36C26322Q0723.docx

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

36C26322Q0723 07-13-2022 Jeffrey Brown Jeffrey.Brown8@va.gov 08-07-2022

5:00 PM

CDT

36C263 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul

MN

55101 X 238290 $16.5 Million N/A X Department of Veterans Affairs Fargo VA Medical Center 2101 Elm St N Fargo

ND

58102 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul

MN

55101

Y Department of Veterans Affairs Financial Services Center PO Box 149971 Austin

TX

78714-9971 See CONTINUATION Page This acquisition is for Elevator Maintenance and Inspection at the Fargo VAMC as defined per the Statement of Work and Maintenance Schedule below.

Emergency repair services included, 24 hours a day, 7 days per week including holidays.

Prior to submitting a quote, please review all documentation within.

Review and follow INSTRUCTIONS TO OFFERORS in Clause 52.212-1 Addendum.

$0.00 See CONTINUATION Page X X X Donald Gilbert 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 36C263 Donald Gilbert Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

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.

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

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Provide Elevator/Cartlift maintenance in accordance with the Statement of Work.

Contract Period: Base POP Begin: 09-01-2022 POP End: 08-31-2023 PRINCIPAL NAICS CODE: 238290 - Other Building Equipment Contractors PRODUCT/SERVICE CODE: J039 - Maintenance, Repair, and Rebuilding of Equipment - Materials Handling Equipment

Provide Elevator/Cartlift maintenance in accordance with the Statement of Work.

Contract Period: Option 1 POP Begin: 09-01-2023 POP End: 08-31-2024

PRODUCT/SERVICE CODE: J039 - Maintenance, Repair, and Rebuilding of Equipment - Materials Handling Equipment

Provide Elevator/Cartlift maintenance in accordance with the Statement of Work.

Contract Period: Option 2 POP Begin: 09-01-2024 POP End: 08-31-2025

PRODUCT/SERVICE CODE: J039 - Maintenance, Repair, and Rebuilding of Equipment - Materials Handling Equipment

Provide Elevator/Cartlift maintenance in accordance with the Statement of Work.

Contract Period: Option 3 POP Begin: 09-01-2025 POP End: 08-31-2026

PRODUCT/SERVICE CODE: J039 - Maintenance, Repair, and Rebuilding of Equipment - Materials Handling Equipment

Provide Elevator/Cartlift maintenance in accordance with the Statement of Work.

Contract Period: Option 4 POP Begin: 09-01-2026 POP End: 08-31-2027

PRODUCT/SERVICE CODE: J039 - Maintenance, Repair, and Rebuilding of Equipment - Materials Handling Equipment

B.3 Price Schedule

This Price Schedule will be utilized to generate an annual cost to fulfill the requirements in the Statement of Work. Work will be completed by qualified Elevator Mechanics and performed in compliance with the requirements in the Statement of Work.

CLIN 0001 Base Year

Quantity Unit Each Total Price

TOTAL

CLIN 1001 Option 1

Quantity Unit Each Total Price

TOTAL

CLIN 2001 Option 2

Quantity Unit Each Total Price

TOTAL

CLIN 3001 Option 3

Quantity Unit Each Total Price

TOTAL

CLIN 4001 Option 4

Quantity Unit Each Total Price

TOTAL

36C26322Q0723

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B.4 STATEMENT OF WORK

Requirements Provide Elevator/Cartlift maintenance services at the VA Medical Center, Fargo, North Dakota. Maintain and keep elevators at originally specified performance levels, providing all parts, labor and equipment necessary to fully maintain, inspect, test and repair all elevators/cartlifts in accordance with all terms, conditions, provisions, specifications and Schedule of Elevators in this Statement of Work to include preventive maintenance services. Perform emergency repair services 24 hours per day, 7 days per week including holidays.

Elevator Inspections are as follows:

FY2023, 2024, 2025, 2026, 2027

Schedule I - Schedule of Items - Base Year

Controls on 6/18/2010

Description / Specifications / Work Statement

1. SCOPE OF WORK

(a) Contractor will provide full maintenance to include emergency call-back service and repair including regular and systematic inspection of each of the elevators listed in the Schedule of Items.

(b) The Contractor shall accomplish all work needed to troubleshoot, clean, lubricate, test, adjust, repair, dismantle, assemble to provide upkeep of the elevators with all repairs and replacements needed to maintain the elevators in accordance with ANSI A17 unless otherwise excluded in these specifications.

(c) All equipment, materials and installations shall conform to the following codes:

1. The American National Standard Safety Code for Elevators, Dumbwaiters, Escalators and Moving Walls, ANSI A17.1-1990 or latest edition.

