36C26118Q9665-001.doc

STATEMENT OF WORK (SOW)

2237: 459-18-4-092-0441 7/20/18

1. Contract Title.

Audiometric Booth

2. Background.

The Department of Veterans Affairs, Pacific Islands Health Care System, Spark M. Matsunaga Medical Center has requested additional Audiology services at the clinic. This requirement calls for installation of 2 new single wall control/double wall exam audiometric (booths). Do to the limited Fee Providers in Hawaii providing this service, the Audiology Department is booked out for Audiometric Testing till December. This why additional booths and equipment are needed to provide timely services to our veterans.

3. Scope.

Scope. This specification addresses prefabricated audiometric examination booths and rooms/suites suitable for the use in testing, calibration, and recording of aural acuity. A booth is defined as a free-standing examination room. Henceforth, the term "audiometric booth" will be used generically when referring to booth, room, or suite. An audiometric booth covered by this specification includes all enclosure panels, components, wiring, lighting fixtures (including dimmers), ventilation silencers, and installation to make the booth completely operable. The entry to exam room will be on the front of the booth. VA (department identified) from herein identifies VA Pacific Islands Health Care System. Vendor from herein identifies the company awarded the contract for the audiometric suite (booth).

4. Specific Tasks.

Once the project is approved, there are many specific tasks that must be completed in the following order to effectively ensure proper installation.

Task 1-Preparing Audiometric Suite (booth)site

I. VA (Engineering)

a) Ensure that the area is free of flooring, ceiling tiles and drywall prior to installation of booth, if any of these items are required to be removed for proper installation of booth.

b) Install electrical requirements (or contract to install) per approved design by the selected booth vendor.

c) Install ventilation/HVAC requirements (or contract to install) per approved design by the selected booth vendor.

Task 2 – Installation of Audiometric Suite (booth)

Audiometric Suite (booth) Vendor (once awarded) will

a) Construct the booth according to pre-approved specifications/design.

b) Give a two-week notice as to the installation date of the Audiometric Suite (booth).

c) Be responsible for any damage caused to the property by its company or subcontractors and promptly provide restitution for repair, but not less than one week from when damage occurred.

d) Remove all trash and clean up installation area daily.

e) Install the pre-manufactured booth in the space described according to the pre-approved specifications/design.

f) Replace or repair the defective components.

II. Audiometric Suite (booth) VA (Engineering) will:

Upon delivery of materials, Engineering may conduct the following pre-installation and post-installation inspections. Should the audiometric booth fail to meet any of the requirements of this specification

Task 3 – Post Installation of Audiometric Suite (booth)

I. VA (Engineering Service) will Install network connectivity for new booth.

II. VA (Engineering Service) will:

a) Activate the electricity

b) Connect pre-existing ventilation/HVAC system to the booth

Task 4 – Audiometric Suite (booth) certification I. Vendor will repair any finish defects and ensure Audiometric booth doors are properly aligned and swing freely without binding other than as necessary for proper sealing.

II. VA (Engineering) shall conduct inspections to ensure that the Audiometric booths are installed such that the floors are level and the walls are plumb. The audiometric booth finish has proper paint coverage and no dents or scratches. Certifies electrical function and ventilation/HVAC.

III. VA (Safety) will clear the booth area for access of all services.

IV. VA (OI&T) will certify data connections are operational.

VA (Bio-Medical) will calibrate and install:

Grason Stadler AudioStar Pro Clinical Two-Channel Audiometer, or equivalent Task 5 - Enterprise Management Controls.

Subtask 5.1 – Audiometric Booth Requirements

ENCLOSURE SIZE AND CONFIGURATION REQUIREMENTS FOR SELECTION

a) Audiometric booth must be a Double Wall Control/ Double Wall Exam Audiometric Suite (booth).

b) Double Wall Audiometric Test Booth

· Inside dimensions: 9'-4" wide by 7'-0" deep by 6'-6" high

· Outside dimensions: 11'-4" wide by 9'-0" deep by 8'-10" high*

c) Doors: Two acoustic doors, 36” clear opening, double magnetic seals with cam-lift hinges.

