36C25018Q9831-0001000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2.

AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. 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 CODE

CODE

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 ITE M 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 r eference 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

BY

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) 09-07-2018 none 36C250 Department of Veterans Affairs Network Contracting Office (NCO) 10 Dayton VA Medical Center 3140 Governor’s Place Blvd. Suite 210 Kettering OH 45409-1337 36C250 Department of Veterans Affairs Network Contracting Office (NCO) 10 Dayton VA Medical Center 3140 Governor’s Place Blvd. Suite 210 Kettering OH 45409-1337 To all Offerors/Bidders

36C25018Q9831

X X X September 17, 2018 - 1400 hours X The purpose of this Amendment 0001 is to:

1. Provide the Quality Assurance Surveillance Plan (QASP) and the Wage Determination;

2. Extend the Solicitation due date; and

3. All other terms and conditions remain the same.

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

HOUSEKEEPING SERVICES

1. Introduction This QAE (Quality Assurance Evaluator) Plan has been developed to implement a housekeeping service contract. It is designed to aid the Government's QAE in providing effective and systematic surveillance of all aspects of housekeeping services. This plan provides for monitoring all contract requirements through a combination of methods.

The below listed methods of surveillance shall be used in the administration of this QASP:

a) Periodic Surveillance by the COR The COR periodically observe the areas to verify that the contractor is meeting the goals of the contract; and when COR receives a complaint to necessitate a surveillance.

b) Customer complaint The COR is the point of contact and will collect all customer complaints. The COR will review all complaints and contact the originator to determine the validity of any claims. Customer complaints will become a permanent part of the COR surveillance records.

c) 100% Inspections Complete evaluation of the performance element.

d) Random Sampling Method used to evaluate performance by randomly selecting and inspecting a sample of cases.

· The principal method of surveillance will be the random sampling of the areas described in the PWS to be cleaned. The PWS has a detailed Cleaning Frequency Char with all areas of building to be cleaned, frequency and expectation. The PWS also includes: Requirement for Specific Tasks, Periodic Cleaning Services and Requirements for Specific Tasks - pertaining to laundry/linen.

· Tasks not surveyed by random sampling will be covered by daily observation in some cases or by use or periodic checklist inspections. Appropriate checklists are provided for recording observations in this type of surveillance.

· The Objective of this surveillance plan is to evaluate how the Contractor is performing in key areas. We are primarily interested in the final product or service being provided and not in the details of accomplishment.

2. Purpose This quality assurance surveillance plan (QASP) is a government-developed and applied document used to make systematic quality assurance methods used in the administration of the performance-based service acquisition (PBSA) standards included in this contract. The intent is to ensure that the contractor performs in accordance with performance metrics set forth in the contract documents and that the government receives the quality of services called for in the contract.

Authority Authority to issue this QASP is provided under Federal Acquisition Clause (FAR) 52.212-4(a) Inspection and Acceptance, which provided for inspections and acceptance of the articles, services, and documentation called for in the contract to be accomplished by the contracting officer or a duly appointed representative.

Scope The contractor, and not the government, is responsible for management and quality control actions necessary to meet the quality standards set forth by the contract. The QASP is put in place to provide government surveillance oversight of the contractor’s quality control efforts to assure that they are timely, effective, and delivering the results specified in the contract. The QASP is not a part of the contract, nor is it intended to duplicate the contractor’s quality control plan.

3. Government Roles and Responsibilities Roles The following definitions for government resources are applicable to this plan:

a) Contracting Officer A person duly appointed with the authority to enter into, administer, or terminate contracts and make related determinations and findings on behalf of the government.

b) Contracting Officer’s Representative (COR) An individual designated in writing by the contracting officer to act as his or her authorized representative to assist in administering a contract. The source and authority for a COR is from the contracting officer. COR limitations are contained in the written letter of designation.

Responsibilities The government resources shall have responsibilities for the implementation of this QASP as follows:

a) Contracting Officer The contracting officer ensures performance of all necessary actions for effective contracting and ensures compliance with the terms of the contract and safeguards the interests of the United States in the contractual relationship. It is the contracting officer who assures that the contractor receives impartial, fair, and equitable treatment under the contract. The contracting officer is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

b) COR The COR is responsible for technical administration of the contract and assures proper government surveillance of the contractor’s performance. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the government’s behalf. Any changes that the contractor deems may affect contract price, terms, or conditions shall be referred to the contracting officer for action.

