A.03.09 Exhibits _ 2022 JWF Gate Attendant Contract_Section Exhibits_approved by KO.pdf

LIST OF ATTACHMENTS

EXHIBITS

EXHIBIT A, Items to be provided at Least One Week Prior to Pre-Work Conference EXHIBIT B, Site Map EXHIBIT C, Work Schedule EXHIBIT D, Park Attendant Forms and Records EXHIBIT E, Minimum Basic Outline for Accident Prevention Plan, OSHA 300 Log EXHIBIT F, Activity Hazard Analysis, CELRH Form 2642 EXHIBIT G, Sample Invoice Format EXHIBIT H, Contractor Quality Control Plan EXHIBIT I, Contract Discrepancy Report (CDR) ORH Form 2759

EXHIBIT A

ITEMS TO BE PROVIDED AT LEAST ONE WEEK

PRIOR TO PRE-WORK CONFERENCE

EXHIBIT A

ITEMS TO BE PROVIDED ONE WEEK PRIOR TO PRE-WORK CONFERENCE

Contractor shall provide the following typed documents, at least 1 week prior to the pre-work conference:

a. Quality Control Plan. Sign the cover sheet, accepting the Quality Control Plan in Exhibit H.

b. Contractor Representatives. List of names of Contractor Representatives.

c. Contractor Accident Prevention Plan. An approved Contractor Accident Prevention Plan shall be prepared by the Contractor using the outline found in Exhibit E.

d. Personnel. A list, with names, addresses, and telephone numbers, of persons who will be available for Park Attendant duties.

e. Emergency Contacts. A prioritized list, including phone numbers, of those persons (normally Contractor Representatives) to call in case of emergencies.

f. Copies of insurance and bonding certificates.

EXHIBIT B

SITE MAP

Legend

IBI Non-impacted Site m BoatRamp

(g Pa,1(1ng Area

" Showers/Restrooms

John W. Flannagan Dam

II Accessible Facllltles

Showers/Restrooms Site 10 Boat Ramp Courtesy Dock

EXHIBIT C

WORK SCHEDULE CALENDARS

- Base Year 27 May 22 to 03 September 22

- Option #1 26 May 23 to 05 September 23

- Option #2 24 May 24 to 03 September 24

The Gatehouses shall be occupied during the following hours:

Gatehouse

DAY OPEN CLOSE

SUNDAY thru

THURSDAY

8:00 A.M. 10:00 A.M

4:00 P.M. 10:00 P.M.

FRIDAY and

SATURDAY

8:00 A.M. 10:00 A.M.

4:00 P.M. 11:00 P.M.

Additionally: on Sundays during holiday weekends, the Gatehouse shall be operated from 4:00 P.M.

until 11:00 P.M.

* The COR may modify working hours on Memorial Day, Independence Day, and Labor Day weekends.

All times given are local (Dickenson County is in the Eastern Time-zone).

EXHIBIT D

PARK ATTENDANT FORMS AND RECORDS

EXHIBIT D

PARK ATTENDANT'S FORMS AND RECORDS

(1) Request for Camping Permit Refund

(2) Camping Permit Request in Excess of 14 Days

(2) Campground Register (Names of Campers/Visitors) – Provided by Contractor

(3) Campground Daily Log (Accidents, Incidents, etc.) – Provided by Contractor

(4) Telephone Log – Provided upon award.

REQUEST FOR CAMPING PERMIT REFUND

The proponent agency is CELRP-OP-R

1. DATE (YYYYMMDD)

2a. PERMIT NUMBER 12b. SITE NUMBER

2c. DATE ISSUED (YYYYMMDD) 12d. EXPIRATION DATE (YYYYMMDD) 12e. DATE OF DEPARTURE (YYYYMMDD)

3a. IT IS REQUESTED THAT A REFUND IN THE AMOUNT OF FOR THE UNUSED PORTION OF THE ABOVE PERMIT BE

MAILED TO ME AT THE FOLLOWING ADDRESS:

3b. NAME (Last, First MI.) 13c. STREET ADDRESS

3d. CITY 13e.STATE 13f. ZIP CODE

3g. REASON FOR EARLY DEPARTURE

4.1T D IS 0 IS NOT RECOMMENDED THAT A REFUND IN THE AMOUNT OF BE MADE AS REQUESTED ABOVE.

