36C26122Q0427_1.docx

36C26122Q0427

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

459-23-1-041-0005 36C26122Q0427 06-15-2022 Tim Smith 916-923-4517 07-08-2022 15:00

PDT

612MCP

Department of Veterans Affairs Network Contracting Office 21 VA Northern California HealthCare System 5342 Dudley Blvd, Bldg McClellan CA 95652-2609 X X 811219 $22 Million N/A X See Statement of Work

612MCP

Department of Veterans Affairs Network Contracting Office 21 VA Northern California HealthCare System 3230 Peacekeeper Way, Bldg. 209 McClellan CA 95652-1012

Department of Veterans Affairs FMS VA-9(101) Financial Services Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page Medical Gases Maintenance Service for VA Pacific Islands Health Care System Base Period of Performance: 10/01/2022 through 9/30/2023 with four one-year option periods Note 1: “Offerors shall follow the submission instructions specified in FAR Provisions 52.212-1 and 52.212-2, and their addendums included in this solicitation. Failure to follow the instructions will result in an unfavorable evaluation and may not be considered for award.”

Note 2: All questions must be submitted no later than 3 days prior to quote due date.

See CONTINUATION Page X X X Sable Williams Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261 Department of Veterans Affairs Network Contracting Office 21 VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

All invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to register and begin submitting electronic invoices, free of charge. The Department of Veterans Affairs Tungsten Number is: AAA544240062 (this allows you to file invoices online for free.)

More information on the VA Financial Services Center is available at http://www.fsc.va.gov/einvoice.asp.

Vendor e-Invoice Set-Up Information:

If you have questions about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

• Tungsten e-Invoice Setup Information: 1-877-489-6135

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

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

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

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

36C26122Q0427

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B.2 STATEMENT OF WORK

Medical Gases Maintenance Oxygen, Compresses Air and Vacuum Systems Services

1. Scope of Work

The Contractor shall provide all labor, material, and equipment to perform a complete inspection, testing, preventive maintenance, and minor repair for the following government-owned equipment at the following Department of Veterans Affairs facilities listed below.

2. Location of Work

2.1 Center for Aging, Building 110, 110 Krukowski Rd, Honolulu, HI & Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI

One (1 Lot) Chemetron 77-03-0002, -0003, -0004, -0005, -0006, -0008, Ball Valve with copper extensions.

2.2 Ambulatory Care Clinic, Building 30, 459 Patterson Road, Tripler Army Medical Center

One (1) Chemetron 61-21-970315 Air Compressor System.

One (1) Chemetron 63-13-970315 Air Dryer Package.

One (1) Air Techniques AirStar 50 Dental Air System.

One (1) Air Techniques VacStar 80H Dental Vacuum System.

One (1) Chemetron 62-3030-970315 Vacuum Pump System.

One (1) Chemetron 86-41-9006 Reserve Manifold, & One Chemetron (1) 86-41-9001 Oxygen Manifold.

Two (2) Chemetron 74-14-1012 Master Alarm Panel.

One (1) Chemetron 74-14-6020 Area Alarm Panel.

Five (5) Chemetron 74-14-6025 Area Alarm Panel.

One (1) Chemetron 77-83-1135 Zone Valve Box.

Two (2) Chemetron 77-83-1113 Zone Valve Box.

One (1 Lot) Chemetron 77-03-0002. -0003. -0004. -0005. -0006. -0008. Ball Valve with copper extensions.

One (1 Lot) Chemetron 64-20-0001, -0002, -0005; 64-01-5001, -5002, -5003 Quick Connect Outlet Stations.

One (1 Lot) Chemetron 64-06-0001 Vacuum Slide, 86-41-9002, -9003, -9004, -9005, -9006 Check Valves, Regulators, etc.

3. Specific Contractor Task:

Contractor shall provide the services listed below:

3.1 Maintenance and inspection service shall be performed by as a minimum journeyman status as recognized by the industry with at least four (4) years experience and certified training in the inspection, testing, and maintenance of medical gases systems.

