A04_Statement_of_Work_0044022317_1.pdf

TECHNICAL PROVISIONS/SPECIFICATIONS

DIVISION 1 - GENERAL REQUIREMENTS

SECTION 01100 SUMMARY OF THE WORK SECTION 01310

PROJECT COORDINATION SECTION 01330 SUBMITTALS

SECTION 01420 DEFINITIONS AND STANDARDS SECTION

01770 PROJECT CLOSEOUT

DIVISION 2 – EARTHWORK AND SITEWORK SECTION 02200

EARTHWORK AND SITE REMEDIATION

ATTACHMENTS

SUBMITTAL REGISTER

PRE-CONSTRUCTION SAFETY CHECKLIST

DRAWINGS

DESCRIPTION SHEET

COVER SHEET, COUNTY/LOCATION MAPS

AND DRAWING INDEX

BERM PLAN AND ELEVATIONS

PHOTOS OF BERM IN CURRNET CONDITION 3 OF 3

DIVISION 1

GENERAL REQUIREMENTS

01310-3

GENERAL REQUIREMENTS SUMMARY OF THE WORK

PART 1 - GENERAL

1.1 Project Title: Remediation of a Small Arms Firing Range (SAFR) at the Fort Niobrara National Wildlife Refuge, near Valentine, NE.

1.2 Work Under These Specifications

A. Contractor shall furnish materials, labor and equipment, and all associated fees for the work described below. Measurement and payment shall be as defined below.

The work includes but is not limited to: Site characterization via soil sampling; excavation and sieving approximately 165 cubic yards of soil for bullet and bullet fragments from the berms face; retest face of berm confirmation sampling via soil and groundwater sampling for metals. If sample come back with exceedances contact the COR and Contracting Officer to discuss removal of additional material. Soil below contaminate levels will be left on-site and is the responsibility of the U.S. Fish and Wildlife Service for further action. Once the site is clean the contractor shall provide a written Corrective Action Completion Report (CACR); and obtain a “No Further Action” letter from the Nebraska Environmental Protection Agency as part of the Site Remediation Program (35 Ill Adm Code Part

740. The contractor must sign up for the Voluntary Cleanup Program with the State of Nebraska and must obtain a No Further Action Letter.

The firing range is approximately .6 acres in size, 40 meters wide, 120 meters long with a 5-meter earthen target berm at the south end (Appendix A). The berm was constructed of earthen materials to serve as the backstop to contain spent ammunition. Most of the earthen berm remains but native grasses and vegetation have overgrown the berm and range. A minor amount of lead, arsenic, tin, and other substances/materials harmful or potentially harmful to soil, water, and living organisms may be present in the berm, the ground in front of the berm, and the surrounding area. Cleanup is expected to be completed and contaminants removed within a year of the contract award date.

The work includes but is not limited to: Site characterization via soil sampling;

excavation and sieving approximately 165 cubic yards of soil for bullet and bullet fragments from the berms face; retest face of berm confirmation sampling via soil and groundwater sampling for metals. If sample come back with exceedances contact the COR and Contracting Officer to discuss removal of additional material. Soil below contaminate levels will be left on-site and is the responsibility of the U.S. Fish and Wildlife Service for further action. Once the site is clean the contractor shall provide a written Corrective Action Completion Report (CACR); and obtain a "No Further Action" letter from the Nebraska Environmental Protection Agency as part of the Site Remediation Program (35 Ill Adm Code Part 740). The contractor must sign up for the Voluntary Cleanup Program with the State of Nebraska and must obtain a "No Further

01310-4

Action Letter".

The contractor shall perform soils characterization of the former firing range site.

Characterization sampling of the soil shall include as a minimum: Collect twenty (20) discrete random soil samples from areas within the range perimeter and sample for "total metals." Metals to be sampled for are Cu, Ni, Pb, Zn, Sb, Sn, and As.

If the samples are found to exceed Statewide Default Background Levels contact the CO and COR immediately.

This work will not be measured for payment and shall be ased on a lump sum payment.

1.3 Location And Inspection of Site

A. The work site is located at Fort Niobrara Wildlife Refuge near Valentine, Nebraska. The mailing address is 39983 Refuge Road Valentine, NE 69201.

B. The Assistant Manager, Katie Schober, may be contacted for further information at the above referenced address or by telephone at (402) 376-3789.

All prospective bidders/quoters, contractors, subcontractors, and related persons are encouraged to visit the site(s) of the proposed Work and to assess the location(s) and extent of the Work prior to submitting bids/quotes. Persons may inspect the site by contacting the Assistant Manager.

