Attachment 2 SOW.pdf

1 | P a g e Statement of Work Replace RTU & Cabinets – CT Area January 2023

STATEMENT OF WORK

RTU & CABINETS – CT AREA

INDIAN HEALTH SERVICE

GPA IDIQ CONTRACT SCHEDULE F – BELCOURT, ND

QUENTIN N BURDICK MEMORIAL HEALTH FACILITY

BELCOURT, ND

AUGUST 2025

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Table of Contents

1. Project Description

2. Scope of Work (SOW)

3. Period of Performance

4. Submittals

5. Schedule/Meetings

6. Miscellaneous

7. Payments to the Contractor

8. Project Officer

9. Invoice Format

10. Closeout Documents

Appendix A – Plan Sheets

Appendix B – Plan Sheets………………………………………………………………………………………………………………………………….13

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Replace RTU & Cabinets – CT Area January 2023

STATEMENT OF WORK

RTU & Cabinets – CT Area

Belcourt Service Unit Belcourt, North Dakota

1. Project Description

A. Title: RTU & Cabinets – CT Area

B. Location: This project is at the Quentin N. Burdick Memorial Health Facility, in Belcourt, ND.

C. Period of Performance: 180 calendar days from notice to proceed.

D. Description: The project defined within this Scope of Work is for replacement of the HVAC unit for the CT room. The RTU will include a direct steam injection humidifier tied into the existing low pressure steam system. Additionally, the interior of the CT building will be renovated to include new cabinets, flooring ceiling tile, and lighting.

E. Background: The existing unit covering the CT is aging and in need of replacement. The existing unit is not designed to provide the air flow and humidity required by applicable building code. Therefore, a new unit will need to be installed to meet the minimum requirements of the building code. The design for the new RTU was previously completed. This contract will cover installation.

F. Related Documents

This SOW and any other standard government or IHS documents are included and considered a part of this contract.

1. NFPA 70 National Electric Code (NEC)

2. NFPA 101 Life Safety Code – 2012

3. NFPA 99 Healthcare Facilities Codebook – 2012

4. 2022 Guidelines for Design and Construction of Hospitals and Outpatient Facilities – The Facilities Guidance Institute

5. ANSI/ASHRAE/ASHE Standard 170-2021

G. Common Acronyms or Definitions

1. IHS – Indian Health Service

2. CO – Contracting Officer

3. COR – Contracting Officer’s Representative

4. PM – Project Manager

5. IGCE – Independent Government Cost Estimate

6. RFI – Request for Information

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2. Scope of Work (SOW) The scope of this project includes all demo, new installation, and clean up for installation of the products described below.

The contractor shall provide all engineering, design, material, labor, equipment and supervision required to accomplish the following:

A. Demolition: The contractor shall demolish the existing rooftop HVAC unit according to design A. This shall include at a minimum removing the existing RTU, single-package steam humidifier, and undersized electrical wire. The contractor shall remove the following: existing ceiling tile, existing ceiling grid, existing flooring, existing lighting, and existing switches as indicated on design B plan sheets.

B. RTU & Steam Humidifier Installation: The installation of the RTU shall be according to design A. This shall include at a minimum installation of the new RTU, low pressure steam supply, low pressure steam return, steam humidifier system, new duct work, & new electrical wire.

C. Cabinets: The contractor shall provide and install all cabinets and hardware required for the installation of the cabinet layout described in design B design sheets A.1 & A.2. Cabinet hardware shall include at a minimum: cabinet doors, hinges, shelves, cover panels, cabinet screws, toe kick clips, edge banding, cabinet connector bolts, toe kicks, & fillers. The contractor shall install new stainless steel single basin sink as shown on design B plan sheet A.2. Contractor is responsible for repair of wall damage during installation of the new cabinets. Cabinets shall be Midmark Synthesis® Cabinetry or approved equal.

Submit on color and style.

D. Plumbing: The contractor shall provide and install new water and sewer lines to the new sink location indicated on design B plan sheet A.2. The contractor shall tie into the existing 1/2” hot and cold copper water lines located above the previously demolished sink. The contractor shall tie into the existing 2” pvc sewer line located below the previously demolished sink. Contractor shall install new faucet. Install new Delta 4” commercial faucet Model# 27C4974 or approved equal.

E. Electrical: All electrical work shall be accomplished by an electrician licensed in the state of North Dakota.

1. Light Switch: See design B design sheet E.2 for light switch locations

a) 3-Way Dimmer Switch: Contractor shall install a white ALCON 3-way dimmer switch Model# 2102 or approved equal at the location indicated by design B plan sheet E.2.

b) Single Pole Dimmer Switch: The contractor shall install a white ALCON single pole switch Model #2102 or approved equal at the location indicated by design B plan sheet E.2.

2. LED Lighting: The contractor shall install new 2’x4’ LED troffer lights. The contractor shall install new ALCON LED Troffer lights model# 24000-RT-2444-50k or approved equal, where indicated on design B plan sheet E.2.