3.2 The contractor shall furnish all tools, equipment, test instruments, cleaning materials and preventive maintenance parts required. All work shall be performed to meet requirements of National Fire Protection Association NFPA 99C “Gas and Vacuum Systems”, The Joint Commission (TJC) standards, ASSE 6000 Standard and any other applicable code standards related to medical gas systems.

3.3 Work is to be performed all year-round Monday through Friday between the hours of 7:30AM and 4:00PM, exclusive of Federal holidays (New Year’s Day, Martin Luther King Day, President’s Day, Memorial Day, Juneteenth, 4th of July, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day, and Christmas Day).

3.4 The Contractor shall respond to service calls at the VA facilities no later than the following schedule:

3.4.1 Emergency Repairs: An emergency repair shall be defined as one in which any portion of the medical gas, compressed air and vacuum systems is shutdown or is inoperable due to breakdown, malfunction, fire, or any other condition determined by the Contracting Officer’s (COR) or authorized Government inspector that presents an immediate danger to personnel or threatens to impair the mission of the facility. A mechanic shall be on the site ready to service the medical gas, compressed air, and vacuum systems within one (1) hour of receiving a request for emergency service call, 24 hours a day, 7 days a week. After receiving a request for emergency service, the work shall be prosecuted continuously until the emergency situation is arrested.

3.4.2 Urgent Repairs: An urgent repair shall be defined as one in which the medical gas, compressed air and vacuum system may become inoperable due to malfunction or need for servicing or threatens to impair the mission of the facility. A mechanic shall be on the site to service the medical gas, compressed air, and vacuum systems within four (4) hours of receiving a request for urgent service, the work shall be prosecuted continuously until the urgent situation is arrested. Examples of urgent repairs includes: Medical gas system leaking seeping or weeping, power fluctuation affecting the system, or medical gas system no longer functioning.

3.4.3 System shut down/standby: The government may direct the contractor to shut down the system at its convenience to allow other Government or contract work to be performed in that area. The contractor shall be available 24 hours a day, seven days a week. The Government will provide the contractor with a 24-hour notice of shut down service. At such time, the contractor will be provided the time and date of the shut down, to include when the equipment will be back to operating status. The contractor is not required to be at the job site during the period the system is shutdown. The Contractor will be compensated for the actual time it takes to shutdown the system and the actual time it takes to turn-on the system. Standby requires the Contractor to be at the job site during specified periods, as directed by the COR. Standby may be required when system is shutdown or when other work (i.e., construction, electrical outages, etc.) may adversely affect the system. The Contractor will be compensated for the entire standby period.

3.4.4 Routine Repair: Service at the site within the next normal workday after the Contractor has been contacted for service. The work is done during regular working hours at no additional cost to the Government. Routine service calls shall be a part of the monthly service costs.

3.5 Shutdown of any portion of any system regardless of duration shall be coordinated through and approved by the VA Facilities Management/Engineering Service staff.

3.6 Contractor shall respond only to calls for service placed by the following VA personnel:

1. VA Facilities Management/Engineering Service BioMed 433-0553.

2. VA Facilities Management/Engineering Service Maintenance & Operations (M&O) section, telephone 433-0168 (M&O personnel calling in may include; Chief - M&O, M&O Foreman, M&O Support Clerk, or M&O Duty Mechanic).

3. Chief, Facilities Management/Engineering, telephone 433-0165.

4. Contracting Officer

3.7 For each visit to the facility, the contractor must log-in at the CFA mechanical room (A118) or ACC mechanical room (1-C10) or CFA Nurse Station B, both upon arrival and prior to departure. This procedure is mandatory and the listed phone numbers above are for informational purposes only. At the end of each month, log-in sheets and checklists are to be turned in to the M&O Office located in E-Wing, room 1-C107A.

3.8 Contractor shall provide all resources required in performing these maintenance services and inspections, including, but not limited to, parts, materials, cleaning fluids, equipment, tools, shipping, travel, and labor. Contractor is responsible to determine the nature and extent of any work required to restore equipment to satisfactory condition and operation as determined by the VA, replacing parts if conditions warrant. All service, maintenance, inspections and testing will be in accordance with attachments (A) through (D) and manufacture/contractors’ standards whichever are more stringent.

