402-21-721 Specifications.pdf

Department of Veteran Affairs

VA Maine Healthcare System, Augusta, ME

Nurse Call Upgrade

Specification

Project No.: 402-21-721

VA Maine Healthcare Systems, Augusta, ME Project No. 402-21-721

00 01 10 - 1

DEPARTMENT OF VETERANS AFFAIRS

VHA MASTER SPECIFICATIONS

VAME Nurse Call Upgrade

PROJECT #: 402-21-721

TABLE OF CONTENTS

Section 00 01 10

01 00 00 General Requirements

Att. – Blank Contractors New Equipment Form Att. – Blank Change Order Form Att. – Blank Submittal Form Att. – Blank SF1413 Form Att. – Blank VA Utility Outage Request Form

11-15

01 33 23 Shop Drawings, Product Data, and Samples 07-15 01 35 26 Safety Requirements

Att. – Sample Hot Work Permit Att. – Infection Control Construction Permit Att. – Sample Interim Life Safety Measure

(ILSM) Form Att. – Sample Fire/Smoke Barrier Penetration

Permit Att. – Blank Pre-employment Information Form Att. – Sample Confined Space Entry Permit Att. – Sample Excavation Permit

09-16

01 74 19 Construction Waste Management 09-13 07 84 00 Firestopping 02-16 07 92 00 Joint Sealants 10-15 27 52 23 Nurse Call

01 00 00 - 1

SECTION 01 00 00

GENERAL REQUIREMENTS

1.1 SAFETY REQUIREMENTS

Refer to section 01 35 26, SAFETY REQUIREMENTS for safety and infection control requirements.

1.2 GENERAL INTENTION

A. Contractor shall completely prepare site for building operations, including demolition and removal of existing structures, and furnish labor and materials and perform work for VAMC Togus, Nurse Call

Upgrades as required by the attached Scope of Work and these specifications.

B. All employees of general contractor and subcontractors shall comply with VA security management program and obtain permission of the VA police, be identified by project and employer, and restricted from unauthorized access.

1.3 STATEMENT OF BID ITEM(S)

A. Contractor shall provide a complete Nurse Call System for B200-3rd floor North and South Inpatient Wards. The work will include a complete replacement of all devices. Project will replace the existing

TekTone300 system which is obsolete and no longer serviceable with the current TekTone model P5 series system that can integrate with our existing patient beds and the newly acquired Vocera communication system.

B. Period of Performance: Work shall be completed in 120 calendar days.

1.4 CONSTRUCTION SECURITY REQUIREMENTS

A. Security Plan:

1. The security plan defines both physical and administrative security procedures that will remain effective for the entire duration of the project.

2. The General Contractor is responsible for assuring that all sub-contractors working on the project and their employees also comply with these regulations.

B. Security Procedures:

01 00 00 - 2

1. General Contractor’s employees shall not enter the project site without appropriate badge. They may also be subject to inspection of their personal effects when entering or leaving the project site.

2. Before starting work the General Contractor shall give one week’s notice to the Contracting Officer Representative so that security arrangements can be provided for the employees. This notice is separate from any notices required for utility shutdown described later in this section.

3. No photography of VA premises is allowed without written permission of the Contracting Officer Representative.

4. VA reserves the right to close down or shut down the project site and order General Contractor’s employees off the premises in the event of a national emergency. The General Contractor may return to the site only with the written approval of the Contracting Officer.

C. Key Control:

1. The General Contractor shall provide duplicate keys and lock combinations to the Contracting officers representative (COR)for the purpose of security inspections of every area of project including tool boxes and parked machines and take any emergency action.

D. Document Control:

1. The General Contractor is responsible for safekeeping of all drawings, project manual and other project information. This information shall be shared only with those with a specific need to accomplish the project.

2. All paper waste or electronic media such as CD’s and diskettes shall be shredded and destroyed in a manner acceptable to the VA.

1.5 OPERATIONS AND STORAGE AREAS

A. The Contractor shall confine all operations (including storage of materials) on Government premises to areas authorized or approved by the Contracting Officer Representative. The Contractor shall hold and save the Government, its officers and agents, free and harmless from liability of any nature occasioned by the Contractor's performance.

01 00 00 - 3

B. The Contractor shall, under regulations prescribed by the Contracting

Officer, use only established roadways, or use temporary roadways constructed by the Contractor when and as authorized by the Contracting

Officer. When materials are transported in prosecuting the work, vehicles shall not be loaded beyond the loading capacity recommended by the manufacturer of the vehicle or prescribed by any Federal, State, or local law or regulation. When it is necessary to cross curbs or sidewalks, the Contractor shall protect them from damage. The

Contractor shall repair or pay for the repair of any damaged curbs, sidewalks, or roads.

C. Working space and space available for storing materials on site shall be coordinated with the COR.

D. Workmen are subject to rules of Medical Center applicable to their conduct.

E. Execute work so as to interfere as little as possible with normal functioning of Medical Center as a whole, including operations of utility services, fire protection systems and any existing equipment, and with work being done by others. Use of equipment and tools that transmit vibrations and noises through the building structure, are not permitted in buildings that are occupied, during construction, jointly by patients or medical personnel, and Contractor's personnel, except as permitted by COR where required by limited working space.

1. Do not store materials and equipment in other than assigned areas.

2. Schedule delivery of materials and equipment to immediate construction working areas within buildings in use by Department of

Veterans Affairs in quantities sufficient for not more than two work days. Provide unobstructed access to Medical Center areas required to remain in operation.

