REQUEST FOR PROPOSALS FOR CHEST X-RAYS …. TIMETABLE A. Release Date of ... by the State of Nevada...

REQUEST FOR PROPOSALS

FOR

CHEST X-RAYS (CXR) SERVICES

FOR ACTIVE TB CLIENTS

SNHD-1-RFP-14-001

JUNE 10, 2014

330 S. Valley View Blvd Las Vegas, NV 89107

TABLE OF CONTENTS

PAGE I. TIMETABLE

A. Release Date of the Request for Proposals ....................................................... 1 B. Designated Contact/Questions ........................................................................... 1 C. Proposal Due Date and Time and Location ....................................................... 1 D. Anticipated Contract Start Date .......................................................................... 1

II. INTRODUCTION A. Intent ................................................................................................................. 2 B. Entity Information .............................................................................................. 2 C. Funding Source ................................................................................................ 3 D. Anticipated Contract Type ................................................................................ 3 E. Anticipated Contract Type ................................................................................ 3

III. SCOPE OF SERVICES A. SNHD Goals and Objectives ............................................................................ 4 B. Scope of Services and Technical Service Requirements ................................. 4

1. Licensed Facility ........................................................................................ 4 2. Experience ................................................................................................ 4 3. Organization Capability ............................................................................. 5 4. Approach ................................................................................................... 5 5. Acknowledgement of Addenda .................................................................. 7 6. Price Proposal ........................................................................................... 7

IV. INSTRUCTIONS TO PROPOSERS A. Preparation of Proposals .................................................................................... 8 B. Proposers Representations ................................................................................ 9 C. Ethics in Public Procurement ........................................................................... 10 D. Interpretation or Correction of Solicitation Documents ..................................... 10 E. Amendments .................................................................................................... 10 F. Multiple, Alternate, or Conditioned Offers ........................................................ 10 G. All or None Offers ............................................................................................. 10 H. Nevada Business License ................................................................................ 10 I. Cancellation/Rejection...................................................................................... 11 J. Proposal Costs ................................................................................................. 11 K. Submission of Proposals .................................................................................. 11 L. Modification, Correction, or Withdrawal of Proposals ....................................... 11 M. Receipt and Opening of Proposals ................................................................... 11 N. Responsive Proposal ....................................................................................... 11 O. Responsible Proposer ...................................................................................... 11

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V. PROPOSAL EVALUATION AND CONTRACT AWARD PROCEDURES A. Evaluation Procedures ..................................................................................... 12 B. Evaluation Criteria ............................................................................................ 12 C. Basis of Contract Award ................................................................................... 12

VI. TERMS AND CONDITIONS A. Acceptance of Terms ....................................................................................... 13 B. Authority ........................................................................................................... 13 C. Price ................................................................................................................. 13 D. Contract Subject to the Availability of Funds .................................................... 13 E. Payments to Contractor.................................................................................... 13 F. Discount Rate ................................................................................................... 14 G. Acceptance of Goods ....................................................................................... 14 H. Governing Laws ............................................................................................... 14 I. Waiver .............................................................................................................. 14 J. Breach; Remedies ............................................................................................ 14 K. Waiver of Breach .............................................................................................. 14 L. Novation, Change of Name or Assignment ...................................................... 14 M. Subcontractors, Successors, and Assigns ....................................................... 15 N. Amendments .................................................................................................... 15 O. Indemnification ................................................................................................. 15 P. Termination or Suspension of Work ................................................................. 15 Q. Audit and Recordkeeping Requirements.......................................................... 16 R. Force Majeure .................................................................................................. 16 S. Confidentiality ................................................................................................... 16 T. Status of Parties, Independent Contractor ....................................................... 17 U. Insurance ......................................................................................................... 18 V. Taxes ............................................................................................................... 18 W. Permits and Responsibilities ............................................................................ 18 X. Limited Liability ................................................................................................. 18 Y. Examination and Retention of Records ............................................................ 18 Z. Public Records; Confidentiality ......................................................................... 18 AA. Ownership of Proprietary Information ............................................................... 18 BB. Affirmative Action/Equal Employment Opportunity ........................................... 19 CC. Debarment and Suspension ............................................................................. 19 DD. Compliance with Laws Unique to Government Funded Contracts & Subcontracts................................................................................. 19 EE. Other Applicable Laws ..................................................................................... 19

ATTACHMENTS A Proposal Cover Letter Form B Acknowledgement of Addenda C1 Pricing Proposal – Total All Years C2 Pricing Proposal – Years 1 & 2, 3, 4, 5

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Chest X-Rays (CXR) Services for Active TB Clients Page 1 of 19 SNHD-1-RFP-14-001

SECTION 1 – TIMETABLE

A. Release Date of the Request for Proposals: June 10, 2014 B. Designated Contact/Questions:

Questions about this Request for Proposals (RFP) may be e-mailed to the Southern Nevada Health District (SNHD) authorized agency contact person’s e-mail address as listed below: SNHD Contact Person: Loni Benard Question/Clarification Deadline: Date: July 8, 2014 Time: 4:00 pm

E-Mail Address: [email protected] Answers to all questions asked will be available on the SNHD’s website at

http://www.southernnevadahealthdistrict.org/public-notices.php. A list of questions and answers will also be sent to everyone who officially requested a copy of the RFP.

CONTACT WITH SNHD DURING THE RFP PROCESS: Communication with any other person other than the designated contact concerning the selection or award of this contract is prohibited from the time the Request for Proposal is advertised to the time of the award. Questions concerning the Request for Proposal shall be directed only to the designated contact. All questions that are asked will be posted on SNHD’s web site under Public Notices. Failure of a PROPOSER, or any of its representatives, to comply with this paragraph will result in their proposal being rejected.

C. Proposal Due Date and Time and Location:

Date: July 15, 2014 Time: 4:00 pm Submittal: Submit your proposal in a sealed envelope clearly marked:

“SNHD-1-RFP-14-001, Chest X-Ray Services.” If Mailed: P.O. Box 3902, Las Vegas, NV 89127 If Hand-Carried: 330 S. Valley View Blvd, Las Vegas, NV 89107

SNHD advises proposers to deliver proposals by hand. E-mailed or faxed proposals will not be accepted. Proposals received at this location after the Proposal Due Date and Time are late and shall not be accepted by the SNHD. The SNHD will consider requests made to the Authorized Agency Contact Person to extend the Proposal Due Date and Time prescribed above. However, unless the SNHD issues a written addendum to the RFP that extends the Proposal Due Date and Time for all proposers, the Proposal Due Date and Time prescribed above shall remain in effect.

