36C25919R0161-0002000.docx

5. PROJECT NUMBER (if applicable)

CODE

7.

ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF

PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

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

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

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE

OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:

Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERE

D 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 amendmen t, 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) 08-06-2019 N/A 36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111 36C259 Department of Veterans Affairs Network Contracting Office

NCO 19

6162 South Willow Drive, Suite 300 Greenwood Village CO 80111 To all Offerors/Bidders

36C25919R0161 07-25-2019

X

The purpose of this amendment is to revise the Statement of Work. Please reference this Statement of work moving forward.

Mary Emily Good Contracting Officer

B.2. PERFORMANCE WORK STATEMENT

WATER SAMPLING SERVICES

At Rocky Mountain Regional VAMC and CBOCs

1. GENERAL:

The Contractor shall collect; measure (temperature, free chlorine, chlorine dioxide, and pH); and mail water samples obtained within the Eastern Colorado Health Care System (ECHCS) to the specified laboratory. Sampling, testing and handling shall conform to current versions of VHA Directive 1061, Centers for Disease Control (CDC) Elite Protocol, Colorado Department of Public Health and Environment (CDPHE); and standard methods of organizations such as, but not limited to, US Environmental Protection Agency (EPA), Occupational Safety and Health Administration (OSHA), National Institute of Safety and Health (NIOSH) and National Environmental Methods Index (NEMI).

2. SPECIFICATIONS:

a. If the Contractor fails to follow sample submittal requirements for the specified CDC Elite lab, repeat sampling shall be at no additional cost to the Government. In general, follow standard methods for pathogenic organism testing when gathering samples and preparing shipments unless otherwise directed by the Contracting Officer.

b. After water samples are mailed, tabulate water test data by location in an MS Excel spreadsheet and provide electronically to the Contracting Officer as an attachment to the following: Sampling plan summary spreadsheet by location; and completed Chain of Custody form(s).

c. Dates and times for collection of samples shall be coordinated with the Contracting Officer or Government Point of Contact (POC) at least 10 days in advance of the work to assure access to all areas and availability of VA escort personnel, if needed. An exception to the typical 10-day timeframe would be when the presence of the VA specified pathogen was reported by the testing lab. After informing the government within 24 hours, additional expedited re-sampling, testing and processing would then be proposed to the Contracting Officer or POC.

d. The Contractor shall provide and use their own testing equipment under this contract. Contractor provided equipment shall be ready for use throughout the periods of work. Neither VA equipment nor on-site storage will be available.

e. Should the VA require additional water sampling locations, then the Contractor may propose them to the Contracting Officer for review and consideration as compensable. For cases of pathogen detection, there are 36 additional samplings allocated for area re-assessments at the discretion of the Contracting Officer.

3. PERFORMANCE LOCATIONS:

Rocky Mountain Regional VA Medical Center (RMRVAMC) Building H and Building K 1700 N. Wheeling St.

Aurora, CO 80045

Pueblo Community Living Center 2600 Oakshire Lane Pueblo, CO 81001

Valor Point Domiciliary 7350 W Eastman Place Lakewood, CO 80227

Denver VA Medical Center PTSD Facility 1055 Clermont St Denver, CO 80220

VA Fisher House 1954 Quentin Street Aurora, CO 80045

4. SAMPLING AND TESTING REQUIREMENTS

a. On a quarterly basis, the estimated minimum number and types of on-site water samples is as follows:

1. Rocky Mountain Regional Medical Center (RMRVAMC) Aurora for Building H (20 samples) for Temperature, Free Chlorine, Chlorine Dioxide, and pH. Of the 20 samples from each plumbing fixture (such as sinks, showers, tubs, ice machines, and ice machine water dispensers) there shall be 10 each taken from the hot tap, and 10 each from the cold tap. In the case of single tap sinks with motion sensors, it is permissible to take only 1 sample because of the mixing valve. At an ice machine, only a cold sample is required from the melted ice. At the ice machine water dispenser, only 1 cold sample is needed.

2. Rocky Mountain Regional Medical Center (RMRVAMC) Aurora Building K (20 samples) for Temperature, Free Chlorine, Chlorine Dioxide, and pH. Of the 20 samples from each plumbing fixture (such as sinks, showers, tubs, ice machines, and ice machine water dispensers) there shall be 10 each taken from the hot tap, and 10 each from the cold tap. In the case of single tap sinks with motion sensors, it is permissible to take only 1 sample because of the mixing valve. At an ice machine, only a cold sample is required from the melted ice. At the ice machine water dispenser, only 1 cold sample is needed. This facility has two thermal pools where 1 sample from each one is required.

3. Pueblo Community Living Center - Twenty (20 samples) for Temperature, Free Chlorine, Chlorine Dioxide, and pH. Of the 20 samples from each plumbing fixture (such as sinks, showers, tubs, ice machines, and ice machine water dispensers) there shall be 10 each taken from the hot tap, and 10 each from the cold tap. In the case of single tap sinks with motion sensors, it is permissible to take only 1 sample because of the mixing valve. At an ice machine, only a cold sample is required from the melted ice. At the ice machine water dispenser, only 1 cold sample is needed.

4. Valor Point Domiciliary – Twenty (20 samples) for temperature, Free Chlorine, Chlorine Dioxide, and pH. Of the 20 samples from each plumbing fixture (such as sinks, showers, tubs, ice machines, and ice machine water dispensers) there shall be 10 each taken from the hot tap, and 10 each from the cold tap. In the case of single tap sinks with motion sensors, it is permissible to take only 1 sample because of the mixing valve. At an ice machine, only a cold sample is required from the melted ice. At the ice machine water dispenser, only 1 cold sample is needed.

5. Denver VA Medical Center Post Traumatic Stress Disorder (PTSD) Facility – Twenty (20 samples) for Temperature, Free Chlorine, Chlorine Dioxide, and pH. Of the 20 samples from each plumbing fixture (such as sinks, showers, tubs, ice machines, and ice machine water dispensers) there shall be 10 each taken from the hot tap, and 10 each from the cold tap. In the case of single tap sinks with motion sensors, it is permissible to take only 1 sample because of the mixing valve. At an ice machine, only a cold sample is required from the melted ice. At the ice machine water dispenser, only 1 cold sample is needed.

6. Fisher House - Twenty (20 samples) for Temperature, Free Chlorine, Chlorine Dioxide, and pH. Of the 20 samples from each plumbing fixture (such as sinks, showers, tubs, ice machines, and ice machine water dispensers) there shall be 10 each taken from the hot tap, and 10 each from the cold tap. In the case of single tap sinks with motion sensors, it is permissible to take only 1 sample because of the mixing valve. At an ice machine, only a cold sample is required from the melted ice. At the ice machine water dispenser, only 1 cold sample is needed.

5. CONTRACTOR PERSONNEL:

a. All work shall be performed by competent technicians, experienced and qualified in collecting and testing samples in a hospital environment in accordance with the terms of this contract.