Exhibit A ASR.pdf

JOHN J. PERSHING VA MEDICAL

CENTER

FARMINGTON, MO COMMUNITY BASED OUTPATIENT CENTER

AGENCY SPECIFIC REQUIREMENTS (ASR)

GENERAL OVERVIEW:

The Department of Veterans Affairs is interested in leasing a minimum of 19,000 (contiguous) net usable square feet of clinical space for a Community Based Outpatient Center (CBOC) in the city of Farmington, Missouri.

Space will be available for use by Tenant (VA) for personnel, furnishings, and equipment to meet the needs and requirements for an Outpatient VA Clinic in the Farmington, MO area.

The leased property will be within the boundaries specified below:

North Boundary: Hunt Rd.

South Boundary: Korber Rd.

East Boundary: Schwartz Rd.

West Boundary: Bray Rd.

Buildings with Property boundary(ies) on the boundary streets are deemed to be within the delineated area of consideration.

LEASED PROPERTY MINIMUM CRITERIA:

The space will be of contiguous office space in a professional and aesthetically pleasing Building. Space offered must be in a quality seismically compliant building of sound and substantial construction, either a new, modernized building, or one that has undergone restoration or rehabilitation for the intended use. Space will be located in a prime commercial office space with attractive, professional surroundings.

Streets and public walkways will be well maintained. Space will be located on the ground floor.

Submitted designs must meet Patient Aligned Care Team (PACT) design guide philosophy. Patient Centered Care (PCC) and the PACT model have transformed the way the Department of Veterans Affairs, Veterans Health Administration, provides care to our nation’s Veterans. PCC and PACT require focus on the Veteran. Lean operations thinking and lean design combine to support a proactive Veteran-focused approach to aligning operations and space. Lean management ideas must be used to center on the Veteran’s needs, increase quality, and decrease waste.

JJP VAMC Farmington, MO CBOC Agency Specific Requirements

(Rev: 08/21/2025)

Space design will provide maximum co-location of the staff providing services to our patients. It will bring the service to the veterans, reduce the number of steps required to deliver services, and simplify the Veteran’s experience.

Design must maximize co-location of the care teams. The team requires a space where they can function as teams. Staff need to be able to see each other, to frequently interact, share information, coordinate care, plan work, and hand-off patients and tasks. They need to be able to see each other in an acoustically conducive space that supports concentration and conversation. The Farmington clinic will offer specialty care, primary care, mental health, physical rehabilitation, and other specialized services such as radiology services. Lessors will coordinate with high-cost high-tech manufacturer recommendations throughout design to meet specific requirements. Bariatric design considerations, including patient lifts, should be included for two exam rooms, procedure room, laboratory blood draw, PMR area, and associated restrooms, as specified in Room Specific Requirements.

The lease will be full serviced and follow the standard specifications and requirements for a New/Replacing Lease as per the GSA Global Lease or Simplified Lease.

Future Expansion:

The leased space will be designed and built with a planned future expansion of up to 25 % or 4,875 NUSF. The future expansion will be designed to include the minimum number of parking stalls established by local codes and regulations.

PROVISIONS:

GOVERNMENT PROVIDED

1) Courier Service

2) Hazardous Material Removal

3) Pest Control

LESSOR PROVIDED (as part of the fully serviced lease)

Recurring Utility Bills

1) Electrical Utility Service

2) Water Service

3) Heating Fuel / Natural Gas Utility Service

4) Trash Removal

5) Cable Television Service

6) Guest WiFi High Speed Internet

Life Safety and Security

(Rev: 08/21/2025)

1) A Fire Alarm and Intrusion System. Include a Dispatch Service and all Maintenance and Testing in accordance with NFPA

2) Security Service that transmits to a 24/7 security service

3) Security Alarm System and Monitoring (cameras included)

4) Duress alarms

Janitorial Services (reference the attached janitorial requirements)

1) Supplies (soaps, tissues, towels, toilet paper, etc.)

2) Wall-mounted hand sanitizer units at a ratio of one (1) for every three (3) doors in administrative areas, one (1) for every door in clinical areas; to be maintained at all times in good working order and stocked with date-compliant hand sanitizer

3) Special Disinfecting requirements – The Lessor will routinely (not less than once daily) wipe down all solid, high contact surfaces in common and high traffic

4) Window washing and window washing supplies

Building & Grounds Maintenance and Repairs

1) Snow / Ice Pretreatment and Removal

2) Lawn and landscaping maintenance (including exterior trash pickup outside 5-foot radius of exterior doors) performed weekly.

3) Air conditioning, and air conditioning system maintenance and repair

4) Plumbing maintenance and repair

5) Electrical maintenance and repair

6) Replacement of exterior/interior light bulbs/lamps that are hardwired to the building power

7) Painting: scheduled paintings every 5 years with wall patching and touchups quarterly at no additional cost

8) Lessor is responsible for moving and returning furniture for services as needed and must coordinate such with the Contracting Officer’s Representative (COR) or designee.

SPACE CRITERIA:

The Veteran’s Health Administration has determined that the Patient Align Care Team (PACT) concept will be implemented in all future Outpatient VA Clinic leases. Essentially the process is for the patient to arrive and be seen by care givers in a manner where the care givers come to the patient. Functions such as blood draw, nutrition/dietary advice, and pharmaceuticals will now come to the patient rather than the patient going to separate offices. Additionally, care givers will no longer have private areas, but sit in communal areas with system furniture.

The guidance for how facilities are to be created and how they will function can be found at the below internet location. It should be noted that not all of the functions identified in the PACT Guidance will be used for this specific lease.