D. Anticipated Contract Start Date: October 1, 2014

Chest X-Rays (CSR) Services for Active TB Clients Page 2 of 19 SNHD-1-RFP-14-001

SECTION II – INTRODUCTION

A. Intent: The Southern Nevada Health District (SNHD) is seeking one appropriately qualified Contractor to provide teleradiology (x-ray reading) and interpretation services of active TB clients referred by the SNHD.

B. Entity Information: The mission of the SNHD is, “[t]o protect and promote the health, the environment and the

well-being of Clark County residents and visitors.” The SNHD is one of the largest local public health organizations in the United States.

The SNHD was created in 1962, following statutory authorization from the Nevada State

Legislature to combine the county health department and the health departments of several surrounding cities. The SNHD serves over 2 million residents and 40 million visitors to the Las Vegas valley each year.

One section of the SNHD Nursing Division works to prevent the spread of tuberculosis

(TB) and eliminate it as a public health problem in Southern Nevada. The SNHD has two goals:

To identify all individuals with suspected or confirmed TB disease and ensure their

appropriate treatment; and Ensure that individuals with latent TB infection (LTBI) who are at high risk for

progression to active disease receive treatment for LTBI and do not develop the disease.

The selected Contractor would provide on-demand, as needed, chest x-ray services for

the SNHD. There are currently approximately 1,000 x-rays per year done for this requirement.

SNHD currently uses HL7 bidirectional messaging data transmission of readings (ordering

and results). The selected Contractor will have access to the same transmission system.

The SNHD currently has locations in the following areas (all have hours of operation between 8:00 am and 4:30 pm): Main Campus 330 S. Valley View Blvd Las Vegas, Nevada TB Clinic 625 Shadow Lane Drive Las Vegas, Nevada East Las Vegas Public Health Center 560 N. Nellis Blvd, Suites D1 & E12 Las Vegas, Nevada

Henderson Public Health Center 520 E. Lake Mead Pkwy Henderson, Nevada

North Las Vegas Public Health Center

955 W. Craig Road, Suite 103D North Las Vegas, Nevada


C. FUNDING SOURCE

The SNHD has been awarded Subgrants from the Nevada Department of Health and Human Services, under grants received from the Centers for Disease Control and Prevention under CFDA Number 93.116, Grant Number 5U52PS907855-23, Program Title: Tuberculosis Elimination and Control Program and under CFDA 93.959, Grant Number 2B08T1010039-13, Program Title: Substance Abuse Prevention and Treatment Agency (SAPTA).

D. Anticipated Contract Type:

a. This is a requirements contract for the services specified and effective for the period stated. The quantities of services specified in the Schedule are estimates only and are not guaranteed to be purchased under this contract. If the SNHD’s requirements do not result in orders in the quantities described as “estimated’’ or “maximum” in Attachment C, that fact shall not constitute the basis for an equitable price adjustment.

b. The SNHD shall order from the Contractor all the services specified in the Attachment

C that are required to be purchased by the SNHD. E. Anticipated Contract Term: It is anticipated that the duration of the contract awarded

from this RFP will be two years, with three one-year options to renew. The SNHD reserves the right, prior to contract award, to determine the length of the initial contract term. A determination to exercise each option year will be made 30 days prior to the term end date.

F. This RFP is not an offer, obligation, or agreement to award work to any individual,

organization, or firm. Services may be awarded to multiple vendors.

G. There will be no subcontracting under the contract that result from this solicitation.


SECTION III: SCOPE OF SERVICES

A. SNHD Goals and Objectives:

The SNHD goals and objectives are as follows:

Prevent the spread of Tuberculosis Disease (TB) and eliminate it as a public health problem across Southern Nevada.

Identify all individuals with suspected or confirmed TB disease and ensure their appropriate treatment, and

Ensure individuals with latent TB infection (LTBI) who are at high risk for progression to active disease receives treatment and do not develop the disease.

To assist the SNHD goals and objectives, the SNHD is seeking a radiology facility licensed by the State of Nevada to provide radiology Chest X-Ray (CXR) services for active Tuberculosis clients across Southern Nevada. All clients serviced by the Contractor for chest X-rays will be referred by the SNHD.

B. Scope of Services and Technical Service Requirements:

1. Licensed Facility.

The Contractor will be an established and licensed facility within Clark County Nevada routinely providing radiographic services to the public. The facility location should be within a ten mile radius of the SNHD TB Prevention Clinic, currently located at 625 Shadow Lane.

2. Experience.

Contractor will have a minimum of three (3) years of experience in all of the following, with greater consideration given to proposers with more than three years of experience:

2.1 Reading and Interpretation Services:

a. Providing remote teleradiology services, which are defined as “the transmission

of digitized medical images (such as x-rays, CAT scans and sonograms) over electronic networks with the interpretation of the transmitted images for diagnostic purposes.”

b. Reading and interpreting the following types of x-ray reports in accordance with

the American College of Radiology Practice Guidelines and Technical Standards for Radiologic Practice:

1) “Normal” Reports.

2) “Abnormal consistent with TB” Reports. Abnormalities suggestive or consistent with TB would be reported with the specific abnormality and also as “low, medium, or high suspicion” for TB. Reports would indicate follow-up as needed.


3) “Abnormalities with potentially life threatening findings” Reports. Abnormalities found on the x-ray that require immediate attention as they may be life threatening (Pneumothorax, pericardial effusion, etc.).

4) “Abnormalities other than TB” Reports. Reported as the specific abnormality (congestive heart failure, pneumonectomy, rib fracture, suture line, etc.).

5) Stat Call Reports. Also known as Wet Readings.

2.2 Experience with a volume of work consistent with SNHD’s estimated annual need for 1, 000 chest x-ray readings and interpretation reports.

