36C25725Q0689 0001.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 9

0001 07-03-2025

36C257

Department of Veterans Affairs NCO 17 North Texas Healthcare System Regional Procurement Office West (RPO-W) 124 E. Hwy 67, Suite 100 Duncanville TX 75137

36C257

NCO 17

Department of Veterans Affairs North Texas Veterans Health Care Center 124 E. Hwy 67, Suite 100 Duncanville TX 75137

36C25725Q0689

X

X X

See CONTINUATION Page

X 1

The purpose of this amendment is to make changes to the statement of work and add updated schedule.

See continuation page.

CONTINUATION PAGE

1. Statement of work changes (see changes in yellow)

2. Updated Price/Schedule

Statement of work

1. GENERAL

1.1. The contractor shall comply with Federal, State, local laws and regulations applicable to the performance of this contract to chemical supply and water testing.

1.2. To Test Decontamination Rooms B460 and B406a water quality from the Faucets in Ambulatory Surgical Unit to ensure it meets and exceeds standard set by the Center for Disease Control and Prevention (CDC) and AAMI ST108.

PLACE OF PERFORMANCE:

El Paso VA Health Care System

VA Medical Center

5001 N Piedras St

El Paso, TX 79930

PERIOD OF PERFORMANCE ON THIS CONTRACT:

Base Year: 09/1/2025 - 08/31/2026.

Option Year 1: 09/1/2026 - 08/31/2027.

Option Year 2: 09/1/2027 - 08/31/2028.

Option Year 3: 09/1/2028 - 08/31/2029.

Option Year 4: 09/1/2029- 08/31/2030

2. Testing Materials

2.1. The contractor shall provide the following:

The contractor shall provide water testing kits for water sample collection, testing chemicals and all supplies needed for the testing. The services will include sampling, testing and reporting activities to confirm that the water used meets the required specifications in compliance with ANSI/AAMI ST108 standards. It is the responsibility of the contractor to bring all the appropriate equipment and/or supplies necessary to complete the work; the VA shall not furnish any supplies or equipment for the performance of the contract.

The Contractor shall return completed sample test results to the COR within 7 calendar days of receiving sample results from the laboratory for Intermittent Test results.

3.1 DESCRIPTION OF SERVICE

Contractor shall test waterlines samples contained in the appropriate tubes mailed to them by the Contractor.

• Rm B460 Decontamination Room has three faucets

• Rm D406a Decontamination Room has two faucets.

• Two samples of each faucet shall be taken and sent for testing on Hot and Cold water.

• Medivator water testing for AAMI ST108 testing there are three Medivators that require water testing monthly

3.2 The service contract shall provide the following:

If resampling and intermittent testing are required, the Vendor shall be contacted for the testing and the Vendor shall respond within 24 hours of being contacted.

The Water Testing Laboratory shall be certified according to Federal Government Certification Authority or its Affiliate.

WATER TESTS TO BE PERFORMED:

The contractor will use a qualified laboratory for processing water samples, using an accredited environmental quality and national environmental laboratory accreditation program. Each sample sent to the contractor’s testing laboratory shall be tested in accordance with AAMI ST108 standards as found in Table 2 below for Utility Water. When Utility Water is used after chemical high-level disinfection as a final rinse (i.e. Medivators), water should also be tested for bacteria and endotoxins.

3.3. FREQUENCY OF TESTING SERVICES REQUIRED

Monthly: Testing shall be performed before the 10th of the month

There are 9 test sites for the HPC(bacteria) TOC and PH

There are 3 test sites: 5 tests in Scope Decon: Left sink hot and cold, right sink hot and cold and handwash sink

1 test in Soiled utility room: mixed

3 tests in Medivator room which also requires endotoxin testing

The contractor will test monthly for the following:

• Bacteria (Heterotrophic platelet count)

• Total Organic carbon (TOC test)

• pH (6-9)

• Endotoxin on the 3 Medivators

Annually: Testing shall be performed before the 10th of the second month

9 Annual tests should be completed for the following:

• Water hardness (less than 150mg/L)

• Ionic Contaminants (Specific for Chloride, Iron, Copper and Manganese)

Intermittent test: Testing shall be as needed

• Endotoxins (LAL test) Installation modification of critical water treatment or when persistent increased microbial levels are detected by heterotrophic plate count, ATP, or TOC.

4. QUALITY CONTROL:

4.1. The contractor shall provide a Quality Control Plan (QC Plan) for the term of the contract that establishes and maintains well-documented quality control procedures that ensure the test results and deliverance of acceptable performance in accordance with this Statement of Work The QC Plan shall assure adequate quality control throughout all areas of performance and shall be implemented to validate reliability and effective performance. The contractor shall be solely responsible for controlling quality work, and providing objective evidence that such control does, in fact, exist. It shall be the responsibility of the contractor to enforce all Quality Control Plan requirements for all subcontractor(s).

