36C25224Q0337_2.docx

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE

DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a.

PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE

ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26.

TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212

-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNAT

URE OF OFFEROR/CONTRACTOR

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

None 695-24-3-6093-0045 36C25224Q0337 04-10-2024 Pasholk,Susan 414-844-4846 04-25-2024 10:00

CDT

36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 X X 811210 $34 Million N/A X 36C252

CLEMENT J. ZABLOCKI VA MEDICAL CENTER

Department of Veterans Affairs

5000 WEST NATIONAL AVENUE

MILWAUKEE WI 53295

36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476

Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971 877-353-9791 512-460-5540 See CONTINUATION Page

MEDICAL GAS SYSTEM TESTING AND INSPECTION

PER THE STATEMENT OF WORK

THIS REQUIREMENT IS 100% SET-ASIDE FOR SMALL BUSINESS

VA POC: PERRY SCOTT 414-384-2000 X43931

CO: SUSAN PASHOLK

414-844-4846

BASE YEAR JUNE 1, 2024 - MAY 31, 2025

OPTION YEAR 1 JUNE 1, 2025 - MAY 31, 2026

OPTION YEAR 2 JUNE 1, 2026 - MAY 31, 2027

OPTION YEAR 3 JUNE 1, 2027 - MAY 31, 2028

OPTION YEAR 4 JUNE 1, 2028 - MAY 31, 2029

See CONTINUATION Page 695-3640162-6093-854100-2543 010050190 X X

SUSAN PASHOLK

CONTRACTING OFFICER

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA (continuation from Standard Form 1449)

OFFERORS MUST COMPLETE AND RETURN ALL INFORMATION DESIGNATED HEREIN PRIOR TO THE TIME SPECIFIED IN BLOCK 8 OF SF 1449 IN ORDER TO BE CONSIDERED FOR AWARD.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

1. CONTRACT ADMINISTRATION: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

CONTRACTOR NAME _____________________________________

ADDRESS _____________________________________

CITY-STATE-ZIP _____________________________________

POINT OF CONTACT/TITLE _____________________________________

UNIQUE ENTITY INDENTIFIER _____________________________________

b. GOVERNMENT: SUSAN PASHOLK, CONTRACTING OFFICER

CONTRACTING OFFICE CODE: 36C252

MILWAUKEE WI 53214

2. ACQUISITION OF COMMERCIAL ITEMS: This Request for Quote (RFQ) solicitation is issued under the authority of FAR Part 13.5 Simplified Procedures for Certain Commercial Items in which simplified acquisition procedures in FAR Part 13 will be used. FAR Part 14 and 15 will not be used. From this RFQ, the Government intends to award a firm fixed price contract where the contractor provides a price that is not subject to any adjustment on the basis of the contractor’s cost experience in performing the contract. (Note: The terms “offeror” and “quoter” are both used in this Solicitation. For the purposes of this Solicitation, these terms are interchangeable; there is no difference in meaning between the two.)

3. SET-ASIDE (If any): See box 10 of STANDARD FORM 1449

4. SOLICITATION TIMELINE SUMMARY:

1. SITE VISIT:

It is strongly suggested and expected that the offeror inspect the campus to be serviced to fully understand the nature of the work and the conditions under which the work is to be performed. In no case shall failure to inspect the campus constitute grounds for a claim after contract award.

SITE VISIT IS SCHEDULED FOR TUESDAY APRIL 16, 2024 AT 9:30 AM LOCAL TIME. ALL INTERESTED PARTIES TO MEET COR PERRY SCOTT (414-629-1213) AT EAST ENTRANCE OF BUILDING 111.

1. RFQ QUESTIONS:

In order to maintain integrity of this solicitation and subsequent award date, all offerors are advised that any question and answer requests must be submitted in a written form via e-mail to the Contracting Officer susan.pasholk@va.gov no later than WEDNESDAY APRIL 17, 2024 AT NOON LOCAL TIME. Contracting will issue a consolidated response via solicitation amendment to https://sam.gov Contract Opportunities within 2 business days to all parties

1. SOLICITATION CLOSES/QUOTES DUE:

See box 8 of STANDARD FORM 1449 or most recent Amendment.

1. SUBMISSION OF QUOTE:

See 52.212-1 Instructions to Offerors—Commercial Products and Commercial Services and addendum for specific instructions to offerors.

5. CONTRACTING OFFICER AUTHORITY:

The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitment or issue changes that will affect price, quantity or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in cost incurred thereof.

