36C24726Q0114 0004.pdf

5. PROJECT NUMBER (if applicable)

CODE7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODECODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

0004 12-19-2025

36C247

Department of Veterans Affairs VISN 7 Network Contracting Activity 501 Greene Street Hatcher Building - Suite 2 Augusta GA 30901

Department of Veterans Affairs VISN 7 Network Contracting Activity 501 Greene Street Hatcher Building - Suite 2 Augusta GA 30901

To all Offerors/Bidders

36C24726Q0114

X

X X

The purpose of this Amendment is to publish an updated Performance Work Statement adding additional information for the Emergency Department repairs.

All other terms and conditions shall remain unchanged.

Jacob A. Tackett Contracting Officer

CONTINUATION PAGE

Medical Gas Repairs Service

Performance Work Statement

A. Introduction: The purpose of this Performance Work Statement (PWS) is to define the requirements for Medical Gas Repairs Service at Ralph H. Johnson VA Medical Center located at 109 Bee St, Charleston, SC 29401. These components are critical for maintaining proper Hospital Operations and ensuring a comfortable environment for patients, staff, and visitors.

B. Scope of Work: The contractor shall provide all labor, equipment (including parts), materials and supervision necessary to perform repairs and install replacement parts to complete the medical gas repairs service.

C. All work shall be performed in accordance with VA standards, NFPA 99, manufacturer recommendations, and applicable local, state, and federal regulations.

D. Task Requirements

a. Check in with COR or designee

b. At the end of each shift in which work is performed, a certifier must certify the work before placing the system back into operation. This must be done each time work is conducted under this contract.

c. Install zone valves to control oxygen, medical air, and vacuum to room A301

d. Install zone valves to control oxygen, medical air, and vacuum to room A302

e. Install zone valves to control oxygen, medical air, and vacuum to room A305

f. Install zone valves to control oxygen, medical air, and vacuum to room A306

g. Install zone valves to control oxygen, medical air, and vacuum to room ED 4

h. Install zone valves to control oxygen, medical air, and vacuum to room ED 5

i. Install zone valves to control oxygen, medical air, and vacuum to room ED 6

j. Install zone valves to control oxygen, medical air, and vacuum to room ED 7

k. Install zone valves to control oxygen, medical air, and vacuum to room ED 8

l. Install zone valves to control oxygen, medical air, and vacuum to room ED 9

m. Install zone valves to control oxygen, medical air, and vacuum to room ED 10

n. Emergency Department: To correct the deficiencies, service valves need to be installed (in the ceiling or under the building) before the current zone box that isolates each zone for rooms in the Emergency Department 4-10. This will correct labeling issues as each zone will have a shut-off labeled.

E. Site Cleanup and Documentation

i. Remove all debris and restore work areas to their original condition.

ii. Provide a detailed report of completed work, including before-and-after photos, test results, and any recommendations for ongoing maintenance.

F. Safety and Compliance

a. The contractor shall adhere to VA safety policies and OSHA regulations.

b. Personal protective equipment (PPE) shall always be used during work activities.

c. The contractor shall coordinate with VA personnel to minimize disruption to hospital operations.

G. Period of Performance

a. The contractor shall complete all work within 60 days from the start date, as agreed upon with the VA contracting officer.

H. Normal working hours are 0700 – 1700 Monday to Friday, except for federal holidays. All work during normal hours shall be completed at the end of that working day. Some work may need to take place during after-hours (1700 – 0700) or during weekends. The contractor shall provide a detailed schedule to meet the requirements. All schedules and work hours shall be requested, coordinated, and approved through the COR.

I. Deliverables

a. Complete all task requirements listed in Section D

b. All dampers are working correctly and verified in the computer monitoring

c. Ensure work area is cleaned

d. Provide a service report to the COR and or designee.

J. DEFINITIONS

a. Medical Gas and Vacuum Systems. Medical Gas and Vacuum Systems store, generate, and supply oxygen, compressed air, carbon dioxide, nitrous oxide, vacuum, and nitrogen to patient care areas.

b. Qualified Staff. Qualified staff members are individuals trained in the installation, maintenance, and testing of Medical Gas and Vacuum Systems as required by NFPA 99.

c. Qualified Third Party. A qualified third party is a vendor certified in American Society of Sanitary Engineering (ASSE) 6010 for system installations, ASSE 6020 for system inspections, ASSE 6030 for systems verifier, and ASSE 6040 systems maintenance, whichever is applicable to the work the vendor is contracted to execute.

INVOICES:

a. Payment will be made upon receipt of a properly prepared detailed invoice, prepared by the Contractor, and submitted through Tungsten Network (formerly known as OB10) https://authentication.tungsten-network.com/login. A properly prepared invoice shall contain:

Invoice Number and Date Contractor’s Name and Address Accurate Purchase Order Number Supply or Service provided Period Supply or Service Provided Total Amount Due

b. Please begin submitting your electronic invoices through the Tungsten Network for payment processing, free of charge.

c. If you have questions about the e-invoicing program or Tungsten Network, contact information is as follows:

Tungsten e-Invoice Setup Information: 1-877-489-6135 Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com FSC e-Invoice Contact Information: 1-877-353-9791

FSC e-invoice email: vafsccshd@va.gov Web Address: HTTP://WWW.FSC.VA.GOV/EINVOICE.ASP

RECORDS MANAGEMENT OBLIGATIONS

A. Applicability

This clause applies to all Contractors whose employees create, work with, or otherwise handle Federal records, as defined in Section B, regardless of the medium in which the record exists.

B. Definitions

“Federal record” as defined in 44 U.S.C. § 3301, includes all recorded information, regardless of form or characteristics, made or received by a Federal agency under Federal law or in connection with the transaction of public business and preserved or appropriate for preservation by that agency or its legitimate successor as evidence of the organization, functions, policies, decisions, procedures, operations, or other activities of the United States Government or because of the informational value of data in them.

The term Federal record:

1. includes [Agency] records.

2. does not include personal materials.

3. applies to records created, received, or maintained by Contractors pursuant to their

[Agency] contract.

4. may include deliverables and documentation associated with deliverables.

C. Requirements

1. Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a).

These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

2. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

3. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

4. [Agency] and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of [Agency] or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C.

2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to [Agency]. The agency must report promptly to NARA in accordance with 36 CFR 1230.

5. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the Contracting Activity.

When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to [Agency] control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

6. The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub-contractor) is required to abide by Government and [Agency] guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

7. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with [Agency] policy.

8. The Contractor shall not create or maintain any records containing any non-public [Agency] information that are not specifically tied to or authorized by the contract.

9. The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.

10. The [Agency] owns the rights to all data and records produced as part of this contract.

All deliverables under the contract are the property of the U.S. Government for which [Agency] shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20.

11. Training. All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take [Agency]-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.

Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.]

D. Flow down of requirements to subcontractors

1. The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same.

2. Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor.