A.02.11 PWS.doc

PERFORMANCE WORK STATEMENT

PWS for Elevator Monthly Maintenance for Deer Creek Dam

General Requirement:

Perform monthly routine maintenance on all components related to Deer Creek Elevator Address:

US Army Corps of Engineers, Deer Creek Dam 21897 Deer Creek Road Mt. Sterling, OH 43143-9505 Scope of Work:

The Contractor shall grease all bearings which include but not limited to, governor shaft, section bearings, wedge clamp safety, deflector sheave, and motor bearings. The Contractor shall ensure that the guide rail lubricators are full of oil and is working properly. Check and adjust all doors at each landing and on the elevator car for proper closure. The Contractor shall change any light bulbs located in the shaft and on the car as needed. The Contractor shall make every effort to minimize spillage of any oils or grease and if so, render clean. The Contractor shall lubricate any moving parts that require aerosol lubricant spray accordingly. The Contractor shall check the drain pan at the gear case and empty excess oil back into gear case and top off if needed. The Contractor shall inform the Government Project POC if there are any issues that need addressed beyond the Scope of Work that may cause additional cost to the Government.

In addition to the above the Routine Monthly Maintenance shall include the following:

1) Check control and landing position systems

2) Check signal fixtures

3) Check machines, drives, motors, governors, sheaves, and ropes

4) Check power units, pumps, valves, and mufflers

5) Check car and hoist way door operating devices and door protection equipment

6) Check load weighers, car frames, and counterweights

7) Check all safety mechanisms

8) Lubricate equipment for smooth and efficient performance.

9) Adjust elevator parts and component

10) Document all work performed Specifications for Routine Maintenance on a Deer Creek Elevator:

The Contractor shall furnish all labor and materials to perform routine maintenance on a Deer Creek Elevator.

Repair or replace components worn due to normal wear that includes controller components, selectors, dispatching equipment, door operators, door protective devices, interlocks, hangers, machines, gears, motors, motor generators, brushes, governors, pumps, pump motors, and valves.

Test equipment per ANSI A17.1.

Contractor and Government Equipment and Supplies

The Contractor shall furnish all personnel, equipment, transportation, disposal, supplies and materials to perform the work. No government equipment or supplies shall be used for this project. The Contractor shall provide Personal Protection Equipment to include steel-toed safety boots, hard hat, safety glasses, hearing protection, sleeved shirts, long pants, gloves, safety harness /w lanyards

Point of Contact for U.S. Army Corps of Engineers

Rachel Rush Resource Manager (Acting), Deer Creek Lake

U.S. Army Corps of Engineers

21897 Deer Creek Road

Mt. Sterling, OH 43143-9505

Telephone: (740) 869-2243

Contractor Accident Prevention Plan (APP).

A. General. Contractor shall comply with all Federal, State and Local safety requirements including those specified by the Occupational Safety and Health Act (OSHA) in 29 CRF 1910 General Industry Standard, 1926 Construction Standard and the U.S. Army Corps of Engineers Safety & Health Requirements Manual EM 385-1-1 as currently revised. Where a conflict exists between safety standards/requirements the contractor shall comply with the more stringent requirement. If the Contractor fails or refuses to promptly comply with safety and security requirements as specified herein, any project employee may stop all or part of the work until satisfactory corrective action has been taken. No part of the time lost due to any such work stoppage shall be made subject to any claims for extension of time or for excess costs or damages sustained by the Contractor. Also, the Contractor will not be paid for work not performed as a result of the stop order.

B. Contractor Accident Prevention Plan (APP). The Contractor shall prepare a site-specific Accident Prevention Plan following the outline provided in EM 385-1-1, Appendix A as a minimum. The contractor shall address each element and sub-element in the outline in the order they appear in Appendix A. Any item from the outline that does not apply must be listed, in its assigned place and a brief explanation of the reason it is not required/provided. The APP shall address any unusual or unique aspects of the project or activity. This plan must be accepted by the Contracting Officer prior to commencement of any work. Contractors are encouraged to contact the USACE Safety & Occupational Health Office for questions or information regarding the development of contract Accident Prevention Plans. Office hours are Monday-Friday 8:30 a.m. - 4 p.m. at (304)399-5039/5032/5326. The web address for EM 385-1-1 is: http://www.publications.usace.army.mil/Portals/76/Publications/EngineerManuals/EM_385-1-1.pdf

(1) The contractor shall have on site an employee designated as a Site Safety and Health Officer (SSHO) who has completed the OSHA 30-hour Construction Safety training or its equivalent as specified in EM 385-1-1, 01.A.17 and has at least five years’ experience relative to the work to be performed. No work will be permitted unless the SSHO is present at the work site.