6. INVOICES:

1. All payments by the Government to the contractor will be made in accordance with: FAR 52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER – SYSTEM FOR AWARD MANAGEMENT (OCT 2018)

1. Invoices shall be submitted quarterly in arrears in accordance with: 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

1. Payments shall be made in arrears upon receipt of a properly prepared invoice

1. Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests.

1. The VA has mandated electronic invoice submission to the Veterans Affairs Financial Services Center (VAFSC). VAFSC has partnered with Tungsten Network e-Invoicing network, for submissions of all electronic invoices to VA. Tungsten Network electronic invoicing is free to all VA vendors. In order to submit electronic invoices, all VA vendors must register with Tungsten Network by submitting an email to VA.Registration@Tungsten-Network.com or calling 1-877-489-6135 for Enrollment.

1. Contractor shall submit an electronic invoice by the tenth (10th) of the following month services were performed to the Veterans Affairs Financial Services Center (VAFSC) e-Invoice through the website at https://portal.Tungsten-Network.com/Login.aspx. For questions regarding the submission of VA electronic invoices, Tungsten Network customer service may be contacted at 1-877-489-6135.

1. All invoices shall reference the vendor name and address, customer name, contract number, appropriate obligation/funding order number, description of services provided, quantity, unit price, and total invoice amount (any additional info). Invoices shall also include any payment discount terms.

1. VA’s Electronic Invoice Presentment and Payment System – The Veterans Affairs Financial Services Center (VAFSC) uses a third-party contractor, Tungsten Network e-Invoice, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/customer-campaigns/veteransaffairs/ to begin submitting electronic invoices, free of charge.

1. As of July 1, 2020, the VA10091 form has been eliminated and the VAFSC is requiring our vendors to update and add their information in the Customer Engagement Portal (CEP) at https://www.cep.fsc.va.gov/. This is for new vendors being added to FMS only.

1. For assistance setting up e-Invoice, the below information is provided:

* Tungsten Network e-Invoice Setup Information: 1-877-489-6135

* Tungsten Network e-Invoice email: VA.Registration@Tungsten-Network.com

* FSC e-Invoice Contact Information: 1-877-353-9791

* FSC e-invoice email: vafsccshd@va.gov

7. FACILITY REQUIREMENTS: In addition to any other requirements set forth in this Contract, the Contractor, including its employees, agents, and subcontractors (collectively “the Contractor”), shall comply with the following facility requirements. Failure to comply with these requirements shall be considered a material breach of this Contract and may be a violation of Federal law resulting in charges answerable in the United States District Court.

1. Contractor is responsible to follow all on site facility policies

1. All VA property is considered Federal property and all Federal laws are applicable.

1. It is the responsibility of the Contractor to park in the appropriate designated parking areas. Information on parking is available from the VA Police Section. The VA will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

1. All VA facilities are drug free. Possession of drugs, to include Marijuana and all Marijuana bi-products are prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court.

1. All contractor personnel are required to adhere to all VA rules and regulations.

1. Smoking is prohibited on the entire campus, both inside and outside the VA Facility

1. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court.

1. VHA DIRECTIVE 1192: This Veterans Health Administration (VHA) directive establishes policy and provides guidance for the prevention of seasonal influenza in VHA facilities through the vaccination or masking of health care personnel (HCP). AUTHORITY: Title 38 United States Code (U.S.C.) 7301(b), 7318(b). Contractor is responsible in ensuring that all aspects of this directive are implemented, including providing face masks and influenza vaccines for all employees working at a VA facility.

8. SECURITY & PRIVACY CONTROL:

The Authorization & Accreditation (A&A) requirements of VHA Handbook 6500.6 do not apply to this requirement, therefore, a Security Accreditation Package is not required. No A&A or MOU/ISA is required. Sensitive information exposure as part of this contract involves applicable security controls within the facility as part of the VA Information Security If there are any questions related to privacy, please have a member of your staff contact the VA Privacy Service at (202) 461-6309. If there are any questions related to the information security, please have a member of your staff contact the Office of Cyber Security at (304) 262-7733.

Visitor Passes:

Issuance of visitor passes is the responsibility and at the discretion of each Facility Director. Visitor passes may be issued to individuals requiring short-term access to a VA facility for a period not to exceed 15 days in a 365-day period. Visitor passes are issued on a daily basis and expire at the end of the day of issuance. Visitor passes are issued following, at a minimum, review of one valid and current State or Federal government issued photo ID. Visitors must be escorted in areas restricted to the general public.

9. FACILITY CHECK IN/OUT PROCEDURES:

Sign in/out is MANDATORY:

Contractor and/or their technicians are required to check in at Graphics Center, Bldg. 113 upon arrival to VAMC, and check out upon departure.

