A.03.09 Exhibits.pdf

SECTION J Exhibits

Exhibits

List of Attachments

A. Items to be Delivered at Least One Week Prior to Pre-Work Conference

B. Mowing and Cleaning Maps

C. Approximate Quantities by Area

D. Safety Plan Outline

E. Partial Listing of Safety Requirements

F. Safety Forms

G. Quality Control Plan

H. Quality Assurance Plan

I. Sample Work Schedule

J. Sample Invoice

K. Government Furnished Equipment List

L. Task Order, SF 1449

M. Job Request Form, CELRH 2770

N. Contract Discrepancy Form, DD 2759

O. Contractor Equipment and Inspection Forms

P. Vehicle Operations

Q. Inspection Forms

Exhibit A

Items to be Delivered at Least One Week Prior to Pre-Work Conference

Exhibit A

Contractor shall provide the following at least one (1) week prior to the pre-work conference:

A. Schedule of Cleanings. The schedule provided by the Contractor shall be of sufficient detail to allow the Government to inspect all items of work covered under Section C-3 and Section C-4 of the contract as they are being performed (See Exhibit K). Schedule should include daily and non-daily items.

B. Quality Control Plan. A suggested outline for the Contractor’s Quality Control Plan is contained in Exhibit G.

C. Contractor Representatives. List of names of Contractor Representatives and contact information.

D. Contractor Quality Control Inspector. List of Quality Control Inspectors.

E. Contractor Safety Plan. A suggested outline for the Contractor Safety Plan is contained in Exhibit D.

F. Emergency Contacts. A prioritized list, including phone numbers, of those persons (normally Contractor

Representatives) to call in case of emergencies.

G. Emergency Work Personnel. A list of names, addresses, and telephone numbers of persons who will be available for emergency work.

H. Operators. A list of qualified equipment operators, their qualifications, experience, and certifications for government furnished equipment.

I. CDL License. A list of individuals with valid CDL operator’s license with endorsements.

J. First Aid and CPR. First Aid and CPR certified individuals on each work crew.

Above documents shall be typed and legible.

Exhibit B

Mowing and Cleaning Maps

Mowing Maps

Deer Creek Lake

Mowing Map

Buck Area B (Map 1 of 2)

Buck Area B (Map 2 of 2)

Dam Area A (Map 1 of 2)

Dam Area A (Map 2 of 2)

Dike Area C

Dam Flats Area G

Doe Area D

Fawn Area F

Overlook Area E

SAO Area S

Cleaning Maps

Cleaning Map

Buck Area B (Map 1 of 2)

Buck Area B (Map 2)

Doe Area D

Fawn Area F

Overlook Area E

Policing of Dam (Map 1 or 2)

Policing of Dam (Map 2 or 2)

Exhibit C

Approximate Quantities by Area

Exhibit C

Approximate Quantities by Area

Item Buck Doe Fawn Overlook SAO Dam Dike Acres to be cleaned 10 10 4 8 0 28 0 Acres to be mowed and trimmed

10 9 3 6 2 11 10

Benches 4 6 5 8 0 0 0 Drinking Fountains 2 5 0 3 0 0 0 Fence (Security) (L.F.) 0 0 85 815 196 0 0 Gates 1 1 2 0 0 3 1 Gravel Lots 1 0 0 1 1 0 1 Grills 4 11 2 0 0 0 0 Parking spaces 77 47 42 40 0 0 0 Blacktop Area (Sq. Yds.) 5,000 4,095 2,710 4,420 164 856 0 Piezometers 2 0 2 0 0 24 0 Picnic Shelters 1 1 0 0 0 0 0 Picnic Tables 9 22 3 6 0 0 0 Picnic Tables in Shelter 15 15 0 0 0 0 0 Playground Equipment (sets)

2 3 0 0 0 0 0

Receptacles 12 20 7 2 0 0 0 Restrooms 1 1 0 0 0 0 0 Roads (miles) .3 .2 .2 .2 .1 .4 0 Signs 6 14 7 7 0 2 0 Vault Toilet 0 0 1 0 0 0 0

Exhibit D

Safety Plan Outline, EM385-1-1 Appendix A

EM 385-1-1

30 Nov 14

APPENDIX A

Minimum Basic Outline for Accident Prevention Plans

1. Accident Prevention Plan (APP) - General. An APP is a safety and health policy and program document that is contract- or job- specific. It is an integral part of the planning process. > See Section 01 and 01.A.12.

a. The APP shall interface with the employer’s overall safety and health program. Any portions of the overall safety and health program that are referenced in the APP shall be included as appropriate.

b. The APP shall be submitted to the GDA for acceptance prior to work starting.

(1) Understanding that the APP is submitted prior to work starting and that some project-specific information is not yet known (e.g., subcontractors to be used, type of fall protection to be used at a certain point in time, specific cranes or other load handling equipment (LHE) to be brought on site, etc.), the known information shall be provided and additional information added at each preparatory phase/meeting along with the appropriate Activity Hazard Analyses (AHAs).

