36C25218R0105-009.docx

DOCX document 56 KB Posted

Attached to
Southern Tier Construction Multiple Award Task Order Contrac (MATOC) Federal contract opportunity
Solicitation number
36C25218R0105
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12

About this file

This statement of work outlines requirements for upgrades to the HVAC and controls system and replacement of landscape light fixtures at the Fisher House on the campus of the Edward Hines Jr. Veterans Affairs Hospital in Hines, Illinois. The scope of work includes demolishing the existing HVAC and controls system, installing a new Johnson Controls system connected to the hospital network, and removing and replacing 51 existing landscape bollards with new LED fixtures. The pre-construction period is 30 days from notice to proceed, with construction to be completed within 60 days thereafter. The contractor must provide various plans and certifications during the pre-construction period, hold biweekly meetings during construction, and provide closeout documentation including as-built drawings within 15 days of completion.

36C25218R0105 S02_SOL-Att-08-Seed Project SOW 578-17-020R2.docx

View the file

Other files for this federal contract opportunity

Other files attached to Southern Tier Construction Multiple Award Task Order Contrac (MATOC), newest first.
File Type Posted
36C25219D0072-001.docx DOCX document
36C25219D0071-001.docx DOCX document
36C25219D0070-001.docx DOCX document
36C25219D0069-001.docx DOCX document
36C25219D0068-003.docx DOCX document
36C25218R0105-0006000.docx DOCX document
36C25218R0105-0005001.pdf PDF
36C25218R0105-0005003.pdf PDF
36C25218R0105-0005002.pdf PDF
36C25218R0105-0005000.docx DOCX document
36C25218R0105-0004001.pdf PDF
36C25218R0105-0004002.zip ZIP file
36C25218R0105-0004000.docx DOCX document
36C25218R0105-0004003.pdf PDF
36C25218R0105-0003000.docx DOCX document
36C25218R0105-0002000.docx DOCX document
36C25218R0105-0001000.docx DOCX document
36C25218R0105-003.docx DOCX document
36C25218R0105-011.pdf PDF
36C25218R0105-005.docx DOCX document
36C25218R0105-010.pdf PDF
36C25218R0105-008.docx DOCX document
36C25218R0105-002.docx DOCX document
36C25218R0105-012.pdf PDF
36C25218R0105-004.docx DOCX document
36C25218R0105-007.docx DOCX document
36C25218R0105-006.docx DOCX document
36C25218R0105-001.docx DOCX document
36C25218R0105-000.docx DOCX document
36C25218R0105-000.docx DOCX document
Show all 30

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

Statement of Work

Upgrades to the Fisher House, Building 100 Project # 578-17-020

March 20, 2018

Attachments:1)Hines VA Campus Site Plan
2)Fisher House As-Builts
3)Fisher House, Bldg. 100 Existing Landscape Light Fixtures
4)Pre-Construction Checklist
5)Safety and Health during Construction Activities
APre-construction/Safety Risk Assessment (PCRA)
BNational Environmental Protection Act Assessment (NEPA)
CConstruction Safety Checklist
DGEMS Awareness Competent Person Training
EConstruction Project Waste Minimization Report
FHines VAH Contractor Safety Disciplinary Procedure
GHines VAH COR Letter of Concern for Safety Non-Compliance
HOSHA Required Competent Person Inspections
ICrane Operation and Minimum Criteria On-Site Inspection Checklist
JHines VA Hospital Planned Critical Lift Plan & Crane Permit
6)Interim Life Safety Measures (ILSM)
7)Infection Control Risk Assessment (ICRA)
8)Contractor PIV Instructions and Form
9)Cutting welding and other hot work
10)Above Ceiling Entry and Wall Construction Permits
11)Landscape Light Fixture (Basis of Design)
12)OIT Horizontal Cable Requirements
13)Specifications Book
14)Drawings, Fisher House Controls Replacement
References:1)VA’s Technical Information Library (TIL)
2)Master Construction Specifications (PG-18-1)
3)Design and Construction Procedures (PG-18-3)
4)Standard Details (PG-18-4)
5)Design Manuals (PG-18-10)
6)Environmental Planning Guidance (PG-18-17)
5)2014 Statement of Conditions Survey for the Edward Hines Jr. Veterans Affairs Hospital (available on request)
6)2017 Facility Condition Assessment for the Edward Hines Jr. Veterans Affairs Hospital (available on request)

A) Mission.

