

*Not covered under this contract: eyeglasses, contact lenses, durable
medical equipment and prosthesis, except as a result of trauma.*

 

C.1.1.8 [Dental Services]{.underline}

-   Doctor's consultations

-   Treatment and medications (except exclusions indicated under
    Exclusions from the coverage)

-   Two routine examinations per year

-   Two cleanings per year

**Clinics that are listed below are acceptable and offerors should
consider working with these particular clinics or ones of the same
standards.**

Dental clinics:

  -------------------------------- --------------------------------------
  **Клініка/clinic**               **Адреса/address**

  Стоматологія \"Порцелян\"        вул. Пімоненка, 10а

  Стоматологія \"Аванто\"          вул. Костянтинівська, 22/17-А

  Стоматологія \"Аванто +\"        вул. Старонаводницька, 13

  Гор.стом.п-ка                    вул. Пімоненка, 10а

  Стоматологія \"Берковська\"      вул. Мечникова, 7

  Стоматологія \"Призма\"          вул. Сагайдачного, 25

  Стоматологія \"Алтей\"           вул. Якира, 2/6

  Стоматологія \"Еслі\"            вул. Тимошенка, 19

  Стоматологія \"ВЛВ\"             вул. Артема, 10

  Клініка \"Медіком\"              вул. Борщагівськая, 129

  Стоматологія \"Фенестра\"        вул. Саксаганського, 84/86

  Стоматологія \"Дента Люкс\"      вул. Артема, 25

  Стоматологія \"Амерiкан Бьютi    вул. Б. Хмельницького, 8/16
  Iнтернешнл\"                     

  Стоматологія \"Евродент\"        вул. Крутий спуск, 6

  Стоматологія \"Кам\'янецький\"   вул. Горького, 9/1

  Стоматологія \"УКДЕНТ\"          вул. В.Вал, 2; Бесарабска пл., 2

  Стоматологія \"Ковіко\"          вул. Прорізна, 10

  Стоматологія \"Байда\"           вул. Миропільска, 3

  Стоматологія \"Дент Ортес\"      вул. Горького, 102

  Стоматологія \"Селт\"            вул. Червоноармійська,134

  Стоматологія \"Борменталь\"      вул. Герцена, 17/25

  Стоматологія \"Кулінський\"       

  Стоматологія \"Апполо\"           

  Стоматологія \"Трішіро\"         вул. Шота Руставелі, 20, офіс 1

  Стоматологія \"Дентал плюс\"     Оболонський пр-т, 26

  Стоматологія \"Мед Лайф\"        вул. Героїв Сталінграда, 20

  Клініка \"Слан -Медіка\"         вул. Котельникова, 95

  Стоматологія \"Третєвіч\"        Пр-т П.Тичини, 16/2

  ЦМКЛ                             вул. Мечникова, 1

  Клініка \"Юнімед\"               вул. Лисенка, 4а

  Стоматологія \"Люкс-А\"          вул. Урицького, 35

  П-ка №2 Шевченківського р-ну     вул. Пімоненка, 10

  Стоматологія \"Топфер\"          вул. Предславінська, 9

  Стоматологія \"Анна-Дент\"       вул. Червоноармійська, 106

  Стоматсервис                     вул.Трьохсвятительська,7; вул.
                                   В.Житомирська, 18а

  Стоматологія \"Естедентакс\"     бул. Л.Українки, 10б

  Стоматологічна клініка №11       вул. Рогозовська, 6

  Стоматологія \"Дієт Сервіс\"     м. Харків, вул. Чернишевського, 26

  Стоматологія \"Діамант\"         м. Житомир, вул..Котовського,33а
  -------------------------------- --------------------------------------

[Exclusions from Dental Coverage:]{.underline}

-   Cosmetic services (the tooth form change, tooth decorations,
    veneers), excluding cases when it is necessary for correction of
    trauma sequences;

-   Bleaching (teeth whitening with special equipment and solutions);

-   Orthodontics (teeth straightening) and bracket system;

-   Prosthesis as bridges, implant, UDA -- universal dental attachments
    (excluding simple prosthesis that are necessary for correction of
    trauma sequences).

 

C.1.1.9. [Physical Therapy]{.underline}

-   Physical Therapy is provided at treating physician's discretion.
    (massages up to 10 per year per person)

 

C.1.1.10. [Psychiatric Treatment]{.underline}

-   Doctor's visit and specialized medical care (if it is not the
    specialized psychiatric state facility).

*[NOTE:]{.underline} The treatment in the specialized psychiatric state
medical establishments [is not covered]{.underline} under this contract*

 C.1.1.11. [Ambulance Service]{.underline}

Ambulance Services in cases of life and death emergencies with
guaranteed arrival time 10-20 minutes.

Ambulance services providers (see para. C.1.1.18.).

 

C.1.1.12. [Hearing Aids]{.underline}

Hearing aids (apparatus), durable medical equipment and prosthesis, if
not as a result of trauma or disease are not covered under this contract
(see exclusions).

 

C.1.1.13. [Expenses Incurred Out-of-Country]{.underline}

Expenses incurred out-of-country must be covered by a separate medical
insurance and are not covered under this contract.

 

C.1.1.14. [Gynecology/Urology treatment]{.underline}

###### 

###### One routine check-up per year (without indications)

###### Doctor's consultations

###### Providing all necessary tests and examinations at treating doctor's discretion

###### STDs diagnostics (consultations and tests)

###### Providing medications

Clinics (see para. C.1.1.18.).

C.1.1.15. [Pediatric care]{.underline}

> [Patronage (children under one year)]{.underline}

###### Assignment of individual pediatrician

###### Pediatrician's visits according to the plan:

+---------+-------------------------+-----------+---------------------+
| ###     | ####### Rout            |           | ####### A           |
| ### Age | ing Well Baby Check ups |           | dditional Check ups |
+---------+-------------------------+-----------+---------------------+
|         | ####### Consultations   | ####      |                     |
|         |                         | ### Tests |                     |
+---------+-------------------------+-----------+---------------------+
| 0 -- 1  | 3 pediatrician's home   | Complete  | Specialists         |
| month   | visits per month        | blood     | according to        |
|         |                         | count     | pediatrician's      |
|         |                         |           | recommendations:    |
|         |                         | (in       | Orthopedist,        |
|         |                         | co        | Ophthalmologist,    |
|         |                         | mplicated | Surgeon.            |
|         |                         | cases)    |                     |
+---------+-------------------------+-----------+---------------------+
| 1 -- 3  | 1 -- 2 pediatrician's   | Complete  | Ultrasound of the   |
| months  | home visits per month   | blood     | hip joint, Surgeon  |
|         | at pediatrician's       | count     | (umbilical ring),   |
|         | discretion.             |           | EMT doctor (nasal   |
|         |                         |           | synopses).          |
|         | 1 home visit of         |           |                     |
|         | Neuropathologist,       |           |                     |
|         | Orthopedist.            |           |                     |
+---------+-------------------------+-----------+---------------------+
| 3 -- 6  | 1 -- 2 pediatrician's   |           | Complete blood      |
| months  | home visits per month   |           | count (when 6       |
|         | at pediatrician's       |           | month).             |
|         | discretion.             |           | Specialists'        |
|         |                         |           | consultations if    |
|         |                         |           | indicated.          |
+---------+-------------------------+-----------+---------------------+
| 6 month | 1 pediatrician's home   | Complete  | Specialists'        |
| -- 1    | visit per month.        | blood     | consultations if    |
| year    |                         | count,    | indicated.          |
|         | 1 visit to              |           |                     |
|         | Ophthalmologist,        | Ur        |                     |
|         | Neuropathologist, EMT,  | inalysis. |                     |
|         | Dentist, Surgeon,       |           |                     |
|         | Orthopedist.            |           |                     |
+---------+-------------------------+-----------+---------------------+

###### 

-   Pediatrician's/specialists' home visits in case of illness

-   Tests and checkups at home at doctor's discretion

-   Immunization program for children, including vaccination

-   Organization of specialists' consultations/tests/checkups at medical
    facilities

-   Physiotherapy at doctor's discretion

```{=html}
<!-- -->
```
-   Up to two alternative consultations upon the parent's request

    [Children from 1 to 18 years]{.underline}

-   Assignment of individual pediatrician

-   Pediatricians/specialists visits at home in cases of illness

-   Organization of pediatricians/specialists
    consultations/tests/checkups at medical facilities

-   Immunization program for children, including vaccination

-   Physiotherapy at pediatrician's prescription

-   Up to two alternative consultations upon the parent's request

    Clinics (see para. C.1.1.18.).

C.1.1.16. [Hospitalization for children (age 0-18)]{.underline}

-   Organization of planned hospitalization

-   Organization of emergency hospitalization

-   Free choice of the medical facility (in cases of emergency this
    choice is made by the physician of the ambulance)

-   Semi-private room and board

-   Providing all necessary tests and examinations according to the
    treating doctor's prescriptions

-   Providing medications

-   Up to two alternative consultations upon parents' request

-   Room and board for one accompanying person (parent, relative or
    nanny)

    until age 6

###### Clinics (see para. C.1.1.18.).

C.1.1.17. [HIV/AIDs treatment]{.underline}

-   Physician's consultations and treatment

-   Medications

C.1.1.18. [Medical and Ambulance facilities]{.underline}

**Clinics that are listed below are acceptable and offerors should
consider working with these particular clinics or ones of the same
standards.**

The preference is given to the private clinics. The clinics are listed
in preference order:

###### Medikom

###### Boris

###### Dobrobut

###### Valeria

###### Garant

###### Ohmatdyt

###### Other private clinics:

Alpha-Vita

Cardio Clinic "Sertse i Sudyny" (Zhylyanska St.)

TASS

When the treatment cannot be provided by the private clinic it should be
organized in specialized clinic (e.g. Oncology Center, Proctology
Center, SRI of Orthopedic & Trauma, SRI of Urology & Nephrology etc.)

**C.1.1.19. [Maximum Limits]{.underline}**

**The maximum health benefit coverage under this contract is determined
not to exceed USD 10,400.00 divided as 10,000.00 USD for medical
services and 400.00 USD for dental services per eligible participant per
one contract year.**

** **

C.1.2 [Exclusions from the coverage under this contract]{.underline}

 

Exclusions from the coverage under this contract are as follows:

1)  Pre-insurance Congenital diseases:

-   Infant Cerebral Palsy

-   Turner's Syndrome, Gonadal Dysgenesis

-   Trisomy

-   Klinefelter's Syndrome

-   Hermaphroditism

-   Testicular Feminisation Syndrom

-   Congenital Heart Abnormalities

-   Gastro-Intestinal Anomaly

-   Kidney Transport Anomaly

-   Congenital Carbohydrates Metabolism Disorder

-   Phenylketonuria

-   Congenital Connective Tissue Disease

-   Ostheochondrodystrophy

2)  Cosmetology treatment (except cases when it is necessary as a result
    of trauma or disease).

3)  Sexually Transmitted Diseases:

-   Chlamydial infection

-   Gonococcal infections

-   Syphilis

-   Genital Herpes Simplex infection

-   Chancroid

-   Granuloma Inguinale (Donovanosis)

-   Limphogranuloma Venerum

-   T. Vaginalis infection

-   Ureoplasma urealiticum

-   Trichomoniasis

-   Human Papillomavirus infection

-   Hepatitis C

4)  Alcohol, drug and tobacco abuse treatment.

5)  Infertility.

6)  Monitoring of medical treatment of mental/nervous disorders at the
    specialized governmental medical facilities.

7)  Treatment of medical consequences of suicide attempt.

8)  Plastic, cosmetic or reconstructive treatment and surgery, if not a
    result of trauma or disease.

9)  Birth control drugs or prescription including the insertion and
    removal of intrauterine spiral (IUS) devices, abortion, vacuum
    extraction of fetus, if not prescribed by the physician.

10) Eyeglasses, contact lenses, durable medical equipment and
    prosthesis, except as a result of trauma.

11) Hearing aids (apparatus), durable medical equipment and prosthesis,
    if not as a result of trauma or disease.

12) Medical certification of general health condition for sports
    facilities, international health insurance, obtaining driver's
    license and for entering educational institutions, as well as
    laboratory tests related to such certifications.

