36C78621Q0163 SOW List of Attachments.docx
DOCX document 2 MB Posted
- Attached to
- Fort Stevens National Cemetery Grounds Maintenance Federal contract opportunity
- Solicitation number
- 36C78621Q0163
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Clatsop WD 2015-5577 rev 14.docx | DOCX document | |
| Subcontracting Checklist.docx | DOCX document | |
| 36C78621Q0163 Ft Stevens NC GM RFQ.docx | DOCX document |
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LIST OF ATTACHMENTS
Attachments Number of Pages
Attachment A – Diagram of Graves (For the purposes of Interments/Disinterments) 2
Attachment B – Headstone Realignment 2
Attachment C – Headstone, Marker and Niche Cover Maintenance Checklist 1
Attachment D – Pesticide Application Data Sheet 1
Attachment E – Vertebrate Pest Inspection Sheet 1
Attachment F – Site Plan of Fort Stevens National Cemetery 1
Attachment G –Fort Stevens National Cemetery Gravesite Layout Map 1
Attachment H –Contractor’s Employee Statement of Compliance 2
ATTACHMENT A – DIAGRAM OF GRAVES
FIGURE 1
ATTACHMENT B
HEADSTONE REALIGNMENT
ATTACHMENT C
HEADSTONE, MARKER AND NICHE COVER MAINTENANCE CHECKLIST (MONTHLY)
| Area/Section Inspected: |
| OK |
| Needs Attention/# |
| N/A |
| Comments |
| OAI Measure |
| Description |
Cleaning
| 4.1 |
| Headstones are clean, free of debris and objectionable accumulations |
Markers are clean, free of debris and objectionable accumulations.
Niche covers are clean, free of debris and objectionable accumulations.
Height and Alignment
| 4.2 |
| Upright headstones are at the proper height and alignment |
Flat markers are at the proper height and alignment
Niche covers are at the proper height and alignment.
Condition
| 4.4 |
| Headstone, marker and niche cover inscriptions are visible and legible as appropriate for the age and historic significance of the marker. |
| 4.5 |
| Damaged and defaced headstones markers, and niche covers have been identified and action taken to replace or repair them. |
| 4.6 |
| Headstones, markers, and niche covers that are no longer useable are disposed of in a manner that is respectful and prevents unacceptable use. |
Signature of Inspector:
Title:
ATTACHMENT D: PESTICIDE APPLICATION DATA SHEET
| Date: |
| Applicator: |
APPLICATION SITE
Certification No.:
| Size of Treatment Area: |
| Location: |
| Description (Turf, Plant Bed, Trees): |
| Plant Age and Condition: |
| Surrounding Sensitive Areas: |
| Soil Conditions: |
| Previous Pesticides Used: |
| Personal Protective Equipment Used: |
| PEST PROBLEM |
| Primary Pest: |
| Damage Observed: |
| Other Pests Present: |
| Location of Damage: |
Beneficials Present:
Severity of Pest Problem:
| PESTICIDE(S) USED | |
| Pesticide(s): | Formulation: |
(1)
| Rate: |
| Total Amount Used: |
(2)
(3)
| Adjuvants Type: |
| Amount: |
| Total Gallons of Diluted Spray Used: |
| Surfactant Type: |
| Amount: |
| APPLICATION |
| Date(s) of Application: |
| Weather Conditions |
Temperature:
| Equipment used: |
| Cloud Cover: |
Wind Speed:
| Equipment Calibrated By: |
| Wind Direction: |
Rain:
Travel Speed:
Total Hours for Application:
Persons Notified or Spoken to Regarding Application:
(1)
(2)
(3)
| FOLLOW UP |
| Effectiveness of Application: |
| Beneficials Present: |
| Pest Resurgence Noted: |
Injury to Non-Target Plants or Surfaces:
COMMENTS
Signature & Date
ATTACHMENT E
VERTEBRATE PEST INSPECTION SHEET
Voles, Moles, Gophers, Ground Squirrels, Skunks, Racoons, Deer, Elk, Fowl, Etc.
