Attachment 1 - Statement of Work Cross Connection Survey.pdf

Statement of Work For:

Perform Cross Connection Survey

Minot AFB, ND

16/Nov/2023

Contracting Officer

Contracting Officer Representative

Eric Sloan, 5 CES/CEOIU

701-723-6003

Eric.sloan@us.af.mil mailto:Eric.sloan@us.af.mil

Contents 1.

INTRODUCTION……………………………………………………………………………………….Err or! Bookmark not defined.

2. TASK

REQUIREMENTS………………………………………………………………………………..Error!

Bookmark not defined.

2.1. PRE-PERFORMANCE

MEETING………………………………………………………………....Error! Bookmark not defined.

2.2. CROSS CONECTION CONTROL SURVEY………………………………………………………2

2.3. CROSS CONNECTION SURVEY DATABASE AND REPORT………………………………….2

3. REFERENCES AND CODES…………………………………………………………………………...3

4. CONTRACTOR QUALIFICATIONS…………………………………………………………………...4

5. ATTACHMENT A. LOCATIONS………………………………………………………………………5

6. SUBMISSION FOR EAL………………………………………………………………………………...8

7. COMMUNICATION…………………………………………………………………………………….6

8. TECHNICAL ACCEPTABILITY………………………………………………………………………..6

9. CONFLICTS WITH TECHNICAL DETAILS ………………………………………………………….6

10. COORDINATION……………………………………………………………………………………...6

11. PERSONNEL…………………………………………………………………………………………...6

12. PROTECTION OF PROPERTY……………………………………………………………………….6

13. CLEANUP………………………………………………………………………………………………7

14. SCHEDULING…………………………………………………………………………………………7

14.1 OPERATING TIMES……………………………………………………………………………...7

15. FEDRAL HOLIDAYS…………………………………………………………………………………..7

16. BASE CLOSURES………………………………………………………………………………………8

17. START OF WORK……………………………………………………………………………………...8

18. ACCESS TO SITE………………………………………………………………………………………8

19. SECURITY REQUIREMENTS………………………………………………………………………... 8

19.1 OPERATIONAL SECURITY………………………………………………………………………8

19.2 BASE ACCESS……………………………………………………………………………………... 8

19.3 REAL ID ACT……………………………………………………………………………………...8

19.4 US PASSPORT…………………………………………………………………………………….8

20. RECORDS MANAGEMENT…………………………………………………………………………..9

21. SPECIAL INSTRUCTIONS…………………………………………………………………………...10

21.1 PROVISIONS OF CONTRACTING OFFICER'S AUHTORITY………………………………..10

21.2 TRAFFIC REGULATIONS……………………………………………………………………….10

21.3 MANDATORY SEATBELT REQUIREMENTS…………………………………………………10

21.4 FEDERAL, STATE, AND LOCAL COMPLIANCE……………………………………………...10

21.5 VEHICLE REGISTRATION……………………………………………………………………...10

21.6 RADAR DETECTORS AND DASH CAMERAS………………………………………………... 10

21.7 DRIVING UNDER SUSPENSION……………………………………………………………….10

21.8 PORTABLE DEVICES…………………………………………………………………………… 10

21.9 HIRING OF ILLEGAL IMMIGRANTS…………………………………………………………...10

22. FIRE PREVENTION………………………………………………………………………………….11

23. COOPERATION WITH GOVERNMENT PERSONNEL…………………………………………..11

24. TOBACCO USE……………………………………………………………………………………….11

1. INTRODUCTION

The Contractor shall accomplish activities necessary to support the Minot AFB Cross-Connection Control and Backflow Prevention Program. The primary goal of this task order is to assist the base in complying with Air Force Manual 32-1067, Water and Fuel Systems (4 August 2020), requirement to conduct a cross-connection survey every five (5) years. Specific objectives are as follows:

1. Conduct a cross-connection control survey of all water-using facilities listed on Attachment 1 – Bldg listing

Sheet. Even though the building listing is believed to be accurate, additional inspection locations may be required that are not listed. For example, backflow prevention devices added since the last survey was completed must be included in the survey.

2. Develop a cross-connection control survey report that includes findings from the survey and prioritized recommendations for program improvement along with associated cost estimates.