3.9 Contractor will certify the system annually in accordance with NFPA 99 standards, which includes calibration of all gauges and affixing a seal, certifying the date of calibration.

3.10 Where the VA gives specific maintenance procedures or guidelines, Contractor shall perform in accordance with these guidelines, in addition to industry guidelines. If the VA does not give a specific procedure, the manufacturer recommended preventive maintenance (PM) procedure as described in the official service manual will be followed, and the Contractor shall submit a detailed description of the procedure to be followed in performance of preventive maintenance (PM).

3.11 Contractor in accordance with Department of Veterans Affairs policies and procedures shall complete documentation of all preventive maintenance and repair for Joint Commission Environment of Care Accreditation standards. Any additional documentation required in preparation for a The Joint Commission (JC) inspections shall be provided by the contractor at no additional cost to the government.

3.12 Any service required which the Contractor believes to be in excess of the contract provisions and required additional payment must not be performed without, prior, authorization from the Contracting Officer or Facilities Management/Engineering contact office, which will arrange a separate purchase order to pay for the additional service, if decide by the VA.

3.13 Contractor shall observe check-in/out procedures by “Signing In and Out”, so that the VA will be aware of the Contractor’s presence at the facility at all times. Upon each departure, Contractor shall serve notice of disposition of work to the Engineering contact office.

3.14 Contractor shall have a comprehensive inventory of parts and components for all equipment covered under contract, immediately, available for necessary repairs in order to limit equipment downtime.

3.15 Payment will be made in arrears of the specified billing period after receipt of a properly prepared invoice, provided all required work, including preventive maintenance, has been performed in accordance with contract.

3.16The Contractor shall obtain all necessary licenses and/or permits required to perform this work.

3.17 Contractor shall take all precautions necessary to protect persons and property from injury or damage during the performance of this contract. Contractor shall be responsible for any injury to any Contractor’s representative, or others, as well as, for any damage to personal or public property that occurs during the performance of this contract that is caused by the Contractor’s fault or negligence.

3.18 Contractor shall be responsible for monitoring the supply levels of the medical oxygen system at both buildings.

3.18.1 This responsibility includes: Change out of empty "H" oxygen cylinders on the supply manifolds as needed or as called by staff at CFA and ACC reporting Low Oxygen Supply.

3.18.2 Included with cylinder change is testing each tank for oxygen purity, replacing empty cylinders to its location in the cage and securing full cylinders to the manifold. VA will supply full oxygen cylinders and ensure ample supply is available when changes are required. This service must be available 24/7, holidays included. Transporting cylinders between ACC manifold and storage area must be done with a cylinder transport truck, provided by the contractor.

3.18.3 Contractor will notify the VA representative with adjustments to medical oxygen cylinder deliveries, if the supply reaches dangerously low levels. If necessary, the Contractor will provide medical oxygen cylinders (type “H”) should an emergency arise due to high unforeseen usage, or the inability of the normal medical oxygen supply vendor to provide an adequate supply. These type “H” medical oxygen cylinders will be billed separately if the emergency arises.

3.19 Requirements related to the Joint Commission (JC): The Contractor shall meet and/or exceed the requirements set forth by the Joint Commission, Management of the Environment of Care standards (EC) and other related documentation required by the VA facility.

3.19.1 Environment of Care standard EC.7.50 The organization maintains, tests, and inspects its medical gas and vacuum systems.

Elements of performance for EC.7.50

1. The organization inspects, tests, and maintains critical components of piped medical gas systems including master signal panels, area alarms, automatic pressure switches, shutoff valves, flexible connectors, and outlets.

2. The organization test piped medical gas and vacuum systems when the systems are installed, modified, or repaired, including cross-connection testing, piping purity testing, and pressure testing.

3. The organization maintains the main supply valve and area shut-off valves of piped medical gas and vacuum systems to be accessible and clearly labeled.

3.20 Documentation requirements

Monthly: Daily logs of previous month’s medical gas system readings.

Any incident reports pertaining to unexpected breakdown/failure of medical gas system components.

Quarterly: Preventive maintenance and repairs logs/reports of previous quarter, including semi-annual and annual logs/reports that were performed during that quarter.