Sa. DATE (YYYYMMDD) 5b. SIGNATURE OF RESERVOIR MANAGER OR RANGER

CELRP FORM 478, JAN 2011 PREVIOUS EDITIONS ARE OBSOLETE.

VERSION 1.0

EXHIBIT E

MINIMUM BASIC OUTLINE FOR ACCIDENT PREVENTION PLAN

(APPENDIX A, EM 385-1-1)

OSHA 300 Log and Instructions

EXHIBIT E

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 s hall 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, weed eating, 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, weed eating 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/Tag Out). 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.

EXHIBIT F

ACTIVITY HAZARD ANALYSIS

EXHIBIT G

SAMPLE INVOICE FORMAT

EXHIBIT G

SAMPLE INVOICE FORMAT

FROM: Contractor's Name INVOICE NO:

Address City, State Zip Phone Number

INVOICE FOR MONTH OF: DATE OF INVOICE:

CONTRACT NUMBER:

TO: John W. Flannagan Dam & Reservoir

2207 Flannagan Dam Rd.

Haysi, VA 24256

Park Attendant Services for the Month of June

DATE QTY EA. AMOUNT

7-1-15 30 Days $ $000.00

TOTAL INVOICE $000.00

EXHIBIT H

CONTRACTOR QUALITY CONTROL PLAN

EXHIBIT H

CONTRACTORS QUALITY CONTROL PLAN

1. INSPECTION OF SERVICES.

a. Scheduled Inspections. At the beginning of each shift, the Park Attendant shall inspect the work performed by the previous shift. The inspection shall include the following:

1) Review of permits issued. Permits shall be checked for accuracy of arrival and departure dates, fees collected, required information recorded, and proper filing. Permits and fees collected shall also be reconciled.

2) Reconciliation of Register of Campers (computer and/or clipboard) and actual campground conditions.

3) Fund security and compliance with safety and security requirements.

4) All other items listed on the attached inspection form.

b. Unscheduled Inspections. If the Contractor is not the primary Park Attendant, the Contractor or his Representative shall make unscheduled inspections, using the following form and above criteria. Unscheduled inspections shall be made a minimum of every week.

c. Records and Filing. All inspections shall be documented and maintained in a file at the Entrance Station. Files shall be available for COR inspection at any time.

2. DEFICIENCIES AND CORRECTIVE ACTION. Errors in User Permits and other records shall be corrected immediately, and documented as required. Notices and reminders shall be posted as necessary to draw attention to repeated errors.

3. INSPECTORS and CONTRACTOR REPRESENTATIVES. A list of names and phone numbers of authorized Inspectors and Contractor Representatives shall be provided at the Pre-Work Conference.

4. I hereby adopt the Contractor Quality Control Plan in Exhibit H.

Contractor Date

QUALITY CONTROL CHECKLIST FOR PARK ATTENDANT SERVICES

DUTY / INSPECTION ITEM

RATING

COMMENTS

Visitor Registration

Fee Collection

Fund Security

Campground Register & Visitor Records

Customer Care & Visitor Assistance

Campground Inspections

Handouts Distributed

Reporting Incidents, Etc.

Log Book

Cooperation with Others

Attendant’s Appearance

Entrance Station Appearance

Entrance Station Security

Safe Work Habits and Equipment

1 – Work Done Correctly 2 – Errors Found (Explain problem, correction, and prevention of repeat problem)

3 – Work Not Begun

SECTION II

ACCEPTANCE/REJECTION OF SERVICES

SECTION II. Acceptance/Rejection of Services

A. General. Inspection of all services performed under this contract will primarily be done in accordance with a schedule developed by the Government, and will primarily be done by using one or a combination of the surveillance methods cited in this plan. The purpose of inspection is to document contractor performance and the quality of services or goods produced.