2.3 Experience employing and supervising staff that are either Board-Eligible or Board–Certified in Diagnostic Radiology Medicine from the American Board of Radiologists, and who are skilled in the interpretation of chest radiographs of adults and pediatric including suspected or confirmed TB. Radiologists are not required to have certification in pediatric radiology; however, radiologists reading pediatric x-rays must have experience reading children’s’ chest x-rays;

2.4 Experience training Board-Eligible or Board-Certified Radiologists in adults and pediatric chest radiography.

3. Organization Capability.

The Contractor would have adequate organizational (i.e., programmatic, technical, managerial and financial) capability to provide the work described in this RFP. Specifically the contractor would:

3.1 Employ radiologists who are licensed as physicians in the state of Nevada, and who are Board Eligible or Board Certified in Diagnostic Radiology Medicine by the American Board of Radiology. Ensure that all radiologists have and maintain all required licenses and certificates to perform the work specified in this RFP.

3.2 Be located within ten (10) miles of SNHD TB Clinic due to the high levels of coordination necessary between the SNHD and the Contractor.

3.3 Demonstrate the ability to hire and retain competent, appropriately-licensed staff to perform the work under this RFP.

3.4 Demonstrate the ability to perform the required services in compliance with all established principles and ethics of the medical professions, Joint Commission Standards, and all applicable federal, state and local laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA).

3.5 Demonstrate the technical ability to:

a. configure, install and maintain secure remote connectivity, and implement an emergency back-up plan if remote connections fail; and

b. maintain equipment that would be reliable and functional to prevent disruption in the delivery of services, and to maintain stable data transmission security.

4. Approach

The Contractor would:


4.1 Provide an estimated 1,000 chest x-ray readings and interpretation reports per year including pediatric and adult chest x-rays in the following classifications:

a. Standard posterior anterior (PA) chest x-ray b. Lateral chest x-ray c. Pediatric (PA/AP and Lateral) chest x-ray d. Apical lordotic chest x-ray e. Oblique (RT and/or LT) chest x-ray f. Other (i.e. extremities, spine, etc.)

TABLE 1

4.2 Read and interpret x-rays in accordance with the American College of Radiology Practice Guidelines and Technical Standards for Radiologic Practice, and transmit reports to the designated SNHD official in accordance with the guidelines and time frames specified below:

a. “Normal” Reports – within 48 hours (Mondays through Fridays, excluding

holidays).

b. “Abnormal consistent with TB” Reports – within 24 hours (Mondays through Fridays, excluding holidays).

Abnormalities suggestive or consistent with TB would be reported with the specific abnormality and also as “low, medium, or high suspicion” for TB.

Reports would indicate follow-up as needed.

c. “Abnormalities with potentially life threatening findings” Reports – notification via telephone within two (2) hours of the interpretation and no later than 10:00 a.m. the next business day. These include abnormalities found on the x-ray that require immediate attention as they may be life threatening (such as pneumothorax, pericardial effusion, etc.).

Type of X-Ray Estimated Annual Volume

Standard PA Chest X-Rays 850

Apical Lordotic Chest X-Rays 10

Lateral Chest X-Rays 30

Pediatric Chest X-Rays 100

Oblique Chest X-Rays 10

Other (sample and est. quantities below) 100 Wrist, Mini 3 Views (10 each) Elbow, Mini 3 views (10) Hand, Mini 3 views (10) Finger(s), Mini 2 views (10) Knee, 3 views (10) Ankle Complete, Mini 3 views (10) Foot Complete, Mini 3 views (10) Toe(s), Mini 2 views (10) Abdomen (10) Spine (10) Readings Only 100 TOTAL 1,200


d. “Abnormalities other than TB” Reports – within 24 hours. Would be reported as the specific abnormality (congestive heart failure, rib fracture, suture line, pneumonectomy etc.).

e. “Stat Call” Reports (Wet Readings) - would be performed on an as-needed basis when requested by the SNHD and transmit the “Preliminary Reports” back to the SNHD within two (2) hours of the request being made. The contractor would transmit the “Final Report” in accordance with the reporting requirements of this RFP.

4.3 Compare new x-ray images with prior x-ray studies in accordance with the

American College of Radiology Practice Guidelines and Technical Standards for Radiologic Practice. Comparison may be a Non-SNHD film comparison.

4.4 Read and interpret hard copy films when necessary and compare them to the new

x-ray images, then provide the interpretation report in accordance with the guidelines below.

4.5 Contractor shall store and maintain SNHD radiology films taken during the course

of this Agreement for a minimum of ten (10) years. These films will be reasonably accessible for use by the SNHD during normal business hours.

4.6 Provide the required services during the Contractor’s normal business hours.

4.7 Work with the SNHD to establish full connectivity for services at SNHD, using HL7

bi-directional messaging data transmission of readings (ordering and results). 4.8 Contractor will have the ability to bill private insurances/Medicaid/Medicare, as

requested. 4.9 Assign a direct contact liaison person in their company to be responsible for all

dealings, including inquiries and billings issues. 4.10 Ensure that all patient medical information, including the interpretation of all x-rays,

is kept confidential in accordance with all applicable federal, state and local laws and regulations.

4.11 Make available necessary documents for auditing by the SNHD. 4.12 Sign an agreement of confidentially (a Business Associate Agreement), in a form

approved by the SNHD.

5. Acknowledgment of Addenda

The Acknowledgment of Addenda form (Attachment B) serves as the proposer’s acknowledgment of the receipt of addenda to this RFP and that may have been issued by the SNHD prior to the Proposal Due Date and Time, as set forth in Section I.C above. This form will be completed and returned with the proposal.

6. Price Proposal

Complete the attached forms: Attachment C1, Pricing Proposal – Total for all 5 Years and Attachment C2, Pricing Proposal - Years 1& 2, 3, 4 and 5, and return in a sealed envelope clearly marked “Pricing.”


