Attachment 1 - PWS Occupational Health Exams.pdf

PERFORMANCE

WORK STATEMENT

(PWS) FOR

TECHNICIAN

OCCUPATIONAL

MEDICAL

SURVEILLANCE

EXAMINATION

SERVICES

Background: The Performance Work Statement (PWS) supports the Washington Army

National Guard (WAARNG) in order to monitor the health of approximately 90 technicians exposed to workplace hazards through technician Occupational Medical Surveillance

Examinations. The physicals will be given to technicians working in aviation and ground heavy equipment maintenance, mechanics, painters, welders, and any other employees exposed to workplace hazards. The Technician Occupational Medical Surveillance

Examination is a statutory OSHA and Department of Defense requirement.

1.1 Period of Performance (PoP): The Period of Performance shall be for a total of a base year including up to 4 option years.

1.2 General Information:

1.2.1 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan

(QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrences of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop

QC procedures that address the areas identified in Technical Exhibit 1, Performance

Requirements Summary. After acceptance of the QCP, the contractor shall obtain the

Contracting Officer’s (KO) acceptance in writing of any proposed changes to its QCP.

1.2.2 Quality Assurance (QA): The Government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance

Plan (QASP). This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) (defect rate(s)).

Recognized Holidays: The following are recognized US holidays. The contractor shall not perform services on these days:

New Year’s Day: January 1st

Martin Luther King Jr.’s Birthday

President’s Day

Memorial Day

Juneteenth-June 19th Independence Day: July 4th

Labor Day

Columbus Day

Veteran’s Day: November 11th

Thanksgiving Day

Christmas Day

2.1 Place and Performance of Services: The contractor shall provide services between the hours of 0700-1600, Tuesday through Friday, except on recognized US holidays or when the

Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings.

Meal and break times will not disrupt services. Performance shall be at four

(4) locations including: Field Maintenance Shop (FMS) #5, Fairchild AFB, Spokane, WA; Maneuver

Area Training Equipment Site (MATES), Yakima Training Center, Yakima, WA;

Army Aviation Support Facility (AASF) #2, Wenatchee, WA; and Field Maintenance Shop (FMS)

#3, Sedro Woolley, WA.

The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/ installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential.

2.2 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of contractor personnel installation driving privileges.

2.3 The contractor’s personnel shall obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation. Contractor personnel should only enter restricted areas when required to do so and only upon prior approval. All contractor personnel shall carry proper identification with them at all times. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance.

2.4 Security Requirements: The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the Contracting

Officer’s Representative (COR). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation

Provost Marshal Office, Director of Emergency Services or Security Office.

2.4.1 . The contractor shall ensure compliance with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. Should the Force Protection

Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

2.4.2 COMSEC/IT Security. All communications with DOD organizations are subject to communications security (COMSEC) review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DOD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DOD organizations. Therefore, the contractor is advised that, any time the contractor places or receives a call, he/she is subject to

COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all personnel dealing with DOD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

2.4.3 Protection of Personally Identifiable Information (PII). The contractor shall protect all

Personally Identifiable Information (PII) encountered in the performance of services in accordance with DFARS 224.103 and DoD 5400.11, Department of Defense Privacy

Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

2.4.4 Protection of Health Insurance Portability and Accountability Act (HIPAA). The contractor shall protect all HIPAA encountered in the performance of services in accordance with federal law, DoDI 6025.18-HIPAA, and DoDI 8580.02. If a HIPAA breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose HIPAA has been compromised.

2.4.4.1 Contractors handling medical documentation are required to complete HIPAA online training and provide the certificate to the COR prior to starting medical examinations.

2.4.5 Physical Security. Contractor personnel shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

3.0 Special Qualifications:

3.1 All personnel must be trained on DoD 6055.05 M and any OSHA Standards that relate to respective hazard exposures. Those performing spirometry testing must have NIOSH-Approved spirometry training. Those performing audiograms must be certified by the Council for

Accreditation in Occupational Hearing Conservation (CAOHC) in accordance with 29 CFR

1910.95. Vision testing is required to be done IAW U.S. Army Technical Guide (TG) 006 and

TG 007.

