> OMB 0990-0115

**PART I - THE SCHEDULE** Request for Proposal No. AHRQ-06-0025

**SECTION A - SOLICITATION FORM** Date Issued: June 5, 2006

Date Questions Due: June 19, 2006

Date Proposals Due: July 11, 2006

Time Due: 12 noon local time

You are invited to submit a proposal to the Agency for Healthcare
Research and Quality (AHRQ) for Request for Proposal (RFP) No.
AHRQ-06-0025, entitled "HIV Research Network." The proposal must be
developed and submitted in accordance with the requirements and
instructions of this RFP.

The Government anticipates awarding this contract on a sole-source basis
to the Johns Hopkins School of Medicine.

A cost reimbursement, service contract is contemplated for a three year
period of performance, with two 1-year options.

For this acquisition, the AHRQ recommended goal (as a percentage of
total planned subcontracting dollars for the base period) is 30% for
Small Businesses, which shall include at least 5% (as a percentage of
total contract value for the base period) for Small Disadvantaged
Businesses, at least 5% (as a percentage of total planned subcontract
dollars for the base period) for Women-Owned Small Businesses, and at
least 3% (as a percentage of total planned subcontract dollars for the
base period) for HUBZone Small Businesses and at least 3% (as a
percentage of total planned subcontract dollars for the base period) for
Veteran-Owned Small Businesses. These goals represent AHRQ's expectation
of the minimum level for subcontracting. The North American Industry
Classification System (NAICS) code that best describes the requirement
is 541990. The small business size standard is \$6.5 million.

Offerors shall submit the following:

A. Technical Proposal (See Section L.7) (Original and 9 copies)

B. Past Performance Information (See Section L.8) (Original and 4
copies)

C. Small Disadvantaged Business Participation Plan (See Section L.9)
(Original)

D. Business Proposal (See Section L.10) (Original and 5 copies)

The Small Business Subcontracting Plan should be submitted as a separate
section of the Business Proposal. (This does not apply to small business
concerns).

**PLEASE NOTE: In addition to the hard copies noted above, one
electronic copy of the proposal needs to be submitted to the Contracting
Officer at sharon.williams@ahrq.hhs.gov**

Your proposal must provide the full name of your company, the address,
including county, Tax Identification Number (TIN), DUN and Bradstreet
No., and if different, the address to which payment should be mailed.
Please note that prospective contractors must be registered in the

Central Contractor Registration database prior to award of contract.
(See FAR 4-11 for further details).

If you intend to submit a proposal in response to this solicitation,
please inform the Contracting Officer of your intent by completing the
Proposal Intent Response Form (Attachment 4 to this solicitation) and
send it to the Contracting Officer no later than June 19, 2006. You may
send it to the address below or fax it to 301-427-1740.

Questions regarding this solicitation shall be received in this office
no later than June 19, 2006 (See Section L.5). It is preferred that all
questions be submitted electronically by e-mail to Sharon Williams,
Contracting Officer at the following email address:
sharon.williams@ahrq.hhs.gov. Otherwise, please address your written
questions to Sharon Williams, Contracting Officer, Agency for Healthcare
Research and Quality, 540 Gaither Road, Rockville, Maryland 20850 and
the envelope should be marked "Proposal Questions RFP No. AHRQ-06-0025."

Answers to questions will be provided in the form of an Amendment to
this solicitation and will be posted on AHRQ's web page:
[www.ahrq.gov](http://www.ahrq.gov/) under "Funding Opportunities,"
"Contracts" and on the Federal Business Opportunities web page:
[www.fedbizopps.gov](http://www.fedbizopps.gov/). It is your
responsibility to monitor the web sites where the RFP will be posted to
learn about any amendments to the solicitation.

**[Discussions with any other individual outside the Division of
Contracts Management, may result in rejection of the potential offeror's
proposal]{.underline}.**

The proposal shall be signed by an authorized official to bind your
organization and must be received in our Contracts Office no later than
**12 noon**, local prevailing time, on **July 11, 2006**. Your proposal
must be mailed to the following address:

Agency for Healthcare Research and Quality

Division of Contracts Management

540 Gaither Road

Rockville, Maryland 20850

Hand carried proposals may be dropped off at the above location.

NOTE: The U.S. Postal Service's "Express Mail" [does not]{.underline}
deliver to our Rockville, Maryland address. Packages delivered via this
service will be held at a local post office for pick-up. [The Government
will not be responsible for picking up any mail at a local post
office]{.underline}.

The RFP does not commit the Government to pay any cost for the
preparation and submission of a proposal. It is also brought to your
attention that the Contracting Officer is the only individual who can
legally commit the Government to the expenditure of public funds in
connection with the proposed acquisition.

Requests for any information concerning this RFP should be referred to
Sharon Williams,

\(301\) 427-1781.

Sincerely,

Sharon Williams

> Contracting Officer, Contracts Management
>
> Agency for Healthcare Research & Quality

**[TABLE OF CONTENTS]{.underline}**

**[PART I]{.underline} [Pages]{.underline}**

Section A Solicitation 1-2

Table of Contents 3

Section B Supplies or Services & Prices/Costs 4-5

Section C Description/Specification/Work Statement 6-18

Section D Packaging and Marking 18

Section E Inspection and Acceptance 18

Section F Deliveries or Performance 19-22

Section G Contract Administration Data 23-25

Section H Special Contract Requirements 26-30

**[PART II]{.underline}**

Section I Contract Clauses 31-35

**[PART III]{.underline}**

Section J List of Attachments 36

**[PART IV]{.underline}**

Section K Representations and Instructions 37-43

Section L Instructions, Conditions & Notices to Offerors 44-59

Section M Evaluation Factors for Award 60-63

**[Attachments]{.underline}**

1\. Past Performance Questionnaire 64-68

2\. SF LLL-A, Disclosure of Lobbying Activities 69-71

3\. Proposal Intent Form 72-73

4\. Small Business Subcontracting Plan 74-81

5\. Sample Breakdown of Proposed Estimated Cost and Labor Hours 82

**[SECTION B-SUPPLIES OR SERVICES AND PRICES/COSTS]{.underline}**

**B.1 BRIEF DESCRIPTION OF SUPPLIES OR SERVICES**

HIV Research Network - See Section C for a complete description.

**B.2. ESTIMATED COST**

a\. The estimated cost for full performance of the work under this
contract, including direct and indirect costs is \$ (TO BE NEGOTIATED)

b.  The total funds currently available for payment and allotted to this
    contract are \$ (TO BE NEGOTIATED).

c\. It is estimated that the amount currently allotted to this contract
will cover performance of the contract through
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

d\. The Contracting Officer may allot additional funds to the contract
without the concurrence of the Contractor. For further provisions on
funding, see the Limitation of Funds and the Allowable Cost and Payment
clauses incorporated into the contract.

c\. The Government's maximum obligation is as follows:

(TO BE NEGOTIATED)

[Base]{.underline}

Period of Performance Estimated Cost

Year 1 \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Year 2 \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Year 3 \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TOTAL \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[Option Period 1 (Year 4)]{.underline}

Period of Performance Estimated Cost

Year 4 \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[Option Period 2 (Year 5)]{.underline}

Period of Performance Estimated Cost

Year 5 \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[Option A -- Expand the Number of Participating Sites to Make the
Project More Representative]{.underline}

Price to be negotiated if option is exercised.

**B.3 PROVISIONS APPLICABLE TO DIRECT COSTS**

a\. Items Unallowable Unless Otherwise Provided Notwithstanding the
clauses, ALLOWABLE COST AND PAYMENT, and FIXED FEE, incorporated into
this contract, unless authorized in writing by the Contracting Officer,
the costs of the following items or activities shall be unallowable as
direct costs:

\(1\) Acquisition, by purchase or lease, of any interest in real
property;

\(2\) Rearrangement or alteration of facilities;

\(3\) Purchase or lease of any item of general purpose-office furniture
or office equipment regardless of dollar value. (General purpose
equipment is defined as any items of personal property which are usable
for purposes other than research, such as office equipment and
furnishings, pocket calculators, etc.);

\(4\) Accountable Government property (defined as both real and personal
property with an acquisition cost of \$1,000 or more, with a life
expectancy of more than two years) and \"sensitive items\" (defined and
listed in the Contractor\'s Guide for Control of Government Property,
1990, regardless of acquisition value;

\(5\) Travel to attend general scientific meetings;

\(6\) Foreign Travel;

\(7\) Any costs incurred prior to the contract\'s effective date;

\(8\) Rental of meeting rooms not otherwise expressly paid for by the
contract;

\(9\) Any formal subcontract arrangements not otherwise expressly
provided for in the contract

> \(10\) Consultant fees in excess of \$1000/day; and

\(11\) Information Technology hardware or software.

> b\. The Contractor, if a non-profit institution, shall invoice and be
> reimbursed for all travel costs in accordance with Section 12 of
> Public Law 100-679.

**[SECTION C/ STATEMENT OF WORK]{.underline}**

**SECTION C**

**DESCRIPTION/SPECIFICATION/WORK STATEMENT**

The contractor shall furnish all the necessary services, qualified
personnel, material, equipment, and facilities to support the HIV
Research Network in accordance with the scope of work.

**A. Background**

During the past decade, major strides have been made in the clinical
treatment of HIV infection. In the mid 1990's, monotherapy with
nucleoside reverse transcriptase inhibitors, such as Zidovudine, was
superseded by therapies involving a combination of medications,
including protease inhibitors (PIs) and non-nucleoside reverse
transcriptase inhibitors (NNRTIs). Such combination therapies were
denoted as Highly Active Antiretroviral Therapy (HAART). In the past ten
years, new therapeutic agents have been introduced; more information has
been gathered regarding potential side effects of HAART regimens, such
as lipodistrophy; and more awareness has been generated regarding the
importance of treating conditions that may be comorbid with HIV
infection, such as hepatitis or diabetes.

These therapeutic advances have, in turn, affected the delivery of
medical and social services to persons with HIV disease. Reports have
described sharp reductions in HIV-related inpatient admission rates,
beginning in 1996 and continuing through 1997. However, in recent years,
declines in inpatient admission rates have leveled, and some data
suggest that inpatient utilization rates may be increasing, especially
due to comorbid conditions. In contrast, outpatient care has assumed a
central role in treating HIV infection. Improvements in clinical status
as a result of the new therapies also may result in reduced demand for
supportive services. On the other hand, the duration of the therapeutic
benefit of combination antiretroviral therapy is unknown. Anecdotal
reports of treatment failures are beginning to accumulate. In addition,
compliance with these therapies is difficult and problematic, leading
some to recommend structured treatment interruptions. ***Thus, the
provision of health services to persons with HIV infection has not yet
reached a stable equilibrium state.*** The continuing development of new
therapeutic regimens and the key role of adherence in promoting
therapeutic efficacy, imply that there remains a need for continued
monitoring of patterns of health services delivery to persons with HIV
disease.

In addition to changes in therapeutic regimens, other factors have
changed the structure of health services delivery to persons with HIV
infection. The epidemiological pattern of HIV incidence continues to
move toward increased representation of racial/ethnic minorities,
persons with a history of substance abuse, women, and disadvantaged
segments of society. Recent data from the HIV Research Network document
the continued existence of racial/ethnic and gender disparities in HIV
care. For example, in 2000 and 2001, women and racial/ethnic minorities
were less likely to report being on a HAART regimen, compared with white
men. Concerns with disparities in health care provision have recently
assumed major importance as a public policy issue, as demonstrated by
the release of annual National Healthcare Disparities Reports by the
Agency for Healthcare Research and Quality. Because HIV disease tends to
strike at the most vulnerable segments of society, continued monitoring
of trends in disparities in HIV care sheds light on the overall
functioning of the health care system, and there is continuing need for
development and implementation of evidence-based strategies for reducing
these disparities.

In addition, issues of medical errors and patient safety are relevant to
the HIV-infected population. The HIV community is an important arena in
which to study safety issues. An HIV treatment panel convened by DHHS
and the Kaiser Family Foundation concluded that, "Antiretroviral
regimens are complex, have major side effects, pose difficulty with
adherence, and carry serious potential consequences from the development
of viral resistance due to non-adherence to the drug regimen or
suboptimal levels of antiretroviral agents". (Anthony Fauci, John
Bartlett, Eric Goosby et al. [Guidelines for the Use of Antiretroviral
Agents on HIV-Infected Adults and Adolescents]{.underline}, Report
developed by the Panel on Clinical Practices for Treatment of HIV
Infection, USDHHS: Washington DC, Jan. 28, 2000.) Patients with HIV
disease have compromised immune systems that leave them with a
diminished capacity to combat infections, untoward consequences of drug
reactions, and harm resulting from medical errors. Furthermore, since
the diffusion of protease inhibitors and three-drug combination therapy
in 1996, problems related to patient compliance and adverse drug
reactions have become a serious concern. It has become increasingly
difficult for even highly motivated patients to comply with drug
regimens that involve a dozen or more drugs and administration of one or
more drugs every few hours (some drugs require refrigeration, some must
be taken by injection, some must be take before meals, and others after
meals).

It also is difficult for physicians who treat persons with HIV disease.
Treatment of HIV disease is complex; new treatments and medications
appear frequently; medications can be extremely toxic; and treatment
guidelines change rapidly. HIV care providers must keep abreast of the
voluminous literature on HIV drug therapy, and there is a constant
danger of adverse reactions from the variety of potent medications taken
by HIV patients. Indeed, information about potential drug interactions,
appropriate medication regimens, and when and how to change drug
regimens is complicated, ever-changing, and extensive. Taken together,
these circumstances increase the likelihood of suboptimal care.
Consequently, there is a need for continuing monitoring of patient
safety issues among patients with HIV disease, in order to assist
patients and providers to avoid errors with potentially serious
consequences.

The rapidity of change in HIV-related treatments and service delivery
means that data collected at the beginning of the HAART era, such as in
the HIV Costs and Service Utilization Study, now do not accurately
represent the current situation. Only by continual monitoring can we
obtain timely estimates of service utilization patterns and changes in
these patterns over time, which provide important policy-relevant
information. For example, estimates of the annual cost of treating a
person with HIV infection need to be revised in light of changes
outlined above, but little current data exist on which to base such
estimates. Moreover, as a result of the spread of managed care plans,
efforts are underway to develop adequate capitation rates for persons
with HIV and appropriate mechanisms for risk-adjustment of capitation
rates. Developing risk adjustment mechanisms also will benefit from the
availability of current data on the utilization and cost of health
services in this population.

***In sum, the rapidity of change requires a mechanism for continual
monitoring AND IMPROVEMENT of HIV service delivery.*** In view of the
rapidity of change in HIV-related treatments and services, policy makers
require the existence of an established, ongoing mechanism to collect
relevant data, conduct relevant analyses of current resource utilization
parameters, and provide current information on access, quality, and
safety of HIV services in a timely manner. Moreover, to address many of
these issues credibly requires access to longitudinal data from
patients, so that their changing disease status can be adequately
controlled in statistical analyses. Finally, providers themselves need
to know what interventions can improve the safety and quality of care.

[The HIV Research Network (HIVRN)]{.underline}

The HIV Research Network (HIVRN) was conceived as a mechanism for
meeting the need for continuing monitoring of health services delivery
to persons with HIV disease. The HIVRN has enjoyed the support of
several federal agencies. In addition to the Agency for Healthcare
Research and Quality, the Substance Abuse and Mental Health Services
Administration (SAMHSA), the Health Resources and Services
Administration (HRSA), the Office of AIDS Research, National Institutes
of Health (OAR/NIH), and office of the Assistant Secretary for Planning
and Evaluation (ASPE) have contributed funds to support this project.

In FY 1999 and 2000, AHRQ and sister agencies provided support to
develop the first phase of the HIV Research Network (HIVRN). In this
phase, over a dozen providers of HIV care were recruited and procedures
for abstraction of data from medical records and delivery to a Data
Coordinating Center were developed. The Data Coordinating Center, which
was located at Johns Hopkins Medical School, received data from members
of the HIVRN. Initial data came from review of records for a six-month
period in 1998. Issues with data availability, quality, and coding were
addressed on a site-by-site basis. This phase was, in essence, a
feasibility study of procedures for organizing data abstraction and
amalgamation across multiple sites.

Subsequently, additional sites were added to the Network, in an effort
to broaden the geographical representation of provider sites. Medical
record data for calendar year 1999 were abstracted at each site and
consolidated at the Data Coordinating Center. Results from analyses of
these data were published in the *Journal of Acquired Immune Deficiency
Syndromes* in May, 2002. ("Hospital and Outpatient Health Services
Utilization among HIV-Infected Patients in Care in 1999." *JAIDS*, 2002;
30: 21-26.) The initial phase of this project thus succeeded in
enrolling a set of HIV care providers in different regions of the U.S.
and in establishing procedures for transferring data on HIV-related
resource utilization and relevant clinical parameters to the
Coordinating Center.

In FY 2001, based on the results of the first phase, a contract was
awarded to Johns Hopkins to continue the activities of the HIVRN. This
contract was extended through FY06, and will terminate on September 30,
2006. The Data Coordinating center resides at Hopkins, which also
provides data on its cohort of HIV patients.

At present, the HIVRN includes 17 HIV care sites that provide data on
their adult patients, and four sites provide data on pediatric patients
to the Data Coordinating Center. Participating sites extract specific
data elements from medical records in a predetermined format and submit
these data electronically to the Data Coordinating Center.

[Medical Record Data.]{.underline} Data elements abstracted from patient
records include the following:

• Demographic characteristics: Gender, age, race/ethnicity, HIV
transmission route;

• Clinical data: dates and results of CD4 tests, dates and results of
viral load tests, AIDS-defining illnesses;

• Therapeutic data: All ART prescribed during study period (drug name,
dose, start and stop dates), PCP prophylaxis, MAC prophylaxis;

• Inpatient resource utilization data: admission and discharge dates,
primary and secondary diagnoses, charges, primary and secondary
insurance;

• Outpatient resource utilization: Dates of each visit, CPT code,
charges, insurance.

• For a subset of sites, pharmacy dispensing data are available.

Patient record data have been provided for calendar years 2000 through
2004, and data for 2005 are in the process of being collected. These
annual data have been assembled into a longitudinal database, in which
data for individual patients are linked across multiple years.

[Interviews with Patients]{.underline}. In addition to medical record
data, in-person interviews were conducted with a sample of 790 adult HIV
patients treated by HIVRN providers in 2003. Topics covered in the
interview included:

• Adherence to antiretroviral regimen;

• Mental health and substance abuse co-morbidities and treatments;

• Potentially adverse medication events;

• Receipt of case management and other supportive services;

• Use of services, including services from providers outside the HIV
Research Network;

• Insurance coverage;

• HIV-related symptoms and general health-related quality of life.

In addition, interviews were conducted with a sample of pediatric
patients. The primary caretaker of the pediatric patient was also
interviewed, unless the patient was an emancipated adolescent. Data from
both adult and pediatric interviews have been merged with data from
medical records.

[Patient-Provider Communication.]{.underline} The existence of
persistent disparities in care for members of minority groups is a cause
for concern. Difficulties in communication between providers and
patients, who may belong to different cultural groups, are one factor
that might give rise to or exacerbate disparities in care. Supported by
funding from the Minority AIDS Initiative, four HIVRN sites, including
Johns Hopkins, have recently begun to design and implement a sub-study
to assess the nature of relationships between patients and providers, to
observe patient-provider communication, and to ascertain the extent to
which disparities in care are associated with problematic aspects of
patient-provider relationships. This sub-study will involve interviewing
a sample of patients in the four sites, as well as audiotaping selected
interactions between patients and providers. This sub-study was
initiated in FY06 and, subject to the availability of funds, is expected
to continue for two additional years.

**B. Purpose**

**The purpose of this project is to gather and analyze timely and
relevant data on the utilization and cost of health care services, and
to implement strategies to improve the quality of care delivered to all
persons with HIV disease.** As noted above, it is important to continue
monitoring the provision of health services to patients with HIV
infection because quickly occurring therapeutic advances, the shifting
epidemiology of HIV infection, and the rapid diffusion of managed care
are having a major effect on patterns of health care resource
utilization for HIV disease. The swiftness of change in HIV service
delivery suggests that an established mechanism for routinely collecting
high quality data is important for policy planning purposes. The purpose
of this project is to continue to maintain a mechanism for collecting
and analyzing timely data on HIV health services, relying on the
existing HIVRN sites.