1.4 Specifications and Drawings for Construction

A. The successful bidder will be provided, upon request, one (1) sets of full size prints of the contract drawings as necessary for execution of this contract. These drawings will be provided at no additional cost to the successful bidder/quoter.

B. Exact location of all affected utilities will be the responsibility of the contractor.

Drawings may not completely show all utilities. Site verification is required in addition to contacting any local authorities and utility companies to determine exact locations of utilities.

C. In case of difference between drawings and specifications, the specifications shall govern.

1.5 Work Not Included In This Contract

A. All items indicated "NIC" on drawings or in specifications are items not included in this contract.

B. Work in place is generally shown as "Existing" on the Contract Drawings.

C. Work to be performed under other contracts and not included as part of this

01310-5 contract is generally shown as "By Others" on the Contract Drawings.

1.6 Items Provided By The Government

A. Work to be accomplished by the Government or manufactured items to be provided by the Government are generally shown as "By Government" on the Contract Drawings.

1. Unless specifically provided herein, no materials or equipment shall be furnished by the Government under this Contract.

1.7 Temporary Facilities

A. Maintain and restore all government roads, service areas and utilities used to pre-construction condition.

B. Temporary toilet facilities must be provided.

1.8 Site Access and Right of Way

A. The construction access limits on Government property will be established by the Government and the Contractor shall be responsible for complying with these limits and governing all Work accordingly. All temporary access roads shall be removed following Work completion unless directed otherwise by the Contracting Officer.

B. Requirements for maintenance of traffic in a safe manner shall follow the Manual on Uniform Traffic Control Devices (MUTCD). Load limits and other restrictions shall be obeyed. All bidders are reminded that they are responsible for contacting the local entity such as township, county, state, etc., having jurisdiction in the project vicinity to insure bidders/quoters are aware of any requirements of the local entity.

These requirements are between the entity and the bidder. If the Contractor proposes to cross private property, permission must be obtained from the owner to use private property or roads in the conduct of the Work.

C. Work scheduled on Saturdays, Sundays, Federal Holidays or other than normal working hours shall be approved in advance by the Government.

1.9 Safety - In addition to FAR 52.236-13 Accident Prevention

A. Contractor shall fill out and submit the “Preconstruction Safety Checklist” to the Contracting Officer (CO) prior to beginning construction.

B. The contractor shall designate a safety officer to ensure a safe work site. The safety officer shall perform daily work site inspections to assure compliance with all safety

01310-6 regulations and standards.

C. The Contractor’s Safety Plan shall be available on-site. The Contractor shall provide Safety Data Sheets for all hazardous materials brought on-site. Safety Data Sheets shall be made available in a conspicuous location.

D. All equipment and work activities shall comply with OSHA Regulations and all accidents incidental to work performed under this contract shall be reported in accordance with OSHA reporting requirements. Additionally a copy of the accident report shall be provided to the Contracting Officer.

E. The Contractor shall provide and install barricades, signs, or other warning devices to delineate the construction area and restrict public access to the construction site. Follow Manual of Uniform Traffic Control Devices (MUTCD).

F. Provide at least one non-freezing-type fire extinguisher in each workshop and shed used for storage of materials on the premises. Place in location readily accessible to workers.

G. Provide at least one non-freezing-type fire extinguisher of the appropriate class for each group of workers performing flammable operations.

H. Provide and maintain a basic first aid kit for use of workers.

(a) Provide first aid supply commensurate with size of project with items necessary for first aid treatment of all injuries. Include first aid items identified on Safety Data Sheets for applicable items, in applicable locations.

(b) Advise all workers of the location of first aid supplies.

(c) Post telephone numbers of nearest hospital or ambulance service and fire station in conspicuous location. Advise all workers of location of telephone numbers.

I. Provide necessary Personnel Protective Equipment (PPE) as identified by Safety Data Sheets and OSHA regulations. Provide documentation workers have been trained in use of PPE prior to individual use.

(END OF SECTION 01100)

01310-7

1.1 Jobsite Administration - Superintendence, Subcontract administration and Quality Control, is the responsibility of the Contractor.

A. Final decisions relative to items in conflict shall be made by the Contracting Officer.

B. The Government shall have the authority to temporarily suspend the Work for such time as necessary because of the failure on the part of the Contractor to perform any of the provisions of the Contract, and no extension of contract performance time will be allowed for such suspensions. Resumption of Work will not be permitted until the Government determines that the deficiencies in performance, which caused the temporary suspension, have been corrected.

C. The Contractor shall notify the COR at least ten (10) days prior to the anticipated date of completion of all Work specified herein. Upon completion of the Work, the COR shall proceed with the final inspection which shall be completed as promptly as practicable. The time required for such inspection and for performing any corrective Work shall be included in the contract performance time.