Double in-swing / out-swing door system. All fire rating requirements specified below must be met.

d) Windows (3): One acoustic window for patient observation, 36” wide by 30” high / One window in both doors: 20” wide by 60” high. All fire rating requirements specified below must be met.

e) Minimum Structural Requirements:

Audiometric booth shall employ an isolated acoustical floor system. Isolated floor system for the audiometric booth shall support the examination room walls so as to fully isolate the floor, walls and ceiling of the enclosure from facility area vibrations.

Floor panels shall be constructed of welded framework of formed steel channel, sheet steel top and bottom skins, and shall be fully insulated. Structural framing shall be minimum 11 gauge cold rolled steel channel sections, spaced as required to meet the structural requirements of section b). Top walking surface shall be minimum 11 gauge sheet steel. Bottom floor panel closure skin shall be minimum 20 gauge sheet steel. Floor panels shall be fully insulated with acoustical filler material which is inert, mildew resistant, and vermin resistant.

Floor panel and isolation system shall accommodate a minimum of a 60 pound per square foot live load without structural deflection which exceeds L/240.

Floor panels shall be welded so as to provide a flat, smooth walking surface, and sheet steel shall be attached to floor panel framework in a manner so as to prevent "popping" or "oil-canning". Any defects in floor panels that are caused as a result of broken welds or other defective construction methods shall be fully repaired by the contractor at the time of installation.

The audiometric booth shall be constructed of prefabricated steel wall and ceiling panels that meet the modularity requirements of section b). Panels shall be a minimum of 4" thick, unless specified otherwise due to special acoustical considerations. Panels shall be constructed of a welded framework of formed steel channel, a solid sheet steel outer panel skin, a perforated steel inner panel skin, and shall be fully insulated. Structural framing shall be minimum 18 gauge steel channel sections on no less than 24" centers. Panel outer skin shall be minimum 16 gauge electro-galvanized, bonderized cold rolled steel. Panel inner skins shall be minimum 22 gauge electro-galvanized, bonderized perforated steel, with perforations not exceeding 1/8" diameter and a perforation pattern that provides at least the minimum sound absorption required.

Audiometric booth walls, ceilings, floors, and doors shall be fully insulated with acoustical filler material which is inert, mildew resistant and vermin resistant. Insulation shall be packed into the panel so as to fully fill the panel cavities, leaving no voids. Fill materials shall provide at least the minimum sound absorption properties required. All fire rating requirements specified below must be met.

Audiometric booth to include an acoustic ventilation silencer system, roof mounted supply and exhaust silencers with duct collars for 6” flex duct connection to be installed into the building’s HVAC system.

Audiometric booth to include two (2) quad outlets beneath window inside booth, two (2) quad outlets beneath window outside booth, three (3) additional duplex outlets.

Booth to include a clinical jack panel beneath window containing twelve (12) ¼” gold plated stereo phone jacks, four (4) USB connections, and one (1) 1 ½” diameter cable pass-through.

A conduit drop, rough in for fire alert device above window, control and exam sides. A conduit drop, rough in for phone / network, adjacent to control side window.

Lighting: Ceiling mounted low heat high efficiency LED lighting with wall mounted switch.

Trim: Extended roof apron panels, 8” above roof line of the booth. Vertical closure panels to close gaps to booths walls for up to 6” wide airspace.

FIRE RATING REQUIREMENTS

As a minimum, audiometric booths shall be constructed of fire rated components, as specified below, to obviate the need for a fire sprinkler system and the associated roof panel penetration necessary for installation.

Wall and ceiling panels and liner materials used in ventilation system, silencers and fan housings, tested in accordance with ASTM E84-87, shall not exceed a rating of 25 for Flame Spread and 50 Smoke Developed.

Carpeting shall meet the requirements of the Federal Flammability Standard FF-I-70, Standard for the Surface Flammability of Concepts and Rugs (Pill Test).