Unless Annotated below, room finishes, equipment, furniture, door hardware and wall mounted items for each room will be as noted within the Room Specific Requirements or the Room Data Matrix.

Room / area specification requirements can be found in the Room Specification Requirements Document and Room Data Matrix referenced within the LDN. Where requirements provided in the ASR and Room Specification Requirements conflict with the Lease Design Narrative (LDN) and the Room Data Matrix (RDM), the ASR and Room Specification Requirements will supersede. Room Specification Requirements that are identified during the design period by Service Line Leadership will be included in the design at no additional cost to the Government (addition or removal of casework, sinks, outlets, data receptacles, PACS, door hardware, and room adjacencies). Consolidated governing codes, standards, references, and guidelines are outlined within the VA Leased CBOC Design Narrative.

FURNITURE, FIXTURES, AND EQUIPMENT:

The lessor will provide the VA with a compiled list of all furniture, fixtures, and equipment that will be installed within the CBOC. The list will include all pertinent product information to include size, make and model number, finish selection, power requirements, and will specify whether each item is provided/installed by the lessor or by the VA. The FF&E list will be included with the 60% design submission and will be updated for each following design submission. The finalized list will be submitted to the VA at the completion of the design.

ROOM REQUIREMENTS:

VESTIBULE

1) Vestibules with an air curtain will be provided at public entrances and exits. In the event of negative air pressure conditions, provisions will be made for equalizing air pressure.

2) Vestibule shall be ADA compliant. Vestibule (air lock) must have 2 sets of doors separated by at least

8 feet. One door in each set must have an automatic door opener.

3) The Lessor will provide permanent entryway systems (such as grilles or grates) to control dirt and particulates from entering the Building at all primary exterior entryways.

4) Lessor will provide VA signage on the vestibule as determined by the VA within the design.

RECEPTION / WAITING AREA

1) Four (4) quad electrical outlets, location as determined by VA.

2) Two (2) sets OIT ports minimum, Cat 6, location as determined by the VA.

3) Additional OIT ports as required to support ancillary equipment; location as determined by VA

4) Minimum 5 (five) foot width x 24 (twenty-four) inch depth worksurface/counter per Reception employee additional 11 (eleven) inch depth to provide surface for client/patient

5) Each desk space will be divided by acoustical partitions

6) Reception space design must consider and allow for “sit to stand” desk accommodations

7) Consider frosted glass as needed in designs to protect patient health information from public view

(Rev: 08/21/2025)

8) 6 workstations for patient check-in & out – workstations must have space for under desk file cabinets

9) Direct view of waiting area and entrance

10) Duress alarm

11) Restricted access or lockable door from the receptionist work area into the clinic area – may require double sided lock

12) Restricted access from the waiting area into the clinic area

13) Support for wall mounted TV Brackets, locations will be determined by VA

14) Upper data port and separate electric outlet for wall mounted TV, locations will be determined by VA

15) One (1) dimmer light switch

16) Double coat hooks on walls behind doors 17) Drinking fountain with bottle filling station 18) Flooring will be per VA’s selection.

17) Nursing/Lactation Room as outlined in Room Specific Requirements.

PHOTOCOPY / FAX, MAIL & STORAGE AREA

1) Accommodates 1 workstation

2) Built in upper cabinetry for supply storage

3) Space for Fax/Printer Multi-Functional Device

CORRIDOR

1) Alcove built off front (toward waiting room) patient corridor to accommodate standing/wheelchair patient scale

2) Additional square footage nook built off the back corridor to host a clinic wide shared printer

3) Non-ligature flat PVC patient handrails ADA compliant 34-38” above floor surface with return to the wall at the end of the handrails

4) Patient corridors must be 6 feet in clear width

LABORATORY

1) To be off the reception area for a shared waiting room space

2) Restroom within laboratory

3) Requires pass through to 2 restrooms one within lab and one restroom adjacent to the lab for specimens

4) Counter mounted swing away eyewash station

5) Shelf for specimen cup beside toilet in restroom adjacent to lab

6) Upper and lower built-in cabinetry around entire perimeter of Laboratory.

7) Three sinks

8) Cabinetry built in design for undercounter refrigerator and freezer

9) Space for growth to eventually accommodate 2 lab draw chairs and 2 technician workstations

10) Duress alarm

11) Independent thermostat required

RESTROOMS (UNISEX)

1) Door, hardware, lavatory, mirror, and other accessories will be accessible and designed for wheelchair access as per the ADAAG

2) Restroom doors should open in but should be equipped with doors and hardware that will permit emergency access (without use of a key, Allen key, or special device) from the outside in a manner that will negate the need to push against a patient who may have collapsed in the restroom

3) Minimum one (1) accessible wall hung water closet and wall hung lavatory or as required by the International Plumbing & Building Codes

4) Grab bars: For water closet

5) Toilet paper dispenser

6) Lavatory: Wall Hung with automatic sensors, gooseneck spout with plain outlet. At VA's option power operated automatic sensors may be required.

7) Mirror: Minimum over lavatory, 24"x 36"

8) Built-in waste receptacle and paper towel dispenser

9) Wall mounted soap dispenser

10) Double coat hooks on walls behind doors

11) Wall-mounted baby changing station

12) One (1) GFCI electrical outlet

13) Pull cord alarm with a location alert to MSA staff at reception area 14) Flooring will be per VA’s selection.