1.2 Modification/Change Order procedures

A. In the event of the need for a Change Order, the Contractor will receive a letter requesting a price quote for proposed changes to the Contract.

B. For evaluation purposes, the Contractor's quote shall be broken down to show the costs of labor and materials for each proposed category of Work included with the change, along with the total cost for Contractor's overhead, profit, and bond for the proposed changes.

C. All Contract time extensions required as a result of a proposed change must be justified and supported in detail at the time of the proposal.

1.3 Preconstruction Conference

A. Soon after award of the Contract and prior to commencing construction, the Contractor and any subcontractors shall attend a preconstruction conference with representatives of the Government.

1. Timely notification of the meeting will be given to the Contractor. Time, date, and place of the conference will be determined by the Contracting Officer.

2. Requirements pertaining to Contract administration, construction operations and the project schedule will be discussed. The project schedule shall be in accordance with Section 01330.

3. The Preconstruction Safety Checklist shall be presented for review and

01310-8 completion during the Preconstruction Conference.

1.4 Progress Meetings

A. Periodic general project meetings will be conducted with a representative of the Contractor at the project site or by telephone by the Government's representative for the purpose of coordinating, expediting, and assessing the work progress.

B. The Contractor shall provide reports of progress on the project, discuss the work schedule for the coming period and present all conflicts, discrepancies or other difficulties for resolution. A record of discussions and decisions will be prepared by the Government and distributed to those attending and others affected.

PART 2 - PRODUCTS (Not Applicable) PART 3 -

EXECUTION (not Applicable)

(END OF SECTION 01310)

SECTION 01330

SUBMITTALS

01330-

1.1 General:

A. Refer to submittal register or technical specifications for all submittals required.

1.2 Submittal Register:

A. A submittal register, listing all items requiring submittals under this solicitation, is provided as an attachment to this document. The Contractor shall provide all required submittals to the COR within 15 days of award except for items noted otherwise on the submittal register.

B. Furnish electronic color copies of all required submittals to the COR.

The remaining copies will be returned to the Contractor.

C. The approval of submittals shall not relieve the Contractor to comply with the terms and conditions of the Contract Drawings and Specifications. The Contractor shall be responsible to determine correct dimension, design, connection, detail and satisfactory construction of all Work.

1.3 Project Schedule: Contractor shall provide as required by Federal Acquisition

Regulation (FAR) clauses. *

1.4 Price Breakdown - Lump Sum Items: Contractor shall provide as required by FAR clauses.

1.5 Subcontractor's List: Submit a list of subcontractors who will be working on the project.

1.6 Submittal of Progress Payment Certificate: Contractor shall provide as required by FAR clauses. *

1.7 Delivery Tickets

A. The Contractor shall submit to the Government's on site representative, one legible copy of each delivery ticket for all material delivered to the construction site.

B. The delivery ticket shall show brand name, catalog number, and number of items received.

1.8 Waste Manifests

SECTION 01330

SUBMITTALS

01330-

A. The Contractor shall submit copies of all waste manifests.

B. Manifests shall state type of waste (i.e., construction debris, hazardous asbestos, etc.), location of disposal, landfill designation, EPA registration of landfill, and EPA registration for transportation of any hazardous wastes.

1.9 Preconstruction Safety Checklist: The Contractor shall submit signed copies of the Preconstruction Safety Checklist.

PART 2 - PRODUCTS (Not Applicable) PART 3 -

EXECUTION (Not Applicable)

* The applicable FAR clauses will be provided in full text to the resultant contractor at the pre-construction conference.

(END OF SECTION 01330)

1.1 Regulatory Requirements

A. All Work shall be accomplished in strict accordance with the regulations, codes, and laws in effect at the time the Work is performed for the location where it is to be performed.

B. All completed construction shall comply with the State of Nebraska, Nebraska EPA, Nebraska Department of Health, and OSHA requirements.

1.2 Means and Methods

A. Means and methods used in the performance of this Contract must be in accordance with all applicable Federal Acquisition Regulations in addition to OSHA regulations, 29 Code of Federal Regulations, acceptable industry practices as recognized by societies, Nebraska EPA, Nebraska Department of Health, and any applicable state safety and health requirements.

1.3 Permits

A. It is the responsibility of the Contractor to obtain all necessary permits and to pay all fees to facilitate the safe and legal accomplishment of all the Work described in this specification.

PART 2 - PRODUCTS (Not Applicable) PART 3 -

(END OF SECTION 01420)

SECTION 01770

PROJECT CLOSEOUT

01770-2

1.1 Final Inspection

A. The Contractor shall request a final inspection in writing at least ten (10) days prior to the anticipated date of completion.