(2) For task orders limited to routine mowing, cleaning and janitorial work SSHO responsibilities may be a collateral duty. Contractor may also elect to use an SSHO with either OSHA 30-hour Construction or General Industry qualifications.

(3) Work crews of two or more must have two people holding current certification in First Aid and CPR from the American Red Cross, American Heart Association or a licensed physician. Training must include a hands-on component that cannot be taken online and the contractor must maintain appropriate First Aid kit on site. Single individuals working alone must have current certification in First Aid as a minimum.

(4) All work that potentially exposes the worker to falls of six feet or more will require the contractor to submit a Site Specific Fall Protection & Prevention Plan in accordance with EM 385-1-1, Section 21.D.

(5) Cranes and hoisting equipment shall be operated only by qualified personnel (operators licensing, physical and drug testing in accordance with EM 385-1-1 Section 16.B). Note: CDL Medical Clearance is not acceptable. Please see attached medical clearance requirements.

(6) Effective November 8, 2010 all “Signalpersons” and “Riggers” shall be qualified. This is a mandatory requirement in accordance with 29 CFR 1926.1400 Regulations. Riggers must be a qualified person for the performance of specified hoisting activities such as during assembly/disassembly, in accordance with OSHA 1926.1404(r)(1) and 1926.1425(c)(3).

(7) Work orders involving potential exposure to Hazardous, Toxic or Radiological Waste shall require development of Site Specific Safety and Health Plan (SSHP) by qualified personnel as specified in EM 385-1-1 Sections 6 and 33.

C. Risk Management Process. The Contractor shall utilize risk management tools such as Activity Hazard Analysis (AHA), Job Hazard Analyses (JHAs), Job Safety Analyses (JSAs) or similar tools to identify, assess, prioritize risks and develop controls to minimize, monitor and control the probability and/or impact of unfortunate events to an acceptable level. Within each major phase, all activities, tasks or Definable Features of Work (DFOWs) shall be identified that will require an AHA/JSA/JHA. For each work activity, task or DFOW contractor shall prepare the initial AHA/JSA/JHA. A Risk Assessment Code (RAC) is assigned to each step, to the risk that remains after controls have been applied (residual risk) a final RAC (cannot be lower than the highest step RAC) shall be assigned. See EM 385-1-1 Section 01.A.14.b. for further guidance or contact the SOHO for assistance. The AHA/JSA/JHA shall be reviewed and accepted by the proper authority in order to proceed with the activity. All on-site employees shall review the accepted AHA/JSA/JHA prior to performing work and during weekly and “Tool Box” safety meetings as appropriate.

1. AHA/JSA/JHA shall define the activities being performed and identify the work sequences, the specific anticipated hazards, site conditions, equipment, materials, and the control measures to be implemented to eliminate or reduce each hazard to an acceptable level of risk. AHA/JSA/JHA should indicate compliance with EM 385-1-1 personal protective equipment requirements (safety-toed work boots, safety glasses, gloves, hard hats, etc.), work crews of two or more must have two people currently qualified in first aid and CPR and the appropriate first aid kit on site. Single individuals working alone must have current certification in First Aid only.

2. The names of the Competent Person(s) and Qualified Person(s) required for a particular activity (e.g., excavation, scaffolding, fall protection, or other activities as specified by OSHA and this manual) shall be identified and included in the AHA/JSA/JHA, as well as proof of their competency/qualification.

D. Accident/Mishap Reporting: The Contractor shall report all recordable mishaps to the GDA within 24-hours in accordance with EM 385-1-1 Section 01.D. Accidents shall be investigated to determine causal factors and corrective actions shall be implemented. Accidents resulting in: days away injuries, days away illnesses, restricted/transfer injuries, property damage of $5,000.00 or more shall be investigated and reported to the GDA using the USACE Accident Investigation Report Form ENG 3394 within 24 hours of the occurrence.

(1) Immediate notification to the GDA is required for all serious accidents:

a. Fatal Injury/illness;

b. Permanent totally disabling injury/illness;

c. Permanent partial disabling injury/illness;

d. One (1) or more persons hospitalized as inpatients as a result of a single occurrence;

e. $500,000 or greater accidental property damage;

f. Three (3) or more individuals become ill or have a medical condition suspected to be related to a site condition, or a hazardous or toxic agent on the site;

g. USACE aircraft destroyed or missing;

The Contractor shall maintain an OSHA Log of Work Related Injuries and Illnesses, OSHA Form 300 and comply with all accident reporting and recordkeeping requirements specified in 29 CFR 1904.39.