3. Where access by Medical Center personnel to vacated portions of buildings is not required, storage of Contractor's materials and equipment will be permitted subject to fire and safety requirements.

F. Phasing:

The Medical Center must maintain its operation 24 hours a day 7 days a week. Therefore, any interruption in service must be scheduled and

01 00 00 - 4 coordinated with the COR to ensure that no lapses in operation occur.

It is the CONTRACTOR'S responsibility to develop a work plan and schedule detailing, at a minimum, the procedures to be employed, the equipment and materials to be used, the interim life safety measure to be used during the work, and a schedule defining the duration of the work with milestone subtasks.

To insure such executions, Contractor shall furnish the COR with a schedule of approximate phasing dates on which the Contractor intends to accomplish work in each specific area of site, building or portion thereof. In addition, Contractor shall notify the COR two weeks in advance of the proposed date of starting work in each specific area of site, building or portion thereof. Arrange such phasing dates to insure accomplishment of this work in successive phases mutually agreeable to

COR and Contractor, as follows:

As required, work plans must detail all utility outages required for completion of the contract. Contractor is to be responsible for field verifying the extent of the outage, what the end user can expect as a result of the utility outage, and how long the end user can expect to be without the utility. A utility outage includes but is not limited to interruptions of the following building systems: Electricity (including interruptions to emergency power), Water, Sewer, HVAC, Fire alarm, fire suppression systems, tel-data, points of egress, elevators, Medical gas, Medical Vacuum, parking spaces and road closures. Requests for utility outages must be submitted to your project COR in writing at a minimum of 14 days prior to the planned utility outage. See attached

VA Utility Outage Request Form

G. Building will be occupied during performance of work.

1. Contractor shall take all measures and provide all material necessary for protecting existing equipment and property in affected areas of construction against dust and debris, so that equipment and affected areas to be used in the Medical Centers operations will not be hindered. Contractor shall permit access to Department of

Veterans Affairs personnel and patients through other construction areas which serve as routes of access to such affected areas and equipment. These routes whether access or egress shall be isolated from the construction area by temporary partitions and have walking

01 00 00 - 5 surfaces, lighting etc to facilitate patient and staff access.

Coordinate alteration work in areas occupied by Department of

Veterans Affairs so that Medical Center operations will continue during the construction period.

a. Temporary partitions shall be provided with 2-hour fire rating, separating the work from the existing facility. Doors in temporary fire rated partitions shall be 90 minute rated.

H. Utilities Services: Maintain existing utility services for Medical

Center at all times. Provide temporary facilities, labor, materials, equipment, connections, and utilities to assure uninterrupted services.

Where necessary to cut existing med gases, oxygen, or conduits, wires, cables, etc. of utility services or of fire protection systems and communications systems (including telephone), they shall be cut and capped at suitable places where shown; or, in absence of such indication, where directed by COR.

1. No utility service such as water, med gas, oxygen, or electricity, or fire protection systems and communications systems may be interrupted without prior approval of the COR and Chief of

Facilities Management. Electrical work shall be accomplished with all affected circuits or equipment de-energized. When an electrical outage cannot be accomplished, work on any energized circuits or equipment shall not commence without a detailed work plan, the

Medical Center Director’s prior knowledge and written approval.

2. Contractor shall submit a request to interrupt any such services to

COR, in writing, 14 days in advance of proposed interruption.

Request shall state reason, date, exact time of, and approximate duration of such interruption.

3. Contractor will be advised (in writing) of approval of request, or of which other date and/or time such interruption will cause least inconvenience to operations of Medical Center. Interruption time approved by Medical Center may occur at other than Contractor's normal working hours.

4. Major interruptions of any system must be requested, in writing, at least 15 calendar days prior to the desired time and shall be performed as directed by the COR.

01 00 00 - 6

5. In case of a contract construction emergency, service will be interrupted on approval of COR. Such approval will be confirmed in writing as soon as practical.

6. Whenever it is required that a connection fee be paid to a public utility provider for new permanent service to the construction project, for such items as water, sewer, electricity, gas or steam, payment of such fee shall be the responsibility of the Government and not the Contractor.

I. Abandoned Lines: Do not abandon lines in place. Remove all branch lined for all utilities back to the trunk.

J. To minimize interference of construction activities with flow of

Medical Center traffic, comply with the following:

1. Keep roads, walks and entrances to grounds, to parking and to occupied areas of buildings clear of construction materials, debris and standing construction equipment and vehicles. Wherever excavation for new utility lines cross existing roads, at least one lane must be open to traffic at all times with approval.

2. Method and scheduling of required cutting, altering and removal of existing roads, walks and entrances must be approved by the COR.

K. Coordinate the work for this contract with other construction operations as directed by COR. This includes the scheduling of traffic and the use of roadways, as specified in Article, USE OF ROADWAYS.

1.6 DISPOSAL AND RETENTION

A. Materials and equipment accruing from work removed and from demolition of buildings or structures, or parts thereof, shall be disposed of as follows:

1. Items not reserved shall become property of the Contractor and be removed by Contractor from Medical Center.

2. Items of portable equipment and furnishings located in rooms and spaces in which work is to be done under this contract shall remain the property of the Government. When rooms and spaces are vacated by the Department of Veterans Affairs during the alteration period, such items which are NOT required to be either relocated or reused

01 00 00 - 7 will be removed by the Government in advance of work to avoid interfering with Contractor's operation.