(2) A copy of the contractor’s project-specific, accepted APP shall be available on the work site. > See ANSI/ASSE A10.38 for programmatic issues.

2. Abbreviated APP. In lieu of a fully-developed APP, for Limited-Scope Service, Supply and R&D Contracts (e.g. grass mowing, park attendant, rest room cleaning, etc.), the Contracting Officer (KO) and local Safety and Occupational Health Office (SOHO) may allow an Abbreviated APP to be developed and submitted for acceptance.

a. The non-mandatory Abbreviated APP Form, Form A-1 (or similar) may be used to insure each area of required information has been provided.

b. This APP is a short-version APP that can be used on low-risk, limited-scope contracts. > See 01.A.12.e, and Appendix A, paragraph 3.k.

c. Each sub-contractor shall be provided a copy of the APP by the prime contractor and be required to comply with it.

3. APP Format. The following areas are typically addressed in an APP, but besides being job-specific, the APP shall also address any unusual or unique aspects of the contract or job for which it is written. The non-mandatory Accident Prevention Plan (APP) Checklist, Form A-2 (or similar), may be used to insure each area of required information has been provided. > See ANSI A10.33 for multi-employer projects.

a. Signature Sheet: Include title, signature, and phone number of the following:

(1) Plan preparer (Qualified Person (QP), Competent Person (CP), Corporate safety staff person, QC) and their qualifications;

(2) Plan must be approved by 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, project QC). Contractors shall provide concurrence of other applicable corporate and project personnel.

b. Background Information. List the following:

(1) Contractor;

(2) Contract number;

(3) Project name;

(4) Brief project description, description of work to be performed, location (map), equipment to be used, anticipated high risk activities, and

(5) Major phases of work anticipated.

(6) Within these major phases of work identified, activities [includes Definable features of Work (DFOWs) and tasks] to be performed that will require an AHA shall be specifically highlighted. This information can then be used by QC, QA and Safety personnel to track AHA submittals. The AHAs for these activities, tasks of DFOWs are NOT submitted at this time (AHAs created/submitted at this time would not be activity-specific as they are intended to be). > See Sections 01.A.14 and 01.A.15.

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 shall also be provided.

d. Responsibilities and Lines of Authority. Provide the following:

(1) A statement of the employer’s ultimate responsibility for the implementation of his SOH program for his own employees, all sub-contractors and all others on the worksite (includes the strict enforcement of the program).

(2) Identification and accountability of personnel responsible for safety at both corporate and project level. Contracts specifically requiring safety or industrial hygiene personnel shall include a copy of their resumes. Qualifications shall be in accordance with Section 01.A.17.

Note: Only official OSHA 30-Hour cards will be accepted or, if equivalent training is provided, appropriate instructor qualifications. > See also Section 01.A.17.i, Exception 2.

(3) If equivalent training to the OSHA 30-hour classes is being presented as qualification, the training shall have covered the following areas:

(a) OSH Act/General Duty Clause;

(b) 29 CFR 1904, Recordkeeping;

(c) Subparts C, CC, D, E, F, K and M of OSHA;

(d) Rigging, load handling equipment (LHE), welding and cutting, scaffolding, excavations, concrete and masonry, demolition, health hazards in construction, materials handling, storage and disposal, hand and power tools, motor vehicles, mechanized equipment, marine operations, steel erection, stairways and ladders, confined spaces or any others that are applicable to the work being performed;

(4) The names of CP(s) and/or QP(s) and proof of competency/qualification to meet specific OSHA CP/QP requirements must be attached. The local SOHO will review the qualifications for acceptance;

(5) Requirements and details of the employer’s Risk Management Process;

Note: USACE uses the Activity Hazard Analysis (AHA) as part of a total risk management process. Contractors and other individual employer’s may use the AHAs or their own version [Job Safety Analyses (JSAs), Job Hazard Analyses (JHAs), or similar Risk Management assessment tools]. These documents are considered equivalent to, and acceptable substitutes for, the USACE’s AHA provided the data collected is the same as that required by the AHA.

(6) Requirements for initial activity-specific AHAs to be submitted and accepted at preparatory meetings, prior to work being performed;

(7) Requirements that no work by the Contractor shall be performed unless a designated CP/SSHO is present on the job site;

(8) Policies and procedures regarding non-compliance with safety requirements (to include disciplinary actions for violation of safety requirements) should be identified;

(9) Lines of authority;

(10) Provide written company procedures for holding managers and supervisors accountable for safety.

e. Subcontractors and Suppliers. If applicable, provide procedures for coordinating

SOH activities with other employers on the job site:

(1) Identification of subcontractors and suppliers. If not known at the time of initial APP submittal, the contractor shall include the following statement in their initial APP: “The subcontractors for the following DFOWs/activities are not known at this time, but additional information will be submitted to the APP for acceptance prior to the start of any activities listed”;

(2) Safety responsibilities of subcontractors and suppliers.

f. Training.

(1) Requirements for new hire SOH orientation training at the time of initial hire of each new employee.

(2) Requirements for mandatory training and certifications that are applicable to this project (e.g. explosive actuated tools, confined space entry, crane operator, underwater diver, vehicle operator, HAZWOPER training and certification, PPE, etc.) and any requirements for periodic retraining/recertification.