4.0 Furnished Property, Material, Equipment and/or Services:

4.1 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S): The

Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

4.1.1 Property/Services/Material: The Government will provide parking lot space at all locations and an 110V power source, must be verified and coordinated with Contracting

Officer Representative (COR).. The WAARNG will also provide PWSs describing examinations required, their prerequisite criteria for standards and medical standards, and the master employee roster listing examinations authorized/required.

4.2 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.2.1 General: Except for those items specifically stated to be Government-Furnished in

Paragraph 4.1.1, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.2.

4.2.2 The contractor shall provide all management, labor, material, equipment, certifications and supplies necessary to provide all listed services. The contractor shall provide a mobile, HIPAA, Privacy Act, OSHA & ADA compliant, stand-alone environment.

4.2.3 The contractor shall provide all Medical Equipment necessary to perform

Technician Occupational Medical Surveillance examinations at all four (4) locations.

4.2.4 The contractor shall have the mobile equipment capability to provide required occupational health surveillance services for up to a minimum of 10 physicals daily. They will provide their own medical supplies, office supplies, and equipment needed for all testing and exams.

4.2.5 The contractor shall ensure that the physician has an exam room with table and supplies available to conduct a thorough fit-for-duty per job description and functional capacity exam.

4.2.6 The contractor's medical van must be able to hook up to an 110V electric line.

4.2.7 The contractor shall provide documented proof of current required technician certification/license and equipment calibration with their proposal.

4.0.1 After the results have been reviewed by the contractor and are available for filing, the contractor will mail 2 (two) paper copies of each physical exam. The contractor will mail one copy to the WAARNG Occupational Health Nurse to include any follow-up instructions given to the employee or required case management by the OHN. The contractor will also mail one copy to each individual patient with notes requiring any follow-up.

4.0.2 The WAARNG Occupational Health Nurse will review the results of each physical exam and file a copy into the Civilian Employee’s Medical Record (CEMR), adding each to the Physicals Tracker/Case Management database.

4.0.3 The contractor must be certified and capable to conduct audiograms.

4.2.9.1 Audiograms MUST include a thorough otoscope examination and evaluation. The contractor shall provide a list of those who have participated in the hearing conservation program training during this medical surveillance event on a separate roster.

4.0.4 The contractor shall be able to conduct quantitative Respiratory Fit Testing for full-face and half-face respirators. The contractor will provide a roster of personnel clearances in writing, to wear respirators, type, and if any restrictions directly to the

OHN.

5.0 Requirements:

5.1 The contractor must be a business entity of the sort that can legally exercise ownership and/or control of persons/employees that are licensed/registered to practice medicine and/or conduct physical examinations in the State of Washington.

5.1.2 Medical surveillance testing to be completed during the tentative time frame of 1

Apr to 30 Sep 2025. Testing schedule will be coordinated through the Occupational Health Nurse. Contractor will be staffed to provide continuous exam operations during duty day hours from 0700 to 1600 hours. Meal and break times will not disrupt services. Set up for the exams will be accomplished prior to the exams. Contractor will develop a schedule for the medical surveillance and have it completed for the OHN and employees 15 days prior to the scheduled testing.

5.1.3 Initial Coordination: Contractor will contact and schedule an initial pre-performance phone call with the WAARNG within fifteen (15) working days after the award of the contract for the purpose of discussing the details of the specifications and implementation of services. Medical histories and questionnaires will be mailed directly to the employee or their work facility prior to testing.

5.1.4 This contract is for “Non Personal” Health Care “Services”, as defined in 37.101. In accordance with FAR Part 37.4 the Government may enter into a non-personal health care services contract with physicians, dentists and other health care providers Under authority of

10 U.S.C. 2304 and 41 U.S.C. 253. The Government shall evaluate the quality of professional and administrative services provided, while the Government retains no control over the medical, professional aspects of services rendered. The Contractor shall indemnify the

Government for any liability producing act or omission by the Contractor, its personnel and agents occurring during contract performance. The Contractor is required to ensure that its subcontractors, if any, for provisions of health care services, contain the requirements of the clause at 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance.