B. Work will not be considered ready for final inspection until all the Work has been completed and the Contractor has certified that all items are complete in strict compliance with all Contract terms and conditions.

C. The Contractor or the project supervisor shall be at the job site during the final inspection.

1.2 Tests

A. Submit required reports of all environmental activities to the Contracting Officer and submit a written Corrective Action Completion Report to Nebraska EPA prior to final payment.

1.3 Record Drawings:

A. The Contractor shall provide and maintain in proper order and in good, clean condition, at the project site, one

(1) complete set of full size prints of all Drawings. On this set, with red pencil or ink, the Contractor will neatly inscribe all changes in Work.

B. At time of final acceptance, and prior to final payment, these corrected prints will be presented to the COR. The Contractor will note all data and changes on these record drawings in sufficient detail and clarity to provide information necessary for preparation of "as built" drawings by the Government.

1.4 Guarantees, Warranties and Certificates

A. The Contractor will submit all guarantees, warranties and certificates to the Government prior to final payment.

PART 2 - PRODUCTS (Not Applicable) PART 3 -

(END OF SECTION 01770)

DIVISION 2

SITEWORK

SECTION 02200

02200-1

PART I – GENERAL

1.1 SUMMARY

A. The requirements of this section shall govern all Earthwork, Site Investigation and Remediation activities.

B. The Contractor shall provide all labor, tools, equipment and materials necessary to perform all earthwork and site remediation activities.

C. It is the intent of these specifications to meet the Ecological Protection requirements for the refuge under the Environmental Protection Agency (EPA)and Nebraska Department of Environment and Energy Voluntary Site Remediation Program and obtain a No Further Action (NFR) Letter.

1.2 JOB CONDITIONS

A. The Fort Niobrara National Wildlife Refuge former firing range was used by Law Enforcement Officers and Refuge Staff, for training and annual re-qualifications, for at least 25 years, however the amount of shooting or lead contamination has not been documented. The shooting area was abandoned several years ago. The firing line distance to target is about 150 meters. It is anticipated the area of greatest concern is the berms face to a depth of three feet located behind where the timber cribbing was located and the firing line.

The berm is estimated to be 40 meters Long, 10 meters Wide, and 5 meters high.

1.3 QUALITY ASSURANCE

A. The Contractor shall have experienced in remediation of Small Arms Firing Ranges.

B. A licensed professional environmental consultant will be responsible for overseeing excavation activities, soil sampling, ground water assessment, and sampling procedures, and providing a CACR report to the Service and the Nebraska EPA and obtaining a Letter of No Further Action from the State of Nebraska. Contractor will pay all associated fees with obtaining the No Further Action Letter.

C. Contractor shall engage a National Environmental Laboratory Conference (NELAC) certified laboratory in the

SECTION 02200

02200-2 state of Nebraska to perform all soils and groundwater monitoring analysis.

Contractor shall pay for all testing.

D. The Contractor shall be responsible for verifying the location of existing utilities.

Any damage incurred to existing utilities will be repaired by the Contractor at his/her expense to the satisfaction of the COR.

E. Contractor is responsible for obtaining and paying for all permits and fees.

F. The Contractor shall be responsible for cleaning and washing all equipment prior to bringing it on site to avoid introducing invasive species, seeds, or plants to the environment.

1.4 SUBMITTALS

A. The contractor shall submit the name and credentials of the licensed professional Environmental Consultant to be used during this project.

B. Submit certification showing that all personnel working on the site has Hazardous Waste Operations (HAZWOPPER) training with a current annual refresher course.

C. Submit certification showing the contractor and all personnel working on the site are currently certified in lead abatement in the state of Nebraska.

D. Submit name of laboratory and certification that it meets the regulatory requirements.

E. Provide a Corrective Action and Completion Report (CACR) of all field activities including but not limited to the following: soil and groundwater test results, findings, conclusions, excavation activities, and a certification of SAFR closure. The report shall be signed by a professional environmental engineer.

F. Provide certification of the Subtitled D Landfill disposal site that accepts all excavated soils.

G. Provide load tickets of all soils and waste manifests of all soils and any debris removed from Refuge property.

SECTION 02200

02200-3

1.5 COORDINATION

A. The Contractor shall notify the FWS and Nebraska Department of Environment and Energy at least thirty days before beginning work.

1. Nebraska Department of Environment and Energy Voluntary Cleanup Program at (402)471-6411.

2. United States Fish and Wildlife Service –Branch of Environmental Compliance – Contracting Officers Representative, Robert McGinn at 612-713-5235, Assistant Refuge Manager, Katie Schober 308-645-7440.