(3) Procedures for periodic safety and health training for supervisors and employees.

(4) Requirements for emergency response training.

g. Safety and Health Inspections.

(1) Specific assignment of responsibilities for a minimum daily jobsite SOH inspection during periods of work activity: Who will conduct (e.g., SSHO, PM, QC, supervisors, employees – depends on level of technical proficiency needed to perform said inspections), proof of inspector’s training/qualifications, when inspections will be conducted, procedures for documentation, deficiency tracking system, and follow-up procedures;

(2) Any external inspections/certifications that may be required (e.g. USCG).

h. Mishap Reporting and Investigation. The Contractor shall identify means to provide the following:

(1) Exposure data (man-hours worked);

(2) Mishap reports, investigations, and documentation. Report all accidents per the requirements covered in Section 01.D. Mishaps shall be reported as soon as possible but not more than 24 hours afterwards to the KO/COR. The contractor shall report, thoroughly investigate, and analyze all mishaps occurring incidentally to an operation, project or facility for which this manual is applicable. Implement corrective actions as soon as reasonably possible and provide notice to the KO/COR when corrective actions are completed;

i. Plans, Programs and Procedures, required by this manual. Based on a risk assessment of contracted activities and on mandatory OSHA compliance programs, the Contractor shall address all applicable SOH risks and associated compliance plans.

(1) Include a project-specific compliance plan, as applicable to the work being performed, and as identified below. The plans shall incorporate project-wide procedures to control hazards to which the employees of all project employers may be exposed.

(2) These procedures shall be coordinated with all project employers and shall include project-specific, project-wide emergency response and evacuation procedures, PPE requirements, recordkeeping and reporting requirements, and training requirements.

(3) The plans shall be prepared prior to the start of any work activities on the job site (as much as the information can be known at that point in time). The plans shall be updated throughout the life of the project to include changes in personnel, equipment, conditions, etc. Additional revisions shall be incorporated as necessary to reflect changing site conditions, construction methods, personnel roles and responsibilities and construction schedules.

(4) No activity (DFOW) shall be started on site until the APP is revised and submitted to the GDA for acceptance, with the site-specific plans, programs and procedures required to complete the project. Using the EM 385-1-1 as a guide, plans, programs, procedures (assessments and evaluations) may include but not be limited to:

• Fatigue Management Plan (01.A.20);

• Emergency Plans (01.E);

• Site Sanitation/Housekeeping Plan (02.B);

• Medical Support Agreement (03.A.01; 03.A.03);

• Blood-Borne Pathogen Program (03.A.05);

• Exposure Control Plan (03.A.05);

• Automatic External Defibrillator (AED) Program (03.B.04);

• Site Layout Plan (04.A);

• Access/Haul Road Plan (04.B);

• Hearing Conservation Program (05.C);

• Respiratory Protection Plan (05.G);

• Health Hazard Control Program (06.A);

• Hazard Communication Program (06.B.01);

• Process Safety Management Program (06.B.04);

• Lead Compliance Plan (06.C.02 & specifications);

• Asbestos Abatement Plan (06.C.03 & specifications);

• Radiation Safety Program (06.F);

• Abrasive Blasting Procedures (06.I.01);

• Heat Stress Monitoring Plan (HSMP) (06.J.02);

• Cold Stress Monitoring Plan (CSMP) (06.J.04)

• Indoor Air Quality Management (06.L);

• Mold Remediation Plan (06.L.04);

• Chromium (VI) Exposure Evaluation (06.M);

• Crystalline Silica Evaluation (06.N.02);

• Lighting Plan for Night Operations (07.A.06);

• Traffic Control Plan (08.C.05);

• Fire Prevention Plan (09.A.01);

• Wild Land Fire Management Plan (09.L);

• Arc Flash Hazard Analysis (11.B);

• Assured Equipment Grounding Control Program (AEGCP) (11.D.05, Appendix E);

• Hazardous Energy Control Program & Procedures (12.A.01);

• Standard Pre-Lift Plan – Load Handling Equipment (16.A.03);

• Critical Lift Plan – Load Handling Equipment (16.H);

• Naval Architectural Analysis – Load Handling Equipment (Floating) (16.L);

• Floating Plant Inspection and Certification (19.A.01);

• Severe Weather Plan for Marine Activities (19.A.03);

• Emergency Plan for Marine Activities (19.A.04);

• Man Overboard/Abandon Ship Procedures (19.A.04);

• Float Plan for Launches, Motorboats, and Skiffs (19.F.04);

• Fall Protection and Prevention Plan (21.D);

• Demolition/Renovation Plan (to include engineering survey) (23.A);

• Rope Access Work Plan (24.H);

• Excavation/Trenching Plan (25.A.01);

• Fire Prevention and Protection Plan for Underground Construction (26.D.01);

• Compressed Air Work Plan for Underground Construction (26.I.01);

• Erection and Removal Plan for Formwork and Shoring (27.C);

• Precast Concrete Plan (27.D.01);