The mechanism to be developed to address these information NEEDS is a
multisite HIV provider network, which is linked by a centralized data
coordinating center. It is imperative that data be obtained from a
relatively large number of HIV care providers, in different regions of
the United States. Because clinical and utilization practices can vary
from site to site, it is necessary to have multiple sites in order to
control for possible site-specific effects in analyses. In addition,
because HIV service parameters, such as average inpatient lengths of
stay, are known to vary by region, it is important to have
representation of providers from each of the four major Census regions
of the U.S. Moreover, generalization of findings will be enhanced to the
degree that the set of participating providers is itself heterogeneous,
varying in terms of such characteristics as public-private status,
affiliation with a university, size of HIV patient caseload, and
demographic characteristics of HIV-infected patients. Access to a
network of HIV care providers, each of whom can provide data on a large
number of patients, is thus a fundamental and significant aspect of this
project. The existing HIVRN is, to our knowledge, the only entity that
can fulfill these criteria.

Each participating data provision site will abstract information from
medical records of patients receiving care for HIV infection at that
site. Data will be abstracted on an annual basis, at a minimum, and
submitted to a Data Coordinating Center by July of the following year.
To maintain continuity with data gathered under the current HIVRN
contract, sites will continue to provide data on **all** data elements
currently collected by the HIVRN:

• demographic characteristics, including insurance coverage;

• clinical information, including results of CD4 and viral load tests
and diagnoses of comorbidities; • inpatient admissions, including length
of stay and discharge diagnoses;

• outpatient visits;

• ER episodes, including whether the ER visit resulted in an inpatient
admission;

• detailed information on antiretroviral medications prescribed,
including start and stop dates;

• and information on mental illness and substance abuse, including
diagnoses and receipt of mental health or substance abuse treatment.

The Data Center serves as the hub of the network and will have the
capability to receive, edit, format, analyze, and disseminate timely
information. The Center receives data in electronic format from each
participating site (and may provide data on its own patients, if
applicable); assembles the data into a uniform, comprehensive data set;
and produces statistical analyses of the data in response to inquiries
from appropriate parties. The Data Coordinating Center must have the
capability to consolidate, analyze, and disseminate information about
the care provided to persons with HIV disease. Data transferred to the
data center must not include patient names or other directly identifying
information (e.g., social security number, patient record number,
insurance policy number). The Data Center contractor will take all
necessary steps to ensure the confidentiality of the data and, upon
request, will provided copies of the de-identified database to staff at
AHRQ. Transfer of data back to provider sites will occur, consistent
with preservation of confidentiality. It is anticipated that analyses
will be conducted both by the contractor and by AHRQ staff; each will
inform the other routinely of analytic activities, decisions, and
results. Representatives of other agencies providing funding support, as
well as researchers at participating sites, will also have access to the
data set.

The guiding vision for this project is one of establishing an ongoing
process of data collection from a heterogeneous array of providers and
patients. The data will be assembled and analyzed rapidly, and the
process will be sufficiently flexible to modify data collection to focus
on emerging issues of concern. In this way, the results of analyses will
be maximally relevant and useful to policy-makers dealing with HIV
health service delivery. Thus, the overarching goal of the project is to
provide timely information by engaging in ongoing data receipt and
analysis from multiple provider sites across the country. Ultimately,
data from this project will provide information from a large number of
HIV providers and will constitute an essential planning and assessment
resource for health care financing systems, government agencies, and
local communities.

Understanding changes in patterns of care is facilitated by having
longitudinal data at the patient level. By examining longitudinal
trends, one can begin to distinguish within-person changes from
aggregate changes in the composition of patients. For example, it may
prove useful to distinguish those patients whose nadir CD4 has never
fallen below 500 from those who had CD4 cell counts low enough to begin
HAART and who have since rebounded to above 500. Longitudinal
information on individual patients' CD4 trajectories is essential to
make such distinctions. At present, the HIVRN has data on over 13,000
patients for a five-year period; longitudinal data for additional
patients is available for shorter periods.

The goals of this current project for the next three years are:

> \(1\) To collect data from a large number of heterogeneous,
> geographically dispersed HIV providers for calendar years 2006, 2007,
> and 2008;
>
> \(2\) To address issues of the prevalence of medical errors in
> treating patients with HIV infection and mechanisms for reporting such
> errors;
>
> \(3\) To test, implement, and spread interventions and process changes
> designed to improve safety and quality.
>
> \(4\) To continue to collect and analyze data relevant to issues of
> patient-provider communication, patient-provider relationships, and
> their association with racial/ethnic and gender disparities.

**C. Scope of Work**

1\. Unless otherwise specified by AHRQ, project work is to be carried
out in a series of tasks over a total project period not to exceed 36
months (with two 1-year options).

2.  The following tasks specify the scope of work for this project for
    the first 12-month performance period.

**[TASKS FOR FIRST PROJECT YEAR]{.underline}**

**TASK I: Collect medical record data from existing HIVRN care provider
sites across the U.S. for CY 2006.**

1**.** The contractor will assemble and clean medical record data from
calendar year 2006, putting them into a uniform format. The contractor
will clean the data, and questions regarding data anomalies or missing
data elements will be discussed with each specific provider site and
resolved. Data on adult HIV patients must be obtained from current HIVRN
sites providing clinical care to patients with HIV infection. If a
current HIVRN site is disenrolled from the project, this decision must
be considered in conjunction with project officers from federal Funding
agencies. In this context, a "site" refers to an independent
organizational entity, such as an outpatient practice or medical center;
different clinical locations within one organization, such as different
clinics under the same administrative structure, do not constitute
separate sites. At least one site must be located in each of the four
major Census regions of the U.S. Variables extracted from medical
records must be the same as those provided by the majority of HIVRN
sites for 2005.

> **Deliverable 1** is the medical records database for 2006 sent to
> AHRQ as a SAS or Stata file.
>
> 2\. The contractor will develop, for each site, a report that lists
> each variable in the database and describes issues of data quality
> regarding that variable (e.g., unavailability of the data element,
> extent of missing data, codes difficult to place in uniform format).
> The report will also identify problems leading to excessively delayed
> data delivery.
>
> **Deliverable 2** is a report that (a) summarizes data quality for
> each variable at each provider site, (b) identifies barriers to timely
> data submission at each site, and (c) identifies strategies for
> improving data quality and accelerating data delivery at each site.

3\. The contractor will link data for 2006 with medical record data from
calendar years 2000-2005. The data will be structured as a longitudinal
file at the patient level. Thus, the contractor must have access to
earlier patient-level medical record data for the same variables as in
2006, for the same patients from prior years.

**Deliverable 3** is a longitudinal database for the years 2000-2006.

4\. **Deliverable 4** is documentation for Deliverables 1 and 3. The
documentation will provide information on coding of each data element.
The documentation will also identify specific variables from specific
sites that contractor's staff regard as having problematic data quality.

5\. The contractor will prepare a report that examines aggregate trends
in service utilization from 2000 through 2006 (e.g., inpatient
admissions and lengths of stay, outpatient visits, receipt of HAART).
The report will compare such trends across sociodemographic groups. The
report will also analyze changes in receipt of antiretroviral
medications at the individual level, assessing factors associated with
changing medication regimens.

> **Deliverable 5** is a copy of this report, and a manuscript derived
> from this report that shall be submitted to a peer-reviewed journal..
> In addition, the contractor shall utilize information obtained from
> the report to create live and audio presentations for various target
> audiences. These presentations should include slides as well as
> customized products such as models, workbooks, and how-to guides.

**TASK II: Statistical Analyses, Report Preparation, and Special Data
Runs**

The contractor will, in conjunction with Federal staff, develop analysis
plans for data received from network providers, conduct statistical
analyses, and prepare reports summarizing results of these analyses.
Priorities for analyses and reports will be established in conjunction
with Federal staff. The contractor shall meet with staff from AHRQ and
from co-funding agencies and will consult with the technical advisory
group to develop a set of five priority research questions. The
contractor will conduct all specific statistical analyses specified by
Federal staff. Priority analyses will address policy-relevant questions
identified in expert meetings such as estimating the net costs of
expanding Medicaid to include early-stage HIV patients, and will address
patient safety issues.

The contractor shall monitor the different analyses conducted using data
provided by network sites, in order to prevent duplication and to ensure
consistency among analyses. The contractor shall provide programming
assistance when asked by members of the network who are involved in
analyzing these data. To meet the requirements of this task,
contractor's staff must include persons with statistical programming
expertise, as well as persons with substantive clinical expertise in the
provision of care to persons with HIV disease.

In addition, the contractor shall conduct special data runs as requested
by the Project Officer. These requests may originate from officials at
AHRQ, the Department, and from other co-funding agencies. However, they
will all be communicated to the contractor through the Project Officer.
The contractor shall conduct these runs in a timely fashion and transmit
these analyses to the Project Officer shortly thereafter.

A report summarizing analyses conducted during the year and their
implications for HIV policy is:

> **Deliverable 6.** This deliverable shall consist of drafts of
> manuscripts, accompanied by an executive summary as well as materials
> (e.g., slides and, web-based tools) that may be used in oral
> presentations.

**TASK III: Establish Technical Advisory Group**

The contractor shall establish a Technical Advisory Group (TAG). The
role of this group will be to provide broad direction to the project and
to ensure that high priority policy-relevant and operationally-useful
research questions are addressed, and to provide advice on ways to use
the data for improving care both inside and outside of the network. The
TAG will include experts in HIV clinical care, patient safety, financing
of care, process improvement, and access to care for vulnerable
populations. TAG members will be selected by the contractor based on
recommendations provided by staff from AHRQ and from co-funders.
Attempts should be made to include representatives from the Department
of Veterans Affairs, State Medicaid agencies, advocacy organizations,
research organizations, and HIV provider sites.

The contractor shall communicate on a regular bases with TAG members,
through at least one in-person meeting and one phone meeting a year

**Deliverable 7** is a report that summarizes the issues raised by TAG
members and outlines possible steps to be taken in response to these
issues.

**TASK IV: Conduct Quarterly Conference Call with Provider Sites**

The contractor will convene a conference call among the provider sites
and project officer (as well as other funders) on a quarterly basis in
order to discuss data collection progress, explore potential research
and dissemination opportunities using the data, discuss early lessons
emerging from the data, identify and discuss potential process
improvements suggested by the data, discuss results from past process
improvements, and discuss other topics raised by the sites, the
contractor, or the funders. During these calls, the contractor will
familiarize network participants with progress that has been made during
the prior three months, afford each of the network an opportunity to
voice their opinions, concerns and wishes regarding the manner in which
the data collection and analysis effort is being conducted, and explore
ways to improve data turn-around time and quality. These meetings will
be designed to help network members develop collaborative relationships
with other members, conduct research projects using the data, and make
process improvements.

**TASK V: Develop Patient Safety Research Agenda**

Motivated by a report from the Institute of Medicine, the issue of
monitoring and reducing medical errors has gained considerable
attention. One focus of the HIVRN is to provide data that could
potentially inform efforts to improve the safety of patients with HIV
infection.

A core component of the project during the first year will be to
continue examination of patient safety issues in HIV care. In
conjunction with investigators at each participating site, priority
HIV-related patient safety research issues will be developed. Steps to
operationalize patient safety indicators and to collect data on these
indicators will be formulated. The contractor will conduct analyses of
Project data to examine these indicators and will circulate the results,
without identifying specific sites, to participating sites. These
analyses will also include information on the nature and frequency of
the specific antiretroviral drug combinations that patients are
receiving. The contractor, in conjunction with Federal staff, will work
with participating sites to distribute information among the sites
concerning procedures implemented by the sites to reduce the chances of
events that might threaten patient safety.

*In particular, issues of medical errors and patient safety related to
antiretroviral therapy are especially relevant to the HIV-infected
population. Treatment of HIV disease is complex and new treatments and
medications appear frequently. Because many of these medications can be
extremely toxic there is a high likelihood that patients will experience
serious consequences as a result of suboptimal care and inappropriate
drug therapy. For these reasons, the contractor shall focus attention on
medication errors among persons with HIV disease*.

> **Deliverable 8** is a report that summarizes the development of
> patient safety indicators and reports results of analyses of these
> indicators. Moreover, the contractor shall propose specific quality
> indicators for HIV care and detail steps involved in the collection of
> data about these indicators. The contractor shall also prioritize
> these indicators on the basis of the potential of successfully
> implementing a plan to improve these indicators and on the basis of
> the potential for improving the health of HIV-infected individuals
> related to the improvement of specific patient safety indicators.

**TASK VI: Initiate Quality Improvement Activities**

Quality improvement activities are an essential part of the everyday
operation of most HIV provider sites. Through these activities HIV care
providers promote an atmosphere in which all members of the care team
ultimately deliver better care to our patients. These activities should
result from the identification and measurement of specific patient
quality indicators*.*

The contractor shall identify opportunities for quality improvement
across sites and discuss possible initiatives with the HIVRN provider
sites. The contractor may utilize the HIVRN intranet to help identify
and track efforts by network providers to improve quality and to
identify potential measures that may be used to document quality
improvement efforts.

Through interactions among provider at HIVRN care sites the contractor
shall identify measures of safety and examine promising methods by which
these measures may be improved through a quality improvement initiative.
The measures of safety and the potential methods of improving quality
across HIVRN shall be discussed among HIVRN provider site
representatives during the regular HIVRN conference calls and/or at
special HIV-related conferences and meetings.

> **Deliverable 9** The contractor shall report efforts relating to the
> identification of quality improvement activities designed to improve
> specific measures of patient safety. The contractor shall also present
> a plan to improve site performance on these indicators over the
> following year. As part of this effort, the contractor shall identify
> at least one patient safety indicator related to the appropriate
> management of antiretroviral therapy and specify a plan to measure and
> to improve site performance related to this measure over the following
> year.

**TASK VII: Develop Provider Site Sampling Frame**

An Expert Meeting conducted on March 3, 2000 in Washington DC to advise
AHRQ on how best to proceed with this project emphasized that the
credibility of data to represent national trends in HIV resource
utilization depends on the breadth and heterogeneity of sites providing
data and access to patients. At present, participating provider sites
have tended to have academic affiliations and to be concentrated in the
Northeast. A broader representation of providers and a clear sense of
the types of provider sites to be included in the project (and excluded
from the project) will enhance the generalizeability of findings from
the project. The focus of this project will remain on care provider
sites that treat at least 25 HIV-infected patients.

As part of a deliverable for the prior HIVRN contract (Deliverable 8), a
report describing a possible frame for expanding the range of providers
participating in the project was developed. As several years have
passed, it is important to update this report, with the goal of being
prepared to systematically include in the project a heterogeneous array
of provider sites located in different geographic regions. A strict
probability sample of provider sites will not be undertaken.

1\. In conjunction with the Project Officer and other relevant Federal
staff, the contractor will review and revise a conceptual typology of
HIV treatment provider sites (e.g., outpatient clinic at an academic
medical center, free-standing outpatient clinic, private practice) based
on characteristics such as for-profit status, academic affiliation,
participation in managed care network, etc. This typology will be based,
in part, on a review of relevant literature that deals with
relationships between provider characteristics, profiles of typical
patients (in terms of demographics, disease stage, and insurance), and
treatment utilization patterns.

2.  Based on the metropolitan areas that are currently receiving Title I
    funds from the Ryan White CARE Act, lists of providers of
    HIV-related medical care will be reviewed and revised. These lists
    can be developed based on HRSA Ryan White contracting information,
    as well as through contacts with local informants. Within each
    Census region, provider sites will be stratified based on the
    typology.

> **Deliverable 10** is a report describing the provider frame and the
> procedures used to develop this frame.

**TASK VIII: Analyze Patient-Provider Communication Data**

As noted above, four sites in the current HIVRN project are engaged in a
sub-study to examine patient-provider communication, patient-provider
relationships, and their relationship to observed gender and
racial/ethnic disparities in HIV care. During FY06, these sites will be
collecting relevant data, in the form of interviews with selected
patients and audiotapes of discussions between these patients and their
main care providers. The contractor will collaborate with these sites to
analyze both the audiotape and the interview data. The contractor will
provide logistical, administrative, and analytic support to these four
sites.

> **Deliverable 11** is a report that outlines major results of analyses
> of audiotape and interview data, and describes potential interventions
> that could be implemented, based on these results.

**[TASKS FOR SECOND PROJECT YEAR]{.underline}**

The second project year will essentially continue data collection and
quality improvement activities conducted in the first year.

**TASK IX: Continue Records-Based Data Collection from Previously
Enrolled Providers**

Data collection from enrolled providers will continue, incorporating
data from 2007. Sites will provide data for calendar year 2007 for those
variables for which data was already provided in prior years. These data
should be linkable to prior years= data for individual patients. The
contractor will clean 2007 data, putting them into a uniform format.
Questions regarding data anomalies or missing data elements will be
discussed with each specific provider site and resolved. The contractor
will combine data from multiple provider sites into a common database,
and develop a longitudinal file for patient-level information. Data for
calendar year 2007 will be linked with data from 2000-2006. In
conjunction with Federal staff, the contractor will analyze the
resulting data and prepare reports.

> **Deliverable 12** the cleaned longitudinal database, with
> patient-level records linked across years, in SAS or Stata format for
> calendar years 2000-2007.
>
> **Deliverable 13** is documentation for this database.

**TASK X: Data Analysis and Report Preparation**

The contractor will, in conjunction with Federal staff, develop analyses
plans for data received by the contractor, will conduct statistical
analyses of data, and will prepare reports summarizing results of these
analyses. Priorities for analyses and reports will be established in
conjunction with Federal staff, taking into account information provided
at expert meetings. Priority analyses will address policy-relevant
questions, such as estimating the net costs of expanding Medicaid to
include early-stage HIV patients, and will address patient safety
issues.

> A report summarizing analyses conducted during the year and their
> implications for HIV policy is **Deliverable 14.**

**Task XI: Conduct Quality Improvement Activities.**

The contractor shall continue to identify opportunities for quality
improvement across sites and continue to discuss possible initiatives
with the HIVRN provider sites. The contractor shall identify measures of
safety and examine promising methods by which these measures may be
improved through a quality improvement initiative. The measures of
safety and the potential methods of improving quality across HIVRN shall
be discussed among HIVRN provider site representatives during the
regular HIVRN conference calls and/or at special HIV-related conferences
and meetings.

> **Deliverable 15** is developing and implementing a strategy to
> disseminate findings related to the quality improvement activities in
> order to broaden their impact to provider sites outside of the HIVRN.
> This strategy may include presentations at conferences, meetings, and
> conventions as well as through publications in professional journals.
> Moreover, the contractor shall produce a report that identifies the
> interventions taken to improve site performance on specific quality
> indicators that were identified pursuant to activities undertaken
> during the first year. This report should spell out factors that
> sustained the successful implementation of these interventions and
> identify which of these interventions is best suited to be exported to
> sites outside of the HIVRN.

**[TASKS FOR THIRD PROJECT YEAR]{.underline}**

The third project year will essentially continue data collection and
quality improvement activities conducted in the first year.

**TASK XII: Continue Records-Based Data Collection from Previously
Enrolled Providers**

Data collection from enrolled providers will continue, incorporating
data from 2008. Sites will provide data for calendar year 2008 for those
variables for which data was already provided in prior years. These data
should be linkable to prior years= data for individual patients. The
contractor will clean 2008 data, putting them into a uniform format.
Questions regarding data anomalies or missing data elements will be
discussed with each specific provider site and resolved. The contractor
will combine data from multiple provider sites into a common database,
and develop a longitudinal file for patient-level information. Data for
calendar year 2008 will be linked with data from 2000-2007. In
conjunction with Federal staff, the contractor will analyze the
resulting data and prepare reports.

> **Deliverable 16** the cleaned longitudinal database, with
> patient-level records linked across years, in SAS or Stata format for
> calendar years 2000-2008.
>
> **Deliverable 17** is documentation for this database.

**TASK XIII: Data Analysis and Report Preparation**

The contractor will, in conjunction with Federal staff, develop analyses
plans for data received by the contractor, will conduct statistical
analyses of data, and will prepare reports summarizing results of these
analyses. Priorities for analyses and reports will be established in
conjunction with Federal staff, taking into account information provided
at expert meetings. Priority analyses will address policy-relevant
questions, such as estimating the net costs of expanding Medicaid to
include early-stage HIV patients, and will address patient safety
issues.

A report summarizing analyses conducted during the year and their
implications for HIV policy is **Deliverable 18.**

**Task XIV: Conduct Quality Improvement Activities.**

The contractor shall continue to identify opportunities for quality
improvement across sites and continue to discuss possible initiatives
with the HIVRN provider sites.

> **Deliverable 19** is a document that elucidates and evaluates
> activities undertaken to help spread findings related to the
> implementation of processes, procedures, and protocols developed by
> the HIVRN to improve the quality of care received by persons with HIV
> disease. This endeavor will detail efforts that have been taken to
> disseminate quality improvement practices and shall present data on
> the uptake of these practices by sites outside of the network. This
> report should enumerate features that led to the successful
> dissemination of specific quality improvement practices.