Semi-annual: Update of medical gas system binder, which includes layout of emergency shutoff valves, rooms served, alarm panel locations.

Record of training of staff at respective sites (Center for Aging, Ambulatory Care Clinic).

Preventive maintenance and repair history on major equipment components.

VISN 21 90 CCA

Contractor Personnel Security Requirements

Reference:

VHA Directive 0710, Personnel Security and Suitability Program/ October 11, 2018 VA Handbook 0710, Personnel Suitability and Security Program/ May 2, 2016

Upon contract award, all key personnel shall be subject to the appropriate type of background investigation or screening per VA/VHA directive 0710 and must receive a favorable adjudication from CCA Personnel Security Specialist or VA Security and Investigations Center (SIC) depending on investigation or screening required. This requirement is applicable to all subcontract personnel. If the investigation or screening is not completed prior to the start date of the contract, the Contractor will be responsible for the actions of those individuals they provide to perform work for VA.

Contract personnel who previously received a favorable adjudication as a result of a Government background investigation or screening may be exempt from this contract requirement. They must provide documentation to support the previous adjudication. Proof of previous adjudication must be submitted by the Contractor to the VA Contracting Officer. Proof of previous adjudication is subject to verification. Some positions maybe subject to periodic re-investigation/screening.

1. Position Risk/Sensitivity – For all positions required under this contract, the position risk/sensitivity has been designated as: High Risk, Medium Risk, or Low Risk

2. Background Investigation/Screening –It is anticipated that the Contractor or contract personnel will be providing services at a VA facility(s) for MORE than 180 days under a single contract or series of contracts, or have access to VA computer data systems, the background investigation/screening commensurate with the requirements of this contract is: BI, MBI OR NACI

3. Contractor Responsibilities

a. The Contractor shall prescreen all personnel to ensure they are able to read, write, speak, and understand the English language.

b. The Contractor shall submit or have their contract personnel submit the following required forms to the Personnel Security Specialist or VA Contracting Officer, through the COR, within five (5) business days of contract award

Low Risk Investigative Requirements

i. Standard Form 85, Questionnaire for Non-Sensitive Positions

ii. Standard Form 86A, Continuation Sheet for Questionnaires Iii. Optional Form 306, Declaration for Federal Employment (This form will only be used to record an applicant’s responses, not for Federal employment purposes) Iv. Electronic Fingerprint Verification or FD 258, U.S. Department of Justice Fingerprint Applicant Chart

All forms are located on the VA Background Investigations for Contractors http://www1.va.gov/VABackground_Investigations/page.cfm?pg=2

Prior to completing the required forms, contract personnel should review the Common Errors on NACI Security Questionnaires, Example_SF85, Example_OF306, and General Questions and Answers about OPM background Investigation. This information is located on the web site above. Incomplete forms will be rejected and could result in a delay of work under the contract.

c. Once the items requested in paragraph 3. b. above are received, VA will pre-screen these items for completeness, and forward them to the appropriate party(s) in order to initiate the required background investigation(s) or screening(s) within fourteen (14) calendar days of appointment. Only after the VA Contracting Officer or Personnel Security Specialist notifies the Contractor that the background investigation(s) or screening(s) was initiated shall the Contractor be authorized to provide services under the contract. As previously stated, if the investigation or screening is not completed prior to the start date of the contract, the Contractor will be responsible for the actions of those individuals they provide to perform work for VA.

d. The Contractor, when notified of an unfavorable determination by the Government, shall withdraw the contract person from consideration of working under the contract.

e. Failure to comply with these Contractor personnel security requirements may result in termination of the contract for default.

4. Government Responsibilities

a. The VA Contracting Officer will ensure a time for contract personnel to complete the fingerprint portion of this requirement, if any, and the COR will responsible for performing any duties assigned by the VA Contracting Officer with regard to fulfilling the Contractor personnel security requirements described herein.

b. Upon receipt, the local VA facility or VA SIC, depending on the type of investigation/screening required, will review the accuracy of the items requested in paragraph 3. b. above and forward these items to OPM to conduct their portion of the background investigation or screening, as applicable.

c. The requesting VA facility will pay for any portion of the investigation or screening conducted by OPM, if any.

d. Depending on the type of investigation/screening required, the Personnel Security Specialist, or VA SIC will notify the VA Contracting Officer of the adjudicating results of the background investigation or screening.

e. The VA Contracting Officer and Personnel Security Specialist will ensure that the required investigations or screening have been completed or are in the process of being requested.