• Lift-Slab Plans (27.E);

• Masonry Bracing Plan (27.F.01);

• Steel Erection Plan (28.B);

• Explosives Safety Site Plan (ESSP) (29.A);

• Blasting Plan (29.A; 26.J);

• Dive Operations Plan (30.A.14, 30.A.16);

• Safe Practices Manual for Diving Activities (30.A.15)

• Emergency Management Plan for Diving (30.A.18)

• Tree Felling and Maintenance Program (31.A.01);

• Aircraft/Airfield Construction Safety & Phasing Plan (CSPP) (32.A.02);

• Aircraft/Airfield Safety Plan Compliance Document (SPCD) (32.A.02);

• Site Safety and Health Plan for HTRW (33.B);

• Confined Space Entry Procedures (34.A.05);

• Confined Space Program (34.A.06).

j. Risk Management Process (AHAs). Detailed project-specific hazards and controls shall be provided by AHAs for each activity (DFOW). No work will begin on an activity (DFOW) until the initial AHA has been accepted by the GDA addressing the project-specific hazards. > See Section 01.A.14 and 01.A.15.

Note: USACE uses the Activity Hazard Analysis (AHA) as part of a total risk management process. Contractors and other individual employer’s may use the AHAs or their own version [Job Safety Analyses (JSAs), Job Hazard Analyses (JHAs), or similar Risk Management assessment tools]. These documents are considered equivalent to, and acceptable substitutes for, the USACE’s AHA provided the data collected is the same as that required by the AHA.

(1) The AHA defines the work sequence, anticipated hazards, conditions, equipment, materials, personnel and the control measures to be implemented to eliminate or reduce each hazard to an acceptable level of risk, and the Risk Assessment Code for each step.

(2) Once this process has occurred, an overall RAC shall be assigned to the activity, based on the highest RAC assigned to an individual step.

(3) Acceptance of risk. The residual risk is that which remains after controls have been applied. This residual risk must be communicated to the proper authority for acceptance in order to proceed with the activity.

(4) Before beginning each work activity/DFOW, the Contractor performing that work activity shall prepare the initial AHA, which will include a RAC for that activity.

(5) No work will begin on the activity until the initial AHA has been accepted by the GDA addressing the activity-specific hazards.

(6) AHA’s are intended to be created by the contractor field crews/workers performing the work, with the assistance of others (SSHO, QC, Superintendent, etc) as needed. They are living documents and are intended to be created in the field and updated (by the workers) as needed.

(7) The AHA shall be reviewed and modified as necessary to address changing site conditions, operations, or change of CP(s)/QP(s).

(a) If a new CP/QP (not on the original list) is added, the list shall be updated (an administrative action not requiring an updated AHA). The new person shall acknowledge in writing that he or she has reviewed the AHA and is familiar with current site safety issues.

(b) If the initial RAC increases due to a change made to the AHA by the workers, the

AHA shall be resubmitted to GDA for acceptance prior to work proceeding.

(c) Changes to or updates of an AHA that do not increase the RAC are not required to be resubmitted for acceptance by the GDA.

(8) Workers/crews shall have in their possession the current AHA that reflects current site conditions, personnel, equipment, control measures, etc while the work is being performed.

(9) The AHA shall be used by the contractor and USACE personnel to assure work is being performed consistent with the AHA. In the event that the work is not being conducted in a safe manner, the contractor and/or the USACE shall stop the unsafe work being conducted until it is in compliance with this manual, APP and the AHA or the APP/ AHA is revised and accepted by the GDA, if necessary. > See Section 01.A.14.

(10) Once the activity has been completed, the AHA shall be available and kept on file on site for the length of the contract.

k. 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 APP in lieu of a full APP. The abbreviated 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. The non-mandatory Abbreviated APP Form, Form A-01 (or similar) may be used to insure each area of required information has been provided.

(1) Title, signature, and phone number of the plan preparer.

(2) Background Information to include:

(a) Contractor;

(b) Contract number;

(c) Project name;

(d) Brief project description, Note: The project description shall provide a means to evaluate the work being done

(see AHA requirements in 01.A.14), associated hazards involved and a RAC assigned to each. The overall RAC for the activity must be determined (based on highest task RAC) and accepted at the appropriate level in order for work to proceed.

(e) Description of work to be performed, and

(f) Location of work being performed, to include a map.

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

(4) 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 be asked to review the qualifications for acceptance.

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

(6) Procedures for job site inspections - assignment of responsibilities and frequency.

(7) Procedures for reporting man-hours worked and reporting and investigating any mishaps required by Section 01.D.

(8) 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.

(9) Drinking Water provisions, toilet and washing facilities.

(10) 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 kits (types/size).

(11) Personal Protective Equipment (PPE).

(a) 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, chainsaw use, etc), they shall be worn.

(b) 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 chainsaw use, chipping, stump grinding, pruning operations, grass mowing, weedeating and blowing operations shall be provided safety eyewear (Z87.1) as a minimum.

(c) 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).

(d) Head Protection. Hard hats shall comply with ANSI Z89.1 and shall be worn by all workers when a head hazard exists, per Section 05.D.