Wall and ceiling panels, tested in accordance with ASTM E119-88 (or equivalent industry standard test method), shall be rated for a minimum of 60 minutes. Test data for both solid and perforated surfaces exposed to fire shall be provided.

Door assemblies, tested in accordance with ASTM E152-81 (or equivalent industry standard test method) shall be rated for a minimum of 45 minutes.

Windows installed in fire-rated wall assemblies, tested in accordance with NFPA 257, Standard for Fire Tests of Window Assemblies (or equivalent industry test method), shall be rated for a minimum of 45 minutes.

The windows to be installed fire-rated wall assemblies shall be of wired safely glass or shall be glazed with a material that has been tested in accordance with NFPA 257, Standard for Fire Test of Window Assemblies (or equivalent industry test method). Glazing material shall be installed in a metal frame in accordance with manufacturer's standard window framing details.

Subtask 5.3 – Installation

a) The Vendor shall be factory trained on proper booth installation techniques and shall install audiometric booths and all specified components in Spark M. Matsunaga Medical Center.

b) Vendor shall completely assemble audiometric booth and all associated components which are provided by the manufacturer. Outlets, plug strips, light fixtures, and all other electrical components internal to the booth shall be installed and booth wiring shall be connected to the main junction box connection point. HVAC silencers shall be installed on the audiometric booth walls or roof. Final connection of HVAC services, main electrical power, thermostats, and any other building services is the responsibility of the Government.

c) The Vendor shall furnish, with each booth, two copies of the equipment manual containing installation, operation, and maintenance instructions; a block diagram showing wiring between related pieces of equipment which make up the complete system; and a parts data section.

d) The parts data section shall include a list of parts and an illustration of all replaceable parts with replacement instructions. "Replacement part" is defined as a part or component thereof that can be removed or exchanged for a like item and restored to its original position without breaking welds or requiring a special operation. The parts list shall identify the contractor's part number. The parts illustrated shall have an identifying number or name for cross reference to parts list. The manual shall include a wiring diagram including ground connections with all major components identified by name.

Subtask 5.4 – Quality Assurance

Upon delivery of materials, VA may conduct the following pre-installation and post-installation inspections. Should the audiometric booth fail to meet any of the requirements of this specification, contractor shall replace or repair the defective components.

a) Inspection of Material Prior to Installation: Upon delivery of the audiometric booths, VA may inspect the panels and materials to be used to construct the booths. Individual panels and enclosure components may be visually inspected to ensure that they are identical to the physical description provided on the test reports submitted by the contractor. In the event that there are substantial deviations between the actual construction of the materials utilized to construct the enclosure and the physical description of the components on the contractor's test reports, the non-complying materials may be rejected. Individual panels may be weighed and panels that weigh more than 10% less than the panel weights indicated on contractor's test report may be rejected.

b) Inspection After Completion of Installation: Upon completion of installation, VA shall conduct inspections to ensure that the audiometric booths are installed such that the floors are level and the walls are plumb. The audiometric booth finish has proper paint coverage and no dents or scratches. Any finish defects shall be repaired by the contractor. Audiometric booth doors are properly aligned and swing freely without binding other than as necessary for proper sealing. All electrical components and jack panels operate properly.

c) Compliance with Ambient Noise Level and Noise Reduction Requirements: Prior to acceptance and upon completion of installation, connection of building services, and with all electrical, lighting, and HVAC systems in operation, VA will conduct ambient noise level measurements at the typical patient location in the completed enclosure to ensure compliance with the maximum ambient sound pressure levels permitted by ANSI S3.1-1991 (revised to ANSI S3.1-1999 [R2008]). Measurements of the enclosure noise reduction will be made in accordance with ASTM E336-90. Results of these noise reduction measurements made in completed enclosures shall be within 6 dB of the specified laboratory noise reduction figures.

d) Compliance with Electromagnetic Shielding Attenuation Requirements: Prior to acceptance and upon completion of installation, connection of building services, and with all electrical, lighting, and HVAC systems in operation (but without audiometric equipment connected), VA will perform measurements of EM-shielding attenuation in accordance with the acceptance test procedures of NSA 65-6, 1964, to the extent permitted by clearances around the booth and the ambient EM noise level.

e) The contractor shall correct the deficiencies in the audiometric booth and retest the booth until it meets all requirements of this specification. All costs associated with testing and repair of the audiometric booth shall be borne by the contractor.