2. American Standard Practice for Inspection of elevators, Inspectors Manual A17.2-1988 or latest edition.

(d) Contractor shall, at his expense, determine the nature and extent of any work or maintenance required to maintain elevators to operate at originally specified performance level and restore the elevators to satisfactory service, shall accomplish all such work required including but not limited to a thorough check of and replacement of safeties, car hatchways, accessories in pits to include lighting in the elevator pits, relays, contacts, contact leads, switches, selectors or associated parts, Including all/any items listed following inspections, except as excluded items listed under paragraph 1. (g) of this Section. Hoist and governor ropes are to be maintained under preventive maintenance standards and replaced as required.

(e) Contractor shall provide one (1) elevator mechanic to be present at safety inspections conducted by separate Inspection Contractor. Maintenance Contractor’s mechanic will perform the tests required on buffers, safeties, governors, normal and final terminal stopping devices, emergency operation, emergency power operation, and door closing force. The above applies to semi-annual, annual and/or 5-year tests. Maintenance Contractor shall provide necessary weights and other accessories required during inspections.

(f) Contractor is responsible for making all repairs and adjustments that safety inspecting Contractor deems necessary for compliance with elevator codes. All said repairs and adjustments shall be accomplished within thirty (30) calendar days after receipt of written notification by the VA that such repairs and adjustments are necessary.

(g) Contractor SHALL NOT:

1. Supply and replace incandescent or fluorescent lamps for car light fixtures;

2. Supply and replace floor covering on elevator car platform; or clean and refinish car interiors and hoistway doors or frames;

3. Install without purchase order authority, new attachments as may be recommended or directed by inspection firms or by Federal, State, Municipal or other Government authorities;

4. Replace or make repairs to main line switches, circuit breakers, or fuses;

5. Repair underground leaks of hydraulic elevators. Leaks underground shall be reported in writing to the Engineering Chief. Repairs will be accomplished by a separate contract;

2. MAINTENANCE INSPECTIONS:

(a) All passenger and service Gear or Traction type elevators shall be cleaned and inspected monthly.

1. All passenger and service (hydraulic type) elevators shall be cleaned and inspected Quarterly.

(b) All cartlifts and dumbwaiters shall be cleaned and inspected bi-annually.

(c) The Contractor shall check in with M&R supervisor and checkout and be certified by the completion of the inspections and providing written service reports to the Engineering Service Maintenance Supervisor.

(d) A maintenance logbook shall be filled out each visit by the elevator repairman and kept in each elevator equipment room.

3. CLEANING, LUBRICATION AND ADJUSTMENT SERVICE: When and as required, in accordance with elevator manufacturer’s requirements, the machines, ropes, brakes, motors, generators, controllers, relay panels, selectors, leveling devices, operating devices, switches on car and hoistway, hoistway door and car door or gate operating device, interlocks and contact guide shoes, or roller guides, guide grooves in hoistway and car door sills, hangers for all doors and car doors or gates, signal system, car safety device, governors, tension frames and sheaves in pit shall be cleaned, lubricated and adjusted. Contractor must furnish all lubricants, cleaning materials and parts as required. During shutdown of elevators for cleaning, lubrication and adjustment, signs must be posted at each floor to inform personnel that elevator is down for repairs. Contractor must coordinate with facility Engineering Service for shutdown(s) and day/time of shutdown(s).

4. CLEANING SERVICES: All parts, equipment, guide rails, sheaves and beams, counterweight frames, top of cars, bottom of platform, hatchways, pits and machine room floors shall be kept clean. Contractor shall clean, remove dirt, lint, excessive grease on or about the elevators, machine, motors, motor generator (MG) sets, controls and associated elevator equipment and accessories. Car tops and pits are to be cleaned at least each time the elevator is inspected, serviced or repaired. Pit cleaning will include removal of rubbish, debris, spillage, and drippings. Contractor shall coordinate day/time with the Engineering Officer, or his designee, for scheduled pit cleaning. Contractor shall furnish all necessary cleaning supplies, i. e., rags, vacuum cleaner, etc. Contractor shall wipe down all machinery and keep it free of dust. Oil rags will be placed in metal/sealed holding containers which shall be removed from the premises and disposed of when full.

5. LUBRICATION SERVICES: All sheave, machine, and motor bearing and hoisting ropes shall be lubricated, machine stuffing box and bearings on motor operated brakes shall be repacked and gear cases and guide lubrication shall be refilled when required. Hydraulic fluid sufficient to maintain required operation levels shall be furnished on all hydraulic elevators.