Engineering Service’s mission is the total oversight and management of the environment of care, as it pertains to the physical infrastructure and base plant operations, at the Edward Hines VA Hospital. Engineering support is for customers that include, but are not limited to, patients, visitors, clinic staff and administrative employees.

B) Goals.

The goal of this project is to upgrade the HVAC and controls system and replace existing landscape light fixtures at the Fisher House, Building 100.

C) Current Conditions.

The following two (2) current conditions at Hines Fisher House are to be addressed by this project:

1) HVAC and control system is out of date and not connected to the network.

2) Existing landscape light fixtures are not energy efficient.

D) Justification.

The Fisher House Foundation, a 38 U.S.C. 501(c)(3) non-profit organization, was created in 1990 by Zachary and Elizabeth Fisher. The Foundation constructs and donates Fisher Houses to the Department of Defense (DOD) and VA for use by families of patients hospitalized in military and VA medical facilities. The Fisher House Foundation requires that all Fisher Houses be used to provide temporary accommodations to the accompanying individuals of Veterans and active duty service members, who require accommodations due to Veterans or active duty service members receiving health care from VA or DOD. The Secretary of Defense and the Secretary of Veterans Affairs are responsible for the operation and maintenance of the Fisher Houses once they are donated by the Foundation. Each House is professionally decorated and furnished and has a common kitchen, laundry facility, dining room, and living room.

Section 221(a) of the Veterans Benefits and Health Care Improvement Act of 2000 (Public Law 106-419) gave VA legislative authority to accept Fisher Houses constructed and donated by the Fisher House Foundation and to use appropriated funds to operate and maintain Fisher Houses.

E) Objectives.

The objectives of this project are to:

1) Upgrade HVAC and controls system.

2) Remove and replace existing landscape light fixtures.

3) Perform the work in a manner least likely to interfere with the daily operations of the Fisher House.

F) Acronyms and Definitions.

The following is a listing of acronyms and/or definitions to terms used in this document.

GCGeneral Contractor (firm)
COContracting Officer
CORContracting Officers Representative as delegated by the CO
CSContracting Specialist assigned by the CO
EHVAHEdward Hines Veterans Affairs Hospital
IDIQIndefinite Delivery Indefinite Quantity
LFLinear or Lineal Feet
NTPNotice to Proceed
OITOffice of Information & Technology
PDTProject Delivery Team – Typically comprised of the CO/CS, the COR, and EHVAH staff
RFIRequest for Information
SFSquare Feet
VADepartment of Veteran Affairs

G) Requirements.

This SOW presumes the contractor will not need access to the Hines LAN or any VA Sensitive Information in order to execute the contract.

The awarded Contractor will adhere to all codes, standards, guidelines and design requirements found in the VA’s Technical Information Library (TIL) including but not limited to the following:

1) Pre-Bid site visit:

a. A pre-bid site walk through is encouraged and should be coordinated by the CO. The intent of this walkthrough is to give the contractor access to the project site so that an accurate evaluation of the project requirements and site assessment can be made.

b. Contractor shall coordinate with the COR to schedule the site visit seven (7) calendar days prior to the requested date.

2) RFI Submittals:

a. The contractor shall submit any RFI’s resulting from the site visit within five (5) working days after the inspection to the CO.

b. Unless otherwise stated the contractor shall allow the COR and CO ten (10) working days to respond to an RFI.

3) Infection Control and Cleanliness:

a. The work area is classified as Infection Control Risk Assessment Class I, and therefore does not require the use of infection control barrier systems. However, while working in general access spaces, contractor shall use temporary barriers (such as pylons and/or caution tape) to prevent non-contractor personnel from entering active worksites.

b. Contractor shall maintain the work area in a clean condition, and hazard free condition during work operations, and perform a final cleanup upon completion of work.

4) Equipment Lead time:

a. Equipment lead times line shall be incorporated in to the project schedule and used in conjunction with the baseline for the project start date.

5) EHVAH Permits:

a. Unless otherwise stated the contractor shall submit for all required VA permits (i.e. above ceiling or dig) fourteen (14) calendar days prior to the event based on the approved project schedule with the COR.