VA contact Person(s): Perry Scott Location (Building/Room Number): Building 70; Room 70-1067 Telephone Number & Extension(s): 414-384-2000, ext. 43931 Contractor -- Provide telephone number(s) to call for your Service Department: ___________ Provide name(s) of authorized contact person(s): __________________

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

Contractor shall provide all L,T,E & M to inspect, functionality test, and perform Preventative Maintenance on the Medical Air Dryer and associated alarm panels to include required documentation per Statement of Work.

Contract Period: Base POP Begin: 06-01-2024 POP End: 05-31-2025 PRINCIPAL NAICS CODE: 811210 - Electronic and Precision Equipment Repair and Maintenance PRODUCT/SERVICE CODE: H265 - Equipment and Materials Testing - Medical, Dental, and Veterinary Equipment and Supplies

0001AA

Dryer function testing per manufacturer recommendation: Semi-Annually in Nov and May

0001AB

Calibrate carbon monoxide monitor: Annually in May

0001AC

Test/check dewpoint monitor with portable instrumentation; Semi Annually in Nov and May

0001AD

Replace all filter element, purge muffler and dew point monitor sensor: Annually in May

0001AE

Test dew point and carbon monoxide master panel signal; Annually in May

Test and evaluate medical gas system Master Alarm Panels to include required documentation per Statement of Work

0002AA

Inspect for proper pressure switch locations, test alarm functions and settings in accordance with manufacturer’s specifications. Place each master in actual alarm conditions and recalibrate. Include check of all lamps and audible alarms for sound at Master Alarm Panels; Annually in May

0002AB

Test each Master Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly in Nov, Feb, May and August

Test and evaluate medical gas system Area Alarm Panels; (Facility Wide). Contractor to provide complete documentation for facility records after each PM visit.

0003AA

Inspect for proper pressure switch locations, test alarm functions and settings in accordance with manufacturer’s specifications. Place each panel in actual alarm conditions and recalibrate. Include check of all lamps and audible alarms for sound at Area Alarm Panels; Annually in May

0003AB

Test each Area Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly (At the conclusion of each panel tested, the Service technician is to provide an immediate Reorientation of panel function and operation to the VA area supervisor. Reorientation training shall be documented on the medical gas panel Test and Inspection report (to include date, time and Supervisor(s) name(s) ); Due in Nov, Feb, May and Aug and Supplies

All L,T,M,E necessary for Contractor to inspect, functionally test and perform preventive maintenance on the dental air compressor system per manufacturer’s and National Fire Protection Agency (NFPA) 99 standards. Contractor to provide complete documentation for facility records after each PM visit.

0004AA

Replacement of all filter elements and recalibrations of the dew point and carbon monoxide monitors shall also be done Semi-annually; Due in Nov and May

0004AB

Perform laboratory particulate and purity annual testing on the dental air system. Lab results must be included in preventative maintenance Report; Due in May

0004AC

Inspect, functionally test, and perform annual preventative maintenance on the Dental vacuum system per manufacturer’s and NFPA 99 standards; Due in May

All L,T,M,E necessary for Contractor to perform testing on all medical gas pressure outlets:

0005AA

Perform annual performance testing for all Medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during normal work hours; Annually in Feb

0005AB

Perform annual performance testing for all medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during premium work hours; Annually in Feb

All L,T,M,E necessary for Contractor to perform annual Inspection, testing and calibration of all medical gas manifold systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary for Contractor to annually provide purity and Particulate testing on oxygen, medical air and nitrous Oxide gas systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records Due in May

All L,T,M,E necessary for Contractor to perform annual Inspection and testing on all zone valve boxes throughout Medical Center for proper location, valve type, label accuracy, and presence/function of gauges per NFPA Standards. Contractor to provide complete documentation of testing and results for facility records; Due in Feb

All L,T,M,E necessary for Contractor to annually perform inspection and leak testing of source valves (Oxygen, Medical Air, and Vacuum – total of 3). Contractor will provide and install CGA/NFPA 99 approved valve tags properly identifying the area(s) being served. Contractor will install proper NFPA 99 pipe labels on the distribution piping adjacent to source valves. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary to inspect, functionally test, and perform preventive maintenance on the Surgery Instrument Air Compressor package and dryer system. Provide complete documentation for facility records after each PM visit.

