BUS Exhibits 2021-2025.pdf

BTCG

SECTION J

LIST OF ATTACHMENTS

EXHIBITS

EXHIBIT A, Items to be provided at Least One Week Prior to Pre-Work Conference EXHIBIT B, Vicinity Map EXHIBIT C, Work Schedule Calendars EXHIBIT D, Park Attendant Forms and Records EXHIBIT E, Minimum Basic Outline for Accident Prevention Plan, OSHA 300 Log EXHIBIT F, Activity Hazard Analysis, CELRH Form 2642 EXHIBIT G, Sample Invoice Format EXHIBIT H, Contractor Quality Control Plan EXHIBIT I, Quality Assurance Surveillance Plan EXHIBIT J, Contract Discrepancy Report (CDR) ORH Form 2759 EXHIBIT K, CESO Checklist A-01

EXHIBIT A

ITEMS TO BE PROVIDED AT LEAST ONE WEEK

PRIOR TO PRE-WORK CONFERENCE

EXHIBIT A

ITEMS TO BE PROVIDED ONE WEEK PRIOR TO PRE-WORK CONFERENCE

Contractor shall provide the following typed documents, at least 1 week prior to the pre-work conference:

a. Quality Control Plan. Sign the cover sheet, accepting the Quality Control Plan in Exhibit H.

b. Contractor Representatives. List of names of Contractor Representatives.

c. Contractor Accident Prevention Plan. A Contractor Accident Prevention Plan shall be prepared by the Contractor using the outline found in Exhibit E.

d. Personnel. A list, with names, addresses, and telephone numbers, of persons who will be available and tested for Park Attendant duties.

e. Emergency Contacts. A prioritized list, including phone numbers, of those persons (normally

Contractor Representatives) to call in case of emergencies.

f. Copies of insurance and bonding certificates.

Exhibit A

EXHIBIT B VICINITY MAP

EXHIBIT C

WORK SCHEDULE CALENDARS

Sun Mon Tue Wed Thu Fri Sat

HOLIDAY

3 4 Non-Peak Season Transmittal if Ordered

5 6 7 8 9

10 11 Non-Peak Season Transmittal if Ordered

13 14 15 16

17 18

Non-Peak Season Transmittal if

20 21 22

24 25 Non-Peak Season Transmittal if Ordered

26 27 28 29 30

January Bulltown Campground Park Attendant Services

Non-Peak Season Transmittal if Ordered

2 3 4 5 6

7 8 Non-Peak Season Transmittal if Ordered

9 10 11 12 13

14 15 Non-Peak Season Transmittal if Ordered

16 17 18 19 20

21 22

Non-Peak Season Transmittal if Ordered

24 25 26 27

February

Non-Peak Season Transmittal if Ordered

2 3 4 5 6

7 8 Non-Peak Season Transmittal if

9 10 11 12

14 15 Non-Peak Season Transmittal if

16 17 18

19 20

Non-Peak Season Transmittal if Ordered

23 24 25 26 27

28 29 Non-Peak Season Transmittal if

30 31

March Bulltown Campground Park Attendant Services

1 2 3

4 5 Non-Peak Season Transmittal if

6 7 8 9

11 12 Non-Peak Season Transmittal if Ordered

13 14 15 16 Campgrounds Open for Self- Registration

18 19 Non-Peak Season Transmittal

23 24

25 26 Non-Peak Season

27 28

29 30

April

2 3 Non-Peak Season

9 10 Non-Peak Season

Transmittal

PA Training 0830-1530

0700-2400 Level 2 17 hours Open Entrance Station

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2200 Level 3 15 hours

0700-2200 Level 3

MEMORIAL DAY

Month: 81 Hrs.

May

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200 Level 1

Level 2 17 hours

0700-2200 Level 2

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Month: 458 Hrs.

June

0700-2400

17 hours

Level 2 17 hours

INDEPENDENCE

DAY

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

Month: 481 Hrs.

July

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4

Month: 473 Hrs.

August

0700-2200

Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-1200

TRANSMITTAL –

Level 1 5 hours

LABOR DAY

Close Ent Station

8 9

10 11

12 13 Non-Peak Season

14 15 16

21 22 23

26 27

28 29

Month: 86 Hrs.

Year: 1,579 Hrs.

September

1 2

3 4

6 7

Non-Peak Season

13 14

15 16

Non-Peak Season

19 20 21

22 23

Non-Peak Season Transmittal

26 27 28 29 30

October

5 6

7 8 Non-Peak Season

Non-Peak Season

23 24 25

Campgrounds Close for Season

Non-Peak Season

November

2018 2017

1 2 3 4

Transmittal if

7 8 9

Non-Peak Season Transmittal if

Non-Peak Season Transmittal if

December

2 3 Non-Peak Season Transmittal if Ordered

4 5 6 7 8

9 10 Non-Peak Season Transmittal if

12 13 14 15

16 17

Non-Peak Season

Non-Peak Season Transmittal if Ordered

25 26 27 28 29

30 31 Non-Peak Season

1 2 3 4 5

6 7 Non-Peak Season Transmittal if Ordered

8 9 10 11 12

13 14 Non-Peak Season Transmittal if Ordered

15 16 17 18 19

20 21

Non-Peak Season Transmittal if Ordered

23 24 25 26

27 28 Non-Peak Season

6 7 Non-Peak Season Transmittal if

8 9 10 11

Non-Peak Season Transmittal if

15 16 17

18 19

Non-Peak Season Transmittal if Ordered

22 23 24 25 26

27 28 Non-Peak Season Transmittal if

29 30 31

3 4 Non-Peak Season Transmittal if

5 6 7 8

Non-Peak Season Transmittal if Ordered

12 13 14 15 Campgrounds Open for Self- Registration

17 18 Non-Peak Season

Non-Peak Season

28 29 30

Non-Peak Season

Transmittal

Level 2 17 hours Open Entrance Station

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2200 Level 3

MEMORIAL DAY

TRANSMITTAL –

Month: 98 Hrs.