13) Fees of persons who are not licensed physicians or nurses; or
    services or supplies, which have not been prescribed or approved by
    a physician.

14) There is no reimbursement for medical expenses incurred outside of
    Ukraine. There is no reimbursement for round trip transportation
    expenses to travel out of country for medical treatment.

C. 1. 3. [Eligible Participants]{.underline}

 

C. 1. 3. 1. [Eligible Employees:]{.underline}

The employees eligible for the health insurance services include the
following:

C.1.3.1.1. All current active employees of the United States Government,
employed within the geographic boundaries of Ukraine paid under the
local compensation plan, and certified by the Contracting Officer are
eligible. Covered employees include:

-   Foreign Service Nationals (FSNs) employed as direct hires

-   FSNs employed under Personal Services Agreements (PSAs)

-   FSNs employed under Personal Services Agreements-Plus (PSAs-Plus)

-   FSNs employed under Personal Services Contracts (PSCs)

-   Third country nationals (TCNs) employed as direct hires

-   TCNs employed under PSAs

-   TCNs employed under PSAs-Plus

-   TCNs employed under PSCs

-   Locally hired U.S. citizens employed as direct hires; and

-   Locally hired U.S. citizens employed under PSAs-Plus

C. 1. 3. 2. The above individuals must be employed within the geographic
boundaries of Ukraine by:

Department of State

U.S. Agency for International Development

Department of Defense

Department of Commerce

Department of Agriculture

Department of Energy

Peace Corps

EXBS

Non-personal services contract personnel and any other individual not
falling within one f the categories of employees described in this
clause are excluded from this contract.

C.1.3.3. [Participants Covered Under a Rider]{.underline}

 

C.1.3.3.1 All current active employees of the Chief of Mission and the
Deputy Chief of Mission assigned to their respective official Government
residences and paid under an ORE account (see separate rider, Exhibit
D). All costs for ORE employees are the responsibility of the employing
officer, not the U.S. Government.

 

C.1.3.3.2 All current active employees of the Employee Association at
Embassy in Kiev Ukraine (see separate rider, Exhibit E). All costs EAEs
are the responsibility of the Employee Association, not the U.S.
Government.

*** ***

C.1.4. [Individuals Not Eligible for Coverage]{.underline}

 

Individuals not eligible for coverage under this contract are
non-personal services contract personnel; Peace Corps Personal Services
Contractors as required by MS 743; employees working on a temporary
basis; employees with an intermittent, seasonal, or WAE (when actually
employed) schedule; and any other individual not falling within one of
the categories of employees described in this clause.

 

C.1.5. [Other Eligible Participants]{.underline}

 

The following additional categories of persons are covered by this
insurance: locally employed employees' dependents are defined as the
employee's legal spouse and each unmarried, economically dependent child
who resides with the employee and children of divorced spouses when the
employee has financial responsibility for the child. An eligible child
will be covered by this medical insurance until the age of 18, or 22, if
a full-time student. A maximum of one spouse and six children will be
covered per employee at one time. If both spouses are employed by the
U.S. Mission, a maximum of six children will be covered per family.
There is no age limit for an eligible child who is physically or
mentally handicapped.

 C.1.6. [Eligibility]{.underline}

 

C.1.6.1. [Term of Eligibility and Effective Date]{.underline}

 

Each current active eligible employee is enrolled for health benefits
under this contract upon award and thereafter during the performance
period of this contract. Each new eligible employee will be enrolled
upon entering on duty with the United States Government. An employee is
considered active (\"on the rolls\") whenever such employee is on
approved leave, whether paid or unpaid.

 

C.1.6.2. [Period of Ineligibility]{.underline}

 

Employees and their dependents are not entitled to health benefits
during any period of employment for which premiums are not paid.

 

Additionally, employee\'s dependents are not entitled to health benefits
during any period of employment during which the employee was not
eligible to participate.

 

During a period of Leave Without Pay or unpaid leave that is one pay
period or less, coverage under the insurance contract will continue. The
USG will pay the total premium cost to the contractor. The employee's
share of the premium will be collected through payroll deduction in that
or the subsequent pay period.

 

During a period of extended (beyond one pay period) of Leave Without Pay
or unpaid leave, the employee is responsible for the full cost of the
insurance premiums for self and dependents. The Mission will pay the
premiums directly to the contractor, and will collect the full cost from
the employee on a quarterly basis. Alternatively, the employee may elect
to have coverage cease if that employee prefers not to pay the premium.

[]{.mark}

C.1.7. [Brochure Requirement]{.underline}

 

C.1.7.1. The contractor shall provide a document
(brochure/pamphlet/other written document) **in Ukrainian/English** that
sets forth a complete listing of the health insurance benefits to be
provided under this contract. This brochure shall be provided in
sufficient quantities so that each covered employee receives a copy. The
contractor shall furnish all copies of the brochures to the COR, who
will ensure that appropriate distribution is made.

 

C.1.7.2. The contractor shall provide the document described in C.1.7.1
to the COR **not later than 15 calendar days after date of contract
award**. The Contractor shall provide additional brochures for new
employees within ten (10) days of the COR's request.

 

C.1.7.3. The contractor assumes full responsibility for ensuring that
the document described in C.1.7.1 accurately reflects the requirements
of the contract, as implemented by the contractor's technical proposal.
In all cases, the contract shall take precedence. Should the COR
discover that the brochure contains inaccuracies, the contractor will be
notified in writing; however, failure on the part of the Government to
notice any inaccuracies shall in no way limit, revise or otherwise
affect the requirement under this contract for the contractor to fully
comply with all contract terms.

 

 

 **"Paragraph C.2 is Reserved**

*** ***

C.3.0 [Definitions]{.underline}

 

**FMO** The Financial Management Officer or the paying office for all U.
S. Government Agencies except AID.

 

**COR** Contracting Officer\'s Representative (Human Resources Officer
at post).

 

**Contributory** Insurance for which the employee contributes toward the
premium.

 

**Dependent**

**Employee** An individual employed by the U.S. Government, under a
direct-hire appointment, personal services contract, or personal
services agreement, as further defined in Section C.1.3 for health
insurance. This may also include an ORE Staff and/or EAE employee, if
this category of individual is an eligible participant, as defined in
C.1.3 for health insurance and C.2.3 or life insurance.

 

**Employer** The United States Government or in the case of ORE and EAE
employees, the Chief of Mission/Deputy Chief of Mission and Employee
Association, respectively.

 

**GSO** General Services Officer in charge of the General Services
Office at post. This officer is usually the Contracting Officer for this
contract.

 

**Hospital** An institution established and operated for the care and
treatment of sick and injured persons. It provides 24-hour nursing care
and has diagnostic, laboratory, treatment, and surgical facilities. Any
institution which does not meet this definition is not considered a
hospital.

 

**Hospital Patient** An individual who has been admitted to a hospital,
is assigned a bed, and is given diagnostic tests or receives treatment
for a disease or an injury.

  

**Customary and Reasonable Treatment** A diagnostic test or medical
treatment which is usually performed in the community where the
individual is being treated.

 

**Physician** An individual who has graduated from an accredited medical
school and is licensed to practice medicine in the jurisdiction in which
the contract is to be performed. If the individual is a medical
specialist, then he or she is Board Certified in that specialty.

 

**Surgical procedure** Any invasive medical procedure by manual or
instrument operation undertaken for diagnosis or treatment of a diseased
patient. 

 

**SECTION D**

**PACKAGING AND MARKING**

 

(Reserved)

**SECTION E**

**INSPECTION AND ACCEPTANCE**

 

E.1. [52.252‑2 Clauses Incorporated by Reference (FEB 1998)]{.underline}

 

This contract incorporates the following clauses by reference, with the
same force and effect as if they were given in full text. Upon request,
the Contracting Officer will make their full text available. Also, the
full text of a clause may be accessed electronically at this address:

 

http://www.acqnet.gov/far or, http://farsite.hill.af.mil/search.htm

 

These addresses are subject to change. If the Federal Acquisition
Regulation (FAR) is not available at the locations indicated above, use
the Dept. of State Acquisition Website at
[http://www.statebuy.state.gov](http://www.statebuy.state.gov/) to see
the links to the FAR. You may also use a network "search engine" (e.g.,
Yahoo, Excite, Alta Vista, etc.) to obtain the latest location of the
most current FAR.

 

 

FEDERAL ACQUISITION REGULATION (48 CFR CH. 1)

 

52.246-4 Inspection of Services - Fixed Price (AUG 1996)

 

E.2. [Quality Assurance and Surveillance Plan (QASP)]{.underline}

 

This plan is designed to provide an effective surveillance method to
promote effective contractor performance. The QASP provides a method for
the Contracting Officer\'s Representative (COR) to monitor contractor
performance, advise the contractor of unsatisfactory performance, and
notify the Contracting Officer of continued unsatisfactory performance.
The contractor, not the Government, is responsible for management and
quality control to meet the terms of the contract. The role of the
Government is to conduct quality assurance to ensure that contract
standards are achieved.

 

 

+---------------------------------+---------+-------------------------+
| **Performance Objective**       | **PWS   | **Performance           |
|                                 | Para**  | Threshold**             |
+---------------------------------+---------+-------------------------+
| **[Services.]{.underline}**     |         |                         |
|                                 |         |                         |
| Performs all the insurance      | C.1.0   | All required services   |
| services set forth in the       | thru    | are performed and no    |
| performance work statement      | C.3.0   | more than **Two (2)     |
| (PWS)                           |         | customer complaints are |
|                                 |         | received per month**    |
|                                 |         |                         |
|                                 |         |                         |
|                                 |         |                         |
|                                 |         | **Repeat Complains for  |
|                                 |         | the same deficiency are |
|                                 |         | not permitted by this   |
|                                 |         | Contract**              |
+---------------------------------+---------+-------------------------+

>  
>
>  

E.3.1 Surveillance. The COR will receive and document all complaints
from Government personnel regarding the services provided. If
appropriate, the COR will send the complaints to the Contractor for
corrective action.

** **

E.3.2 Standard**.** The performance standard is that the Government
receives no more than two (2) customer complaint per month. The COR
shall notify the Contracting Officer of the complaints so that the
Contracting Officer may take appropriate action to enforce the
inspection clause (FAR 52.246-4, Inspection of Services -- Fixed Price
(AUG 1996) or the appropriate Inspection of Services clause), if any of
the services exceed the standard.

 

E.3.3 Procedures.

** **

\(a\) If any Government personnel observe unacceptable services, either
incomplete work or required services not being performed, they should
immediately contact the COR.

 

\(b\) The COR will complete appropriate documentation to record the
complaint.

 

\(c\) If the COR determines the complaint is invalid, the COR will
advise the complainant. The COR will retain the annotated copy of the
written complaint for his/her files.

 

\(d\) If the COR determines the complaint is valid, the COR will inform
the Contractor and give the Contractor additional time to correct the
defect, if additional time is available. The COR shall determine how
much time is reasonable.

 

\(e\) The COR shall, as a minimum, orally notify the Contractor of any
valid complaints.

 

\(f\) If the Contractor disagrees with the complaint and challenges the
validity of the complaint, the Contractor will notify the COR. The COR
will review the matter to determine the validity of the complaint.

 

\(g\) The COR will consider complaints as resolved unless notified
otherwise by the complainant.

 

\(h\) Repeat customer complaints are not permitted for any services. If
a repeat customer complaint is received for the same deficiency during
the service period, the COR will contact the Contracting Officer for
appropriate action under the Inspection clause.

 

**SECTION F**

**DELIVERIES OR PERFORMANCE**

 

F.1. [52.252‑2 Clauses Incorporated by Reference (FEB 1998)]{.underline}

 

This contract incorporates the following clauses by reference, with the
same force and effect as if they were given in full text. Upon request,
the Contracting Officer will make their full text available. Also, the
full text of a clause may be accessed electronically at this address:

 

http://www.acqnet.gov/far or, http://farsite.hill.af.mil/search.htm

 

These addresses are subject to change. If the Federal Acquisition
Regulation (FAR) is not available at the locations indicated above, use
the Dept. of State Acquisition Website at
[http://www.statebuy.state.gov](http://www.statebuy.state.gov/) to see
the links to the FAR. You may also use a network "search engine" (e.g.,
Yahoo, Excite, Alta Vista, etc.) to obtain the latest location of the
most current FAR.