Documentation of contractor performance will be done on the appropriate Inspection Checklist (see Section VI of this plan).

B. Acceptance.

1. Statistically Sampled Work. Whenever the number of defects for a lot falls at or below the established reject level the work will be considered satisfactory. However, the contractor is still required to correct the deficiencies.

2. 100% Inspection. When all work is performed in accordance with the Work Order.

C. Rejection.

1. Statistically Sampled Work. Whenever the defects exceed the reject level the Government will issue a CDR and effect a monetary deduction from the Contractor's invoice.

2. 100% Inspection. Whenever the work does not conform to all requirements of the Work Order, the Government will issue a CDR and proceed in accordance with the Inspection of Services Clause of the contract.

SECTION III

CALCULATING DEDUCTIONS

SECTION III. Calculating Deductions

A. General. Whenever work or parts of work are rejected deductions will be made. The following hypothetical examples are given to demonstrate how deductions for deficiencies would be calculated.

B. Examples.

1. Random Sampling. Once a random sample has been taken of a lot or population, and the number of defective items exceeds the AQL for that lot, a deduction will be made. The following example demonstrates how a deduction would be calculated for excessive defects in Park Attendant Services. In this example, the lot or population size (i.e., the number of services over a 30 day period) is 30.

IF: Quality of work for registration/fee processing is found to be unsatisfactory (i.e., the AQL of 5% is exceeded).

AND: Contract price is $2,000 for the number of hours of Park Attendant Services ordered.

AND: The deducted percentage for registration/fee processing is 35% (taken from the Performance Requirements Summary Table).

AND: Sample size is 7 with a reject level of 3.

AND: Number of defects in sample is 5.

THEN: Deductions from the contractor's monthly invoice for performing one month of Park Attendant Services would be calculated according to the following equation:

No. of Defects X Deduct Percentage X Contract Price for = Amount of Sample Size PA Services PA Services Deduction

Substituting in the numerical values (from the example) the deducted amount would be calculated as follows:

5/7 X .35 X 2000 = 500.00

Therefore, $500.00 would be deducted from the contractor's monthly invoice for one month of Park Attendant Services.

2. Planned and Unscheduled Sampling. This example shows how a deduction would be calculated when planned or unscheduled sampling documents deficiencies in performing park attendant services. In this example, planned sampling has documented 3 defects in Visitor Assistance services during a month with 31 days. Therefore, the deduction would be calculated as follows:

a. Given factors: The Bid Item Price for the number of hours of Park Attendant Services ordered is $2,500.00. There are 31 days in the month. Therefore, the price per day is $2,500.00 / 31, or $80.65. (Note: All days will be considered of equal value, for the purposes of making deductions.)

b. Equation:

Number Bid Item Price Deduction Amount of X for One Day of X Percentage = of

Defects PA Services for Service Deduction

Substituting the numerical values from the example, the deducted amount would be calculated as follows:

3 defects X $80.65/ day X 0.30 = $72.58 deduction

Therefore, $72.58 would be deducted from the Contractor's invoice for performing Park Attendant for the month in question.

SECTION IV

PERFORMANCE REQUIREMENTS SUMMARY TABLES

│ PERFORMANCE REQUIREMENTS SUMMARY │

│ Required │ Section │ Maximum Allowable │ Method of │ Deduction │ │ Services │ Number │Degree of Deviation│ Surveillance │ % │ │ │ │ From Requirement │ │ │

│ │ │ (AQL) │ │ │

│Registration │ │ │ │ │ │and Fee │ C-2.2 │ 5% │Random Sampling│ 35% │ │Processing │ │ │ │ │ │Entrance │ C-2.2 │ 5% │Random Sampling│ 35% │ │Station │ │ │ │ │ │Operation an d │ │ │ │ │ │Management │ │ │ │ │ │Visitor │ C-2.2 │ 5% │Random Sampling│ 30% │ │Assistance │ │ │ │ │

SECTION V

SAMPLING GUIDES

1. Service Requirement: Registration and Fee Processing, Entrance Station Operation and Management, and Visitor Assistance.