1.7 PROTECTION OF EXISTING VEGETATION, STRUCTURES, EQUIPMENT, UTILITIES, AND

IMPROVEMENTS

A. The Contractor shall preserve and protect all structures, equipment, and vegetation (such as trees, shrubs, and grass) on or adjacent to the work site, which are not to be removed and which do not unreasonably interfere with the work required under this contract. The Contractor shall only remove trees when specifically authorized to do so, and shall avoid damaging vegetation that will remain in place. If any limbs or branches of trees are broken during contract performance, or by the careless operation of equipment, or by workmen, the Contractor shall trim those limbs or branches with a clean cut and paint the cut with a tree-pruning compound as directed by the Contracting Officer.

B. The Contractor shall protect from damage all existing improvements and utilities at or near the work site and on adjacent property of a third party, the locations of which are made known to or should be known by the Contractor. The Contractor shall repair any damage to those facilities, including those that are the property of a third party, resulting from failure to comply with the requirements of this contract or failure to exercise reasonable care in performing the work. If the

Contractor fails or refuses to repair the damage promptly, the

Contracting Officer may have the necessary work performed and charge the cost to the Contractor.

1.8 RESTORATION

A. Remove, cut, alter, replace, patch and repair existing work as necessary to install new work. Except as otherwise shown or specified, do not cut, alter or remove any structural work, and do not disturb any ducts, plumbing, steam, gas, or electric work without approval of the

COR. Existing work to be altered or extended and that is found to be defective in any way, shall be reported to the COR before it is disturbed. Materials and workmanship used in restoring work, shall conform in type and quality to that of original existing construction, except as otherwise shown or specified.

B. Upon completion of contract, deliver work complete and undamaged.

Existing work (walls, ceilings, partitions, floors, mechanical and

01 00 00 - 8 electrical work, lawns, paving, roads, walks, etc.) disturbed or removed as a result of performing required new work, shall be patched, repaired, reinstalled, or replaced with new work, and refinished and left in as good condition as existed before commencing work.

C. At Contractor's own expense, Contractor shall immediately restore to service and repair any damage caused by Contractor's workmen to existing piping and conduits, wires, cables, etc., of utility services or of fire protection systems and communications systems (including telephone) which are not scheduled for discontinuance or abandonment.

D. Expense of repairs to such utilities and systems not shown on drawings or locations of which are unknown will be covered by adjustment to contract time and price.

1.9 USE OF ROADWAYS

A. For hauling, use only established public roads and roads on Medical

Center property and, when authorized by the COR, such temporary roads which are necessary in the performance of contract work. Temporary roads shall be constructed and restoration performed by the Contractor at Contractor's expense. When necessary to cross curbing, sidewalks, or similar construction, they must be protected by well-constructed bridges.

1.10 TEMPORARY USE OF EXISTING ELEVATORS

A. Contractor will not be allowed the use of existing elevators. Outside type hoist shall be used by Contractor for transporting materials and equipment.

1.11 TEMPORARY TOILETS

A. Provide where directed, (for use of all Contractor's workmen) ample temporary sanitary toilet accommodations with suitable sewer and water connections; or, when approved by COR, provide suitable dry closets where directed. Keep such places clean and free from flies, and all connections and appliances connected therewith are to be removed prior to completion of contract, and premises left perfectly clean.

1.12 AVAILABILITY AND USE OF UTILITY SERVICES

A. The Government shall make all reasonably required amounts of utilities available to the Contractor from existing outlets and supplies, as specified in the contract. The amount to be paid by the Contractor for

01 00 00 - 9 chargeable electrical services shall be the prevailing rates charged to the Government. The Contractor shall carefully conserve any utilities furnished without charge.

B. The Contractor, at Contractor's expense and in a workmanlike manner, in compliance with code and as satisfactory to the Contracting Officer, shall install and maintain all necessary temporary connections and distribution lines, and all meters required to measure the amount of electricity used for the purpose of determining charges. Before final acceptance of the work by the Government, the Contractor shall remove all the temporary connections, distribution lines, meters, and associated paraphernalia and repair restore the infrastructure as required.

C. Contractor shall install meters at Contractor's expense and furnish the

Medical Center a monthly record of the Contractor's usage of electricity as hereinafter specified.

1.13 INSTRUCTIONS

A. Contractor shall furnish Maintenance and Operating manuals (hard copies and electronic) and verbal instructions when required by the various sections of the specifications and as hereinafter specified.

B. Manuals: Maintenance and operating manuals and one compact disc (two hard copies and one electronic copy each) for each separate piece of equipment shall be delivered to the COR coincidental with the delivery of the equipment to the job site. Manuals shall be complete, detailed guides for the maintenance and operation of equipment. They shall include complete information necessary for starting, adjusting, maintaining in continuous operation for long periods of time and dismantling and reassembling of the complete units and sub-assembly components. Manuals shall include an index covering all component parts clearly cross-referenced to diagrams and illustrations. Illustrations shall include "exploded" views showing and identifying each separate item. Emphasis shall be placed on the use of special tools and instruments. The function of each piece of equipment, component, accessory and control shall be clearly and thoroughly explained. All necessary precautions for the operation of the equipment and the reason for each precaution shall be clearly set forth. Manuals must reference

01 00 00 - 10 the exact model, style and size of the piece of equipment and system being furnished. Manuals referencing equipment similar to but of a different model, style, and size than that furnished will not be accepted.