0010AA

Replace all compressor filter elements and belts. Properly lubricate as required. Replace all dryer elements, purge mufflers and dew point sensor; Due in August

0010AB

Perform semi-annually, thorough inspection, testing and recalibration of the instrument Air Compressor and dryer; Due in August and February

All L,T,M,E necessary for Contractor to provide initial inventory and perform testing and evaluation of each Medical Gas vacuum inlet for proper identification, - function, flow, latching, cleanliness, and vacuum pressure per NFPA 99s standards: Due in March

Provide a medical gas awareness training program for each applicable department throughout the facility. Provide two (2) focused awareness programs for the Police staff.

All L,T,M,E necessary to perform Flexible Outlet/Inlet Hose assembly testing; Due in August

Emergency Service/Maintenance performed outside normal hours of coverage.

BASE YEAR TOTAL $_____________________

Contractor shall provide all L,T,E & M to inspect, functionality test, and perform Preventative Maintenance on the Medical Air Dryer and associated alarm panels to include required documentation per Statement of Work.

Contract Period: Option 1 POP Begin: 06-01-2025 POP End: 05-31-2026

PRODUCT/SERVICE CODE: H265 - Equipment and Materials Testing - Medical, Dental, and Veterinary Equipment and Supplies

1001AA

Dryer function testing per manufacturer recommendation: Semi-Annually in Nov and May

1001AB

Calibrate carbon monoxide monitor: Annually in May

1001AC

Test/check dewpoint monitor with portable instrumentation; Semi Annually in Nov and May

1001AD

Replace all filter element, purge muffler and dew point monitor sensor: Annually in May

1001AE

Test dew point and carbon monoxide master panel signal; Annually in May

Test and evaluate medical gas system Master Alarm Panels to include required documentation per Statement of Work

1002AA

Inspect for proper pressure switch locations, test manufacturer’s specifications. Place each master in actual alarm conditions and recalibrate. Include

1002AB

Test each Master Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly in Nov, Feb, May and August

Test and evaluate medical gas system Area Alarm Panels; (Facility Wide). Contractor to provide complete documentation for facility records after each PM visit.

1003AA

Inspect for proper pressure switch locations, test alarm functions and settings in accordance with manufacturer’s specifications. Place each panel in actual alarm conditions and recalibrate. Include check of all lamps and audible alarms for sound at Area Alarm Panels; Annually in May

1003AB

Test each Area Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly (At the conclusion of each panel tested, the Service technician is to provide an immediate Reorientation of panel function and operation to the VA area supervisor. Reorientation training shall be documented on the medical gas panel Test and Inspection report (to include date, time and Supervisor(s) name(s) ); Due in Nov, Feb, May and Aug

All L,T,M,E necessary for Contractor to inspect, functionally test and perform preventive maintenance on the dental air compressor system per manufacturer’s and NFPA 99 standards. Contractor to provide complete documentation for facility records after each PM visit.

1004AA

Replacement of all filter elements and recalibrations of the dew point and carbon monoxide monitors shall also be done Semi-annually; Due in Nov and May

1004AB

Perform laboratory particulate and purity annual testing on the dental air system. Lab results must be included in preventative maintenance Report; Due in May

1004AC

Inspect, functionally test, and perform annual preventative maintenance on the Dental vacuum system per manufacturer’s and NFPA 99 standards; Due in May

All L,T,M,E necessary for Contractor to perform testing on all medical gas pressure outlets:

1005AA

Perform annual performance testing for all Medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during normal work hours; Annually in Feb

1005AB

Perform annual performance testing for all medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during premium work hours; Annually in Feb

All L,T,M,E necessary for Contractor to perform annual Inspection, testing and calibration of all medical gas manifold systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary for Contractor to annually provide purity and Particulate testing on oxygen, medical air and nitrous Oxide gas systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records Due in May

All L,T,M,E necessary for Contractor to perform annual Inspection and testing on all zone valve boxes throughout Medical Center for proper location, valve type, label accuracy, and presence/function of gauges per NFPA Standards. Contractor to provide complete documentation of testing and results for facility records; Due in Feb

All L,T,M,E necessary for Contractor to annually perform inspection and leak testing of source valves (Oxygen, Medical Air, and Vacuum – total of 3). Contractor will provide and install CGA/NFPA 99 approved valve tags properly identifying the area(s) being served. Contractor will install proper NFPA 99 pipe labels on the distribution piping adjacent to source valves. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary to inspect, functionally test, and perform preventive maintenance on the Surgery Instrument Air Compressor package and dryer system. Provide complete documentation for facility records after each PM visit., and

1010AA

Replace all compressor filter elements and belts. Properly lubricate as required. Replace all dryer elements, purge mufflers and dew point sensor; Due in August

1010AB

Perform semi-annually, thorough inspection, testing and recalibration of the instrument Air Compressor and dryer; Due in August and February

All L,T,M,E necessary for Contractor to provide initial inventory vacuum inlet for proper identification, - function, flow, latching, cleanliness, and vacuum pressure per NFPA 99s standards; Due in March

Provide a medical gas awareness training program for each applicable department throughout the facility. Provide two (2) focused awareness programs for the Police staff.