6) Project Pay Applications:

a. All submitted project pay applications require certified payroll and waste report documents to be current with each pay submission.

b. Certified payroll documents shall be submitted to the COR weekly.

c. Approval of all invoices will require documents to be current.

7) Work outside of normal business hours or weekends:

a. All work performed after hours or on weekends requires coordination with the COR and shall be requested fourteen (14) calendar days prior in writing or e-mail to the COR for approval.

b. No work shall take place without written or e-mail confirmation from the project COR.

8) Utility Shutdowns:

a. Contractor shall provide twenty-one (21) calendar days advance notice for any planned utility shutdowns to all allow the station to notify staff/visitors and prepare contingency plans if necessary.

b. Planned utility shutdowns should be indicated on the project schedule.

9) Submittals and Shop Drawings:

a. Unless otherwise stated the contractor shall provide shop drawings and equipment submittals for review and approval by the COR seven (7) calendar days prior to the start of construction.

b. No work shall be started prior to review and approval by the COR.

10) Certifications:

a. When applicable, the contractor shall provide certification for all personnel performing any welding and shall certify all welds prior to the start-up of any of the units.

b. These certifications shall be supplied to the COR and retained as a permanent record of the project folder.

c. Personnel certifications shall be provided to the COR prior to the start of construction.

d. All weld certifications shall be provided to the COR at the end of every work week when applicable.

11) OSHA Certification:

a. The contractor shall have an OSHA certified site superintendent on site whenever any work is being performed.

b. A copy of the OSHA certification shall be supplied to the COR prior to the start of any work and retained as part of the project folder.

H) Scope of Work.

The Scope of Work for this project includes all labor, management, and materials for the upgrades of the HVAC and controls system and to remove and replace existing landscaping light fixtures at the Fisher House, Building 100, in accordance with the attached Specifications Book and Drawings, Fisher House – Controls Replacement. All measurements/dimensions are approximate and shall be field-verified by the Contractor. Major items of work include, but are not limited to the following items:

1) HVAC and Controls System Upgrade to be connected to the Hines VA network:

a. Demolition:

1. Provide temporary work area access control, as necessary.

2. Maintain staff, patient, and visitor access to the building during demolition per specifications.

3. Protect fire sprinkler heads during demolition.

4. Maintain a clean worksite. All debris (garbage and trash) needs to be covered at all times while it is in transit through Fisher House hallways to and from the dumpster. Dumpster needs to be covered at all times and emptied as needed. It is contractor’s responsibility to keep the area surrounding your dumpster clean at all times.

5. Dispose of all demolition material and construction debris in accordance with federal, state and local environmental requirements.

6. Protect all existing electrical outlets and any supporting equipment from damage during demolition work.

7. Remove existing bypass and VVT controllers, and temperature sensors for the Carrier AHU’s. Dispose of properly.

b. Installation: (Use Johnson PCT controls as basis of design)

1. Continue to provide temporary work area access control, as necessary.

2. Maintain staff, patient, and visitor access to the building during construction per specifications.

3. Label existing I/O wiring.

4. Install four (4) air handling unit (AHU) Controllers. Include actuated dampers and air flow monitor to the outside air duct. Include sensors for filter pressure differential, supply, return, and mixed air temperature sensors, and a global outside air temperature sensor.

5. Install four (4) AHU Bypass TEC Controllers with electronic actuators.

6. Install thirty-three (33) new Room Temperature Sensors with displays.

7. Install thirty-three (33) new VAV damper controllers including electronic actuators. Include flow sensors and discharge air temperature sensors. Install room thermostats with a VAV controller space sensor and warmer/cooler adjustment of +/- 3 deg F from the base set point.

8. Install one (1) new JACE (Java Application Control Engine) Network Controller. Controller must be a Johnson Controls Model FX80 to be compatible with automated controls system. Include a graphic interface using the JACE wireless technology for access by the Fisher House Director.

9. Install a boiler operations controller with sensors for water temperature points, room space temperature, pump status points, boiler alarm status, and boiler room set points.

10. Install a Variable Frequency Drive (VFD) controller for each of the three (3) 10-ton AHU’s. To be compatible with existing systems equipment, controllers shall be FX-PCA Advanced Application Programmable Controllers, as manufactured by Johnson Controls, and must have built-in N2 or BACnet communications protocols.