Subtask 5.5 – Packaging, Packing and Shipping Instructions.

The Audiometric Suite (booth) will be received at the Spark M. Matsunaga Medical Center once the area is prepped and the sound booth is constructed.

Subtask 5.6 – Inspection and Acceptance Criteria.

Upon delivery of materials, VA (Engineering) may conduct the following pre-installation and post-installation inspections. Should the audiometric booth fail to meet any of the requirements of this specification, contractor shall replace or repair the defective components.

a) Inspection of Material Prior to Installation: Upon delivery of the audiometric booths, VA (Engineering) may inspect the panels and materials to be used to construct the booths. Individual panels and enclosure components may be visually inspected to ensure that they are identical to the physical description provided on the test reports submitted by the contractor. In the event there are substantial deviations between the actual construction of the materials utilized to construct the enclosure and the physical description of the components on the contractor's test reports, the non-complying materials may be rejected. Individual panels may be weighed and panels that weigh more than 10% less than the panel weights indicated on contractor's test report may be rejected.

b) Inspection After Completion of Installation: Upon completion of installation, VA shall conduct inspections to ensure that the audiometric booths are installed such that the floors are level and the walls are plumb. The audiometric booth finish has proper paint coverage and no dents or scratches. Any finish defects shall be repaired by the contractor. Audiometric booth doors are properly aligned and swing freely without binding other than as necessary for proper sealing. All electrical components and jack panels operate properly.

c) Compliance with Ambient Noise Level and Noise Reduction Requirements: Prior to acceptance and upon completion of installation, connection of building services, and with all electrical, lighting, and HVAC systems in operation, VA will conduct ambient noise level measurements at the typical patient location in the completed enclosure to ensure compliance with the maximum ambient sound pressure levels permitted by ANSI S3.1-1991 (revised to ANSI S3.1-1999 [R2008]). Measurements of the enclosure noise reduction will be made in accordance with ASTM E336-90. Results of these noise reduction measurements made in completed enclosures shall be within 6 dB of the specified laboratory noise reduction figures.

d) Compliance with Electromagnetic Shielding Attenuation Requirements: Prior to acceptance and upon completion of installation, connection of building services, and with all electrical, lighting, and HVAC systems in operation (but without audiometric equipment connected), VA will perform measurements of EM-shielding attenuation in accordance with the acceptance test procedures of NSA 65-6, 1964, to the extent permitted by clearances around the booth and the ambient EM noise level.

e) The contractor shall correct the deficiencies in the audiometric booth and retest the booth until it meets all requirements of this specification. All costs associated with testing and repair of the audiometric booth shall be borne by the contractor.

Sound Booth [specifications are outlined in VHA Handbook 1170.02, Appendix D, Booth Audiometric Examination Specifications (IB 11-87, June 1993), dtd March 14, 2011]

• Must be single walled operator side

• Must be double walled test suite

• A maximum four inch tolerance is allowed on length and width to permit booth to fit into standard footages of space.

• Booth must consist of: -Vibration isolation system -Floor assembly -Wall and roof panel assembly -Acoustical door units -Acoustical window units -Assembly hardware, including connecting panel joints -Electrical and lighting wiring, components and fixtures -Silenced forced air ventilation system (or packaged air conditioning silencers for connection to building HVAC systems) -Carpeting -Paint and other specified finishes -Dust seals/shields and closure strips -Jack panel

10. Place of Performance.

Department of Veteran Affairs Pacific Islands Health Care System Spark M. Matsunaga Medical Center

459 Patterson Road, Audiology

Honolulu, HI 96819

11. Period of Performance.

Three months