All L,T,M,E necessary to perform Flexible Outlet/Inlet Hose assembly testing; Due in August

Emergency Service/Maintenance performed outside normal hours of coverage.

TOTAL OPTION YEAR 1 $__________________

Contractor shall provide all L,T,E & M to inspect, functionality test, and perform Preventative Maintenance on the Medical Air Dryer and associated alarm panels to include required documentation per Statement of Work.

Contract Period: Option 2 POP Begin: 06-01-2026 POP End: 05-31-2027

PRODUCT/SERVICE CODE: H265 - Equipment and Materials Testing - Medical, Dental, and Veterinary Equipment and Supplies

2001AA

Dryer function testing per manufacturer recommendation: Semi-Annually in Nov and May

2001AB

Calibrate carbon monoxide monitor: Annually in May

2001AC

Test/check dewpoint monitor with portable instrumentation; Semi Annually in Nov and May

2001AD

Replace all filter element, purge muffler and dew point monitor sensor: Annually in May

2001AE

Test dew point and carbon monoxide master panel signal; Annually in May

Test and evaluate medical gas system Master Alarm Panels to include required documentation per Statement of Work

2002AA

Inspect for proper pressure switch locations, test manufacturer’s specifications. Place each master in actual alarm conditions and recalibrate. Include

2002AB

Test each Master Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly in Nov, Feb, May and August

Test and evaluate medical gas system Area Alarm Panels; (Facility Wide). Contractor to provide complete documentation for facility records after each PM visit.

2003AA

Inspect for proper pressure switch locations, test alarm functions and settings in accordance with manufacturer’s specifications. Place each panel in actual alarm conditions and recalibrate. Include check of all lamps and audible alarms for sound at Area Alarm Panels; Annually in May

2003AB

Test each Area Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly (At the conclusion of each panel tested, the Service technician is to provide an immediate Reorientation of panel function and operation to the VA area supervisor. Reorientation training shall be documented on the medical gas panel Test and Inspection report (to include date, time and Supervisor(s) name(s) ); Due in Nov, Feb, May and Aug

All L,T,M,E necessary for Contractor to inspect, functionally test and perform preventive maintenance on the dental air compressor system per manufacturer’s and NFPA 99 standards. Contractor to provide complete documentation for facility records after each PM visit.

2004AA

Replacement of all filter elements and recalibrations of the dew point and carbon monoxide monitors shall also be done Semi-annually; Due in Nov and May

2004AB

Perform laboratory particulate and purity annual testing on the dental air system. Lab results must be included in preventative maintenance Report; Due in May

2004AC

Inspect, functionally test, and perform annual preventative maintenance on the Dental vacuum system per manufacturer’s and NFPA 99 standards; Due in May

All L,T,M,E necessary for Contractor to perform testing on all medical gas pressure outlets:

2005AA

Perform annual performance testing for all Medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during normal work hours; Annually in Feb

2005AB

Perform annual performance testing for all medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during premium work hours; Annually in Feb

All L,T,M,E necessary for Contractor to perform annual Inspection, testing and calibration of all medical gas manifold systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary for Contractor to annually provide purity and Particulate testing on oxygen, medical air and nitrous Oxide gas systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records Due in May

All L,T,M,E necessary for Contractor to perform annual Inspection and testing on all zone valve boxes throughout Medical Center for proper location, valve type, label accuracy, and presence/function of gauges per NFPA Standards. Contractor to provide complete documentation of testing and results for facility records; Due in Feb

All L,T,M,E necessary for Contractor to annually perform inspection and leak testing of source valves (Oxygen, Medical Air, and Vacuum – total of 3). Contractor will provide and install CGA/NFPA 99 approved valve tags properly identifying the area(s) being served. Contractor will install proper NFPA 99 pipe labels on the distribution piping adjacent to source valves. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary to inspect, functionally test, and perform preventive maintenance on the Surgery Instrument Air Compressor package and dryer system. Provide complete documentation for facility records after each PM visit.