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Month: 462 Hrs.

0700-2400

Level 2 17 hours

INDEPENDENCE

DAY

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

Month: 481 Hrs.

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

0700-2200

Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-1200

TRANSMITTAL –

Level 1 5 hours

LABOR DAY

Non-Peak Season

13 14 15

Month: 71 Hrs.

Year: 1,585 Hrs.

Non-Peak Season

Non-Peak Season

18 19 20

Non-Peak Season Transmittal

25 26 27 28 29

30 31

4 5

Non-Peak Season

Non-Peak Season

22 23 24

Non-Peak Season

Transmittal if

6 7 8

Non-Peak Season Transmittal if

13 14 15

Non-Peak Season Transmittal if

Non-Peak Season

Non-Peak Season Transmittal if Ordered

4 5 6 7

8 9 Non-Peak Season Transmittal if Ordered

10 11 12 13 14

Non-Peak Season

18 19 20 21

Non-Peak Season

25 26 27

Non-Peak Season Transmittal if

5 6 Non-Peak Season Transmittal if Ordered

7 8 9 10 11

12 13 Non-Peak Season Transmittal if Ordered

14 15 16 17 18

Non-Peak Season Transmittal if Ordered

22 23 24 25

26 27 Non-Peak Season Transmittal if

5 6 Non-Peak Season Transmittal if

7 8 9 10

Non-Peak Season Transmittal if

Non-Peak Season Transmittal if Ordered

21 22 23 24 25

26 27 Non-Peak Season Transmittal if

28 29 30 31

2 3 Non-Peak Season Transmittal if

4 5 6 7

Non-Peak Season Transmittal if Ordered

11 12 13 14 Campgrounds Open for Self- Registration

16 17 Non-Peak Season

18 19 20

Non-Peak Season

27 28 29

Non-Peak Season

Transmittal

Level 2 17 hours Open Entrance Station

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2200 Level 3 15 hours

MEMORIAL DAY

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Month: 113 Hrs.

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Month: 460 Hrs.

0700-2400

TRANSMITTAL –

Level 4 17 hours

0700-2200 Level 2 15 hours

INDEPENDENCE

DAY

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Month: 479 Hrs.

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-1200

TRANSMITTAL –

Level 1 5 hours

LABOR DAY

Non-Peak Season

12 13 14

Month: 56 Hrs.

Year: 1,581 Hrs.

3 4 5 6 7

Non-Peak Season

Non-Peak Season

17 18 19

Non-Peak Season

24 25 26

Non-Peak Season

3 1

Non-Peak Season

Non-Peak Season

Non-Peak Season

29 29 30

Transmittal if

5 6 7

Non-Peak Season Transmittal if

Non-Peak Season Transmittal if

Non-Peak Season

Non-Peak Season Transmittal if Ordered

3 4 5 6

7 8 Non-Peak Season Transmittal if Ordered

9 10 11 12 13

Non-Peak Season

17 18 19 20

Non-Peak Season

24 25 26

Non-Peak Season Transmittal if

30 31

4 5 Non-Peak Season Transmittal if Ordered

6 7 8 9 10

11 12 Non-Peak Season Transmittal if Ordered

13 14 15 16 17

Non-Peak Season Transmittal if Ordered

21 22 23 24

25 26 Non-Peak Season Transmittal if

27 28 29

3 4 Non-Peak Season Transmittal if

5 6 7 8

Non-Peak Season Transmittal if

Non-Peak Season Transmittal if Ordered

19 20 21 22 23

24 25 Non-Peak Season Transmittal if Ordered

26 28 28 29 30

Non-Peak Season Transmittal if Ordered

2 3 4 5 6

7 8 Non-Peak Season Transmittal if Ordered

9 10 11 12 Campgrounds Open for Self- Registration

Non-Peak Season

16 17 18 19

Non-Peak Season

Non-Peak Season

Transmittal

Level 2 17 hours Open Entrance Station

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2200 Level 3 15 hours

MEMORIAL DAY

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Month: 145 Hrs.

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 1 15 hours

0700-2200 Level 1 15 hours

0700-2400

Month: 462 Hrs.

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2400

Level 2 17 hours

INDEPENDENCE

DAY

0700-2400 Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

Level 3 15 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

Level 3 15 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 1 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 2 17 hours

0700-2400

Month: 477 Hrs.

0700-2400 Level 2 17 hours

0700-1200

TRANSMITTAL –

Level 1 5 hours

LABOR DAY

Non-Peak Season

10 11 12

Month: 22 Hrs.

Year: 1,585 Hrs.

6 7

Non-Peak Season

Non-Peak Season

Non-Peak Season

29 30 31

Non-Peak Season

7 8 9

Non-Peak Season Transmittal

19 20 21 22 23

26 27 28

Non-Peak Season Transmittal

3 4 5 6 7

Transmittal if

10 11 12

Non-Peak Season Transmittal if

Non-Peak Season Transmittal if

Transmittal if

2 3 4

5 6 Non-Peak Season Transmittal if Ordered

7 8 9 10 11

12 13 Non-Peak Season

14 15 16 17 18

Non-Peak Season

Non-Peak Season Transmittal if

2 3 Non-Peak Season Transmittal if Ordered

4 5 6 7 8

9 10 Non-Peak Season Transmittal if Ordered

11 12 13 14 115

Non-Peak Season Transmittal if Ordered

19 20 21 22

23 24 Non-Peak Season Transmittal if

25 26 27 28

2 3 Non-Peak Season Transmittal if

4 5 6 7

Non-Peak Season Transmittal if

11 12 13

Non-Peak Season Transmittal if Ordered

18 19 20 21 22

23 24 Non-Peak Season Transmittal if Ordered

25 26 27 28 29

30 31 Non-Peak Season

6 7 Non-Peak Season Transmittal if Ordered

8 9 10 11 12

13 14 Non-Peak Season Transmittal if Ordered

15 16 17 18 Campgrounds Open for Self-

Non-Peak Season

Non-Peak Season

Transmittal

Level 2 17 hours Open Entrance Station

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2200 Level 3 15 hours

MEMORIAL DAY

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

Month: 160 Hrs.