SECTION IV. INSTRUCTIONS TO PROPOSERS

Proposals entitled to consideration must be made to the SNHD in accordance with the following instructions: A. Preparation of Proposals:

To be eligible for evaluation, the proposal must adhere strictly to the format set forth below. The RFP response must be submitted in a standard 8 1/2” x 11” format for ease of review and reproduction. Each of the required sections identified must be addressed and specifically labeled. The content and sequence of the proposal will be as follows:

Section Title

1 Cover Letter and Cover Letter Form (Attachment A) 2 Technical Proposal

Narrative License to Practice in State of Nevada Background in Required Areas References (minimum of 3) Resumes and/or Description of Qualifications for Board-eligible or Board

certified radiologists who will work under this contract 3 Information and Statements 4 Collusion and Advance Disclosures 5 Acknowledgement of Addenda Form (Attachment B) 6 Pricing Proposal (Attachments C1, C2)(submitted in a separate sealed envelope)

1. Cover Letter

The proposal shall consist of a letter identifying the subject of the request for proposal, the RFP Number (SNHD-1-RFP-14-001) the date of the proposal, the proposer’s name, address, telephone number, e-mail address, and website, if available. The cover letter will consist of a concise, yet sufficiently detailed statement of interest identifying why the respondent is interested in providing X-ray services and why the respondent should be considered as qualified. In addition, complete and return Attachment A, Cover Letter form.

2. Technical Proposal

Provide a narrative on how you plan on providing the services required under this RFP. This section shall address the scope of work to be performed, and shall include, at a minimum, information regarding the firm’s experience in providing x-rays readings and interpretations, experience handling the estimated volume of work, organizational capabilities (i.e. programmatic, technical, managerial and financial), and experience providing the stated x-ray classifications. Provide an affirmative statement that includes that the proposed facility is within Clark County Nevada and routinely provides radiographic services to the public. Also state that the facility and all assigned key professional staff are properly licensed.


3. Information and Statements

The following information should be provided:

An affirmative statement that the firm/individual is independent of the SNHD and not related in any way to the SNHD’s business operations.

An affirmative statement that no conflict of interest exists with regard to any other

work performed for SNHD. Disclose any pending or anticipated litigation involving SNHD and describe the nature of the litigation, if any.

Information about the circumstances and status of any legal malpractice claims

or lawsuits either pending or resolved, and any complaints filed with any state regulatory bodies or professional organizations against the firm/individual.

A list of any prior work performed for the SNHD. Please indicate the nature and

scope of the work as well as the dates.

4. Collusion and Advance Disclosures

Pursuant to Nevada Revised Statute 332.165 evidence of agreement or collusion among proposer(s) and prospective proposers(s) acting to illegally restrain freedom of competition by agreement to bid a fixed price, or otherwise, shall render the offers of such proposer(s) void.

Advance disclosures of any information to any particular proposer(s) which gives

that particular proposer(s) any advantage over any other interested proposer(s), in advance of the opening of proposals, whether in response to advertising or an informal request for proposals, made or permitted by a member of the governing body or an employee or representative thereof, shall operate to void all proposals received in response to that request for proposals.

5. Acknowledgement of Addenda (Attachment B). Complete and return Attachment

B with your proposal. 6. Pricing Proposal (Attachment C1, C2)

Proposals shall be submitted on the forms provided (Attachment C1, Pricing Proposal – Total for all 5 Years, Attachment C2, Pricing Proposal - Years 1 & 2, 3, 4 and 5). Attachment C1 must be manually signed by an authorized representative of the proposer. The forms may be completed on-line, printed, and manually signed; or printed, manually completed, and signed.

Erasures or other changes made to the proposal document must be initialed by

the person signing the proposal. B. Proposer’s Representations:

1. Each proposer, by submitting a proposal, represents that he/she has read and understands the solicitation documents, and the proposal is made in accordance therewith.


2. Proposers certify, by the submission of their proposal that they comply with the applicable portions of the Federal Civil Rights Act of 1964, the Equal Employment Opportunity Act, and the regulations issued under these acts by the state and/or federal governments. Offerors not in compliance with these requirements will be declared nonresponsive.

3. Proposers certify by submittal of their proposal that the prices submitted have been

independently arrived at and without collusion. Penalties for participation in anticompetitive practices may include, but are not limited to, rejection of the offer, suspension, debarment, civil and/or criminal prosecution.

C. Ethics in Public Procurement: It is unlawful for any vendor to offer, or any employee

of the SNHD or their immediate family to solicit or accept a gratuity in connection with the solicitation, award, or administration of an order issued by the SNHD.

D. Interpretation or Correction of Solicitation Documents:

1. Proposers shall promptly notify the SNHD in writing of any ambiguity, inconsistency, or error which they may discover upon examination of the solicitation documents.

2. Proposers requiring clarification or interpretation of the solicitation documents shall

make a written request which shall reach the SNHD not later than ten (10) days prior to the date for receipt of proposals.

3. Any interpretation, correction, or change of the solicitation documents will be made by written amendment. Interpretations, corrections, or changes of the solicitation documents made in any other manner will not be binding and proposer shall not rely upon such interpretations, corrections or changes.

4. Protests based upon any omissions or errors or on the content of the solicitation will

be disallowed if not made known in writing, prior to the proposal due date. E. Amendments:

1. All who are known by the SNHD to have received the solicitation documents will be notified of any amendments issued.

2. No amendment will be issued later than four (4) days prior to the date for opening of proposals except an amendment withdrawing the Request for Proposals or one which includes postponement of the date for opening of proposals.

3. It shall be the proposer's responsibility to complete and return Attachment B.

F. Multiple, Alternate, or Conditioned Offers: Unless specifically allowed, multiple, or

alternate offers, or proposals conditioned upon receiving award of all or a portion of this and/or another contract shall be deemed non responsive, and shall be rejected.

G. All or None Offers: Unless specifically allowed, line item or lot offers which restrict

acceptance to the entire offer shall be rejected as nonresponsive. H. Nevada Business License: Proposer must supply evidence of the proposer’s valid

Nevada business license. The Nevada business license number must be entered in the space provided on Attachment A.


I. Cancelation/Rejection: Any or all bids received in response to a request for bids may be

rejected by the SNHD if the SNHD determines that any such bidder is not responsive or responsible or that the quality of the services, supplies, materials, equipment or labor offered does not conform to requirements or if the public interest would be served by such a rejection.