**[Options]{.underline}**

The following options may be considered, depending on the future
availability of funds, but are not included in the scope of work for
this solicitation:

[**Option Period 1** **- Year 4**]{.underline}

The contractor shall continue with the tasks to be performed under the
third year of this contract as stated in the Statement of Work. Data
from calendar year 2009 will be collected from medical records at
participating sites, in a manner consistent with earlier years. These
data will be linked with data from earlier years in a longitudinal
database and work on quality improvement within and outside the network
will continue.

**[Option Period 2 - Year 5]{.underline}**

The contractor shall continue with the tasks to be performed under the
fourth year of this contract as stated in the Statement of Work. Data
from calendar year 2010 will be collected from medical records at
participating sites, in a manner consistent with earlier years. These
data will be linked with data from earlier years in a longitudinal
database and work on quality improvement within and outside the network
will continue.

**[Option A -- Expand the Number of Participating Sites to Make the
Project More Representative]{.underline}**

The contractor shall enroll additional sites, with the goal of making
findings from the project more nationally representative. Providers will
be considered for participation based, first, on the extent and quality
of their medical record data. Additional criteria include: the facility
with which data can be extracted from medical records in electronic
format; the size of the HIV patient caseload; geographical location;
whether the provider is affiliated with a school of medicine or is
community-based.

**[SECTION D - PACKAGING AND MARKING]{.underline}**

Not Applicable

**[SECTION E - INSPECTION AND ACCEPTANCE]{.underline}**

**E.1 INSPECTION AND ACCEPTANCE**

a\. The contracting officer or the duly authorized representative will
perform inspection and acceptance of materials and services to be
provided.

b\. For the purpose of this SECTION the Government Project Officer is
the authorized technical representative of the contracting officer.

c\. Inspection and acceptance will be performed at:

Agency for Healthcare Research and Quality

540 Gaither Road

Rockville, Maryland 20850

**E.2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)**

> This contract incorporates the following clause 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: www.arnet.gov/far

**FAR Clause No. Title and Date**

52.246-5 Inspection of Services-Cost Reimbursement (April 1984)

> **SECTION F - PERIOD OF PERFORMANCE AND DELIVERY SCHEDULE**

**F.1 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)**

> This contract incorporates the following clause 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: www.arnet.gov/far

**FEDERAL ACQUISITION REGULATION (FAR) (48 CFR CHAPTER 1) CLAUSES**

**FAR Clause No. Title and Date**

52.242-15 Stop Work Order (AUG 1989)

Alternate I (APRIL 1984)

**F.2 PERIOD OF PERFORMANCE**

> a\. The period of performance under this contract shall be for a Base
> Period of three (3) years with two 1-year Options. The base period
> shall begin on September 30, 2006 and end on September 29, 2009.
>
> b\. If the Government exercises its option(s) below, the period of
> performance will be extended as follows:

[Option Period]{.underline} [Period of Performance]{.underline}

> 1 9/30/09 -- 9/29/10
>
> 2 9/30/10 - 9/29/11

**F.3 REPORTING REQUIREMENTS AND DELIVERABLES**

The Contractor shall submit monthly financial and progress reports to
the Project Officer and to the Contracting Officer.

The items specified for delivery below are subject to the review and
approval of the Project Officer before final acceptance. The Contractor
shall be required to make revisions deemed necessary by the Project
Officer.

The Contractor shall submit the following products to the Project
Officer in the quantities and within the time frame indicated:

**Schedule of Deliverables**

1\. Deliverable 1: Medical records database for 2006 sent to AHRQ as a
SAS or Stata file.

Quantity: 1

Delivery: Eleven months from effective date of contract (EDOC).

2\. Deliverable 2: A report that describes problems or impediments to
rapid data transfer and data quality for each variable on a site-by-site
basis.

Quantity: 5

Delivery: Eleven months from EDOC.

3\. Deliverable 3: Longitudinal database, in SAS or Stata format,
containing medical record data from CY 2003 through CY 2006 from each
participating site in uniform format.

Quantity: 1

Delivery: Eleven months from EDOC.

4\. Deliverable 4: Documentation for databases in Deliverables 1 and 3

Quantity: 5

Delivery: Eleven months from EDOC.

5\. Deliverable 5: Report of trends in service utilization, 2000-2006.

Quantity: 5

Delivery: Eleven months from EDOC

6\. Deliverable 6: Report of data analyses, findings, and policy
implications, based on calendar year 2006 data.

Quantity: 5

Delivery: Eleven months from EDOC.

7 Deliverable 7: Report that summarizes issues raised by TAG members and
outlines steps to be taken in response to these issues.

Quantity: 5

Delivery: Nine months from EDOC.

8\. Deliverable 8: Report that summarizes the development of patient
safety indicators.

Quantity: 5

Delivery: Nine months from EDOC.

9\. Deliverable 9: Report that outlines efforts relating to the
identification of quality improvement activities.

Quantity: 5

Delivery: Eleven months from EDOC.

10\. Deliverable 10: Report that describes the provider frame and
procedures used to develop revised list of providers of HIV-related
medical care and services.

Quantity: 1

Delivery: Eleven months from EDOC.

11\. Deliverable 11: Report that outlines major results of analyses of
audiotape and interview data.

Quantity: 5

Delivery: Eleven months from EDOC.

12\. Deliverable 12: The cleaned longitudinal database with patient
records from 2000-2007 in SAS format.

Quantity: 5

Delivery: Twenty-three months from EDOC.

13\. Deliverable 13: Documentation for database in Deliverable 12.

Quantity: 1

Delivery: Twenty-three months from EDOC.

14\. Deliverable 14: Report summarizing analyses conducted during year
and implication for HIV policy.

Quantity: 5

Delivery: Twenty-three months from EDOC.

15\. Deliverable 15: Material describing methods of implementing a
strategy to disseminate quality improvement processes.

Delivery: Twenty-three months from EDOC

16\. Deliverable 16: Cleaned longitudinal database with patient records
linked across 2000-2008.

Delivery : Thirty-five months from EDOC

17\. Deliverable 17: Documentation for Deliverable 16.

Quantity: 1

Delivery: Thirty-five months from EDOC

18\. Deliverable 18: Report of data analyses, findings, and policy
implications, based on calendar year 2008 data.

Quantity: 5

Delivery: Forty-months from EDOC

19\. Deliverable 19: Reports that details activities undertaken to help
spread quality improvement practices to outside the network.

Quantity: 5

Delivery: Forty-months from EDOC

20\. Deliverable 20: Final report

Quantity: 6 (including one copy for Contracting Officer)

Delivery: 35 months from EDOC.

21\. Subcontracting Report for Individual Contracts (SF 294)

Quantity: 1 -- Electronically through e-SRS

Delivery: Annually, April 30 and October 30

22\. Summary Subcontractor Report (SF 295)

Quantity: 1 -- Electronically through e-SRS

Delivery: Annually -- October 30

23\. Small Disadvantaged Business Participation Report (OF 312)

Quantity: 1 copy

Delivery: Upon contract completion (to Contracting Officer only)

**EDOC - Effective Date of Contract**

**CO - Contracting Officer**

> The above items shall be addressed and submitted to the Government
> Project Officer. In addition, one copy of the monthly and final report
> and the Subcontracting and Small Disadvantaged Business Reports shall
> be submitted to the Contracting Officer at the following address:

Agency for Healthcare Research and Quality

ATTN: Contracting Officer

Division of Contracts Management

540 Gaither Road

Rockville, Maryland 20850

**SECTION G - CONTRACT ADMINISTRATION DATA**

**G.1 KEY PERSONNEL**

> Pursuant to the Key Personnel clause incorporated in Section I of this
> contract, the following individual(s) is/are considered to be
> essential to the work being performed hereunder:

[NAME]{.underline} [TITLE]{.underline}

**(TO BE COMPLETED AT TIME OF CONTRACT AWARD)**

> The clause cited above contains a requirement for review and approval
> by the Contracting Officer of written requests for a change of Key
> Personnel reasonably in advance of diverting any of these individuals
> from this contract. Receipt of written requests at least 30 days prior
> to a proposed change is considered reasonable.

**G.2 PROJECT OFFICER**

> The following Project Officer(s) will represent the Government for the
> purpose of this contract:

**(TO BE COMPLETED AT TIME OF CONTRACT AWARD)**

> The project officer is/are responsible for: (1) monitoring the
> contractor\'s technical progress, including the surveillance and
> assessment of performance and recommending to the contracting officer
> changes in requirements; (2) interpreting the statement of work and
> any other technical performance requirements; (3) performing technical
> evaluation as required; (4) performing technical inspections and
> acceptances required by this contract; and (5) assisting in the
> resolution of technical problems encountered during performance.
>
> The contracting officer is the only person with authority to act as an
> agent of the Government under this contract. Only the contracting
> officer has authority to: (1) direct or negotiate any changes in the
> statement of work; (2) modify or extend the period of performance; (3)
> change the delivery schedule; (4) authorize reimbursement to the
> contractor of any costs incurred during the performance of this
> contract; or (5) otherwise change any terms and conditions of this
> contract.
>
> The Government may unilaterally change its Project Officer
> designation.

**G.3 INVOICE SUBMISSION**

a\. INVOICE SUBMISSION

> Billing Instructions are attached and made part of this contract.
> Instructions and the following directions for the submission of
> invoices must be followed to meet the requirements of a \"proper\"
> payment request pursuant to FAR 32.9, and must be in accordance with
> the General Provisions clause 52.232-25 Prompt Payment (OCT 2003).

Invoices/financing requests shall be submitted in an original and three
copies to:

Contracting Officer

Agency for Healthcare Research and Quality

Division of Contracts Management

540 Gaither Road

Rockville, Maryland 20850

**G.4 INFORMATION ON VOUCHERS**

\(1\) The Contractor agrees to include the following minimum information
on vouchers:

\(a\) Contractor's name and invoice date;

\(b\) Contract Number;

\(c\) Description and price of services actually rendered;

\(d\) Other substantiating documentation or information as required by
the contract;

\(e\) Name (where practicable), title, phone number, and complete
mailing address or responsible official to whom payment is to be sent;
and

\(f\) The Internal Revenue Service Taxpayer Identification Number.

\(2\) The Contractor shall furnish the following [minimum]{.underline}
information in support of costs submitted:

\(a\) [Direct Labor]{.underline} - include all persons, listing the
person's name, title, number of hours or days worked, labor rate, the
total cost per person and a total amount of this category;

\(b\) [Fringe Costs]{.underline} - show rate, base and total amount as
well as verification/allowability or rate changes (when applicable);

\(c\) [Overhead or Indirect Costs]{.underline} - show rate, base and
total amount as well as verification/allowability or rate changes (when
applicable);

\(d\) [Consultants]{.underline} - include the name, number of days or
hours worked, a total amount per consultant and a total amount for this
category;

\(e\) [Travel]{.underline} - include for each airplane or train trip
taken the name of the traveler, date of travel, destination, the
transportation costs including ground transportation, shown separately,
and per diem costs. Other travel costs shall also be listed. A total
amount for this category shall be provided;

\(f\) [Subcontractors]{.underline} - include for each subcontractor, the
same data that is being provided for the prime contractor. A total
number for this category shall be provided.

\(g\) [Data Processing]{.underline} - include all non-labor costs, i.e.,
computer time, equipment purchase, lease or rental, data tapes, etc. A
total amount for this category shall be provided.

\(h\) [Other]{.underline} - include a listing of all other direct
charges to the contract, i.e., office supplies, telephone, equipment
rental, duplication, etc.

\(i\) [Equipment Cost]{.underline} - itemize and identify separately
from material costs including reference to approval in all cases;

\(j\) [G&A]{.underline} - show rate, base and total as well as
verification/allowability of rate changes (when applicable); and

\(k\) [Fee]{.underline} - show rate, base and total.

\(3\) Payment shall be made by:

PSC Finance

Parklawn Building, Room 16-23

5600 Fishers Lane

Rockville, Maryland 20857

Telephone Number (301) 443-6766

**G.5 INDIRECT COST RATES**

> In accordance with Federal Acquisition Regulation (FAR) (48 CFR
> Chapter 1) Clause 52.216-7(d)(2), [Allowable Cost and
> Payment]{.underline}, incorporated by reference in this contract, in
> Part II, Section I, the primary contact point responsible for
> negotiating provisional and/or final indirect cost rates is the
> cognizant contracting official as set forth in FAR Subpart 42.7 -
> Indirect Cost Rates.
>
> Reimbursement will be limited to the rates and time periods covered by
> the negotiated agreements. The rates, if negotiated, are hereby
> incorporated without further action of the contracting officer.

**G.6 ELECTRONIC FUNDS TRANSFER**

> Pursuant to FAR 52.232-33, Payment by Electronic Funds Transfer -
> Central Contractor Registration (OCT 2003), the Contractor shall
> designate a financial institution for receipt of electronic funds
> transfer payments. This designation shall be submitted, in writing, to
> the finance office designated in the contract.

**SECTION H - SPECIAL CONTRACT REQUIREMENTS**

**H.1 RELEASE AND USE AND COPYRIGHT OF DATA FIRST PRODUCED FROM WORK
PERFORMED UNDER THIS CONTRACT**

\(a\) Release and Use -- Data first produced in the performance of the
Contract. As permitted in FAR 52.227-17, the provisions of this Section
H.1 shall apply to any release or use of data first produced in the
performance of the Contract and any analysis, tools, methodologies, or
recorded product based on such data.

\(b\) Release and Use -- Requirements related to confidentiality and
quality. To ensure public trust in the confidentiality protections
afforded participants in Agency for Healthcare Research and Quality
(AHRQ)-supported research, AHRQ requires and monitors compliance by its
contractors with section 934(c) of the Public Health Service Act (PHS
Act) (42 U.S.C. 299c-3(c)), which states in part that

> No information, if the establishment or person supplying the
> information or described in it is identifiable, obtained in the course
> of activities undertaken or supported under this title, may be used
> for any purpose other than the purpose for which it was supplied
> unless such establishment or person has consented\...to its use for
> such other purpose. Such information may not be published or released
> in other form if the person who supplied the information or who is
> described in it is identifiable unless such person has consented\...to
> its publication or release in other form.

In addition to this requirement, section 933(b)(1) of the PHS Act (42
U.S.C. 299c-2(b)(1)) requires AHRQ to assure that statistics and
analyses developed with Agency support are of high quality,
comprehensive, timely, and adequately analyzed. Accordingly \--

> \(1\) prior to the release or use of data based upon work performed
> under this Contract, the Contractor agrees to consult with the Project
> and Contract Officers regarding the proposed release or use. The
> Contractor will in good faith consider, discuss, and respond to any
> comments or suggested modifications that are provided by AHRQ within
> two months of receiving the proposed release or use.
>
> The purpose of such consultation is to assure that:
>
> \(A\) identifiable information is being used exclusively for the
> purpose(s) for which it was supplied or appropriate consents have been
> obtained;
>
> \(B\) the confidentiality promised to individuals and establishments
> supplying identifiable information or described in it is not violated;
> and
>
> \(C\) the quality of statistical and analytical work meets the
> statutory standards cited above.
>
> \(2\) The Contractor must satisfy conditions (1)(A) and (1)(B). At the
> conclusion of any consultation required by paragraph (b)(1) above, if
> AHRQ and the Contractor cannot agree that a proposed use or release
> satisfies condition (1)(C) above:
>
> \(A\) the research professional at the Contractor responsible for the
> quality of the Contract work will, in advance of any release or use of
> such data, certify in a letter to the Contracting Officer what
> differences of opinion cannot be resolved regarding the statutory
> standards referenced in condition (1)(C) and the basis for Contractor
> assertions that these standards have been met; and
>
> \(B\) the Contractor must print prominently on the release or other
> product, or on any portion that is released, or state prior to any
> oral presentation or release of such material, the following
> disclaimer:
>
> THIS presentation/ publication/or other product is derived from work
> supported under a contract with THE AGENCY FOR HEALTHCARE RESEARCH AND
> QUALITY (AHRQ) (# ). However, this presentation/ publication/or other
> product HAS NOT BEEN APPROVED by the agency.

\(c\) Required Statement Regarding Protected Information. On all written
material or other recorded products, or preceding any presentation or
other oral disclosure, release or use of material based on identifiable
information obtained in the course of work performed under this
contract, the Contractor shall make the following statement:

> IDENTIFIABLE INFORMATION ON WHICH THIS REPORT, PRESENTATION, OR OTHER
> FORM OF DISCLOSURE IS BASED IS PROTECTED BY FEDERAL LAW, SECTION
> 934(c) OF THE PUBLIC HEALTH SERVICE ACT, 42 U.S.C. 299c-3(c). NO
> IDENTIFIABLE INFORMATION ABOUT ANY INDIVIDUALS OR ENTITIES SUPPLYING
> THE INFORMATION OR DESCRIBED IN IT MAY BE KNOWINGLY USED EXCEPT IN
> ACCORDANCE WITH THEIR PRIOR CONSENT. ANY CONFIDENTIAL IDENTIFIABLE
> INFORMATION IN THIS REPORT OR PRESENTATION THAT IS KNOWINGLY DISCLOSED
> IS DISCLOSED SOLELY FOR THE PURPOSE FOR WHICH IT WAS PROVIDED.

\(d\) Copyright -- Data first produced in the performance of the
Contract. Subject to the terms of this Section regarding release and use
of data, AHRQ, through its Contracting Officer, will grant permission
under FAR 52.227-17(c)(1)(i) to the Contractor to establish claim to
copyright subsisting in scientific and technical articles based on or
containing data first produced in the performance of this contract that
are submitted for publication in academic, technical or professional
journals, symposia proceedings or similar works. When claim to copyright
is made, the Contractor shall affix the applicable copyright notice of
17 U.S.C. 401 or 402 and acknowledgment of Government sponsorship
(including contract number) to the data when such data are delivered to
the Government, as well as when the data are published or deposited for
registration as a published work in the U.S. Copyright Office. In such
circumstances, the Contractor hereby agrees to grant to AHRQ, and others
acting on its behalf, a paid-up, nonexclusive, irrevocable, worldwide
license for all such data to reproduce, prepare derivative works,
distribute copies to the public, and perform publicly and display
publicly, by or on behalf of AHRQ. A description of this license will be
incorporated into the copyright notices required above.

\(e\) Subcontracts. Whenever data, analyses, or other recorded products
are to be developed by a subcontractor under this Contract, the
Contractor must include the terms of H.1 in the subcontract, without
substantive alteration, with a provision that the subcontractor may not
further assign to another party any of its obligations to the
Contractor. No clause may be included to diminish the Government's
stated requirements or rights regarding release or use of products or
materials based on data derived from work performed under this contract.

**H.2 LACK OF COMPLIANCE WITH REQUIREMENTS FOR RELEASE OR USE**

Failure to submit materials for statutorily mandated confidentiality and
statistical and analytic quality reviews as required by Section H.1 of
this contract will be viewed as a material violation and breach of the
terms of this contract, as the requirements of this provision are
necessary for AHRQ to carry out its statutory obligations and
responsibilities. Records of the Contractor\'s performance, including
the Contractor\'s performance pertaining to this Contract, will be
maintained in AHRQ\'s Contracts Management Office and will be considered
as an element of past performance which is part of all subsequent
competitive contract proposal reviews.

**H.3 SALARY RATE LIMITATION LEGISLATION PROVISION**

Pursuant to P.L. 109-149, no Fiscal Year 2006 (October 1, 2005 --
September 30, 2006) funds may be used to pay the direct salary of an
individual through this contract at a rate in excess of the direct
salary rate for Executive Level I of the Federal Executive Pay Scale.
That rate is \$183,500 per year for the period of January 1, 2006
through December 31, 2006. Direct salary is exclusive of overhead,
fringe benefits, and general and administrative expenses. The salary
limit also applies to individuals proposed under subcontracts. If this
is a multi-year contract, it may be subject to unilateral modifications
by the Government if any salary rate ceilings are established in future
DHHS appropriation acts. P.L. 109-149 states in pertinent part:

> None of the funds appropriated in this Act for the National Institutes
> of Health, the Agency for Healthcare Research and Quality, and the
> Substance Abuse and Mental Health services Administration shall be
> used to pay the salary of an individual, through a grant or other
> extramural mechanism, at a rate in excess of Executive Level I.

Contractors shall absorb that portion of an employee's salary (plus the
dollar amount for fringe benefits and indirect costs associated with the
excess) that exceeds a rate of \$183,500 a year.

**H.4 SUBCONTRACTS**

The contractor must include in any subcontracts executed or used to
provide the support specified in this contract the terms of requirements
H.1, H.2, and H.3. These requirements are to be included without
substantive alteration, and no clause may be included to diminish these
requirements.

Award of any subcontract is subject to the written approval of the
Contracting Officer upon review of the supporting documentation as
required by FAR Clause 52.215-12, Subcontractor Cost or Pricing Data, of
the General Clauses incorporated into this contract. A copy of the
signed subcontract shall be provided to the Contracting Officer.