6. ADJUSTMENT SERVICES: All hoisting ropes shall be examined quarterly, and tension equalized, and report of rope condition written in every report, as specified under Paragraph 9, Report of Service. The exterior of the machinery and any other parts of equipment, subject to rust, shall always be kept properly painted and presentable. The motor windings shall be kept free of rust where roller guides are used and properly lubricated where sliding guides are used. Guide shoe rollers and gibs shall be renewed as required to ensure smooth and satisfactory operation. All electrical wiring and conductors extending to elevators and dumbwaiters from circuit breakers or mainline switches in machine rooms and from outlets in the hoistway shall be repaired and/or replaced when required. Circuit breakers or main line switches, together with fuses for same, are excluded. When/if Contractor’s recommendation to replace hoisting ropes is approved, all hoisting ropes and governor ropes shall be replaced as required.

7. PARTS TO BE FURNISHED, INSTALLED OR REPAIRED: Contractor shall furnish and install or repair when as necessary, machine hydraulic pumps, motor generators, controllers and boards, selectors, gears, thrusts, windings, commutators, hydraulic pump belts and pulleys, hydraulic valve components and coils, circuits magnet frames, relays, contactors, control fuses, cams, car door and hoist way door hangers tracks and door guides, door operating devices, interlocks and contacts, car gates, safety devices, governors, push buttons, LED lights, annunciators, hall lanterns and indicators, lamp replacement in signal systems and all other elevator signal and accessory equipment complete. All parts shall be of the original manufacturer’s design and specification.

8. EMERGENCY CALL BACK SERVICE:

(a) Prompt emergency call back service shall be provided on site within two (2) hours in response to requests (telephone or otherwise) from the Engineering Officer or his designee in case of shutdown or any emergency trouble arising between scheduled service calls. This service shall be rendered at any hour of any day of the week at no extra charge, regardless of cause. The serviceman responding to the call must personally call the person that made the service request and confirm that he/she is enroute to the medical center. If a serviceman is not immediately available, the office receiving the call must be notifying the person that made the service request stating the length of time of delay. Contractor will be advised at that time if the service call can be deferred. If prompt response is not available, the Government reserves the right to procure services from a noncontract source and bill the excess costs to the Contractor if deemed necessary. The Government will be the sole judge in making this determination. No overtime or travel will be charged.

(b) A local contact from within a 50-mile range of the VAMC, must be made available to respond to emergency calls.

(c) The contractor shall enter below the addresses and telephone numbers of the office which will receive calls for service:

REGULAR HOURS OF BUSINESS:

Hours______________________________________________________ Address____________________________________________________ Telephone Number ___________________________________________

OTHER THAN REGULAR HOURS OF BUSINESS:

Address ____________________________________________________ Telephone Number___________________________________________

9. REPORT OF SERVICE: Upon completion of all/any services, the Contractor shall report to the Facilities Engineering Officer or his designee and a written report of services performed shall be furnished for each service call. Report shall state corrective action taken. Quarterly reports shall be submitted in January, April, July and at the end of the contract period. Reports shall list each roped elevator separately and shall be specific as to rope condition, i.e. tension, lubrication and wear.

10. RECORDS: Contractor shall maintain a complete, orderly, and chronological file including drawings, parts lists, and copies of all reports as required by these specifications. A record of all call backs and repairs shall be kept indicating any difficulty experienced and corrective measures taken to eliminate difficulties. This file shall be available for inspection upon request, and a copy of this complete file will be furnished each VAMC during the last month of the contract period.

11. HOURS OF WORK: Work required in the performance of this contract shall be performed during the medical center’s regular administrative working hours, 8:00 am to 4:30 pm weekdays. Contractor shall provide prompt emergency service 24 hours per day, seven days per week, including holidays. Upon arriving at the installation to perform services, the Contractor shall report to the Engineering Officer or his designee. (After working hours report to Boiler Plant in building 10 and call 701-239-3700 extension 3068). All work requiring the interruption of service, will require notification to and concurrence by the Engineering Officer. Interruption of service is work requiring shutdown for more than fifteen (15) minutes at any one time.

12. LOG: The Contractor shall maintain a log of services performed in the VAMC Facilities Engineering Service. The log shall list the date and time of all maintenance service and trouble calls. Each trouble call shall be fully described, including the nature of the call, necessary correction performed and/or parts replaced. The log will be kept in each elevator equipment room.

13. MAINTENANCE SERVICES: The maintenance service specified in this solicitation shall not include the performance of any work required as a result of improper use, accident, or negligence for which the Contractor is not directly responsible.