5.1.5 The Contractor shall provide all labor, materials, and equipment necessary for performance of individual examinations. In the event of the Contractor’s equipment failure, specific testing and/or parts of examinations that are not completed during the testing period shall be completed at a scheduled time mutually convenient for the Contractor and the

WAARNG. Unfinished testing/examinations will be completed at no cost to the Government.

The Contractor shall be directly responsible to cover costs for completing these examinations.

5.1.6 Contractor shall ensure all procedures are conducted in accordance with applicable

American Board of Occupational and Environmental Medicine (ABOEM), American

Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), and the National Institute for

Occupational Safety and Health (NIOSH) Standards.

5.1.7 Contractor shall ensure all clinical laboratory/chemistry services are performed by a laboratory licensed through the U.S. Department of Health and Human Services (DHHS), Health Care Financing Administration pursuant to the terms of the Clinical Laboratories

Improvement Act of 1967 (42 U.S.C. 263a) and the College of American Pathologists.

5.1.8 Contractor shall provide a Board Certified Occupational Health Physician to oversee the job-related medical surveillance physical examinations and occupational health consultation services. This individual shall also be a U.S. Department of Transportation, Federal Motor

Carrier, Medical Examiner. All personnel must be trained on DOD 6055.05M and any OSHA

Standards relating to the specific hazard exposures. The medical provider is responsible to notify both the technician AND the OHN immediately when an abnormality in the examination or laboratory results are identified.

5.1.9 Contractor shall provide certified/licensed medical technicians to administer medical surveillance screening/testing. Personnel conducting audiometric testing will be certified by a Council for Accreditation in an Occupational Hearing Conservation (CAOHC) approved program. Personnel conducting spirometry will be certified by a National Institute for

Occupational Safety and Health (NIOSH) approved program.

5.1.10 Contractor's instrumentation shall meet or exceed appropriate performance standards and accuracy must be verified IAW current Occupational Medicine

Certification standards.

5.1.11 Contractor shall ensure each healthcare worker complies with the requirements of 29 CFR

1910.1030 Bloodborne Pathogens Standard. Disposal of all infectious waste shall be in accordance with local, state, and federal regulation and disposed of by the contractor unless other accommodations have been coordinated in writing.

5.1.12 Contractor shall complete a head-to-toe functional capacity exam on each employee, to include weight lifting, range of motion, and identifying any physical limitations.

michelle.pletcher Cross-Out

5.1.2Respirator wearers-Contractor shall ensure Pulmonary Function Tests (PFTs) performed by a licensed physician, Certified Pulmonary Function Technologist, or Registered Respiratory Therapist in accordance with TB MED 509, Spirometry in

Occupational Health Programs. Reports will include respirator use clearance.

5.1.2.1 Test will include as a minimum Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), FEV1/FVC ratio, comparison with recognized normal results (Hankinson/NHANES III) for the individual’s height and weight, and a documented interpretation by a pulmonologist or certified Occupational Health physician.

5.1.2.2 Specifications regarding equipment guidelines and calibration test administration, and test interpretation must meet applicable OSHA and ANSI standards. Supporting documentation will be provided to this office upon request.

5.1.3 Contractor shall only use Quantitative Fit Testing to ensure the WAARNG technician is fit tested with the same make, model, style, and size of respirator that will be used. Fit testing will be done in accordance with 29 CFR 1910.134.

5.1.4 Contractor will use vision screening to detect the possible need for visual referral.

Parameters surveyed will include:

5.1.4.1 Visual acuity for distance and near.

5.1.4.2 Over 40 visual acuity for distance and near.

5.1.4.3 Vertical and lateral phoras for distance and near.

5.1.4.4 Depth perception

5.1.4.5 Color Parameters

5.1.4.6 Peripheral vision

5.1.4.7 Nondestructive Inspection and Testing (NDI) vision screenings IAW Federal Aviation association regulations.

5.1.4.8 The OHN will be notified of any abnormal findings per the TG 006 in writing or follow-up required testing immediately.