WEIGHING STATION ALCOVES

1) (1) Weighing station alcove 5’ foot deep to accommodate a wheelchair scale up to 45” by 45” with clearance for rolling on and off the ramp

2) (1) Weighing station alcove to accommodate a standing patient scale with rails 22” by 60”

GROUP / CONFERENCE ROOMS

1) STC 50 requirements for partitions and sound gasketing and sweeps for the doors 2) Eight

(8) duplex Electrical outlets

3) Three (3) sets OIT ports, Cat 6

4) One (1) additional OIT port located by COR for conference call system (Possible location: Floor center of room)

5) Support for wall mounted TV Bracket, locations will be determined by VA

6) Upper data port and separate electric outlet for wall mounted TV, locations will be determined by VA

7) Duress Alarm

8) One (1) Dimmer light switch

9) Flooring will be per VA’s selection

10) Closet storage

(Rev: 08/21/2025)

PHYSICAL THERAPY / WHOLE HEALTH ROOM

1) STC 50 requirements for partitions. Door cores must have a minimum STC of 35 with sound gasketing and acoustic door bottom seals to achieve a NIC of 39 at 3’

2) Eight (8) duplex electrical outlets – two (2) per wall

3) Three (3) sets OIT ports, Cat 6, location as determined by VA

4) Outlets and ports at heights determined by VA to accommodate wall mounted otoscope, vital machine, wall mounted computer station, wall mounted phone

5) Ceiling must be 10’ height

6) PT workroom adjacent to the PT room with views and sound access

RADIOLOGY ROOMS

1) STC 50 requirements for partitions. Door cores must have a minimum STC of 35 with sound gasketing and acoustic door bottom seals to achieve a NIC of 39 at 3’

2) Two (2) sets OIT ports, Cat 6, location as determined by VA

3) Outlets and ports at heights determined by VA to accommodate wall mounted otoscope, vital machine, wall mounted computer station, wall mounted phone

4) Double coat hooks on walls behind doors

5) Door window glass panels will be frosted for privacy (or other method of privacy as accepted by

CO)

6) Duress Alarm

7) Wall-mounted sink needs to have a cabinet on wall above it. The sink casework must not have storage below it or designed in a way where items could be stored and become damaged by a plumbing leak or moist environment. Sink casework requires drawers. Location of sink as determined by VA.

8) Wall mounted soap and paper towel dispenser need to be at sink

9) One (1) Dimmer light switch

10) Two (2) 20-amp electrical outlet. One near provider area.

11) Ceiling mounted healthcare standard cubicle curtain track around perimeter of door swing from wall to adjacent wall, inclusive of hooks to support quantity of cubicle curtains required for patient privacy. Cubicle curtains to be provided and maintained by VA.

12) Walls will have internal structural bracing to support modular wall-mounted exam room casework and armature that supports PC, location to be determined by VA

13) Each room will have a sliding door

14) Design of the space application must follow the VA Design Guides found in the VA Technical

Information Library and referenced within the LDN

15) Flooring will be per VA’s selection

EXAMINIATION / PROCEDURE / CONSULTATION ROOM

1) STC 50 requirements for partitions. Door cores must have a minimum STC of 35 with sound gasketing and acoustic door bottom seals to achieve a NIC of 39 at 3’

2) Eight (8) duplex electrical outlets – two (2) per wall

(Rev: 08/21/2025)

3) Two (2) sets OIT ports, Cat 6, location as determined by VA

4) Outlets and ports at heights determined by VA to accommodate wall mounted otoscope, vital machine, wall mounted computer station, wall mounted phone

5) Double coat hooks on walls behind doors

6) Door window glass panels will be frosted for privacy (or other method of privacy as accepted by

CO)

7) Duress Alarm

8) Wall-mounted sink needs to have a cabinet on wall above it. The sink casework must not have storage below it or designed in a way where items could be stored and become damaged by a plumbing leak or moist environment. Sink casework requires drawers. Location of sink as determined by VA.

9) Wall mounted soap and paper towel dispenser need to be at sink

10) One (1) Dimmer light switch

11) Two (2) 20-amp electrical outlet. One near exam table for BP, table, etc., the other near provider area.

12) Ceiling mounted healthcare standard cubicle curtain track around perimeter of door swing from wall to adjacent wall, inclusive of hooks to support quantity of cubicle curtains required for patient privacy. Cubicle curtains to be provided and maintained by VA.

13) Walls will have internal structural bracing to support modular wall-mounted exam room casework and armature that supports PC, location to be determined by VA

14) Each room will have 2 entrance/exit, each with a sliding door as outlined in the PACT Space module design guide (2015)

15) Exam tables will not face the door 31) Flooring will be per VA’s selection

PACT TEAM ROOMS

1) Must have solid plan to minimize acoustics – very important

2) Sound absorbing wood grain acoustic panels with aesthetic design may be wall or ceiling mounted

3) STC 50 requirements for partitions and sound gasketing and sweeps for the doors

4) Eight (8) duplex electrical outlets – two (2) per employee, location as determined by VA

5) Two (2) sets OIT ports per employee, Cat 6, location as determined by VA

6) No less than two (2) sets of double coat hooks on walls behind doors

7) Door window glass panels will be frosted for privacy (or other method of privacy as accepted by

COR)

8) Duress Alarm

9) One (1) Dimmer light switch

10) One (1) 20-amp electrical outlet

11) Flooring will be per VA’s selection

EMPLOYEE BREAK ROOM

1) All perimeter walls will extend from floor slab to six inches above the ceiling grid and filled with acoustic panels to ensure acoustical privacy

2) Four (4) GFCI Electrical outlets and one 20-amp refrigerator outlet (not GFCI)

(Rev: 08/21/2025)

3) Two (2) sets OIT ports, Cat 6, location as determined by VA

4) Minimum of six (6) feet of counter with base and overhead cabinets; single compartment sink