(2) In addition to the above, any mishap occurring in any of the following high hazard areas shall be reported immediately to the GDA, investigated and corrective actions implemented.

a. Electrical (includes Arc Flash, electrical shock, etc.);

b. Uncontrolled Release of Hazardous Energy (includes electrical and non-electrical);

c. Load Handling Equipment (LHE) or Rigging;

d. Fall-from-Height (any level or other than same surface);

e. Underwater Diving

SECURITY REQUIREMENTS

All Contractors and subcontractor employee(s) working on this contract who require access in and/or around any Huntington District facilities (i.e. flood control dams, locks and dams, etc.) shall receive authorization to be on our facilities based upon a favorable background investigation in accordance with “Homeland Security Presidential Directive 12: Policy for a Common Identification Standard for Federal Employees and Contractors” (HSPD 12). The Huntington District Security Management Office shall submit contractor(s) information in order to complete the background investigation and make a recommendation to the Contracting Office of an employee’s suitability for work on Government property. The Procuring Contracting Officer (PCO) has the right to deny any contractor or subcontractor employee from working on the contract based upon the results provided by the Huntington District Security Management Office of the background investigation. The Government, Contractor, and subcontractors shall not permit any employee(s) access to drawings, blueprints, records, photos, sites, or projects until the Huntington District Security Management Office has completed a review of such items and determined they can be released.

Contractors shall submit a complete investigation packet for each contractor and subcontractor employee to the Huntington District Security Management office within 10 working days after award of any contract, or prior to the individual being permitted unescorted access in or around all District facilities. The Contractor must also provide the following: (1) Name of the Contract Specialist with whom he/she is working, (2) Project Name, (3) Contract Number and (4) Task Order Number when applicable.

The documents listed below are required:

SF 85, Questionnaire for Non-Sensitive Positions (see http://www.opm.gov/forms/ to print form). FD 258, Contractor Fingerprint Card (one card for digital prints, two for ink prints) (NOTE: a trained/qualified individual must take prints, ORI block on the FD 258 must be USOPM000Z) (Contractor Fingerprint Cards (FD-258) may be obtained by Contracting Division by contacting the Huntington District Security Management office).

Contractor shall report any changes in personnel or at any time conditions change at least 5 working days prior to individual(s) need to have access to the site. The Contractor shall provide the same information as listed above for all new employees.

Following submission of paperwork, the Security Management Office will conduct an initial criminal check based upon the information provided. If there are no issues, Security Management Office will make recommendations to the PCO or their Designated Representative. The Security Management Office cannot give approval due to unfavorable report(s). The Security Management Office shall coordinate with Office of Counsel and will jointly make recommendations to the PCO and/or the Designated Representative. The PCO will make the determination whether to allow the Contractor personnel to work on the site based on Security and Office of Counsel recommendations, and the PCO will advise Contractor of the decision.

FOREIGN NATIONALS

The Contractor shall provide the package listed above, as well as additional materials noted below for all Foreign Nationals. The Contractor is to expect additional time in the approval process for all Foreign Nationals due to the level of review and elevation of the review to Headquarters Staff to accomplish. All Foreign Nationals must comply with the following paragraph:

In accordance with Engineering Regulation 380-1-18, “Technology Transfer, Disclosure of Information and Contacts with Foreign Representatives” dated 1 August 1996, Section 4, all foreign nationals who work on Corps of Engineers’ contracts shall be approved by the Headquarters US Army Corps of Engineers (HQ USACE) Foreign Disclosure Officer before beginning work on this contract; this regulation includes subcontractor employees. The Contractor shall submit to the Security Management Office, the names of all foreign nationals proposed for performance under this contract, along with documentation to verify legal admittance into the United States at least 10 business days (excluding Federal holidays) prior to the requested work start date. Such documentation shall include at least one of the following a U.S. passport, Certificate of U.S. Citizenship (INS Form N-560 or N-561), Certificate of Naturalization (INS Form N-550 or N-570), Alien Registration Card with photograph (INS Form I-151 or I-551), Employment Authorization Card (INS Form I-688A), etc.

All foreign government Requests for Visit Authorizations to the Department of Army organizations must be submitted at least ten business days (excluding Federal holidays) prior to the requested start date of the visit due to attempting to support, accommodate and approve the high number of short-fused Requests for Visit Authorizations (RVAs) received into the Foreign Disclosure Office on a daily basis.

In order to assure forms are properly completed, and to minimize time delays, Contractor is encouraged to work closely with the Security Management Office. The Government will return for correction incomplete forms, illegible forms, etc. which will delay the contractor / subcontractor from beginning work.