PART 2 – MATERIALS

N/A

PART 3 - EXECUTION

3.1 The contractor shall perform soils characterization of the SAFR site.

A. Characterization sampling of the SAFR shall include as a minimum:

1. Collect twenty (20) discrete random soil samples from areas within the SAFR perimeter and sample for “total metals” as shown on the contract drawings. Metals to be sampled for are Cu, Ni, Pb, Zn, Sb, Sn, and As.

2. If the samples are found to exceed Statewide Default Background Levels contact the CO and COR immediately.

3.2 Berm Backstop Face Remediation.

A. Contractor shall excavate soils from berms backstop as shown on the contract drawings. Removed soil shall be contained as to not contaminate the surrounding environment.

B. Contained soils shall be sieved using a No. 4 sieve to

SECTION 02200

02200-4 remove lead bullets and lead fragments. Method of soil sieving is Contractors option on condition that all the soils are contained to prevent further contamination to the environment.

C. Lead bullets and fragments shall be removed from sieve, treated as scrap metal and recycled through a licensed recycler. A recycled waste manifest shall be given to the CO and COR.

D. Following sieving, perform SPLP or TCLP test on sieved soil and the berm backstop to determine suitability that soils may be disposed of in a certified Subtitle D landfill disposal site. (check landfills for verification of testing required)

1. If soils exceed hazardous levels contact the COR immediately.

2. Perform soil stabilization to all soils exceeding hazardous levels.

a. Method of soil stabilization shall be contractor’s choice as approved by the COR.

b. For estimating purposes two cubic yards of soil are to be stabilized by add/mix Portland cement on an average 5 percent of the soils lead concentration to total contaminated soils.

3. Upon determination the berms soils meet the requirements for disposal excavate and dispose of the entire berm to surface level. Dispose of all soils including the contained soils in a subtitle D landfill.

4. For the purpose of this contract approximately one hundred (165) cubic meters of soils are estimated for disposal.

5. Contractor shall provide a waste manifest and fee tickets for disposal of material at the subtitle D landfill. Contractor shall pay for all transportation and landfill permits, fees, and testing.

3.3 Confirmation sampling of the excavated berm as a minimum:

A. Twenty (20) random soil samples shall be obtained from the area of the excavated berm and sampled for total metals.

1. If the samples are found to exceed Statewide Default Background Levels contact the CO and COR immediately.

B. Two groundwater samples shall be obtained from the berm face area of the excavated berm and sampled for total metals and compared to Groundwater Surface Water Interface (GSI) action levels.

1. Groundwater samples may be obtained using the “Low Flow” method.

2. If the groundwater samples exceed Groundwater Surface Water Interface

(GSI) action levels contact the COR immediately.

3.4 The contractor shall submit to the FWS and Nebraska EPA a

SECTION 02200

02200-5

Corrective Action and Completion Report detailing all site activities including but not limited to the following: Site Characterization, soil sampling and analysis; soil sieving; soil excavation and soil disposal including waste manifest from the landfill disposal site;

analysis and results of all soil and groundwater confirmation sampling; include tables indicating all laboratory samples to date, dates sampled, and results of each sample; any field measurement taken; References, such as maps or photos of the sampling, and certification the SAFR has been re-mediated and closed according to EPA, Nebraska EPA, and all, Federal, State, and local regulations.

3.5 The Refuge will provide topsoil and revegetate the site.

3.6 The Contractor shall take reasonable precaution to protect natural plant and tree growth outside of the earth moving limits against damage from earth moving operations.

3.7 Contractor shall comply with all Federal, State, County and local regulations when removing and disposing trash, debris, and other waste materials off Government property.

(END OF SECTION 02200)

SUBMITTAL REGISTER PAGE 1 of 1

DATE 08/19/24

SHOP DRAWINGS, EQUIPMENT DATA, AND MATERIAL SAMPLES

CONTRAC

T NO:

PROJECT:

LOCATIO

N:

Firing Range Remediation Fort Niobrara Wildlife Refuge County - Cherry

CONTRA

CTOR:

ADDRESS

CONST.

MANAGER:

McGinn

SPECIFICATION SECTION NO.

DESCRIPTION DATE RECEIVED TRANS. NO. REVIEWED BY

DATE ACT. TAKEN

ACTION CODE DATE RESUBM.