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 1 15 hours

0700-2200 Level 1 15 hours

0700-2400

TRANSMITTAL –

Month: 458 Hrs.

0700-2200

Level 2 17 hours

INDEPENDENCE

DAY

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

Level 3 15 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

Level 3 15 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Month: 475 Hrs.

0700-2400 Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 1 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 4 15 hours

0700-2200

Level 2 17 hours

0700-2200

TRANSMITTAL –

Level 2 17 hours

0700-2400 Level 2 17 hours

0700-2400

0700-1200

TRANSMITTAL –

Level 1 5 hours

LABOR DAY

Non-Peak Season

9 10 11

Month: 5 Hrs.

Year: 1,577 Hrs.

5 6

Non-Peak Season

Non-Peak Season

Non-Peak Season

3 3 Non-Peak Season

6 7 8

Non-Peak Season Transmittal

18 19 20 21 22

25 26 27

Non-Peak Season Transmittal

2 3 4 5 6

Transmittal if

9 10 11

Non-Peak Season Transmittal if

Non-Peak Season Transmittal if

Transmittal if

EXHIBIT D

PARK ATTENDANT FORMS AND RECORDS

PARK ATTENDANT'S FORMS AND RECORDS

(1) Park Attendant Log Book

(2) Campground Onsite Report (Names of Campers by Site from system)

(3) Property Control Receipt (ENG 4900-R)

(4) See Park Attendant Handbook for other applicable forms.

EXHIBIT E

MINIMUM BASIC OUTLINE FOR ACCIDENT

PREVENTION PLAN

(APPENDIX A, EM 385-1-1)

OSHA 300 Log and Instructions

EXHIBIT E

APPENDIX A

MINIMUM BASIC OUTLINE FOR ACCIDENT PREVENTION PLANS

An Accident Prevention Plan (APP) is a safety and health policy and program document. The following areas are typically addressed in an APP, but an APP shall be job-specific and shall also address any unusual or unique aspects of the project or activity for which it is written.

The APP shall interface with the employer’s overall safety and health program, and a copy shall be available on the work site. Any portions of the overall safety and health program that are referenced in the APP shall be included as appropriate. ANSI/ASSE A10.38 should be referenced for Programmatic Issues.

> For LIMITED-SCOPE SERVICE, SUPPLY AND R&D CONTRACTS, for example, mowing (only), park attendant, rest room cleaning, the Contracting Officer and SOHO may allow an ABBREVIATED APP (customized APP requirements and waive the more stringent elements of this section). > See 01.A.11, and Appendix A, paragraph 11.11. ABBREVIATED APP for LIMITED-SCOPE SERVICE, SUPPLY AND R&D CONTRACTS. If service, supply and R&D contracts with limited scopes are awarded, the Contractor may submit an abbreviated Accident Prevention Plan. This APP shall address the following areas at a minimum. If other areas of the EM 385-1-1 are pertinent to the contract, the Contractor must assure these areas are addressed as well.

a. Title, signature, and phone number of the plan preparer.

b. Background Information to include: Contractor; Contract number; Project name; Brief project description, description of work to be performed, and location (map); The project description shall provide a means to evaluate the work being done (see AHA requirements in 01.A.13) and associated hazards involved. Contractor’s APP shall address the identified hazards involved and the control measures to be taken.

c. Statement of Safety and Health Policy detailing their commitment to providing a safe and healthful workplace for all employees.

d. Responsibilities and Lines of Authorities – to include a statement of the employer’s ultimate responsibility for the implementation of his SOH program; Identification and accountability of personnel responsible for safety at all levels to include designated site safety and health officer (SSHO) and associated qualifications. The District SOHO will review the qualifications for acceptance.

e. Training - new hire SOH orientation training at the time of initial hire of each new employee and any periodic retraining/recertification requirements.

f. Procedures for job site inspections - assignment of responsibilities and frequency.

g. Procedures for reporting man-hours worked and reporting and investigating any accidents as soon as possible but not more than 24 hours afterwards to the Contracting Officer/Representative (CO/COR). An accident that results in a fatal injury, permanent partial or permanent total disability shall be immediately reported to the Contracting Officer.

h. Emergency Planning. Employees working alone shall be provided an effective means of emergency communication. This may be cellular phone, two-way radio or other acceptable means. The selected means of communication must be readily available and must be in working condition.

i. Drinking Water provisions, toilet and washing facilities.

j. First Aid and CPR training (at least two employees on each shift shall be qualified/certified to administer first aid and CPR) and provision of first aid kit (types/size).

k. Personal Protective Equipment.

(1) Work Clothing - Minimum Requirements. Employees shall wear clothing suitable for the weather however minimum requirements for work shall be short-sleeve shirt, long pants (excessively long or baggy pants are prohibited) and leather work shoes. If analysis determines that safety-toed (or other protective) footwear is necessary (i.e., mowing, weed eating, chain saw use, etc), they shall be worn

(2) Eye and Face Protection. Eye and face protection shall be worn as determined by an analysis of the operations being performed HOWEVER, all involved in chain saw use, chipping, stump grinding, pruning operations, grass mowing, weed eating and blowing operations shall be provided safety eyewear (Z87.1) as a minimum.