Personnel Identity Verification (PIV) of Contractor Personnel

In accordance with FAR 52.204-9 and VA Directive 0735 – Personal Identity Verification of Federal Employees and Contractors, any contract person who requires routine physical access to a Federally-controlled facility and/or routine access to a Federally-controlled information system will be required to verify their identity prior to providing services under the contract. Prior to providing services under the contract, each contract person will be asked to provide two (2) forms of identification from the Accepted Identification Documentation List to the appropriate VA representative in order to obtain a proper VA-issued identification card. See the Accepted Identification Documentation List provided below. The COR, or designee, will be responsible for sponsoring each contract person that requires a VA-issued identification card.

PIV ID Proofing Criteria

The following criteria must be met by all VA employees, contractors, and affiliates prior to being issued a PIV card.

Continued Next Page

Table of Accepted Identification (From Form I-9) Last Update: January 7, 2008

1. Two forms of identification are required from the above list of acceptable documents. Either of the following is accepted:

a. Two forms of identification from the left column (Federal or State Government issued picture ID).

b. One form of identification from the left column (Federal or State Government issued picture ID) and one form from the right column (Non-Picture ID or Acceptable Picture ID not issued by Federal or State Government).

2. Two forms of identification are required from the above list of acceptable documents. Either of the following is accepted:

c. Two forms of identification from the left column (Federal or State Government issued picture ID).

d. One form of identification from the left column (Federal or State Government issued picture ID) and one form from the right column (Non-Picture ID or Acceptable Picture ID not issued by Federal or State Government).

3. The following rules apply for form identification:

a. Any form of identification used for ID proofing may not be expired (except U.S. Passport)

b. Department of Veterans Affairs site/facility badges are not accepted as a valid form of identification.

c. VA PIV Cards are federally issued ID cards and can be used as a valid form of identification.

d. Handwritten, or photocopied documents are not accepted.

e. An ID issued before a legal name change (e.g., birth certificate or driver's license) can be presented as one form of ID if a legal document (e.g., marriage certificate/license or a court order) is also presented linking the previous name to the current legal name. The linking document has to display both the former and current legal names. Both documents must be valid and not expired (except U.S Passport). For example, a married woman may use both a certified copy of her birth certificate displaying her maiden name and a driver’s license displaying her married name as the 2 forms of ID compliant with PIV Guidelines, as long as she provides a marriage license displaying both her maiden name and married name.

f. The Applicant’s name listed on the VA PIV Registration Portal, Request for One-VA Identification Card, must match the name on one of the IDs presented by the Applicant.

g. The names on both forms of ID presented for ID proofing must match exactly. If one form of ID has a middle name or initial, the other form of ID must have a matching middle name or initial. One form can contain a middle name and the other can have a middle initial as long as they match. ALL names must be accounted for on both forms of ID. Please see the acceptable and unacceptable ID proofing examples provided below.

ACCEPTABLE NAME VARIATIONS

ID # 1 – John Henry Smith; ID # 2 – John Henry Smith

ID # 1 – John H. Smith; ID # 2 – John H. Smith

ID # 1 – John Henry Smith; ID # 2 – John H. Smith

UNACCEPTABLE NAME VARIATIONS

ID # 1 – John Henry Smith; ID # 2 – John Smith

ID # 1 – John H. Smith; ID # 2 – John Smith

Access to and Safeguard of VA Information/Computer Systems

a. VA may provide contract personnel with access to VISTA and general files maintained on VA computer systems. Sharing of these access codes or misuse of VA information/computer systems is a Federal crime. When contract personnel no longer provide services to VA, the Contractor shall immediately inform the COR to deactivated their access. The COR is responsible for deactivation.