2010AA

Replace all compressor filter elements and belts. Properly lubricate as required. Replace all dryer elements, purge mufflers and dew point sensor; Due in August

2010AB

Perform semi-annually, thorough inspection, testing and recalibration of the instrument Air Compressor and dryer; Due in August and February

All L,T,M,E necessary for Contractor to provide initial inventory vacuum inlet for proper identification, - function, flow, standards; Due in March

Provide a medical gas awareness training program for each applicable department throughout the facility. Provide two (2) focused awareness programs for the Police staff.

All L,T,M,E necessary to perform Flexible Outlet/Inlet Hose assembly testing; Due in August

Emergency Service/Maintenance performed outside normal hours of coverage.

TOTAL OPTION YEAR 2 $_____________________

Contractor shall provide all L,T,E & M to inspect, functionality test, and perform Preventative Maintenance on the Medical Air Dryer and associated alarm panels to include required documentation per Statement of Work.

Contract Period: Option 3 POP Begin: 06-01-2027 POP End: 05-31-2028

PRODUCT/SERVICE CODE: H265 - Equipment and Materials Testing - Medical, Dental, and Veterinary Equipment and Supplies

3001AA

Dryer function testing per manufacturer recommendation: Semi-Annually in Nov and May

3001AB

Calibrate carbon monoxide monitor: Annually in May

3001AC

Test/check dewpoint monitor with portable instrumentation; Semi Annually in Nov and May

3001AD

Replace all filter element, purge muffler and dew point monitor sensor: Annually in May

3001AE

Test dew point and carbon monoxide master panel signal; Annually in May

Test and evaluate medical gas system Master Alarm Panels to include required documentation per Statement of Work

3002AA

Inspect for proper pressure switch locations, test manufacturer’s specifications. Place each master in actual alarm conditions and recalibrate. Include

3002AB

Test each Master Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly in Nov, Feb, May and August

Test and evaluate medical gas system Area Alarm Panels; (Facility Wide). Contractor to provide complete documentation for facility records after each PM visit.

3003AA

Inspect for proper pressure switch locations, test alarm functions and settings in accordance with manufacturer’s specifications. Place each panel in actual alarm conditions and recalibrate. Include check of all lamps and audible alarms for sound at Area Alarm Panels; Annually in May

3003AB

Test each Area Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly (At the conclusion of each panel tested, the Service technician is to provide an immediate Reorientation of panel function and operation to the VA area supervisor. Reorientation training shall be documented on the medical gas panel Test and Inspection report (to include date, time and Supervisor(s) name(s) ); Due in Nov, Feb, May and Aug

All L,T,M,E necessary for Contractor to inspect, functionally test and perform preventive maintenance on the dental air compressor system per manufacturer’s and NFPA 99 standards. Contractor to provide complete documentation for facility records after each PM visit.

3004AA

Replacement of all filter elements and recalibrations of the dew point and carbon monoxide monitors shall also be done Semi-annually; Due in Nov and May

3004AB

Perform laboratory particulate and purity annual testing on the dental air system. Lab results must be included in preventative maintenance Report; Due in May

3004AC

Inspect, functionally test, and perform annual preventative maintenance on the Dental vacuum system per manufacturer’s and NFPA 99 standards; Due in May

All L,T,M,E necessary for Contractor to perform testing on all medical gas pressure outlets:

3005AA

Perform annual performance testing for all Medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during normal work hours; Annually in Feb

3005AB

Perform annual performance testing for all medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during premium work hours; Annually in Feb

All L,T,M,E necessary for Contractor to perform annual Inspection, testing and calibration of all medical gas manifold systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary for Contractor to annually provide purity and Particulate testing on oxygen, medical air and nitrous Oxide gas systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records Due in May

All L,T,M,E necessary for Contractor to perform annual Inspection and testing on all zone valve boxes throughout Medical Center for proper location, valve type, label accuracy, and presence/function of gauges per NFPA Standards. Contractor to provide complete documentation of testing and results for facility records; Due in Feb

All L,T,M,E necessary for Contractor to annually perform inspection and leak testing of source valves (Oxygen, Medical Air, and Vacuum – total of 3). Contractor will provide and install CGA/NFPA 99 approved valve tags properly identifying the area(s) being served. Contractor will install proper NFPA 99 pipe labels on the distribution piping adjacent to source valves. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary to inspect, functionally test, and perform preventive maintenance on the Surgery Instrument Air Compressor package and dryer system. Provide complete documentation for facility records after each PM visit.