 

FEDERAL ACQUISITION REGULATION (48 CFR CH. 1)

 

52.242-15 Stop Work Order (AUG 1989)

52.242-17 Government Delay of Work (APR 1984)

 

F.2 [Period of Performance.]{.underline} The performance period of this
contract is one year beginning on **[\_March , 2006]{.underline}** **up
to four one-year options to renew**.

 

F.3 [Options.]{.underline}

 

\(a\) The Government may extend this contract in accordance with the
option clause at Section I, clause I.2, [FAR Clauses Incorporated by
Full Text]{.underline} (FAR 52.217-9, Option to Extend the Term of the
Contract), which also specifies the total potential duration of the
contract.

 

(b) (b)               The Government may exercise the option set forth
    at Section I, \"FAR 52.217-8, Option to Extend Services\".

 

F.4 [Reports and Other Deliverables]{.underline}

 

All reports and other deliverables required under this contract shall be
delivered to the following address:

 

Attn: Contracting Office,

US Embassy Kiev, Ukraine

4 Glybochytska St,

Artem Business Center

**SECTION G**

**CONTRACT ADMINISTRATION DATA**

 

G.1. [652.242-70 Contracting Officer's Representative (COR) (AUG
1999)]{.underline}

 

\(a\) The Contracting Officer may designate in writing one Government
employee, by name or position title, to take action for the Contracting
Officer under this contract. This designee shall be identified as a
Contracting Officer's Representative (COR). Such designation shall
specify the scope and limitations of the authority so delegated;
provided, that the designee shall not change the terms or conditions of
the contract, unless the COR is a warranted Contracting Officer and this
authority is delegated in the designation.

 

\(b\) The COR for this contract is the Human Resources Officer.

 

G.2 [COR Duties]{.underline}

 

G.2.1 The COR is responsible for inspection and acceptance of services.
These duties include review of Contractor invoices, including the
supporting documentation required by the contract. The COR may provide
technical advice, substantive guidance, inspections, invoice approval,
and other purposes as deemed necessary under the contract.

 

G.2.2 In addition, the COR shall maintain updated list of employees and
dependents insured, which will supersede the initial list provided under
this contract and as reported to the insurer or through the broker if
the contractor is a broker, without prejudice to the ineligibility
clause.

 

G.2.3. The COR has the additional responsibility of maintaining the
eligible listing of employees and dependents for insurance coverage.

 

G.2.4 The COR may not change the terms and conditions of the contract.
While the COR is authorized to provide the Contractor with updated
listings of eligible employees and dependents, only the Contracting
Officer may modify existing task orders or issue new task orders,
reflecting these changes, since only the Contracting Officer can
obligate funding and commit the Government.

 

 

G.3. Payment shall be made in UAH in accordance with the USD exchange
rate of National Bank Of Ukraine on the day of payment.

 

G.4 Submission of Invoices and Payment

 

G.4.1. Invoices shall be submitted in an original and one (1) copy to
the following address (designated billing office only for the purpose of
submitting invoices):

 

a\) For US Government Employees:

Attn. COR, HR Office,

US Embassy Kiev, Ukraine

4 Glybochytska St, Artem Business Center

b\) For ORE Employees:

Attn. AMB, DCM, EXO Office,

US Embassy Kiev, Ukraine

10 Yuria Kotsyubinskoho St

 

G.4.2.1 Frequency of Payments. All funds under this contract will be
obligated by issuance of task orders, as described in H.3. Each task
order will fund a specific period of time and number of employees, and
the task orders will be issued at the frequency described in H.3. All
payments under this contract will be made at the conclusion of the
period covered. Invoices may be submitted be-weekly with payments being
made be-weekly by the Government.

 

G.4.3. U.S. Government Employees. The Government shall make payments
directly to the contractor for all Government employees, whether or not
the employee is contributing to the premium amount.

G.4.4. ORE Staff. The Chief of Mission and/or Deputy Chief of Mission
will make payment directly to the contractor for the entire premium
amount of the ORE staff, whether or not the ORE employee is contributing
to the premium amount.

 

G.5 Refunds to the Government

 

If at any time during performance of the contract the Government finds
that the contractor has been overpaid because the number of employees
and/or dependents covered has decreased, the Contracting Officer may
either allow that overpayment to be credited to the Government's account
or require that the contractor refund the overpayment. If the
Contracting Officer requests a refund, the contractor shall make that
refund to the Government within ten calendar days of receipt of the
request.

 ** **

G.6 The contractor shall show Value Added Tax (VAT) as a separate item
on invoices submitted for payment.

 

**SECTION H**

**[SPECIAL CONTRACT REQUIREMENTS]{.underline}**

 

H.1 [Security]{.underline}. On occasion, a Contractor employee may
require entry into U.S. Government-owned or -operated facilities. If so,
the Contractor should be prepared to provide the necessary
identification to permit escorted access within that facility.

 

H.2 [Standards of Conduct]{.underline}. The Contractor shall maintain
satisfactory standards of employee competency, conduct, cleanliness,
appearance, and integrity and shall be responsible for taking such
disciplinary action with respect to employees as may be necessary. Each
Contractor employee is to adhere to standards that reflect credit on
themselves, their employer, and the United States Government.

 

H.3 [Ordering Procedures]{.underline}. The Government will issue a task
order as soon as possible after contract award to identify all employees
to be covered by the insurance described in this contract and the
coverage selected by each employee, including dependents to be covered.
The ORE and EA employees under separate riders shall be identified under
two separate task orders, with ORE employees identified under one task
order and EA employees under another task order. The COR will make
subsequent additions or deletions to this list in writing and provide
the revised list to the Contractor. All such revisions shall be
consolidated, and a new or modified task order will be issued by the
Contracting Officer. If any changes have been made to the coverage
listing, the Government anticipates issuance of a new task order on
**\[X\] BEWEEKLY**. This new task order will include all changes made
since the previous task order was issued and will include any increase
or decrease in necessary funding. The changes to the list of eligible
individuals will supersede the initial list provided under prior task
orders without prejudice to the ineligibility clause. Task orders will
indicate the effective date of employment, for purposes of calculating
the premium due.

 

H.4. [Contractor Responsibility in Claims and Reimbursement to
Claimants]{.underline}

 

[General]{.underline}. The Contractor shall be responsible for all
planning, estimating, programming, project management, scheduling,
dispatching, supervision, and inspection of work. The Contractor shall
maintain his own reference library of technical reference works and
local laws and regulations, including current tariffs and registries.
The Contractor shall treat the information provided by the Embassy
concerning employee\' personal data, medical information, and salaries
as highly sensitive and not divulge any employee information to
unauthorized persons. The Contractor shall establish procedures for
handling medical insurance claims as follows:

 

\(a\) [Administrative Records.]{.underline}

\(1\) The Contractor shall maintain medical insurance files for each
covered employee and each covered dependent including receipts and proof
of paid claims, requests for claim reimbursements, and accounting of
paid benefits with balances of amounts remaining in the annual per
person reimbursement ceiling.

 

\(2\) The Contractor shall provide the COR with the necessary claim
forms for each type of benefit that can be claimed under the contract.
These forms shall specify a list of documents required to be appended to
each claim and otherwise provide instructions for claim filing.

 

\(3\) The Contractor shall use the English spelling of the employees\'
names in all transactions, including reimbursement checks.

 

\(4\) The Contractor shall send employee claim reimbursement checks to
employees not later than two weeks after a claim is submitted

** **

\(b\) [Medical Insurance Claims.]{.underline} Settlement of medical
insurance shall be completed as follows:

\(1\) All medical claims shall be submitted directly to the Contractor
by employees, through a drop box in the COR\'s office. The claims shall
be picked up from the COR each Tuesday.

 

\(2\) The Contractor shall date stamp and screen all claims submitted on
the day of receipt. If there are any missing documents or information
thereby disallowing said claim to be payable, the Contractor shall
notify the employee within two days, with a copy to the COR (if
notification is written).

 

\(3\) The contractor shall settle the claims no later than two weeks
from the date the claim is submitted to the Contractor.

 

\(4\) Settlement shall be by issuance of checks in the name of the
employee for each claim submitted. Each check shall be accompanied by a
form providing details of the amount reimbursed with an explanation of
deductions, if any.

 

\(5\) The Contractor shall accept the employee\'s or dependent\'s choice
to go for surgery to hospitals designated by the Contractor in order
that the Contractor will pay the expenses directly to the hospitals.

 

\(c\) This Paragraph is Reserved

 

H.5. [Report Requirements]{.underline}. The Contractor shall provide the
following reports monthly. All reports must be received by the COR no
later than the 10th day of each month. These reports shall report on the
previous month\'s activities.

 

\(a\) [Employee Claims Report]{.underline}. The report will list all
claims paid by the Contractor to a claimant, including the name of the
claimant, date claim is received by the Contractor, and the amount
claimed. This report shall also include all outstanding claims and a
brief description of why claim has not been paid.

  (b) The Contractor shall provide the COR and CO with two copies of a
report showing the volume, cost and balance of services rendered by the
Contractor to persons covered under this contract.

H.6. [Miscellaneous Contractor Requirements]{.underline}.

 

H.6.1. [General.]{.underline} The Contractor shall take all such steps
as are necessary, and obtain and pay for all permits, taxes and fees as
are required by the Ukrainian government to establish and/or operate a
commercial venture locally. A contract with the U.S. Government conveys
no special privileges or immunities to the Contractor. The Contractor is
an independent commercial concern and not a part of the U.S. mission.
The Contractor\'s employees are not U.S. Government employees.
Registration of this contract with the Ukrainian government, if required
by law, will be the sole responsibility of the Contractor, and any fees,
taxes, or other duties shall be payable by the Contractor without
recourse to the Government of the amounts thereof.

 

H.6.2. [Licenses and Local Laws]{.underline}. The Contractor shall
possess all permits, licenses, and any other appointments required for
the prosecution of work under this contract, all at no additional cost
to the Government. The Contractor shall perform this contract in
accordance with local laws.

 

H.7 [Erroneous Payments]{.underline}. If the Government becomes eligible
for a refund of payment because of erroneous overpayment or other cause,
the Contractor shall refund the amounts or use them to offset future
payments owed by the Government, whichever the Government prefers. The
Contractor shall refund any refunds not complete or discovered after the
completion date of this contract.

 

H.8 [Requiring Activity]{.underline}. The requiring activity under this
contract is the U.S. Embassy/Consulate.

**SECTION I**

**[CONTRACT CLAUSES]{.underline}**

 

I.1. 52.252‑2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

 

This contract incorporates the following clauses by reference, with the
same force and effect as if they were given in full text. Upon request,
the Contracting Officer will make their full text available. Also, the
full text of a clause may be accessed electronically at this address:

http://www.acqnet.gov/far or, http://farsite.hill.af.mil/search.htm

 

These addresses are subject to change. If the Federal Acquisition
Regulation (FAR) is not available at the locations indicated above, use
the Dept. of State Acquisition Website at
<http://www.statebuy.gov/home.htm> to see the links to the FAR. You may
also use a network "search engine" (e.g., Yahoo, Excite, Alta Vista,
etc.) to obtain the latest location of the most current FAR.