J. Proposal Costs: There shall be no obligation for the SNHD to compensate proposers for

any costs responding to this Request for Proposal. K. Submission of Proposals:

1. Proposals will be received at the time and place stated on page 1 of 18. It is the sole responsibility of the proposer to see that his/her proposal is submitted in time. Proposals received after the scheduled opening time will not be considered.

2. This invitation does not obligate the SNHD to pay any costs incurred in the preparation or submission of such proposals, or to purchase or to contract for materials and/or service.

L. Modification, Correction or Withdrawal of Proposals: Proposals may be modified,

corrected or withdrawn on written requests received prior to the time fixed for proposal opening.

M. Receipt and Opening of Proposals:

1. Proposals received prior to the advertised hour of opening will be time stamped and kept securely sealed. Time of receipt will be determined by the procurement office time stamp. Proposals received after the specified date and time of proposal opening are late. Late hand-carried proposals shall not be accepted. Proposals received by other methods shall remain unopened in the proposal file.

2. No responsibility will attach to the SNHD or its representatives for the premature opening of, or the failure to open, a proposal not properly addressed and identified.

3. At the time and place fixed for the opening of proposals, the SNHD's representative will cause the proposals to be opened and publicly read aloud. Proposers and other persons properly interested may be present, in person or in representative.

4. The proposal acceptance period shall extend for a period of ninety (90) calendar days

from the date of proposal opening for the purpose of proposal evaluation and award unless otherwise stated elsewhere in this solicitation.

N. RESPONSIVE PROPOSAL: A responsive proposal is one which conforms in all

material respects to the solicitation. The SNHD reserves the right to waive technicalities or minor informalities in determining a proposer's responsiveness.

O. Responsible Proposer: A responsible proposer means a proposer who has the capability

in all respects to perform fully the contract requirements, and the integrity and reliability which will assure good faith performance.


SECTION V. PROPOSAL EVALUATION AND CONTRACT AWARD PROCEDURES

A. Evaluation Procedures

All proposals accepted by the Agency will be reviewed to determine whether they are responsive or nonresponsive to the requisites of this RFP. Proposals that are determined by SNHD to be nonresponsive will be rejected. The SNHD’s Evaluation Committee will evaluate and rate all remaining proposals based on the Evaluation Criteria prescribed below. The SNHD reserves the right to conduct site visits and/or interviews and/or to request that proposers make presentations and/or demonstrations, as the SNHD deems applicable and appropriate. Although discussions may be conducted with proposers submitting acceptable proposals, the SNHD reserves the right to award contracts on the basis of initial proposals received, without discussions; therefore, the proposer’s initial proposal should contain its best programmatic, technical and price terms.

B. Evaluation Criteria

The following evaluation criteria are listed in order of importance: 1. Demonstrated relevant experience

2. Price (lowest price will be determined by combining the total price for all 5 years)

3. Demonstrated organizational capability

C. Basis of Contract Award

A contract will be awarded to the responsible proposer whose proposal is determined to be the most advantageous to the SNHD, taking into consideration the evaluation criteria above, and other criteria that are set forth in this RFP.


VI. TERMS AND CONDITIONS

The following terms and conditions are made a part of this Request for Proposals and any resulting contract between the SNHD and Proposer, and proposer agrees as follows: A. Acceptance of Terms:

a. Written acceptance or shipment of all or any portion of the items covered by any purchase order resulting from this Request for Proposal shall constitute unqualified acceptance of all its terms and conditions.

b. No modification of any of the terms or conditions of this order, including, but not limited to, delivery, price, quality, quantities, and specifications, will be effective without the prior written consent of the SNHD.

c. Any additional or different terms and conditions which may appear in any communication from Seller or in any printed form of Seller are hereby rejected and shall not be effective or binding unless specifically agreed to in writing by the SNHD.

d. No such additional or different terms or conditions shall become part of the purchase order despite the SNHD's acceptance thereof unless such acceptance specifically agrees to their inclusion.

B. Authority: The SNHD contact person whose name appears on the cover sheet of this solicitation has authority to act as agent for the SNHD. Seller is cautioned that instructions contrary to the provisions of this solicitation, which are received from employees not specifically delegated authority to act in this matter, are not valid or binding on the SNHD.

C. Price:

a. The SNHD shall receive the benefit of any general reduction in Proposer's prices prior to delivery and in no event shall the SNHD be charged higher prices than Proposer's similar customers who take delivery in substantially the same amounts and in substantially similar circumstances.

b. Prices proposal shall be exclusive of any federal or state taxes from which the SNHD is exempt. Tax exemption No. RCE-004-676.

D. Contract Subject to the Availability of Funds: The SNHD’s obligation under this Contract is contingent upon the availability of funds from which payment for Contract purposes can be made. No legal liability on the part of the SNHD for any payment may arise until funds are made available to the SNHD for this Contract and until the Contractor receives notice of such availability, confirmed by issuance of a purchase order by the SNHD.

E. Payment to Contractor:

a. Payments for services furnished under any order resulting from this Request For Proposals will be due thirty (30) days after the receipt of proper invoicing for such services, and receipt of all required documents.

b. The SNHD shall not be liable for interest charges on late payments.

c. Payments shall be based on approved Contractor's invoices submitted in accordance with this article. The sum of payments shall not exceed allowable compensation stated


in the awarded contract and no payments shall be made in excess of the maximum allowable total for this contract.

d. Contractor's invoices shall be submitted monthly for months during which services are performed, as applicable, in a summary format, which details costs incurred for each item identified in the project budget. Backup documentation including but not limited to invoices, receipts, proof of payments or any other documentation requested by the SNHD, is required, and shall be maintained by the Contractor in accordance with cost principles applicable to this contact. Contractor invoices shall be signed by the Contractor's official representative, and shall include a statement certifying that the invoice is a true and accurate billing. Cost principles contained in the federal acquisition regulations, 48 CFR, Subpart 31.3 and OMB circular A-21 shall be used as criteria in the determination of allowable costs.

e. In the event items on an invoice are disputed, payment on those items will be held until the dispute is resolved. Undisputed items will not be held with the disputed items.

f. The Contractor shall submit a final invoice and required documentation within 90 days after final acceptance of services by the SNHD. The SNHD will not be held liable for payment of invoices submitted after this time unless prior written approval has been given.

