36C25223B0007 0001.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 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) 695-23-2-6085-0002 695-22-111 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 To all Offerors/Bidders

36C25223B0007 12-22-2022

X X X

X See Continuation Page for further details.

Ryan McMillin Contracting Officer Continuation Page of Block 14, Standard Form 30 Solicitation: 36C25223B0007 Amendment: 0001

The purpose of this amendment is to:

1. Provide a revised Statement of Work. This statement of work incorporates Preliminary Work Phase 0 with a Limited Notice to Proceed (L-NTP). The total project period of performance shall be completed within Two Hundred and Seventy-One (271) calendar days after the issuance of the Limited Notice to Proceed (L-NTP). The project period of performance will include 61 calendar days for performance as part of the Limited Notice to Proceed (L-NTP) and 210 calendar days for performance as part of the full Notice to Proceed (NTP).

2. Provide the site visit attendance sheet from the site visit conducted on December 21, 2022.

3. Provide Single Source Justifications for the following items:

a. HILTI Firestop System

b. Johnson Controls Metasys material

There is NO change to the Bid Due Date/Time and the Bid Opening Date/Time on Tuesday, January 31, 2023 at 1:00PM (CST).

All documents within this amendment supersede previous versions.

--------------------Space Intentionally Left Blank--------------------

36C25223B0007 0001 Page 2 of 6

Clement J. Zablocki VA Medical Center Replace EP Lab Server Room AHU Project 695-22-111 Statement of Work November 3, 2022

US Department of Veterans Affairs Clement J. Zablocki VA Medical Center 5000 W. National Ave.

Milwaukee, WI 53295-0001

)STATEMENT OF WORK

)Prepared by:

Facility Management Division

I. General Description:

Provide Construction Services for Project#: 695-22-111 Replace EP Lab Server Room AHU.

1. Contractor shall provide for and furnish all labor, materials, equipment, qualified supervision, and other items designated in this contract in accordance with the specifications and drawings to complete Project # 695-22-111: Replace EP Lab Server Room AHU at Clement J. Zablocki VA Medical Center, 5000 West National Avenue Milwaukee, WI.

2. Within the Electrophysiology Lab (EP) Area of Building 111, this project includes the replacement of a Computer Room Air Conditioner (CRAC) Unit, installation of a remote condensing unit, and the necessary utilities and controls for the Server Room Cooling System. The new CRAC system and its components shall meet manufacturer requirements for maintenance clearances. The new CRAC System will be commissioned by a third-party Commissioning Agent retained by the VA. The contractor will be responsible for providing commissioning support as required by Specification 01 91 00.

3. The existing CRAC system is connected to a Drycooler. The existing Drycooler shall be reused with the new CRAC system. See specifications and drawings for more details.

4. Appropriate infection control and life safety measures shall be practiced during construction. Penetration repairs, firestopping, and restoration shall be performed in areas affected by construction.

5. Construction work shall not interrupt or disrupt services of equipment, the EP Lab, or other hospital operations. Construction work shall adhere to phasing and hours of work as specified in the drawings and specifications.

6. All work shall be completed within 271 calendar days after receiving Formal Notice to Proceed.

This project period of performance shall be completed within Two Hundred and Seventy-One (271) calendar days after the issuance of the Limited Notice to Proceed (L-NTP). The project period of performance will include 61 calendar days for performance as part of the Limited Notice to Proceed (L-NTP) and 210 calendar days for performance as part of the full Notice to Proceed (NTP).

III Project Duration/Phases:

1. Phase 0: Preliminary Work Phase is L-NTP+60. Limited Notice to Proceed (L-NTP) issued. The purpose of the L-NTP is to allocate time dedicated to submission and approval of submittals for equipment, material, and the Schedule of Values (SOV). A Contract Orientation Meeting is anticipated to be scheduled on the effective date identified in the L-NTP. Phase 0 is projected not to exceed 60 calendar days. The contractor has 30 calendar days to provide submittals for equipment, material and a Schedule of Values (SOV) based on time duration. The VA has 30 days for submittal review. Contractors will order equipment as submittals are approved.

2. Phase 1: Notice to Proceed Issued. Pre-construction (kick-off) Meeting is anticipated to be scheduled on the effective date identified in the Notice to Proceed (NTP).

3. Phase 2: Pre-Construction Period (A) Duration is 30 calendar days and shall not exceed Formal NTP + 30 days. Within this period the contractor shall submit the following and schedule a review meeting with the COR and VA Safety (as applicable per the specification requirements):

a. Construction Schedule (Initial) – 01 32 16.15

b. Accident Prevention Plan – 01 35 26

4. Phase 3: Pre-Construction Period (B) Duration is 15 calendar days and shall not exceed Formal NTP + 45 days. Within this period the contractor shall submit the following Pre-Construction Submittals (as applicable per the specification requirements):

a. Construction Site Security Plan – 01 00 00

b. Construction Phasing Plan(s) – 01 00 00

c. Existing Conditions Survey – 01 00 00

d. Obtain PIV badges – 01 01 10-SN

e. Contractor’s Impact Statement – 01 01 10-SN

f. Contractor Checklist – 01 01 10-SN

g. Submittal Register – 01 33 23

h. Quality Control Plan – 01 33 23

i. Schedule of Values – 01 33 23

j. Activity Hazard Analyses – 01 35 26

k. SSHO and CP List for the Project – 01 35 26

l. OSHA Certificates, Licenses, and Training Documents – 01 35 26

m. Infection Control Plan(s) – 01 35 26

n. Fire Safety Plan – 01 35 26

o. Construction Waste Management Plan – 01 74 19

5. Phase 4: Pre-Construction VA Review Period/Construction Kickoff Meeting Duration is 30 calendar days and shall not exceed Formal NTP + 75 calendar days. Within this period the VA shall complete all review of contractor Pre-Construction Submittals.

Once all Pre-Construction Submittals have been approved and the contractor is ready to mobilize, a Construction Kickoff Meeting will be held.

6. Phase 5: Construction Period Duration is anticipated to be 90 calendar days and shall be completed no later than Formal NTP + 165 calendar days. All applicable documentation listed in Phases 2 & 3 and any necessary submittals required to mobilize must be approved by the COR prior to commencing work. No demolition or construction shall be started without COR review and approval of those items listed in the Pre-Construction Period unless authorized in writing by the COR or the CO.

7. Phase 6: Post-Substantial Completion Period Duration is anticipated to be 45 calendar days and shall be completed no later than Formal NTP + 210 calendar days.

The GC shall provide all required materials within 30 days of reaching Post-Substantial Completion (Formal NTP + 195 calendar days). The contractor is expected to comply with and provide:

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

b. Final Approval and Beneficial Occupancy when applicable

c. Warranties documents and O&M Manuals

d. As-built drawings and record submittals

e. Staff training when applicable

f. Final Waste Manifest Reports

g. Existing Conditions Re-survey

h. Release of Claims

The last 15 days of the Post-Substantial Completion Period is reserved for the VA to review and approve the submitted closeout documents, which will be completed no later than Formal NTP + 210 calendar days.

-- End SOW –

Attachments:

See attached document: S06 - HVAC_BAS_Controls_SingleSourceJustification_MPT-SAT.

See attached document: S06 - Firestop_SingleSourceJustification_MPT-SAT.

See attached document: S06 - Site Visit Attendance Sheet_695-22-111.

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