 

FEDERAL ACQUISITION REGULATION (48 CFR CH. 1)

 

52.202-1 DEFINITIONS (JUL 2004)

52.203-3 GRATUITIES (APR 1984)

52.203-5 COVENANT AGAINST CONTINGENT FEES (APR 1984)

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE

GOVERNMENT (JUL 1995)

52.203-7 ANTI-KICKBACK PROCEDURES (JUL 1995)

52.203-8 CANCELLATION, RESCISSION, AND RECOVERY OF FUNDS

FOR ILLEGAL OR IMPROPER ACTIVITY (JAN 1997)

52.203-10 PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR IMPROPER

ACTIVITY (JAN 1997)

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL
TRANSACTIONS (JUN 2003)

52.204-4 PRINTING/COPYING DOUBLE-SIDED ON RECYCLED PAPER

(AUG 2000)

52.209-6 PROTECTING THE GOVERNMENT'S INTEREST WHEN SUBCONTRACTING WITH
CONTRACTOR'S DEBARRED,

SUSPENDED, OR PROPOSED FOR DEBARMENT (JAN 2005)

52.215-2 AUDIT AND RECORDS - NEGOTIATION (JUN 1999)

52.215-8 ORDER OF PRECEDENCE\--UNIFORM CONTRACT FORMAT

(OCT 1997)

52.215-21 REQUIREMENTS FOR COST OR PRICING DATA OR INFORMATION OTHER
THAN COST OR PRICING DATA\--

MODIFICATIONS (OCT 1997)

52.222-39 NOTIFICATION OF EMPLOYEE RIGHTS CONCERNING

PAYMENT OF UNION DUES OR FEES (DEC 2004)

52.224-1 PRIVACY ACT NOTIFICATION (APR 1984)

52.224-2 PRIVACY ACT (APR 1984)

52.225-13 RESTRICTIONS ON CERTAIN FOREIGN PURCHASES

(MAR 2005)

52.225-14 INCONSISTENCY BETWEEN ENGLISH VERSION AND TRANSLATION OF
CONTRACT (FEB 2000)

52.228-4 WORKERS' COMPENSATION AND WAR-HAZARD INSURANCE

> OVERSEAS (APR 1984)

52.228-5 INSURANCE-WORK ON A GOVERNMENT INSTALLATION

(JAN 1997)

52.229-6 TAXES - FOREIGN FIXED PRICE CONTRACTS (JUN 2003)

52.232-1 PAYMENTS (APR 1984)

52.232-8 DISCOUNTS FOR PROMPT PAYMENT (FEB 2002)

52.232-11 EXTRAS (APR 1984)

52.232-17 INTEREST (JUN 1996)

52.232-18 AVAILABILITY OF FUNDS (APR 1984)

52.232-24 PROHIBITION OF ASSIGNMENT OF CLAIMS (JAN 1986)

52.232-25 PROMPT PAYMENT (OCT 2003)

52.232-34 PAYMENT BY ELECTRONIC FUNDS TRANSFER -- OTHER THAN CENTRAL
CONTRACTOR REGISTRATION (MAY 1999)

52.233-1 DISPUTES (JUL 2002) ALTERNATE I (DEC 1991)

52.233-3 PROTEST AFTER AWARD (AUG 1996)

52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM (OCT 2004)

52.237-2 PROTECTION OF GOVERNMENT BUILDINGS, EQUIPMENT, AND VEGETATION
(APR 1984)

52.242-13 BANKRUPTCY (JUL 1995)

52.243-1 CHANGES (AUG 1997) - ALTERNATE I (APR 1984)

52.244-6 SUBCONTRACTS FOR COMMERCIAL ITEMS (MAR 2005)

52.246-25 LIMITATION OF LIABILITY - SERVICES (FEB 1997)

52.248-1 VALUE ENGINEERING (FEB 2000)

52.249-2 TERMINATION FOR CONVENIENCE OF THE GOVERNMENT (FIXED PRICE)
(MAY 2004)

52.249-8 DEFAULT - FIXED PRICE SUPPLY AND SERVICE (APR 1984)

 

[I.2. FAR CLAUSES INCORPORATED IN FULL TEXT]{.underline}

 

52.216-18 [ORDERING (OCT 1995)]{.underline}

 

\(a\) Any supplies and services to be furnished under this contract
shall be ordered by issuance of delivery orders or task orders by the
individuals or activities designated in the Schedule. Such orders may be
issued from the first day of the ongoing performance period through the
last day of that performance period. See F.2.

 

\(b\) All delivery orders or task orders are subject to the terms and
conditions of this contract. In the event of conflict between a delivery
order or task order and this contract, the contract shall control.

 

\(c\) If mailed, a delivery order or task order is considered \"issued\"
when the Government deposits the order in the mail. Orders may be issued
orally, by facsimile, or by electronic commerce methods only if
authorized in the Schedule.

 

52.216-19 [ORDER LIMITATIONS. (OCT 1995)]{.underline}

 

\(a\) Minimum order. When the Government requires supplies or services
covered by this contract in an amount of less than **\$135,000.00** the
Government is not obligated to purchase, nor is the Contractor obligated
to furnish, those supplies or services under the contract.

 

\(b\) Maximum order. The Contractor is not obligated to honor\--

 

\(1\) Any order for a single item in excess of **\$1,500,000.00;**

\(2\) Any order for a combination of items in excess of **\$7,500,
000.00;** or

 

\(3\) A series of orders from the same ordering office within **5 days**
that together call for quantities exceeding the limitation in
subparagraph (1) or (2) above.

 

\(c\) If this is a requirements contract (such as, includes the
Requirement clause at subsection 52.216-21 of the Federal Acquisition
Regulation (FAR)), the Government is not required to order a part of any
one requirement from the Contractor if that requirement exceeds the
maximum-order limitations in paragraph (b) above.

 

\(d\) Notwithstanding paragraphs (b) and (c) above, the Contractor shall
honor any order exceeding the maximum order limitations in paragraph
(b), unless that order (or orders) is returned to the ordering office
within **5 days** after issuance, with written notice stating the
Contractor\'s intent not to ship the item (or items) called for and the
reasons. Upon receiving this notice, the Government may acquire the
supplies or services from another source.

 

21. 52.216-21               [REQUIREMENTS (OCT 1995)]{.underline}

 

\(a\) This is a requirements contract for the supplies or services
specified, and effective for the period stated, in the Schedule. The
quantities of supplies or services specified in the Schedule are
estimates only and are not purchased by this contract. Except as this
contract may otherwise provide, if the Government\'s requirements do not
result in orders in the quantities described as \"estimated\" or
\"maximum\" in the Schedule, that fact shall not constitute the basis
for an equitable price adjustment.

 

\(b\) Delivery or performance shall be made only as authorized by orders
issued in accordance with the Ordering clause. Subject to any
limitations in the Order Limitations clause or elsewhere in this
contract, the Contractor shall furnish to the Government all supplies or
services specified in the Schedule and called for by orders issued in
accordance with the Ordering clause. The Government may issue orders
requiring delivery to multiple destinations or performance at multiple
locations.

 

\(c\) Except as this contract otherwise provides, the Government shall
order from the Contractor all the supplies or services specified in the
Schedule that are required to be purchased by the Government activity or
activities specified in the Schedule.

 

\(d\) The Government is not required to purchase from the Contractor
requirements in excess of any limit on total orders under this contract.

 

\(e\) If the Government urgently requires delivery of any quantity of an
item before the earliest date that delivery may be specified under this
contract, and if the Contractor will not accept an order providing for
the accelerated delivery, the Government may acquire the urgently
required goods or services from another source.

 

\(f\) Any order issued during the effective period of this contract and
not completed within that period shall be completed by the Contractor
within the time specified in the order. The contract shall govern the
Contractor\'s and Government\'s rights and obligations with respect to
that order to the same extent as if the order were completed during the
contract\'s effective period; *provided*, that the Contractor shall not
be required to make any deliveries under this contract after **30 days**
(**the number is based on how long it would take the contractor to
complete a task order issued the last day of the performance period).**

(End of clause)

 

52.217-8 [OPTION TO EXTEND SERVICES (NOV 1999)]{.underline}

 

The Government may require continued performance of any services within
the limits and at the rates specified in the contract. The option
provision may be exercised more than once, **but the total extension of
performance hereunder shall not exceed 6 months**. The Contracting
Officer may exercise the option by written notice to the Contractor
within the performance period of the contract.

 

52.217-9 [OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR
2000)]{.underline}

 

\(a\) The Government may extend the term of this contract by written
notice to the **Contractor within the performance period of the contract
or within 30 days after funds for the option year become available,
whichever is later**.

 

\(b\) If the Government exercises this option, the extended contract
shall be considered to include this option clause.

 

\(c\) **The total duration of this contract, including the exercise of
any options under this clause, shall not exceed 60 months or 5 years.**

** **

**52.222-39 [NOTIFICATION OF EMPLOYEE RIGHTS CONCERNING PAYMENT OF UNION
DUES OR FEES (DEC 2004) (only if over \$100,000)]{.underline}**

 

\(a\) *Definition*. As used in this clause---

*United States* means the 50 States, the District of Columbia, Puerto
Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S.
Virgin Islands, and Wake Island.

\(b\) Except as provided in paragraph (e) of this clause, during the
term of this contract, the Contractor shall post a notice, in the form
of a poster, informing employees of their rights concerning union
membership and payment of union dues and fees, in conspicuous

places in and about all its plants and offices, including all places
where notices to employees are customarily posted. The notice shall
include the following information (except that the information
pertaining to National Labor Relations Board shall not be

included in notices posted in the plants or offices of carriers subject
to the Railway Labor Act, as amended (45 U.S.C. 151-- 188)).

 

Notice to Employees

Under Federal law, employees cannot be required to join a union or
maintain membership in a union in order to retain their jobs. Under
certain conditions, the law permits a union and an employer to enter
into a union-security agreement requiring employees to pay uniform
periodic dues and initiation fees. However, employees who are not union
members can object to the use of

their payments for certain purposes and can only be required to pay
their share of union costs relating to collective bargaining, contract
administration, and grievance adjustment.

 

If you do not want to pay that portion of dues or fees used to support
activities not related to collective bargaining, contract
administration, or grievance adjustment, you are entitled to an
appropriate reduction in your payment. If you believe that you have been
required to pay dues or fees used in part to support activities not
related to collective bargaining, contract administration, or grievance
adjustment, you may be entitled to a refund and to an appropriate
reduction in

future payments.

 

For further information concerning your rights, you may wish to contact
the National Labor Relations Board (NLRB) either at one of its Regional
offices or at the following

address or toll free number:

 

National Labor Relations Board

Division of Information

1099 14th Street, N.W.

Washington, DC 20570

1-- 866-- 667-- 6572

1-- 866-- 316-- 6572 (TTY)

 

To locate the nearest NLRB office, see NLRB's website at
*http://www.nlrb.gov*.

 

\(c\) The Contractor shall comply with all provisions of Executive Order
13201 of February 17, 2001, and related implementing regulations at 29
CFR part 470, and orders of the Secretary of Labor.

 

\(d\) In the event that the Contractor does not comply with any of the
requirements set forth in paragraphs (b), (c), or (g), the Secretary may
direct that this contract be cancelled, terminated, or suspended in
whole or in part, and declare the Contractor ineligible for further
Government contracts in accordance with procedures at 29 CFR

part 470, Subpart B--- Compliance Evaluations, Complaint Investigations
and Enforcement Procedures. Such other sanctions or remedies may be
imposed as are provided by 29 CFR part 470, which implements Executive
Order 13201, or as are otherwise provided by law.

 

\(e\) The requirement to post the employee notice in paragraph (b) does
not apply to---

 

\(1\) Contractors and subcontractors that employ fewer than 15 persons;

\(2\) Contractor establishments or construction work sites where no
union has been formally recognized by the Contractor or certified as the
exclusive bargaining representative of the Contractor's employees;

\(3\) Contractor establishments or construction work sites located in a
jurisdiction named in the definition of the United States in which the
law of that jurisdiction forbids enforcement of union-security
agreements;

\(4\) Contractor facilities where upon the written request of the
Contractor, the Department of Labor Deputy Assistant Secretary for
Labor-Management Programs has waived the posting requirements with
respect to any of the Contractor's facilities if the Deputy

Assistant Secretary finds that the Contractor has demonstrated that---

\(i\) The facility is in all respects separate and distinct from
activities of the Contractor related to the performance of a contract;
and

\(ii\) Such a waiver will not interfere with or impede the effectuation
of the Executive order; or

\(5\) Work outside the United States that does not involve the
recruitment or employment of workers within the United States.