(e) 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.

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

(g) 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.

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

(12) Machine Guards and safety devices. Power tools/equipment must have appropriate guards and safety devices in place and operational.

(13) Hazardous Substances. When any hazardous substances are procured, used, stored or disposed, a Hazard Communication Program must be in place and MSDSs (SDSs) 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.

(14) Traffic control shall be accomplished in accordance with DOT’s MUTCD.

(15) 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. > See Section 12.

(16) High hazard activities should not be encountered on these types of jobs. If they are (i.e., driving/operating equipment on slopes, working from/in boats, etc), a determination shall be made by the KO and local SOH Office as to whether an abbreviated APP is applicable. If so, they shall be fully addressed in the APP. AHAs are required on work activities which include high hazard activities.

Exhibit E

Partial Listing of Safety Requirements

Exhibit E

PARTIAL LISTING OF SAFETY AND SECURITY REQUIREMENTS

1. The following is a clarification of the Corps of Engineers' policy concerning the use of personal protective equipment for contract employees as defined in the EM 385-1-1, Safety and Health Requirements Manual. This is not meant to be a complete review of required safety equipment, but is simply provided to answer some of the more common questions concerning our safety policy.

The items of equipment listed below should be issued to each employee or made readily available for employee's use, when the work environment requires it:

a. Safety shoes - All employees except park aids performing traffic surveys and clerical personnel are to wear hard toe safety shoes at all times. For those not required to wear steel toed safety shoes, leather work shoes shall be worn.

b. Hard hats - Hard hats are to be worn when operating or working around equipment that lifts overhead (e.g.

backhoe-endloader) or working at ground level around mowing equipment. Hard hats will not be required when operating a riding mower, unless other mowing equipment is present. Hard hats will be required during construction type activities and wildfire suppression.

c. Safety glasses or goggles - Safety glasses with side shields or goggles are to be worn when operating equipment or working around equipment that may cause harm from flying debris (e.g. weed eaters), and when using power or hand tools.

d. Welders - Full face welder's helmets are to be worn during electric arc welding operations, and appropriate shields or warning shall be given or posted to protect other persons from the flash. During oxyacetylene welding or cutting, appropriate goggles or full face shield shall be worn.

e. Gloves - The proper type gloves are to be worn when there is a danger of burns, cuts, scrapes, scratches, wood splinters, or other injury to employee's hands.

f. Ear protection - Ear plugs or muffs shall be worn when operating any device that has been determined to produce 85 decibels or greater on a time-weighted average. It is the

Contractor’s responsibility to determine the noise level of your equipment. Each piece of equipment that exceeds 85dB(A) rating should be labeled to indicate the need for hearing protection.

g Protective leg chaps - Protective leg chaps are to be worn when operating equipment such as a chain saw.

h. P.F.D's (Personal Flotation Device/Life Jacket) - P.F.D's are to be worn at all times when working around the water or on board watercraft.

i. Safety cans - Containers for flammable liquids shall be labeled and meet the requirements specified in Section 9.B.

j. Seat belts - Seat belts are to be worn at all times when operating, or being transported by motor vehicles and when operating mobile equipment with rollover protection.

k. Safety vests - High-visibility apparel meeting, at minimum, ANSI/ISEA 07-2004 Performance Class 2 requirements, shall be worn when employees are working along roadways.

l. Lock-Out/Tag-Out - Lock-Out/Tag-Out procedures will be used in accordance with EM385-1-1, Section 12 and in coordination with project personnel.

m. Respiratory Protection - For work involving hazardous atmospheres, Contractors will provide a written Respiratory Protection Plan, which includes training and medical clearance. Section 05.G

2. The Contractor shall conduct monthly safety meetings and weekly "tool box" safety meetings in accordance with EM 385-1-1, Safety and Health Requirements Manual. The Contractor may contact the COR about upcoming work planned, to determine appropriate subjects for the monthly safety meetings. The Government makes no guarantee that the list of upcoming work planned, will actually be ordered nor will work ordered be restricted to said list. The Contractor shall inform the COR of the date, time, and place of the monthly safety meeting, a minimum of 7 days prior to the meeting.

3. Great emphasis will be given to the development and proper use of Activity Hazard Analysis (AHA). When ordered, AHAs will be developed in detail, utilized during job performance, and available to employees at the job site.

4. Transporting employees and equipment to worksites:

a. Vehicles used to transport staff and equipment must be well maintained and never overloaded. Each vehicle occupant must have a seat belt available to him or her and must wear the belt.

b. Personnel and tools must be kept apart during travel. Tools and tool boxes must be secured in a manner which will prevent their causing injury in case of a sudden stop or collision.

c. Tool box lids must be securely latched or locked.

5. Contractor vehicles involved in liter pick-up along project and public roads must be equipped with an orange rooftop revolving light, a rear mounted warning sign and reflective warning tape on the bumper. Employees performing liter pickup along public and project roads must wear High-visibility apparel meeting, at minimum, ANSI/ISEA 07-2004 Performance Class 2 requirements.