5) Cabinetry built in to accommodate full size refrigerator (Lessor provided, 25 Cu. Ft minimum)

6) 65 cubby lockers to be provided by lessor (Precise location to be determined in design)

7) Flooring per VA’s selection

HOUSEKEEPING / JANATORIAL CLOSET

1) Required if lessor does not have housekeeping closet on site with onsite management 2) Mop Sink

3) Four (4) GFCI Electrical outlets

4) Adjustable shelving on two walls

5) Flooring per VA’s selection

6) Must be accessible by VA staff

SUPPLY / STORAGE ROOMS

1) Four (4) Electrical outlets

2) One (1) set OIT ports, Cat 6

3) Adjustable shelving on two walls of each storage room - 3 shelves per wall with a depth of 15” and space for a roll-in prosthetics supply cabinet

4) Requires both a keypad and keyed lock

5) Flooring per VA’s selection

6) Separate temperature and humidity control with relative humidity <60% and temperature control of

64-76 degrees Fahrenheit

7) No windows permitted

MEDICATION STORAGE ROOM

1) Four (4) Electrical outlets

2) Two (2) set OIT ports, Cat 6

3) Flooring per VA’s selection

4) One wall to have cabinets, the other wall with side by side Pyxis, Pyxis Tower/Cabinet

(31Wx28Dx79.5H), and Medication Refrigerator

5) Equipment alcove with electrical outlet

6) Temperature and humidity control with additional capacity for AC (cooling) – see HVAC requirements

- relative humidity <60% and temperature control of 68-76 degrees Fahrenheit

7) Independent Thermostat required

8) Facility requires backup generator or power specifically to support and maintain medication room temperature parameters and medication room vaccine refrigerator during a power outage 8) No windows permitted

(Rev: 08/21/2025)

OTHER CONSIDERATIONS

1) Centralized check-in/check-out

2) The reception area is to be strategically located to give the office manager and/or team leader clear observation of waiting areas

3) Each workspace without an exterior window, will have glass pane adjacent to door frame, in the door, or in the office with shades for secure view of visitors (or other privacy mechanism as approved by COR)

4) Signage outside building provided by the Lessor, according to VA specifications and meets City Ordinances

5) All rooms (except Data Closet) should be master keyed, locking mechanism should be on the inside of the frame, and locking mechanism must be approved by the VA.

6) Facilities will be non-smoking

7) The VA requires two walls with a series of exterior windows, maximizing the amount of natural light, unless waived by the Leasing Contracting Officer (LCO)

8) Outdoor non-corrosive metal bench for Veteran seating to be provided by lessor. Final selection to be determined by the VA

9) Facility requires backup generator or power to support the following during a power outage:

a) Medication room temperature and humidity control

b) Medication room vaccine refrigerator

c) Supply room temperature and humidity control

d) Laboratory room refrigerators and freezers

e) Data closet HVAC system, switches, and servers

GENERAL TECHNICAL REQUIREMENTS:

ACCESSIBILITY

Facility must be in full compliance with Americans with Disabilities Act (ADA) Guidelines, including building, building access, and parking. Accessibility for new construction: to be considered for award, building to be constructed must fully meet the new construction requirements of the Americans with Disabilities Act Accessibility Guide (ADAAG) (36 CFR Par 36, App. A), the Uniform Federal Accessibility Standards (UFAS) and Department of Veterans Affairs Barrier Free Design Guide (PG-18-13, 11/1/18).

All doors to patient accessible areas will be 48” minimum width. Where standards conflict, the more stringent will apply.

CODES

Structure will be in compliance with local, national, and the International Building Code, and all applicable current NFPA Fire and Life Safety codes. Where codes conflict, the more stringent will apply.

1) The Lessor will develop and submit a design that is clearly defined, meets the overall solution for the primary VA Clinic construction project. The design will be in accordance with the Criteria For Design

(Rev: 08/21/2025)

And Project Development, General Requirements and address the technical requirements, and new construction.

2) The Lessor will meet with the Contracting Officer’s Representative (COR) prior to start of design to determine detailed requirements of work involved.

3) The Lessor will design the space to conform to the requirements of the following VA documents, Codes, and Standards outlined within the Lease Design Narrative. Design will be in accordance with applicable federal, state, and local codes. The Lessor is responsible for obtaining and complying with all such criteria.

CONSTRUCTION STANDARDS AND SHELL COMPONENTS:

Design must also support creation of flexible use space and standardization that will permit ease of alteration as the mission and operational requirements of the facility changes.

Design of the space must follow VA Design Guides as referenced in the LDN. This includes, but is not limited to, all Design Criteria, Leasing Criteria, BIM/CAD standards, and other information for use and inclusion in the design and construction of this leased space.

BUILDING COMMISSIONING

Lessor will contract with an independent 3rd party commissioning agent (“Commissioning Agent”) to perform Acceptance and Testing Phase Commissioning.

Systems requiring commissioning include Fire Suppression, Plumbing, HVAC, Electrical, Communications, Electronic Safety and Security, and Integrated Systems Tests. The cost of the Commissioning will be paid by the lessor and included in the build out cost.

BUILDING DIMENSIONS

Area of building must be roughly rectangular in shape and must not be more than 3 times longer than its width.

FLOORS

All areas, waiting area, reception area, vestibule, exam rooms and other rooms with sinks will be VA approved resilient flooring system or equivalent. VA is to select color. Please refer to VA Design Guides referenced within the LDN.

SIZES

All room square feet listed are minimums. The facility may have up to 30% larger rooms or 15% additional rooms. Rooms other than storage rooms and corridors may not be over 3 times longer than they are wide.