2. TASK REQUIREMENTS

The Contractor shall furnish the personnel, equipment, materials, and other requirements necessary for, or incidental to the performance of work associated with this task order as noted in the tasks below.

Task 2.1: Pre-Performance Meeting

A Pre-Performance meeting/teleconference shall be performed with the Minot AFB Backflow Program Manager and Contracting to discuss the work, and associated requirements to be accomplished under this task order (TO).

The purpose of the meeting will be for the Contractor to become familiar with the project expectations and requirements, and to begin preliminary planning and data gathering. Other issues affecting installation operations and actions will be included in the discussions. At a minimum, the following will be discussed:

• Points of contact and lines of communication

• Information/data available

• Applicable installation policies and requirements

• Applicable installation procedures for site access and coordination

• Various compliance plans, programs, and policy

During the teleconference, the Contractor shall present their Work Plan. The work plan shall address project organization, personnel, and project management; technical approach; coordination procedures and activity and deliverables schedule; quality assurance and quality control procedures, and activities that will contribute to the successful execution of this contract.

Also under Task 1, the Contractor shall request necessary documents from the base and conduct a comprehensive review of that data prior to the site survey. This data may include:

• GIS maps and engineering drawings of the installation potable water system (including associated irrigation and building footprints)

• Existing backflow prevention device (BPD) records, specifications and other documents that may be of value in defining the cross-connection and backflow prevention issues

• Real property listing of all base buildings (excluding housing)

• Previous cross-connection survey results can be made available by the government. Previous survey results shall be used as a guide only, not as a confirmation of existing base-wide conditions.

• Appendix A (see page 4) lists approximate distances from each Missile Alert Facility (MAF) to Minot

Air Force Base and the approximate distances between each MAF.

Minot AFB points of contact will be provided following contract award.

Task 2.2: Cross-Connection Control Survey

The Contractor shall inspect each building suspected of having a connection to the potable water system including a 100-foot radius surrounding the outside of each building surveyed. The survey team shall consist of at least one person trained and experienced in cross-connection survey methodology. The Contractor shall assume that 303 buildings with water will be assessed during the cross-connection control survey and that military family housing will be excluded from the effort. The Contractor shall survey Minot AFB main base facilities and all 15 Missile Alert facilities. The Contractor shall note that the Missile Alert facilities are geographically separated from the main base location. Additional identification information shall be provided as applicable for the contractor to gain access to the Missile Alert facilities.

The Contractor shall identify all water uses and examine all visibly exposed water piping and point of use devices internal and external to the facility. All potential cross-connections between the potable and non-potable water uses or sewers shall be documented. Each cross-connection shall be located, catalogued, and tagged. The Contractor shall identify, catalog, and evaluate all existing protections, including air gaps, vacuum breaks, and other BPDs.

Information shall include location, type, manufacturer, model number, serial number, device size and date installed, if applicable. The Contractor shall include a color photograph of each cross-connection and device where installed.

The Contractor shall not inventory devices integral to food service equipment and medical equipment.

The Base Bioenvironmental Engineer and Backflow Program Manager shall be notified of all high hazards when identified in order that any serious health threat can be corrected immediately.

Every Missile Alert Facility (MAF) Alpha - Oscar will have a cross-connection survey. Alpha, Echo and Fox have testable devices. Bravo, Delta, Lima, Mike, and November have non-testable devices. Charlie, Golf, Hotel, India, Juliet, and Kilo have no backflows, they utilize Dual Checks.

Task 2.3: Cross-Connection Survey Database and Report

Under Task 3, the Contractor shall produce a Cross-Connection Survey Report in draft version. This report shall include identification of all actual and potential cross-connections, the hazard classification of each, and recommended corrective actions along with approximate costs to implement each recommendation. This report will include a section outlining the justification for recommended corrective actions. The Contractor shall include a narrative description of the building, identify where BPDs are installed, and determine where BPDs or corrective actions are needed. For each potential cross-connection identified that requires corrective action, the Contractor shall rank in descending order, from most hazardous to least hazardous, to allow prioritization of corrective action to be accomplished. The Contractor shall identify approximate costs for each corrective action, considering material, labor, and equipment. Contractor shall provide surveyor/tester/equipment qualifications and/or certifications. The Contractor shall incorporate edits based on draft report review comments and submit the final report to the government. The final report shall include data and reports in electronic format. Approved formats shall be on an AF Form 848, Inventory of Cross-Connection Control and Backflow Prevention Devices, a computerized maintenance management system (CMMS), or state submittal forms.