(3) Hearing Protection. Hearing protection must be worn by all those exposed to high noise activities (to include grass mowing and trimming, chainsaw operations, tree chipping, stump grinding and pruning).

(4) Head Protection. Hard hats shall comply with ANSI Z89.1 and shall be worn by all workers when a head hazard exists. At a minimum, hard hats shall be worn when performing activities identified in (2) above.

(5) High Visibility Apparel shall comply with ANSI/ISEA 107, Class 2 requirements at a minimum and shall be worn by all workers exposed to vehicular or equipment traffic.

(6) Protective Leg chaps shall be worn by all chainsaw operators.

(7) Gloves of the proper type shall be worn by persons involved in activities that expose the hands to cuts, abrasions, punctures, burns and chemical irritants.

(8) If work is being performed around water and drowning is a hazard, PFDs must be provided and worn as appropriate.

l. Machine Guards and safety devices. Lawn maintenance equipment must have appropriate guards and safety devices in place and operational.

m. Hazardous Substances. When any hazardous substances are procured, used, stored or disposed, a hazard communication program must be in effect and MSDSs shall be available at the worksite. Employees shall have received training in hazardous substances being used. When the eyes or body of any person may be exposed to corrosives, irritants or toxic chemicals, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within 10 seconds of the worksite.

n. Traffic control shall be accomplished in accordance with DOT’s MUTCD.

o. Control of Hazardous Energy (Lockout/Tag Out). Before an employee performs any servicing or maintenance on any equipment where the unexpected energizing or startup of the equipment could occur, procedures must be in place to ensure adequate control of this energy.

p. Driving, working on (i.e., working with equipment/mowers) while on slopes, working from/in boats/skiffs, etc shall also be considered and dealt with accordingly.

EXHIBIT F

ACTIVITY HAZARD ANALYSIS

G)

OJ

-I

ACTIVITY HAZARD ANALYSIS (AHA)

Authority EM 385·1-1

1a. DATE PREPARED(YYYYMMDD) 1b. PROJECT NAME 1c. RISK ASSESSMENT CODE (RAC Per AR 385-10 end DA Pamphlet 385-10)

1d. CONTRACT NUMBER (If Applicable) 1e. BRIEF PROJECT DESCRIPTION

11. PHONE NUMBER 1g. PREPARERS EMAIL 1h. PREPARED BY (Neme First M.I. Last, Title) 11. PREPARERS SIGNATURE

2a. REVIEWERS COMMENTS AND RECOMMENDATIONS

2b. REVIEWERS EMAIL 2c. REVIEWED BY (Name First M.I. Last, Title) 2d. DATE REVIEWED (YYYYMMDD) 2e. REVIEWERS SIGNATURE

3. ADDIT IONALCOMMENTS AND RECOMMENDATIONS AS PROJECT PROGRESSED OR FUTURE ADDITIONAL SAFETY CONSIDERATIONS THAT NEED TAKEN INTO ACCOUNT

4. RECOMMENDED PROTECTIVE CLOTHING AND EQUIPMENT

' E = EXTR EMELY HIGH RISK PROBABILITY

I-a::

w w

II)

H = HIGH RISK

M= MODERATE RISK

L = LOW RISK

FREQUENT

LIKELY

OCCASIONAL

SELDOM

UNLIKELY

CATASTROPHIC E □ E □ H □ H □ M □

CRITICAL E □ H □ H □ M □ L □

MARGINAL H □ M □ M □ L □ L □

NEGLIGIBLE

M □ L D L D L □ L D

6.JOB STEPS

7.HAZARDS

8. EQUIPMENT

9. TRAINING

10. INSPECTIONS

11. CONTROLS AND

ACTIONS TO ELIMINATEOR

MINIMIZE HAZARDS

12. EM 38&·1-1

(Paragraph Reference)

CELRH FORM 2642, MAY 2010 PREVIOUS EDITIONS ARE OBSOLETE. Page 1 of_

VERSION 1.0

OJ

-I G)

CELRH FORM 2642C, MAY 2010

PREVIOUS EDITIONS ARE OBSOLETE.

Page 2 of_

CONTINUATION

1a. DATE PREPARED (YYYYMMDD) 1b. PROJECT NAME 1d. CONTRACT NUMBER (If Appllcab/e)

6. JOB STEPS

7. HAZARDS

8. EQUIPMENT

9. TRAINING

10. INSPECTIONS

11. CONTROLS AND

ACTIONS TO ELIMINATE OR

MINIMIZE HAZARDS

12. EM 385-1-1

(Paragraph Referenca)

TASK HAZARD ACTION TO ELIMINATE OR REDUCE HAZARD

13.Park Attendant Services

13.1 Slips, trips and

falls

13.2 Vehicle

accidents

13.3 Bee stings, dog bites and other animal related injuries

13.4 Confrontations

with the public

13.5 Environmental

Exposure

13.1.1 Workers must be conscious of surface footing and walking conditions at all times. Non-slip, non-skid shoes shall be worn at all times. Good housekeeping practices shall be followed to eliminate obstacles in the work area and tripping hazards. Special care shall be taken when walking at night, during rain or snow or on uneven surfaces.

13.2.1 Toolbox safety meetings shall be Conducted prior to

beginning work to orient workers with conditions and operations.

Only qualified, licensed personnel shall operate vehicles. All vehicles shall receive a pre-operational check prior to operation.

Should any problems be discovered which would adversely affect safe operation they shall be corrected before operation. Seat belts shall be worn at all times during operation by both the operator and passengers. Defensive driving practices shall be followed at all times. Attendants shall constantly be alert for children, pedestrians, bicyclists, animals, balls and other objects in the roadway and prepared to make sudden stops. Likewise, attendants shall constantly be aware of on-coming traffic around the entrance station or while on foot patrol thru areas and act defensively.