(Rev: 08/21/2025)

WALLS

The Lessor will provide sound dampening insulation inside all interior walls. Walls will extend from floor slab to six inches above the ceiling grid and filled with acoustic panels to ensure acoustic privacy

See Privacy & Acoustical Requirements.

WALL FINISHES

Wall coverings will be washable paint. VA to select colors. Scheduled paintings every 3 years with wall patching and touchups quarterly at no additional cost. Lessor will be responsible for moving and returning furniture to allow wall repair and painting and will be responsible for wall repair/repainting as needed during the lifetime of the rental agreement. Painting/repair work will be done after hours and must be odor free when open for business. Perimeters of rooms must have rubber or vinyl cove base.

All walls will be finished, no exposed ductwork, conduit or piping. Corners will also be protected with appropriate wall-guard materials.

PAINTING

Prior to acceptance, all surfaces within the Space which are designated by VA for painting will be newly finished in colors acceptable to the Government. Painted surfaces will conform to requirements as outlined with the Lease Design Narrative (LDN).

FLOORING

Waiting area, Conference Room, Team offices, and Reception area flooring will be per VA selection and may be LVT/LVP, or linoleum plank tile. Breakroom, restroom flooring and wainscoting will be ceramic/porcelain tile, large format is preferable on the floor, surface must meet or exceed 0.42 DCOF wet. Corridors, Group rooms, Multipurpose room, Exam/Procedure/Consultation rooms will be per VA selection and may be LVT/LVP or linoleum plank tile. Vestibule flooring needs to be a modular walk-off tile product. MDF room will have static dissipative tile. VA to select color. All flooring must meet Class 1 fire/smoke resistance requirements as per code. All flooring will be occupancy-ready from the factory.

Flooring materials will be free of asbestos containing materials.

COVE BASE

Cove base may be either vinyl or rubber. It needs to be standard toe. Cove base height in Exam/Procedure/Consultation rooms should be 6”, all other rooms and corridors should be 4” height.

Continuous roll is preferable. Color to be determined by VA.

CEILING FINISH

Ceilings may be sheetrock or non-textured washable lay in tile with a Class A fire performance rating and an NRC of between 0.70 and 0.80. Lessor to replace any wet, cut, or damaged ceiling tiles or sheetrock

(Rev: 08/21/2025) as damage occurs. Complete ceiling tiles to be replaced and metal grid replaced or repainted every 10 years.

LIGHTING

Fixture location will be coordinated with the furniture and cubicle curtain track layout so they do not interfere with the lighting. Lighting requirements and standards are outlined within the LDN.

ASBESTOS / ENVIRONMENTAL HAZARDS

Existing buildings must be asbestos, mold and lead free.

ENERGY CONSERVATION

The windows must be double glazed, and the walls and roofs must be insulated. Entire facility, including doors and windows must be weather tight. Building insulation and HVAC system must meet DOE recommendations for this region.

SECURITY

The leased property will conform to VA’s Physical Security and Resiliency Requirements Design Manual for //Life Safety Protected Facilities//Mission Critical Facilities// VA Technical Information Library, www.cfm.va.gov/TIL. The required Intrusion Detection System (IDS), and Video Assessment and Surveillance System (VASS) will be compliant for use on VA’s OI&T secure network and compatible with the VASTLHCS’s current security infrastructure provider. The Lessor will consult with VASTLHCS’s security infrastructure provider (PASS Security) for compatibility of any IDS or VASS components. The costs associated with connecting the IDS and VASS to the VA’s secure network will be borne by the Lessor.

DOORS

Minimum door width is 36 inches. Half of the exam room doors must have a minimum of 42 inches.

Doors will be 1-3/4” solid core wood. Exterior entrance door will be a minimum of 48 inches. Automatic door openers are required at the main entrance of the clinic and waiting room bathrooms for handicap accessibility. Doors to the clinic area will be push pad operated on the clinic side and numerical combination operated on the waiting room side. Exterior doors with removable hinge pins will be retained with set pins or spot welded. A locked door will be required from the main waiting room to access the clinic areas. VA will assign locations of doors after award of contract. Patient access doors on the exam rooms may be sliding but must be sealable and must have a soft close dampening system for noise and slam reduction. All airspaces around the doors will be sealed for soundproofing and privacy.

STC 50 requirements for partitions. Door cores must have a minimum STC of 35 with sound gasketing and acoustic door bottom seals to achieve a NIC of 39 at 3’. See Acoustical Requirements

(Rev: 08/21/2025)

DOOR HARDWARE

Doors will have door handles or door pulls with heavyweight hinges. All doors will have corresponding doorstops (wall or floor mounted) and silencers. All public use doors and toilet room doors will be equipped with 34 inch height door protection plates. Exterior doors and all common area doors will have automatic door closers. All building exterior doors will have locking devices will be panic type devices. All hardware will provide unrestricted egress and be capable of restricting access from the exterior. Properly rated and labeled fire door assemblies will be installed on all fire egress doors.

Doors will have door handles or door pulls with heavyweight hinges. The Lessor is encouraged to avoid the use of chrome-plated hardware. All doors will have corresponding doorstops (wall- or floor-mounted) and silencers. Doors designated by the Government will be equipped with 7-pin, tumbler cylinder locks and strike plates. All door entrances leading into the government-demised area from public corridors and exterior doors will have automatic door closers. All locks will be master keyed.

Furnish at least two master keys for each lock to the government. Any exterior entrance will have a high security lock, with appropriate key control procedures, as determined by government specifications.