11. Install one (1) maintenance connection software.

12. Reuse existing AHU duct smoke detectors. Connect to new control system per manufacturer’s instructions.

13. Generate Floorplan and Mechanical Equipment Graphics for the Fisher House Controls.

14. Set up schedule, alarm, and trend analysis capability (as required by COR and AC Shop).

15. New components must be compatible with the existing Niagara AX system and software.

16. Write new program and install in the controllers to allow graphic interface with the Facility Maintenance front end. Provide a copy of the operating program to Hines A/C Shop

17. Install a new data communication line along with supporting hardware and network infrastructure that meets or exceeds all the Category 6A/Class EA requirements in ANSI/TIA-568-C.2, CENELEC EN 50173 series and ISO/IEC 11801:2002 including its amendments 1 and 2. The current standard at the facility is a Structured Connectivity Solutions (SCS) warranty from Systimax. Variation from this standard will require approval from the Hines OI&T and the Contracting Officer or their representative. The Contractor shall submit any additional warranties offered by the manufacturer, at no additional cost, to the OIT/COR. (See Attachment 13 Specifications Book).

18. Re-use existing communications cabling, which is assumed to be in good condition and compatible with the Carrier system. During construction, if cabling is determined to be unusable, Contractor shall notify the Contracting Officer and Contracting Officer’s Representative (COR) immediately for resolution.

19. Test and run all equipment and systems. Perform test and balance of the system to verify proper air flows per the original design intent. Provide test reports.

20. Provide on-site operator training as required per the Specifications Book.

21. Provide As-Built Controls Drawings with sequence of operations. Provide Operations and Maintenance Manuals and parts lists.

2) Remove and Replace Existing Landscape Light Fixtures:

a. Demolition:

1. Maintain staff, patient, and visitor access to the building during demolition per specifications.

2. De-energize power circuits feeding existing landscape bollards.

3. Remove 51 existing landscape bollards and dispose of properly.

4. Maintain a clean worksite. Dumpster needs to be covered at all times and emptied as needed. It is contractor’s responsibility to keep the area surrounding your dumpster clean at all times.

5. Dispose of all demolition material and construction debris in accordance with Federal, State and local environmental requirements.

6. Protect all existing electrical outlets and any supporting equipment from damage during demolition work.

7. Protect all existing drainage structures from debris and sedimentation.

b. Installation: (Use Lithonia Lighting; KBA8 LED as basis of design)

1. Maintain staff, patient, and visitor access to the building during construction per specifications.

2. Repair 51 concrete bases for new LED light fixtures as needed.

3. Install 51 new Symmetric (16C), Dark Bronze, Round Top, Landscape Fixtures LED Bollards on existing concrete bases.

4. Connect new LED fixtures to existing wiring.

5. Verify proper operation of all bollards from master control time clock.

The Contractor shall inspect the area under contract prior to commencing work and identify any pre-existing damage and provide an Existing Site Conditions report with related photos to the Contracting Officer for review and approval.

Any deviation from this scope of work requires the express authorization of the Contracting Officer. The Contracting Officer Representative (COR) does not hold the authority to authorize changes to this scope of work.

I) Constraints.

1) Work hours for EHVAH staff are from 7:00 am until 3:30 pm, Monday through Friday.

2) Photographs may be taken of the work performed at the jobsite. However, photographs containing patients and/or staff are a violation of the Patient Privacy and hospital policy. Both violations are subject to penalties and dismissal. Permission from the EHVAH Public Affairs Officer (PAO) is required and should be coordinated with the project COR.

3) Exploratory demolition is permitted but must be coordinated with the COR.

4) All contractors visiting the jobsite will need to receive a temporary PIV badge. The procedure to follow is:

a. Contractors must FIRST get their fingerprints done by Human Resources located in Building 17.

b. It takes between 3-5 days at least for fingerprints clear.

c. Once fingerprints have cleared the person requesting a badge can be sponsored.

d. The contractor must then complete a “Request for a PIV card” form. See Attachment 8 and then turn in to the Engineering Services.

e. The contractor can then be sponsored upon verification the fingerprints have been cleared.

f. Once contractor has been sponsored the COR, they can call PIV (708) 202-5170 to make arrangements for issuance of a PIV for badge.