**H.5 LATE PAYMENTS TO THE GOVERNMENT**

Late payment of debts owed the Government by the Contractor, arising
from whatever cause, under this contract/order shall bear interest at a
rate or rates to be established in accordance with the Treasury Fiscal
Requirements Manual. For purposes of this provision, late payments are
defined as payments received by the Government more than 30 days after
the Contractor has been notified in writing by the Contracting Officer
of:

a\. The basis of indebtedness.

b\. The amount due.

c\. The fact that interest will be applied if payment is not received
within 30 days from the date of mailing of the notice.

d\. The approximate interest rate that will be charged.

**H.6 PRIVACY ACT**

The Privacy Act clauses cited in Section I (FAR 52.224-1 and 52.224-2)
are applicable to the consultant records kept by the Contractor for the
Agency for Healthcare Research and Quality.

You are hereby notified that the Contractor and its employees are
subject to criminal penalties for violations of the Act (5 U.S.C.
552a(i)) to the same extent as employees of the Department. The
Contractor shall assure that each Contractor employee is aware that
he/she can be subjected to criminal penalties for violations of the Act.
Disposition instructions: Records are to be destroyed after contract
closeout is completed and final payment is made and in accordance with
IRS regulations.

**H.7 PRO-CHILDREN ACT of 1994**

The Pro-Children Act of 1994, P.L. 103-227, imposes restrictions on
smoking where certain federally funded childrens' services are provided.
P.L. 103-227 states in pertinent part:

> PHS strongly encourages all grant and contract recipients to provide a
> smoke-free workplace and to promote the non-use of all tobacco
> products. In addition, P.L. 103-227, the Pro-Children Act of 1994,
> prohibits smoking in certain facilities (or in some cases, any portion
> of a facility) in which regular or routine education, library, day
> care, health care or early childhood development services are provided
> to children."

**H.8 PERSONNEL SECURITY REQUIREMENTS**

BACKGROUND

> The Office of Assistant Secretary for Management and Budget,
> Department of Health and Human Services (DHHS), requires that all DHHS
> employees and contractor employees (including subcontractors) who will
> be working in a DHHS-owned or leased space and/or who will have access
> to DHHS equipment, and non-public privileged, proprietary, or trade
> secret information, undergo a background investigation.

GENERAL

> Notwithstanding other submission requirements stated elsewhere in this
> contract, the contractor shall appoint and identify a Contractor
> Security Representative and submit the following information for each
> employee to the Contracting Officer within thirty (30) calendar days
> after contract award.

SF-85 Questionnaire for Non-Sensitive Positions

HHS Credit Release

OF-306 Declaration for Federal Employment

Current resume

Note: Forms are available at:
[[http://www.gsa.gov/Portal/formslibrary.jsp]{.underline}](http://www.gsa.gov/Portal/formslibrary.jsp)

> Within thirty (30) days after contract award each employee will be
> required to have electronic fingerprinting performed ----
> Fingerprinting services are available by appointment only through the
> Program Support Staff (PSC) and will be arranged by AHRQ.

**H.9 DATA CONFIDENTIALITY**

> The Contractor is to provide for secure and confidential storage,
> retrieval, maintenance, and disposition of data and other information
> used in work performed under this contract consistent with OMB
> Circular A-130, Appendix III, regarding security for automated systems
> and with 42 U.S.C. 299-3(c), regarding the confidentiality of
> identifiable data collected with AHRQ support.

**PART II - CONTRACT CLAUSES**

(05/06-DCM)

(FAC 2005-09)

**SECTION I**

**CONTRACT CLAUSES**

**GENERAL CLAUSES FOR A COST-REIMBURSEMENT CONTRACT WITH**

**EDUCATIONAL INSTITUTIONS**

CLAUSES INCORPORATED BY REFERENCE (FEBRUARY 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.arnet.gov/far/

I. FEDERAL ACQUISITION REGULATION (FAR) (48 CFR CHAPTER 1)

CLAUSES

FAR Clause No. Title and Date

52.203-3 Gratuities (APR 1984)

52.203-5 Covenant Against Contingent Fee (APR 1984)

52.203-6 Restrictions on Subcontractor Sales to the Government

> (JULYl 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 (SEP 2005)

52.204-4 Printing or Copying Double-Sided on Recycled Paper (AUG 2000)

52.204-7 Central Contractor Registration. (OCT 2003)

52.209-6 Protecting the Government\'s Interest When Subcontracting With
Contractors Debarred, Suspended, or Proposed for Debarment (JAN 2005)

52.215-2 Audit and Records - Negotiation (JUN 1999) (ALT II) (APR 1998)

52.215-8 Order of Precedence-Uniform Contract Format (OCT 1997)

52.215-10 Price Reduction for Defective Cost or Pricing Data (OCT 1997)
(applicable to contract actions over \$550,000)

52.215-12 Subcontractor Cost or Pricing Data (OCT 1997)

52.215-15 Pension Adjustments and Asset Reversions (JAN 2004)

52.216-7 Allowable Cost and Payment (DEC 2002)

52.216-11 Cost Contract -- No Fee (APR 1984)

52.217-5 Evaluation of Options (JUL 1990)

52.217-8 Option to Extend Services (NOV 1999)

52.219-8 Utilization of Small Business Concerns (MAY 2004)

52.219-9 Small Business Subcontracting Plan (JULY 2005)

52.222-2 Payment for Overtime Premiums (JUL 1990). The amount in

> paragraph (a) is \"zero\" unless different amount is separately
>
> stated elsewhere in contract.

52.222-3 Convict Labor (JUNE 2003)

52.222-26 Equal Opportunity (APR 2002)

52.222-35 Equal Opportunity for Special Disabled Veterans, Veterans of
the Vietnam Era, and Other Eligible Veterans. (DEC 2001)

52.222-36 Affirmative Action for Workers With Disabilities (JUNE 1998)

52.222-37 Employment Reports on Special Disabled Veterans, Veterans of
the Vietnam Era, and Other Eligible Veterans. (DEC 2001)

52.222-39 Notification of Employee Rights Concerning Payment of Union
Dues or Fees (DEC 2004)

52.223-6 Drug Free Workplace (MAY 2001)

52.223-14 Toxic Chemical Release Reporting (AUG 2003)

52.224-1 Privacy Act Notification (APRIL 1984)

52.224-2 Privacy Act (APRIL 1984)

52.225-1 Buy American Act - Supplies (JUNE 2003)

52.225-13 Restrictions on Certain Foreign Purchases (FEB 2006)

52.227-1 Authorization and Consent (JULY 1995)

52.227-2 Notice and Assistance Regarding Patent and Copy-

> Right Infringement (AUG 1996)

52.227-3 Patent Indemnity (APRIL 1984)

52.227-14 Rights in Data - General (JUNE 1987)

52.228-7 Insurance-Liability to Third Persons (MAR 1996)

52.230-2 Cost Accounting Standards (APR 1998)

52.230-3 Disclosure and Consistency of Cost Accounting Practices (APR
1998)

52.230-6 Administration of Cost Accounting Standards (NOV 1999)

52.232-9 Limitation on Withholding of Payments (APRIL 1984)

52.232-17 Interest (JUNE 1996)

52.232-20 Limitation of Cost (APR 1984)

52.232-22 Limitation of Funds (APR 1984)

52.232-23 Assignment of Claims (JAN 1986)

52.232-25 Prompt Payment (OCT 2003)

52.232-33 Payment by Electronic Funds Transfer Central Contractor
Registration (Oct 2003)

52.233-1 Disputes (JULY 2002)

52.233-3 Protest After Award (AUG 1996) Alternate I (JUNE 1985)

52.233-4 Applicable Law for Breach of Contract Claim (OCT 2004)

52.237-10 Identification of Uncompensated Overtime (Oct 1997)

52.239-1 Privacy or Security Safeguards (AUG 1996)

52.242-1 Notice of Intent to Disallow Costs (APRIL 1984)

52.242-3 Penalties for Unallowable Costs (MAY 2001)

52.242-4 Certification of Final Indirect Costs (Jan 1997)

52.242-13 Bankruptcy (JULY 1995)

52.243-2 Changes - Cost Reimbursement (AUG 1987) - Alternate II

> (APRIL 1984)

52.244-2 Subcontracts (AUGUST 1998)

52.244-5 Competition in Subcontracting (DEC 1996)

52.245-5 Government Property (Cost Reimbursement, Time-and-

> Material, or Labor-Hour Contract (MAY 2004)

52.246-5 Inspection of Services-Cost Reimbursement (APRIL 1984)

52.246-23 Limitation of Liability-(FEB 1997)

52.248-1 Value Engineering (FEB 2000)

52.249-5 Termination for Convenience of the Government (Educational and
Other Nonprofit Institutions (SEP 1996)

52.249-14 Excusable Delays (APRIL 1984)

52.251-1 Government Supply Sources (APRIL 1984)

52.253-1 Computer Generated Forms (JAN 1991)

II\. DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION

REGULATION (HHSAR) (48 CFR CHAPTER 3) CLAUSES

HHSAR

Clause No. Title and Date

352.202-1 Definitions (JAN 2001) Alternate h

352.216-72 Additional Cost Principles (OCT 1990)

352.224-70 Confidentiality of Information (APRIL 1984)

352.228-7 Insurance - Liability to Third Persons (DEC 1991)

352.232-9 Withholding of Contract Payments (APRIL 1984)

352.233-70 Litigation and Claims (APR 1984)

352.242-71 Final Decisions on Audit Findings (APRIL 1984)

352.270-1 Accessibility of Meetings, Conferences, and Seminars to

> Persons With Disabilities (JAN 2001)

352.270-6 Publication and Publicity (JUL 1991)

352.270-7 Paperwork Reduction Act (JAN 2001)

[The following clauses are applicable to this contract and are provided
in full text:]{.underline}

**OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) FAR 52.217-9  **

\(a\) The Government may extend the term of this contract by written
notice to the Contractor within 30 days of the expiration date of the
contract; provided that the Government gives the Contractor a
preliminary written notice of its intent to extend at least 60 days
before the contract expires. The preliminary notice does not commit the
Government to an extension.

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

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

(End of clause)

**KEY PERSONNEL (APRIL 1984) (HHSAR 352.270-5)**

The personnel specified in this contract are considered to be essential
to the work being performed hereunder. Prior to diverting any of the
specified individuals to other programs, the Contractor shall notify the
Contracting Officer reasonably in advance and shall submit justification
(including proposed substitutions) in sufficient detail to permit
evaluation of the impact on the program. No diversion shall be made by
the Contractor without the written consent of the Contracting Officer;
provided, that the Contracting Officer may ratify in writing such
diversion and such ratification shall constitute the consent of the
Contracting Officer required by this clause. The contract may be amended
from time to time during the course of the contract to either add or
delete personnel, as appropriate.

(End of clause)

**PART III- LIST OF DOCUMENTS, EXHIBITS AND ATTACHMENTS**

**SECTION J - LIST OF ATTACHMENTS**

[Attachment]{.underline} Page Number

1\. Past Performance Questionnaire 65-68

2\. SF LLL-A, Disclosure of Lobbying Activities 69-71

3\. Proposal Intent Form 72-73

4\. Small Business Subcontracting Plan 74-81

5\. Sample Breakdown of Proposed Estimated Cost (Plus Fee) and Labor
Hours 82

**NOTE: ALL ATTACHMENTS ARE LOCATED AT THE END OF THIS REQUEST
PROPOSAL**

(FAC 2005-09)

PART IV. REPRESENTATIONS AND INSTRUCTIONS

SECTION K

REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS OF OFFERORS

K.1 HHSAR 315.204-5 Representations and Instructions

K.2. FAR 52.204-8 Annual Representations and Certifications (JAN 2005)

K.3. FAR 52.222-21 Prohibition of Segregated Facilities (FEB 1999)

K.4. FAR 52.230-1 Cost Accounting Standards Notices and Certification
(JUNE 2000)

K.5. FAR 15.406-2 Certificate of Current Cost and Pricing Data

K.6. P.L. 103-227 Certification Regarding Environmental

> Tobacco Smoke

K.l REPRESENTATIONS AND INSTRUCTIONS

\(a\) Section K, Representations, certifications, and other statements
of offerors.

\(1\) This section shall begin with the following and continue with the
applicable representations and certifications:

TO BE COMPLETED BY THE OFFEROR: (The Representations and Certifications
must be executed by an individual authorized to bind the Offeror.) The
Offeror makes the following Representations and Certifications as part
of its proposal. (Check or complete all appropriate boxes or blanks on
the following pages.)

(Name of Offeror) (RFP No.)

(Signature of Authorized Individual) (Date)

(Typed Name of Authorized Individual)

NOTE: The penalty for making false statements in offers is prescribed in
18 U.S.C. 1001.

K.2. ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2005) (FAR 52.204-8)

(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) 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 certification 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.]{.underline}](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.

(End of provision)

K.3. PROHIBITION OF SEGREGATED FACILITIES

(FEB 1999) (FAR 52.222-21)

\(a\) \"Segregated facilities,\" as used in this clause, means any
waiting rooms, work areas, rest rooms and wash rooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or
dressing areas, parking lots, drinking fountains, recreation or
entertainment areas, transportation, and housing facilities provided for
employees, that are segregated by explicit directive or are in fact
segregated on the basis of race, color, religion, or national origin
because of written or oral policies or employee custom. The term does
not include separate or single-user rest rooms or necessary dressing or
sleeping areas provided to assure privacy between the sexes.

\(b\) The Contractor agrees that it does not and will not maintain or
provide for its employees any segregated facilities at any of its
establishments, and that it does not and will not permit its employees
to perform their services at any location under its control where
segregated facilities are maintained. The Contractor agrees that a
breach of this clause is a violation of the Equal Opportunity clause in
this contract.

\(c\) The Contractor shall include this clause in every subcontract and
purchase order that is subject to the Equal Opportunity clause of this
contract.

(End of Clause)

K.4. COST ACCOUNTING STANDARDS NOTICES AND

CERTIFICATION

(FAR 52.230-1) (JUNE 2000)

NOTE: This notice does not apply to small businesses or foreign
governments. This notice is in three parts, identified by Roman numerals
I through III.

> Offerors shall examine each part and provide the requested information
> in order to determine Cost Accounting Standards (CAS) requirements
> applicable to any resultant contract.
>
> If the offeror is an educational institution, Part II does not apply
> unless the contemplated contract will be subject to full or modified
> CAS-coverage pursuant to 48CFR 9903.201-2(c)(5) or
> 9903.201-2(c)(6),respectively.

I. Disclosure Statement - Cost Accounting Practices and Certification

\(a\) Any contract in excess of \$500,000 resulting from this
solicitation, will be subject to the requirements of the Cost Accounting
Standards Board (48 CFR, Chapter 99), except for those contracts which
are exempt as specified in 48 CFR 9903.201-1.

\(b\) Any offeror submitting a proposal which, if accepted, will result
in a contract subject to the requirements of 48 CFR Chapter 99 must, as
a condition of contracting, submit a Disclosure Statement as required by
48 CFR 9903.202. When required, the Disclosure Statement must be
submitted as a part of the offeror\'s proposal under this solicitation
unless the offeror has already submitted a Disclosure Statement
disclosing the practices used in connection with the pricing of this
proposal. If an applicable Disclosure Statement has already been
submitted, the offeror may satisfy the requirement for submission by
providing the information requested in paragraph (c) of Part I of this
provision. Caution: In the absence of specific regulations or agreement,
a practice disclosed in a Disclosure Statement shall not, by virtue of
such disclosure, be deemed to be a proper, approved, or agreed-to
practice for pricing proposals or accumulating and reporting contract
performance cost data.

(c) Check the appropriate box below:

\[ \] (1) Certificate of Concurrent Submission of Disclosure Statement.

> The offeror hereby certifies that, as a part of the offer, copies of
> the Disclosure Statement have been submitted as follows: (i) original
> and one copy to the cognizant Administrative Contracting Officer (ACO)
> or cognizant Federal agency official authorized to act in that
> capacity, as applicable, and (ii) one copy to the cognizant Federal
> auditor.

(Disclosure must be on Form No. CASB DS-1 or CASB

> DS-2, as applicable. Forms may be obtained from the cognizant ACO or
> Federal official and/or from the loose-leaf version of the Federal
> Acquisition Regulation.)

Date of Disclosure
Statement:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Name and Address of Cognizant

ACO or Federal official where filed:

> The offeror further certifies that practices used in estimating costs
> in pricing this proposal are consistent with the cost accounting
> practices disclosed in the Disclosure Statement.

\[ \] (2) Certificate of Previously Submitted Disclosure Statement.

> The offeror hereby certifies that the required Disclosure Statement
> was filed as follows:
>
> Date of Disclosure
> Statement:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Name and Address of Cognizant

ACO or Federal official where filed:

> The offeror further certifies that the practices used in estimating
> costs in pricing this proposal are consistent with the cost accounting
> practices disclosed in the applicable Disclosure Statement.
>
> \[ \] (3) Certificate of Monetary Exemption.
>
> The offeror hereby certifies that the offeror together with all
> divisions, subsidiaries, and affiliates under common control, did not
> receive net awards of negotiated prime contracts and subcontracts
> subject to CAS totaling more than \$25 million in the cost accounting
> period immediately preceding the period in which this proposal was
> submitted. The offeror further certifies that if such status changes
> before an award resulting from this proposal, the offeror will advise
> the Contracting Officer immediately.
>
> \[ \] (4) Certificate of Interim Exemption.
>
> The offeror hereby certifies that (i) the offeror first exceeded the
> monetary exemption for disclosure, as defined in (3) of this
> subsection, in the cost accounting period immediately preceding the
> period in which this offer was submitted and (ii) in accordance with
> 48 CFR, Subpart 9903.202-1, the offeror is not yet required to submit
> a Disclosure Statement. The offeror further certifies that if an award
> resulting from this proposal has not been made within 90 days after
> the end of that period, the offeror will immediately submit a review
> certificate to the Contracting Officer, in the form specified under
> subparagraph (c)(1) or (c)(2) of Part I of this provision, as
> appropriate, to verify submission of a completed Disclosure Statement.
>
> Caution: Offerors currently required to disclose because they were
> awarded a CAS-covered prime contract or subcontract of \$25 million or
> more in the current cost accounting period may not claim this
> exemption (4). Further, the exemption applies only in connection with
> proposals submitted before expiration of the 90-day period following
> the cost accounting period in which the monetary exemption was
> exceeded.

II\. Cost Accounting Standards - Eligibility for Modified Contract
Coverage

> If the offeror is eligible to use the modified provisions of 48 CFR,
> Subpart 9903.201-2(b) and elects to do so, the offeror shall indicate
> by checking the box below. Checking the box below shall mean that the
> resultant contract is subject to the Disclosure and Consistency of
> Cost Accounting Practices clause in lieu of the Cost Accounting
> Standards clause.
>
> \[ \] The offeror hereby claims an exemption from the Cost Accounting
> Standards clause under the provisions of 48 CFR, Subpart 9903.201-2(b)
> and certifies that the offeror is eligible for use of the Disclosure
> and Consistency of Cost Accounting Practices clause because during the
> cost accounting period immediately preceding the period in which this
> proposal was submitted, the offeror received less than \$25 million in
> awards of CAS-covered prime contracts and subcontracts or the offeror
> did not receive a single CAS-covered award exceeding \$1 million. The
> offeror further certifies that if such status changes before an award
> resulting from this proposal, the offeror will advise the Contracting
> Officer immediately.

Caution: An offeror may not claim the above eligibility for modified
contract coverage if this proposal is expected to result in the award of
a CAS-covered contract of \$25 million or more or if, during its current
cost accounting period, the offeror has been awarded a single
CAS-covered prime contract or subcontract of \$25 million or more.

III\. Additional Cost Accounting Standards Applicable to Existing
Contracts

> The offeror shall indicate below whether award of the contemplated
> contract would, in accordance with subparagraph (a)(3) of the Cost
> Accounting Standards clause, require a change in established cost
> accounting practices affecting existing contracts and subcontracts.

\[ \] Yes \[ \] No

(End of Provision)

ALTERNATE I (APR 1996)

\[ \] (5) Certificate of Disclosure Statement Due Date by Educational
Institution.

> If the offeror is an educational institution that, under the
> transition provisions of 48 CFR 9903.202-1(f), is or will be required
> to submit a Disclosure Statement after receipt of this award, the
> offeror hereby certifies that (check one and complete):

\[\] (a) A Disclosure Statement filing Due Date of

> has been established with the cognizant Federal agency.
>
> \[\] (b) The Disclosure Statement will be submitted within the six
> month period ending months after receipt of this award.
>
> Name and Address of cognizant ACO or Federal Official where Disclosure
> Statement is to be filed:

(END OF ALTERNATE I)

K.5. CERTIFICATE OF CURRENT COST OR PRICING DATA

(FAR 15.406-2)

CERTIFICATE OF CURRENT COST OR PRICING DATA

When cost or pricing data are required, the contracting officer shall
require the contractor to execute a Certificate of Current Cost or
Pricing Data using the format in this paragraph, and shall include the
executed certificate in the contract file.