C. Instructions: Contractor shall provide qualified, factory-trained manufacturers' representatives to give detailed training to assigned

Department of Veterans Affairs personnel in the operation and complete maintenance for each piece of equipment. All such training will be at the job site. These requirements are more specifically detailed in the various technical sections. Instructions for different items of equipment that are component parts of a complete system, shall be given in an integrated, progressive manner. All instructors for every piece of component equipment in a system shall be available until instructions for all items included in the system have been completed.

This is to assure proper instruction in the operation of inter-related systems. All instruction periods shall be at such times as scheduled by the COR and shall be considered concluded only when the COR is satisfied in regard to complete and thorough coverage. The contractor shall submit a course outline with associated material to the COR for review and approval prior to scheduling training to ensure the subject matter covers the expectations of the VA and the contractual requirements. The Department of Veterans Affairs reserves the right to request the removal of, and substitution for, any instructor who, in the opinion of the COR, does not demonstrate sufficient qualifications in accordance with requirements for instructors above.

1.14 WARRANTY OF CONSTRUCTION

A. All work shall be warranted for a period of one year, as specified under Warranty of Construction, to be free of any defect in equipment, material, or design furnished, or workmanship performed by the

Contractor or any subcontractor or supplier at any tier.

B. Contractor shall also, as specified under Warranty, obtain all warranties that would be given in normal commercial practice executed, in writing, for the benefit of the Government.

01 00 00 - 11

1.15 ATTACHED FORMS

A. The contractor shall fill out the attached forms following this paragraph and submit them before the start of applicable work.

1. Contractor’s New Equipment Form

2. Change Order Form

3. Submittal Form

4. SF1413

5. VA Utility Outage Request Form

- - - E N D - - -

Contractor’s New Equipment Form

Equipment Name: ____________________________________

GENERAL CONTRACTOR’S NAME:___________________________

MANUFACTURER: _______________________________________

MODEL:_______________________________________________

SERIAL NUMBER: _____________________________________

LIFE EXPECTANCY [YEARS]:_____________________________

EQUIPMENT CATEGORY: _________________________________

P.O. [CONTRACT#] NO.:________________________________

VENDOR:______________________________________________

ACQ. DATE: [Install date] __________________________

WARRANTY EXPIRATION DATE:____________________________

LOCATION [Room/Building #]: _________________________

OWNERS/OPERATOR’S MANUALS SUPPLIED, (x4) Y N

COMMENTS(W):

10.0%

7.5%

5.0%

10.0%

7.5%

5.0%

10.0%

7.5%

5.0%

ON NEXT $30,000

DIRECT

OVERHEAD

(Line 8)

TOTAL DIRECT COST ►

10B

10C

3A

3C

PROJECT NO.

PROJECT LOCATION

CONTRACT NO. NAME OF PRIME CONTRACTOR

PRIME CONTRACTOR EQUIPMENT RENTAL

MECHANICAL AND HVAC

TOTAL SUBCONTRACTOR COST ►

ELECTRICAL

3B

-$ 1C

ON FIRST $20,000

ON NEXT $30,000

DESCRIPTION OF WORK

PRIME CONTRACTOR DIRECT LABOR

PRIME CONTRACTOR DIRECT MATERIAL

1A

LINE

NO.

1B SUBCONTRACTOR

PROPOSAL

(VA FORM 10-3385b)1D

1E

Profit, Overhead, and Fee Calculation in accordance with VAAR 852.236.88 (Jul 2002)VA FORM 08-3385a

11A

13 TAXES ON MATERIAL AND EQUIPMENT

11B (Line 8)

(Line 8)

DATE

0.0%

ESTIMATOR

(Name & Title)

TOTAL CHANGE ORDER COST (Line 4 + 14) ► -$ -$

TOTAL PRIME CONTRACTOR COST ► -$

CONSTRUCTION CHANGE ORDER COST SUMMARY

(PRIME CONTRACTOR)

Department of Veterans Affairs

PROPOSAL REQUEST NO. VA PROCEED ORDER NO. VA CHANGE ORDER NO.

PROJECT NAME

ADDED WORK

(COST)

(C)

ITEM

(A)

SITE WORK

(Line 8)

(Line 8)

PROFIT

OMITTED WORK

(CREDIT)

(B)

SPECIAL/GENERAL/CONSTRUCTION

(Project Name)

(Company Name)

(Line 6 and 7)0.0%

INSURANCE AND TAXES (Labor Burden)

10A

(Line 5)12

ON FIRST $20,000

ON NEXT $30,000

ON FIRST $20,000

11C

(Line 8)

PRIME

CONTRACTOR

FEE

OTHERS (Equipment, testing, etc.)

TOTAL ►

ON BALANCE OVER $50,000

ON BALANCE OVER $50,000

NET DIRECT COST (Line 8, Col.C - Col.B) ►

ON BALANCE OVER $50,000

10.0%

7.5%

5.0%

10.0%

7.5%

5.0%

(Name & Title)

VA FORM 08-3385b Profit, Overhead, and Fee Calculation in accordance with VAAR 852.236.88 (Jul 2002)

ESTIMATOR DATE

12 CREDIT PROPOSAL (Line 10, Col B - Col C) -$

REMARKS

(Lines 2 and 3) -$ -$

-$ -$ 8 INSURANCE AND TAXES (Labor Burden) 0.0% (Line 1)

10 TOTAL ► -$ -$

11 COST PROPOSAL (Line 10, Col C - Col B) -$

7B

7A

PROFIT

ON FIRST $20,000 -$

7C ON BALANCE OVER $50,000 -$ (Line 5)