5.1.9 Contractor shall conduct an audiogram to include a record of the threshold of audibility of each ear for pure tone test frequencies:

5.1.9.1 500, 1000, 2000, 3000, 4000, and 6000 Hertz.

5.1.9.2 Hearing conservation training will be provided during testing.

5.1.9.3 Contractor shall provide vital signs to include measured height, weight, blood pressure, and pulse.

5.2 Contractor shall ensure an Occupational Health Physician (MD or OD), ARNP, or PA only with the appropriate qualifications, training, licensing, and experience in occupational health shall:

5.2.1 Provide a physical examination.

5.2.2 Verbally counsel patients on findings and wellness education.

5.3 Complete written reports/results will be administratively organized, put in envelopes and mailed. One copy will be mailed to the Occupational Health Office address below, and one copy mailed to each patient’s Home of Record no later than 60 days following the medical testing date.

Mail hard copies to:

WAARNG Office of the State Surgeon ATTN: Michelle Pletcher, Occ. Health Bldg 34 Aviation Drive, Camp Murray

Tacoma, WA 98430

5.3The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the National

Guard Bureau via a secure data collection site.

5.3.1 The contractor shall completely fill in all required data fields rising the following web address: http://www.ecmra.mil/. Reporting inputs shall be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through

September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2025. Contractors may direct questions to the help desk at http://www.ecmra.mil.

6.0 Other Requirements

6.1 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with Federal Acquisition Regulations

Subpart 42.5. The KO, Contracting Officer’s Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the Contracting Officer will apprise the contractor of how the

Government views the contractor’s performance and the contractor shall notify the Government of problems, if any, being experienced. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the

Government.

6.2 Contract Manager (CM): The contractor shall designate a CM who shall ensure performance is in compliance with this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO. The

CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR, (or the KO if a COR is not assigned), to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor personnel do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor personnel understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

6.3 Identification of Contractor Personnel: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e- mail) and dealings with Government or non-Government entities. Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, personnel name and the word “contractor” displayed. The contractor shall retrieve all identification media (including vehicle passes) from their personnel who depart employment for http://www.ecmra.mil/ http://www.ecmra.mil/ any reason. All identification media (i.e., badges and vehicles passes) shall be returned to the

KO within 14 days of personnel departure.

6.4 Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor personnel shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its personnel of the United States Government’s zero tolerance policy, the actions that will be taken against personnel for violations of this policy. Such actions may include, but are not limited to, removal from the contract, reduction in benefits, or termination of employment. The

Contractor shall take appropriate action, up to and including termination, against personnel or subcontractors that violate the US Government policy as described at FAR 22.17.

6.5 Data Rights: The Government has unlimited rights to all documents/material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the

Government with all rights and privileges of ownership/copyright belonging exclusively to the Government.

These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

6.6 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the

KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO and in the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may affect other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

6.7 AT/OPSEC requirements: Access and general protection/security policy and procedures. This standard language is for contractor employees with an area of performance within the installation, facility, or area. Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost

Marshal Office. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, DA, NGB and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

Access to government information systems. All contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel

Management.

If computer network is required: IA Contractor Training and Certification. This contract provides for the contractor to provide information assurance (IA) workforce personnel and therefore DFARS 252.239-7001 is incorporated into this contract for IA personnel. These persons must also comply with IS access requirements.

OPSEC requirements: Contractors shall comply with DoD Directive 5205.02 and any applicable service regulation and Army Regulation 530-1. The contractor shall implement OPSEC measures as ordered by the

CDR. The CDR/COR shall supply the Contractor with the required OPSEC training for their work location.

Additionally contract employees shall receive appropriate OPSEC training for their worksite.

AT Requirements: Contractor and all associated sub-contracts employees must successfully complete

Army presented Level One Anti-Terrorism training within 5 days of the beginning of this contract.

Optional AT/OPSEC training: As part of the request for proposal, issuance of the contract or any subcontract being issued the AT/OPSEC trifold will be provided and reviewed by each employee prior to arrival at the site of work.