4. Procedures This surveillance plan has been organized to facilitate use by the QAE. It is the QAE's responsibility to develop a monthly schedule for activities based on the surveillance plan's requirements. The monthly schedule will be completed by the last workday of the preceding month and a copy will be submitted to a CO or other management official for information and review by an assigned workday of the month.

· To build the inspection schedule, the QAE will select areas and times for the random sampling using the procedures shown in the surveillance plan. Periodic checklist items to be surveyed during the month will be programmed into the schedule to facilitate their accomplishment. This monthly schedule should show what the QAE is monitoring each day. Changes will be posted weekly and copies sent to appropriate officials. The reasons for changes will be fully documented and explained. Actual surveillance activity must be comparable to the monthly schedule. The responsible management official must be able to observe a QAE's performance by using the monthly schedule, as updated. One should be able to conduct a complete audit trail from the monthly schedule by observing the QAE perform sampling or other checklist surveillance, and completion of tally and other checklists. An auditor should be able track from the above items to the management's actions (performance rating deductions or other actions as necessary if contract service is being performed), described on a CDR.

· Monthly tally checklists will be prepared for each sampling guide and will be used to record information on observations and defects. Each observation in the sampling will be recorded on the tally checklists. These documents will then become a formal record for later reference. The tally of observations and defects at the end of each month will be compared to the acceptable number of defects appearing in the relevant sampling guide. Any errors detected during the course of the surveillance, even if not of sufficient degree to render the service unsatisfactory in terms of the AQL parameters, will require corrective action by the Contractor. Errors detected by the QAE in the course of surveillance will be communicated to the Contractor. Notification of errors will take place within 1 working day. Specifics concerning any errors should be recorded on the tally checklist. The Contractor should be asked to initial this record.

· If the sampling guide indicates that the number of defects is too high, the current month's service will be considered unsatisfactory. If performance in any area is judged unsatisfactory, based on random sampling or other criteria as set forth in the Fisher House Housekeeping Performance Work Statement, a Contractor will be given a CDR by the COR. When completed and signed, the CDR, along with the tally checklist becomes the documentation supporting an unfavorable performance evaluation for Contractor provided services.

· There are some requirements in a contract which are more conveniently monitored on an individual periodic basis. For example, a Contractor is required to provide continuing training. When these items are checked (quarterly and monthly, for example), the deficiencies will be recorded on the appropriate checklist. When these items are discovered to be unsatisfactory, actions as described above will be taken. For the number of allowable defects, see the Performance Objective in the PWS.

5. Performance Standards Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets or does not meet these standards.

· The Performance Requirements are listed below. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL). Refer to the PWS:

a. Section vii. Cleaning Frequency Chart

b. Section viii. Requirements for Specific Tasks

c. Section ix. Periodic Cleaning Services

d. Section x. Requirements for Specific Tasks (Linen and Laundry)

Performance Requirements Summary Chart

Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

Incentive – Favorable contractor performance evaluation Disincentive:

Unfavorable contractor performance evaluation

a. Any additional expense cause by contractor delay is borne by the contractor.

b. Delays not approved by the CO/COR may cause Cure Notice action and or termination of the task order.

c. A Contract Discrepancy Report (CDR) may be issued on the first instance of failure to meet delivery requirement.

6. Performance Requirements Summary Method of Application The Contractor is required to perform all the work specified in the PWS. If the contractor fails to perform a specific element of the work, performance rating for the task in question will be subject to reductions as specified. The purpose of this section is to:

List the contract requirements considered most critical to acceptable contract performance.

Show, where applicable, the maximum allowable degree of deviation from perfect performance for each requirement that shall be allowed by the Government before contract performance is considered unsatisfactory. This is known as the AQL and represents the level of service and quality required.

Explain the quality assurance methods the Government will use to evaluate the Contractor's performance in meeting the contract requirements.

Define the procedure the Government shall use in reducing the Contractor's performance rating if the Contractor does not render satisfactory performance.

The criteria for acceptable and unacceptable performance are as follows:

When the number of deficiencies in the Contractor's performance discovered by the Facility COR exceeds the unacceptable criteria level, the COR with involvement and concurrence of the Contracting Officer (CO) shall be required to complete a CDR (Contract Discrepancy Report). The CDR will require the Contractor to explain in writing to the CO why performance was unacceptable, how performance will be returned to acceptable levels, and how recurrence of the problem will be prevented in the future.