Hinge pins and hasps will be secured against unauthorized removal by using spot welds or peened mounting bolts. The exterior side of the door will have a lock guard or astragal to prevent jimmying of the latch hardware. Doors used for egress only will not have any operable exterior hardware. All security-locking arrangements on doors used for egress will comply with requirements of NFPA 99 and 101.

Patient restroom doors: Should open in but should be equipped with doors and hardware that will permit emergency access (without use of a key, Allen key, or special device) from the outside in a manner that will negate the need to push against a patient who may have collapsed in the restroom

Telecommunication closet(s) doors: Suite entry door and all other doors connecting the government space with the rest of the building, will be equipped with 7-pin Interchangeable Cores and strike plates to be operated by card readers. Total card readers could be up to 13 readers with one scramble pad. No cost change order will be authorized during DIDs if lessor bids less card readers during their proposal.

LOCKS

All doors must be equipped with cylinder lock locking hardware and master keyed to match existing VA “Best” brand, 7 pin locking system. Single motion egress mortise style locks are required on the Data Closet and Medication Room doors. Egress doors must be equipped with panic hardware and meet NFPA requirements for exit. Toilets are to be equipped with privacy locks that can be unlocked in emergency with a coin from outside. The Lessor will be responsible for providing and installing an automatic locking system with a keypad entry to be used on the door from the waiting room to access the clinic area. The Lessor/Owner will provide all hardware to include the interchangeable cores. The Lessor will be responsible for the cost of the cores. The Lessor/Owner will provide a door schedule submittal for VA approval. The key numbering convention will be agreed upon during the design phase. VA uses “Best” locks SFIC 7 pin cores with a “K keyway”

(Rev: 08/21/2025)

Three master keys will be provided to the government. An exception to the building entrance will be made when the VA is not sole building tenant. The entire space will be keyed the same with the exception of the following spaces: Electrical Closet, OI&T Closet, Janitorial Closet, Storage/Supply Closets, Medication Storage Room, Mechanical Space

INTERIOR SIGNAGE

All rooms must be equipped with solid plastic identification signs with room function and room number.

Toilet rooms/Restrooms that include Baby Changing Stations must include the appropriate identification on the signage. Restrooms not designated as containing Diaper Changing Tables, signage will be placed to indicate to users where the nearest available diaper changing table can be accessed. Signage will be posted outside the restroom, near the restroom entrance and conspicuously within the restroom. Lessor to provide overhead directional signage to Lab, restrooms, clinics, and Behavioral Medicine. Emergency egress signage meeting Life Safety code and The Joint Commission (TJC) is required. All patient care rooms will have slide style occupancy indicators installed on the outside of the door to indicate if the room is in use. All signage must be ADA compliant and comply with VA standards outlined within the

LDN.

PRIVACY

Aural privacy is required between rooms and between rooms and corridor so that private patient information may be discussed without being overheard. For sound privacy, walls of exam/procedure rooms, Team Offices, Mental Health, telemedicine, group and Multipurpose/conference rooms must go from deck to deck and be sound insulated with an approved acoustical insulation. All doors must be solid core and include mechanical door bottom seals where necessary. There is to be a privacy door(s) between the clinical area and the waiting/reception area.

Privacy curtain tracks at doors required in all exam rooms. Track to be provided by lessor and curtain by

VA.

ACOUSTICAL REQUIREMENTS

1) Reverberation Control. Ceilings in offices, conference rooms, and corridors having resilient flooring will have an NRC of not less than 0.65.

2) Ambient Noise Control. Ambient noise from mechanical equipment will not exceed noise criteria curve (NC) 35 in accordance with the ASHRAE Handbook of Fundamentals in offices and conference rooms; STC 50 in corridors, cafeterias, lobbies, and toilets; STC 50 in other spaces.

3) Noise Isolation. Rooms separated from adjacent spaces by ceiling high partitions (not including doors) shall not be less than the following noise isolation class (NIC) standards when tested in accordance with ASTM E 336: a) Group Rooms STC 47-50

b) Counseling Offices/Exam Rooms STC 50

4) The sound resistant enclosures (partitions, doors, duct system) of the spaces listed below will be designed to suppress generated noise and provide a satisfactory degree of acoustical isolation for adjacent occupied spaces. A minimum Sound Transmission Class (STC) rating of 50 will be achieved.

The required rating may be achieved through the use of construction such

(Rev: 08/21/2025) as a double layer of GWB on both sides or Quiet Rock product on both sides, slab/slab and/or ROXUL insulation for above ceiling.

5) Alternatively, a gypsum board ceiling or gypsum board lay-in ceiling panels, both with sound attenuation blanket above the ceiling, will be provided where ducts, pipes, etc., make it impractical to extend sound partitions to slabs or deck above. Where gypsum board ceilings with attenuation blankets are used, the double GWB partitions and sound attenuation blanket will extend 6" above the ceiling. Studs will continue to the floor above. Special attention will be given to prevent possible flanking paths for noise transmission.

a) The sound resistant enclosures of the following spaces will be designed to assure speech privacy and achieve an STC rating of 50.

b) Use sound gasketing around doors and door sweeps.

c) In the design of exterior building walls at sites near airports, freeways, or heavy city traffic, consideration will be given for the control of noise transmission from external sources.

WINDOW TREATMENT

Windows need to be covered with solar window shades of no greater than 1% openness provided by the Lessor. Shades that utilize loop pull cords are not acceptable. Horizontal blinds are acceptable only as enclosed blinds integrated inside windows sealed between the glass. Draperies are not acceptable.