Contractor access to certain buildings: Contractor employees must be accompanied by an authorized

WMD/WNG employee at all times while in any gov’t building as dictated by the Contracting Officer

Representative.

FPCON change language in all contracts: During FPCON Charlie and Delta ALL services are discontinued. services will resume when FPCON level is reduced to level Bravo or lower.

7.0 Applicable Publications: Publications applicable to this PWS are listed below:

Publication

(Chapter/Page)

Date of Publication Mandatory or

Advisory

Website

New DoDI 6055.1 Safety and

Occupational Health

(SOH) Program 14 Oct 2014 Mandatory

DoD

Instruction

6055.05-M

“Occupational Medical

Examinations and

Surveillance Mandal”

27 July 2022 Mandatory

DoD Instruction

6055.12 “Hearing

Conservation

Program (HCP)

14 Aug 2019 Mandatory

DA PAM 40–501

The Army Hearing

Conservation

Program

08 Jan 2015 Mandatory

29 CFR 1910

“Occupational

Safety and Health

Standards for

General Industry”

Advisory

29 CFR 1960

“Program Elements for Federal Employee

Occ. Safety & Health

Programs”

Mandatory

NGR 40-5, The

Army National

Guard Preventive

Medicine

Feb 2013 Mandatory

AR 11-34, The Army

Respiratory Protection

Program

July 25, 2013 Mandatory

Army Regulation

40-10, Health Hazard

Assessment Program

Advisory

Technical Guide

(TG-006)

Vision &

Safety Eyewear Guide for US Army Civilian

& Military Job Series

January 2016

Mandatory

AR 40-501 Army

Standards of Medical

Fitness

June 14, 2017 Mandatory

Department of

Health and Human

Services, National

Institute for

Occupational Safety and Health, Publication No. 79-

116, “A guide to the

Work- Relatedness of Disease”

August 7,2023 Advisory

Headquarters, Department of the

Army Pamphlet (DA

PAM) 40-506 Vision

Conservation

July 15, 2009 Mandatory

8.0 Definitions and Acronyms:

8.1.1 CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

8.1.2 CONTRACTING OFFICER (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

8.1.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the

U.S. Government designated by the KO to monitor contractor performance. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

8.1.4 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

8.1.5 DELIVERABLE. Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

8.1.6 KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS.

When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

8.1.7 PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

8.1.8 QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

8.1.9 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

8.1.10 QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

8.1.11 SUBCONTRACTOR. One that enters into a contract with a prime contractor.

8.1.12 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

8.1.13 WORK WEEK. Tuesday through Friday, unless specified otherwise.

9.0 ACRONYMS:

AFARS

ALT

AP

AR

ARNG

AST

AT/OPSEC

BUN

CBC

CdB

CdU

CFR

CONUS

COR

COTS

CSMS

DA

DA PAM

dB dBA

DD250

DD254

Army Federal Acquisition Regulation Supplement

Alanine aminotransferase

Alkaline phosphatase

Army Regulation

Army National Guard

Aspartate transferases

Antiterrorism/Operational Security

Blood urea nitrogen

Complete blood count

Blood cadmium

Urine cadmium

Code of Federal Regulations

Continental United States (excludes Alaska and Hawaii)

Contracting Officer Representative

Commercial-Off-the-Shelf

Combined Surface Maintenance Shop

Department of the Army

Department of the Army Pamphlet decibel

A-Weighted decibel

Department of Defense Form 250 (Receiving Report) Department of Defense Contract Security Requirement List

DFARS Defense Federal Acquisition Regulation Supplement

DOD Department of Defense

DoDI DoD Instruction

DOEHRS-HC Defense Occupational and Environmental Health Readiness System- Hearing

Conservation

FAR Federal Acquisition Regulation

FEF Forced expiratory flow

FEV-1 Forced expiratory volume in the first second

FMS Field Maintenance Shop

FVC Forced vital capacity g/dL Grams/deciliter

GFP/M/E/S Government Furnished Property/Material/Equipment/Services

GGT Glutathione transferases

H & H Hemoglobin and hematocrit

HCP Hearing Conservation Program

HDL High density lipoprotein

HIPAA Health Insurance Portability and Accountability Act

Hz Hertz

IA Information Assurance

IS Information System(s)