13.3.1 Attendants shall be alert for bees, spiders, snakes, dogs and other animals in or around the work area. Caution shall be exercised when approaching campsites with pets. First aid and snakebite kits shall be readily accessible.

13.4.1 Courtesy, tact and diplomacy shall be used when dealing with the public. Service Effectiveness Training techniques shall be employed. Attendants shall avoid placing themselves in vulnerable positions whenever possible. Arguments, open hostility or physical confrontations shall be avoided. Only on- duty personnel are permitted inside the entrance station. Loitering is prohibited.

Attendants shall keep the entrance station and gates closed and make optimal use of telephone and radio communication to notify the Contractor, Corps and Law Enforcement personnel whenever problems are anticipated. In the event of a robbery, attendants shall cooperate with the robber without resistance, obtain as much information about them as possible, then contact Law Enforcement personnel immediately.

13.5.1 Protective clothing shall be worn when exposed to excessive heat or sunlight, cold or precipitation. During floods or violent storms attendants shall be alert to rising water levels, strong winds, trees and power lines which could cause damage to themselves as well as co-workers, campers, contractors, public and private property.

Likewise they shall keep campers, contractors and the Government

13.6 Electrocution

apprised of hazardous conditions. Special care shall be taken when crossing moving water, such as streams or fords, which are subject to rapid change.

13.6.1 Only properly trained and certified attendants shall be permitted to respond to "no power" complaints involving campsite pedestals. Caution shall also be used operating any electrical equipment, such as the entrance gates, radios, heaters or computers during lightning storms.

EXHIBIT G

SAMPLE INVOICE FORMAT

SAMPLE INVOICE FORMAT

FROM: Contractor’s Name INVOICE NO:

Address City, State, Zip Phone Number

INVOICE FOR MONTH OF: DATE OF INVOICE:

CONTRACT NUMBER:

To: Resource Manager Burnsville Lake 2550 South Main Street Burnsville WV 26335-7516

Date Item Amount

6-1-18 Scheduled Park Attendant Services for May $000.00

TOTAL INVOICE $000.00

EXHIBIT H

CONTRACTOR QUALITY CONTROL PLAN

CONTRACTORS QUALITY CONTROL PLAN

1. INSPECTION OF SERVICES.

a. Scheduled Inspections. At the beginning of each shift, the Park Attendant shall inspect the work performed by the previous shift. The inspection shall include the following:

1) Review of permits issued. Permits shall be checked for accuracy of arrival and departure dates, fees collected, required information recorded, and proper filing. Permits and fees collected shall also be reconciled.

2) Reconciliation of Register of Campers (computer and/or "clipboard) and actual campground conditions.

3) Fund security and compliance with safety and security requirements.

4) All other items listed on the attached inspection form.

b. Unscheduled Inspections. If the Contractor is not the primary Park Attendant, the Contractor or his Representative shall make unscheduled inspections, using the following form and above criteria. Unscheduled inspections shall be made a minimum of every week.

c. Records and Filing. All inspections shall be documented and maintained in a file at the Entrance Station. Files shall be available for COR inspection at any time.

2. DEFICIENCIES AND CORRECTIVE ACTION. Errors in User Permits and other records shall be corrected immediately, and documented as required. Notices and reminders shall be posted as necessary to draw attention to repeated errors.

3. INSPECTORS and CONTRACTOR REPRESENTATIVES. A list of names and phone numbers of authorized Inspectors and Contractor Representatives shall be provided at the Pre-Work Conference.

4. I hereby adopt the Contractor Quality Control Plan in Exhibit H.

Contractor Date

QUALITY CONTROL CHECKLIST FOR PARK ATTENDANT SERVICES

DUTY / INSPECTION ITEM RATING COMMENTS

Visitor Registration

Fee Collection

Fund Security

Campground Register & Visitor Records

Customer Care & Visitor Assistance

Campground Inspections

Gates Operated Correctly

Handouts Distributed

Reporting Incidents, Etc.

Log Book

Cooperation with Others

Attendant’s Appearance

Entrance Station Appearance

Entrance Station Security

Use Fee Transmittal

Safe Work Habits and Equipment

1 – Work Done Correctly 2 – Errors Found (Explain problem, correction, and prevention of repeat problem) 3 – Work Not Begun X – Work Not Scheduled

EXHIBIT I

QUALITY ASSURANCE SURVEILLANCE PLAN

PARK ATTENDANT SERVICES

BURNSVILLE LAKE

Date Procuring Contracting Officer

Table of Contents

SECTION PAGE NO.

SECTION I. Introduction.

A. General B. Roles and Responsibilities C. Authority D. Acronyms and Definitions

SECTION II. Acceptance/Rejection of Services A. General B. Acceptance C. Rejection

SECTION III. Calculating Deductions A. General B. Examples

1. Random Sampling

2. Planned Sampling

SECTION IV. Performance Requirements Summary Tables

SECTION V. Sampling Guides

SECTION VI. Inspection Checklists A. Examples

1. Park Attendant

SECTION VII. Random Sample Tables Table 1. Normal Surveillance Table 2. Tightened Surveillance Table 3. Reduced Surveillance

SECTION I. Introduction

A. General. This plan will be used to assure the government that work specified under this contract is completed satisfactorily. The plan is included for information purposes only. It does not supersede any of the requirements in other sections of the contract. Surveillance or inspections will be primarily conducted in three ways; however, the Government has the right to change or modify inspection methods at its discretion.

The three principle inspection methods are random, one hundred percent, and planned. In conjunction with describing the principle methods used for providing surveillance (i.e., inspecting), this plan defines common terms and acronyms; summarizes in table form the performance requirements for each contract section; summarizes in table form a "sampling guide" for each contract section; explains how deductions are calculated; and, provides examples of Inspection Checklists.