\(f\) The Department of Labor publishes the official employee notice in
two variations; one for contractors covered by the Railway Labor Act and
a second for all other contractors. The Contractor shall---

\(1\) Obtain the required employee notice poster from the Division of
Interpretations and Standards, Office of Labor-Management Standards,
U.S. Department of Labor, 200 Constitution Avenue, NW, Room N-- 5605,
Washington, DC 20210, or from any

field office of the Department's Office of Labor-Management Standards or
Office

of Federal Contract Compliance Programs;

\(2\) Download a copy of the poster from the Office of Labor-Management
Standards website at *http://www.olms.dol.gov*; or

\(3\) Reproduce and use exact duplicate copies of the Department of
Labor's official poster.

\(g\) The Contractor shall include the substance of this clause in every
subcontract or purchase order that exceeds the simplified acquisition
threshold, entered into in connection with this contract, unless
exempted by the Department of Labor Deputy

Assistant Secretary for Labor--Management Programs on account of special
circumstances in the national interest under authority of 29 CFR
470.3(c). For indefinite quantity subcontracts, the Contractor shall
include the substance of this clause if

the value of orders in any calendar year of the subcontract is expected
to exceed

the simplified acquisition threshold. Pursuant to 29 CFR part 470,
Subpart B--- Compliance Evaluations, Complaint Investigations and
Enforcement Procedures, the Secretary of Labor may direct the Contractor
to take such action in the enforcement of these regulations, including
the imposition of sanctions for noncompliance with respect to any such
subcontract or purchase order. If the Contractor becomes involved in
litigation with a subcontractor or vendor, or is threatened with such
involvement, as a result of such

direction, the Contractor may request the United States, through the
Secretary of Labor, to enter into such litigation to protect the
interests of the United States.

 

 

52.232‑19 [AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR
1984)]{.underline}

 

Funds are not presently available for performance under this contract
beyond [30 September of each Government Fiscal Year]{.underline}. The
Government\'s obligation for performance of this contract beyond that
date is contingent upon the availability of appropriated funds from
which payment for contract purposes can be made. No legal liability on
the part of the Government for any payment may arise for performance
under this contract beyond [30 September of each Government Fiscal
Yea]{.underline}r, until funds are made available to the Contracting
Officer for performance and until the Contractor receives notice of
availability, to be confirmed in writing by the Contracting
Officer***.***

 

52.237-3 [CONTINUITY OF SERVICES (JAN 1991)]{.underline}

 

\(a\) The Contractor recognizes that the services under this contract
are vital to the government and must be continued without interruption
and that, upon contract expiration, a successor, either the government
or another contractor, may continue them. The Contractor agrees to (1)
furnish phase-in training and (2) exercise its best efforts and
cooperation to effect an orderly and efficient transition to a
successor.

 

\(b\) The Contractor shall, upon the contracting officer's written
notice, (1) furnish phase-in, phase-out services for up to 90 days after
this contract expires and (2) negotiate in good faith a plan with a
successor to determine the nature and extent of phase-in , phase-out
services required. The plan shall specify a training program and a date
for transferring responsibilities for each division of work described in
the plan, and shall be subject to the contracting officer's approval.
The Contractor shall provide sufficient experienced personnel during the
phase-in, phase-out period to ensure that the services called for by
this contract are maintained at the required level of proficiency.

 

\(c\) The Contractor shall allow as many personnel as practicable to
remain on the job to help the successor maintain the continuity and
consistency of the services required by this contract. The Contractor
also shall disclose necessary personnel records and allow the successor
to conduct on site interviews with these employees. If selected
employees are agreeable to the change, the contractor shall release them
at a mutually agreeable date and negotiate transfer of their earned
fringe benefits to the successor.

 

\(d\) The Contractor shall be reimbursed for all reasonable phase-in,
phase-out costs (i.e., costs incurred within the agreed period after
contract expiration that result from phase-in, phase-out operations) and
a fee (profit) not to exceed a pro rata portion of the fee (profit)
under this contract.

 

52.237-7 [INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (JAN
1997)]{.underline}

 

\(a\) It is expressly agreed and understood that this is a nonpersonal
services contract, as defined in Federal Acquisition Regulation (FAR)
37.101, under which the professional services rendered by the Contractor
are rendered in its capacity as an independent contractor. The
Government may evaluate the quality of professional and administrative
services provided, but retains no control over professional aspects of
the services rendered, including by example, the Contractor\'s
professional medical judgment, diagnosis, or specific medical
treatments. The Contractor shall be solely liable for and expressly
agrees to indemnify the Government with respect to any liability
producing acts or omissions by it or by its employees or agents. The
Contractor shall maintain during the term of this contract liability
insurance issued by a responsible insurance carrier of not less than the
following amount(s) per specialty per occurrence: **5,000.00 USD.**

 

\(b\) An apparently successful offeror, upon request by the Contracting
Officer, shall furnish prior to contract award evidence of its
insurability concerning the medical liability insurance required by
paragraph (a) of this clause.

 

\(c\) Liability insurance may be on either an occurrences basis or on a
claims-made basis. If the policy is on a claims-made basis, an extended
reporting endorsement (tail) for a period of not less than 3 years after
the end of the contract term must also be provided.

 

\(d\) Evidence of insurance documenting the required coverage for each
health care provider who will perform under this contract shall be
provided to the Contracting Officer prior to the commencement of
services under this contract.

 

\(e\) The policies evidencing required insurance shall also contain an
endorsement to the effect that any cancellation or material change
adversely affecting the Government\'s interest shall not be effective
until 30 days after the insurer or the Contractor gives written notice
to the Contracting Officer. If during the performance period of the
contract the Contractor changes insurance providers, the Contractor must
provide evidence that the Government will be indemnified to the limits
specified in paragraph (a) of this clause, for the entire period of the
contract, either under the new policy, or a combination of old and new
policies.

 

\(f\) The Contractor shall insert the substance of this clause,
including this paragraph (f), in all subcontracts under this contract
for health care services and shall require such subcontractors to
provide evidence of and maintain insurance in accordance with paragraph
(a) of this clause. At least 5 days before the commencement of work by
any subcontractor, the Contractor shall furnish to the Contracting
Officer evidence of such insurance.

 

\* Contracting Officer insert the dollar value(s) of standard
coverage(s) prevailing within the local community as to the specific
medical specialty, or specialties, concerned, or such higher amount as
the Contracting Officer deems necessary to protect the Government\'s
interests.

 

 

[I.3 DEPARTMENT OF STATE ACQUISITION REGULATION (DOSAR)]{.underline}

[CLAUSES, 48 CFR CH. 6 included in full text:]{.underline}

 

652.216-70 [ORDERING - INDEFINITE-DELIVERY CONTRACT (APR
2004)]{.underline}

 

The Government shall use one of the following forms to issue orders
under this contract:

 

\(a\) The Optional Form 347, *Order for Supplies or Services*, and
Optional Form 348, *Order for Supplies or Services Schedule -
Continuation*; or,

 

\(b\) The DS-2076, *Purchase Order, Receiving Report and Voucher*, and
DS-2077, *Continuation Sheet*.

(End of clause)

 

 

652.225-71 [SECTION 8(A) OF THE EXPORT ADMINISTRATION ACT OF 1979, AS
AMENDED (AUG 1999)]{.underline}

 

\(a\) Section 8(a) of the U.S. Export Administration Act of 1979, as
amended (50 U.S.C. 2407(a)), prohibits compliance by U.S. persons with
any boycott fostered by a foreign country against a country which is
friendly to the United States and which is not itself the object of any
form of boycott pursuant to United States law or regulation. The Boycott
of Israel by Arab League countries is such a boycott, and therefore, the
following actions, if taken with intent

to comply with, further, or support the Arab League Boycott of Israel,
are prohibited activities under the Export Administration Act:

\(1\) Refusing, or requiring any U.S. person to refuse to do business
with or in Israel, with any Israeli business concern, or with any
national or resident of Israel, or with any other person, pursuant to an
agreement of, or a request from or on behalf of a boycotting country;

\(2\) Refusing, or requiring any U.S. person to refuse to employ or
otherwise discriminating against any person on the basis of race,
religion, sex, or national origin of that person or of any owner,
officer, director, or employee of such person;

\(3\) Furnishing information with respect to the race, religion, or
national origin of any U.S. person or of any owner, officer, director,
or employee of such U.S. person;

\(4\) Furnishing information about whether any person has, has had, or
proposes to have any business relationship (including a relationship by
way of sale, purchase, legal or commercial representation, shipping or
other transport, insurance, investment, or supply) with or in the State
of Israel, with any business concern organized under the laws of the
State of Israel, with any Israeli national or resident, or with any
person which is known or believed to be restricted from having any
business relationship with or in Israel;

\(5\) Furnishing information about whether any person is a member of,
has made contributions to, or is otherwise associated with or involved
in the activities of any charitable or fraternal

organization which supports the State of Israel; and,

> (6)Paying, honoring, confirming, or otherwise implementing a letter of
> credit which contains any condition or requirement against doing
> business with the State of Israel.

\(b\) Under Section 8(a), the following types of activities are not
forbidden \`\`compliance with the boycott,\'\' and are therefore
exempted from Section 8(a)\'s prohibitions listed in paragraphs
(a)(1)-(6) above:

> \(1\) Complying or agreeing to comply with requirements:
>
> (i)Prohibiting the import of goods or services from Israel or goods
> produced or services provided by any business concern organized under
> the laws of Israel or by nationals or residents of Israel; or,
>
> \(ii\) Prohibiting the shipment of goods to Israel on a carrier of
> Israel, or by a route other than that prescribed by the boycotting
> country or the recipient of the shipment;

\(2\) Complying or agreeing to comply with import and shipping document
requirements with respect to the country of origin, the name of the
carrier and route of shipment, the name of the supplier of the shipment
or the name of the provider of other services, except that no
information knowingly furnished or conveyed in response to such
requirements may be stated in negative, blacklisting, or similar
exclusionary terms, other than with respect to carriers or route of
shipments as may be permitted by such regulations in order to comply
with precautionary requirements protecting against war risks and
confiscation;

\(3\) Complying or agreeing to comply in the normal course of business
with the unilateral and specific selection by a boycotting country, or
national or resident thereof, of carriers, insurance, suppliers of
services to be performed within the boycotting country or specific goods
which, in the normal course of business, are identifiable by source when
imported into the boycotting country;

\(4\) Complying or agreeing to comply with the export requirements of
the boycotting country relating to shipments or transshipments of
exports to Israel, to any business concern of or organized under the
laws of Israel, or to any national or resident of Israel;

\(5\) Compliance by an individual or agreement by an individual to
comply with the immigration or passport requirements of any country with
respect to such individual or any member of such individual\'s family or
with requests for information regarding requirements of employment of
such individual within the boycotting country; and,

> \(6\) Compliance by a U.S. person resident in a foreign country or
> agreement by such person to comply with the laws of that country with
> respect to his or her activities exclusively therein, and such
> regulations may contain exceptions for such resident complying with
> the laws or regulations of that foreign country governing imports into
> such country of trademarked, trade named, or similarly specifically
> identifiable products, or components of products for his or her own
> use, including the performance of contractual services within that
> country, as may be defined by such regulations.

 

652.229-71 [PERSONAL PROPERTY DISPOSITION AT POSTS ABROAD (AUG
1999)]{.underline}

 

Regulations at 22 CFR Part 136 require that U.S. Government employees
and their families do not profit personally from sales or other
transactions with persons who are not themselves entitled to exemption
from import restrictions, duties, or taxes. Should the contractor
experience importation or tax privileges in a foreign country because of
its contractual relationship to the United States Government, the
contractor shall observe the requirements of 22 CFR Part 136 and all
policies, rules, and procedures issued by the chief of mission in that
foreign country.

 

RESERVED. 652.237-72 [OBSERVANCE OF LEGAL HOLIDAYS AND ADMINISTRATIVE
LEAVE (APR 2004)]{.underline}

 

All work shall be performed during 9:00-18:00 from Monday through Friday
except for the holidays identified below. Other hours may be approved by
the Contracting Officer\'s Representative. Notice must be given 24 hours
in advance to COR who will consider any deviation from the hours
identified above.