5 CONS shall receive original copies of all transmittal letters. The number of copies to be mailed directly to Minot AFB via overnight service by the contractor is as follows:

Agency Type “A” Survey Report

5 CES/CEOIU 3 bound hard copies and 1 electronic* on CD

445 Peace Keeper Place

Minot AFB, ND 58705

*Electronic drawings shall be submitted in AutoCAD and Adobe (pdf) format while reports and other data shall be submitted in the appropriate Microsoft Office software format and Adobe (pdf) documents.

3. REFERENCES AND CODES

The Contractor shall perform activities in conformance with instructions given in Air Force Manual (AFMAN) 32-1067, North Dakota State Plumbing Board, Uniform Plumbing Code (UPC) 2021 Section 603.0 Cross- Connection Control, and the Manual of Cross-Connection Control by the University of Southern California, 10th edition.

4. CONTRACTOR QUALIFICATIONS

The survey team shall consist of at least one person trained and experienced in cross-connection survey methodology. At least one person on the team shall possess one or more of the following credentials:

a) Successful completion of Cross-connection Control Tester Certification Course approved by the state of North Dakota.

5. ATTACHMENT-A LOCATIONS

NAME ESTIMATE QUANTITY

Distance to MAF from Minot AFB Approximate Miles

A-1 50 Miles B-1 50 Miles C-1 50 Miles D-1 40 Miles E-1 60 Miles F-1 55 Miles G-1 65 Miles H-1 75 Miles I-1 50 Miles J-1 45 Miles K-1 50 Miles L-1 75 Miles M-1 50 Miles N-1 40 Miles O-1 40 Miles

Distance from MAF to MAF Approximate Miles A-1 to B-1 25 Miles B-1 to C-1 20 Miles C-1 to D-1 30 Miles D-1 to E-1 30 Miles E-1 to F-1 10 Miles F-1 to G-1 30 Miles G-1 to H-1 25 Miles H-1 to I-1 35 Miles I-1 to J-1 25 Miles J-1 to K-1 20 Miles K-1 to L-1 30 Miles L-1 to M-1 30 Miles M-1 to N-1 20 Miles N-1 to O-1 20 Miles

6. SUBMISSION FOR EAL

6.1 Prepare a submission document for an EAL. This will need to include a list of employees and specific PERSONALLY IDENTIFIABLE INFORMATION (PII). The Contracting Officer (CO) or CES POC will provide specific instructions on how to submit this information securely upon contract award. Any persons disqualified from the EAL process will not be authorized to work directly on this project.

7. COMMUNICATION

7.1 Use of cellular phones while in the WSA is strictly forbidden. Contractors will be required to use radios to communicate between interior and exterior crews.

8. TECHNICAL ACCEPTABILITY

All proposals must have the following documentation to be deemed technically acceptable by 5 CES. For all construction projects, include a scope of work. Any work proposed or deemed necessary by the contractor shall be annotated as “proposed work” within the appropriate section. For all construction projects, include a detailed estimate of the project cost. This may be formatted in either UNIFORMAT or MasterFormat industry standards.

Line items shall include appropriate codes. For projects with a Period of Performance exceeding 30 days, include a preliminary timeline. This shall include start day (Day 0), basic workflow chart with all major tasks lined out, and a closeout date (Day n). Use a Gantt chart industry standard format for timelines.

9. CONFLICTS WITH TECHNICAL DETAILS

If conflicts between technical documents are found, the contractor is responsible for stopping work until the conflict can be resolved. The COR will make the final call on the most appropriate directive to follow.

10. COORDINATION

The Contractor shall be responsible for coordinating all phases of their operations with the appropriate base personnel through the Contracting Officer or an authorized representative (hereafter CO). The facility shall remain in operation throughout the Period of Performance. The Contractor shall coordinate around the normal activities of the facility.

11. PERSONNEL

The Contractor shall strictly adhere to all relevant regulations as stated in 29 CFR 1910, Occupational Health and Safety. The Contractor must have a minimum of two qualified workers. In the event of a problem, either worker must be able to provide assistance to the other. Particular care shall be exercised in connection with operation of vehicles and other equipment on the site, and in transit to and from the site.