SECURITY REQUIREMENTS

1. The Contractor shall cooperate with the Government in providing for the security of Government property.

Some examples of the security measures expected include:

a. Closing and locking all gates and doors which were opened to allow Contractor personnel access for work.

b. Ensure that only Government personnel or authorized Contractor personnel enter secured areas. The COR or his representative shall be informed immediately if any unauthorized persons enter a secured area.

c. Secure or maintain constant surveillance on all pilfer able items to prevent theft. Provide control to ensure that Government furnished equipment, property, or materials are utilized only for contract-purposes.

Exhibit F

Safety Forms

Activity Hazard Analysis, CELRH-2796 OSHA’s Form 300 Log of Work Related Injuries and Illnesses

Accident Investigation Report, ENG-3394

ACTIVITY HAZARD ANALYSIS CHECKLIST

1. Are all blocks in the top 1/3 of the form completed including:

Project:

Date:

Job:

Estimated Starting Date:

Prepared by:

Recommended Protective Clothing and Equipment:

Reviewed by:

Page of ______ Positions Assigned to do Job:

2. Does the "Job" block include the job request number and sufficiently descriptive information to understand the tasks to be performed?

3. Is all the protective equipment necessary for all phases of the work listed in PART I?

4. Are all job steps listed and numbered consecutively in Part I including if applicable but not limited to:

a. Inspection of equipment and safety gear.

b. Loading and unloading of personnel and equipment.

c. Transportation to and from the job site.

d. Setting up equipment and safety markers.

e. Performance of tasks.

f. Securing job site while it is unattended.

g. Clean-up and storage of safety gear and equipment.

5. Are all hazards associated with each job step in Part I listed in Part II opposite the appropriate job step? Hazards may include but are not limited to:

a. Potential injuries during loading and unloading of equipment.

b. Potential injuries from improperly loaded and/or secured equipment and vehicles during transportation to and from job site.

c. Potential injuries from failure to follow defensive driving procedures or wear seat belts and shoulder harnesses to and from job site.

d. Potential electrical shock and/or fire hazards.

Exhibit G

Quality Control Plan

CONTRACTOR QUALITY CONTROL PLAN (OUTLINE)

1. INSPECTION OF SERVICES. Define the method of inspection for each service in the contract including, but not limited to: the individual(s) who shall inspect the service (Quality Control Inspectors);

when or with what frequency inspections shall be performed (e.g. at the completion of each task, etc.); and a copy of the Contractor's inspection forms or other documents identifying the specific tasks involved in the service which shall be inspected.

2. DEFICIENCIES AND CORRECTIVE ACTION. Explain the procedures for identifying deficiencies in the quality of services provided and methods of correction, before the level of performance is unacceptable.

3. RECORDS. Define the method for maintaining records of inspections and records of corrective actions taken, the individual(s) responsible for the records, and the location where the records shall be kept.

4. QUALITY CONTROL INSPECTORS. A consolidated list of authorized Quality Control Inspectors.

5. CONTRACTOR REPRESENTATIVES. A list of names and phone numbers of authorized Contractor

Representatives.

6. SECURITY. Define and explain the procedures and safeguards which shall be used to protect all equipment, materials, supplies, tools, and other resources provided by the Government to the Contractor including; but not limited to, Contractor audit procedures and inventory systems, if appropriate. Examples of procedures and safeguards include:

a. All pilferable materials shall be kept under constant surveillance and shall be collected at the end of each work day and secured under lock.

b. Keys shall be removed from all vehicles and equipment when not in use.

c. All gates and doors which were opened to allow Contractor personnel access for work shall be closed and locked. Only authorized Contractor personnel or Government personnel shall be permitted to enter secured areas. The COR or his representative shall be informed immediately if any unauthorized person enters a secured area.

Exhibit H

QUALITY ASSURANCE SURVEILLANCE PLAN

DEER CREEK LAKE

Date Contracting Officer Table of Contents

SECTION

SECTION I. Introduction.

A. General B. Acronyms and Definitions

SECTION II. Acceptance/Rejection of Services A. General B. Acceptance C. Rejection

SECTION III. Calculating Deductions A. General B. Examples

1. Random Sampling

2. One-hundred Percent Sampling

3. Planned Sampling

SECTION IV. Performance Requirements Summary Tables

SECTION V. Sampling Guides

SECTION VI. Inspection Checklists A. Examples

1. "Generic" Inspection Form

2. Pesticide Application

3. Cleaning Services, Recreation Areas

4. Grass Mowing and Maintenance of Landscaped Areas

5. Janitorial Services

6. Park Attendant

7. Contractor's Quality Control Program

8. Emergency Work Orders, Estimated Work Orders, etc.

SECTION I

INTRODUCTION

SECTION I. Introduction

A. General This plan will be used to assure the government that work specified under this contract is completed satisfactorily. The plan is included for information purposes only. It does not supersede any of the requirements in other sections of the contract. Surveillance or inspections will be primarily conducted in three ways; however, the Government has the right to change or modify inspection methods at its discretion. The three principle inspection methods are random, one-hundred percent, and planned. In conjunction with describing the principle methods used for providing surveillance (i.e., inspecting), this plan defines common terms and acronyms; summarizes in table form the performance requirements for each contract section; summarizes in table form a "sampling guide" for each contract section; explains how deductions for unsatisfactory performance are calculated; and, provides examples of Inspection Checklists.