J) Tasks and Responsibilities.

A pre-construction (kick-off) meeting between the Contracting Officer (CO) or Contracting Specialist (CS), the Contracting Officers Representative (COR), and key GC team members will be conducted to review project objectives, scope, deliverables, communication, site access, schedule, and responsibilities. During this meeting the Notice to Proceed (NTP) should be signed. After this meeting the awarded GC firm shall provide their services according to the approved project schedule

1) Preconstruction Period: The Contractor shall provide the following:

a. Logistics Plan: A comprehensive narrative describing the chronological planned development of the project. The Logistics Plan includes an organizational chart, hourly rates, staging plan, description of means and methods, and hours of work.

b. Construction Security Plan: Defines both physical and administrative security.

c. Construction Phasing Plan: It is the CONTRACTOR'S responsibility to develop a work plan and schedule detailing, at a minimum, the procedures to be employed, the equipment and materials to be used, the interim life safety measure to be used during the work, and a schedule defining the duration of the work with milestone subtasks.

d. Submittal Registry: The Submittal Registry shall include a listing of all documentation required for pre-approved submissions including shop drawings, technical data, product performance information, calculations, and samples.

e. Accident Prevention Plan: The APP (aka Construction Safety & Health Plan) shall interface with the Contractor's overall safety and health program.

f. Activity Hazard Analyses: AHAs are also known as Job Hazard Analyses, Job Safety Analyses, and Activity Safety Analyses.

g. Construction Schedule: WBS schedule including start/end dates, duration and sequencing, preferably in MS Project or Primavera format (include floats).

h. Schedule of Values: A detailed Breakdown for Payment, including design stages, work performed and work invoiced per Progress Payment submission.

i. Existing Conditions Survey: Before any work is started, the Contractor shall make a thorough survey with the COR of the buildings or areas of buildings in which alterations occur and areas which are anticipated routes of access, and furnish a report, signed by both, to the Contracting Officer.

j. Infection Control Plan (ICP): Narrative description of the dust control and debris disposal process including disposal destination and methodology.

k. Quality Control Plan (QCP): Describes the methods by which the Contractor will ensure all work is being accomplished in accordance with specifications and this SOW.

l. Environmental Protection Plan: The Contractor shall meet with the COR to discuss the proposed Environmental Protection Plan and to develop mutual understanding relative to details of environmental protection.

m. Document Submissions. All documents included as Attachments to this SOW that are required to be filled out and signed or jointly signed by the Contractor.

n. Demolition Debris Management Plan.

o. Certificates, Licenses, and Training Documents.

p. Obtain PIV badges.

q. RFI’s: Other than those resulting directly from demolition or construction.

2) Construction Period: The Contractor shall provide the following during construction services:

a. Display the signed PCRA, ICRA, ILSM and Emergency Contact Information in a location coordinated with the COR.

b. Attending biweekly construction meetings which are facilitated by the COR.

c. Submit RFI’s during construction as necessary.

d. Issue biweekly field reports of construction progress to the COR.

e. Attend field inspections and punch list inspections as requested by the COR.

3) Construction Close-out Period:

a. The Contractor shall provide the following:

1. Inspection and Approval by the COR and/or the CO.

2. Final Approval and Beneficial Occupancy when applicable.

3. Warranties documents and O&M Manuals.

4. As-built drawings and record submittals.

5. Staff training when applicable.

6. Contractor Release of Claims.

7. All Waste Reports submitted per Safety and Health during Construction Activities.

8. Existing Conditions Re-survey.

b. The COR shall review the contractor close-out submissions for thoroughness and conformance with the contract document requirements. The COR shall also review field-marked as-built drawings for conformance with final installations.

c. The COR shall utilize these as-built drawings and specifications from the contractor and generate as recorded drawings and specifications.

K) Deliverables.

1) The contractor shall provide all submittals required by the Specifications Book.

L) Time Frames.