3010AA

Replace all compressor filter elements and belts. Properly lubricate as required. Replace all dryer elements, purge mufflers and dew point sensor; Due in August

3010AB

Perform semi-annually, thorough inspection, testing and recalibration of the instrument Air Compressor and dryer; Due in August and February

All L,T,M,E necessary for Contractor to provide initial inventory vacuum inlet for proper identification, - function, flow, standards; Due in March

Provide a medical gas awareness training program for each applicable department throughout the facility. Provide two (2) focused awareness programs for the Police staff.

All L,T,M,E necessary to perform Flexible Outlet/Inlet Hose assembly testing; Due in August

Emergency Service/Maintenance performed outside normal hours of coverage.

TOTAL OPTION YEAR 3 $__________________

Contractor shall provide all L,T,E & M to inspect, functionality test, and perform Preventative Maintenance on the Medical Air Dryer and associated alarm panels to include required documentation per Statement of Work.

Contract Period: Option 4 POP Begin: 06-01-2028 POP End: 05-31-2029

PRODUCT/SERVICE CODE: H265 - Equipment and Materials Testing - Medical, Dental, and Veterinary Equipment and Supplies

4001AA

Dryer function testing per manufacturer recommendation: Semi-Annually in Nov and May

4001AB

Calibrate carbon monoxide monitor: Annually in May

4001AC

Test/check dewpoint monitor with portable instrumentation; Semi Annually in Nov and May

4001AD

Replace all filter element, purge muffler and dew point monitor sensor: Annually in May

4001AE

Test dew point and carbon monoxide master panel signal; Annually in May

Test and evaluate medical gas system Master Alarm Panels to include required documentation per Statement of Work

4002AA

Inspect for proper pressure switch locations, test manufacturer’s specifications. Place each master in actual alarm conditions and recalibrate. Include

4002AB

Test each Master Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly in Nov, Feb, May and August

Test and evaluate medical gas system Area Alarm Panels; (Facility Wide). Contractor to provide complete documentation for facility records after each PM visit.

4003AA

Inspect for proper pressure switch locations, test alarm functions and settings in accordance with manufacturer’s specifications. Place each panel in actual alarm conditions and recalibrate. Include check of all lamps and audible alarms for sound at Area Alarm Panels; Annually in May

4003AB

Test each Area Alarm Panel for proper audible and visual function, and inspect for Proper labeling; Quarterly (At the conclusion of each panel tested, the Service technician is to provide an immediate Reorientation of panel function and operation to the VA area supervisor. Reorientation training shall be documented on the medical gas panel Test and Inspection report (to include date, time and Supervisor(s) name(s) ); Due in Nov, Feb, May and Aug

All L,T,M,E necessary for Contractor to inspect, functionally test and perform preventive maintenance on the dental air compressor system per manufacturer’s and NFPA 99 standards. Contractor to provide complete documentation for facility records after each PM visit.

4004AA

Replacement of all filter elements and recalibrations of the dew point and carbon monoxide monitors shall also be done Semi-annually; Due in Nov and May

4004AB

Perform laboratory particulate and purity annual testing on the dental air system. Lab results must be included in preventative maintenance Report; Due in May

4004AC

Inspect, functionally test, and perform annual preventative maintenance on the Dental vacuum system per manufacturer’s and NFPA 99 standards; Due in May

All L,T,M,E necessary for Contractor to perform testing on all medical gas pressure outlets:

4005AA

Perform annual performance testing for all Medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during normal work hours; Annually in Feb

4005AB

Perform annual performance testing for all medical gas pressure outlets (oxygen, medical air, nitrous oxide, nitrogen) – during premium work hours; Annually in Feb

All L,T,M,E necessary for Contractor to perform annual Inspection, testing and calibration of all medical gas manifold systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary for Contractor to annually provide purity and Particulate testing on oxygen, medical air and nitrous Oxide gas systems in accordance with the requirements of NFPA 99, CGA, USP, and the manufacturer’s instructions/literature. Contractor to provide complete documentation of testing and results for facility records Due in May

All L,T,M,E necessary for Contractor to perform annual Inspection and testing on all zone valve boxes throughout Medical Center for proper location, valve type, label accuracy, and presence/function of gauges per NFPA Standards. Contractor to provide complete documentation of testing and results for facility records; Due in Feb

All L,T,M,E necessary for Contractor to annually perform inspection and leak testing of source valves (Oxygen, Medical Air, and Vacuum – total of 3). Contractor will provide and install CGA/NFPA 99 approved valve tags properly identifying the area(s) being served. Contractor will install proper NFPA 99 pipe labels on the distribution piping adjacent to source valves. Contractor to provide complete documentation of testing and results for facility records; Due in May

All L,T,M,E necessary to inspect, functionally test, and perform preventive maintenance on the Surgery Instrument Air Compressor package and dryer system. Provide complete documentation for facility records after each PM visit.