b. Computer access will require VA Cyber Security Awareness Training annually and acknowledge all agreements prior to access. (See attachment for security requirements). The COR is responsible for ensuring and documenting this requirement.

c. Contract personnel with Computer access will take necessary precautions to safeguard information and prevent disclosures. If contract personnel suspect a compromised, they will report such knowledge to the COR that same day.

d. Remotely access will require prior approval from Information Security Officer (ISO).

e. The Contractor shall make its internal policies and practices regarding the safeguarding medical electronic information available to VA. Contractors are not authorized to employ a lesser requirement then what is established by this document.

g. Any changes in the VA directives governing the during the term of this contract, shall be deemed to be incorporated into this contract.

MAINTENANCE FOR MEDICAL OXYGEN SYSTEM

Medical Oxygen System:

Daily:

· Read contents of oxygen manifolds (in use and reserve) and record supply on daily log.

· Read pressure gages for the oxygen manifolds and record readings on daily log. Investigate and correct any variations in supply pressure from the normal manifold system operating pressure range.

· Read pressure gage on main line and record on daily log. Investigate and correct any variation in main line pressure from the normal operating range, due to regular malfunction or other problems.

· Read pressure gages on reserve supply system and record readings on daily log. Investigate and correct any variation in reserve supply system from the normal operating range.

· Read oxygen pressure gages at all area alarm panel locations and record readings on daily log. Investigate and correct any variation in line pressure from the normal operating range.

· Check that oxygen cylinders, valves, regulators, gages, and fittings are free of contact with oil, grease, organic lubricants, or other materials of an organic nature. Clean equipment of all such contamination, as required.

· Inspect bulk storage supply, cylinders, manifold control unit, and main supply piping for audible leaks. Repair, as required.

Monthly:

· Test audible and visual signals of reserve-in-use warning signals for proper operation. Repair, as necessary.

· Inspect bulk storage supply, cylinders, manifolds, manifold control units, and main supply piping for leakage by bubble test solution or other affective means of safe detection for use with oxygen. Repair or replace components, as required.

Medical Oxygen System:

Annually:

· Test operation of the liquid level low warning signal.

· Test operation of the reserve-in-use warning signal and actuating switch for the reserve supply.

· Test operation of the reserve low warning signal and actuating switch for the reserve supply.

· Test operation of the pressure high/low and pressure switch for the oxygen piping system by raising and lowering the system pressure with the regulators.

· Perform inspection and calibration of oxygen regulators. Work shall include unit inspection, calibration and any parts replacement to keep equipment in optimal operating condition. Inspection/calibration stickers are required on each individual unit and are to include date of inspection/calibration and next due date.

MAINTENANCE FOR MEDICAL AIR SYSTEMS

Daily:

· Read compressor discharge pressure gages and record on log. Repair compressors or pressure switch if abnormal pressure conditions are detected.

· Check that pressure switches operate within desired limit and readjust, as necessary.

· Check for proper alteration of compressors by the control system.

· Check belts for proper tension and slippage, Adjust, as required.

· Check compressor for excessive start/stop cycling and adjust or repair, as required.

· Check compressor for excessive noise, heat, or vibration from the compressors and motors, repair accordingly.

· Check receiver for excessive accumulation of moisture. Drain air receiver.

· Drain reservoirs and verify that automatic traps are working properly.

· Check for pressure drop across air filters and replace or clean, as necessary.

· Read inlet and outlet pressures of pressure regulator. Fix or adjust regulator, as necessary, if pressures are above or below the normal operating range.

· Record desiccant air dryer gages on daily log and fix or repair desiccant air dryer if readings are abnormal.

· Check desiccant air dryer for proper operating/cycling and fix or repair air dryer if not working within normal operating modes.

· Record refrigerant air dryer gages on daily log and fix or repair air dryer if readings are abnormal.

· Check compressors, receiver, desiccant air dryers, refrigerated air dryer, air filters, air regulators and piping for audible leaks. Repair, as required.

· Read air pressure gages at all alarm panel locations and record on daily log. Investigate and repair any line pressure variations from the normal operating range.

· Check Dental air compressor operation. Inspect moisture monitor.

