Attachment 1 - NSWCPD COVID-19 Screening and Self-Assessment Questionnaire.pdf
PDF 104 KB Posted
- Attached to
- NSWCPD Temperature Screening Services (*RESOLICITED*) Federal contract opportunity
- Solicitation number
- N6449821Q0133
About this file
This document contains a screening questionnaire and details of a federal contract solicitation. The screening questionnaire requires individuals entering Naval Sea Systems Command facilities to confirm they have not traveled internationally or domestically outside a 50 mile radius in the past 14 days, been exposed to or experienced symptoms of COVID-19, and outlines related screening protocols.
The solicitation seeks temperature screening services at all NSWCPD facilities on a firm-fixed-price basis. Quotations are requested by email no later than 12:00 PM EST on December 2, 2020 and must reference solicitation number N6449821Q0133. The services do not require medical personnel as only temperature screening will be conducted. A mandatory Department of Labor wage determination is included. Offerors must provide past performance information and technical details in their response.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N6449821Q0133.pdf | ||
| EXHIBIT 1 - CDRL A001 NSWCPD Temperature Scanning.pdf |
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Text version
2 DEC 2020
Revision 9
NSWCPD COVID-19 SCREENING & SELF-ASSESSMENT QUESTIONNAIRE
1. Have you traveled INTERNATIONALLY (to include Canada) within the last 14 days? YES or NO
2. Have you traveled DOMESTICALLY (U.S.) outside of our authorized local travel radius in the past 14 days?
(As a general rule the local travel radius is defined as 50 miles from the worksite. If the employee lives beyond 50 miles, then the local travel radius is extended for the normally used commute route. For non-swipe contractors/visitors, the NSWCPD POC shall be contacted for final disposition). YES or NO
3. Have you had close personal contact, as defined below, with anyone who has been diagnosed with COVID-19 (lab or clinical diagnosis) OR anyone who has any symptoms consistent with COVID-19? YES or NO
a. Within 6 feet for a cumulative of 15 minutes within a 24 hour period
b. In a confined space (car, small room, shared stateroom, berthing proximity, office, etc.)
c. Had direct contact with infectious secretions (been coughed, sneezed on, etc.)
4. Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19? YES or NO
5. Are you currently waiting on the results of a COVID-19 test due to suspected exposure to the virus or based on experiencing the symptoms below? YES or NO
6. In the last 14 days, have you experienced any of the following symptoms:
Symptoms Yes No Symptoms Yes No Fever or chills Loss of taste or smell Shortness of breath Sore throat Difficulty breathing Congestion or runny nose Fatigue Nausea Muscle or body aches Vomiting Headache Diarrhea
Seek medical advice by calling your insurance provided health line number and/or:
• Pennsylvania Department of Public Health: 1.877.724.3258 or visit, health.pa.gov
• New Jersey Department of Public health: 1.800.962.1253 or text, NJCOVID to 898-211 or visit, covid19.nj.gov
• Delaware Department of Public Health: 1.866.408.1899, or email, DPHcall@delaware.gov, or visit, coronavirus.delaware.gov
If you have answered YES to any of the above questions or have tested positive for COVID-19 in the last 14 days, DO NOT ENTER the building and contact your direct supervisor/company for further direction.
File details come from the government source that posted it. Updated .