RESTROOMS

Please refer to VA Design guides as referenced within the LDN. Sinks will be equipped with electronic liquid antimicrobial soap dispenser provided by the lessor. A shelf and mirror provided by the lessor will be installed above each sink. Each restroom will have a toilet paper dispenser provided by the lessor installed within easy reach. Lessor will provide all soap and paper products. A paper towel dispenser provided by the lessor shall be installed near the sink. Each stall in the Women’s, Unisex and Family restrooms shall have a tampon/sanitary napkin disposal bin. Each women’s, unisex and family restroom shall have a non-coin operated tampon/sanitary napkin dispenser. Lessor will provide all feminine hygiene products. All bathrooms shall meet handicap accessibility codes and will include grab bars at commode. Metal partitions required at urinals and metal partitions with doors at commodes unless otherwise noted. All stalls will be mounted from the ceiling/wall and not floor for infection prevention/cleaning purposes. Lessor to install baby changing station in public female, male and unisex patient/visitor restrooms.

CORRIDORS

Patient corridors must be 6 feet in clear width. Install healthcare grade non-ligature handrail at ADAAG-specified height of 34-38” above floor surface on both sides of all corridors to protect wall surfaces.

Must have return to the wall at the end of the handrails. Provide continuous reinforcing in the wall for attachment of chair/handrails and wall guards.

http://www.cfm.va.gov/TIL

(Rev: 08/21/2025)

FIRE EXTINGUISHERS

Portable 10 lb. fire extinguishers will be provided, hung and maintained in accordance with the most recent addition of NFPA by the Lessor. Lessor is to install recessed fire extinguisher cabinets at appropriate locations to meet NFPA Lessor to provide and hang signage highlighting fire extinguisher location.

SPECIAL FIRE CODE

The storage rooms, laboratory room, mechanical rooms and housekeeping closets will be protected by one-hour fire walls and doors.

WET AUTOMATIC FIRE SPRINKLERS

Building will have an NFPA compliant wet automatic sprinkler system. Building will be fully sprinklered and contain all necessary fire alarm features.

COUNTERS

All counter tops will be solid surface material (ex. Corian type) or quartz composite material, all exposed edges will have a minimum 1/2” radius (top, bottom, and corners). No aprons are approved.

CASEWORK

Casework needs to be in Breakroom, Lab and Reception only and modular casework to go in the exam rooms. All casework vertical surfaces must be finished with high-pressure laminate. No exposed substrate is acceptable. All exposed toe-kicks to be the same vinyl or rubber cove base as the balance of the clinic. Casework in Reception shouldn’t include any storage but should be worksurface/countertop only, with the top surface at a height of no less than 29” above the finished floor. The reception casework should not have an apron. All countertop/worksurface should be either quartz composite or solid surface. All hardware must be ADA compliant.

CANOPIES

All entrance doors will have a minimum of 6 ft by 6 ft rain canopies over each entrance door. Vestibule (air lock) must have 2 sets of doors separated by at least 8 feet. One door in each set must have an automatic door opener. Primary (Main) entrance will be roof covered by a patient drop off canopy, sufficiently sized to accommodate 1 vehicular drop off lane (minimum height of 14 feet). Lessor to provide clearance height signage for traffic under the canopy.

AMBULANCE BUILDING ACCESS POINT

An ambulance building access point and staging area must be provided separate from the Main Entrance. The ambulance entrance will be located adjacent to the patient care areas with sufficient

(Rev: 08/21/2025) means of egress to accommodate stretchers/gurneys. All doors located along egress routes from patient care areas to the ambulance access point will be a minimum of 48” wide. The canopy over the ambulance building access point will be sized as outlined within the LDN.

MAILBOX

Lessor to install a mailbox at the main entrance of the clinic. VA will assist in defining the location during design. Mailbox must lock.

SITE CONSIDERATIONS:

LOCATION

Facility must be highly visible and located in an area accessible to and from main thoroughfares.

PARKING

Adequate, safe lighted parking on site for regular vehicles and handicap vehicle parking spaces will be provided, with one designated van drop off/loading area.

ACCESSIBLE PARKING

The accessible parking spaces must be immediately adjacent to the building, meeting local code but not exceeding a distance of 60 feet from the main entrance. Accessible spaces will be marked with signage by lessor. Entrance to the clinic must be handicap accessible in accordance with ADA.

SITE TOPOGRAPHY

Site topography must not have pedestrian traffic grades exceeding 3% slope, 1 ft elevation change in 33 feet.

SITE / EXTERIOR SIGNAGE

Lessor must provide internally lighted sign with VA logo and words "Department of Veterans Affairs Clinic" on sign a minimum of 4 ft by 6 ft legible from main serving road. Sign will be a minimum of 24 inches above finished grade. Please refer to VA Design Guides referenced within the LDN for additional information.

SIGNAGE AND WAYFINDING

A "wayfinding" process needs to be designed into every project. Veteran clients, visitors, and staff need to know where they are, what their destination is, how to get there, and how to return to their origination point. Identification, personalization of occupied spaces, and orientation are all to be

(Rev: 08/21/2025) addressed in the design. Wayfinding is to be thought of broadly as building elements, color, texture, and pattern cues, as well as a coordinated set-up for separate contacted signage and artwork. Lessor will provide interior signage for and 10 x 2 inch standard aluminum wall sign (holder) for slide in name plates. (VA will purchase name plates). Signage must state room number only. Room name or purpose must not be stated on sign.

SITE FLAGPOLE

A flagpole will be provided and installed by the Lessor at a location to be approved by the COR. The flagpole will be 25 foot (minimum height). Flagpole will include adequate lighting to illuminate flag between dusk and dawn. Flagpole will be protected from vehicular traffic. Lighting will be controlled by a photocell device. The lessor will provide an American Flag and a POW flag. The flags will be provided by the Lessor. The lessor will provide new flags when the existing flags are damaged or deteriorated (frayed or discolored).