B. Roles and Responsibilities

The following personnel shall oversee and coordinate surveillance activities.

Procuring Contracting Officer (PCO) – The PCO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The PCO shall also ensure that the contractor receives impartial, fair, and equitable treatment under this contract. Determine the final assessment of the contractor’s performance.

Assigned PCO: Cynthia Oxley Organization or Agency: US Army Corps of Engineers, Huntington District Telephone: 304-399-5337 Email: mary.l.newman@usace.army.mil

Contracting Officer’s Representative (COR) The COR is responsible for providing continuous technical oversight of the contractor’s performance. The COR uses the QASP to conduct the oversight/surveillance process. The COR shall keep a Quality Assurance file that accurately documents the contractor’s actual performance. The purpose is to ensure that the contractor meets the performance standards contained in the contract. The COR is responsible for reporting early identification of performance problems to the KO. The COR is required to provide an annual performance assessment to the KO which will be used in documenting past performance. The QASP is the primary tool for documenting contractor performance. The COR is not empowered to make any contractual commitments or to authorize any contractual change on the Government’s behalf.

Other Key Government Personnel This may include performance monitors, inspectors, or others who provide information that helps the COR monitor contractor performance.

C. Authority

Authority for issuance of this QASP is provided under Part 46 of the Federal Acquisition Regulation, Inspection of Services clauses, which provides for inspection, acceptance and documentation of the service called for in the contract or order. This acceptance is to be executed by the contracting officer or a duly authorized representative.

B. Acronyms and Definitions.

1. List of Acronyms.

mailto:mary.l.newman@usace.army.mil

a. AQL . . . . . . . . Acceptable Quality Level

b. CDR . . . . . . . . Contract Discrepancy Report

c. COR . . . . . . . . Contracting Officer Representative

d. CO. . . . . . . . . Contracting Officer

e. PRS . . . . . . . . Performance Requirements Summary

f. PWS . . . . . . . . Performance Work Statement

g. QA. . . . . . . . . Quality Assurance

h. QAE . . . . . . . . Quality Assurance Evaluator

i. QASP. . . . . . . . Quality Assurance Surveillance Plan

j. QC. . . . . . . . . Quality Control

k. QCP . . . . . . . . Quality Control Plan

l. N/A . . . . . . . . Non-Applicable

2. Definitions.

a. Acceptable Quality Level. Predetermined value used by the Government to distinguish between satisfactory and unsatisfactory performance. AQL may be stated in percent and is the maximum number of defects per 100 units that can be considered satisfactory. As long as the defective performance does not exceed the AQL, the total service will not be rejected by the Government. The contractor, however, must reperform the defective service.

b. Defect. Any deficiency determined to be significant as to render the unit unsatisfactory.

c. Deficiency. Any inspection unit which does not meet the Contract requirements in their entirety.

d. Inspection Unit. For statistical sampling the unit is identified in the sampling guide. For all other work the inspection unit is the job. The inspection unit may include several tasks.

e. Inspector. Individual designated by the COR to perform Quality Assurance.

f. Item. The term item, when used with the Contract, refers to the Bid Items contained in Section B of the Contract.

g. Job. A job describes an individual, separate, and defined element of work to be performed. "Mowing the Below Dam Recreation Area" or "Painting the Number One Picnic Shelter in the Below Dam Area" are examples of jobs.

h. Lot Size. The total number of times the service is performed in a given period of time, such as the total number of cleanings per month. Also called a population.

i. 100% Inspection. An inspection method requiring the examination of each completed job. It is not required that the inspector be at the job site 100 percent of the time while the job is occurring. This approach is best suited for monitoring contract requirements that occur infrequently or are of great importance.

j. Percent of Sample Found Defective. Determined by dividing the number of defects by the sample size.

k. Planned Sampling. An evaluation method designed to inspect some part but not necessarily all of the contract requirements. Sample selection is based on some subjective rationale and sample size is usually arbitrarily determined.

l. Quality Assurance. Those actions taken by the Government to insure goods or services meet the requirements of the contract.

m. Quality Assurance Evaluator. A Government official responsible for evaluating contractor's performance. Also, known as an inspector.

n. Quality Control. Those actions taken by a contractor to control the production of goods or services to insure that they meet the requirements of the contract.

o. Random Number Table. A table of numbers arranged in a random fashion. A table used to make random samples.

p. Random Sample. A sampling method whereby each service output in a lot has an equal chance of being selected, or where any occurrence of a contract requirement is as likely to be evaluated as any other occurrence.

q. Random Sampling. A method of looking at a few individual items in a lot to determine the quality of that lot against a standard.

r. Reject Level. The number of defects beyond which the total service for that lot is rejected by the Government and deductions are made. The contractor must reperform defective services, when possible, even if the number of defects is less than the reject level.