 

a\) The Department of State observes the following holidays:

 

New Year\'s Day

Martin Luther King\'s Birthday

Washington's Birthday

Memorial Day

Independence Day

Labor Day

Columbus Day

Veterans Day

Thanksgiving Day

Christmas Day

b\) Ukrainian holidays list:

*** ***New Year's Day

Orthodox Christmas

International Women's Day

Orthodox Easter

International Labor

## Victory Day

Holy Trinity

Constitution Day

Independence Day

\* The exact dates and days of holidays will be provided separately.

Any other day designated by Federal law, Executive Order or Presidential
Proclamation.

 

\(b\) When any such day falls on a Saturday or Sunday, the following
Monday is observed. Observance of such days by Government personnel
shall not be cause for additional period of performance or entitlement
to compensation except as set forth in the contract.

 

652.242-73 AUTHORIZATION AND PERFORMANCE (AUG 1999)

 

\(a\) The contractor warrants the following:

 

\(1\) That it has obtained authorization to operate and do business in
the country or countries in which this contract will be performed;

 

\(2\) That it has obtained all necessary licenses and permits required
to perform this contract; and,

 

\(3\) That it shall comply fully with all laws, decrees, labor
standards, and regulations of said country or countries during the
performance of this contract.

 

\(b\) If the party actually performing the work will be a subcontractor
or joint venture partner, then such subcontractor or joint venture
partner agrees to the requirements of paragraph (a) of this clause.

(End of clause)

 

652.243-70 [NOTICES (AUG 1999)]{.underline}

 

Any notice or request relating to this contract given by either party to
the other shall be in writing. Said notice or request shall be mailed or
delivered by hand to the other party at the address provided in the
schedule of the contract. All modifications to the contract must be made
in writing by the contracting officer.

 

**SECTION J**

**[LIST OF EXHIBITS/ATTACHMENTS]{.underline}**

Exhibit A -- EMPLOYEE STATISTICS

 

**\
**

Exhibit B - ORE EMPLOYEES RIDER

ORE - employees 5 Total - 10

DCR - employees 2 Total - 3

 

 

**SECTION K**

**[REPRESENTATIONS, CERTIFICATIONS,]{.underline}**

**[AND OTHER STATEMENTS OF OFFERORS]{.underline}**

 

 

K.1 [52.203-2 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR
1985)]{.underline}

 

\(a\) The offeror certifies that

 

\(1\) The prices in this offer have been arrived at independently,
without, for the purpose of restricting competition, any consultation,
communication, or agreement with any other offeror or competitor
relating to (i) those prices, (ii) the intention to submit an offer, or
(iii) the methods or factors used to calculate the prices offered:

 

\(2\) The prices in this offer have not been and will not be knowingly
disclosed by the offeror, directly or indirectly, to any other offeror
or competitor before bid opening (in the case of sealed bid
solicitation) or contract award (in the case of a negotiated
solicitation) unless otherwise required by law; and

 

\(3\) No attempt has been made or will be made by the offeror to induce
any other concern to submit or not submit an offer for the purpose of
restricting competition.

 

\(b\) Each signature on the offer is considered to be certification by
the signatory that the signatory -

 

\(1\) Is the person in the offeror\'s organization responsible for
determining the prices being offered in this bid or proposal, and that
the signatory has not participated and will not participate in any
action contrary to subparagraphs (a)(1) through (a)(3) above; or

 

(2)(i) Has been authorized, in writing, to act as agent for the
following principals in certifying that those principals have not
participated, and will not participate in any action contrary to
subparagraphs (a)(1) through (a)(3) above
[                        ]{.underline}

[                                                                  ]{.underline}

(insert full name of person(s) in the offeror\'s organization
responsible for determining the prices offered in this bid or proposal,
and the title of his or her position in the offeror\'s organization);

 

\(ii\) As an authorized agent, does certify that the principals named in
subdivision (b)(2)(i) above have not participated, and will not
participate, in any action contrary to subparagraphs (a)(1) through
(a)(3) above.

 

\(iii\) as an agent, has not personally participated, and will not
participate, in any action contrary to subparagraphs (a)(1) through
(a)(3) above.

 

\(c\) if the offeror deletes or modifies subparagraph (a)(2) above, the
offeror must furnish with its offer a signed statement setting forth in
detail the circumstances of the disclosure.

 

 

K.2. [52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO
INFLUENCE CERTAIN FEDERAL TRANSACTIONS (APR 1991)]{.underline}

 

\(a\) The definitions and prohibitions contained in the clause, at FAR
52.203-12. Limitation on Payments to Influence Certain Federal
Transactions, included in this solicitation, are hereby incorporated by
reference in paragraph (b) of this certification.

 

\(b\) The offeror, by signing its offer, hereby certifies to the best of
his or her knowledge and belief as of December 23, 1989, that-

 

\(1\) No Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
congress, or an employee of a Member of Congress on his or her behalf in
connection with the awarding of any Federal contract, the making of any
Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal,
amendment or modification of any federal contract, grant, loan or
cooperative agreement;

 

\(2\) If any funds other than Federal appropriated funds (including
profit or fee received under a covered Federal transaction) have been
paid, or will be paid, to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress
on his or her behalf in connection with this solicitation, the offeror
shall complete and submit, with its offer, OMB standard form LLL.
Disclosure of Lobbying Activities, to the Contracting Officer; and

 

\(3\) He or she will include the language of this certification in all
subcontract awards at any tier and require that all recipients of
subcontract awards in excess of \$100,000 shall certify and disclose
accordingly.

 

\(c\) Submission of this certification and disclosure is a prerequisite
for making or entering into this contract imposed by Section 1352, Title
31, United States Code. Any person who makes an expenditure prohibited
under this provision or who fails to file or amend the disclosure form
to be filed or amended by this provision, shall be subject to a civil
penalty of not less than \$10,000 and not more than \$100,000 for each
such failure.

 

K.3. [52.204-3 TAXPAYER IDENTIFICATION (OCT 1998)]{.underline}

 

(a) (a)                            Definitions.

 

\"Common parent\", as used in this provision, means that corporate
entity that owns or controls an affiliated group of corporations that
files its Federal income tax returns on a consolidated basis, and of
which the offeror is a member.

 

\"Taxpayer Identification Number (TIN)\", as used in this provision,
means the number required by the IRS to be used by the offeror in
reporting income tax and other returns. The TIN may be either a Social
Security Number or an Employer Identification Number.

 

(b) (b)               All offerors must submit the information required
    in paragraphs (d)through (f) of this provision in order to comply
    with debt collection requirements of 31 U.S.C. 7701(c) and 3325 (d),
    reporting requirements of 26 USC 6041, 6041A, and 6050M and
    implementing regulations issued by the Internal Revenue Service
    (IRS). If the resulting contract is subject to the reporting
    requirements described in FAR 4.904, the failure or refusal by the
    offeror to furnish the information may result in a 31 percent
    reduction of payments otherwise due under the contract.

 

(b) (c)                The TIN may be used by the Government to collect
    and report on any delinquent amounts arising out of the offeror's
    relationship with the Government (3l USC 7701(c)(3)). If the
    resulting contract is subject to the payment reporting requirements
    described in FAR 4.904, the TIN provided hereunder may be matched
    with IRS records to verify the accuracy of the offeror's TIN.

 

\(d\) Taxpayer Identification Number (TIN).

TIN: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_ TIN has been applied for.

\_\_\_ TIN is not required because:

 

\_\_ Offeror is a nonresident alien, foreign corporation, or foreign
partnership that does not have income effectively connected with the
conduct of a trade or business in the U.S. and does not have an office
or place of business or a fiscal paying agent in the U.S.;

 

\_\_ Offeror is an agency or instrumentality of a foreign government;

\_\_ Offeror is an agency or instrumentality of the Federal Government.

 

\(e\) Type of Organization.

\_\_ Sole Proprietorship;

\_\_ Partnership:

\_\_ Corporate Entity (not tax exempt);

\_\_ Corporate Entity (tax exempt);

\_\_ Government entity (Federal, State, or local);

\_\_ Foreign government;

\_\_ International organization per 26 CFR 1.6049-4;

\_\_ Other
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

 

\(f\) Common Parent.

\_\_\_ Offeror is not owned or controlled by a common parent as defined
in paragraph (a) of this clause.

\_\_\_ Name and TIN of common parent;

Name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TIN
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(End of provision)

 

 

K.4 [52.204-6 CONTRACTOR IDENTIFICATION NUMBER -DATA UNIVERSAL NUMBERING
SYSTEM (DUNS) NUMBER (OCT 2003)]{.underline}

 

> \(a\) The offeror shall enter, in the block with its name and address
> on the cover page of its offer, the annotation \"DUNS\" or \"DUNS+4\"
> followed by the DUNS number or \"DUNS+4\" that identifies the
> offeror\'s name and address exactly as stated in the offer. The DUNS
> number is a nine-digit number assigned by Dun and Bradstreet, Inc. The
> DUNS+4 is the DUNS number plus a 4-character suffix that may be
> assigned at the discretion of the offeror to establish additional CCR
> records for identifying alternative Electronic Funds Transfer (EFT)
> accounts (see Subpart 32.11) for the same parent concern.
>
>  
>
> \(b\) If the offeror does not have a DUNS number, it should contact
> Dun and Bradstreet directly to obtain one.
>
>  
>
> \(1\) An offeror may obtain a DUNS number-
>
> \(i\) If located within the United States, by calling Dun and
> Bradstreet at 1-866-705-5711 or via the Internet at
> *http://www.dnb.com*; or
>
> \(ii\) If located outside the United States, by contacting the local
> Dun and Bradstreet office.
>
>  
>
> \(2\) The offeror should be prepared to provide the following
> information:
>
> \(i\) Company legal business name.
>
> \(ii\) Tradestyle, doing business, or other name by which your entity
> is commonly recognized.
>
> \(iii\) Company physical street address, city, state and Zip Code.
>
> \(iv\) Company mailing address, city, state and Zip Code (if separate
> from physical).
>
> \(v\) Company telephone number.
>
> \(vi\) Date the company was started.
>
> \(vii\) Number of employees at your location.
>
> \(viii\) Chief executive officer/key manager.
>
> \(ix\) Line of business (industry).
>
> \(x\) Company Headquarters name and address (reporting relationship
> within your entity).

 

K.5 [52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS]{.underline}

[(JAN 2005)]{.underline}

 

(a)(1) If the clause at 52.204--7, Central Contractor Registration, is
included in this solicitation, paragraph (b) of this provision applies.

 

\(2\) If the clause at 52.204--7 is not included in this solicitation,
and the offeror is currently registered in CCR, and has completed the
ORCA electronically, the offeror may choose to use paragraph (b) of this
provision instead of completing the corresponding individual
representations and certifications in the solicitation. The offeror
shall indicate which option applies by checking one of the following
boxes:

 

\[ \] (i) Paragraph (b) applies.

 

\[ \] (ii) Paragraph (b) does not apply and the offeror has completed
the individual representations and certifications in the solicitation.

 

\(b\) The offeror has completed the annual representations and
certifications electronically via the Online Representations and
Certifications Application (ORCA) website at *http://orca.bpn.gov*.
After reviewing the ORCA database information, the offeror verifies by
submission of the offer that the representations and certifications
currently posted electronically have been entered or updated within the
last 12 months, are current, accurate, complete, and applicable to this
solicitation (including the business size standard applicable to the
NAICS code referenced for this solicitation), as of the date of this
offer and are incorporated in this offer by reference (see FAR 4.1201);
except for the changes identified below

 

\[*offeror to insert changes, identifying change by clause number,
title, date*\].

 

These amended representation(s) and/or certification(s) are also
incorporated in this offer and are current, accurate, and complete as of
the date of this offer.

 

+--------------+-------------------+---------------+-----------------+
| FAR Clause   | Title             | Date          | Change          |
|              |                   |               |                 |
| \#           |                   |               |                 |
+--------------+-------------------+---------------+-----------------+
|              |                   |               |                 |
+--------------+-------------------+---------------+-----------------+

 

Any changes provided by the offeror are applicable to this solicitation
only, and do not result in an update to the representations and
certifications posted on ORCA.