B. Roles and Responsibilities. The following personnel shall oversee and coordinate surveillance activities.

1. Procuring Contracting Officer (PCO). The PCO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The PCO shall also ensure that the contractor receives impartial, fair, and equitable treatment under this contract. Determine the final assessment of the contractor’s performance.

Assigned PCO: Mary L. Newman Organization or Agency: US Army Corps of Engineers, Huntington District Telephone: 304-399-5228 Email: mary.l.newman@usace.army.mil

2. Contracting Officer’s Representative (COR). The COR is responsible for providing continuous technical oversight of the contractor’s performance. The COR uses the QASP to conduct the oversight/surveillance process. The COR shall keep a Quality Assurance file that accurately documents the contractor’s actual performance. The purpose is to ensure that the contractor meets the performance standards contained in the contract. The COR is responsible for reporting early identification of performance problems to the KO. The COR is required to provide an annual performance assessment to the KO which will be used in documenting past performance. The QASP is the primary tool for documenting contractor performance. The COR is not empowered to make any contractual commitments or to authorize any contractual change on the Government’s behalf.

3. Other Key Government Personnel This may include performance monitors, inspectors, or others who provide information that helps the COR monitor contractor performance.

C. Authority. Authority for issuance of this QASP is provided under Part 46 of the

Federal Acquisition Regulation, Inspection of Services clauses, which provides for inspection, acceptance and documentation of the service called for in the contract or order.

This acceptance is to be executed by the contracting officer or a duly authorized representative.

D. Acronyms and Definitions.

1. List of Acronyms.

a. AQL ........ Acceptable Quality Level

b. CDR ........ Contract Discrepancy Report

c. COR ........ Contracting Officer Representative

d. CO ..........Contracting Officer

e. PRS ........Performance Requirements Summary

f. PWS ....... Performance Work Statement

g. QA ..........Quality Assurance

h. QAE ........ Quality Assurance Evaluator

i. QASP ..... Quality Assurance Surveillance Plan

j. QC ..........Quality Control

k. QCP ........Quality Control Plan

l. N/A ..........Non-Applicable

2. Definitions.

a. Acceptable Quality Level. Predetermined value used by the Government to distinguish between satisfactory and unsatisfactory performance. AQL may be stated in percent and is the maximum number of defects per 100 units that can be considered satisfactory. As long as the defective performance does not exceed the AQL, the total service will not be rejected by the Government. The contractor, however, must reperform the defective service.

b. Defect. Any deficiency determined to be significant as to render the unit unsatisfactory.

c. Deficiency. Any inspection unit, which does not meet the Contract requirements in their entirety.

d. Inspection Unit. For statistical sampling the unit is identified in the sampling guide. For all other work the inspection unit is the job. The inspection unit may include several tasks.

e. Inspector. Individual designated by the COR to perform Quality Assurance.

f. Item. The term item, when used with the Contract, refers to the Bid Items contained in Section B of the Contract.

g. Job. A job describes an individual, separate, and defined element of work to be performed. "Mowing the Below Dam Recreation Area" or "Painting the Number One Picnic Shelter in the Below Dam Area" is examples of jobs.

h. Lot Size. The total number of times the service is performed in a given period of time, such as the total number of cleanings per month. Also called a population.

i. 100% Inspection. An inspection method requiring the examination of each completed job. It is not required that the inspector be at the job site 100 percent of the time while the job is occurring. This approach is best suited for monitoring contract requirements that occur infrequently or are of great importance.

j. Percent of Sample Found Defective. Determined by dividing the number of defects by the sample size.

k. Planned Sampling. An evaluation method designed to inspect some part but not necessarily all of the contract requirements. Sample selection is based on some subjective rationale and sample size is usually arbitrarily determined.

l. Quality Assurance. Those actions taken by the Government to insure goods or services meet the requirements of the contract.

m. Quality Assurance Evaluator. A Government official responsible for evaluating contractor's performance. Also, known as an inspector.

n. Quality Control. Those actions taken by a contractor to control the production of goods or services to insure that they meet the requirements of the contract.

o. Random Number Table. A table of numbers arranged in a random fashion. A table used to make random samples.

p. Random Sample. A sampling method whereby each service output in a lot has an equal chance of being selected, or where any occurrence of a contract requirement is as likely to be evaluated as any other occurrence.

q. Random Sampling. A method of looking at a few individual items in a lot to determine the quality of that lot against a standard.

r. Reject Level. The number of defects beyond which the total service for that lot is rejected by the Government and deductions are made. The contractor must reperform defective services, when possible, even if the number of defects is less than the reject level.

s. Sample. A sample consists of one or more service outputs drawn from a lot, the outputs being chosen at random. The number of outputs in the sample is the sample size.

t. Sampling Guide. The part of the surveillance plan, which contains all the information, needed to perform a random sample. A "how to inspect guide" for each type of work to be performed.

u. Service Requirement. A job to be performed to the specified standard and within the acceptable quality level. The contractor must do the specific job, meet the standard, and meet the acceptable quality level before performance is acceptable and contractor will be paid.

v. Surveillance Plan. An organized written Government Document used for quality assurance surveillance.

w. Unscheduled Inspection. Impromptu inspections of contract requirements without a pre-planned schedule.

x. Validated Complaints. An evaluation method utilizing customer awareness.

y. Work. The general scope of services covered under the specifications of this contract.

SECTION II. Acceptance/Rejection of Services

A. General. Inspection of all services performed under this contract will primarily be done in accordance with a schedule developed by the Government, and will primarily be done by using one or a combination of the surveillance methods cited in this plan. The purpose of inspection is to document contractor performance and the quality of services or goods produced. Documentation of contractor performance will be done on the appropriate Inspection Checklist (see Section VI of this plan).

B. Acceptance.

1. Statistically Sampled Work. Whenever the number of defects for a lot falls at or below the established reject level the work will be considered satisfactory.