F. Discount Date: Cash discount period on any invoice received shall commence on the date invoice is received by the SNHD. In the event of adjustment to an invoice subject to cash discount, the discount period will commence on the date the amended invoice is received.

G. Acceptance of Goods:

a. All work performed is subject to the SNHD's inspection and acceptance.

b. Final inspection and acceptance shall be conclusive except as to hidden damage found in a timely manner, latent defects, fraud, such gross mistakes as amount to fraud, and Proposer's warranty obligations.

H. Governing Laws: This Agreement shall be governed by and enforced in accordance with the laws of the State of Nevada.

I. Waiver: The waiver of any breach of the terms of this contract by the SNHD shall not constitute a waiver of any subsequent breach, nor shall any payment for goods delivered or services constitute such waiver.

J. Breach; Remedies: Failure of either Party to perform any obligation of this Agreement shall be deemed a breach. Except as otherwise provided for by law or this Agreement, the rights and remedies of the Parties shall not be exclusive and are in addition to any other rights and remedies provided by law or equity, including but not limited to actual damages, and to a prevailing Party, reasonable attorneys’ fees and costs.

K. Waiver of Breach: Failure to declare a breach or the actual waiver of any particular breach of the Agreement or its material or nonmaterial terms by either Party shall not operate as a waiver by such Party of any of its rights or remedies as to any other breach.

L. Novation, Change of Name, or Assignment:

a. SNHD contracts are not transferable, or otherwise assignable without the express written consent of the Director of Administration. Requests for transfer or assignment of a contract must be made in writing, and in advance.


b. Assignment of monies due under this contract is permissible, except that the instrument of assignment must provide that the assignment of monies is subject to prior claims of persons, firms and corporations for services or supplies provided in the performance of the contract.

M. Subcontractors, Successors, and Assigns:

a. If any Scope of Work under this contract includes named firms or individuals, then such firms or individuals shall be employed for the designated services, unless the contract is changed by modification.

c. Neither Party shall assign, sublet, transfer or delegate any rights, obligations, duties, or interest in this contract without the prior written consent of the other Party.

d. The Contractor binds itself, its partners, its subcontractors, assigns and legal representatives to this contract and to the successors, assigns, and legal representatives of the SNHD with respect to all covenants of this contract.

N. Amendments: This Agreement may be amended only by a writing signed by a duly authorized agent/officer of each Party and effective as of the date stipulated therein.

O. Indemnification: Neither Party waives any right or defense to indemnification that may exist in law or equity

P. Termination or Suspension of Work:

a. This contract may be terminated by either party upon 30 days written notice if the other party fails substantially to perform in accordance with its terms through no fault of the party initiating the termination. The SNHD may at any time terminate or suspend work under this contact for its needs or convenience

b. In the event of termination or suspension, the Contractor shall deliver all work products, reports, estimates, schedules and other documents and data prepared pursuant to this contract to the SNHD.

Q. Audit and Recordkeeping requirements:

a. AUDIT REQUIREMENTS

1) Contractors that receive a combined total of $500,000 or more annually from any combination of federal funding sources are subject to federal audit requirements per Public Law 98-502, “The Single Audit Act”. Contractor shall comply with OMB Circulars A-122, A-110 and A-133 as applicable. The single audit report along with any required corrective action plan, if applicable, shall be submitted to SNHD for review within (6) months following the close of the fiscal year which occurs within the project period of this Agreement.

2) Contractor shall schedule an annual financial audit and shall submit a copy to SNHD for review within six (6) months following the close of Contractor’s fiscal year. Failure to meet this requirement may result in loss of current funding and disqualification from consideration for further SNHD administered funding. This audit shall be made by an independent auditor in accordance with generally acceptable accounting principles. This requirement applies equally to any subcontractor of Contractor that receives funding under this Agreement. Contractor shall include this requirement in all its subcontractor agreements. Any subcontracts prepared by Contractor shall be furnished to SNHD to insure conformance with all requirements.


3) Contractor shall make appropriate corrections within six (6) months after receipt of an audit report to remedy any material weaknesses identified by the audit report. SNHD may withhold payment for non-correction of material weaknesses identified by the audit report in addition to its right to terminate this Agreement.

4) All payments made under this Agreement shall be subject to an audit and all shall be adjusted in accordance with said audit.

b. BOOKS AND RECORDS. Each Party shall keep and maintain under generally accepted accounting principles full, true and complete books, records, and documents as are necessary to fully disclose to the other Party, properly empowered government entities, or their authorized representatives, upon audits or reviews, sufficient information to determine compliance with the terms of this Agreement and any applicable statutes and regulations. All such books, records and documents shall be retained by each Party for a minimum of three years, and for five years if any federal funds are used pursuant to this Agreement, from the date of termination of this Agreement. This retention time shall be extended when an audit is scheduled or in progress for a period of time reasonably necessary to complete said audit and/or to complete any administrative and judicial litigation which may ensue.

c. FISCAL MONITORING AND ADMINISTRATIVE REVIEW OF ADVERSE FINDINGS. SNHD may, at its discretion, conduct a fiscal monitoring of Contractor at any time during the term of the Agreement. Contractor will be notified in writing at least three weeks prior to the visit outlining documents that must be available prior to SNHD’s visit. SNHD shall notify Contractor in writing of any Adverse Findings and recommendations as result of the fiscal monitoring. Adverse Findings are defined as Lack of Adequate Records, Administrative Findings, Questioned Costs and Costs Recommended for Disallowance. Contractor will have the opportunity to address adverse findings in writing responding to any disagreement of adverse findings. SNHD shall review disagreement issues, supporting documentation and files and forward a decision to the Contractor in writing.

R. Force Majeure: Neither Party shall be deemed to be in violation of this Agreement if it is prevented from performing any of its obligations hereunder due to strikes, failure of public transportation, civil or military authority, act of public enemy, accidents, fires, explosions, or acts of God, including, without limitation, earthquakes, floods, winds, or storms. In such an event the intervening cause must not be through the fault of the Party asserting such an excuse, and the excusing Party is obligated to promptly perform in accordance with the terms of the Agreement after the intervening cause ceases.