 

 

K.6 [52.209‑5 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, PROPOSED
DEBARMENT, AND OTHER RESPONSIBILITY MATTERS (DEC 2001)]{.underline}

 

\(a\) (1) The Offeror certifies, to the best of its knowledge and
belief, that‑

 

\(i\) The Offeror and/or any of its Principals‑

 

\(A\) Are are not presently debarred, suspended, proposed for debarment,
or declared ineligible for the award of contracts by any Federal agency;

 

\(B\) Have have not , within a three year period preceding this offer,
been convicted of or had a civil judgment rendered against them for
commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (Federal, state, or local)
contract or subcontract; violation of Federal or state antitrust
statutes relating to the submission of offers; or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of
records, making false statements, tax evasion or receiving stolen
property; and

\(C\) Are\_\_ are not \_\_ presently indicated for, or otherwise
criminally or civilly charged by a governmental entity with, commission
of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this
provision.

 

 

 

\(ii\) The Offeror has \[ \] has not \[ \], within a three-year period
preceding this offer, had one or more contracts terminated for default
by any Federal agency.

 

\(2\) \"Principals,\" for the purpose of this certification, means
officers; directors; owners; partners; and, persons having primary
management or supervisory responsibilities within a business entity
(e.g., general manager; plant manager; head of a subsidiary, division,
or business segment, and similar positions).

 

> THIS CERTIFICATION CONCERNS A MATTER WITHIN THE JURISDICTION OF AN
> AGENCY OF THE UNITED STATES AND THE MAKING OF A FALSE, FICTITIOUS, OR
> FRAUDULENT CERTIFICATION MAY RENDER THE MAKER SUBJECT TO PROSECUTION
> UNDER SECTION 1001, TITLE 18, UNITED STATES CODE.

 

\(b\) The Offeror shall provide immediate written notice to the
Contracting Officer if, at any time prior to contract award, the Offeror
learns that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.

 

\(c\) A certification that any of the items in paragraph (a) of this
provision exists will not necessarily result in withholding of an award
under this solicitation. However, the certification will be considered
in connection with a determination of the Offeror\'s responsibility.
Failure of the Offeror to furnish a certification or provide such
additional information as requested by the Contracting Officer may
render the Offeror non-responsible.

 

\(d\) Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render, in good faith,
the certification required by paragraph (a) of this provision. The
knowledge and information of an Offeror is not required to exceed that
which is normally possessed by a prudent person in the ordinary course
of business dealings.

 

\(e\) The certification in paragraph (a) of this provision is a material
representation of fact upon which reliance was placed when making award.
If it is later determined that the Offeror knowingly rendered an
erroneous certification, in addition to other remedies available to the
Government, the Contracting Office may terminate the contract resulting
from this solicitation for default.

 

 

K.7 [52.2l5-06 TYPE OF BUSINESS ORGANIZATION (OCT 1997)]{.underline}

 

The offeror or respondent, by checking the applicable box, represents
that -

 

\(a\) It operates as \[ \] an individual, \[ \] a partnership, \[ \] a
nonprofit organization, \[ \] a joint venture, or \[ \] a corporation
incorporated under the laws of the State of
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

 

\(b\) If the offeror or respondent is a foreign entity, it operates as
\[ \] an individual, \[ \] a partnership, \[ \] a nonprofit
organization, \[ \] a joint venture, or \[ \] a corporation, registered
for business in \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (country).

 

K.8 [AUTHORIZED CONTRACT ADMINISTRATOR]{.underline}

 

If the offeror does not fill-in the blanks below, the official who
signed the offer will be deemed to be the offeror\'s representative for
Contract Administration, which includes all matters pertaining to
payments.

 

Name:[                                                ]{.underline}

 

Address:[                                             ]{.underline}

 

[                                             ]{.underline}

 

Telephone Number:[                                    ]{.underline}

 

K.9 [652.225-70 ARAB LEAGUE BOYCOTT OF ISRAEL (AUG 1999)]{.underline}

 

\(a\) Definitions. As used in this provision:

Foreign person means any person other than a United States person as
defined below.

 

United States person means any United States resident or national (other
than an individual resident outside the United States and employed by
other than a United States person), any domestic concern (including any
permanent domestic establishment of any foreign concern), and any
foreign subsidiary or affiliate (including any permanent foreign
establishment) of any domestic concern which is controlled in fact by
such domestic concern, as provided under the Export Administration Act
of 1979, as amended.

\(b\) Certification. By submitting this offer, the offeror certifies
that it is not:

\(1\) Taking or knowingly agreeing to take any action, with respect to
the boycott of Israel by Arab League countries, which Section 8(a) of
the Export Administration Act of 1979, as amended (50 U.S.C. 2407(a))
prohibits a United States person from taking; or,

(2) (2)               Discriminating in the award of subcontracts on the
    basis of religion.

 

K.10 [DEFENSE BASE ACT INSURANCE -- COVERED CONTRACTOR
EMPLOYEES]{.underline}

*** ***

\(a\) Bidders/Offerors shall indicate below whether or not any of the
following categories of employees will be employed on the resultant
contract, and, if so, the number of such employees:

+--------------------------------------------+--------+---------------+
| **Category**                               | **Ye   | **Number**    |
|                                            | s/No** |               |
+--------------------------------------------+--------+---------------+
| \(1\) United States citizens or residents  |        |               |
+--------------------------------------------+--------+---------------+
| \(2\) Individuals hired in the United      |        |               |
| States, regardless of citizenship          |        |               |
+--------------------------------------------+--------+---------------+
| \(3\) Local nationals or third country     |        | Local         |
| nationals where contract performance takes |        | nationals:    |
| place in a country [where there are        |        |               |
| no]{.underline} local workers'             |        | \_            |
| compensation laws                          |        | \_\_\_\_\_\_\ |
|                                            |        | _\_\_\_\_\_\_ |
|                                            |        |               |
|                                            |        | Third Country |
|                                            |        | Nationals:    |
|                                            |        | \_\_\_\_\_\_\ |
|                                            |        | _\_\_\_\_\_\_ |
+--------------------------------------------+--------+---------------+
| \(4\) Local nationals or third country     |        | Local         |
| nationals where contract performance takes |        | nationals:    |
| place in a country where there             |        |               |
| [are]{.underline} local workers'           |        | \_            |
| compensation laws                          |        | \_\_\_\_\_\_\ |
|                                            |        | _\_\_\_\_\_\_ |
|                                            |        |               |
|                                            |        | Third Country |
|                                            |        | Nationals:    |
|                                            |        | \_\_\_\_\_\_\ |
|                                            |        | _\_\_\_\_\_\_ |
+--------------------------------------------+--------+---------------+

 

\(b\) If the bidder/offeror has indicated "yes" in block (a)(4) of this
provision, the bidder/offeror shall submit, as part of its offer, a
statement that indicates that such local nationals and/or third country
nationals will be provided workers' compensation coverage against the
risk of work injury or death under a local workers' compensation law.
For those employees, the bidder/offeror shall also assume liability
toward the employees and their beneficiaries for war-hazard injury,
death, capture, or detention, in accordance with the clause at FAR
52.228-4.

 

\(c\) If the bidder/offeror has indicated "yes" in blocks (a)(1), (2),
or (3) of this provision, the bidder/offeror shall compute Defense Base
Act insurance costs covering those employees pursuant to the terms of
the contract between the Department of State and the Department's
Defense Base Act insurance carrier at the rates specified in DOSAR
652.228-74. If DOSAR provision 652.228-74 is not included in this
solicitation, the bidder/offeror shall notify the contracting officer
before the closing date so that the solicitation can be amended
accordingly.

**SECTION L**

**INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS**

 

L.1. [Submission of Offers.]{.underline}

 

This solicitation is for the provision of insurance and services
described in Sections C and J, under the terms and conditions set forth
herein 

 

L.2. [Summary of Instructions.]{.underline} Each proposal must consist
of the following separate volumes:

 

[Volume]{.underline} [Title]{.underline} [No. of Copies]{.underline}

1 Executed Standard Form 33, Solicitation

Offer and Award, and completed Section K

REPRESENTATIONS, CERTIFICATIONS,\
AND OTHER STATEMENTS OF OFFERORS. 2

 

2 Price Proposal and complete Section B

Supplies or Services and Price/Costs 2

 

3 Technical Proposal containing all technical

factors and subfactors 4

 

L.3. [Delivery of Proposals and Exceptions to Solicitation.]{.underline}
The offeror shall submit the complete offer to the address indicated at
Block 7, if mailed, or Block 9, if hand delivered, of Standard Form 33,
Solicitation, Offer and Award. Any deviation, exceptions, or conditional
assumptions taken with respect to any of the instructions or
requirements of this solicitation shall be identified and
explained/justified in the appropriate volume of the offer.

 

L.4. [Contents of Proposals.]{.underline} The proposals shall contain
documents filled out in strict conformance with the detailed
instructions set forth as follows:

 

L.4.1. Volume 1 \-- **Standard Form 33: Complete Blocks 12 through 18,
as appropriate and fill in all the blanks in Section K of this
solicitation.**

** **

L.4.2. Volume 2 \-- **Price Proposal and fill in Section B.**

** **

\(a\) Price proposal for the base year of insurance program;

 

\(b\) Price proposal for the option years of insurance program;
**[however, a price proposal for an option year with no proposal for the
base year will not be considered, nor will a proposal for a base period
which does not include a proposal for all optional periods for that same
type of insurance.]{.underline}**

 

L.4.3. Volume 3 \-- **Technical Proposal**

 

L.4.3.1 [Management Approach]{.underline}

(a) (a)                                                                           
    [Understanding of the Requirement.]{.underline}

 

> \(i\) The offeror must demonstrate that it understands the requirement
> set forth in Sections C, through Section J of the solicitation. The
> offeror must demonstrate a knowledge and familiarity in providing the
> insurance and services required in the aforementioned sections of the
> solicitation. The offeror must also describe the pool of coverage in
> which the covered employees will be contained, and, a description of
> how the experience rating would be determined in regards to Section
> B.4.

 

(ii) **Proposals shall contain only the benefit levels stated in
     Section C. Proposals offering benefit levels greater or less than
     those levels required in Section C may be rejected as
     unacceptable.**

(iii) 

> **Proposals shall contain the list of clinics that specifies where
> medical services will be provided.**
>
> Ability to provide clinics that are specified in Section C.1.1.5,
> C.1.1.8, C.1.1.18 will be taken into consideration while evaluating
> proposals. Offerors should consider working with these particular
> clinics or ones of the same standards.

(b) (b)                                                                           
    [Plan Administration.]{.underline}

 

> **The offeror must demonstrate how it plans to perform the contract,
> especially as it relates to:**
>
>  

-           providing the insurance

-           maintaining adequate reserves to pay claims, including
    accounting procedures

-           administering and prompt payment of insured claims for
    reimbursement

-           procedures for reviewing claims (including where and how
    claims will be processed and settled)

-           description of the system for tracking utilization of
    services by claimants by diagnostic or other actuarial
    categories/profiles and comparing them against regional or national
    norms

-           availability of central point of contact and phone number
    for employees to call regarding claims or information

-           description of procedure how the hospitalization cases and
    other difficult medical cases will be handled and followed up.

-           providing periodic reporting and accounting of financial
    results of the plan, including reporting formats

-           procedures and rates for converting from group insurance to
    individual insurance policies

-           the overall management of the contract.

 

L.4.3.2.1. [Experience and Past Performance.]{.underline}

 

**List all contracts and subcontracts your company has held over the
past three years for the same or similar work. Provide the following
information for each contract and subcontract:**

 

> \(a\) Customer\'s name, address, and the telephone numbers of previous
> contractors for whom similar insurance and services were provided;

 

\(b\) Contract number and type of contract;

 

> \(c\) Date and place of performance of the contract and delivery dates
> and period of performance;

 

> \(d\) Scope of the contract, i.e., types of insurance provided and
> range of population covered, as well as total dollar amount;

 

\(e\) Brief description of the performance requirements;

 

\(f\) Comparability to the work required under this solicitation;

 

> \(g\) Brief discussion of any major technical problems and their
> resolutions.

*** ***

*** ***

L.4.3.2.2 [Licensing Information]{.underline}

 

The offeror shall include a notarized copy of the most current
license/certificate/-accreditation, which demonstrates that the offeror
is licensed/certified/accredited or otherwise authorized by the
Government of Ukraine or its agent (e.g., insurance commission, board)
to provide health insurance coverage to persons (to include
organizations, companies, groups) within the host country.