F. Painting: The contractor shall repaint the rooms indicated on design B plan sheet A.5. The contractor shall use two coats Clark & Kensington Semi-Gloss paint or approved equal throughout. Submit on paint manufacturer’s full range of colors for approval by project engineer.

G. Ceiling Grid: The contractor shall provide and install a new Armstrong 2’x4’ drop ceiling grid in the rooms indicated on design B plan sheet A.5. The contractor shall follow manufacturer’s specifications for installation of new ceiling grid. Replace ceiling grid to match the layout of the existing grid.

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H. Ceiling Tile: The contractor shall install 2’x4’x1” Armstrong Calla Health Zone Ceiling Tile or approved equal throughout, where indicated on design B plan sheet A.5. The contractor shall follow manufacturer’s specifications for installation of new ceiling tile.

I. Flooring: The contractor shall install Tarkett Granit iQ SD flooring or approved equal, where indicated on design B plan sheet A.5. Submit on flooring manufacturer’s full range of colors for approval by the project engineer. The contractor shall provide physical samples to project engineer. Follow all manufacturer’s installation specifications.

J. Vinyl Wall Base: The contractor shall install new Tarkett Johnsonite Duracove 6” Wall Base or approved equal where indicated on design B plan sheet A.5. Submit from flooring manufacturer’s full range of colors for approval by project engineer. The contractor shall provide physical samples to the project engineer.

K. Warranty: Provide a 1-year labor and material warranty at no additional cost to the government which provides for the repair of all work and equipment that was provided under this scope of work.

L. RTU Commissioning: The Design Builder shall commission the RTU and steam humidifier upon completion of their construction. The systems in the building will be operated in their different modes of operation to ensure the facility operates properly as a whole. This testing provides the owner with documentation that the building was operating properly at turnover. The commissioning will ensure the installed RTU & steam humidifier meet the needs required by the facility. The contractor shall schedule and direct the testing once all construction has been completed. The contractor will provide verification to the project engineer that all systems are functioning as designed. Skilled technicians shall be provided by the appropriate contractor familiar with the system and building to execute the performance testing of the control system and perform performance testing of the equipment. A third-party commissioner is not required for this project. The contractor shall perform the testing while the project engineer is on site.

M. Facility Requirements: Jobsite shall be cleaned daily and must comply with the Infection Control & Safety Officer’s requirements given with the ICRA and PRCA. The construction areas involved shall be free of any debris, rubbish and left-over material scraps upon completion of the project. Trash receptacles used for the collection of this debris and their removal from the project site shall be provided by the contractor. The site will be inspected by the engineer prior to final payment to ensure the sites return to their original condition prior to construction.

N. Site Restoration: The construction site shall be free of any materials, debris and/or rubbish. The contractor will be responsible for the removal of this debris and must restore the site to its original condition as approved by the project engineer. Photos are to be taken before construction begins for documentation the sites original condition by the contractor.

O. Additional Facility Requirements: Contractor shall comply with the requirements of the hospital’s Facility Manager, Infection Control Officer and Safety Officer. These requirements will be laid out during the pre- construction meeting. Other permits and requirements will be given after the pre-construction meeting and the ICRA and PRCA assessments are completed.

3. Period of Performance.

A. Time of the Essence: All time limits for Milestones, if any, Substantial Completion, and completion and readiness for final payment as stated in the Contract Documents are of the essence of the Contract.

B. The Work will be substantially completed within One Hundred and Eighty (180) calendar days after the

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Replace RTU & Cabinets – CT Area January 2023 date when the Contract Times commence to run.

C. On site construction duration shall not exceed 30 calendar days. The on-site construction will shut down use of the CT and construction duration should be minimized to the maximum extent possible. The contractor’s schedule must indicate on-site construction duration.

D. Submittals or shop drawings shall be submitted for the following items and shall be delivered electronically to the COR or designated PM for final approval before ordering any new material or equipment.

1. Roof Top HVAC Unit

2. RTU Electrical Connection and Circuit Breaker

3. Steam Humidifier System

4. Steam Piping and steam piping insulation

5. Combination Humidistat/Thermostat

6. Cabinets

7. Sink Basin

8. Faucet

9. LED lighting

10. Ceiling Tile

11. Ceiling Grid

12. Wall Paint

13. Light Switch

14. Supply Diffusers

15. Return Grilles

4. Schedule/Meetings A. The general contractor shall submit a detailed schedule to the COR for approval within (14) calendar days of the award.

B. Pre-Construction Meeting: One Pre-Construction meeting shall be conducted prior to the start of the construction of the contract.

C. Progress Meetings: Progress meetings shall be conducted at regular intervals as merited by the progress of the work.

D. Substantial Completion: One substantial completion meeting shall be held following notification of the Project Officer by the General Contractor that the project is Substantially Complete.

E. Final Completion: One final completion meeting shall be held following determination that the project is complete.

5. Miscellaneous

A. Security Requirements.

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1. The on-site superintendent must pass a full background check.