At a minimum, the contractor’s Quality Control Plan shall include:

a. An internal quality control for required services.

b. A method to identify and correct any deficiencies in services that may occur.

5. WORK HOURS:

The following is a list of U.S. Government holidays. If the holiday falls on a Saturday, the proceeding Friday is observed as the holiday; if the holiday falls on a Sunday, the following Monday is observed as the holiday and any other day specifically declared by the President of the United States to be a national holiday.

HOLIDAY DATE

New Year’s Day Jan 1 Martin Luther King’s Birthday 3rd Monday in Jan President’s Day 3rd Monday in Feb Memorial Day Last Monday in May Juneteenth June 19th Independence Day July 4 Labor Day 1st Monday in Sep

Columbus Day 2nd Monday in Oct Veterans Day Nov 11 Thanksgiving Day 4th Thursday in November Christmas Day December 25

6. ACRONYMS AND DEFINITIONS

6.1. Contracting Officer (CO). A person duly appointed with the authority to enter into and administer contracts on behalf of the U.S. Government.

6.2. Contracting Officer’s Representative (COR). An individual designated in writing by the Contracting Officer to act as an authorized representative of the Contracting Officer to perform specific contract administrative functions within the scope and limitations as defined by the Contracting Officer.

7. LITIGATION:

7.1. Contractor shall be responsible for any litigation, including the cost of litigation, brought against it, its employees or agents for alleged acts or omissions. The CO shall be notified in writing of all litigation pertaining to this contract and provided copies of any pleadings filed or said litigation within five working days of the filing. The Contractor shall cooperate with Government legal staff and/or the United States Attorney regarding any requests pertaining to federal or Contractor litigation.

8. Roles and Responsibilities of Participating Government Officials

a. The COR will be responsible for monitoring, assessing, recording, and reporting performance of the Contractor. The COR will have primary responsibility for completing “Quality Assurance Surveillance Forms” to document their evaluation of the Contractor’s work performance. COR shall be the Point of Contact (POC) for access to the VA Facility by the Vendor when needed to obtain Contractor/Visitors Badge and escorted to the desired location.

b. The Contracting Officer (CO) or designee has overall responsibility for evaluating the Contractor’s performance in areas of contract compliance, contract administration, and The CO shall review the COR’s evaluation of the Contractor’s performance and invoices.

9 RECORDS MANAGEMENT LANGUAGE:

9.1.All records (administrative and program specific) created during the period of the contract belong to EL Paso Veterans Affairs Health Care System (ELPVAHCS) and must be returned to EL Paso Veterans Affairs Health Care System (ELPVAHCS) at the end of the contract or destroyed in accordance to the VHA Record Control Schedule (RCS)10-1.

9.2. Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

9.3.In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C.

chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

9.4.In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

9.5. ELPVAHCS and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of ELPVAHCS or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to ELPVAHCS records officer . The agency must report promptly to NARA in accordance with 36 CFR 1230.

9.6. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the contract. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to ELPVAHCS control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle].

Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

9.7.The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub-contractor) is required to abide by Government and ELPVAHCS guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

9.8. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with ELPVAHCS policy.

9.9. The Contractor shall not create or maintain any records containing any non-public ELPVAHCS information that are not specifically tied to or authorized by the contract.

9.10.The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.

9.11. The ELPVAHCS owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which [Agency] shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20

Updated schedule

PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

12.00 MO __________________ __________________

ASU water sampling contract

Contract Period: Base POP Begin: 09-01-2025 POP End: 08-31-2026 retesting and intermittent testing as required

Contract Period: Base POP Begin: 09-01-2025 POP End: 08-31-2026

Contract Period: Option 1 POP Begin: 09-01-2026 POP End: 08-31-2027

Contract Period: Base POP Begin: 09-01-2026 POP End: 08-31-2027

Contract Period: Option 2 POP Begin: 09-01-2027 POP End: 08-31-2028

Contract Period: Base POP Begin: 09-01-2027 POP End: 08-31-2028

Contract Period: Option 3 POP Begin: 09-01-2028 POP End: 08-31-2029

Contract Period: Base POP Begin: 09-01-2028 POP End: 08-31-2029

Contract Period: Option 4 POP Begin: 09-01-2029 POP End: 08-31-2030

Contract Period: Option 3 POP Begin: 09-01-2029 POP End: 08-31-2030

GRAND TOTAL __________________

End of Document