12. PROTECTION OF PROPERTY

The Contractor shall be responsible to check and determine that all necessary precautions have been taken to protect all property, both Government and private, in all areas where work is being accomplished. Damage caused from failure or neglect of the Contractor to exercise proper precautions in the performance of work shall be immediately repaired to the satisfaction of the CO without cost to the Government.

13. CLEANUP

Proper care of materials and waste shall be observed throughout the period of performance. All waste shall be promptly stored in a container suitable for outdoor storage, and all materials not in use shall be stored until needed for installation. Tools and equipment shall remain properly stored unless in use. All waste shall be properly disposed of by the Contractor per local laws and regulations. Any waste scattered by natural or man-made events shall be reclaimed by the Contractor, excepting where the waste moves into an unauthorized area to the Contractor. Upon completion of the work, the Contractor is obliged to perform a final cleanup of any remaining material, tools, equipment, and waste to the satisfaction of the CO. Any cleanup accomplished by the Government due to failure or neglect on the Contractor shall be charged to the Contractor and will be deducted from the final payment of the contract amount.

14. SCHEDULING

14.1 OPERATING TIMES

Working days and hours for the Contractor will normally be from Mondays to Fridays between the hours of 7:30 a.m. to 4:30 p.m. local time, excluding Saturdays, Sundays, and Federal holidays. If the contractor would like to request to work during periods other than above, it must be requested in writing to the CO at least three days in advance. The CO reserves the right to allow or deny work outside the normal hours.

15. FEDERAL HOLIDAYS

The following holidays are observed by the Government, and work will not occur on these days without prior approval from the CO. If holidays occur on a Saturday, the preceding Friday will be observed. If holidays occur on a Sunday, the following Monday will be observed. If a holiday occurs on a scheduled service day, the contractor will be responsible for rescheduling services for the first day after or before the holiday observance.

The list of holidays provided below is for informational and convenience purposes only. The full list and up-to-date list of holidays is found at:

https://www.opm.gov/policy-data-oversight/pay-leave/federal-holidays/

Calendar Year 2023 Holidays List:

• New Year’s Day – 2 January

• Martin Luther King Day – 16 January

• Washington’s Birthday – 20 February

• Memorial Day – 29 May

• Juneteenth – 19 June

• Independence Day – 4 July

• Labor Day – 4 September

• Columbus Day – 9 October

• Veteran’s Day – 10 November

• Thanksgiving Day – 23 November

• Christmas Day – 25 December https://www.opm.gov/policy-data-oversight/pay-leave/federal-holidays/

16. BASE CLOSURES

Scheduled work that cannot progress due to base closure shall resume as soon as possible after re-opening the base. The Period of Performance will be extended by the amount of time lost due to base closure.

17. START OF WORK

The Contractor will coordinate the date for actual commencement of work with the, CO, COR, and Engineering Representative after the Entry Access List is approved.

18. ACCESS TO SITE

U.S. Air Force personnel control the site and the right-of-way.

Emergency Access: The Contractor shall not block vehicle access to and from the base.

The contractor shall immediately obey any and all orders to vacate the site for any reason.

19. SECURITY REQUIREMENTS

The contractor is required to comply with all Minot AFB security regulations and directives.

19.1 OPERATIONAL SECURITY

1.1.1. The Contractor will abide by the Unit Commander’s OPSEC policy.

The Contractor will be provided with the Minot AFB Critical Information List and unit Critical Information List.

Contract personnel shall prohibit the disclosure of information that is contained in the Critical Information List.

19.2 BASE ACCESS/PASSES

The Contractor shall be responsible for obtaining all necessary passes or other items required for access to the areas in which work will be performed. The Contractor shall request contractor passes through the Contracting Officer by providing the name, social security number, date of birth, work phone, and home phone of employees requiring passes on the contractor’s company letterhead. Pass requests will be forwarded by the Contracting Officer to the 5th Security Forces Squadron Visitor’s Control Center who will conduct the required criminal history background check for each employee. Personnel identified with a felony conviction within the past 10 years, any sex crimes and or homicide will be denied base access. Upon completion or termination of the contract or an individual’s release from employment, the contractor shall retrieve the identification issued above and surrender it to the 5th Security Forces Squadron Pass and ID Section located in the Visitor Control Center.