2. All contractors are required to check-in with the facility manager/maintenance staff before commencing work on any project.

3. The contractor will be responsible for the security of the work site. The hospital and the Indian Health Service staff shall not be responsible for the security of the contractor’s tools, equipment, or material during the course of the project.

B. Protection of Government Property. The contractor shall protect all Government property against damage, to include but not limited to dust, fumes, impact, scratching, water, paint, joint compound, power failure, power surges, weather, heavy equipment, etc.

1. All damage caused by the contractor, whether to equipment, roads, landscaping, building components or any other type of Government property encountered at or near the project site shall be repaired or replaced to match the existing and to the satisfaction of the Project Officer at no cost to the Government.

2. The Contractor assumes responsibility for all damage and/or injury to persons or property resulting from any action of prime contractor and subcontractor employees (at any tier).

3. The Contractor, at the Contractor’s expense, shall maintain adequate public liability and property damage insurance during the continuance of this contract, insuring the Contractor against all claims for injury or damage.

4. The Contractor shall maintain Workers’ Compensation and other legally required insurance with respect to the Contractor’s own employees and agents.

5. The Government shall in no event be liable or responsible for damage or injury to any person or property occasioned through the use, maintenance, or operation of any vehicle or other equipment by, or the action of, the Contractor or the Contractor’s employees and agents in performing under this contract, and the Government shall be indemnified and held harmless against claims for damage or injury in such cases.

C. Occupancy of Government Facilities. The contractor shall be responsible for properly informing the COR of any condition which would jeopardize the building or its contents, such as loss of heat, air conditioning, danger of pipes freezing, loss of electrical power, water, sewer or loss of building security.

D. Correspondence. All correspondence shall be addressed to the COR. Each letter, document, etc., shall contain the following information:

1. Date

2. Project Numbers, Contract Number, Delivery Order Number and Service Unit Name/Location.

3. Name of those who were sent copies.

E. Superintendent. The prime contractor shall have an onsite superintendent for this project while any and all work is being performed unless prior approval is grant from the COR. The site superintendent shall be required to pass a full background check.

F. TERO/EPA. The contractor is required to acquire and maintain a tribal business license before any work will commence. The contractor shall comply with the Tribal Employment Rights Ordinance (TERO) and pay TERO and EPA fees.

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G. Construction Materials and Storage

1. All materials shall be stored and handled according the manufacturers’ recommendations.

2. All materials shall be submitted to the COR prior to ordering, for approval by the project engineer.

3. The contractor(s) shall be present and on site to receive all construction material, equipment, or products. IHS staff will not be present, responsible, nor receive, or provide any type of offloading equipment for construction materials, products, or equipment. It is solely the contractor(s) responsibility to properly receive any and all construction equipment, products, and materials on site.

4. The contractor(s) shall provide their own means of storing any and all construction materials, products, or equipment required for installation. IHS staff will not be responsible or provide any means of storing construction material, products, or equipment before or during construction.

All material, products, or equipment remain the contractor(s) property until the project has been deemed substantially completed by all parties

H. Hours Of Operation

1. The project shall start after award.

2. The work hours shall be 8:00am – 5:00pm, Monday – Friday. Weekends and after-hours work may be available upon request.

6. Payments to the Contractor

1. The Government will pay the Contractor a fixed price, as indicted below, which will constitute full compensation for all Contractor professional and incidental services, travel expenses, and materials necessary to furnish complete project as required and specified in this SOW.

2. Progress payments will be paid following acceptance by the Government of that particular schedule item and a properly submitted and approved invoice.

7. Project Officer

Taylor Strand will be designated as the Contracting Officer’s Representative (COR) for this Order. His address and telephone are:

Taylor Strand Great Plains Area Indian Health Service Division of Facilities Management & Engineering 2050 36th Ave SW, Ste. 102 Minot, ND 58701 Office: 701-420-9219 taylor.strand@IHS.gov

Any change in COR designation will be documented by the Contracting Officer in writing.

8. Invoice Format The Contractor is responsible for delivering one copy of the invoice to the COR. The invoice shall include the contractor’s official invoice with the contractor’s letter head and a filled-out Form AAO-107C along with the contractor’s schedule of values showing a detailed breakdown of the construction items with the progress of each. The COR is responsible to approve or reject the invoice and provide a copy to the Contract Specialist mailto:taylor.strand@IHS.gov

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Replace RTU & Cabinets – CT Area January 2023 and delivery of the original to the payment office.

Upon reaching 100% completion of the entire task order, submission of the final invoice must be accompanied by a Final Claims Release before payment can be approved. Failure to provide the proper information may cause the invoice to be returned or delayed.

9. Closeout Documents The Contractor shall submit one hard copy set of all final, installed submittal items, accessories, and all installation/operation/maintenance documents to the facility manager/engineer. The final installed submittal package and O&M shall also be sent electronically to the COR and/or PM.

Appendix A – Plan Sheets