(Line 5)

9 TAXES ON MATERIAL AND EQUIPMENT 0.0%

ON NEXT $30,000 -$ (Line 5) -$

6B ON NEXT $30,000 -$ (Line 5) -$

6A

DIRECT

OVERHEAD

ON FIRST $20,000 -$ (Line 5)

6C ON BALANCE OVER $50,000 -$ (Line 5) -$

1 DIRECT LABOR -$ -$

4 TOTAL DIRECT COST ► -$ -$

3 EQUIPMENT RENTAL -$ -$

5 NET DIRECT COST (Line 4, Col. C - Col. B) ► -$

DIRECT MATERIAL -$ -$

Department of Veterans Affairs

CONSTRUCTION CHANGE ORDER COST SUMMARY

(SUBCONTRACTOR)

PROJECT NO. PROJECT NAME

ITEM

(A)

OMITTED WORK

(CREDIT)

(B)

ADDED WORK

(COST)

(C)

(Company Name)

LINE

NO.

DESCRIPTION OF WORK

PROPOSAL REQUEST NO. VA PROCEED ORDER NO. VA CHANGE ORDER NO.

(Project Name)

PROJECT LOCATION

CONTRACT NO. NAME OF SUBCONTRACTOR

852.236-88 Contract changes - supplement.

As prescribed in 836.578, insert the following clause:

CONTRACT CHANGES - SUPPLEMENT (JUL 2002)

The clauses entitled “Changes” in FAR 52.243-4 and “Differing Site Conditions” in FAR 52.236-2 are supplemented as follows:

(a) Paragraphs (a)(1) through (a)(4) apply to proposed contract changes costing over $500,000.

(1) When requested by the contracting officer, the contractor shall submit proposals for changes in work to the resident engineer. Proposals, to be submitted as expeditiously as possible but within 30 calendar days after receipt of request, shall be in legible form, original and two copies, with an itemized breakdown that will include material, quantities, unit prices, labor costs (separated into trades), construction equipment, etc.

(Labor costs are to be identified with specific material placed or operation performed.) The contractor must obtain and furnish with a proposal an itemized breakdown as described above, signed by each subcontractor participating in the change regardless of tier. When certified cost or pricing data are required under FAR Subpart 15.403, the cost or pricing data shall be submitted in accordance with FAR 15.403-5.

(2) When the necessity to proceed with a change does not allow sufficient time to negotiate a modification or because of failure to reach an agreement, the contracting officer may issue a change order instructing the contractor to proceed on the basis of a tentative price based on the best estimate available at the time, with the firm price to be determined later. Furthermore, when the change order is issued, the contractor shall submit a proposal, which includes the information required by paragraph (a)(1), for cost of changes in work within 30 calendar days.

(3) The contracting officer will consider issuing a settlement by determination to the contract if the contractor's proposal required by paragraphs (a)(1) or (a)(2) of this clause is not received within 30 calendar days o if agreement has not been reached.

(4) Bond premium adjustment, consequent upon changes ordered, will be made as elsewhere specified at the time of final settlement under the contract and will not be included in the individual change.

(b) Paragraphs (b)(1) through (b)(11) apply to proposed contract changes costing $500,000 or less:

(1) When requested by the contracting officer, the contractor shall submit proposals for changes in work to the resident engineer. Proposals, to be submitted as expeditiously as possible but within 30 calendar days after receipt of request, shall be in legible form, original and two copies, with an itemized breakdown that will include material, quantities, unit prices, labor costs (separated into trades), construction equipment, etc. (Labor costs are to be identified with specific material placed or operation performed.) The contractor must obtain and furnish with a proposal an itemized breakdown as described above, signed by each subcontractor participating in the change regardless of tier. When certified cost or pricing data or information other than cost or pricing data are required under FAR 15.403, the data shall be submitted in accordance with FAR 15.403-5. No itemized breakdown will be required for proposals amounting to less than $1,000.

(2) When the necessity to proceed with a change does not allow sufficient time to negotiate a modification or because of failure to reach an agreement, the contracting officer may issue a change order instructing the contractor to proceed on the basis of a tentative price based on the best estimate available at the time, with the firm price to be determined later. Furthermore, when the change order is issued, the contractor shall submit within 30 calendar days, a proposal that includes the information required by paragraph (b)(1) for the cost of the changes in work.

(3) The contracting officer will consider issuing a settlement by determination to the contract if the contractor's proposal required by paragraphs (b)(1) or (b)(2) of this clause is not received within 30 calendar days, or if agreement has not been reached.

(4) Allowances not to exceed 10 percent each for overhead and profit for the party performing the work will be based on the value of labor, material, and use of construction equipment required to accomplish the change. As the value of the change increases, a declining scale will be used in negotiating the percentage of overhead and profit. Allowable percentages on changes will not exceed the following: 10 percent overhead and 10 percent profit on the first $20,000; 7-1/2 percent overhead and 7-1/2 percent profit on the next $30,000; 5 percent overhead and 5 percent profit on balance over $50,000. Profit shall be computed by multiplying the profit percentage by the sum of the direct costs and computed overhead costs.

(5) The prime contractor’s or upper-tier subcontractor’s fee on work performed by lower-tier subcontractors will be based on the net increased cost to the prime contractor or upper-tier subcontractor, as applicable. Allowable fee on changes will not exceed the following: 10 percent fee on the first $20,000; 7-1/2 percent fee on the next $30,000; and 5 percent fee on balance over $50,000.