Location of Service: Fort Stevens National Cemetery
Date of Service: ______________________
| NO. |
| CEMETERY SECTION |
| ID# OF NEAREST HEADSTONE |
| ANIMAL PEST TYPE |
| OLD OR NEW DAMAGE? |
| DATE OF DISCOVERY |
| CHEMICAL OR TRAP TREATMENT |
| DATE OF TREATMENT |
| DATE OF TURF REPAIR |
| CONTRACTOR SIGNATURE |
| COMMENTS |
ATTACHMENT F
SITE PLAN OF FORT STEVENS NATIONAL CEMETERY
ATTACHMENT G
FORT STEVENS NATIONAL CEMETERY GRAVESITE LAYOUT MAP
ATTACHMENT H
CONTRACTOR’S EMPLOYEE STATEMENT OF COMPLIANCE
| EMPLOYEE NAME: | ______________________________ |
| POSITION/TITLE: | ______________________________ |
| DATE: | ______________________________ |
Please check the appropriate blank.
| ____ | New Employee, New Contractor |
| ____ | Annual Confirmation for current Employees or Contractor(s) (Due on Nov. 1 of each Contract year or immediately after NTP.) |
FOR ALL EMPLOYEES
I have been briefed and understand the following guidance:
INITIALS
| _________ | The National Cemetery Administration honors veterans with a final resting place and lasting memorial that commemorate their service to our Nation. National Cemeteries are National Shrines. Therefore, the standards for management, maintenance, appearance and operational procedures have been established by the National Cemetery Administration to reflect this Nations’ concern and respect for those interred there. For this reason, my strict adherence to the Performance Work Statement, Performance Work Requirements Summary and Guidance Specifications shall be required and shall be essential. |
| _________ | I will remain aware of the remains buried in the grounds where work is being performed. The utmost care must be given to these remains and the headstones and flat grave markers that mark those gravesites and memorialize the service of individuals. |
| _________ | I will not walk, stand, lean, sit or jump on headstones, markers, or monuments. Nor will I drive over them. |
| _________ | I will not place or lean tools, equipment, or other items on headstones, markers, or monuments at any time. |
| _________ | I have been briefed on the approved methods and tools to remove headstones and markers from their sockets in accordance with the Contract Specifications. I will use the tools and methods approved by the Contracting Officer Representative (COR) to lift headstones and markers out of the ground in order to avoid damage; pick axes are not an acceptable tool. |
| _________ | I will not place headstones or markers on dirt piles or mud once they are removed from their sockets; in order to show appropriate respect towards the families visiting the gravesites and the remains that are buried, I will ensure headstones and markers are carefully stored on each associated gravesite and protected from damage or soiling, in accordance with Contract Specifications. |
| _________ | I understand that the Contractor shall be responsible for replacing damaged headstones and markers and for restoring turf damaged during performance of this work. |
| _________ | Should any on-site activity, incident, emergency, or disaster result in exposure and/or damage to any remains, container for remains (i.e., casket or urn), or outer burial container, I will IMMEDIATELY notify the Cemetery Director, the COR and/or the Contracting Officer; I will take immediate steps to protect and render safe any exposed remains; and stop any further work until the Cemetery Director provides the Contractor ‘s Supervisor guidance regarding disposition of the remains and permission to proceed. |
SIGNATURE BLOCK
Signature Printed Name Date
IF THIS STATEMENT IS THE EMPLOYEE’S ANNUAL COMPLIANCE STATEMENT, THIS COMPLIANCE STATEMENT MUST BE RETURNED TO THE COR BY NOVEMBER 1 OR AFTER NTP.
AS TO STATEMENTS OR COMMITMENTS OF FUTURE ACTIONS, THIS COMPLIANCE STATEMENT COVERS THE PERIOD FROM OCTOBER 1 OF THE CALENDAR YEAR DURING WHICH THIS COMPIANCE STATEMENT IS DUE THROUGH SEPTEMBER 30 OF THE NEXT CALENDAR YEAR.
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