19.3 REAL ID ACT

Individuals, who do not possess a driver’s license or identification card compliant with the REAL ID Act and do not possess an acceptable alternate identification credential, will be denied access. One form of the following documents will be accepted as proof of identity. The document must be a picture ID and all documents must be unexpired and valid. The goal is to minimize, within acceptable risk, the potential of improper screening and access credential issuance. NOTE: The information in section 3.7.6.1. – 3.7.6.15. is from Handbook for Employers, Instructions for Completing Form I-9 (Employment Eligibility Verification Form), U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services and REAL ID Act of 2005 Implementation: An Interagency Security Committee Guide

19.4 US Passport

Permanent Resident Card/Alien Registration Receipt Card (Form I-551) Foreign passport with a temporary (I-551) stamp or temporary (I-551) printed notation on a machine-readable immigrant visa Employment authorization document that contains a photograph (Form I-766) Driver’s License that is current and meets REAL ID Act it contains a photograph and biographic information such as name, date of birth, gender, height, weight, eye color, and address Identification card issued by Federal, State, or local government agencies, provided it contains a photograph and biographic information such as name, date of birth, gender, height, eye color, and address.

U.S. Coast Guard Merchant Mariner Cards/Credentials PIV or Federally Issued PIV-1 Cards (Personal Identification Verification) issued by the Federal Government PIV-I cards (Personal identification verification-Interoperable Issued by Non-Federal Government entities’ DHS “Trusted Traveler Cards” (Global entry, NEXUS, SENTRI, FAST) Merchant Mariner card issued by DHS/ United States Coast Guard (USCG) Border Crossing Card (Form DSP-150) U.S. Certificate of Naturalization or Certificate of Citizenship (Form N-550) and U.S. Permanent Resident Card (Form I-551) U.S. Refugee travel document or other travel document or evidence of immigration status issued by DHS containing a photograph Foreign Government Issued Passport Prior to beginning any work in a controlled secure area, the Contractor shall be required to submit a list of employees that includes actual employee identification credentials (i.e. driver’s license information (driver’s license number State of Issue, and name listed on the license exactly as displayed on the license) in order for an EAL letter to be developed to gain access into secure areas. The contractor or the designated representative shall be responsible for pre-announcing workers into controlled/secure areas. Preannouncement is handled through the controlled area monitor of the owning/using unit. Each person must present their submitted identification matching the EAL.

Occasionally, Government forces will conduct various disaster or contingency exercises. Should the contractor be in an area subject to control, they shall immediately comply with the directions of Minot AFB personnel. This may include cessation of work and immediate departure from the area. The contractor or their representative shall immediately inform the CO and await a clearance to return to the area under work. The contractor may shift workers to other work sites with concurrence of the CO. Disruption of work schedules shall be at no cost to the Government. These military exercises occur 5-10 times per year.

20. RECORDS MANAGEMENT

All records, files, documents, regardless of media (e.g., paper, electronic, etc.), that are the responsibility of the contractor are the property of the Government and shall remain so upon termination or completion of the contract.

The contractor shall keep these items current and maintain and dispose of them in accordance with the requirements established in Air Force Instruction (AFI) 33-322, Records Management Program, and the Air Force Records Disposition Schedule which can be provided by the records management POC upon request. Records shall be turned over to the Government upon completion of the contract unless otherwise stated. All records are subject to the Freedom of Information and Privacy Act. The Minot AFB Installation Records Management Office (5 BW/IPR), 723-7917, will provide assistance and training to the contractor to ensure compliance with Federal record keeping requirements.

Records shall be submitted on government approved forms and formatted according to government standards. The government uses portable data file (PDF) formatted fillable forms and digital signatures. Blank forms and templates shall be provided by the government.

21. SPECIAL INSTRUCTIONS

21.1 PROVISION OF CONTRACTING OFFICER’S AUTHORITY

No person other than the CO shall have the authority to modify the terms of this contract. In the event the contractor, or any subcontractor, effects any change to the terms and conditions of this contract at the direction of any person other than the CO, the change will be considered to have been made without authority, and no increase in cost or price will be made to the contract amount.

