S02 Clarifications Q and A.pdf

1. General: Please confirm exactly what procedures will be performed in the new Cath Lab and the required Imaging Class to design towards (Class 2 or 3). Per FGI Guidelines, cardiac catheterizations may be performed in a Class 2 imaging room. However, if the procedure results in a required surgery to close or replace anything, it is recommended to perform the surgical procedure in a Class 3 imaging room. (It will not be possible to meet the requirements of a Class 3 imaging room (restricted access, room size requirements etc.) in this location.

In the equipment specification we had included the types of procedures: “right and left heart catheterization, coronary angiography, percutaneous coronary interventions, structural heart procedures (valvuloplasty, PFO closure, left atrial appendage closure [e.g. Watchman]), electrophysiology diagnostic procedures, peripheral angiography and venography, peripheral artery interventions. This system may be used in the future for TAVR procedures.”

Although the footprint is smaller than guidelines, if we can get the HVAC updated to surgical OR standards that may be adequate to allow us to do some TAVRs in the cath lab. So, class 2 with OR rated HVAC would be best.

2. In 2016 the VA TIL issued a Standards Alert moving Cardiac Catheterization rooms (XCCE1) from the Cardiovascular Laboratory Service Design Guide to the Surgical and Endovascular Services Design Guide. Please see the attached Room Templates and incorporated changes. The original room template had a 650 SF requirement and allowed for GWB lay-in ceilings, amongst other things. The new template has an 850 SF minimum and monolithic GWB ceilings and laminar flow requirements amongst other things. This move to the Surgical Design Guide, also notes access from a semi-restricted corridor and access to the surgical clean core. Please confirm which version of this Room Template the Design-Build team should plan for, and which requirements will receive deviations. For example, the existing room is only 320 SF and will not meet design guide requirements. Please confirm the VA understands that some elements of the room will be reduced in size to meet the available room area.

We are limited to the footprint that we have. OR like HVAC with laminar flow may allow us to do other procedures (e.g. some TAVR) in the future. We understand that the footprint may not be able to be enlarged.

3. General: Has Philips confirmed that the current room will accommodate the requested equipment and all clearances?

Philips did a basic site survey of this Cath Lab at the West Roxbury location. The primary purpose of the survey was to evaluate the room size (fit test) to evaluate if the standard Azurion 7 M 20 ceiling mount will fit and it was found that it could be sited without issue.

4. General: Please confirm the imaging class of the current Cath Lab and if any anesthesia is currently used.

Anesthesia is used rarely for emergency cases and some cases where we need to sedate patients more heavily.

5. General: Please confirm that there is no Design-Build scope related to a temporary mobile cath lab for this project.

Confirmed, there is no design-build scope to include temporary mobile Cath Lab for this project.

6. General: Please provide any existing drawings of the current room from all disciplines.

See Attachment S02 Existing drawings that includes a zip file of existing drawings.

7. SOW Section 2.1.A: Please confirm a certified historic consultant is not required to complete the Section 106 for. We understand this can be completed by the Architect, please confirm.

Confirmed, a certified historic consultant is not required to complete Section 106. GC to include filling out forms and submitting as required.

8. SOW Section 2.1.A: b. Please confirm that only the structural, electrical, mechanical, plumbing and fire protection capacity investigations are included in this scope of work. If additional capacity or systems are determined to be required, please confirm they would be part of an additional service request. Re-work of existing systems is understood to be included as part of the base scope.

Confirmed.

9. SOW Section 2.1.A: Please confirm if any destructive testing is anticipated to confirm structural capacity

Confirmed.

10. SOW Section 2.1.A: Are there any known infrastructure deficiencies?

There are no known infrastructure deficiencies.

11. SOW Section 2.1.A: The A/E team will review the contractors As-Built drawings during the project close out period. Please confirm if the VA would also like the A/E to provide Record Drawings at project close out, incorporating all known design changes.