Monthly:

· Check belts for misalignment, tightness, excess wear. Replace or adjust, as necessary.

· Check pulley and pulley clamp screws for tightness. Replace or adjust, as necessary.

· Check for clogging of strainer and clean as necessary.

· Check operation of high temperature shutdown. Adjust or repair, as necessary.

· Inspect, check valves for free operation, excessive wear and clogging. Overhaul check valves if contamination, binding, or wear are detected.

· Verify that the compressor is running at the correct rpm or amperage and adjust, as necessary.

· Verify the operation of safety valves.

· Clean or replace intake filter, as necessary.

· Clean compressor and cooling fins, as necessary.

· Blow and clean the condenser of the refrigerated air dryer to remove any accumulated dust using compressed air.

· Check and inspect unloaded solenoid valve. Repair or replace, as necessary.

Quarterly:

· Recheck the location of the air intake to assure that if continues to be a satisfactory source of medical compressed air.

· Check refrigerant charge of refrigerated air dryer and replenish as necessary. Record on log if refrigerant has been added.

Semi-Annually:

· Check compressor bearings for wear. Lubricate or replace, as necessary.

· Check motor bearings for wear. Lubricate or replace, as necessary.

Annually:

· Lubricate compressor bearings.

· Lubricate motor bearings.

· Test operation of the pressure high/low and pressure switch for the medical air piping system by raising and lowering the system pressure with the regulators.

· Test operation of Carbon Monoxide High and Dew Point High.

· Test operation of Medical Air Compressor Malfunction.

· Test operation of Desiccant Dryer Malfunction.

· Test operation of Discharge High Air Temperature.

· Check intake filters for Dental air compressor. Clean or replace as required.

· Change/replace intake filters for dental air compressor.

· Perform inspection and calibration of medical air regulators. Work shall include unit inspection, calibration and any parts replacement to keep equipment in optimal operating condition. Inspection/calibration stickers are required on each individual unit and are to include date of inspection/calibration and next due date.

· Replace the cartridge for the Amalgam Separator.

MAINTENANCE FOR MEDICAL VACUUM SYSTEMS

Daily:

· Read vacuum suction pressure gages and record on log. Repair vacuum pump or vacuum switch if abnormal conditions are detected.

· Check that pressure switches operate within desired limits and readjust, as necessary.

· Check for proper alteration of compressors by the control system.

· Check vacuum pumps for excessive start/stop cycling and adjust and repair, as needed.

· Check discharge piping for obstruction and clear, as necessary.

· Check pumps for oil leaks. Investigate and repair oil leak, as necessary.

· Check oil level in crankcase and add oil, if necessary, to bring level to the full mark. Record on log if oil has been added.

· Read vacuum gage in inlet piping. Investigate and clear obstructions if readings are higher than obtained at the work or process area.

· Check process piping for leaks and/or malfunction valves.

· Check for excessive noise, heat, or vibration from the vacuum pumps and motors and repair accordingly.

· Read vacuum pressure gages at all alarm panel locations and record on daily log. Investigate and repair any line pressure variations from the normal operating range.

· Check Dental oral evacuation pumps for proper operation.

· Clean Dental oral evacuation lines as needed. Check and clean in-line filter.

· Clean solids collector on Dental oral evacuation unit weekly.

· Alternate operation of Dental oral evacuation pumps on every other day schedule so that the pumps are used evenly.

· Inspect Dental - Amalgam Separator collection container.

· Change the collection container (when full or once every 12 months, whichever comes first).

· Check operation of the vacuum pump.

· Check all flexible hose for kinks, breaks, or loose clamps.

· Check all connections for breaks or cracks.

· Listen for vacuum leaks.

Monthly:

· Check couples for misalignment, tightness, or excess wear. Replace or adjust, as necessary.

· Check for clogging of strainer and clean, as necessary.

· Verify that the vacuum pumps are running at the correct rpm or amperage and adjust, as necessary.

· Clean pump and cooling fins, as necessary.

Quarterly:

· Perform oil change by draining crankcase of old oil and refill with new oil, as recommend by the manufacturer.