(6) Not more than four percentages, none of which exceed the percentages shown above, will be allowed regardless of the number of tiers of subcontractors.

(7) Where the contractor's or subcontractor’s portion of a change involves credit items, such items must be deducted prior to adding overhead and profit for the party performing the work. The contractor’s fee is limited to the net increase to contractor of subcontractors’ portions cost computed in accordance herewith.

(8) Where a change involves credit items only, a proper measure of the amount of downward adjustment in the contract price is the reasonable cost to the contractor if he/she had performed the deleted work. A reasonable allowance for overhead and profit are properly includable as part of the downward adjustment for a deductive change. The amount of such allowance is subject to negotiation.

(9) Cost of Federal Old Age Benefit (Social Security) tax and of Worker’s Compensation and Public Liability insurance appertaining to changes are allowable. While no percentage will be allowed thereon for overhead or profit, prime contractor’s fee will be allowed on such items in subcontractors’ proposals.

(10) Overhead and contractor’s fee percentages shall be considered to include insurance other than mentioned herein, field and office supervisors and assistants, security police, use of small tools, incidental job burdens, and general home office expenses and no separate allowance will be made therefore. Assistants to office supervisors include all clerical, stenographic and general office help Incidental job burdens include, but are not necessarily limited to, office equipment and supplies, temporary toilets, telephone and conformance to OSHA requirements. Items such as, but not necessarily limited to, review and coordination, estimating and expediting relative to contract changes are associated with field and office supervision and are considered to be included in the contractor’s overhead and/or fee percentage.

(11) Bond premium adjustment, consequent upon changes ordered, will be made as elsewhere specified at the time of final settlement under the contract and will not be included in the individual change.

(End of Clause)

PREVIOUS EDITION IS OBSOLETE.

MATERIAL APPROVAL SUBMITTAL

(See Instructions on Reverse)

TO: (Contracting Officer)

PROJECT NUMBER

FOR GOVERNMENT USE ONLY

Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project OMB No 9000-0062, Washington DC 20503.

Please DO NOT RETURN your form to either of these addresses. Send your completed form to: SAF/AQCO, Pentagon, Washington DC 20330-1000.

FROM: (Contractor)

DATE

For Evaluation and Action

TO: (Base Civil Engineering Officer/ COR)

TYPE OR PRINT NAME AND GRADE SIGNATURE

TO: (AF Contracting Office)

RECOMMEND APPROVAL DISAPPROVAL AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE

APPROVED

DISAPROVED AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE SIDE. REQUEST

TO: (Contractor)

DATE TYPE OR PRINT NAME AND GRADE SIGNATURE

DATE

DATE TYPE OR PRINT NAME AND GRADE SIGNATURE

MODIFIED AF FORM 3000, SEP 91 (EF)

SUBMITTALSUBMISSION NUMBERCONTRACT NUMBER

NEW RESUBMITTAL

PREVIOUS SUBMISSION NUMBER

ITEM

NO.

SPECIFICATION SECTION/

PARA NO./DRAWING NO.

DESCRIPTION OF MATERIAL

(Include Type, Model Number, Mfg., etc. & file name of attachments)

SEE

REVERSE INITIAL

BY COMPLETING THIS FORM, THE UNDERSIGNED CONTRACTOR CERTIFIES THAT

THE MATERIAL COMPLIES WITH ALL SPECIFICATIONS OF SUBJECT CONTRACT.

AP-

PROVED

DISAP-

PROVED

TO BE COMPLETED BY CONTRACTOR

DATE TYPE OR PRINT NAME AND TITLE

SIGNATURE

FOR GOVERNMENT USE ONLY

Form Approved OMB No 9000-0062 Expires Apr 30, 1993

RESUBMITTAL ON DISAPPROVED ITEMS WITHIN DAYS OF DATE SHOWN BELOW.

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COMMENTS

(Number to correspond with applicable Item Number on reverse)

INSTRUCTIONS TO CONTRACTORS

1. The term "material" is defined as articles, supplies, raw materials, equipment, parts, components, and end items that are to be incorporated into the work required by the contract.

2. This form is to be used by contractors for submitting Shop Drawings (*.DWG or *.PDF format), Manufacturer's Literature and Certificates (scanned as *.PDF) to the Government for approval in accordance with the provisions of this contract. Unless otherwise specified, it is to be prepared, signed, and E-mailed to the contracting officer with appropriate attachments. One paper format copy is to be submitted also.

3. Item(s) to be approved will be clearly tabbed or identified. Data pertaining to item(s) to be approved will be clearly identified or tabbed, particularly where documents are voluminous, in order to properly evaluate the materials or articles to be incorporated in the work. Each attachment will be numbered to correspond with the item number shown on the face of this form.

4. Requests submitted shall be numbered consecutively, by contract, in the space entitled "Submission No.". This number, in addition to the Contract No., will be used to identify each Material Approval Submittal. Resubmissions will be indicated in the appropriate block and the insertion of previous submission number and data in addition to a new submission number. A single submission should be used for all work of a section of the specifications, but in NO instance should the submission include work for more than one (1) contract. Submittals requiring priority handling will be submitted by separate submittal using the form and so marked across the face of the form.

5. This Material Approval Submittal is not valid unless it is signed by the contracting officer. This approval is required as called for by the contracting officer under the terms of this contract. One paper copy of the submittal is to be hand signed for Contracting Officers records.