ACTION CODE

COMMENTS

01330, 1.3 Progress Schedule 01330, 1.4 Price Breakdown 01330, 1.5 Subcontractor's List 01330, 1.6 Progress Payment Certificate 01330, 1.9 Delivery Tickets 01330, 1.10 Waste Manifests 01770, 1.3 Test Reports 01770, 1.4 Maintenance and Operating Instructions 01770, 1.5 Record Drawings 01770, 1.6 Guarantees, Warranties, and Certificates

02200 1.04 A Contractor EPA ID Number 02200 1.04 B Personnel HAZWOPPER Training Certs.

02200 1.04 C Contractor and Personnel

Lead Certification Laboraty Certification

02200 1.04 D 02200 1.04 E Corrective Action Completion Report 02200 1.04 F Certification of Subtitle D Landfill 02200 1.04 G Waste Manifest

Preconstruction Safety Checklist

CONTINUED ON NEXT SHEET

Action Codes A - Approved as Submitted D - No Action Taken - See Comments B - Approved Except As Noted - Resubmission Not Required E - Disapproved - See Comments - Resubmission Required C - Approved Except As Noted - Resubmission Required

FWS Form 3-2199 09/01 Page 1 of 5

PRECONSTRUCTION SAFETY CHECKLIST

PROJECT T ITLE: CONTRACT NUMBER: PROJECT LOCATION:

PRECONSTRUCTION MEETING

DATE:

NAME AND ADDRESS OF

CO NT RACT OR :

NAME OF CONTRACTOR

SU PER INT EN DE NT /FO RE M AN

NAME OF SERVICE

CONTRACTING OFFICER:

NAM E O F C ON TR ACT OR ’S

COM PETEN T PERSO N (PER 29

CFR

PROPOSED CONSTRUCTION

STAR T D ATE:

The Fish and Wildlife Service (FWS) places safety and health as a top priority at all Service contracted construction sites (360 FW 4). The contractor has ultimate responsibility for safety during construction until final completion and acceptance of the project by FWS.

This checklist serves as an assurance tool/guide in assessing safety program preparations of the contractor, and is not all- inclusive. As tasks change and new risks and hazards are introduced, you may need to address additional safeguards and corrective m easures.

The contractor and subcontractor(s) must com ply with all Occupational Safety and Health Administration (OSHA) regulations applicable to the construction project, including requirements set forth within solicitation provisions and contract clauses (e.g., FAR 52.236 -13 “Accident Prevention” with Alternate I and Special Provisions). It is the responsibility of the contractor/subcontractor(s) to adhere to regulations found at 29 CFR 1910, 1926, and 1928. (See page 5 for Table of Contents of OSHA Construction Safety Standards.) Each contractor/subcontractor must initiate and maintain an effective safety program that provides adequate systematic policies, procedures, and practices to protect their em ployees from, and allow them to recognize, job-related safety and health hazards. The program must include provisions for the systematic identification, evaluation, and prevention/control of general work site hazards, specific job hazards, and potential hazards that may arise from foreseeable conditions, as well as providing a competent person to conduct frequent and regular inspections. The contractor must instruct each employee to recognize and avoid unsafe conditions and the regulations applicable to the work environm ent.

The contractor may use at its option the latest edition of the “Bureau of Reclamation Safety and Health Standards” manual and appedixes as a safety program implem entation guide for the duration of the contract. .

FWS Form 3-2199 09/01 Page 2 of 5

The contractor will address the following items prior to and/or during the Preconstruction Conference (the Contracting Officer/Contracting Officer’s Representative will record these items) :

1. The contractor has read and understands his/her re spo nsibilities for compliance with contractual safety language - FAR 52.236-13, Accident Prevention, Alternate I and applicable safety provisions?

YES NO

2. Has contractor prepared a Safety Plan that analyzes anticipated hazards of the project and indicates how the hazards will be controlled? Contractor must identify specific procedures for controlling hazardous operations such as crane use, scaffolding, excavation/trenching, hot work/welding, etc,.

YES NO N/A

FWS Form 3-2199 09/01 Page 3 of 5

3. How will contractor/subcontractor address the four leading hazards of construction work:

falls, struck by, caught in/between, and electrical?

4. The “Designated Competent Person” (responsible for the project’s safety and health perform ance) is knowledgeable in applicable OSHA regulations and capable of identifying existing/predictable hazards, and has the authority to prompt corrective measures? YES NO

5. Do contractor and subcon tractor em ployees know wha t to do in the event of an em erge ncy (e.g., injury, fire, accident, hazardous material spill, etc.) with regard to the following actions?

a. Notification of Departm ent, FW S Facility Manager, CO, COR , CI, etc.

b. Means of com munication with contact numbers (e.g., radio, cellular, pager, etc.).

c. Availability of first-aid/medically-trained contractor personnel with appropriate medical supplies.

d. Personnel (including subcontractors) knowledge of location for imm ediate aid (e.g., first-aid, etc.).

e. Evacuation routes, signals, and procedures are provided to all on-site personnel.

f. Safety and health information disseminated to all site personnel (e.g., contractor and subcontractor employees).

