ATTACHMENT D Contractor VA System Outage Request.docx

DOCX document 25 KB Posted

Attached to
H259--ELECTRICAL DISTRIBUTION SYSTEM TESTING & INSPECTION BASE + 2 OYS Federal contract opportunity
Solicitation number
36C25221Q0496
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12

About this file

This document contains an outage request form and related federal contract opportunity. The outage request form is for contractors working at the Clement J. Zablocki Medical Center in Milwaukee, WI to request disabling or restoring electrical systems for maintenance and repairs. It requires details on the contractor, location and systems impacted, dates and times of the outage, and reason for and impact of the outage.

The related federal contract opportunity is solicitation number 36C25221Q0496 to provide maintenance, inspection, testing and calibration of the electrical power distribution system and components at the Clement J. Zablocki Medical Center for an initial period of one year with two additional one-year option periods. The services are required to support the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12. The opportunity was posted as a full and open competitive solicitation.

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Other files for this federal contract opportunity

Other files attached to H259--ELECTRICAL DISTRIBUTION SYSTEM TESTING & INSPECTION BASE + 2 OYS, newest first.
File Type Posted
36C25221Q0496 0001.docx DOCX document
ATTACHMENT A - BASE YEAR.docx DOCX document
ATTACHMENT C - OPTION YEAR 2.docx DOCX document
ATTACHMENT B - OPTION YEAR 1.docx DOCX document
36C25221Q0496.docx DOCX document
ATTACHMENT E VA DIRECTIVE 1028 dated 24 Feb 2020.docx DOCX document

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Text version

VA Outage Request Contract Number: Click here to enter text.

Project Number: Click here to enter text.

Project Name: Click here to enter text.

Contractors Contractor: Click here to enter text.

Sub-Contractor: Click here to enter text.

Location of Work Building: Click here to enter text.

Floor: Click here to enter text.

Wing: Click here to enter text.

Describe Area: Click here to enter text.

Outage Request Date Disabled: Click here to enter a date.

Time Disabled: Click here to enter text.

Date Restored: Click here to enter a date.

Time Restored: Click here to enter text.

Primary Outage Type: Choose an item.

Secondary Outage Type: Choose an item.

Tertiary Outage Type: Choose an item.

Service: Choose an item.

Descriptions LO/TO Device ID: Click here to enter text.

Reason: Click here to enter text.

Impact: Click here to enter text.

Remarks: Click here to enter text.

3/12/2021

File details come from the government source that posted it. Updated .