Semi-Annually:

· Checks pump bearings for wear. Lubricate or replace, as necessary.

· Check motor bearings for wear. Lubricate or replace, as necessary.

Annually:

· Lubricate compressor bearings.

· Lubricate motor bearings.

· Test operation of Vacuum Low and pressure switch for the vacuum piping system.

· Test operation of Vacuum Pump Malfunction.

· Perform inspection and calibration of continuous suction regulators. Work shall include unit inspection, calibration and any parts replacement to keep equipment in optimal operating condition. Inspection/calibration stickers are required on each individual unit and are to include date of inspection/calibration and next due date.

· Certify the operation of Amalgam Separator to include the waste handling and disposal.

MAINTENANCE FOR MEDICAL GAS ALARM SYSTEM

Daily:

· Activate all audible and visual signals on the medical gas alarms using the test indicator. Replace defective alarm modules, as required. Inspect all piping and wiring connections and tighten, as required.

Monthly:

· Emergency Shut-Off Valves:

· Check shut-off valve and pressure gages for external leakage by bubble test solution or other affective means of detection safe for use with oxygen. Repair or replace defective valves, as required. Verify operation of valves by closing and reopening rapidly to avoid disruption of service to the end-use connections.

Semi-Annually:

· End-User Connections:

· Perform semi-annual inspection of all end-user connections. Schedule inspections and testing of end-user connections to avoid interruption of service to hospital activities. The Contractor shall notify the COR of any outlets that cannot be inspected at the time of the scheduled maintenance. The COR shall reschedule the inspection of the outlets for a time approved by the clinical staff.

· Clean all exposed parts. Clean faceplates and other exposed areas with a cloth dampened with water and/or common on hospital disinfectant. Do not use oil or grease on or near outlets.

· Use appropriate adapters to check for proper operation of outlets. Repair quick-disconnect outlet stations if binding, looseness, or other malfunction is detected.

· Check for audible leakage around the outlets without the adapter and repair, as required.

· Check oxygen and medical air pressures at each connection. Investigate and repair any variation in pressure from the normal operating ranges.

· Measure the free airflow into each vacuum inlet terminal while simultaneously checking the vacuum level. Investigate and repair any variation in vacuum pressure and flow from the normal operating range.

SECONDARY EQUIPMENT TESTING

Regulators and Flowmeters:

Annually:

· Clean and test all flowmeters and regulators provided by staff and generate reports identifying each equipment status.

PERSONNEL TRAINING FOR EMERGENCY PROCEDURES

Semi-annually:

· Provide equipment training to medical personnel in the operation of and emergency shut-off valves for the medical gas systems during emergency or disaster occurrence.

NARA Records Management Language for Contracts (May 2017):

https://www.archives.gov/records-mgmt/handbook/records-mgmt-language.html

RECORDS MANAGEMENT OBLIGATIONS

A. Applicability

This clause applies to all Contractors whose employees create, work with, or otherwise handle Federal records, as defined in Section B, regardless of the medium in which the record exists.

B. Definitions

“Federal Record” as defined in 44 U.S.C. § 3301, includes all recorded information, regardless of form or characteristics, made or received by a Federal agency under Federal law or in connection with the transaction of public business and preserved or appropriate for preservation by that agency or its legitimate successor as evidence of the organization, functions, policies, decisions, procedures, operations, or other activities of the United States Government or because of the informational value of data in them.

The term Federal record:

1. includes [Agency] records.

2. does not include personal materials.

3. applies to records created, received, or maintained by Contractors pursuant to their [Agency] contract.

4. may include deliverables and documentation associated with deliverables.

C. Requirements

The following standard Items relate to records generated in executing this contract and should be included in a typical contract where records could possibly be created, maintained or dispositioned:

1. 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.

2. 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.

3. 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.

4. VAPIHCS 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 VAPIHCS 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 VAPIHCS. The agency must report promptly to NARA in accordance with 36 CFR 1230.

5. 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 vehicle]. 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 VAPIHCS 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).

6. 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 VAPIHCS guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

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

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

9. 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.

10. The VAPIHCS 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 VAPIHCS 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.

11. Training. All Contractor employees assigned…