However, the contractor is still required to correct the deficiencies.

2. 100% Inspection. When all work is performed in accordance with the Work Order.

C. Rejection.

1. Statistically Sampled Work. Whenever the defects exceed the reject level the Government will issue a CDR and effect a monetary deduction from the Contractor's invoice based on Section III B1 or B2.

2. 100% Inspection. Whenever the work does not conform to all requirements of the Work Order, the Government will issue a CDR and proceed in accordance with the contract clause 52.246-4.

SECTION III. Calculating Deductions

A. General. Whenever work or parts of work are rejected deductions will be made.

The following hypothetical examples are given to demonstrate how deductions for deficiencies would be calculated.

B. Examples.

1. Random Sampling. The process used to determine what specific services that will be inspected using random sampling is defined in the Huntington District Random Sampling Manual. All the services that will be performed in the month are listed and numbered. A computer program is then used to pick at random the specific services that will be sampled based upon the number of samples required as defined in the surveillance tables at the end of the QASP.

IF: Quality of work for registration/fee processing is found to be unsatisfactory (i.e., the AQL of 5% is exceeded).

AND: Contract price is $2,000 for the number of hours of Park Attendant Services ordered.

AND: The deducted percentage for registration/fee processing is 35% (taken from the Performance Requirements Summary Table).

AND: Sample size is 7 with a reject level of 3.

AND: Number of defects in sample is 5.

THEN: Deductions from the contractor's monthly invoice for performing one month of Park Attendant Services would be calculated according to the following equation:

No. of Defects X Deduct Percentage X Contract Price = Amount of Sample Size PA Services for PA Services Deduction

Substituting in the numerical values (from the example) the deducted amount would be calculated as follows:

5/7 X .35 X 2000 = 500.00

Therefore, $500.00 would be deducted from the contractor's monthly invoice for one month of Park Attendant Services.

Planned and Unscheduled Sampling. This example shows how a deduction would be calculated when planned or unscheduled sampling documents deficiencies in performing park attendant services. In this example, planned sampling has documented 3 defects in Visitor Assistance services during a month with 31 days. Therefore, the deduction would be calculated as follows:

a. Given factors: The Bid Item Price for the number of hours of Park

Attendant Services ordered is $2,500.00. There are 31 days in the month. Therefore, the price per day is $2,500.00 / 31, or $80.65. (Note: All days will be considered of equal value, for the purposes of making deductions.)

b. Equation:

Number Bid Item Price Deduction Amount Of X for One Day of X Percentage = of Defects PA Services for Service Deduction

Substituting the numerical values from the example, the deducted amount would be calculated as follows:

3 defects X $80.65/ day X 0.30 = $72.58 deduction

Therefore, $72.58 would be deducted from the Contractor's invoice for performing Park Attendant for the month in question.

SECTION IV. PERFORMANCE REQUIREMENTS SUMMARY TABLES

Required Services

Section Number

Paragraph

Number

Maximum Allowable Degree of Deviation From Requirement

(AQL)

Method of

Surveillance and Fee

Processing

C-2.2

C-2.2.f

5%

Random Sampling

Entrance Station

Operation and

Management

C-2.2.a-k

Visitor Assistance

C-2.2.a

SECTION V. SAMPLING GUIDES

1. Service Requirement: Registration and Fee Processing, Entrance Station Operation and Management, and Visitor Assistance.

2. Corresponding Contract Section: C-2.2

3. Method of Q.A.: Random Sampling

4. Acceptable Quality Level: 5%

5. Lot Size for Sampling: Variable

6. Sampling Size: Variable

7. Reject Level: Variable

8. Sampling Procedures: The COR will randomly select dates for park attendant station operation to be inspected each month, and inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be conducted in accordance with contraction specifications for park attendant services. Information will be recorded on an inspection checklist. The Contractor will be informed of the Government's assessment of this performance.

10. Performance Criteria: The Contractor shall perform all work as specified on the individual work orders. For all identified deficiencies, the Contractor will be allowed to reperform if the work order and contract specifications allow. Defects in Contractor performance may be addressed by issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies y reperformance, or for any defects/rejects in service requirements. Should the reject level be exceeded, a deduction for unsatisfactory performance will be made.

SECTION VI

INSPECTION CHECKLISTS

Registration and Fee Processing

Registration Forms Correct

ENG Form 3313 Correct

Funds Security

Appropriate Fees Collected and Recorded

Entrance Station Operation and Management

Safe Work Habits / Equipment

Attendant's Appearance (uniform, campsite)

Entrance Station Appearance

Loitering or Loafing

Cooperation with Corps

Handouts Distributed Correctly

Gates Operated Properly

Log Books / Visitor Register Correct

Visitor Assistance

Customer Care

Park Inspection

Campers Informed of Rules

Reporting Incidents / Accidents

Violations Reported / 14 Day Camping Violations

Inspection Checklist Project:

Contractor:

Contract No:

Work Order No.:

Delivery Date:

Weather:

Service Requirement: Rating Code: (1) Acceptable (2) Unacceptable (3) Work in Progress (4) Work Not Started

Specific Task(s) or Item(s)

Work Areas

Complete Following Only If

Deficiencies Noted:

Signature of CR or QCI who Reviewed

Date Time

OR

Signature of CR or QCI who Received a Copy

Date Time

Time

Inspector's Signature Date COR Signature Date

See back for description of deficiencyDefect Acceptable

Park Attendant

Specific Task(s) or Item(s)

Specific Task(s) or Item(s)

This notice is to advise you of deficiencies found during inspection. The deficiencies found are in the performance and/or quantity of work. The deficiencies are to be corrected as specified.