SIDEWALKS

Accessible minimum 5-foot-wide sidewalks must be available from parking to entrance.

RAMPS

Ramps with over 5% rise, 1:20 slope, must have metal handicap style handrails on both sides.

LANDSCAPING

If site topography permits, site will be equipped with bushes and trees. Outdoor bench for Veteran seating to be provided by lessor.

MARQUEE

Marquee will be required if the property is located within a mall-type area. The Lessor will provide a lighted marquee. VA will provide design.

MAINTENANCE:

JANITORIAL SERVICES AND SUPPLIES

The Lessor is responsible for interior cleaning according to the attached schedule (See Janitorial Requirements Attachment). The Lessor is responsible for exterior cleaning and maintenance.

PEST CONTROL

Pest control will be provided by the VA.

MAINTENANCE

Building equipment and maintenance requirements, interior and exterior, will be met by the Lessor. The Lessor must have a building superintendent or local designated representative to promptly correct deficiencies or attempt to correct safety deficiencies within 4 hours. Lessor’s representative will be available via pager or cell phone for emergencies. Cosmetic and nonemergent deficiencies must be corrected within two weeks. If no attempt is made to correct the deficiency within the required time frame, the cost of the repairs will be deducted from the next month's lease payment. The Lessor is responsible for the total maintenance of the leased property with the exceptions listed specifically in this document. Such maintenance includes but is not limited to electrical systems, light fixtures, mechanical systems, fire alarm, intercom/emergency call systems, exterior care for the building and the site, all sidewalks, parking areas, driveways, private access roads, lawns, shrubbery including all repairs and replacements. All equipment will be maintained to provide reliable service without unusual interruption, disturbing noises, exposure to fire or safety hazards, unusual emissions of dirt. All maintenance will be done with applicable codes and manufacturer recommendations.

The Lessor will provide all labor and materials and supervision to adequately maintain the structure, roof, necessary building appurtenances to provide watertight integrity, structural soundness and acceptable appearance. All work done by the Lessor will be coordinated with the VA Contracting Officers Representative (COR).

SNOW AND ICE REMOVAL

Lessor will provide snow/ice removal services for the government on all days for which this leased property is in operation. Lessor will clear parking lots if the accumulation of snow exceeds two inches.

Lessor will clear sidewalks, walkways and other entrances before accumulation exceeds 1.5 inches. The snow removal will occur no later than 6:30 AM, without exception. Should snow accumulation continue throughout the day, the Lessor will provide such additional removal services to prevent accumulation greater than the maximums specified in this paragraph. In addition to snow removal, the Lessor will keep walkways, sidewalks and parking lots free of ice during the normal hours. Preventative salting will occur as to stop any ice from surface accumulation. The Lessor will remove excess buildup of sand and/or ice melt to minimize slipping hazards. Building waiting rooms must be mopped If the building entrance(s) has a northern exposure, then Lessor will take additional measures to protect the safety of pedestrians.

EXTERIOR MAINTENANCE

Lessor is responsible for removing weeds from around building, parking areas and sidewalks. The Lessor is responsible for mowing, edging, trimming landscaping and watering lawns as well as leaf raking and removal.

(Rev: 08/21/2025)

PARKING LOT

Lessor will re-seal parking lot and re-paint parking space lines as damaged. Entire lot to be resealed and painted every five (5) years.

PLUMBING PROBLEMS

Drain problems that can be solved by simple application of a plunger will be handled by VA Staff. Drain problems that cannot be solved by simple application of a plunger or require repeated applications will be solved by the Lessor. All other plumbing problems are the responsibility of the Lessor and will be addressed within 24 hours of notification to Lessor’s representative.

UTILITIES:

EMERGENCY POWER:

Facility requires backup generator or power to support the following during a power outage:

• Medication room temperature and humidity control

• Medication room vaccine refrigerator

• Supply room temperature and humidity control

• Laboratory room refrigerators and freezers

• Data closet HVAC system, switches, and servers and humidity control

CABLE TELEVISION

Lessor will provide empty 2x4 boxes for cable TV audio/video wall jack for connection to a VA furnished television in the reception area (2 locations) and staff break room, locations to be determined by VA. A 120-volt duplex electrical outlet will be located adjacent to the cable box outlet. The Lessor will provide duplex outlet, empty cable box and cable route access. Lessor will provide and pay for basic cable.

MESSAGE BOARD

Lessor will provide a 120V power and a data outlet for the message board. Outlet will be located 6” below the finished ceiling at a location identified during the design phase.

EMERGENCY CALL SYSTEM

An emergency call system from each toilet to the reception area will be provided. A call light will be installed above the door to each of these rooms. The call system in the toilet will include a vinyl pull cord extending from 30 inches above floor to within 6 inches of the floor at the water closet.

RESTROOM SANITARY FIXTURES

The lessor will provide and install wall-mounted soap dispenser and paper towel dispenser for each sink.

(Rev: 08/21/2025)

PLUMBING

In addition to the rooms with sinks noted in page one (1) of this SOW, all other rooms will be plumbed for future expansion or alteration.

STAFF CONFERENCE / BREAK / MEETING / STAFF EDUCATION ROOM

UTILITIES

This room will be equipped with a small kitchen-type sink, counter with over and under storage cabinets along with counter space for a microwave (microwave can be within the cabinet space design) and floor space for a freestanding refrigerator. The microwave and refrigerator will be provided by the VA. All casework below sinks must be closed off per design manual. Lessor to provide Power/data above ceiling for projector.

EMERGENCY LIGHTING

Must have…