Confirmed. The proposal should include record drawings and incorporating them into design changes.

12. SOW Section 2.1.A: Please confirm if the requested 'radiation shield divider' is intended to be a mobile shield, or a built shielded alcove? Please confirm the contractor shall provide the shield in either instance. Please confirm the VA will provide the Physicist Shielding Report for A/E use.

The 'radiation shield divider' is intended to be a built-in radiation shielded alcove/desk.

Contractors shall provide the shield. The VA will provide the Physicist Shielding Report for A/E use.

13. SOW Section 2.1.B: Please confirm what phasing will be required for this project. We assume the contractor will have access to the entire project area and no portions need to remain operational during construction. Please confirm

GC will have access to the entire project area during construction. However, the project area is located within an active ward and construction activities which affect normal operation should be considered off hours. Construction phasing to be proposed by contractor.

14. SOW Section 2.3: Existing medical gas and vacuum services available are medical air, medical oxygen and medical vacuum. Please confirm if other specialty gases are needed for example, nitrous oxide, WAGD, nitrogen, CO2, etc.

Only medical air, medical oxygen, and medical vacuum are needed.

15. SOW Section 2.3: Please confirm expected extents of the noted room reconfiguration.

Condition will be reviewed and confirmed during the design phase.

Conditions will be reviewed and confirmed during the design phase.

16. SOW Section 2.3: SOW calls for a new contractor provided and installed patient lift.

Based on the amount of overhead equipment required for the Philips Azurion, we do not believe that a ceiling mounted patient lift will be possible. Please confirm that the VA will provide a mobile patient lift if required in this room.

Ceiling mounted patient lift is not considered. Mobile patient lift is currently available for use.

17. SOW Section 2.3: 'Demolition' section notes to replace all doors and windows, but 'Doors & Windows' section notes to evaluate them for replacement. For the sake of the proposal, please confirm if the design-build team should be planning to replace all doors and windows.

The team should include an evaluation of doors and replace all doors including new lead lined double door, new storage door and control room door. The team should include an evaluation of windows and determine if the windows need to be replaced. The proposal should not include new windows.

18. SOW Section 2.3: SOW calls for replacing all drywall, please confirm if the intent is to replace all GWB in the SOW area, or only where walls are being modified?

Only where walls are being modified.

19. SOW Section 2.3: Please confirm any known issues with the existing radiation protection project boundary.

No known issues.

20. SOW Section 2.3: SOW calls for 2x2 gypsum based ceiling tiles, based on the Imaging class requirements, this may not be an available option.

GC’s AE to determine the best option to meet imaging class requirements for VA to review.

21. SOW Section 3.0.c: Please confirm if the concept design options noted in section 2.1 are intended to be a formal submittal? If so, the submission requirements and schedule will need to be adjusted to account for them and VA review time.

Only 30%, 60% and 100% will be formal submittal.

22. SOW Section 4.0: Please confirm there are no PSRDM requirements for this project and no consultant is required.

The door design should meet the PSRDM requirement for the nature of its room function.

23. SOW Section 9.0: Please confirm if the construction completion period is 310 calendar days or 365 calendar days after NTP

365 calendar days after NTP.

24. SOW Section 9.0: The project schedule will be contingent upon receipt of preliminary and final vendor equipment drawings. Please confirm if the VA already has preliminary site-specific drawings? Please confirm that the schedule will be adjusted to allow for the 30% SD submission to be completed 14 calendar days follow the receipt of preliminary site-specific drawings and the 60% DD submission to be completed 14 calendar days following the receipt of the final site specific drawings.

No, we don’t have preliminary site-specific drawings. The equipment order is currently out for solicitation and the reward is expected by end of Dec 2025. Confirmed that the schedule will be adjusted to allow for the 30% SD submission to be completed 14 calendar days following the receipt of preliminary site-specific drawings and the 60% DD submission to be completed 14 calendar days following the receipt of the final site-specific drawings.