KO Contracting Officer

NFPA National Fire Protection Association

NGB National Guard Bureau

OCI Organizational Conflict of Interest

ODC Other Direct Costs

OSHA Occupational Safety and Health Administration

PFT Pulmonary function Testing

PII Personally Identifiable Information

PIPO Phase In/Phase Ort

POC Point of Contact

PPD Tuberculosis/Tuberculin Skin Test

PPE Personal Protective Equipment

PRS Performance Requirements Summary

PWS Performance Work Statement

QA Quality Assurance

QAP Quality Assurance Program

QASP Quality Assurance Surveillance Plan

QC Quality Control

QCP Quality Control Program

STS Significant Threshold Shift

TE Technical Exhibit

TWA Time-Weighted Average

ZPP Zinc Protoporphyrin

TECHNICAL EXHIBIT 1

Performance Requirements Summary

This Performance Requirements Summary includes performance standards. The Government will use these standards to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

PWS Paragraph Task Performance

Standard Acceptable Quality

Levels (AQL) Surveillance

Method /

1.2

The contractor shall provide Technician Occupational Medical Surveillance Examinations to all technicians requiring medical surveillance 100% of the time.

The contractor shall complete all personnel requiring medical surveillance, 100% of the time each month.

2% failure to provide Technician Occupational Medical Surveillance Examinations to all technicians available requiring medical surveillance.

Periodic Inspection- COR will review all testing and exam results for completeness and accuracy against the master roster of employees to be tested

5.1.7

The contractor shall provide Occupational Medical Surveillance Examinations in accordance with DoD and OSHA Regulations

The contractor shall perform occupational medical surveillance examinations based on regulation 100% of the time each month.

0% failure to provide the specified components of the regulatory Occupational Medical Surveillance Examinations.

Periodic Inspection – COR will review examinations to ensure regulatory compliance.

5.1.9

The contractor shall notify the technician both verbally and in writing if there is an abnormality requiring farther follow-up.

Any abnormalities that are related to work place hazard exposures require notification to the

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0% failure to notify of abnormal results

Periodic Inspection of records

The contractor shall notify the technician both verbally and in writing if there is abnormality in the exam results and recommended medical follow-up. Any abnormality that may be related to the job hazard exposure will require notification of the Occupational Health Nurse both verbally and in writing.

Any non- work related abnormality should include written recommendation for follow-up, 100% of the time.

The contractor shall The contractor shall 0% failure to provide certified staff to perform Technician Occupational Medical Examination services each month.

Periodic Inspection -provide physicians, provide certified staff COR will review provider technicians and/or within the established certification.

certified staff in timeframes 100% of

5.1.9 and 5.1.10 accordance with all legal and regulatory the time each month.

requirements of the

State of WA.

The contractor shall The contractor shall 0% failure to provide certified equipment in the performance of Technician Occupational Medical Examinations.

Periodic Inspection- COR will review equipment certification logs provide provide equipment

5.1.11 instrumentation that is certified and instrumentation that meets or exceeds meets performance performance standards 100% of standards.

the time

5.1.12

The Contractor shall dispose of all Infectious Waste 100 % of the time.

All sharp instruments, blood, and urine is handled and disposed of in accordance with federal, state, and

0% failure to dispose of all infectious waste.

Periodic Inspection – COR will observe for proper handling and disposal of potentially infected materials local regulations 100% of the time.

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Co pies

Medium/Format Submit To

5.4 – Copy of employee’s examination findings

30 business days following medical examination

Hardcopy

Hardcopy

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Patient

5.4 – Summary

Spreadsheets

30 business days following medical examination

Internet Database

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TECHNICAL EXHIBIT 3

Estimated Workload Data

(This information is provided for historical background only. It is not a guarantee of workload quantities.)

ITEM NAME

ANNUAL ESTIMATED

QUANTITY

Technician Occupational

Medical Surveillance

Examinations - All four (4) locations

10-15 Exams per day or annual estimate of 125 technicians over the course of the month when exams are being conducted.