PWS Attach 3 - CUP Monthly Report Amend 0006.pdf
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- Solicitation number
- 1333ND20RNB190010
About this file
This document contains a monthly report template for a federal contract to provide operations, maintenance, and repair services for the central utility plant at the National Institute of Standards and Technology in Boulder, Colorado. The report requires the contractor to provide detailed logs and summaries of major and minor repairs, preventative maintenance completed, chemical testing results, spare parts inventory, man-hour reporting, and after-hours responses. The contract has a base period of one year with four optional one-year extensions, and the contractor must also perform maintenance at field sites in Fort Collins, Colorado and Kekaha, Hawaii. The North American Industry Classification System code for this requirement is 811310.
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Text version
Major Repairs:
Minor Repairs:
Boiler Monthly Repair Log
Month:
Year:
Company:
PWS Attach 3 - CUP Monthly Report Page 1 of 16 1333ND20RNB190010 Amendment 0006
Major Repair Summary:
Minor Repair Summary:
Air Compressor Repair Summary
Month:
Year:
Company:
PWS Attach 3 - CUP Monthly Report Page 2 of 16 1333ND20RNB190010
Month: Year:
Day Start End Daily Total
Building Water Usage Report
PWS Attach 3 - CUP Monthly Report Page 3 of 16 1333ND20RNB190010
Date Daily DA Tank Temp
Daily DA Tank Press
Daily System Condensate Return
Daily Total Make-Up Water Flow
DA Tank - Pressure - Temps
PWS Attach 3 - CUP Monthly Report Page 4 of 16 1333ND20RNB190010
Date
BLR 17
Meter reading
BLR 18
Meter reading
BLR 19
Meter reading
BLDG. 42
Meter reading
NIST Boulder Gas Usage
PWS Attach 3 - CUP Monthly Report Page 5 of 16 1333ND20RNB190010
BLR Date Daily M/CF Total Gas Flow
Daily GALS Total FDW Flow
Daily LBS/H Total BLR Steam Flow
Daily Lbs/H Total SYS Steam Flow
Daily PSI Total System Steam Press
Daily PSI Total BLR Steam Press
Daily LBS / H Total BLR Steam LG Flow
Boiler - Pressures - Flow
PWS Attach 3 - CUP Monthly Report Page 6 of 16 1333ND20RNB190010
BLR Date Daily Total Temp Stack ENT
Daily Total Temp Stack
LVG
Daily Total Temp Econo IN
Daily Total Temp Econo
OUT
Daily Total Temp OAT
Boiler Temps
PWS Attach 3 - CUP Monthly Report Page 7 of 16 1333ND20RNB190010
Monthly Man Hour Report Month of:
Contracted Work;
a) Contract Number:
b) Contract Type (Select Type): ( ) Construction ( ) Service
c) Project Name: Central Utility Plant Operation and Maintenance
d) Company Name:
e) NAICS Code for the Company performing the work:
f) Total number of man-hours worked this month (must include subcontractor hours):
g) Lost Time Injury experienced during the month:
h) Near Miss Incidents for the month:
i) Fire/Property Damage Incidents:
j) No Work Completed this Month:
2. COR’s are responsible for collecting the forms from your contractor and submit to FMD Safety offic
1. All contractors, service and construction, are required to submit a monthly man-hour/ injury report. This report needs to be submitted to the EMSS Safety office no later than the 5th of each month. The report needs to contain the following information;
PWS Attach 3 - CUP Monthly Report Page 8 of 16 1333ND20RNB190010
Monthly Maintenance Summary:
Ft. Collins Maintenance Summary
Month:
Year:
Company:
Contractor to provide Maintenance reports/checklists on the PMs completed at the Ft.
Collins site, and record preventative maintenance information from the job plan inputted into Maximo Logs. Any temperature, voltage or pressure readings listed in the job plan shall be provided in the Maximo logs.
PWS Attach 3 - CUP Monthly Report Page 9 of 16 1333ND20RNB190010
Monthly Maintenance Summary:
Hawaii Maintenance Summary
Month:
Year:
Company:
Contractor to provide Maintenance reports/checklists on the PMs completed at the Hawaii site, and record preventative maintenance information from the job plan inputted into Maximo Logs. Any temperature, voltage or pressure readings listed in the job plan shall be provided in the Maximo logs.
PWS Attach 3 - CUP Monthly Report Page 10 of 16 1333ND20RNB190010
Date Time Time
Alarm Cleared
Dispatch Personnel Name of Alarm Description Description of Actions Taken
Stationary Engineer
Initials
After Hours Log
PWS Attach 3 - CUP Monthly Report Page 11 of 16 1333ND20RNB190010
Monthly Repair / Replacement Summary:
Discrepancies:
Steam Trap Repair / Replacement Summary
Month:
Year:
Company:
PWS Attach 3 - CUP Monthly Report Page 12 of 16 1333ND20RNB190010
Chemical Testing Summary:
Month:
Year:
Company:
Testing to be completed every 8 hours based on selected manufacturer's recommendations checklist and submitted as part of the monthly report.
- Chemical testing of B-17, 18 and 19 every 8 hours
- B-42 closed loop chilled water system tested monthly
- B-42 condenser water system tested every 8 hours
Contractor shall provide monthly reporting on any anomalies found in the testing for the month, and the manufacturer's recommendations on chemical adjustments or treatments to be made.
Chemical Testing Summary (Revised Amend 0006)
PWS Attach 3 - CUP Monthly Report Page 13 of 16 1333ND20RNB190010
Chilled Water Repair Summary
Month:
Year:
Company:
PWS Attach 3 - CUP Monthly Report Page 14 of 16 1333ND20RNB190010
Type of equipment
Spare Parts Quantity needed
Spare parts Quantity on hand Chemical LMI pumps 2
Liquid end assemblies 2
LMI pump Repair kits 2
B-1 Steam traps 2
B-2 Steam Traps 2
B-3 Steam Traps 2
Thermo Dynamic traps 2
CUP Building 42 Government Provided Parts
PWS Attach 3 - CUP Monthly Report Page 15 of 16 1333ND20RNB190010
Generator Preventative Maintenance
Month:
Year:
Company:
PWS Attach 3 - CUP Monthly Report Page 16 of 16 1333ND20RNB190010
| Boiler Repairs |
| Air Comp Repair |
| Building Water Usage |
| DA Tank Daily |
| Gas Usage Report |
| Boiler Daily Read Pressure Flow |
| Boiler Daily Temp Readings |
| Man Hour |
| Ft. Collins Maint. Summary |
| Hawaii Maint Summary |
| After Hours Log |
| Steam Trap |
| Chemical Treatment |
| Chilled Water |
| Spare Parts Inventory |
| Generator PMs |
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