S. Confidentiality: To comply with the Health Insurance Portability and Accountability Act of 1996, as amended by the Health Information Technology for Economic and Clinical Health Act, to protect the security, confidentiality, and integrity of protected health information, the Contractor will execute a Business Associate Agreement with the SNHD.

T. Status of Parties, Independent Contractor:

a. The Parties are associated with each other only for the purposes and to the extent set forth in this Agreement and in respect to performance of Services pursuant to this Agreement. In the performance of such Services, Contractor shall at all times be an independent Contractor with respect to SNHD. Contractor is not an employee or agent of SNHD. Further, it is expressly understood and agreed by the Parties that nothing contained in this Agreement will be construed to create a joint venture, partnership, association, or other affiliation or like relationship between the Parties.


b. This contract may be declared null and void should the SNHD determine that by Internal Revenue Service criteria the Contractor is an employee of the SNHD.

U. Insurance:

a. The Contractor shall not commence work under this contract until satisfactory evidence has been provided to the SNHD that the Contractor can cover the requirements set forth in this provision with regard to the Contractor and all subcontractors when engaged in any work performed under this contract.

b. Without limiting Contractor's indemnification, it is agreed that Contractor shall purchase at its own expense and maintain in force at all times during the performance of services under this agreement policies of insurance (or the Contractor shall maintain self-insurance if certified in strict accordance with subsection (a) of this provision) covering the following types and limits:

(1) Workers' Compensation Insurance: The Contractor shall provide and maintain, for all employees of the Contractor engaged in work under this contract, Workers' Compensation Insurance as required by the laws of the state where the work is to be performed. The Contractor shall be responsible for Workers' Compensation Insurance for any subcontractor who directly or indirectly provides services under this contract. This coverage must include statutory coverage for states in which employees are engaging in work and employer's liability protection not less than $100,000 per person, $100,000 per occurrence. Where applicable, coverage for all federal acts (i.e., U.S.L. & H and Jones Act) must also be included.

(2) Comprehensive (Commercial) General Liability Insurance: With coverage limits not less than $300,000 combined single limit per occurrence and annual aggregates where generally applicable and shall include premises-operations, independent contractors, products/completed operations, broad form property damage, blanket contractual, and personal injury endorsement.

(3) Comprehensive Automobile Liability Insurance: Covering all owned, hired, and non-owned vehicles with coverage limit not less than $100,000 per person/300,000 per occurrence bodily injury and $50,000 property damage.

(4) Professional Liability Insurance: Covering all errors, omissions, or negligent or wrongful acts of the Contractor, subcontractor, or anyone directly or indirectly employed by them, made in the performance of this contract which result in financial loss to the SNHD.

Limits required per the following schedule:

Contract Amount Minimum Required limits Under $100,000 - $100,000 per Occurrence/Annual Aggregate $100,000 to $499,999 - $250,000 per Occurrence/Annual Aggregate $500,000 to $999,999 - $500,000 per Occurrence/Annual Aggregate $1,000,000 or over Negotiable--Refer to SNHD, (Specific Limits are set forth as Alterations in General Provisions.)

c. Coverage shall be maintained for the duration of this contract plus one year following the date of final payment. Failure to comply with this provision may preclude other contracts and agreements between the Contractor and the SNHD. Where specific limits are shown, it is understood that they shall be the minimum acceptable limits. If the Contractor's policy contains higher limits, the SNHD shall be entitled to coverage to the extent of such higher limits. Certificates of Insurance must be furnished to the


Contract Administrator prior to beginning work and must provide for a 30-day prior notice to the SNHD of cancellation, non-renewal, or material change. Failure to furnish satisfactory evidence of insurance or lapse of the polity is a material breach and grounds for termination of the Contractor's services.

V. Taxes:

a. As a condition of contract performance, the Contractor shall pay when due all federal, state and local taxes and assessments applicable to the Contractor. The Contractor shall be responsible for its subcontractor's compliance with the requirements of this provision, including this statement, in every subcontract.

b. The SNHD is a tax-exempt institution.

W. Permits and Responsibilities: The Contractor shall be responsible for obtaining any necessary licenses and permits, and for complying with any applicable federal, state and municipal laws, codes, and regulations, in connection with the performance of the work under this contract.

X. Limited Liability: The Parties will not waive and intend to assert available NRS Chapter 41 liability limitations in all cases. Agreement liability of both Parties shall not be subject to punitive damages. To the extent applicable, actual agreement damages for any breach shall be limited by NRS 353.260 and NRS 354.626

Y. Examination and Retention of Records: The Contractor shall, at any time during normal business hours and as often as the SNHD, the Comptroller General of the United States, or their agents may deem necessary, make available for examination all of its records with respect to all matters covered by this contract for a period ending three (3) years after date of final payment under this contract or any subcontract whichever is later. Upon request, and within a reasonable time, the Contractor shall submit such other information and reports relating to its activities under this contract in such form and at such times as the SNHD or the Comptroller General my reasonably require. The Contractor shall permit the SNHD, the Comptroller General, or their agents to examine and make copies of such records, invoices, materials, payrolls, records of personnel, and other data relating to all matters covered by the contract. The Contractor shall include the substance of this provision, including this statement, in all subcontracts.

Z. Public Records; Confidentiality: Pursuant to NRS 239.010, information or documents, including this Agreement, and any other documents generated incidental thereto may be open by SNHD to public inspection and copying. Any record which is made confidential by law or a common law balancing of interests shall not be disclosed only to the extent that such information is made confidential by law or a common law balancing of interests.

AA. Ownership of Proprietary Information: Unless otherwise provided by law or this Agreement, any reports, histories, studies, tests, manuals, instructions, photographs, negatives, blue prints, plans, maps, data, system designs, computer code (which is intended to be consideration under this Agreement), or any other documents or drawings, prepared or in the course of preparation by either Party in performance of its obligations under this Agreement shall be the joint property of both Parties.