14. INSPECTION OF PREMISES: Potential offerors may inspect VAMC premises prior to submitting proposals in order to be fully aware of the scope of the services required. Failure to inspect all premises will not relieve the successful offeror from performing in accordance with the strict intent and meaning of the specifications. Appointments can be made with the following Engineering Service personnel, the Contracting Officer’s Representative (COR): Maintenance Supervisor at 701-239-3700 x 3061.

END OF STATEMENT OF WORK

NARA Records Management Language for Contracts (July 10, 2019) https://www.archives.gov/records-mgmt/policy/records-mgmt-language

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.

1. does not include personal materials.

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

1. may include deliverables and documentation associated with deliverables.

Per VHA Records Manager – Only add the line items below that pertain to the contract. (10/22/2020)

C. Requirements

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.

1. 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.

1. 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.

1. [FACILITY] 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 [FACILITY] 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 [FACILITY]. The agency must report promptly to NARA in accordance with 36 CFR 1230.

1. 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 [FACILITY] 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).

1. 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 [FACILITY] guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

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

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

1. 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.

1. The [FACILITY] 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 [FACILITY] 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.

1. Training. All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take [FACILITY]-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.

[Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.]

D. Flowdown of Requirements to Subcontractors

1. The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same.

1. Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor.

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B.5 QUALITY ASSURANCE SURVEILLANCE PLAN

For: Elevator Maintenance

Contract Number: < Upon award, Government will enter contract number>

Contract Description: Maintain, repair, and inspect elevators, lifts, and dumb waiters located throughout the Fargo VA Medical Center.

Contractor’s name: <Enter your company name.> (hereafter referred to as the contractor).

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: Christopher Volk, Department of Veterans Affairs, Fargo VA Health Care System

b. Contracting Officer’s Technical Representative (COTR) - The COTR 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 COTR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned COTR: Matthew Hanson

c. Other Key Government Personnel: Dennis Langevin (Engineering Supervisor)

3. CONTRACTOR REPRESENTATIVES

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

a. Program Manager - <Enter name.>

b. Other Contractor Personnel - <Enter name(s) or delete these lines if not applicable> Title: <Enter title(s) or delete these lines if not applicable.>

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 Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

Task

ID

Indicator

Standard

· The American National Standard Safety Code for Elevators, Dumbwaiters, Escalators, and Moving Walls, ANSI A17.1-1990 or latest edition

· American Standard Practice for Inspection of elevators, Inspector Manual A17.2-1988 or latest edition

· Performed during normal Medical Center regular administrative scheduled hours, (8:00 AM till 4:30 PM Monday through Friday except holidays)

· Customers are informed of expected repair time.

· Response and repair is made within the specified time.

· Notification of work requiring interruption of service

Submit reports or administrative requirements in accordance with the Statement of Work (SOW) Submitted at the completion of services or as required by the Statement of Work (SOW)

Available for inspection upon request, 100% of the time

Review of submitted reports / auditing date received compared to VAMC Facilities Engineer Service Log

All terms and conditions established within this contract are subject to evaluation to assess the Contractor’s level of performance

5. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COTR shall use the surveillance methods listed below in the administration of this QASP.

6. 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:

Review of Automated Reports of Performance Measure Completion, Entry of Medical Data, Clinical Information Return, Patient Satisfaction Scores and Direct Observation.

7. 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 COTR shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COTR shall document the discussion and place it in the COTR file.

When the COTR determines formal written communication is required, the COTR 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 to present this corrective action plan to the COTR. 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.

8. FREQUENCY OF MEASUREMENT

a. Frequency of Measurement.

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

b. Frequency of Performance Assessment Meetings.

The COTR may meet with the contractor quarterly to assess performance and shall provide a written assessment.

<After award, both the contractor’s Program Manager and the COTR shall sign this document.>

Signature – Contractor Program Manager

Signature – Contracting Officer’s Technical Representative

(End of Provision)

B.6 VHA Supplemental Contract Requirements for Combatting COVID-19

1. Contractor employees who work in or travel to VHA locations must comply with the following:

a. Documentation requirements:

1) If fully vaccinated, contractors shall show proof of vaccination.

i. NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS-319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

2) If unvaccinated, contractors shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test that includes an affiliated telehealth service.

3) Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Contracting Officer Representatives (CORs) or other hospital personnel.

4) Documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

2. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

a. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

3. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

1. For indefinite delivery contracts: Contractor agrees to comply with VHA Supplemental Contract Requirements for any task or delivery orders issued prior to this modification when performance has already commenced.

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the Contracting Officer (see 32.607-2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has…