MODIFIED AF FORM 3000, SEP 91 (E-MAIL FORMAT) (EF) (REVERSE)

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STATEMENT AND ACKNOWLEDGMENT OMB Control Number: 9000-0014 Expiration Date: 1/31/2021

PART I - STATEMENT OF PRIME CONTRACTOR

1. PRIME CONTRACT NUMBER 2. DATE SUBCONTRACT

AWARDED

3. SUBCONTRACT NUMBER

15b. TITLE OF PERSON SIGNING

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1413 (REV. 4/2013)

Prescribed by GSA/FAR (48 CFR) 53.222(e)

4. PRIME CONTRACTOR 5. SUBCONTRACTOR

a. NAME a. NAME

b. STREET ADDRESS b. STREET ADDRESS

c. CITY d. STATE e. ZIP CODE c. CITY d. STATE e. ZIP CODE

6. The prime contract does, does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation."

7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in item 5 by the following firm:

a. NAME OF AWARDING FIRM

b. DESCRIPTION OF WORK BY SUBCONTRACTOR

8. PROJECT 9. LOCATION

10a. NAME OF PERSON SIGNING 11. BY (Signature) 12. DATE SIGNED

10b. TITLE OF PERSON SIGNING

PART II - ACKNOWLEDGMENT OF SUBCONTRACTOR

13. The subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract:

Contract Work Hours and Safety Standards Act - Overtime Compensation (If included in prime contract see Block 6) Payrolls and Basic Records Withholding of Funds Disputes Concerning Labor Standards Compliance with Construction Wage Rate Requirements and Related Regulations

Construction Wage Rate Requirements Apprentices and Trainees Compliance with Copeland Act Requirements Subcontracts (Labor Standards) Contract Termination - Debarment Certification of Eligibility

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY

A C

B D

15a. NAME OF PERSON SIGNING 16. BY (Signature) 17. DATE SIGNED

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number.

The OMB control number for this collection is 9000-0014. We estimate that it will take .05 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

Utility Outage Request Form

Contractor Outage Number:

Plumbing: Electrical: Med Gas: Fire Sprinkler: Other: ________________

Phone:

Job Title:

Outage Request for: HVAC:

Date Outage Request Submitted:

Contractor:

Supervisor on Job Site:

COR/CCR Representative: Phone:

What Building(s), Level(s), Block(s) , Department(s), and rooms (if less than 15 rooms) affected by this Outage:

What is the purpose of this outage? Provided a description of each activity to be performed start to finish with times for each activity (MOP).

(1) YES NO

(2) YES NO

(3) YES NO

(1) Did you insert the Job title on this form?

(2) Did you insert the date and time of outage on this form?

(3) Did you insert the alternative date and time of outage on this form a minimum of 7 days forward?

(4) Did you provide a detailed MOP explaining each activity with time frames for each activity of the outage? (4) YES NO

(5) YES NO

(6) YES NO

(7) YES NO

NO

(5) Did you attached floor plans highlighting all impacted devices, registers, fixtures, units and equipment?

(6) Did you attach plans highlighting the impacted utility from its source to the end users location?

(7) Did you add the Department names adjacent to the impacted locations on the attached floor plans?

(8) Did you indicate the containment on the drawings with a red box and word "containment" adjacent to it? (8) YES

(9) Is the Material and parts to perform this outage on site? (if NO place date expected) (9) YES NO If you checked "NO" to any questions 1-7 your request will be denied. Exception: If the outage impacts the entire building or multiple of buildings then 5-7 may be answered "NO". NOTE: If work is in containment then yes to 8 is mandatory.

Optimal Date/Times system is requested to be secured:

Alternative Date/Times system is requested to be secured (minimum 7 days forward):

Is the VA electrical shop support required? (Explain How)

MANDATORY CHECKLIST

DEPARTMENT OF VETERANS AFFAIRS

VA Maine Healthcare System 1 VA Center Augusta, ME 04330

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IMPACT STATEMENT

The Impact statement is to relay to the End User what is impacted. IE: What Utility is impacted? How does this utility impact the End User? What

Building(s), Level(s), Block(s), Department(s) and Room(s) are impacted?

What is the mitigation strategy if any to reduce impact?

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SECTION 01 35 26

SAFETY REQUIREMENTS

1.1 APPLICABLE PUBLICATIONS:

A. Latest publications listed below form part of this Article to extent referenced. Publications are referenced in text by basic designations only.

B. American Society of Safety Engineers (ASSE):

A10.1-2011...........Pre-Project & Pre-Task Safety and Health

Planning

A10.34-2012..........Protection of the Public on or Adjacent to

Construction Sites

A10.38-2013..........Basic Elements of an Employer’s Program to

Provide a Safe and Healthful Work Environment

American National Standard Construction and

Demolition Operations

C. American Society for Testing and Materials (ASTM):

E84-2013.............Surface Burning Characteristics of Building

Materials

D. The Facilities Guidelines Institute (FGI):

FGI Guidelines-2010Guidelines for Design and Construction of

Healthcare Facilities

E. National Fire Protection Association (NFPA):

10-2013..............Standard for Portable Fire Extinguishers

30-2012..............Flammable and Combustible Liquids Code

51B-2014.............Standard for Fire Prevention During Welding, Cutting and Other Hot Work

70-2014..............National Electrical Code

70B-2013.............Recommended Practice for Electrical Equipment

Maintenance

70E-2015 ............Standard for Electrical Safety in the Workplace

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99-2012..............Health Care Facilities Code

241-2013.............Standard for Safeguarding Construction, Alteration, and Demolition Operations