s. Sample. A sample consists of one or more service outputs drawn from a lot, the outputs being chosen at random. The number of outputs in the sample is the sample size.

t. Sampling Guide. The part of the surveillance plan which contains all the information needed to perform a random sample. A "how to inspect guide" for each type of work to be performed.

u. Service Requirement. A job to be performed to the specified standard and within the acceptable quality level. The contractor must do the specific job, meet the standard, and meet the acceptable quality level before performance is acceptable and contractor will be paid.

v. Surveillance Plan. An organized written Government Document used for quality assurance surveillance.

x. Unscheduled Inspection. Impromptu inspections of contract requirements without a pre-planned schedule.

y. Validated Complaints. An evaluation method utilizing customer awareness.

z. Work. The general scope of services covered under the specifications of this contract.

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 restroom cleanings. In this example, the lot or population size (i.e., the number of restroom cleanings over a 30 day period) is 125.

IF: Quality of work for cleaning restrooms is found to be unsatisfactory (i.e., the AQL of 5% is exceeded).

AND: Contract price is $2,000 for 30 days of restroom cleaning services.

AND: The deducted percentage for cleaning restrooms is 25% (taken from the Performance Requirements Summary Table).

AND: Sample size is 55 with a reject level of 6.

AND: Number of defects in sample is 10.

THEN: Deductions from the contractor's monthly invoice for performing Level 3 cleanings would be calculated according to the following equation:

Number of documented defects X Deduct Percentage X Contract Price Sample Size For Restroom Cleaning for Cleaning Services

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

10/55 X .25 X 2,000 = $90.91

Therefore, $90.91 would be deducted from the contractor's monthly invoice for cleaning services.

2. One-hundred Percent Sampling. Two hypothetical situations involving a fixed price (e.g., mowing) and a negotiated (e.g., replacement of fascia) work order have been selected for demonstrating how a deduction would be calculated where the inspection mode is 100%.

a. Mowing (Fixed Price).

IF: Work Order specifies the mowing and trimming of five recreation areas.

AND: Contract price is $10,000.00 per complete mowing.

AND: By the expiration of the completion date given on the Work Order contractor has successfully mowed and trimmed four areas, but has not begun work on the fifth and last area.

THEN: The contractor shall stop all mowing operations, a CDR may be issued, and the services of another contractor would normally be employed by the Government to complete the mowing and trimming of the fifth area. Actual costs incurred by the Government to obtain the services of another contractor to correct the deficiencies in the fifth area will be deducted from the contractor's invoice amount.

IF: The actual cost to the Government to correct the deficiencies is $2,000.00 which will be deducted from the Contractor's invoice for mowing.

THEN: $2,000.00 will be deducted from the contractor's invoice of $10,000.00.

b. Replacing Fiscia Board on Picnic Shelter (Negotiated Price Example).

SITUATION. In this example the Work Order specified the installation and painting of new fascia boards on a picnic shelter. Issuance of the Work Order was preceded by Contractor/Government negotiations which culminated in the issuance of the work order for the negotiated cost of $400. The final inspection revealed the contractor has satisfactorily installed, but failed to complete the painting of, the new fascia by the completion date specified on the Work Order.

GOVERNMENT ACTION. The Government would issue the Contractor a CDR and take the necessary action to correct the deficiency (i.e., paint the new fascia). In this example, the Government exercised the option to correct the deficiency by utilizing Government personnel. The Government would then deduct from the contractor's invoice the actual cost to the Government to correct the deficiency (i.e., paint the fascia).

CALCULATING THE DEDUCTION. Assuming the effective rate of the Government maintenance personnel was $12.50 per hour and it took 2 employees 6 hours to correct the deficiency:

Deduction = (2) (6) (12.50) = $150

Therefore, $150 would be deducted from the contractor's monthly invoice.

3. Planned Sampling. This example shows how a deduction would be calculated when planned sampling documents deficiencies in Janitorial Services. In this example, planned sampling has documented 3 defects in services over a 30 day (month) period. Therefore, the deduction would be calculated as follows:

a. Given factors: The Bid Item Price for Janitorial Services is $30.00/day.

b. Equation:

No. of Defects x Bid Item Price for = Amt. of Deduction Janitorial Services

Substituting in the numerical values from the example the deduction would be calculated as follows:

3 defects x $30.00/service = $90.00 deduction

Therefore, $90.00 would be deducted from the contractor's invoice for Janitorial Services for the month in question.

SECTION IV

PERFORMANCE REQUIREMENTS SUMMARY TABLES

PERFORMANCE REQUIREMENT SUMMARY

Required Services

Section Number

Paragraph Number

Maximum Allowable Degree of Deviation from Requirement (AQL)

Method of Surveillance

Deduction %

Initial Mobilization

C-1 C-1.2-1.33 All work must be performed in accordance with contract spec.

100% inspection N/A

Required Services

Section Number

Paragraph Number

Maximum Allowable Degree of Deviation from Requirement (AQL)

Method of Surveillance

Deduction %

Mowing Service (including initial mowing)

C-2 C-2.3 All work must be performed in…