Other Requirements: The criteria for other requirements are the level of performance deemed acceptable to the Government. When the number of defects discovered by the Facility COR exceeds the number shown in the AQL column, a CDR, as described above will be issued.

The Performance Rating of the Contractor will be reduced for unsatisfactory performance. During each month, Contractor performance will be compared to contract standards and acceptable quality levels using the Quality Assurance Plan. If performance in any required service is unsatisfactory for the period of surveillance (monthly, quarterly, etc.) and the poor performance is clearly the fault of the Contractor, a non-favorable rating will be given for the service as stated in the fifth column of the Performance Requirements Summary.

7. Customer Complaint Surveillance The checklist contains those contract requirements that can best be monitored by the individual or activity receiving the service.

At the start of the contract, the QAE shall instruct customers on the requirements of the contract and on the proper method to complete the customer complaint form. A written copy of the specific contract requirement will be provided to each customer. Customers shall be required to submit the complaint form within 1 working day of the discovery of the discrepancy.

Once each year, the QAE will contact each customer to assure that there is an understanding of the contract requirements. The QAE will document the annual visits.

When a complaint is received, the QAE will verify the complaint. If the complaint is valid, the QAE will notify the Contractor of VA management whoever is applicable of the defect in writing.

The QAE will retain the complaint form in the files. At the end of each month, all validated complaints will be tabulated to determine satisfactory or unsatisfactory performance, in each are, based on the criteria in the AQL column in the "Performance Requirements Summary."

8. Customer Complaint Record Date/time of complaint:

Source of complaint:

Office:

Individual:

Nature of complaint:

QAE evaluation:

Date/time Contractor or VA informed of complaint:

CPM initials

Action taken by Contractor or VA:

QAE signature _____________________________________________________________

WD 15-4731 (Rev.-5) was first posted on www.wdol.gov on 01/16/2018

REGISTER OF WAGE DETERMINATIONS UNDER | U.S. DEPARTMENT OF LABOR

THE SERVICE CONTRACT ACT | EMPLOYMENT STANDARDS ADMINISTRATION

By direction of the Secretary of Labor | WAGE AND HOUR DIVISION

Daniel W. Simms Division of | Revision No.: 5 Director Wage Determinations| Date Of Revision: 01/10/2018 Note: Under Executive Order (EO) 13658, an hourly minimum wage of $10.35 for calendar year 2018 applies to all contracts subject to the Service Contract Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.35 per hour (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in calendar year 2018. The EO minimum wage rate will be adjusted annually.

Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts State: Ohio

Area: Ohio Counties of Greene, Miami, Montgomery **Fringe Benefits Required Follow the Occupational Listing**

OCCUPATION CODE - TITLE FOOTNOTE RATE

11000 - General Services And Support Occupations

Note: Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal Contractors, applies to all contracts subject to the Service Contract Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2017. If this contract is covered by the EO, the contractor must provide employees with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid sick leave each year. Employees must be permitted to use paid sick leave for their own illness, injury or other health-related needs, including preventive care; to assist a family member (or person who is like family to the employee) who is ill, injured, or has other health-related needs, including preventive care; or for reasons resulting from, or to assist a family member (or person who is like family to the employee) who is the victim of, domestic violence, sexual assault, or stalking. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts.

ALL OCCUPATIONS LISTED ABOVE RECEIVE THE FOLLOWING BENEFITS:

HEALTH & WELFARE: $4.41 per hour or $176.40 per week or $764.40 per month

HEALTH & WELFARE EO 13706: $4.13 per hour, or $165.20 per week, or $715.87 per month*

*This rate is to be used only when compensating employees for performance on an SCA-covered contract also covered by EO 13706, Establishing Paid Sick Leave for Federal Contractors. A contractor may not receive credit toward its SCA obligations for any paid sick leave provided pursuant to EO 13706.

VACATION: 2 weeks paid vacation after 1 year of service with a contractor or successor, 3 weeks after 8 years, and 4 weeks after 15 years. Length of service includes the whole span of continuous service with the present contractor or successor, wherever employed, and with the predecessor contractors in the performance of similar work at the same Federal facility. (See 29 CFR 4.173)

HOLIDAYS: A minimum of eleven paid holidays per year: New Year's Day, Martin