36C26319Q0054-008.doc

Quality Assurance Surveillance Plan (QASP) For: Minneapolis HCS Legionella Sampling and Dental Waterline Sampling Contract

Contract Number:

Contract Description: The contract is for the collection and analysis of water samples for the possible presence of Legionella. The contract is also for the supplies for collection of dental waterline samples and for the analysis of dental waterline samples for heterotropic water bacteria; collection of dental waterline samples will also be required at some dental clinics.

Contractor’s name: ______________________

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

· What will be monitored.

· How monitoring will take place.

· Who will conduct the monitoring.

· How monitoring efforts and results will be documented.

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document,” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. Government Roles and Responsibilities

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: _______________________ NCO 23 Black Hills VA Contracting Office Organization or Agency: VA Midwest Health Care Network (VISN 23)

b. Contracting Officer’s Technical Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COTR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned COR: Tim Darnell, COR, Engineering Tech

1. Other Key Government Personnel – Health Care System Points of Contact and Dental Office Points of Contact for sampling and for distribution of Dental waterline sampling equipment.

3. Contractor Representatives The following employees of the contractor serve as the contractor’s program manager for this contract.

a. Program Manager –

b. Other Contractor Personnel -

4. Performance Standards Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets, or does not meet these standards.

The Performance Requirements Summary Matrix, paragraph 3 in the Performance Work Statement (PWS), includes performance standards. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

Disincentives

The Government shall use past performance as incentives. Incentives shall be based on exceeding, meeting, or not meeting performance standards.

6. Methods of QA Surveillance Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

a. DIRECT OBSERVATION. (Can be performed periodically or through 100% surveillance). Health Care System Points of Contact, Dental Office Points of Contact, and Tim Darnell will complete direct observation.

b. 100% INSPECTION. (Evaluates all outcomes). Tim Darnell will evaluate and monitor all aspects of the contract. Health Care System Points of Contact and Dental Office Points of Contact will evaluate and monitor the aspects of the contract as they relate to their respective facilities.

7. Ratings Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used: Observation and inspection to be completed by

8. DOCUMENTING PERFORMANCE

a. Acceptable Performance The Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action.

b. Unacceptable performance When unacceptable performance occurs, the COR shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case, the COR shall document the discussion and place it in the COR file.

When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the contractor's program manager.

The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has until to present this corrective action plan to the COR. The Government shall review the contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

9. Frequency of Measurement

a. Frequency of Measurement.

During contract performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed.

b. Frequency of Performance Assessment Meetings.

The COR shall meet with the contractor on a frequent basis to assess performance and shall provide a written assessment.

Signature: Contractor Program Manager

Signature: Contracting Officer’s Representative (COR) Health Care System Points of Contact, Dental Office Points of Contact, and the COR will conduct observation and inspection.