Holiday Moratorium - The Department of Defense traditionally imposes a moratorium on Requests for Visit Authorization (RVA's) during the December and January timeframes each calendar year. Where it is possible, the Contractor should avoid scheduling visits unless they are mission essential during this timeframe. The DOD Foreign Visits System will be operational; however, Army foreign disclosure will only process RVA's designated as mission essential by the Contracting Officer. The only two exceptions to the 10 working day suspense requirement are (1) visits to the Army Secretariat and Army Staff, and (2) visits deemed mission essential or time sensitive by the U. S. Army. A waiver to the Office of the Deputy Chief of Staff, G-2 must be submitted to authorize the request.

Security requirements are subject to change in accordance with HSPD-12, Office of Personnel Management, regulation or policy changes, etc. The Government shall add any changes to security requirements by modification to the contract.

The Contractor shall contact the Security Management Office by phone, letter, or email at the following numbers/addresses:

CELRH-SM

502 Eighth Street

Huntington, WV 25701 Stephen R. Curry, phone (304) 399-5695; email stephen.r.curry@usace.army.mi Sandra L. Hardwick, phone (304) 399-5612; email sandra.l.hardwick@usace.army.mil Matthew D. Green, phone (304) 399-5294; email matthew.d.green@usace.army.mil AT/OPSEC Requirements. The following shall be accomplished by the contractor before any work will be ordered:

1. AT Level I Training. All contractor employees, to include subcontractor employees, requiring access to Army installations, facilities and controlled access areas shall complete AT Level I awareness training within thirty (30) calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the contracting officer, if a COR is not assigned, within five (5) calendar days after completion of training by all employees and subcontractor personnel. AT Level I awareness training is available at the following website: https://atlevel1.dtic.mil/at/; or it can be provided by the RA ATO in presentation form which will be documented via memorandum.

2. Access and General Protection/Security Policy and Procedures. All Contractor and all associated sub‐contractors employees shall comply with applicable installation, facility, and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also provide all information required for background checks or background investigation and to meet installation/facility access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services, or Security Office. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

3.

Suspicious Activity Reporting Training (e.g. iWATCH, CorpsWatch, or See Something, Say Something). The contractor and all associated sub-contractors shall receive a brief/training (provided by the RA) on the local suspicious activity reporting program. This locally developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the project manager, security representative or law enforcement entity. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance with the results reported to the COR NLT 5 calendar days after the completion of the training.

4. Suspicious Activity Reporting Training (e.g. iWATCH, CorpsWatch, or See Something, Say Something). The contractor and all associated sub-contractors shall receive a brief/training (provided by the RA) on the local suspicious activity reporting program. This locally developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the project manager, security representative or law enforcement entity. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance with the results reported to the COR NLT 5 calendar days after the completion of the training.

5.

For Contracts that Require OPSEC Training. All new contractor employees will complete Level I OPSEC Training within 30 calendar days of their reporting for duty. Additionally, all contractor employees must complete annual OPSEC awareness training. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee, to the COR or to the contracting officer (if a COR is not assigned), within 5 calendar days after completion of training. OPSEC awareness training is available at the following websites: https://www.iad.gov/ ioss/ or http://www.cdse.edu/catalog/operations-security.html; or it can be provided by the RA OPSEC Officer in presentation form which will be documented via memorandum.

6. Pre-screen candidates using E-Verify Program. The Contractor must pre-screen Candidates using the E-verify Program (http://www.uscis.gov/e-verify) website to meet the established employment eligibility requirements. The Vendor must ensure that the Candidate has two valid forms of Government issued identification prior to enrollment to ensure the correct information is entered into the E-verify system. An initial list of verified/eligible Candidates must be provided to the COR no later than 3 business days after the initial contract award." *When contracts are with individuals, the individuals will be required to complete a Form I-9, Employment Eligibility Verification, with the designated Government representative. This Form will be provided to the Contracting Officer and shall become part of the official contract file.

ATTACHMENT 1

APPENDIX A

MINIMUM BASIC OUTLINE FOR ACCIDENT PREVENTION PLANS

An Accident Prevention Plan (APP) is a safety and health policy and program document. The following areas are typically addressed in an APP, but an APP shall be job-specific and shall also address any unusual or unique aspects of the project or activity for which it is written.

The APP shall interface with the employer’s overall safety and health program, and a copy shall be available on the work site. Any portions of the overall safety and health program that are referenced in the APP shall be included as appropriate. ANSI/ASSE A10.38 should be referenced for Programmatic Issues.