6. W ill a contractor/s ubc ontra ctor tra iler be broug ht on site and its hook-up/p lacem ent coord inated with COR /CI?

a. Location and type of trailer (office or equipment).

b. Telephone hook-up.

c. Electrical hook-up.

YES NO (If no, skip to # 7)

d. Vehicle parking arrang em ent (adequate space).

e. Propane used for heating?

f. Serve as first-aid station? YES NO

7. Is contractor aware that he/she must ensure construction area is clearly delineated and posted with appropriate warning signs (e.g., “Hard H at Area”, “Construction Site – CLOSED”, “Area C losed to Public”, etc.), and that

FWS Form 3-2199 09/01 Page 4 of 5 instructional signs (e.g., designated parking area, etc.) and flagmen or barriers may be required?

Yes No

8. Housekeeping - Is contractor/subcontractor aware that they must ensure that following acceptable housekeeping standards are practiced from project’s start to finish? YES NO

a. Form/scrap lumber with protruding nails and all other debris shall be kept clear from work areas.

b. Com bustible scrap and debris shall be removed at regular/frequent intervals.

c. Materials shall be stored with regard to their fire characteristics with effective fire protection and prevention measures used.

d. An enclosed chute shall be used whenever materials are dropped more than 20 feet to an exterior point of a building.

e. Aisles, exits, and passageways shall be kept clear and in good repair.

9. Is contractor aware of following Environmental and Personal Controls standards? YES NO

a. Potable water provided.

b. Restroom facilities provided.

c. W ashing facility provided for employees engaged in operations involving harmful substances.

d. Intoxicating beverages, controlled substances, and/or firearms are not permitted under any circumstances on the construction site.

e. All activities in or around water bodies must be in compliance with regulations for worker safety, including personal flotation devices or buoyant work vests, lifelines, ring buoys and guardrails while working over or adjacent to water hazards, and from barges, boats, and/or launches.

FWS Form 3-2199 09/01 Page 5 of 5

10. Is contractor/subcontactor aware that following employee training considerations may need to be addressed?

YES NO

a. Confined Space.

b. Scaffolding.

c. Fall Protection.

d. Hazard Comm unication.

e. Lockout/Tagout.

f. Respiratory Protection.

g. First Aid.

11. Contractor/subcontractor is responsible for requiring the wearing of appropriate personal protective equipment in all operations where there is an exposure to hazardous conditions or where the need is indicated for using such equipment to reduce the hazard to their employee(s). The contractor/subcontractor is also responsible for ensuring that personnel using protective equipment shall be trained and medically qualified to do so. Such personal protective equipment may include the following: Discussed with contractor?

a. Eye and face protection (safety goggles, safety glasses, welding goggles, face shields, etc.).

b. Protective footwear (safety shoes, boots).

c. Protective gloves (leather, rubber, insulated).

d. Respirators (dust, half-face, full-face, etc.).

e. Hearing protection (ear plugs, m uffs, etc.).

f. Coast G uard-approved PFD/buoyant vest.

g. Fall protection equipm ent.

12. Tools (hand, electric, pneumatic) Standards: Discussed with contractor? YES NO

a. Hand tools, power tools, and jacks are maintained in safe operating condition and used only for the purpose for which they were designed.

b. Electric power-operated tools must be either approved double-insulated, or be properly grounded (see Ite m #13 “Electrical” for additional considerations).

13. Electrical Standards:

a. Ground Fault Circuit Interrupters (GFCIs) or an assured equipment-grounding conductor program must be used to protect employees from ground-fault hazards.

b. Electrical cords/insulation m ust be in good condition (not frayed or dam aged).

c. All ground plugs m ust be on electrical cords, if so designed by the manufacturer.

d. W orkspace, walkways, and similar locations shall be kept clear of electrical cords.

e. All electrical extension cords must be of the three-wire type.

f. Contractor/subcontractor must determine need and implem ent an appropriate Lock-

FWS Form 3-2199 09/01 Page 6 of 5 out/Tag-out program.

14. W ill motor vehicles, cranes, and/or heavy equipment be used? YES NO (If no, skip to #15)

a. Crane and derrick use must comply with applicable standards.

b. Rollover protection as required.

c. Back-up alarms or observer signals as required.

d. No crawler type vehicles are allowed on an improved road.

e. All utilities must be located prior to excavating soil.