This is to certify that, to the best of my knowledge and belief, the
cost or pricing data (as defined in Section 15.401 of the Federal
Acquisition Regulation(FAR) and required under FAR subsection 15.403-4)
submitted, either actually or by specific identification, in writing, to
the contracting officer or the contracting officer\'s representative in
support of \* are accurate, complete, and current as of \*\*.

This certification includes the cost or pricing data supporting any
advance agreements and forward pricing rate agreements between the
offeror and the Government that are part of the proposal.

FIRM

NAME Signature

TITLE

DATE OF EXECUTION\*\*\*

\* Identify the proposal, request for price adjustment, or other
submission involved, giving the appropriate identifying number (e.g.,
Request for Proposal number).

\*\* Insert the day, month, and year when price negotiations were
concluded and price agreement was reached or, if applicable, an earlier
date agreed upon between the parties that is as close as practicable to
the date of agreement on price.

\*\*\* Insert the day, month, and year of signing, which should be as
close as practicable to the date when the price negotiations were
concluded and the contract price agreed to.

End of Certificate

K.6. ENVIRONMENTAL TOBACCO SMOKE

> The Public Health Service strongly encourages all grant and contract
> recipients to provide a smoke-free workplace and to promote the nonuse
> of all tobacco products. In addition, Public Law 103-227, the
> Pro-Children Act of 1994, prohibits smoking in certain facilities (or
> in some cases, any portion of a facility) in which regular or routine
> education, library, day care, health care or early childhood
> development services are provided to children.

[CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE]{.underline}

Public Law 103-227, also known as the Pro-Children Act of 1994 (Act),
requires that smoking not be permitted in any portion of any indoor
facility owned or leased or contracted for by an entity and used
routinely or regularly for the provision of health, day care, early
childhood development services, education or library services to
children under the age of 18, if the services are funded by Federal
programs either directly or through State or local governments, by
Federal grant, contract, loan, or loan guarantee. The law also applies
to children\'s services that are provided in indoor facilities that are
constructed, operated, or maintained with such federal funds. The law
does not apply to children\'s services provided in private residences;
portions of facilities used for inpatient drug or alcohol treatment;
service providers whose sole source of applicable Federal funds is
Medicare or Medicaid; or facilities where WIC coupons are redeemed.
Failure to comply with the provisions of the law may result in the
imposition of a civil monetary penalty of up to \$1000 for each
violation and/or the imposition of an administrative compliance order on
the responsible entity.

By signing this certification, the offeror/contractor certifies that the
submitted organization will comply with the requirements of the Act and
will not allow smoking within any portion of any indoor facility used
for the provision of services for children as defined by the Act.

The submitting organization agrees that it will require that the
language of this certification be included in any subawards which
contain provisions for children\'s services and that all subrecipients
shall certify accordingly.

Organization:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Title\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS**

**L.1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) (FAR
52.252-1)**

> This solicitation incorporates the following solicitation provisions
> by reference, with the same force and effect as if they were given in
> full text. Upon request, the contracting officer will make the full
> text available. Also, the full text of a clause may be assessed
> electronically at this address: http://www.arnet.gov/far/

a\. Federal Acquisition Regulation (FAR) (48 CFR Chapter 1) Solicitation
Provisions

\(1\) 52.215-16 Facilities Capital Cost of Money (OCT 1997)

> \(2\) 52.215-20 Requirements for Cost or Pricing Data or Information
> Other Than Cost or Pricing Data (OCT 1997)

**L.2 DATA UNIVERSAL NUMBERING (DUNS) NUMBER (OCT 2003)**

**(FAR 52.204-6)**

\(a\) 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 Information Services. 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 DUNSnumber---

\(i\) If located within the United States, by calling Dun and Bradstreet
at 1-866-705-5711 or via the iInternet at
[*http://www.dnb.*com](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, sity, 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).

(End of provision)

**L.3 TYPE OF CONTRACT (APRIL 1984)(FAR 52.216-1)**

> The Government contemplates award of a cost-reimbursement service
> contract resulting from this solicitation.
>
> It is anticipated that a single award will be made from this
> solicitation.

**L.4 SERVICE OF PROTEST (AUG 1996)(FAR 52.233-2)**

\(a\) 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:

Director, Division of Contracts Management

Agency for Healthcare Research and Quality

540 Gaither Road

Rockville, Maryland 20850

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

**L.5 POINT OF CONTACT FOR TECHNICAL INQUIRIES**

> The technical contact for additional information and answering
> inquiries is the Contracting Officer. All questions regarding this
> solicitation shall be in writing and received by the Contracting
> Officer no later than **June 19, 2006**. It is requested that all
> questions be submitted by both e-mail and hardcopy. E-mail to
> <sharon.williams@ahrq.hhs.gov> ; fax to 301-427-1740).

**L.6 GENERAL INSTRUCTIONS**

[Introduction]{.underline}

> The following instructions will establish the acceptable minimum
> requirements for the format and contents of proposals. Special
> attention is directed to the requirements for technical and business
> proposals to be submitted in accordance with these instructions:

a\. [Contract Type and General Provisions]{.underline}: It is
contemplated that a cost-type contract will be awarded. In addition to
the special provisions of this request for proposal (RFP), any resultant
contract shall include the general clauses applicable to the selected
offeror\'s organization and type of contract awarded. Any additional
clauses required by Public Law, Executive Order, or procurement
regulations, in effect at the time of execution of the proposed
contract, will be included.

b\. [Authorized Official and Submission of Proposal]{.underline}: The
proposal shall be signed by an official authorized to bind your (the
offeror\'s) organization. Your proposal shall be submitted in the number
of copies, to the address, and marked as indicated in the cover letter
of this solicitation. Proposals will be typewritten, reproduced on
letter sized paper and will be legible in all required copies. To
expedite the proposal evaluation, all documents required for responding
to the RFP should be placed in the following order:

I. [TECHNICAL PROPOSAL]{.underline}: See Technical Proposal Instructions
for recommended format (L.7). Please mark as original or copy.

II. [BUSINESS PROPOSAL]{.underline}: See Business Proposal Instructions
    for recommended format (L.10). Include Small Disadvantaged Business
    Participation Plan (L.9) and Representations and Certifications in
    the original Business Proposal.

> III\. [PAST PERFORMANCE PROPOSAL]{.underline}: See Past Performance
> Information for more information (L.8)

c\. [Separation of Technical and Business Proposal]{.underline}: The
proposal shall be in three parts:

> \(1\) Technical Proposal; (2) Business Proposal; and (3) Past
> Performance Proposal. Each of the parts shall be separate and complete
> in itself so that evaluation of one may be accomplished independently
> of, and concurrently with, evaluation of the other. The technical
> proposal shall not contain reference to cost; however resources
> information, such as data concerning labor hours and categories,
> materials, subcontracts, etc., shall be contained in the technical
> proposal so that your understanding of the Statement of Work (SOW) may
> be evaluated. It must disclose your technical approach in as much
> detail as possible, including, but not limited to, the requirements of
> the technical proposal instructions.

d\. [Evaluation of Proposals]{.underline}: The Government will evaluate
technical proposals in accordance with the criteria set forth in Section
M, [Evaluation/Award Criteria]{.underline}.

e\. [Rejection of Proposals]{.underline}: The Government reserves the
right to reject any or all proposals received. It is understood that
your proposal will become part of the official contract file.

f\. [Unnecessarily Elaborate Proposals]{.underline}: Unnecessarily
elaborate brochures or other presentations beyond those sufficient to
present a complete and effective proposal are not desired and may be
construed as an indication of the offeror\'s lack of cost consciousness.
Elaborate art work, expensive visual and other presentation aids are
neither necessary nor wanted.

g\. [Privacy Act]{.underline}: The Privacy Act of 1974 (Public Law
(P.L.) 93-579) requires that a Federal agency advise each individual
whom it asks to supply information: 1) the authority which authorized
the solicitation; 2) whether disclosure is voluntary or mandatory; (3)
the principal purpose or purposes for which the information is intended
to be used; (4) the uses outside the agency which may be made of the
information; and 4) the effects on the individual, if any, of not
providing all or any part of the requested information.

Therefore:

> \(1\) The Government is requesting the information called for in this
> RFP pursuant to the authority provided by Section 301(g) of the Public
> Health Service Act, as amended, and P.L. 92-218, as amended.

\(2\) Provisions of the information requested are entirely voluntary.

\(3\) The collection of this information is for the purpose of
conducting an accurate, fair, and adequate review prior to a discussion
as to whether to award a contract.

\(4\) Failure to provide any or all of the requested information may
result in a less than adequate review.

\(5\) The information provided by you may be routinely disclosed for the
following purposes:

> -to the cognizant audit agency and the General Accounting Officer for
> auditing;

-to the Department of Justice as required for litigation;

-to respond to Congressional inquiries; and

-to qualified experts, not within the definition of Department employees
for opinions as a part of the review process.

In addition, the Privacy Act of 1974 (P.L. 93-579, Section 7) requires
that the following information be provided when individuals are
requested to disclose their social security number.

> Provision of the social security number is voluntary. Social security
> numbers are requested for the purpose of accurate and efficient
> identification, referral, review and management of AHRQ contracting
> programs. Authority for requesting this information is provided by
> Section 305 and Title IV of the Public Health Service Act, as amended.

h\. The RFP does not commit the Government to pay any cost for the
preparation and submission of a proposal. It is also brought to your
attention that the Contracting Officer is the only individual who can
legally commit the Government to the expenditure of public funds in
connection with this or any acquisition action.

> The Government reserves the right to award a contract without
> discussions if the Contracting Officer determines that the initial
> prices are fair and reasonable and that discussions are not necessary.

**L.7 TECHNICAL PROPOSAL INSTRUCTIONS**

> The technical proposal shall contain an original and nine (9) copies.
> The technical proposal described below shall be limited to **125
> pages** not including resumes or bibliographies, with no less than a
> 11 point pitch, with the majority of the text double-spaced (lists of
> deliverables, person loading charts, and similar materials need not be
> double-spaced, so long as they are legible). Resumes or CVs are only
> required for key personnel. Brief biographic sketches of other
> personnel may be provided. Lengthy proposals and voluminous appendices
> are neither needed nor desired as they are difficult to read and
> evaluate and may indicate the offeror's inability to concisely state
> their proposal.

a\. [Recommended Technical Proposal Format]{.underline}

> The offeror's proposal should present sufficient information to
> reflect a thorough understanding of the work requirements and a
> detailed plan for achieving the objectives of the scope of work.
> Technical proposals shall not merely paraphrase the requirements of
> the Agency's scope of work or parts thereof, or use of phrases such as
> "will comply" or "standard techniques will be employed." The technical
> proposal must include a detailed description of the techniques and
> procedures to be used in achieving the proposed end results in
> compliance with the requirements of the Agency's scope of work.

\(1\) [Cover Page]{.underline}: The name of the proposing organization,
author(s) of the technical proposal, the RFP number and the title of the
RFP should appear on the cover. One (1) manually signed original copy of
the proposal and the number of copies specified in the RFP cover letter
are required.

\(2\) [Table of Contents]{.underline}: Provide sufficient detail so that
all important elements of the proposal can be located readily.

\(3\) [Introduction]{.underline}: This should be a one or two page
summary outlining the proposed work, your interest in submitting a
proposal, and the importance of this effort in relation to your overall
operation.

> \(4\) Technical Discussion: The offeror shall prepare a technical
> discussion which addresses evaluation criteria A through E below. The
> offeror shall further state that no deviations or exceptions to the
> SOW are taken.
>
> The technical proposal submitted in response to this RFP shall address
> each of the items described below, and shall be organized in the same
> manner and within the page limitations specified. The proposal shall
> be prepared in double-spaced format, with numbered pages.

The evaluation criteria are as follows:

**A. [UNDERSTANDING THE PROBLEM]{.underline}**

The offeror=s proposal shall include, in the offeror=s own words, a
statement of the problem, the research and policy context of the
project, and the scope and purpose of the project. The offeror shall
demonstrate a complete understanding of the project=s intent and
requirements.

B.  **[TECHNICAL APPROACH]{.underline}**

The offeror=s proposal shall present the technical approach in as much
detail as possible. The proposal shall outline the recommended
approaches to be followed in arriving at the best solutions for the
tasks in the statement of work, as described in Section C of this RFP.
The presentation of the technical approach should be specific, detailed,
and complete enough to demonstrate clearly and fully that the offeror
thoroughly understands the intent of the statement of work, together
with proposed solution approaches. Merely stating that you understand
and will comply with the statement of work, or parts thereof, is
considered inadequate. While all technical factors cannot be detailed in
advance, the technical proposal must be sufficient as to how the offeror
proposes to comply with the applicable statement of work, including a
full explanation of the techniques and procedures the offeror proposes
to employ.

The offeror shall clearly describe procedures to be used to safeguard
the confidentiality of data from providers and from patients. The
offeror shall outline the steps necessary to obtain any required
approvals from Institutional Review Boards and Human Subjects Protection
Committees.

The offeror shall describe in detail the methods and procedures used in
selecting providers to participate in the network. The offeror shall
also describe in detail the specific data elements to be abstracted from
medical records and shall describe any known problems with data access
or data quality for specific variables on a site-by-site basis. The
offeror shall describe the extent to which (1) pharmacy dispensing and
(2) billing or financial claims data are available for patients at each
site.

The offeror shall discuss the following issues:

> \* availability of data from provider records and data quality issues
> (e.g., extent of missing data, duplicate records, non-uniform coding
> across sites),
>
> \* availability of encounter-level billing data,
>
> \* extent to which one provider=s records may not capture the full
> range of services patients utilize (e.g., services from other
> providers),
>
> \* procedures for obtaining information on substance abuse and mental
> health treatment service use,
>
> \* procedures for obtaining information on use of supportive services
> funded under the Ryan White Act,
>
> \* mechanisms for developing a research agenda related to patient
> safety issues in HIV care.

The offeror shall discuss potential obstacles to accomplishing the tasks
outlined in the scope of work. The offeror shall present possible
approaches for minimizing such obstacles.

The offeror shall describe the nature of its relationship with an
existing network or association of providers of HIV care, if applicable.
The offeror shall describe its history of collaborating with a provider
network or with a significant number of individual members of that
network. The offeror shall outline those factors that will be conducive
to the development of close working relationships between the offeror,
the network per se, and individual network members. The offeror shall
describe the data collection that has been completed (i.e., number of
patients at each site, number of patients with 1, 2, 3, or 4 years of
linked followup data, analyses completed or in progress).

Offeror will describe in detail their strategy and expertise in using
data and the partnership for quality improvement and the spread of
proven interventions.

C.  **[MANAGEMENT PLAN]{.underline}**

The offeror shall describe the organizational and management methods to
be used to perform the technical management of the activities required
by the scope of work. The offeror shall describe a proposed plan for
managing the resources necessary to complete the tasks specified in the
Statement of Work. This shall include a description of how the project
will be organized, roles and responsibilities defined and assigned, work
monitored, and quality and timeliness assured. The offeror shall explain
how the organizational structure will lend itself to completing complex
tasks within narrow time frames and assuring quality of products
delivered.

The offeror shall indicate a schedule for completing each of the
requirements outlined in the statement of work, justify estimated time
required to complete each task, and justify the level of training and
experience of staff proposed to accomplish each task.

It is **essential** that the offeror describe in detail

> \* plans for communicating with staff at provider sites,
>
> \* procedures to be used to oversee or manage activities of data
> collectors, computer programmers, or other provider staff necessary to
> assemble data required under the scope of work.
>
> \* procedures to be used to improve safety and quality and track the
> impact of these efforts.

The offeror must demonstrate that it has the capability to obtain timely
cooperation from staff at provider sites in performing data assembly and
transmission activities, and in collaborating to improve safety and
quality**.**

**D. [KEY PERSONNEL]{.underline}**

The proposal shall include resumes or bio-sketches identifying the types
of professional personnel that will be employed to perform the contract.
Resumes shall describe the experience; education; background; specific
scientific, clinical, or technical accomplishments; and any special
qualifications that are applicable to the performance of the contract,
including relevant experience in projects of a broadly similar nature.

The proposal shall specify how professional personnel employed under the
contract shall operate organizationally and shall specify the name and
title of the person who will provide overall technical direction for the
project.

As data processing, cleaning, and statistical analysis are major
components of the scope of work, the offeror shall describe the extent
to which key personnel have the requisite training and experience in
these activities. In addition, because many issues in HIV service
delivery are influenced by new clinical developments, the offeror must
show the extent to which key personnel have sufficient clinical
expertise in treating patients with HIV infection. Finally, offeror must
show personnel capacity in quality improvement and spread of
evidence-based interventions.

**E. [FACILITIES]{.underline}**

General background, experience, and qualifications of the offeror=s
organization shall be furnished. Most important, computer hardware and
software resources for database management and statistical analysis
shall be described in detail.

**L.8 PAST PERFORMANCE INFORMATION**

> Offerors shall submit the following information in an original and
> three (3) copies as part of their proposal for both the offeror and
> proposed major subcontractors:
>
> \(1\) Provide a listing of the offeror\'s recently completed (since
> January 1, 2003) and ongoing work (contracts and grants) **directly
> related** to the requirements of this acquisition. This listing shall
> include a brief description of each relevant project. Contracts or
> grants may include those entered into by the Federal Government,
> agencies of State and local governments and commercial customers.
> Offerors that are newly formed entities without prior contracts/grants
> should provide
>
> evaluations forms for contracts/grants and subcontracts as required
> above for all key personnel.

Include the following information for each contract, subcontract or
grant:

A. Name of contracting/grant activity

B. Contract/Grant number

C. Contract/Grant type

D. Total contract/grant value

E. Brief description of Contract/Grant

F. Contracting Officer and telephone number

G. Program Manager and telephone number

> H. Administrative Contracting Officer, if different from F., and
> telephone number

I. List of major subcontractors

> \(2\) The offeror may provide information on problems encountered on
> the contracts, grants and subcontracts identified in (1) above and
> corrective actions taken to resolve those problems. Offerors should
> not provide general information on their performance on the identified
> contracts/grants. General performance information will be obtained
> from the evaluation forms.
>
> \(3\) The offeror may describe any quality awards or certifications
> that indicate the offeror possesses a high-quality process for
> developing and producing the product or service required. Identify
> what segment of the company (one division or the entire company) that
> received the award or certification. Describe when the award or
> certification was bestowed. If the award or certification is over
> three years old, present evidence that the qualifications still apply.
>
> \(4\) Each offeror will be evaluated on his/her performance under
> existing and prior contracts for similar products or services.
> Performance information will be used for both responsibility
> determinations and as an evaluation factor against which offerors=
> relative rankings will be compared to assure best value to the
> Government. The Government will focus on information that demonstrates
> quality of performance relative to the size and complexity of the
> procurement under consideration.
>
> The attached Past Performance Questionnaire and Contractor Performance
> Form (Attachment 1) shall be completed by those contracting
> organizations listed in (1) above. The evaluation forms shall be
> completed and forwarded directly to the following:

Sharon Williams

Agency for Healthcare Research and Quality

Contracts Management Staff

540 Gaither Road

Rockville, Maryland 20850

FAX: 301-427-1740

> Evaluation forms must be received by **July 11, 2006** in order to be
> included in the review process. It is the responsibility of the
> offeror to ensure that these documents are forwarded to the
> Contracting Officer.

**L.9 SMALL DISADVANTAGED BUSINESS PARTICIPATION PLAN**

In accordance with FAR Part 15.304(c)4, the extent of participation of
Small Disadvantaged Business (SDB) concerns in performance of the
contract shall be evaluated in unrestricted acquisitions expected to
exceed a total estimated cost of \$500,000 (\$1,000,000 for
construction) subject to certain limitations (see FAR 19.201 and
19.1202).

A. All offerors, regardless of size, shall submit the following
information (an original only is required).

A plan on the extent of participation of Small Disadvantaged Business
concerns in performance of the contract. Participation in performance of
the contract includes the work expected to be performed by SDB
concern(s). This can include SDB (as prime contractor), joint ventures,
teaming arrangements, and subcontracts. Include the following
information in SDB participation plans:

1\. The extent of an offeror's commitment to use SDB concerns.
Commitment should be as specific as possible, i.e., are subcontract
arrangements already in place, letters of commitment, etc. Enforceable
commitments will be weighted more heavily than non-enforceable ones.

2\. Specifically identify the SDB concerns with point of contact and
phone number.

3\. The complexity and variety of the work SDB concerns are to perform.

4\. Realism for the use of SDB in the proposal.

5\. Past performance of the Offeror in complying with subcontracting
plans for SDB concerns.

6\. Targets expressed as dollars and percentage of total contract value
for each participating SDB; which will be incorporated into and become
part of any resulting contract.