> For LIMITED-SCOPE SERVICE, SUPPLY AND R&D CONTRACTS, for example, mowing (only), park attendant, rest room cleaning, the Contracting Officer and SOHO may allow an ABBREVIATED APP (customized APP requirements and waive the more stringent elements of this section). > See 01.A.11, and Appendix A, paragraph 11.

11. ABBREVIATED APP for LIMITED-SCOPE SERVICE, SUPPLY AND R&D CONTRACTS. If service, supply and R&D contracts with limited scopes are awarded, the contractor may submit an abbreviated Accident Prevention Plan. This APP shall address the following areas at a minimum. If other areas of the EM 385-1-1 are pertinent to the contract, the contractor must assure these areas are addressed as well.

a. Title, signature, and phone number of the plan preparer.

b. Background Information to include: Contractor; Contract number; Project name; Brief project description, description of work to be performed, and location (map); The project description shall provide a means to evaluate the work being done (see AHA requirements in 01.A.13) and associated hazards involved. Contractor’s APP shall address the identified hazards involved and the control measures to be taken.

c. Statement of Safety and Health Policy detailing their commitment to providing a safe and healthful workplace for all employees.

d. Responsibilities and Lines of Authorities – to include a statement of the employer’s ultimate responsibility for the implementation of his SOH program; Identification and accountability of personnel responsible for safety at all levels to include designated site safety and health officer (SSHO) and associated qualifications. The District SOHO will review the qualifications for acceptance.

e. Training - new hire SOH orientation training at the time of initial hire of each new employee and any periodic retraining/recertification requirements.

f. Procedures for job site inspections - assignment of responsibilities and frequency.

g. Procedures for reporting man-hours worked and reporting and investigating any accidents as soon as possible but not more than 24 hours afterwards to the Contracting Officer/Representative (CO/COR). An accident that results in a fatal injury, permanent partial or permanent total disability shall be immediately reported to the Contracting Officer.

h. Emergency Planning. Employees working alone shall be provided an effective means of emergency communication. This may be cellular phone, two-way radio or other acceptable means. The selected means of communication must be readily available and must be in working condition.

i. Drinking Water provisions, toilet and washing facilities.

j. First Aid and CPR training (at least two employees on each shift shall be qualified/certified to administer first aid and CPR) and provision of first aid kit (types/size).

k. Personal Protective Equipment.

(1) WORK CLOTHING - Minimum Requirements. Employees shall wear clothing suitable for the weather however minimum requirements for work shall be short-sleeve shirt, long pants (excessively long or baggy pants are prohibited) and leather work shoes. If analysis determines that safety-toed (or other protective) footwear is necessary (i.e., mowing, weedeating, chain saw use, etc), they shall be worn.

(2) Eye and Face Protection. Eye and face protection shall be worn as determined by an analysis of the operations being performed HOWEVER, all involved in chain saw use, chipping, stump grinding, pruning operations, grass mowing, weedeating and blowing operations shall be provided safety eyewear (Z87.1) as a minimum.

(3) Hearing Protection. Hearing protection must be worn by all those exposed to high noise activities (to include grass mowing and trimming, chainsaw operations, tree chipping, stump grinding and pruning).

(4) Head Protection. Hard hats shall comply with ANSI Z89.1 and shall be worn by all workers when a head hazard exists. At a minimum, hard hats shall be worn when performing activities identified in (2) above.

(5) High Visibility Apparel shall comply with ANSI/ISEA 107, Class 2 requirements at a minimum and shall be worn by all workers exposed to vehicular or equipment traffic.

(6) Protective Leg chaps shall be worn by all chainsaw operators.

(7) Gloves of the proper type shall be worn by persons involved in activities that expose the hands to cuts, abrasions, punctures, burns and chemical irritants.

(8) If work is being performed around water and drowning is a hazard, PFDs must be provided and worn as appropriate.

l. Machine Guards and safety devices. Lawn maintenance equipment must have appropriate guards and safety devices in place and operational.

m. Hazardous Substances. When any hazardous substances are procured, used, stored or disposed, a hazard communication program must be in effect and MSDSs shall be available at the worksite. Employees shall have received training in hazardous substances being used. When the eyes or body of any person may be exposed to corrosives, irritants or toxic chemicals, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within 10 seconds of the worksite.

n. Traffic control shall be accomplished in accordance with DOT’s MUTCD.

o. Control of Hazardous Energy (Lockout/Tagout). Before an employee performs any servicing or maintenance on any equipment where the unexpected energizing or startup of the equipment could occur, procedures must be in place to ensure adequate control of this energy.

p. Driving, working on (i.e., working with equipment/mowers) while on slopes, working from/in boats/skiffs, etc shall also be considered and dealt with accordingly.