F. The Joint Commission (TJC)

TJC Manual ..........Comprehensive Accreditation and Certification

Manual

G. U.S. Nuclear Regulatory Commission

10 CFR 20 ...........Standards for Protection Against Radiation

H. U.S. Occupational Safety and Health Administration (OSHA):

29 CFR 1904 .........Reporting and Recording Injuries & Illnesses

29 CFR 1910 .........Safety and Health Regulations for General

Industry

29 CFR 1926 .........Safety and Health Regulations for Construction

Industry

CPL 2-0.124..........Multi-Employer Citation Policy

I. VHA Directive 2005-007

1.2 DEFINITIONS:

A. OSHA “Competent Person” (CP). One who is capable of identifying existing and predictable hazards in the surroundings and working conditions which are unsanitary, hazardous or dangerous to employees, and who has the authorization to take prompt corrective measures to eliminate them (see 29

CFR 1926.32(f)).

B. "Qualified Person" means one who, by possession of a recognized degree, certificate, or professional standing, or who by extensive knowledge, training and experience, has successfully demonstrated his ability to solve or resolve problems relating to the subject matter, the work, or the project.

C. High Visibility Accident. Any mishap which may generate publicity or high visibility.

D. Accident/Incident Criticality Categories:

01 35 26 - 3

No impact – near miss incidents that should be investigated but are not required to be reported to the VA;

Minor incident/impact – incidents that require first aid or result in minor equipment damage (less than $5000). These incidents must be investigated but are not required to be reported to the VA;

Moderate incident/impact – Any work-related injury or illness that results in:

1. Days away from work (any time lost after day of injury/illness onset);

2. Restricted work;

3. Transfer to another job;

4. Medical treatment beyond first aid;

5. Loss of consciousness;

6. A significant injury or illness diagnosed by a physician or other licensed health care professional, even if it did not result in (1) through (5) above or,

7. any incident that leads to major equipment damage (greater than $5000).

These incidents must be investigated and are required to be reported to the VA;

Major incident/impact – Any mishap that leads to fatalities, hospitalizations, amputations, and losses of an eye as a result of contractors’ activities. Or any incident which leads to major property damage (greater than $20,000) and/or may generate publicity or high visibility. These incidents must be investigated and are required to be reported to the VA as soon as practical, but not later than 2 hours after the incident.

E. Medical Treatment. Treatment administered by a physician or by registered professional personnel under the standing orders of a physician. Medical treatment does not include first aid treatment even through provided by a physician or registered personnel.

01 35 26 - 4

1.3 REGULATORY REQUIREMENTS:

A. In addition to the detailed requirements included in the provisions of this contract, comply with 29 CFR 1926, comply with 29 CFR 1910 as incorporated by reference within 29 CFR 1926, comply with ASSE A10.34, and all applicable federal, state, and local laws, ordinances, criteria, rules and regulations. Submit matters of interpretation of standards for resolution before starting work. Where the requirements of this specification, applicable laws, criteria, ordinances, regulations, and referenced documents vary, the most stringent requirements govern except with specific approval and acceptance by the

Contracting Officer Representative.

1.4 ACCIDENT PREVENTION PLAN (APP):

A. The APP (aka Construction Safety & Health Plan) shall interface with the Contractor's overall safety and health program. Include any portions of the Contractor's overall safety and health program referenced in the APP in the applicable APP element and ensure it is site-specific. The Government considers the Prime Contractor to be the

"controlling authority" for all worksite safety and health of each subcontractor(s). Contractors are responsible for informing their subcontractors of the safety provisions under the terms of the contract and the penalties for noncompliance, coordinating the work to prevent one craft from interfering with or creating hazardous working conditions for other crafts, and inspecting subcontractor operations to ensure that accident prevention responsibilities are being carried out.

B. The APP shall be prepared as follows:

1. Written in English by a qualified person who is employed by the

Prime Contractor articulating the specific work and hazards pertaining to the contract (model language can be found in ASSE

A10.33). Specifically articulating the safety requirements found within these VA contract safety specifications.

2. Address both the Prime Contractors and the subcontractors work operations.

3. State measures to be taken to control hazards associated with materials, services, or equipment provided by suppliers.

4. Address all the elements/sub-elements and in order as follows:

01 35 26 - 5

a. SIGNATURE SHEET. Title, signature, and phone number of the following:

1) Plan preparer (Qualified Person such as corporate safety staff person or contracted Certified Safety Professional with construction safety experience);

2) Plan approver (company/corporate officers authorized to obligate the company);

3) Plan concurrence (e.g., Chief of Operations, Corporate Chief of Safety, Corporate Industrial Hygienist, project manager or superintendent, project safety professional). Provide concurrence of other applicable corporate and project personnel (Contractor).

b. BACKGROUND INFORMATION. List the following:

1) Contractor;

2) Contract number;

3) Project name;

4) Brief project description, description of work to be performed, and location; phases of work anticipated (these will require an AHA).

c. STATEMENT OF SAFETY AND HEALTH POLICY. Provide a copy of current corporate/company Safety and Health Policy Statement, detailing commitment to providing a safe and healthful workplace for all employees. The Contractor’s written safety program goals, objectives, and accident experience goals for this contract should be provided.

d. RESPONSIBILITIES AND LINES OF AUTHORITIES. Provide the following:

1) A statement of the employer’s ultimate responsibility for the implementation of his SOH program;

2) Identification and accountability of personnel responsible for safety at both corporate and project level.