1) This project shall be completed within Ninety (90) days once NTP is issued.

a. Phasing – This project shall be executed in one single, uninterrupted phase.

b. Pre-construction (kick-off) Meeting is when the Notice to Proceed (NTP) is signed.

c. Pre-Construction Period duration is NTP + 30 calendar days. Within this period the contractor shall provide all materials included under Tasks and Responsibilities and the following:

1. Logistics Plan.

2. Construction Security Plan.

3. Construction Phasing Plan.

4. Submittal Registry.

5. Accident Prevention Plan.

6. Activity Hazard Analyses.

7. Construction Schedule.

8. Schedule of Values.

9. Existing Conditions Survey.

10. Infection Control Plan.

11. Quality Control Plan.

12. Environmental Protection Plan.

13. Document Submissions.

14. Demolition Debris Management Plan.

15. Certificates, Licenses, and Training Documents.

16. Obtain PIV badges.

d. Construction Period - To be determined based upon the approved schedule for construction. The estimated construction period is 30 calendar days with all product submittals to be delivered prior to the start of construction to the COR for review and approval. No demolition or construction shall be started without the review and approval from the COR for those items listed in the Pre-Construction Period unless authorized in writing by the COR or the CO.

e. Construction Closeout Period duration is NTP + 90 calendar days. The contractor shall submit within 15 calendar days from EHVAH acceptance of the completed punch list items and commissioning reports (if applicable). Within this period the contractor shall provide all materials included under Tasks and Responsibilities and the following:

1. Inspection and Approval by the COR and/or the CO.

2. Final Approval and Beneficial Occupancy when applicable.

3. Warranties documents and O&M Manuals.

4. As-built drawings and record submittals.

5. Staff training when applicable.

6. Contractor Release of Claims.

7. Waste Reports.

8. Existing Conditions Re-survey.

M) Performance Monitoring.

The Government will periodically evaluate the Contractor’s performance by appointing a representative(s) to monitor such performance and ensure services are received. The Government representative will evaluate the Contractor’s performance through intermittent on-site inspections of the Contractor's performance

N) Other Pertinent Information or Special Considerations.

1) All Contractor personnel shall be certified by appropriate federal and state regulatory agencies to meet federal and local certification requirements as applicable. All licenses, permits and welding certifications shall be kept current throughout the period of performance of the contract. The Contractor shall provide the Government copies of such certificates.

2) Per VA Information Security Program policy – VA Directive and Handbook 6500 and 6500.6, Appendix A, contractor storage, generation, transmission or exchanging of VA sensitive information during this construction project is not acceptable.

3) All work shall be scheduled to meet requirements of EHVAH. All work shall be coordinated through the Contracting Officer. Local coordination shall be routed through the Contracting Officer’s Representative.

4) The contractor shall provide to the Contracting Officer record of work certifications for all trades relative to this contract 5 calendar days prior to beginning work. Certifications shall include welders, pipe installers, machine operators, etc.

5) Contractor is responsible for repairing any damages to existing utilities incurred during construction or demolition.

6) Utilities within the area and identified on existing drawings are not to be interpreted as the exact location, or as the only existing site conditions. Contractor shall verify all existing conditions and proceed with caution around any anticipated obstructions.

7) Where any work disturbs the grass areas, sod, walls, ceilings, floors, windows, entrances or building structures, etc. or where new and old work join, the Contractor shall restore, repair or refinish affected areas or surfaces to their original condition, or as existed before the commencement of this project. Upon completion of the contract, the Contractor shall deliver all work complete and undamaged. Any damage that may be caused by the Contractor or his work crews or subcontractors to any existing structure, grounds and utilities shall be repaired or replaced to their original condition.

8) Should a conflict exist between VA requirements and VA adopted nationally recognized codes and standards, the conflict shall be brought to the attention of the Contracting Officer. The resolution of the conflict shall be made by the authority having jurisdiction for VA to ensure system-wide consistency. All work conducted under this scope of work shall comply with the Department of Veterans Affairs Master Specifications and all applicable state and federal regulations and codes.

O) Risk Control.

1) Refer to the attached ICRA form.

P) Government Furnished Equipment (GFE)/Government Furnished Information (GFI).

1) GFE.

a. None

2) GFI.

a. No additional information is intended to be supplied other than information that is requested by the Contractor.

Q) Point of Contact at the EHVAH.

1) Ernest Wright Engineer, Project Planning Section Engineering Service Edward Hines Jr. VA Hospital Ernest.Wright@va.gov Phone: 708-202-8387 ext. 21147

FAX: 708-202-2167

image1.jpeg

File details come from the government source that posted it. Updated .