7\. The extent of participation of SDB concerns in terms of the total
acquisition.

B.  SDB participation information will be used for both responsibility
    determinations and as an evaluation factor against which offeror's
    relative rankings will be compared to assure the best value to the
    Government. The Government will focus on information that
    demonstrates realistic commitments to use SDB concerns relative to
    the size and complexity of the acquisition under consideration. The
    Government is not required to contact all references provided by the
    offeror. Also, references other than those identified by the offeror
    may be contacted by the Government to obtain additional information
    that will be used in the evaluation of the offeror's commitment to
    SDB participation.

**L.10 BUSINESS PROPOSAL**

> The offeror shall submit as part of the proposal a
> [separate]{.underline} enclosure titled "Business Proposal." The
> Business Proposal shall include the Cost/Price Proposal and Other
> Administrative Data in accordance with the following:

A. [Cost/Price Proposal]{.underline}

A cost proposal shall be submitted in accordance with FAR 15, in a
format similar to Attachment 5. The offeror's own format may be
utilized, but all required information in Attachment 5 shall be
provided.

The business proposal must contain sufficient information to allow the
Government to perform a basic analysis of the proposed cost or price of
the work. This information shall include the amounts of the basic
elements of the proposed cost or price.

As appropriate, cost breakdowns shall be provided for the following cost
elements.

\(a\) [Direct Labor]{.underline}

> The estimated cost for all personnel who will be assigned for direct
> work on this project shall be included. Give the name, title, percent
> of effort or time, salary and fringe benefits for each employee.
>
> Salary increases that are anticipated during performance of a
> resultant contract should be proposed as a cost. If escalation is
> included, state the degree (percent) and methodology, e.g., annual
> flat rate applied to a base rate as of a specific date or a
> mid-pointed rate for the period of performance. State whether any
> additional direct labor (new hires) will be required during the
> performance period of this procurement. If so, state the number
> required and anticipated date of hire. Also, specify the month and day
> on which your fiscal year commences.

\(b\) [Supplies and Equipment]{.underline}

> Include description, unit price, quantity, total price, justification
> for purchasing or leasing items and the basis for pricing (vendor
> quotes, invoices prices, etc.).
>
> \(c\) [Travel]{.underline}
>
> The amount proposed for travel shall be supported with a breakdown
> which includes purposes, destination, duration, and estimated cost
> (transportation and per diem) for each proposed trip. If travel costs
> are proposed on the basis of your organization's established travel
> policy, a copy of the policy must be provided.
>
> \(d\) [Consultants]{.underline}
>
> This element should include name(s) of consultant, number of days, and
> daily rate. The method of obtaining each consultant, either sole
> source or competitive, and the degree of competition or the rationale
> for sole source shall be explained.
>
> \(e\) [Subcontractors]{.underline}
>
> Subcontractor costs shall be broken down and supported by cost and
> pricing data adequate to establish the reasonableness of the proposed
> amount. Support documentation should include degree of subcontract
> competition and basis for selecting source.
>
> \(f\) [Other Direct Costs]{.underline}
>
> Any proposed other direct costs shall be supported with breakdown
> outlining the separate costs proposed and details supporting the
> formulation of the costs proposed. A signed agreement between the
> offeror and any personnel other than direct employees that includes
> dates of employment, salary, and specific tasks to be performed should
> be included.
>
> \(g\) [Indirect Costs]{.underline}
>
> Indicate how you have computed and applied indirect costs, and provide
> a basis for evaluating the reasonableness of the proposed rates.

B.  [Small Business Subcontracting Plan:]{.underline}

> All offerors except small businesses are required to submit a
> subcontracting plan in accordance with the Small Business
> Subcontracting Plan, FAR 52.219-9, incorporated in this solicitation.
> A copy of the AHRQ model subcontracting plan is provided as an
> attachment to this solicitation. If the model plan is not used, all
> elements outlined must be addressed in the offeror's format. If the
> offeror is not a small business and fails to submit a subcontracting
> plan with the initial proposal, the offeror will be considered
> nonresponsive and their proposal will be returned without further
> consideration.
>
> [This provision does not apply to small business concerns. This
> provision does apply to all other offerors, including large business
> concerns, colleges, universities and non-profit
> organizations.]{.underline}

The term "subcontract" means any agreement (other than one involving an
employer-employee relationship) entered into by a Federal Government
prime contractor or subcontractor calling for supplies or services
required for the performance of the original contract or subcontract.
This includes, but is not limited to, agreements/ purchase orders for
supplies and services such as equipment purchase, copying services, and
travel services.

The offeror understands that:

a\. No contract will be awarded unless and until an acceptable plan is
negotiated with the Contracting Officer. The plan will be incorporated
in to the contract.

b\. An acceptable plan must, in the determination of the Contracting
officer, provide the maximum practicable opportunity for small business
concerns and small business concerns owned and controlled by socially
and economically disadvantaged persons to participate in the performance
of the contract.

c\. If a subcontracting plan acceptable to the Contracting Officer is
not negotiated within the time limits prescribed by the contracting
activity and such failure arises out of causes within the control and
with the fault or negligence of the offeror, the offeror shall be
ineligible for award. The Contracting Officer shall notify the
Contractor in writing of the reasons for determining a subcontracting
plan unacceptable early enough in the negotiation process to allow the
Contractor to modify the plan within the time limits prescribed.

d\. Prior compliance of the offeror with other such subcontracting plans
under previous contracts will be considered by the Contracting Officer
in determining the responsibility of the offeror for award of the
contract.

e\. It is the offeror's responsibility to develop a satisfactory
subcontracting plan with respect to small business concerns and small
business concerns owned and controlled by socially and economically
disadvantaged individuals, and women-owned small business concerns, and
that each such aspect of the offeror's plan will be judged independent
of the other.

f\. The offeror will submit, as required by the Contracting Officer,
subcontracting reports in accordance with the instructions thereon, and
as further directed by the Contracting Officer. Subcontractors will also
submit these reports to the Government Contracting Officer or as
otherwise directed, with a copy to the prime Contractor's designated
small and disadvantaged business liaison.

g.  For this particular acquisition, the AHRQ recommended goal (as a
    percentage of total contract value for the base period) is 30% for
    Small Businesses, which shall include at least 5% (as a percentage
    of total planned subcontract dollars for the base period) for Small
    Disadvantaged Businesses, at least 5% (as a percentage of total
    planned subcontract dollars total planned subcontract dollars for
    the base period) for Women-Owned Small Businesses, and at least 3%
    (as a percentage of total planned subcontract dollars for the base
    period) for HUBZone Small Businesses and at least 3% (as a
    percentage of total planned subcontract dollars for the base period)
    for Veteran-Owned Small Businesses. These goals represent AHRQ's
    expectations of the minimum level for subcontracting with small
    business at the prime contract level. Any goal stated less than the
    AHRQ recommended goal shall be justified and is subject to
    negotiation.

C. [Other Administrative Data]{.underline}

\(1\) [Terms and Conditions]{.underline}: The proposal shall stipulate
that it is predicated upon the terms and conditions of the RFP. In
addition, it shall contain a statement to the effect that it is firm for
a period of at least 120 days from the date of receipt thereof by the
Government.

> Minimum Bid Acceptance Period (April 1984)

\(a\) \"Acceptance period,\" as used in this provision, means the number
of calendar days available to the Government for awarding a contract
from the date specified in this solicitation for receipt of bids.

\(b\) This provision supersedes any language pertaining to the
acceptance period that may appear elsewhere in this solicitation.

\(c\) The Government requires a minimum acceptance period of

> 120 days.

\(d\) A bid allowing less than the Government\'s minimum acceptance
period may be rejected.

\(e\) The bidder agrees to execute all that it has undertaken to do, in
compliance with its bid, if that bid is accepted in writing within (i)
the acceptance period stated in paragraph (3) above, or (ii) any longer
acceptance period stated in paragraph (4) above.

\(2\) [Authority to Conduct Negotiations]{.underline}: The proposal
shall list the names and telephone numbers of persons authorized to
conduct negotiations and to execute contracts.

> \(3\) [Property]{.underline}:

\(a\) It is HHS policy that contractors will provide all equipment and
facilities necessary for performance of contracts. Exception may be
granted to furnish Government-owned property, or to authorize purchase
with contract funds, only when approved by the contracting officer. If
additional equipment must be acquired, you shall include the
description, estimated cost of each item and whether you will furnish
such items with your own funds.

\(b\) You shall identify Government-owned property in your possession
and/or property acquired from Federal funds to which you have title,
that is proposed to be used in the performance of the prospective
contract.

\(c\) The management and control of any Government property shall be in
accordance with HHS Publication (OS) 74-115 entitled,
[Contractor\'s]{.underline}

> [Guide for Control of Government Property]{.underline}\" 1990, a copy
> of which will be provided upon request.

\(4\) [Royalties]{.underline}: You shall furnish information concerning
royalties which are

> anticipated to be paid in connection with the performance of work
> under the
>
> proposed contract.

\(5\) [Commitments]{.underline}: You shall list other commitments with
the Government relating to the specified work or services and indicate
whether these commitments will or will not interfere with the completion
of work and/or services contemplated under this proposal.

\(6\) [Financial Capacity]{.underline}: You shall provide sufficient
data to indicate that you have the necessary financial capacity, working
capital, and other resources to perform the contract without assistance
from any outside source. If not, indicate the amount required and the
anticipated source. (Financial data such as balance sheets, profit and
loss statements, cash forecasts, and financial histories of your
organization\'s affiliated concerns should be utilized.)

\(7\) [Performance Capability]{.underline}: You shall provide acceptable
evidence of your \"ability to obtain\" equipment, facilities, and
personnel necessary to perform the requirements of this project. If
these are not represented in your current operations, they should
normally be supported by commitment or explicit arrangement, which is in
existence at the time the contract is to be awarded, for the rental,
purchase, or other acquisition of such resources, equipment, facilities,
or personnel. In addition, you shall indicate your ability to comply
with the required or proposed delivery or performance schedule taking
into consideration all existing business commitments, commercial as well
as Government.

(8) Representations and Certifications: Section K, \"Representations and
    Certifications and Other Statements of Offerors\" shall be completed
    and signed by an official authorized to bind your organization.
    **This section shall be made a part of the original business
    proposal**

**L.11 SELECTION OF OFFERORS**

a\. The acceptability of the technical portion of each contract proposal
will be evaluated by the technical review committee. The committee will
evaluate each proposal in strict conformity with the evaluation criteria
of the RFP, utilizing point scores and written critiques. The committee
may suggest that the Contracting Officer request clarifying information
from an offeror.

b\. The business portion of each contract proposal will be subjected to
a cost review, management analysis, etc.

c\. Past performance, Small Business Subcontracting Plan and the Small
Disadvantaged Business Participation Plan of the technically acceptable
offerors will be evaluated by AHRQ staff. A competitive range will be
determined. Oral or written discussions will be conducted with all
offerors in the competitive range, if necessary. All aspects of the
proposals are subject to discussions, including cost, technical
approach, past performance, Small Disadvantaged Business Participation
Plan and contractual terms and conditions. Final Proposal Revisions will
be requested with the reservation of the right to conduct limited
negotiations after submission of the Final Proposal Revisions.

d\. A final best-buy analysis will be performed taking into
consideration the results of the technical evaluation, cost analysis,
past performance, and ability to complete the work within the
Government's required schedule. The Government reserves the right to
make an award to the best advantage of the Government, technical merit,
cost, past performance, and other factors considered.

e.  The Government reserves the right to make a single award, multiple
    awards, or no award at all to the RFP.

**L.12 PROPOSAL INTENT**

It is requested that if an offeror intends to submit a proposal to this
solicitation that the attached Proposal Intent Form (Attachment 3) be
completed and returned to the address indicated by June 19, 2006. The
submission of the intent form is not binding on an offeror to submit a
proposal, nor does the failure to submit the form prohibit an offeror
from submitting a proposal. The purpose is to provide us with an
estimated number of proposals to assist us in our planning and logistics
for proposal reviews. We have added a request to include your contact
information to a bidders list. The bidders list will be provided to
interested offerors for subcontracting opportunities. In order for AHRQ
to include your contact information on the bidders list, you must return
the Proposal Intent Form and check the box that grants permission to add
your name no later than the date listed above.

> **[SECTION M - EVALUATION FACTORS FOR AWARD]{.underline}**

**[TECHNICAL EVALUATION CRITERIA]{.underline}**

[EVALUATION CRITERIA]{.underline}

Selection of an offeror for contract award will be based on an
evaluation of proposals against four factors and award will be made to
that responsible offeror whose proposal is most advantageous to the
Government. The four factors are: scientific technical merit, cost, past
performance, and the Small Disadvantaged Business Participation Plan.
The scientific technical merit of the proposals will receive paramount
consideration in the selection of the Contractor(s) for this
acquisition. Offerors that submit technically acceptable proposals will
then be evaluated for past performance and for their Small Disadvantaged
Business Participation Plan. Following these evaluations a competitive
range will be determined.

All evaluation factors, other than cost or price, when combined are
significantly more important than cost or price. However, cost/price may
become a critical factor in source selection in the event that two or
more offerors are determined to be essentially equal following the
evaluation of all factors other than cost or price. In any event, the
Government reserves the right to make an award to that offeror whose
proposal provides the best overall value to the Government. The
Government reserves the right to make a single award, multiple awards,
or no award at all.

**THE GOVERNMENT RESERVES THE RIGHT TO**

**MAKE AN AWARD WITHOUT DISCUSSION**

All proposals will be reviewed in accordance with the governing
regulations and AHRQ policies and procedures. The technical proposal,
past performance information and Small Disadvantaged Business
Participation Plan will be evaluated in terms of the offeror's responses
to each of the evaluation factors. Each proposal will be evaluated on
the likelihood of meeting the Government's requirements. The evaluation
will be based on the technical and administrative capabilities in
relation to the needs of the program, anticipated tasks, and the
reasonableness of costs shown in relation to the work to be performed.
The Government reserves the right to make an award to the best advantage
of the Government.

The evaluation factors and assigned weights which will be used in the
overall review of the offeror's proposal are outlined below. The
technical proposal shall consist of the responses to evaluation criteria
A through F (including subcriteria). The offeror should show that the
objectives stated in the proposal are understood and offer a logical
program for their achievement. The following criteria will be used to
evaluate proposals and will be weighted as indicated in establishing a
numerical rating for all proposals submitted. Factors facilitating the
evaluation of each criteria below are referenced in the corresponding
criteria found in Section L of this solicitation:

**[EVALUATION CRITERIA]{.underline}**

**A. [Understanding of the Problem]{.underline}** **WEIGHT = 10**
**pts.**

The proposal shall be evaluated on the completeness of the proposal and
the offeror=s demonstrated understanding of the project in its response
to the objectives and tasks outlined in the scope of work. The offeror
shall demonstrate an in-depth understanding of:

current status of clinical treatment of HIV disease,

existing literature concerning HIV-related service utilization and cost,

possible policy issues that would be informed by data on HIV-related
resource utilization,

the history of the treatment of HIV/AIDS

quality improvement through cross-site collaboration

**B. [Technical Approach]{.underline}** **WEIGHT = 50 pts.**

The proposal shall be evaluated on the completeness, reasonableness,
clarity, and feasibility of the approach to satisfy the requirements of
each individual task referenced in the Statement of Work. This shall
include sequencing of tasks, methods to be used, and scheduling of time
and resources.

The offer shall demonstrate familiarity with and understanding of the
nature and quality of data typically found in provider-level medical and
billing records including an understanding of the challenges of
protecting confidentiality and challenges of using data to improve care
across sites.

**C. [Management Plan]{.underline} WEIGHT = 10** **pts.**

The proposal shall be evaluated on the comprehensiveness, viability, and
precision of the plan for managing the resources necessary to complete
the tasks specified in the Statement of Work. Moreover, the proposal
shall be evaluated on how well the organization, roles, and
responsibilities of the project are defined and how carefully and
adequately the proposal has specified the work assignments and time
schedules.

**D. [Key Personnel]{.underline} WEIGHT = 20 pts.**

The proposal shall be evaluated on the relevant experience and
qualifications of key personnel, with respect to

knowledge of latest developments in the clinical treatment of HIV
infection,

knowledge of methods for valuing the economic costs of medical and
social services provided to persons with HIV infection,

understanding of the organizational and policy context of delivery of
HIV-related health services,

familiarity with, and contributions to, prior research on resource
utilization in HIV disease,

knowledge of and experience with primary data collection methods,

computer programming and large-scale database management skills,

knowledge of multivariate statistical analysis methods and availability
of consultation from experienced statisticians when confronting
nonstandard analysis problems.

knowledge of strategires for cross-site quality improvement.

**E. [Facilities]{.underline} WEIGHT = 5 pts.**

Proposals will be evaluated on the availability of adequate facilities,
space, and equipment for accomplishing project goals and objectives.
Equipment includes, but is not limited to, telephones, personal
computers, main-frame computers, word processing, xerographic, and
facsimile. In addition to computer hardware, proposals will be evaluated
on the offeror=s access to and skill using database management software
and statistical analysis software (such as SAS, STATA, S+).

**TOTAL POINTS BEFORE PAST PERFORMANCE 90 points**

**F. [Past Performance]{.underline} WEIGHT = 20** **pts.**

> (TO BE RATED ONLY AFTER A DETERMINATION OF TECHNICAL ACCEPTABILITY OF
> THE OFFEROR'S PROPOSAL, BASED ON THE ABOVE TECHNICAL EVALUATION
> CRITERIA)
>
> The offeror's past performance will be evaluated after completion of
> the technical evaluation. Only those offerors determined to be
> technically acceptable will be evaluated. Each offeror will be
> evaluated on its performance under existing and prior contracts for
> similar products or services. Performance information will be used for
> both responsibility determinations and as an evaluation factor against
> which offeror's relative rankings will be compared.
>
> The Government reserves the right to evaluate relevant past
> performance information not specifically provided by the offeror.
>
> The Government will assess the relative risks associated with each
> offeror. Performance risks are those associated with an offeror's
> likelihood of success in performing the acquisition requirements as
> indicated by the offeror's record of past performance.
>
> If the offeror or the proposed employees for the offeror, do not have
> a past performance history relative to this acquisition, or past
> performance not relative to this acquisition, the offeror will not be
> evaluated favorably or unfavorably on this factor. A neutral rating
> will be determined.
>
> In evaluating past performance the Government, will consider the
> offeror's effectiveness in quality of products or services; timeliness
> of performance; cost control; business practices; customer
> satisfaction, and key personnel past performance.
>
> [NOTICE: Past Performance questionnaires are to be provided to the
> contracting office NO LATER than the closing date and time of this
> solicitation. It is the offeror's responsibility to ensure that these
> documents are forwarded to the contracting office.]{.underline}

**G. [Small Disadvantaged Business Participation Plan]{.underline}**
**WEIGHT = 5 pts**

> The evaluation will be based on information obtained from the plan
> provided by the offeror, the realism of the proposal, other relevant
> information obtained from named SDB concerns, and any information
> supplied by the offeror concerning problems encountered in SDB
> participation.
>
> Evaluation of the SDB Participation Plan will be a subjective
> assessment based on a consideration of all relevant facts and
> circumstances. It will not be based on absolute standards of
> acceptable performance. The Government is seeking to determine whether
> the offeror has demonstrated a commitment to use SDB concerns for the
> work that it intends to perform as the prime contractor.
>
> The assessment of the offeror's SDB Participation Plan will be used as
> a means of evaluating the relative capability and commitment of the
> offeror and the other competitors. Thus, an offeror with an
> exceptional record of participation with SDB concerns may receive more
> points and a more favorable evaluation than another whose record is
> acceptable, even though both may have acceptable technical proposals.
>
> SDB participation will be scored with offerors receiving points from 0
> to 5, with 5 being the most favorable.

**TOTAL AVAILABLE POINTS [115]{.underline}**

**ATTACHMENT 1**

**PAST PERFORMANCE QUESTIONNAIRE**

**PART ONE: INSTRUCTIONS**

The offeror listed below has submitted a proposal in response to the
Agency for Healthcare Research and Quality (AHRQ) Solicitation No.
AHRQ-06-0025, entitled "HIV Research Network." Past performance is an
important part of the evaluation criteria for this acquisition, so input
from previous customers of the offeror is important. This office would
greatly appreciate you taking the time to complete this form. **This
information is to be provided to Sharon Williams, the AHRQ Contracting
Officer and is NOT to be disclosed to the offeror either verbally or in
writing.** Please provide an honest assessment and return to AHRQ to the
address shown below, no later than **July 11, 2006** If you have any
questions, please contact Ms. Sharon Williams at (301) 427-1781.