21.2 TRAFFIC REGULATION

The contractor will abide by all traffic regulations outlined in the Air Force Regulation 31-204, for Minot AFB, as supplemented. Copies of these regulations and supplements are available for review at Base Pass and Registration, 15 Missile Avenue or Base Security Police Office, 547 Tanker Trail. Changes will be furnished to the contractor prior to enforcement.

21.3 MANDATORY SEATBELT REQUIREMENT

The use of seatbelts by all vehicle operators and passengers is mandatory on Minot AFB, ND, to include the operation of vehicles on Minot AFB Missile Sites. Violations can result in the temporary or complete loss of the violators on base driving privileges.

21.4 FEDERAL, STATE, AND LOCAL COMPLIANCE

In addition to base ordinance, law, and policy, the contractor shall comply with all applicable federal, state, and local statutes, ordinances, laws, and regulations at all times while on Minot AFB.

21.5 VEHICLE REGISTRATION

All contractor vehicles must be permanently or temporarily registered with the State of North Dakota Motor Vehicle Department, per applicable State Law. Details concerning a non-resident permit will be provided at the pre-performance conference.

21.6 RADAR DETECTORS AND DASH CAMERAS

Radar detectors and dashboard mounted video systems must be turned off while on the base.

21.7 DRIVING UNDER SUSPENSION

The contractor is responsible for ensuring all drivers under their employ have valid driver’s licenses by the issuing state. Any person caught driving under suspension will be escorted off the base and barred from returning.

21.8 PORTABLE DEVICES

It is illegal to use hand-held phones, GPS, or other portable devices while driving on Minot AFB. Use of devices while parked is acceptable. Anyone caught using a portable device while driving will be escorted off base and barred from returning.

21.9 HIRING OF ILLEGAL IMMIGRANTS

It is prohibited to hire illegal immigrants. All undocumented workers will not be permitted access to Minot AFB, ND. Violation of this policy will result in corrective action, up to and including termination of the contract.

22. FIRE PREVENTION

The Contractor shall ensure that all contract employees know how to report a fire. Contractor personnel shall observe all requirements for handling and storage of combustible supplies, materials, waste, and trash. Contractor employees operating critical equipment shall be trained to properly respond during a fire alarm or fire. Welding shall not be accomplished without prior coordination and approval of the Base Fire Department.

23. COOPERATION WITH GOVERNMENT PERSONNEL

The contractor must always obey federal Equal Employment Opportunity directives. The Air Force, and all other government entities, maintain a zero-tolerance policy toward anyone in violation of those directives, as well as harassing government personnel, or fellow co-worker by using profanities or other offensive language during meetings, phone calls, working on Federal facilities, or through any other electronic media. Harassment of any person based on race, color, sex (including pregnancy, sexual orientation, transgender status or identity, sex stereotyping, and sexual harassment), religion, national origin, age, disability, or any other category protected by law or policy will not be tolerated. Harassment by anyone, including harassment by any manager, supervisor, work leader, co-worker, or contractor is strictly prohibited. This requirement is a material part of the contract and will form a significant part of the performance evaluation conducted by the Contracting Officer during and after the contract period of performance. Failure to comply is grounds for removal from any government or military installation in addition to termination for cause /default.

24. TOBACCO USE

(AFI 40-102 – 26 MAR 2012) Tobacco use is prohibited on Air Force installations except in Designated Tobacco Areas (DTAs). Tobacco use includes cigarettes, cigars, and electronic cigarettes, stem pipes, water pipes, hookahs, and smokeless products that are chewed, dipped, or sniffed. Following contract award, the Designated Tobacco Areas will be identified to the contractor.

Designated Tobacco Areas shall be marked with signs: “Designated Tobacco Area.” Designated Tobacco Areas:

Shall be away from common points of facility entry/egress, and not in front of buildings or air intake ducts. The distance from the building shall not be less than 50 feet. DTAs shall be a minimum of 50 feet from pedestrian walkways, to include parking lots. DTAs shall be a minimum of 100 feet from playgrounds. Tobacco use is prohibited in Air Force vehicles.

Medical Treatment Facility campuses shall be tobacco free. Medical Treatment Facility campuses are defined as the contiguous area surrounding the clinic or hospital, to include parking structures and lots; and other outdoor areas contiguous with the Medical Treatment Facility.