 

This section shall demonstrate that the offeror is
licensed/certified/accredited through no less than the final day of the
base performance period and that the offeror is eligible for renewal for
the option periods. This section shall also summarize and describe any
probationary, disciplinary or actions taken upon the offeror, which are
in force or are about to be imposed upon the offeror by the government
of Ukrasine or its agents.

 

Failure to demonstrate that the offeror is an authorized insurance
company permitted to write and administer health insurance policies in
Unkraine shall be grounds for rejection of the proposal.

 

L.4.3.3. [Profit Sharing Credit]{.underline}.

 

The offeror shall indicate whether any insurance plan offered will be
subject to participation in any profit sharing credit program, pooling
agreement (including multinational agreements) or any other premium
credit procedure. If this is applicable, please describe. This is for
evaluation only to distinguish between otherwise equally priced,
technically acceptable proposals and will not be considered in
determining the lowest-priced offeror.

L.4.3.4 [Employee Pool]{.underline}

 

The offeror shall describe the pool that will apply to the employees
under this contract. The offeror will describe the size of the pool,
whether it is a mixture of commercial and government (if applicable),
alternative pools that are available in the event the economic price
adjustment clause becomes effective.

 

L.5 [52.252‑1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB
1998)]{.underline}

 

This contract incorporates the following provisions by reference with
the same force and effect as if they were given in full text. Upon
request, the Contracting Officer will make their full text available.
The offeror is cautioned that the listed provisions may include blocks
that must be completed by the offeror and submitted with its quotation
or offer. In lieu of submitting the full text of those provisions, the
offeror may identify the provision by paragraph identifier and provide
the appropriate information with its quotation or offer. Also, the full
text of a solicitation provision may be accessed electronically at this
address:

 

http://www.acqnet.gov/far or, http://farsite.hill.af.mil/search.htm

 

These addresses are subject to change. If the Federal Acquisition
Regulation (FAR) is not available at the locations indicated above, use
of a network "search engine" (e.g., Yahoo, Infoseek, Alta Vista, etc.)
is suggested to obtain the latest location of the most current FAR.

 

FEDERAL ACQUISITION REGULATION (48 CFR CH. 1)

 

52.214-34 SUBMISSION OF OFFERS IN ENGLISH LANGUAGE (APR 1991)

52.215-1 INSTRUCTIONS TO OFFERORS---COMPETITIVE ACQUISITIONS

> (JAN 2004)

 

L.6 [Solicitation Provisions Included In Full Text]{.underline}

 

L.6.1 [52.216-1 TYPE OF CONTRACT (APR 1984)]{.underline}

 

The Government contemplates award of a requirements type contract that
contains fixed prices with economic price adjustment, resulting from
this solicitation. The quantities shown in Section B are estimates only
and the Government is not obligated to order the estimated quantities
shown in this section.

 

L.6.2 [ECONOMIC PRICE ADJUSTMENT]{.underline}

 

See B.4 and B.8 for information relating to the economic price
adjustment features of this contract.

 

L.6.3 [52.233-2 SERVICE OF PROTEST (AUG 1996)]{.underline}

 

\(a\) Protests, as defined in section 33.101 of the Federal Acquisition
Regulation, that are filed directly with an agency, and copies of any
protests that are filed with the General Accounting Office (GAO) shall
be served on the Contracting Officer (addressed as follows) by obtaining
written and dated acknowledgment of receipt from **US Embassy General
Services Office Secretary, at Artem Business Center, 4 Glubochtska
Street, Kiev.**

\(b\) The copy of any protest shall be received in the office designated
above within one day of filing a protest with the GAO.

 

L.7. [652.206-70 COMPETITION ADVOCATE/OMBUDSMAN (AUG 1999)]{.underline}

 

(a) (a)                The Department of State\'s Competition Advocate
    is responsible for assisting industry in removing restrictive
    requirements from Department of State solicitations and removing
    barriers to full and open competition and use of commercial items.
    If such a solicitation is considered competitively restrictive or
    does not appear properly conducive to competition and commercial
    practices, potential offerors are encouraged to first contact the
    contracting officer for the respective solicitation. If concerns
    remain unresolved, contact the Department of State Competition
    Advocate on (703) 516-1680, by fax at (703) 875-6155, or write to:
    Department of State, Competition Advocate, Office of the Procurement
    Executive (A/OPE), Suite 603, SA-6, Washington, DC 20522-0602.

 

> \(b\) The Department of State\'s Acquisition Ombudsman has been
> appointed to hear concerns from potential offerors and contractors
> during the preaward and postaward phases of this acquisition. The role
> of the ombudsman is not to diminish the authority of the contracting
> officer, the Technical Evaluation Panel or Source Evaluation Board, or
> the selection official. The purpose of the ombudsman is to facilitate
> the communication of concerns, issues, disagreements, and
> recommendations of interested parties to the appropriate Government
> personnel, and work to resolve them. When requested and appropriate,
> the ombudsman will maintain strict confidentiality as to the source of
> the concern. The ombudsman does not participate in the evaluation of
> proposals, the source selection process, or the adjudication of formal
> contract disputes. Interested parties are invited to contact the
> contracting activity ombudsman**, Jennifer Bonner, Management
> Counselor Of US Embassy Kie, Ukraine,** at **490-4521 and fax
> 490-4085**. For an American Embassy or overseas post, refer to the
> numbers below for the Department Acquisition Ombudsman. Concerns,
> issues, disagreements, and recommendations which cannot be resolved at
> a contracting activity level may be referred to the Department of
> State Acquisition Ombudsman at (703) 516-1680, by fax at (703)
> 875-6155, or write to: Department of State, Acquisition Ombudsman,
> Office of the Procurement Executive (A/OPE), Suite 603, SA-6,
> Washington, DC 20522-0602.

**L.8. Pre-Proposal Conference**

** **

**L.8.1. [A pre-proposal conference to discuss the requirements of this
solicitation will be held on January 31, 2006 at 16:00 at the Artem
Business Center, 4 Glubochytska Street, 4^th^ floor Conference
room.]{.underline} Offerors interested in attendance should contact the
following individual:**

 

####### Stavnycha Olena 490-4113 490-4085

NAME TELEPHONE NUMBER FAX NUMBER

 

 

L.8.2. Offerors are urged to submit written questions at least three
days before the scheduled pre-proposal conference date, using the
address provided in block 9 of Standard Form 33, Solicitation, Offeror
and Award, of this solicitation or by faxing the questions to the above
fax number, marked to the attention of the above-named individual.

 

L.8.3. Attendees may also bring written questions to the proposal
conference; however, if the answer requires research, there is no
guarantee that the question will be able to be answered at that
conference.

 

L.8.4. The Government's statements at the pre-proposal conference shall
not be considered to be a change to the solicitation unless a written
amendment is issued.

 

L.8.5. Following the conference, all prospective offerors who received a
copy of the solicitation will be provided a copy of all questions
presented in writing prior to the conference, along with answers. If the
answer requires a change to the solicitation, a solicitation amendment
will also be issued.

 

 

L.9 FINANCIAL STATEMENT

 

If asked by the Contracting Officer, the offeror shall provide a current
statement of its financial condition, certified by a third party. This
current statement shall include:

 

[Income (profit-loss) Statement]{.underline} that shows profitability
for the past **3years;**

 

[Balance Sheet]{.underline} that shows the assets owned and the claims
against those assets, or what a firm owns and what it owes; and

 

[Cash Flow Statement]{.underline} that shows the firm's sources and uses
of cash during the most recent accounting period. This will help the
Government assess a firm's ability to pay its obligations.

 

The Government will use this information to determine the offeror's
financial responsibility and ability to perform under the contract.
Failure of an offeror to comply with a request for this information may
cause the Government to determine the offeror to be nonresponsible.

**SECTION M**

**EVALUATION FACTORS FOR AWARD**

 

 

M.1. [Evaluation of Proposals]{.underline}

 

M.1.1. [General]{.underline}**. To be acceptable and eligible for
evaluation, proposals must be prepared in accordance with Section L
-INTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS, and must meet all the
requirements** **set forth in the other sections of this solicitation.
Acceptable proposals will be evaluated pursuant to this section, and
award shall be made as set forth in M.3 below.**

 

M.2. [Overall Evaluation]{.underline}.

 

**Proposals will be evaluated in two phases: a technical evaluation to
determine the acceptability of the offer to the solicitation technical
requirements; and a price evaluation to determine the total evaluated
price proposed by each offeror. The \"total evaluated price\" is the
cumulative total of the base year insurance plus all option years for
the total estimated quantity of employees specified in Section B.**

 

The Government will make a responsibility determination by analyzing
whether the apparent successful offeror complies with the requirements
of FAR 9.1, including:

 

-   adequate financial resources or the ability to obtain them;

-   ability to comply with the required performance period, taking into
    consideration all existing commercial and governmental business
    commitments;

-   satisfactory record of integrity and business ethics;

-   necessary organization, experience, and skills or the ability to
    obtain them;

-   necessary equipment and facilities or the ability to obtain them;
    and

-   otherwise qualified and eligible to receive an award under
    applicable laws and regulations.

 

M.3. [Award Selection]{.underline}

 

M.3.1. **General. The award selection will go to the lowest priced,
technically acceptable, responsible offeror. As described in FAR
52.215-1, \"Instructions to Offerors - Competitive Acquisition" , which
is incorporated by reference in Section L, award may be made based upon
initial offers, without discussions. The offeror must also be
licensed/certified/accredited as described in Section M.5.2 below.**

** **

M.3.2. [Profit Sharing Credit Plan]{.underline}

 

In the event of equal proposals and in the event that one offeror
presents an acceptable Profit Sharing Credit plan, the offeror proposing
the most generous plan, in terms of benefit to the Government will
receive the award. This profit sharing credit plan will be part of the
resultant contract.

 

M.4. [Fixed Prices]{.underline}.

 

**Offerors must propose fixed prices for the coverage identified in
Section B - SERVICES AND PRICES. Proposals that do not include fixed
prices cannot be evaluated for the total requirement and will be
rejected.**

 

M.5. [Technical Evaluation]{.underline}. Offers will be evaluated on:

 

> **(i)     meeting each of the individual mandatory
> requirements/minimums for health insurance coverage specified in
> Section C through H and the Exhibit(s).**

**The Government may reject, as technically, unacceptable proposals
that:**

** **

(a) **(a)    fail to provide the minimum benefits required by the
    solicitation; or**

** **

(a) **(b)   offer additional benefits not required by the solicitation
    (even though there is no increase in the price).**

(b) **fail to provide the list of clinics that specifies where medical
    services will be provided (see Section L.4.3.1.)**

    ** **

**(ii) the demonstration that the offeror is
licensed/certified/accredited or otherwise authorized by the government
of Ukraine or its agent (e.g., insurance commission, board) to provide
health insurance coverage to persons (to include organizations,
companies, groups) within the host country and,**

** **

**(iii) meet all other terms and conditions set forth in this
solicitation.**

** **

M.6. [52.217-5 EVALUATION OF OPTIONS (JUL 1990)]{.underline}

 

The Government will evaluate offers for award purposes by adding the
total price for all options to the total price for the basic
requirement. Evaluation of options will not obligate the Government to
exercise the option(s).

M.7. [Quantities for Evaluation]{.underline}

 

For the purpose of evaluation, and for no other purpose, evaluation of
prices submitted will be made on the basis that the Government will
order the estimated quantities shown in Section B -- SERVICES AND
PRICES, of this solicitation.

 

M.8. [Separate Charges]{.underline}

 

Separate charges, in any form, are not solicited. For example, proposals
containing any charges for failure of the Government to exercise any
options will be rejected. The Government shall not be obligated to pay
any charges other than the contract price, including any exercised
options.

 

M.9 [Award Without Discussions]{.underline}

** **

**In accordance with FAR provision 52.215-1 (included in Section L of
this RFP), offerors are reminded that the Government may award this
contract based on initial proposals and without holding discussions,
pursuant to FAR 15.610(a).**