Sharon Williams

Agency for Healthcare Research and Quality

Division of Contracts Management

540 Gaither Road

Rockville, Maryland 20850

FAX: (301) 427-1740

NAME OF
OFFEROR:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

ADDRESS:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**[Contractor Performance Form]{.underline}**

1\. Name of
Contractor:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

2\.
Address:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. Contract/Grant Number:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

4\. Contract/Grant Value (Base Plus Options):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

5\. Contract/Grant Award Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

6\. Contract/Grant Completion Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

7\. Type of Contract/Grant: (Check all that apply) ( )FP ( )FPI

( ) Award Fee ( ) CPFF-Completion ( ) CPFF-Term ( ) CPIF ( ) CPAF

( ) IO/IQ ( ) BOA ( ) Requirements ( ) Labor-Hour ( )T&M ( ) SBSA

( )8(a) ( )SBIR ( ) Sealed Bid( )Negotiated( )Competitive (
)Non-Competitive

8\. Description of Requirement:

**[CONTRACTOR'S PERFORMANCE RATING]{.underline}**

Ratings: Summarize contractor performance and circle in the column on
the right the number which corresponds to the performance rating for
each rating category. Please see reverse page for explanation of rating
scale.

+------------------+-----------------------------------------------+---+
| Quality of       | Comments                                      | 0 |
| Product or       |                                               |   |
| Service          |                                               | 1 |
|                  |                                               |   |
|                  |                                               | 2 |
|                  |                                               |   |
|                  |                                               | 3 |
|                  |                                               |   |
|                  |                                               | 4 |
|                  |                                               |   |
|                  |                                               | 5 |
+------------------+-----------------------------------------------+---+
| Cost             | Comments                                      | 0 |
|                  |                                               |   |
| Control          |                                               | 1 |
|                  |                                               |   |
|                  |                                               | 2 |
|                  |                                               |   |
|                  |                                               | 3 |
|                  |                                               |   |
|                  |                                               | 4 |
|                  |                                               |   |
|                  |                                               | 5 |
+------------------+-----------------------------------------------+---+
| Timeliness of    | Comments                                      | 0 |
|                  |                                               |   |
| Performance      |                                               | 1 |
|                  |                                               |   |
|                  |                                               | 2 |
|                  |                                               |   |
|                  |                                               | 3 |
|                  |                                               |   |
|                  |                                               | 4 |
|                  |                                               |   |
|                  |                                               | 5 |
+------------------+-----------------------------------------------+---+
| Business         | Comments                                      | 0 |
| Relations        |                                               |   |
|                  |                                               | 1 |
|                  |                                               |   |
|                  |                                               | 2 |
|                  |                                               |   |
|                  |                                               | 3 |
|                  |                                               |   |
|                  |                                               | 4 |
|                  |                                               |   |
|                  |                                               | 5 |
+------------------+-----------------------------------------------+---+
|                  |                                               |   |
+------------------+-----------------------------------------------+---+

Customer Satisfaction - Is/was the Contractor committed to customer
satisfaction? Yes No ; Would you use this Contractor again? Yes No

Reason:

**NAME OF EVALUATOR:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**TITLE OF EVALUATOR:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**SIGNATURE OF
EVALUATOR:**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**DATE:**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**MAILING ADDRESS:**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**PHONE
#:**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Rating Guidelines:** Summarize contractor performance in each of the
rating areas. Assign each area a rating 0(Unsatisfactory), 1(Poor),
2(Fair), 3(Good), 4(Excellent) 5(Outstanding). Use the following
instructions as guidance in making these evaluations.

+------------+-------------+-----------+------------+----------------+
|            | **Quality** | **Cost    | **         | **Business     |
|            |             | Control** | Timeliness | Relation**     |
|            |             |           | of**       |                |
|            |             |           |            |                |
|            |             |           | **Per      |                |
|            |             |           | formance** |                |
+------------+-------------+-----------+------------+----------------+
|            | -Compliance | -Within   | -Met       | -Effective     |
|            | with        | bud       | interim    | management     |
|            | contract    | get(over/ | milestones |                |
|            |             |           |            | -Businesslike  |
|            | r           | under     | -Reliable  | correspondence |
|            | equirements | target    |            |                |
|            |             | costs)    | -          | -Responsive to |
|            | -Accuracy   |           | Responsive | contract       |
|            | of reports  | -Current, | to         |                |
|            |             | accurate, | technical  | requirements   |
|            | -Technical  | and       |            |                |
|            | excellence  |           | direction  | -Prompt        |
|            |             | complete  |            | notification   |
|            |             | billings  | -Completed | of problems    |
|            |             |           | on time,   |                |
|            |             | -Rel      |            | -Reasonab      |
|            |             | ationship | including  | le/cooperative |
|            |             | of        | wrap-up    |                |
|            |             |           | and        | -Flexible      |
|            |             | n         |            |                |
|            |             | egotiated | contract   | -Pro-active    |
|            |             | costs to  | adm        |                |
|            |             |           |            | -Effective     |
|            |             | actual    | -No        | small/small    |
|            |             |           | liquidated |                |
|            |             | -Cost     | damages    | disadvantaged  |
|            |             | eff       |            | business sub-  |
|            |             | iciencies | assessed   |                |
|            |             |           |            | contracting    |
|            |             | -Change   |            | program        |
|            |             | orders    |            |                |
|            |             | issue     |            |                |
+------------+-------------+-----------+------------+----------------+
| 0-unsa     | Nonc        | Ability   | Delays are | Response to    |
| tisfactory | onformances | to manage | je         | inquiries,     |
|            | are         | cost      | opardizing |                |
|            |             |           |            | tech           |
|            | j           | issues is | the        | nical/service/ |
|            | eopardizing | jeo       | a          | administrative |
|            | the         | pardizing | chievement |                |
|            |             |           | of         | issues is not  |
|            | achievement | pe        |            | effective      |
|            | of contract | rformance | contract   |                |
|            |             | of        | req        |                |
|            | re          | contract  | uirements, |                |
|            | quirements, |           |            |                |
|            | despite use | requ      | despite    |                |
|            |             | irements, | use of     |                |
|            | of Agency   | despite   | Agency's   |                |
|            | resources   |           |            |                |
|            |             | use of    | resources  |                |
|            |             | Agency    |            |                |
|            |             |           |            |                |
|            |             | resources |            |                |
+------------+-------------+-----------+------------+----------------+
| 1-Poor     | Overall     | Ability   | Delays     | Response to    |
|            | compliance  | to manage | require    | inquiries,     |
|            |             | cost      | major      |                |
|            | requires    |           |            | tech           |
|            | major       | issues    | Agency     | nical/service/ |
|            | Agency      | requires  | resources  | administrative |
|            |             | major     | to         |                |
|            | resources   |           |            | issues is      |
|            | to ensure   | Agency    | ensure     | marginally     |
|            |             | resources | a          | effective      |
|            | achievement | to        | chievement |                |
|            | of contract |           | of         |                |
|            |             | ensure    |            |                |
|            | r           | ac        | contract   |                |
|            | equirements | hievement | re         |                |
|            |             | of        | quirements |                |
|            |             |           |            |                |
|            |             | contract  |            |                |
|            |             | req       |            |                |
|            |             | uirements |            |                |
+------------+-------------+-----------+------------+----------------+
| 2-Fair     | Overall     | Ability   | Delays     | Response to    |
|            | compliance  | to manage | require    | inquiries,     |
|            |             | cost      | minor      |                |
|            | requires    |           |            | tech           |
|            | minor       | issues    | Agency     | nical/service/ |
|            | Agency      | requires  | resources  | administrative |
|            |             | minor     | to         |                |
|            | resources   |           |            | issues is      |
|            | to ensure   | Agency    | ensure     | somewhat       |
|            |             | resources | a          | effective      |
|            | achievement | to        | chievement |                |
|            | of contract |           | of         |                |
|            |             | ensure    |            |                |
|            | r           | ac        | contract   |                |
|            | equirements | hievement | re         |                |
|            |             | of        | quirements |                |
|            |             |           |            |                |
|            |             | contract  |            |                |
|            |             | req       |            |                |
|            |             | uirements |            |                |
+------------+-------------+-----------+------------+----------------+
| 3-Good     | Overall     | M         | Delays do  | Response to    |
|            | compliance  | anagement | not impact | inquiries,     |
|            | does        | of cost   |            |                |
|            |             |           | a          | tech           |
|            | not impact  | issues    | chievement | nical/service/ |
|            | achievement | does not  | of         | administrative |
|            | of          | impact    | contract   |                |
|            |             |           |            | issues is      |
|            | contract    | ac        | re         | usually        |
|            | r           | hievement | quirements | effective      |
|            | equirements | of        |            |                |
|            |             | contract  |            |                |
|            |             |           |            |                |
|            |             | req       |            |                |
|            |             | uirements |            |                |
+------------+-------------+-----------+------------+----------------+
| 4          | There are   | There are | There are  | Response to    |
| -Excellent | no quality  | no cost   | no delays  | inquiries,     |
|            |             |           |            |                |
|            | problems    | m         |            | tech           |
|            |             | anagement |            | nical/service/ |
|            |             | issues    |            | administrative |
|            |             |           |            |                |
|            |             |           |            | issues is      |
|            |             |           |            | effective      |
+------------+-------------+-----------+------------+----------------+

5-Outstanding. The Contractor has demonstrated an outstanding
performance level that justifies adding a point to the score. It is
expected that this rating

will be used in those rare circumstances where Contractor performance
clearly exceeds the performance levels described as "Excellent."

**ATTACHMENT 2 0348-0046**

Complete this form to disclose lobbying activities pursuant to 31 U.S.C.
1352

(See reverse for public burden disclosure.)

+-----------------------+-----------------------+----------------------+
| 1\. Type of Federal   | 2\. Status of Federal | 3\. Report Type:     |
| Action:               | Action:               |                      |
|                       |                       | > a\. initial filing |
| > a\. contract        | a\.                   | >                    |
| >                     | bid/offer/application | > b\. material       |
| > b\. grant           |                       | > change             |
| >                     | b\. Initial award     | >                    |
| > c\. cooperative     |                       | > For Material       |
| > agreement           | c\. post-award        | > Change Only:       |
| >                     |                       | >                    |
| > d\. loan            |                       | > year \_\_\_\_\_\_  |
| >                     |                       | > quarter            |
| > e\. loan guarantee  |                       | > \_\_\_\_\_\_\_     |
| >                     |                       | >                    |
| > f\. loan insurance  |                       | > date of last       |
|                       |                       | > re                 |
|                       |                       | port\_\_\_\_\_\_\_\_ |
+-----------------------+-----------------------+----------------------+

+----------------------------------+-----------------------------------+
| 4\. Name and Address of          | 5\. If Reporting Entity in No. 4  |
| Reporting Entity:                | is Subawardee, Enter Name and     |
|                                  | Address of Prime                  |
| G Prime G Subawardee             |                                   |
|                                  | Congressional District, if known: |
| Tier\_\_\_\_\_, if known:        |                                   |
|                                  |                                   |
| Congressional District, if       |                                   |
| known:                           |                                   |
+----------------------------------+-----------------------------------+
| 6\. Federal Department/Agency:   | 7\. Federal Program               |
|                                  | Name/Description                  |
|                                  |                                   |
|                                  | CFDA Number, if applicable:       |
|                                  | \_\                               |
|                                  | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+----------------------------------+-----------------------------------+
| 8\. Federal Action Number, if    | 9\. Award Amount, if known:       |
| known:                           |                                   |
|                                  | \$                                |
+----------------------------------+-----------------------------------+
| 10\. a. Name and Address of      | b\. Individual Performing         |
| Lobbying Entity                  | Services (including address if    |
|                                  | different from No. 10a)           |
| (if individual, last name, first |                                   |
| name, MI):                       | (last name, first name, MI)       |
|                                  |                                   |
| (attach Continuation Sheet(s)    | SF-LLL-A, if necessary)           |
+----------------------------------+-----------------------------------+
| 11\. Amount of Payment (check    | 13\. Type of Payment (check all   |
| all that apply):                 | that apply):                      |
|                                  |                                   |
| \$\_\_\_\_\_\_\_\_\_\_ G actual  | G a. retainer                     |
| G planned                        |                                   |
|                                  | G b. one-time fee                 |
|                                  |                                   |
|                                  | G c. commission                   |
|                                  |                                   |
|                                  | G d. contingent fee               |
|                                  |                                   |
|                                  | G e. deferred                     |
|                                  |                                   |
|                                  | G f. other; specify:              |
|                                  | \_\_\_\_\_\_\_\_\_\_\_\_\         |
|                                  | _\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |
+----------------------------------+-----------------------------------+
| 12\. Form of Payment (check all  |                                   |
| that apply):                     |                                   |
|                                  |                                   |
| G a. cash                        |                                   |
|                                  |                                   |
| G b. in-kind; specify:           |                                   |
| nature\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
|                                  |                                   |
| v                                |                                   |
| alue\_\_\_\_\_\_\_\_\_\_\_\_\_\_ |                                   |
+----------------------------------+-----------------------------------+

+------------------------------+------+--------------------------------+
| 14\. Brief Description of    |      |                                |
| Services Performed or to be  |      |                                |
| Performed and Date(s) of     |      |                                |
| Service, including           |      |                                |
| officer(s), employee(s), or  |      |                                |
| Member(s) contacted, for     |      |                                |
| payment indicated in Item    |      |                                |
| 11:                          |      |                                |
|                              |      |                                |
| (attach Continuation         |      |                                |
| Sheet(s) SF-LLL-A, if        |      |                                |
| necessary)                   |      |                                |
+------------------------------+------+--------------------------------+
| 15\. Continuation Sheet(s)   | Yes  | No                             |
| SF-LLL-A attached:           |      |                                |
+------------------------------+------+--------------------------------+

+-----------------------------------------+----------------------------+
| 16\. Information requested through this | Signature:\_\_\_\_\_       |
| form is authorized by title 31 U.S.C.   | \_\_\_\_\_\_\_\_\_\_\_\_\_ |
| section 1352. This disclosure of        | \_\_\_\_\_\_\_\_\_\_\_\_\_ |
| lobbying activities is a material       |                            |
| representation of fact upon which       | Print                      |
| reliance was placed by the tier above   | Name:\_\_\_\_\_\_\_\_\_\_  |
| when this transaction was made or       | \_\_\_\_\_\_\_\_\_\_\_\_\_ |
| entered into. This disclosure is        | \_\_\_\_\_\_\_\_\_\_\_\_\_ |
| required pursuant to 31 U.S.C. 1352.    |                            |
| This information will be reported to    | Title:\_\_\_\_\_\_\_\_\_   |
| the Congress semi-annually and will be  | \_\_\_\_\_\_\_\_\_\_\_\_\_ |
| available for public inspection. Any    | \_\_\_\_\_\_\_\_\_\_\_\_\_ |
| person who fails to file the required   |                            |
| disclosure shall be subject to a civil  | Telephone                  |
| penalty of not less than \$10,000 and   | No.:\_\_\_\_\_\            |
| not more than \$100,000 for each        | _\_\_\_\_\_\_\_\_\_\_\_Dat |
| failure.                                | e:\_\_\_\_\_\_\_\_\_\_\_\_ |
+-----------------------------------------+----------------------------+

+-----------------------------------------+----------------------------+
| **Federal Use Only**                    | Authorized for Local       |
|                                         | Reproduction               |
|                                         |                            |
|                                         | Standard Form\--LLL        |
+-----------------------------------------+----------------------------+

**DISCLOSURE OF LOBBYING ACTIVITIES**

**CONTINUATION SHEET**

Approved by OMB

0348-0046

  -----------------------------------------------------------------------------------------------------------

  Reporting
  Entity:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
  Page \_\_\_\_\_ of \_\_\_\_\_

  -----------------------------------------------------------------------------------------------------------

Authorized for Local Reproduction

Standard Form\--LLL-A

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether
subawardee of prime Federal recipient, at the initiation or receipt of a
covered Federal action, or a material change to a previous filing,
pursuant to title 31 U.S.C. section 1352. The filing of a form is
required for each payment or agreement to make payment to any lobbying
entity for influencing of 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 in connection with a covered
Federal action. Use the SF-LLL-A Continuation Sheet for additional
information if the space on the form is inadequate. Complete all items
that apply for both the initial filing and material change report. Refer
to the implementing guidance published by the Office of Management and
Budget for additional information.

1\. Identify the type of covered Federal action for which lobbying
activity is and/or has been secured to influence the outcome of a
covered Federal action.

2\. Identify the status of the covered Federal action.

3\. Identify the appropriate classification of this report. If this is a
follow-up report caused by a material change to the information
previously reported, enter the year and quarter in which the change
occurred. Enter the date of the last previously submitted report by this
reporting entity for this covered Federal action.

4\. Enter the full name, address, city, state and zip code of the
reporting entity. Include Congressional District, if known. Check the
appropriate classification of the reporting entity that designates if it
is, or expects to be, a prime or subaward recipient. Identify the tier
of the subawardee, e.g., the first subawardee of the prime is the 1st
tier. Subawards include but are not limited to subcontracts, subgrants
and contract awards under grants.

5\. If the organization filing the report in item 4 checks
\"Subawardee,\" then enter the full name, address, city, state and zip
code of the prime Federal recipient. Include Congressional District, if
known.

6\. Enter the name of the Federal agency making the award or loan
commitment. Include at least one organizational level below agency name,
if known. For example, Department of Transportation, United States Coast
Guard.

7\. Enter the Federal program name or description for the covered
Federal action (item 1). If known, enter the full Catalog of Federal
Domestic Assistance (CFDA) number for grants, cooperative agreements,
loans, and loan commitments.

8\. Enter the most appropriate Federal identifying number available for
the Federal action identified in item 1 (e.g., Request for Proposal
(RFP) number, Invitation for Bid (IFB) number, grant announcement
number, the contract, grant, or loan award number, the
application/proposal control number assigned by the Federal agency).
Include prefixes, e.g., \"RFP-DE-90-001.\"

9\. For a covered Federal action where there has been an award or loan
commitment by the Federal agency, enter the Federal amount of the
award/loan commitment for the prime entity identified in item 4 or 5.

10\. (a) Enter the full name, address, city, state and zip code of the
lobbying entity engaged by the reporting entity identified in item 4 to
influence the covered Federal action.

\(b\) Enter the full names of the individual(s) performing services, and
include full address if different from 10(a); Enter Last Name, First
Name, and Middle Initial (MI).

11\. Enter the amount of compensation paid or reasonably expected to be
paid by the reporting entity (item 4) to the lobbying entity (item 10).
Indicate whether the payment has been made (actual) or will be made
(planned). Check all boxes that apply. If this is a material charge
report, enter the cumulative amount of payment made or planned to be
made.

12\. Check the appropriate box(es). Check all boxes that apply. If
payment is made through an in-kind contribution, specify the nature and
value of the in-kind payment.

13\. Check the appropriate box(es). Check all boxes that apply. If
other, specify nature.

14\. Provide a specific and detailed description of the services that
the lobbyist has performed, or will be expected to perform, and the
date(s) of any services rendered. Include all preparatory and related
activity, not just time spent in actual contact with Federal officials.
Identify the Federal official(s) or employee(s) contacted or the
officer(s), employee(s), or Member(s) of Congress that were contacted.

15\. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached.

16\. The certifying official shall sign and date the form, print his/her
name, title and telephone number.