4010AA

Replace all compressor filter elements and belts. Properly lubricate as required. Replace all dryer elements, purge mufflers and dew point sensor; Due in August

4010AB

Perform semi-annually, thorough inspection, testing and recalibration of the instrument Air Compressor and dryer; Due in August and February

All L,T,M,E necessary for Contractor to provide initial inventory vacuum inlet for proper identification, - function, flow, standards; Due in March

Provide a medical gas awareness training program for each applicable department throughout the facility. Provide two (2) focused awareness programs for the Police staff.

All L,T,M,E necessary to perform Flexible Outlet/Inlet Hose assembly testing; Due in August

Emergency Service/Maintenance performed outside normal hours of coverage.

TOTAL OPTION YEAR 4 $___________________

MILWAUKEE VA MEDICAL CENTER

MEDICAL GAS SYSTEM TESTING & INSPECTION

STATEMENT OF WORK

The contractor shall provide all labor, materials, supervision, tools and equipment (L,T,M,E)necessary to perform Preventive Maintenance/Inspections/Emergency Service for MEDICAL GAS SYSTEMS as described in this Statement of Work for Clement J. Zablocki VA Medical Center, 5000 W. National Ave, Milwaukee, WI.

1. SCOPE OF WORK

A. Contractor shall perform scheduled preventative maintenance (PM) and inspections in accordance with manufacturer's specifications.

B. Critical Elements:

l) Contractor shall provide complete inventory and initial inspection of each piece of equipment listed herein. Inventory shall be submitted to COR electronically using MS Excel (or other mutually agreed upon format). See Section 2.

2) Based on initial inventory/inspection; Contractor shall establish and provide to the COR, a complete Preventive Maintenance Plan (PMP) to include proposed schedule to ensure requirements of the contract are met. PMP shall be provided within 10 days of completion of initial inventory/inspection. See Sections 6 &11

3) In addition to a PMP, Contractor shall establish a Quality Control Program (QCP) which shall be provided to COR within 10 days of completion of initial inventory/inspection. See Section 19.

4) Contractor shall provide written work reports. See Sections 10 & 13.

5) Contractor response time shall be within 8 hours after call is received for emergency services associated with the medical gas systems. See Section 8.

6) Preventive maintenance shall be scheduled accordingly as defined per system. See Section 4.

7) Requests for extensive repairs shall be submitted in writing to the COR. See Section 16.

8) Documentation for all work performed under this contract shall be submitted electronically using MS Excel (or other mutually agreed upon format). See Sections 2 & 13.

2. TECHNICAL WORK REOUIREMENTS

Upon award of the contract the Contractor shall coordinate with the COR a non-labor intensive plan to inventory and inspect the Medical Gas Systems and provide the COR a written and electronic report of condition to include drawings. The report of condition shall be provided to the COR before work in the specified area starts. Within 10 days of completion of initial inventory/inspection, Contractor shall be required to submit a Preventive Maintenance Plan for all equipment listed herein.

3. CONFORMANCE STANDARDS

A. Contractor shall perform PM and inspections in accordance with manufacturer's specifications. The Contractor shall perform the services in such a manner that does not damage government property. In the event damage occurs to Government property, or any adjacent property by reason of services performed under this contract, the Contractor shall replace or repair the same to the satisfaction of the COR at no cost to the Government. If damage caused by the Contractor has to be repaired or replaced by the Government, the cost of such work shall be deducted from the monies due the Contractor.

B. For any failures found during inspections/testing, the COR and Operations & Maintenance Manager shall be emailed within 24 hours of failure.

C. The Contractor shall secure all permits, licenses, and/or certificates, or any such approvals or plans or specifications as may be required by federal, state and local laws, ordinances, rules, or regulations, for the proper execution and completion of the work under this contract.

D. Chemicals used shall not cause damage to government owned equipment, furniture, exterior building surfaces, etc. Any excess servicing chemicals spilled shall be cleaned-up, the residue neutralized as required, and the surface washed and dried. Spilled clean water shall be cleaned up and the surfaces dried. Contractor shall furnish a listing of proposed chemicals, along with Material Safety Data Sheets (MSDS), to be used for approval by the Government to the COR.

4. PREVENTIVE MAINTENANCE AND INSPECTIONS SHALL INCLUDE

A. All L,T,M,E necessary for Contractor to inspect, functionally test and perform preventive maintenance on the Medical Air Dryer and the Associated Alarm Panels.