15. Excavating and Trenching work? YES NO (If no, skip to #16)

a. All excavating/trenching must be in accordance with applicable safety standards.

b. All utilities must be located prior to excavating.

FWS Form 3-2199 09/01 Page 7 of 5

16. Elevated W ork? YES NO (If no, skip to #17)

a. Ladders and their use must conform to standards.

b. Aerial lift usage must meet applicable requirements.

c. Fall protection needs must be assessed per standards.

d. Scaffold work must conform to standards.

e. Stair design, construction, and use must meet applicable requirements.

f. Toeboards, when used to protect workers from falling objects, must be erected along the edge of the overhead walking/working surface.

g. Safety net use must com ply with standards.

h. Railing must conform to standards.

17. Contractor is aware of and understands the need to incorporate app licable requirem ents for concrete and m asonry construction. YES NO N/A

18. Contractor is aware of and understands the need to incorporate welding and cutting operations that com ply with applicable safe ty requirem ents (e.g., compressed gas cylinders are protected from vehicle traffic, valve caps secured, etc.). YES NO N/A

19. Contrac tor is aw are o f and understands the need to m anage hazard ous m aterials/waste appro priately (e.g., paints, solvents, fuels, etc.) including the following:

YES NO N/A

a. Use and storage of flammable/combustible liquids.

b. Aboveground fuel storage tanks properly managed/contained.

c. Com pressed gases and cylinders managed correctly (e.g., secured and protected from dam age, etc.).

d. Procedures for managing use, storage, and disposal of hazardous materials properly established.

e. Excess/waste product(s) and containers properly disposed of per environmental regulations.

f. Hazards of product use and the need for protective measures (e.g., personal protective equipment, etc.) conveyed to employees.

g. Asbestos work conform s to applicable standards.

h. Exposure to toxic gases, vapors, fum es, dusts, and m ists managed correctly.

i. Lead, laser, and any other hazardous components managed per the applicable standard.

j. Contract employees must conduct hazardous waste operations work within the parameters of a written safety & health plan.

20. Com ments, notes, additional requirements:

FWS Form 3-2199 09/01 Page 8 of 5

The contractor has the ultimate responsibility for safety on the project site at all times until final completion and acceptance of the project.

The contractor’s signature below indicates the above information was discussed and understood.

Contractor signature: Date:

Date:

Contracting Officer/Contracting Officer’s Representative

FWS Form 3-2199 09/01 Page 9 of 5

OSHA CONSTRUCTION SAFETY STANDARDS - 29 CFR 1926:

(Following standards can be accessed at http://www.osha.gov):

Subpart A (1926.1 - 1926.5) - General Subpart B (1926.10 - 1926.16) - General Interpretations Subpart C (1926.20 - 1926.35) - General Safety and Health Provisions Subpart D (1926 .50 - 1926 .66 ) - Occupational Health and Environm ental Controls Subpart E (1926.95 - 1926.107) - Personal Protective and Life Saving Equipment Subpart F (1926.150 - 1926.155) - Fire Protection and Prevention Subpart G (1926.200 - 1926.203) - Signs, Signals and Barricades Subpart H (1926.250 - 1926.252) - Materials Handling, Storage, Use and Disposal Subpart I (1926.300 - 1926.307) - Tools - Hand and Power Subpart J (1926.350 - 1926.354) - W elding and Cutting Subpart K (1926.400 - 1926.449) - Electrical Subpart L (1926.450 - 1926.454) - Scaffolds Subpart M (1926.500 - 1926.503)

- Fall Protection Subpart N (1926.550 - 1926.555) - Cranes, Derricks, Hoists, Elevators and Conveyors Subpart O (1926. 600 - 1926.606) - Motor Vehicles, Mechanized Equipment and Marine Operations Subpart P (1926.650 - 1926.652) - Excavations Subpart Q ( 1926.700 - 1926.706) - Concrete and Masonry Construction Subpart R (1926.750 - 1926.752) - Steel Erection Subpart S ( 1926 .800 - 1926.804 ) - Underground Construction, Caissons, Cofferdam s and Compressed Air Subpart T (1926.850 - 1926.860) - Demolition Subpart U (1926.900 - 1926.914) - Blasting and the Use of Explosives Subpart V (1926.950 - 1926.960) - Power Transmission and Distribution Subpart W (1926.1000-1926.1003)- Rollover Protective Structures; Overhead Protection Subpart X (1926.1050 -1926.1060 )- Stairways and Ladders Subpart Y (1926.1071 -1926.1092)- Diving Subpart Z (1926.1100 -1926.1152)- Toxic and Hazardous Substances

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