+-----------------------------------------------------------------------+
| > Public reporting burden for this collection of information is       |
| > estimated to average 30 minutes per response, including time for    |
| > reviewing instructions, searching existing data sources, gathering  |
| > and maintaining the data needed, and completing and reviewing the   |
| > collection of information. Send comments regarding the burden       |
| > estimate or any other aspect of this collection of information,     |
| > including suggestions for reducing this burden, to the Office of    |
| > Management and Budget, Paperwork Reduction Project (0348-0046),     |
| > Washington, D.C. 20503.                                             |
+-----------------------------------------------------------------------+

> **ATTACHMENT 3**
>
> ***PROPOSAL INTENT RESPONSE SHEET***
>
> **[RFP No. AHRQ-06-0025]{.underline}**
>
> **Please review the attached request for proposal. Furnish the
> information requested below and return this page by June 19, 2006.
> Your expression of intent is not binding but will greatly assist us in
> planning for the proposal evaluation.**
>
> **\[ \] INTEND TO SUBMIT A PROPOSAL**
>
> **\[ \] DO NOT INTEND TO SUBMIT A PROPOSAL FOR THE FOLLOWING
> REASONS:**
>
> **\[ \] I GRANT PERMISSION TO THE AGENCY FOR HEALTHCARE RESEARCH AND
> QUALITY, CONTRACTS OFFICE TO ADD THE CONTACT INFORMAION BELOW TO A
> BIDDERS LIST TO PROVIDE TO OTHER INTERESTED OFFERORS FOR
> SUBCONTRACTING OPPORTUNITIES. (\*MUST INCLUDE AUTHORIZED SIGNATURE)**
>
> **COMPANY/INSTITUTION NAME:**
>
> **\*AUTHORIZED SIGNATURE:**
>
> **TYPED NAME AND TITLE:**
>
> **DATE:**
>
> **\[ \] PLEASE [DO NOT]{.underline} RELEASE THE CONTACT INFORMATION.**
>
> **Please return to:**
>
> **Sharon Williams**
>
> **Agency for Healthcare Research and Quality**
>
> **Contracts Management**
>
> **540 Gaither Road**
>
> **Rockville, Maryland 20850**

**Attachment 4**

**SMALL BUSINESS SUBCONTRACTING PLAN**

**DATE OF PLAN**: \_\_\_\_\_\_\_\_\_\_\_\_\_\_

CONTRACTOR
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

ADDRESS:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

DUNN & BRADSTREET NUMBER:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SOLICITATION OR CONTRACT NUMBER:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

ITEM/SERVICE (Description):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TOTAL CONTRACT AMOUNT: \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Total contract or Option #1

> Base-Year, if options (if applicable)

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Option #2 Option #3 Option #4

(if applicable) (if applicable) (if applicable)

TOTAL MODIFICATION AMOUNT, IF APPLICABLE \$
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TOTAL TASK ORDER AMOUNT, IF APPLICABLE\$ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PERIOD OF CONTRACT PERFORMANCE (Month, Day & Year):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

The following outline meets the minimum requirements of section 8(d) of
the Small Business Act, as amended, and implemented by Federal
Acquisition Regulations (FAR) Subpart 19.7. While this outline has been
designed to be consistent with statutory and regulatory requirements,
other formats of a subcontracting plan may be acceptable. It is not
intended to replace any existing corporate plan that is more extensive.
Failure to include the essential information of FAR Subpart 19.7 may be
cause for either a delay in acceptance or the rejection of a bid or
offer when a subcontracting plan is required. "SUBCONTRACT," as used in
this clause, means any agreement (other than one involving an
employer‑employee relationship) entered into by a Federal Government
prime contractor or subcontractor calling for supplies or services
required for performance of the contract or subcontract. **If assistance
is needed to locate small business sources, contact the Office of Small
and Disadvantage Business Utilization (OSDBU) at (202) 690-7300 or the
OPDIV Small Business Specialist at
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**. **Sources may also be obtained
from SBA's PRONET website**. Please note that the Department of Health
and Human Services (HHS) has subcontracting goals of \_30\_\_% for small
business (SB), \_5\_% for small disadvantaged business (SDB), \_3\_\_%
for HubZone businesses (HUBZone), \_\_\_5\_\_% for women-owned business
(WOSB), \_\_3\_\_% for veteran-owned business (VOSB), and service
disabled veteran-owned small business (SDVOSB) concerns for fiscal year
\_\_\_\_\_. For this procurement, HHS expects all proposed
subcontracting plans to contain the following goals, at a minimum,
\_\_\_\_\_% for small business, \_\_\_\_% small disadvantaged business,
\_\_\_\_% for HubZone businesses, \_\_\_\_\_\_% for woman owned
businesses, and \_\_\_\_\_\_% for veteran-owned businesses. These
percentages shall be expressed as percentages of the total estimated
subcontracting dollars. **The offeror is required to include an
explanation for a category that has zero as a goal.**

**NOTE TO CONTRACTORS:** Please provide your CCS number with your Dun &
Bradstreet number.

**1. Type of Plan (check one)**

> \_\_\_\_\_ ***Individual plan*** (all elements developed specifically
> for this contract and applicable for the full term of this contract).
>
> \_\_\_\_\_ ***Master plan*** (goals developed for this contract) all
> other elements standardized and approved by a lead agency Federal
> Official; must be renewed every three years and contractor must
> provide copy of lead agency approval.
>
> \_\_\_\_\_ ***Commercial products/service plan*** This plan is used
> when the contractor sells products and services customarily used for
> non-government purposes. Plan/goals are negotiated with the initial
> agency on a company-wide basis rather than for individual contracts.
> The plan is effective only during the year approved. The contractor
> must provide a copy of the initial agency approval, and must submit an
> annual SF 295 to HHS with a breakout of subcontracting prorated for
> HHS (with a OPDIV breakdown, if possible.)

**2. Goals**

State separate dollar and percentage goals for Small Business (SB),
Small Disadvantaged Business (SDB), Woman‑owned Small Business (WOSB),
Historically Underutilized Business Zone (HUBZone) Small Business,
Veteran‑owned (VOSB), Service-Disabled Veteran-owned Small Business
(SDVOSB) and "Other than small business" (Other) as subcontractors, for
the base year and each option year, as specified in FAR 19.704 (break
out and append option year goals, if the contract contains option years)
or project annual subcontracting base and goals under commercial plans.

a.  Total estimated dollar value of ALL planned subcontracting, i.e.,
    with ALL types of concerns under this contract is \$
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (b + h = a) (Base
    Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

b.  Total estimated dollar value and percent of planned subcontracting
    with SMALL BUSINESSES (including SDB, WOSB, HUBZone, SDVOSB and
    VOSB): (% of "a") \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_%

> (Base Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

c.  Total estimated dollar value and percent of planned subcontracting
    with SMALL DISADVANTAGED BUSINESSES: (% of "a") \$
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_% (Base Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

d.  Total estimated dollar value and percent of planned subcontracting
    with WOMAN‑OWNED SMALL BUSINESSES: (% of "a") \$
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_% (Base Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

e.  Total estimated dollar and percent of planned subcontracting with
    HUBZone SMALL BUSINESSES:

> (% of "a") \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_% (Base Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

Total estimated dollar and percent of planned subcontracting with
VETERAN SMALL BUSINESSES: (% of "a") \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
and \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_% (Base Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

g.  Total estimated dollar and percent of planned subcontracting with
    Service-Disabled Veteran-Owned Small Business: (% of "a)
    \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_% (Base Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

h.  Total estimated dollar and percent of planned subcontracting with
    "OTHER THAN SMALL BUSINESSES":

> (% of "a") \$ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_% (Base Year)

FY \_\_\_1^st^ Option FY \_\_\_2^nd^ Option FY \_\_\_3^rd^ Option FY
\_\_\_4^th^ Option

\$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_\_\_\_\_\_

> **Notes:** 1. Federal prime contract goals are:
>
> SB equals 30%; SDB equals 11%; HUBZone equals 3%, WOSB equals 5% and
> SDVOSB equals 3%, VOSB equals 3% and can serve as objectives for
> subcontracting goal development.

2.  SDB, WOSB, HUBZone, SDVOSB and VOSB goals are subsets of SB and
    should be counted and reported in multiple categories, as
    appropriate.

3.  If any contract has more four options, please attach additional
    sheets showing dollar amounts and percentages.

Provide a description of ALL the products and/or services to be
subcontracted under this contract, and indicate the size and type of
business supplying them (check all that apply).

  ------------------- ------- ------ ------ ------- ---------- ------ --------
  Product/Service     Other   SB     SDB    WOSB    HUBZone    VOSB   SDVOSB

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      

                                                                      
  ------------------- ------- ------ ------ ------- ---------- ------ --------

> i\. Provide a description of the method used to develop the
> subcontracting goals for SB, SDB, WOSB, HUBZone, and VOSB concerns.
> Address efforts made to ensure that maximum practicable subcontracting
> opportunities have been made available for those concerns and explain
> the method used to identify potential sources for solicitation
> purposes. Explain the method and state the quantitative basis (in
> dollars) used to establish the percentage goals. Also, explain how the
> areas to be subcontracted to SB, SDB, WOSB, HUBZone, and VOSB concerns
> were determined, how the capabilities of these concerns were
> considered contract opportunities and how such data comports with the
> cost proposal. Identify any source lists or other resources used in
> the determination process. (Attach additional sheets, if necessary.)
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> j\. Indirect costs have \_\_\_\_ have not \_\_\_\_ been included in
> the dollar and percentage subcontracting goals above (check one).

k.  If indirect costs have been included, explain the method used to
    determine the proportionate share of such costs to be allocated as
    subcontracts to SB, SDB, WOSB, HUBZone, SDVOSB and VOSB concerns.

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**3.** **Program Administrator:**

> NAME/TITLE:
>
> ADDRESS:
>
> TELEPHONE/E-MAIL:

**Duties**: Does the individual named above have general overall
responsibility for the company's subcontracting program, i.e.,
developing, preparing, and executing subcontracting plans and monitoring
performance relative to the requirements of those subcontracting plans
and perform the following duties? (If NO is checked, please indicate who
in the company performs those duties, or indicate why the duties are not
performed in your company.)

> Developing and promoting company‑wide policy initiatives that
> demonstrate the company's support for awarding contracts and
> subcontracts to SB, SDB, WOSB, HUBZone, SDVOSB and VOSB concerns; and
> for assuring that these concerns are included on the source lists for
> solicitations for products and services they are capable of providing.
> \_\_\_\_\_\_ yes \_\_\_\_\_\_ no
>
> Developing and maintaining bidder source lists of SB, SDB, WOSB,
> HUBZone, SDVOSB and VOSB concerns from all possible sources;
> \_\_\_\_\_\_ yes \_\_\_\_\_\_\_\_ no

a.  Ensuring periodic rotation of potential subcontractors on bidder's
    lists; \_\_\_\_\_ yes \_\_\_\_\_ no

b.  Assuring that SB, SDB, WOSB, HUBZONE, SDVOSB and VOSB businesses are
    included on the bidders' list for every subcontract solicitation for
    products and services that they are capable of providing.

> \_\_\_\_\_\_ yes \_\_\_\_\_\_\_ no

c.  Ensuring that requests for proposals (RFPs) are designed to permit
    the maximum practicable participation of SB, SDB, WOSB, HUBZone,
    SDVOSB and VOSB concerns. \_\_\_\_\_\_\_ yes \_\_\_\_\_\_ no

d.  Reviewing subcontract solicitations to remove statements, clauses,
    etc., which might tend to restrict or prohibit small, HubZone small,
    small disadvantaged, and women-owned small business participation.

> \_\_\_\_\_\_\_ yes \_\_\_\_\_\_ no

e.  Accessing various sources for the identification of SB, SDB, WOSB,
    HUBZone, SDVOSB and VOSB concerns to include the SBA's PRO-Net and
    SUB-Net Systems, ([http://www.sba.gov](http://www.sba.gov/)), the
    National Minority Purchasing Council Vendor Information Service,
    the Office of Minority Business Data Center in the Department of
    Commerce, local small business and minority associations, contact
    with local chambers of commerce and Federal agencies' Small Business
    Offices; \_\_\_\_\_\_ yes \_\_\_\_\_\_\_ no

f.  Establishing and maintaining contract and subcontract award records;
    \_\_\_\_\_\_ yes \_\_\_\_\_\_ no

g.  Participating in Business Opportunity Workshops, Minority Business
    Enterprise Seminars, Trade Fairs, Procurement Conferences, etc;

h.  Ensuring that SB, SDB, WOSB, HUBZone, and VOSB concerns are made
    aware of subcontracting opportunities and assisting concerns in
    preparing responsive bids to the company;

i.  Conducting or arranging for the conduct of training for purchasing
    personnel regarding the intent and impact of Section 8(d) of the
    Small Business Act, as amended;

j.  Monitoring the company's subcontracting program performance and
    making any adjustments necessary to achieve the subcontract plan
    goals;

k.  Preparing, and submitting timely, required subcontract reports;

l.  Conducting or arranging training for purchasing personnel regarding
    the intent and impact of 8(d) of the Small Business Act on
    purchasing procedures.

m.  Coordinating the company's activities during the conduct of
    compliance reviews by Federal agencies; and

n.  Other duties:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**4.** **Equitable Opportunity**

Describe efforts the offeror will Describe efforts Describe efforts the
offeror will make to ensure that SB, SDB, WOSB, HUBZone, and VOSB
concerns will have an equitable opportunity to compete for subcontracts.
These efforts include, but are not limited to, the following activities:

a.  Outreach efforts to obtain sources:

    1.  Contacting minority and small business trade associations; 2)
        contacting business development organizations and local chambers
        of commerce; 3) attending SB, SDB, WOSB, HUBZone, and VOSB
        procurement conferences and trade fairs; 4) requesting sources
        from the Small Business Administrations (SBA) PRO-Net and
        SUB-Net Systems, (<http://www.sba.gov/>) and other SBA and
        Federal agency resources. Contractors may also conduct market
        surveys to identify new sources, to include, accessing the NIH
        e-Portals in Commerce, (e-PIC), (<http://epic.od.nih.gov/>). The
        NIH e-Portals in Commerce is not a mandatory source and may be
        used at the offeror's discretion.

b\. Internal efforts to guide and encourage purchasing personnel:

1.  Conducting workshops, seminars, and training programs;

2.  Establishing, maintaining, and utilizing SB, SDB, WOSB, HUBZone, and
    VOSB source lists, guides, and other data for soliciting
    subcontractors; and

3.  Monitoring activities to evaluate compliance with the subcontracting
    plan.

> Additional efforts:
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**5.** **Flow Down Clause**

The contractor agrees to include the provisions under FAR 52.219‑8,
"Utilization of Small Business Concerns," in all acquisitions exceeding
the simplified acquisition threshold that offers further subcontracting
opportunities. All subcontractors, except small business concerns, that
receive subcontracts in excess of \$500,000 (\$1,000,000 for
construction) must adopt and comply with a plan similar to the plan
required by FAR 52.219‑9, "Small Business Subcontracting Plan." (Flow
down is not applicable for commercial items/services as described in
52.212-5(e) and

52.244-6(c).)

**6.** **Reporting and Cooperation**

The contractor gives assurance of (1) cooperation in any studies or
surveys that may be required; (2) submission of periodic reports which
show compliance with the subcontracting plan; (3) submission of Standard
Form (SF) 294, "Subcontracting Report for Individual Contracts," and
attendant Optional Form 312, SDB Participation Report, if applicable,
(required only for contracts containing the clause 52.219-25) and SF
295, "Summary Subcontract Report," in accordance with the instructions
on the forms; and (4) ensuring that subcontractors agree to submit
Standard Forms 294 and 295.

  --------------------------- ------------------------- ------------------
  Reporting Period            Report Due                Due Date

  Oct 1 - Mar 31              SF 294                    4/30

  Apr 1 - Sept 30             SF 294                    10/30

  Oct 1 - Sept 30             SF 295                    10/30

  Contract Completion         OF 312                    30 days after
                                                        completion
  --------------------------- ------------------------- ------------------

Special instructions for commercial plan: SF 295 Report is due on 10/30
each year for the previous fiscal year ending 9/30.

a.  Submit SF 294 to cognizant Awarding Contracting Officer.

> b\. Submit Optional Form 312, (OF-312), if applicable, to cognizant
> Awarding Contracting Officer.
>
> c\. Submit SF 295 to cognizant Awarding Contracting Officer and to
> the:
>
> Office of Small and Disadvantaged Business Utilization
>
> Department of Health and Human Services
>
> 200 Independence Avenue, SW
>
> Humphrey H. Building, Room 517‑D
>
> Washington, D.C. 20201
>
> d\. Submit "information" copy of the SF 295 and the SF 294 upon
> request to the SBA Commercial Market Representative (CMR); visit the
> SBA at <http://www.sba.gov/gc> and click on assistance directory to
> locate your nearest CMR.

**7. Record keeping**

FAR 19.704(a) (11) requires a list of the types of records your company
will maintain to demonstrate the procedures adopted to comply with the
requirements and goals in the subcontracting plan. The following is a
recitation of the types of records the contractor will maintain to
demonstrate the procedures adopted to comply with the requirements and
goals in the subcontracting plan. These records will include, but not be
limited to, the following:

a.  SB, SDB, WOSB, HUBZone, and VOSB source lists, guides and other data
    identifying such vendors;

b.  Organizations contacted in an attempt to locate SB, SDB, WOSB,
    HUBZone, and VOSB sources;

c.  On a contract‑by‑contract basis, records on all subcontract
    solicitations over \$100,000, which indicate for each
    solicitation (1) whether SB, SDB, WOSB, HUBZone, and/or VOSB
    concerns were solicited, if not, why not and the reasons solicited
    concerns did not receive subcontract awards.

d.  Records to support other outreach efforts, e.g., contacts with
    minority and small business trade associations, attendance at small
    and minority business procurement conferences and trade fairs;

e.  Records to support internal guidance and encouragement provided to
    buyers through (1) workshops, seminars, training programs, incentive
    awards; and (2) monitoring performance to evaluate compliance with
    the program and requirements;

f.  On a contract‑by‑contract basis, records to support subcontract
    award data including the name, address, and business type and size
    of each subcontractor. (This item is not required on a *contract --
    by -- contract basis* for company or division‑wide commercial
    plans.)

g.  Other records to support your compliance with the subcontracting
    plan: (Please describe)

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**8. Timely Payments to Subcontractors**

FAR 19.702 requires your company to establish and use procedures to
ensure the timely payment of amounts due pursuant to the terms of your
subcontracts with small business concerns, HubZone small business
concerns, small disadvantaged small business concerns, veteran-owned
small business concerns and women-owned small business concerns.

Your company has established and uses such procedures: \_\_\_\_\_\_\_\_
yes \_\_\_\_\_\_\_\_\_ no

**9. Description of Good Faith Effort**

Maximum practicable utilization of small, HubZone small, small
disadvantaged, veteran-owned, and women-owned small business concerns as
subcontractors in Government contracts is a matter of national interest
with both social and economic benefits**. When a contractor fails to
make a good faith effort to comply with a subcontracting plan, these
objectives are not achieved, and 15 U.S.C. 637(d) (4) (F) directs that
liquidated damages shall be paid by the contractor.** In order to
demonstrate your compliance with a good faith effort to achieve the
small, HubZone, small disadvantaged, veteran-owned and women-owned small
business subcontracting goals, outline the steps your company plans to
take. These steps will be negotiated with the contracting officer prior
to approval of the plan.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**SIGNATURE PAGE**

Signatures Required:

This subcontracting plan was submitted by:

**Signature:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Typed Name:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Title:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Date:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

This plan was reviewed by:

**Signature:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Typed Name:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Title: [\_\_\_\_\_\_\_\_Contracting
Officer\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Date:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

This plan was reviewed by:

**Signature:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Typed Name:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Title: [\_\_\_\_\_\_\_\_Small Business
Specialist\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Date:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

This plan was reviewed by:

**Signature:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Typed Name:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Title: [\_\_\_\_\_\_\_\_SBA Procurement Center
Representative\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Date:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**And Is Accepted By:**

**OPDIV:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Typed Name:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Title:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**Date:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

Attachment 5

RFP Number:

Organization:

Date:

SAMPLE

[BREAKDOWN OF PROPOSED ESTIMATED COST (PLUS FEE) AND LABOR
HOURS]{.underline}

[COST ELEMENT]{.underline} [Year 1]{.underline} [Year 2]{.underline}
[Year 3]{.underline} [Year 4]{.underline} [Year 5]{.underline} [Year
6]{.underline} [Year 7]{.underline} [Total]{.underline}

[DIRECT LABOR:]{.underline}

[Hours]{.underline} [Hours]{.underline} [Hours]{.underline}
[Hours]{.underline} [Hours]{.underline} [Hours]{.underline}
[Hours]{.underline} [Hours]{.underline}

[Labor Category]{.underline} [Rate]{.underline} [Amt]{.underline}
[Amt]{.underline} [Amt]{.underline} [Amt]{.underline} [Amt]{.underline}
[Amt]{.underline} [Amt]{.underline} [Amt]{.underline}

(Title and Name\--

use additional

pages as necessary)

[DIRECT LABOR COST]{.underline}: \$ \$ \$ \$ \$ \$ \$ \$

[MATERIAL COST]{.underline}: \$ \$ \$ \$ \$ \$ \$ \$

[TRAVEL COST]{.underline}: \$ \$ \$ \$ \$ \$ \$ \$

[OTHER (Specify)]{.underline} \$ \$ \$ \$ \$ \$ \$ \$

[OTHER (Specify)]{.underline} \$ \$ \$ \$ \$ \$ \$ \$

TOTAL [DIRECT]{.underline} COST: \$ \$ \$ \$ \$ \$ \$ \$

[FRINGE BENEFIT COST]{.underline}:

(if applicable)

\% of Direct Labor Cost \$ \$ \$ \$ \$ \$ \$ \$

[INDIRECT COST]{.underline}:

\% of Total Direct Cost \$ \$ \$ \$ \$ \$ \$ \$

[TOTAL COST]{.underline}: \$ \$ \$ \$ \$ \$ \$ \$

[FIXED FEE]{.underline}:

(if applicable)

\% of Total Est. Cost \$ \$ \$ \$ \$ \$ \$ \$

[GRAND TOTAL EST COST]{.underline} \$ \$ \$ \$ \$ \$ \$ \$

(PLUS FIXED FEE )