BB. Affirmative Action/Equal Employment Opportunity: As an Equal Opportunity Employer, SNHD has an ongoing commitment to hire, develop, recruit and assign the best and most qualified individuals possible. SNHD employs employees without regard to race, national origin, creed, color, sex, religion, age, disability or handicap condition (including AIDS and AIDS-related conditions) and/or status as a disabled veteran, or veteran of the Vietnam era, or sexual orientation. Contractor likewise agrees that it will comply with all


state and federal employment discrimination statutes, including but not limited to Title VII, rules enforced by the Nevada Equal Rights Commission (“NERC”), the Rehabilitation Act of 1973, as amended (P.L. 93-112), and the American with Disabilities Act of 1990 (P.L. 101-136), 42 U.S.C. 12101, as amended, and regulations adopted thereunder contained in 28 CFR 26.101-36.999, in connection with this Agreement. Requester agrees to comply with all applicable portions of the Federal Civil Rights Act of 1964, as amended, Equal Employment Opportunity Act, and the regulations issued under these acts by the state and federal governments, as applicable.

CC. Debarment and Suspension: Contractor certifies, by signing this Agreement, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from participation in this transaction by any federal department or agency. This certification is made pursuant to regulations implementing Executive Order 12549, Debarment and Suspension, 28 C.F.R. pt. 67 67.510, as published as pt. VII of May 26, 1988, Federal Register (pp 19150-19211). This provision/clause shall be required of every contractor and/or subcontractor receiving any payment in whole or in part from federal funds.

DD. Compliance with Laws Unique to Government Funded Contract & Subcontracts: The Contractor agrees to comply with 31 U.S.C. 1352 relating to limitations on the use of appropriated funds to influence certain Federal contracts; 18 U.S.C. 431 relating to officials not to benefit; 40 U.S.C. 3701, et seq., Contract Work Hours and Safety Standards Act; 41 U.S.C. 51-58, Anti-Kickback Act of 1986; 41 U.S.C. 4712 and 10 U.S.C. 2409 relating to whistleblower protections; and 41 U.S.C. 423 relating to procurement integrity.

EE. Other Applicable Laws: Any provision required to be included in an agreement of this type by any applicable and valid Executive Order, Federal, State, or local laws, ordinance, rule or regulation, including the Renegotiation Act of 1951, as amended, and examination of records by the U.S. Comptroller General shall be deemed to be incorporated herein. All applicable portions of Nevada Statutes 45.01 to 45.09, et seq. (UCC), are by this reference deemed a part of this order.

ATTACHMENT A SNHD-1-RFP-14-001 Cover Letter Form

CHEST X-RAYS (CXR) SERVICES FOR ACTIVE TB CLIENTS

Proposer:

Company Name:

Address:

Tax Identification #:

License #:

Proposer’s Contact Person:

Name:

Title:

Telephone #:

E- Mail Address:

Proposer’s Authorized Representative:

Name:

Title:

Signature:

Date:

ATTACHMENT B SNHD-1-RFP-14-001

Acknowledgement of Addenda

DIRECTIONS: Complete Part I or Part II, whichever is applicable.

PART I: Listed below are the dates of issue for each addendum received in connection with this RFP:

ADDENDUM #1, DATED

ADDENDUM #2, DATED

ADDENDUM #3, DATED

ADDENDUM #4, DATED

ADDENDUM #5, DATED

PART II: No Addendum was received in connection with this RFP.

Date: ______________________

Proposer (Printed Name)

Proposer (Signature)

ATTACHMENT C1SNHD-1-RFP-14-001 PRICING PROPOSAL

TOTAL ALL FIVE Years Chest X-Rays (CXR) Services for TB Clients

Contractor Name:

The total price for all 5 years provided in the TOTAL box below will be the price used to determine the lowest priced proposal for evaluation criteria scoring.

Year Total Price

Total for Years 1 and 2

Total for Year 3

Total for Year 4

Total for Year 5

TOTAL PRICE FOR ALL 5 YEARS

By signing below, I certify that the above unit prices are firm and apply to any quantity ordered during the contract term, from zero to the maximum quantities depicted above:

Signature of Authorized Representative:

Typed Name:

Title:

* The numbers provided are an estimated number of annual readings only. There is noguaranteed minimum or maximum number of readings. SNHD shall only reimburse thecontractor for actual readings done. The price per reading is inclusive of readings of thestandard chest x-ray, and all other x-rays of the same person’s x-ray done per visit, whichincludes, without limitation, apical lordotics, laterals, pediatric chest x-rays, and is alsoinclusive of preparation and transmission of all Stat Call Reports, (Wet Readings), electronicreports, instant messaging for “Abnormalities with potentially life threatening finding”readings, discrepancies in readings/re-readings, telephone inquiries, and all other costassociated with performing the services. The price per reading is also inclusive of travel,teleconference, and all other costs associated with performing the services.

ATTACHMENT C2SNHD-1-RFP-14-001

PRICING PROPOSAL (Years 1&2, 3, 4, 5) Chest X-Rays (CXR) Services for TB Clients

Contractor Name:

Estimated Annual

Quantities* Years 1 & 2

Price Each Years 1 & 2

Total Price Years 1 & 2

Estimated Annual

Quantities* Years 3 - 5

Price Each

Year 3 Total Price

Year 3

Price Each

Year 4 Total Price

Year 4

Price Each

Year 5

Total Price

Year 5

Standard PA Chest X-Rays

Apical Lordotic Chest X-Rays

Lateral Chest X-Rays Pediatric (PA & Lateral Chest X-Rays)

Oblique Chest X-Rays

Other (i.e., wrist, knee, abdomen, foot, toe(s), etc.)

Readings Only

* The numbers provided are an estimated number of annual readings only. There is no guaranteed minimum or maximum number of readings. SNHD shall only reimburse thecontractor for actual readings done. The price per reading is inclusive of readings of the standard chest x-ray, and all other x-rays of the same person’s x-ray done per visit,which includes, without limitation, apical lordotics, laterals, pediatric chest x-rays, and is also inclusive of preparation and transmission of all Stat Call Reports, (Wet Readings),electronic reports, instant messaging for “Abnormalities with potentially life threatening finding” readings, discrepancies in readings/re-readings, telephone inquiries, and allother cost associated with performing the services. The price per reading is also inclusive of travel, teleconference, and all other costs associated with performing the services.

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