2. Corresponding Contract Section: C-2.2

3. Method of Q.A.: Random Sampling

4. Acceptable Quality Level: 5%

5. Lot Size for Sampling: Variable

6. Sampling Size: Variable

7. Reject Level: Variable

8. Sampling Procedures: The COR will randomly select dates for park attendant station operation to be inspected each month, and inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be conducted in accordance with contraction specifications for park attendant services. Information will be recorded on an inspection checklist. The Contractor will be informed of the Government's assessment of this performance.

10. Performance Criteria: The Contractor shall perform all work as specified on the individual work orders. For all identified deficiencies, the Contractor will be allowed to reperform if the work order and contract specifications allow. Defects in Contractor performance may be addressed by issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies y reperformance, or for any defects/rejects in service requirements.

SECTION VI

INSPECTION CHECKLISTS

Inspection Checklist Project: Contract No: Delivery Date:

Contractor: Work Order No.: Weather:

Service Requirement: Rating Code: (1) Acceptable (2) Unacceptable (3) Work in Progress (4) Work Not Started Work Areas

Park Attendant

Specific Task(s) or Item(s)

Registration and Fee Processing Complete Following

Only If Deficiencies Noted:

Registration Forms Correct

ENG Form 3313 Correct

Funds Security

Appropriate Fees Collected and Recorded

Entrance Station Operation and Management Signature of CR or QCI who Reviewed

Date Time

OR

Safe Work Habits / Equipment

Attendant's Appearance (uniform, campsite)

Entrance Station Appearance

Loitering or Loafing

Cooperation with Corps

Handouts Distributed Correctly

Gates Operated Properly

Log Books / Visitor Register Correct

Visitor Assistance Signature of CR or QCI who

Received a Copy

Date Time

Customer Care

Park Inspection

Campers Informed of Rules

Reporting Incidents / Accidents

Violations Reported / 14 Day Camping Violations

Time

Defect Acceptable

See back for description of deficiency

Inspector's Signature Date COR Signature Date

This notice is to advise you of deficiencies found during inspection. The deficiencies found are in the performance and/or quantity of work. The deficiencies are to be corrected as specified.

Location

Comments and deficiencies which shall be corrected before work will be acceptable and satisfactory are as follows:

Comments on correction of deficiencies:

Inspector

Date

EXHIBIT I

CONTRACT DISCREPANCY REPORT (CDR) ORH FORM 2759

I

CONTRACT DISCREPANCY REPORT

Contract Number Work Order Number(s)

To(Contractor and Manager's Name) From (COR)

Prepared 1Ora

DATES

lNotification Retumedby Contr. ActionComplete

Discrepancy or Problem(Describe indetail: include reference inContract/Work Order: attach continuation sheet if necessary)

Signatureof ContractingOfficer or Authorized Representative

To(Contracting Officer or Authorized Representative) From(Contractor)

Contractor Response as to Cause,Corrective Actionarnd ActionstoPrevent Recurrence: Attach Continuation Sheet if Necessary.

(Citeapplicable Q.C.program procedures or new Q.C.procedures.)

Signature of Contractor Representatvi e IDate

Government Evaluation(Acceptance, partial acceptance, rejection: attach continuation sheet if necessary.)

Government Actions(Payment deduction,curenotice,show cause, other.)

CLOSE OUT

Name-Title Signature Date

Contractor Notified

COR

co

CEORD Form 1104-R

1 Feb 90

RM-F