Comments and deficiencies which shall be corrected before work will be acceptable and satisfactory are as follows:

Location ____________________________________________________________

Comments on correction of deficiencies:

Inspector

Date

SECTION VII

RANDOM SAMPLE TABLES

Table A-1 Sample Sizes and Reject Levels

Population Size

Normal Surveillance

AQL 5% AQL 10%

Sample Size Reject Size Sample Size Reject Size 2-8 3 1 3 2

9-15 5 2 5 2 16-25 8 2 8 3 26-50 13 3 13 4

50 15 3 17 4 75 16 3 19 4

100 17 3 21 5 125 18 3 22 5 150 18 3 22 5 175 19 3 23 5 200 19 3 23 5 225 19 3 24 5 250 19 3 24 5 275 19 3 24 5 300 20 3 24 5 325 20 3 24 5 350 20 3 24 5 375 20 3 25 5 400 20 3 25 5 450 20 3 25 5 500 20 3 25 5 550 20 3 25 5 600 20 3 25 5 650 20 3 25 5 700 20 3 25 5 750 20 3 25 5 800 20 3 25 5 900 20 3 26 6

1,000 21 4 26 6 1,200 21 4 26 6 1,400 21 4 26 6 1,600 21 4 26 6 1,800 21 4 26 6 2,000 21 4 26 6 2,500 21 4 26 6 3,000 21 4 26 6 3,500 21 4 26 6 4,000 21 4 26 6 5,000 21 4 26 6 6,000 21 4 26 6 8,000 21 4 26 6

10,000 21 4 26 6

Table A-2

Tightened Surveillance

AQL 5% AQL 10%

Sample Size Reject Size Sample Size Reject Size 2-8 5 2 5 2

9-15 8 2 8 2 16-25 13 2 13 3 26-50 20 3 20 4

50 33 4 37 6 75 42 5 49 8

100 49 5 58 9 125 55 6 66 10 150 59 6 72 11 175 63 7 78 12 200 66 7 82 13 225 68 7 86 13 250 70 7 89 14 275 72 8 92 14 300 74 8 95 15 325 75 8 97 15 350 76 8 99 15 375 77 8 101 16 400 78 8 103 16 450 80 8 106 16 500 82 9 109 17 550 83 9 111 17 600 84 9 113 17 650 85 9 114 18 700 86 9 116 18 750 86 9 117 18 800 87 9 118 18 900 88 9 120 18

1,000 89 9 122 19 1,200 90 9 124 19 1,400 91 10 126 19 1,600 92 10 128 20 1,800 92 10 129 20 2,000 93 10 130 20 2,500 94 10 131 20 3,000 94 10 132 20 3,500 95 10 133 20 4,000 95 10 134 21 5,000 96 10 135 21 6,000 96 10 135 21 8,000 96 10 136 21

10,000 96 10 137 21

Table A-3

Reduced Surveillance

AQL 5% AQL 10%

Sample Size Reject Size Sample Size Reject Size 2-8 2 1 2 1

9-15 3 1 3 2 16-25 5 2 5 2 26-50 7 2 7 3

50 7 3 9 4 75 7 3 10 4

100 8 3 10 5 125 8 3 10 5 150 8 3 10 5 175 8 3 11 5 200 9 3 11 5 225 9 3 11 5 250 9 3 11 5 275 9 3 11 5 300 9 3 11 5 325 9 3 11 5 350 9 3 11 5 375 9 3 11 5 400 10 3 11 5 450 10 3 12 5 500 10 3 12 5 550 10 3 12 5 600 10 3 12 5 650 10 3 12 5 700 10 3 12 5 750 10 3 12 5 800 10 3 12 5 900 10 3 12 6

1,000 10 4 12 6 1,200 10 4 12 6 1,400 10 4 12 6 1,600 10 4 12 6 1,800 10 4 12 6 2,000 10 4 12 6

EXHIBIT J

CONTRACT DISCREPANCY REPORT (CDR)

ORH FORM 2759

CONTRACT DISCREPANCY REPORT

Contrac t Number Work Order Number(s)

To (Contractor and Manager' s Name) From (COR)

I DATES I Prepared OralNotification Returnedby Contr. ActionComplete

Discrepancyor Problem(Describe indetail: include referencein Contract/WorkOrder: attachcontinuation sheetif necessary)

Signatureof Contracting Officeror Authorized Representative

To (Contracting Officer or Authorized Representative) From(Contractor)

Contractor Response as to Cause, Corrective Actionand Actionsto Prevent Recurrence: AttachContinuation Sheet if Necessary.

(Citeapplicable Q.C. program procedures or new Q.C.procedures.)

Signature of Contractor Representative I Date

Government Evaluation(Acceptance , partialacceptance, rejection: attachcontinuation sheetif necessary.)

Government Actions(Payment deduct ion, curenotice,show cause,other.)

CLOSE OUT

Name-Title Signature Date

Contractor Notified

COR

co

CEORD Form 1104-R 1 Feb 90

RM-F

EXHIBIT K

CESO Checklist A-01

Item Description Yes No N/A

1. Signature sheet

a. Includes the name, signature, and title of the Plan Preparer (Qualmed person, i.e. corporate safety staff person, QC)

b. Includes the name, signature,and tiUe of the Plan Approver {e.g.

owner, company president, regional vice presiden

c. Includes the name{s), signature(s), and title{s) for Plan Concurrence (provide concurrence of other applicable corporate and project personnel(contractor))

2.Background information

a. Includes the Contractor Name.

b. Includes the Contract Number.

c. Includes the Project Name.

d. Includes the Brief Project Description.

e. Includes the Location of the Project {map).

f. Includes a means to evaluate the work being done (see AHA requirements in 01.A.13) and associated hazards involved.

g. Addresses the identified hazards involved and the control measures to be taken.

3. Statement of Safety and Health Policy detailing their commitment to providing a safe and healthfulworkplace for all employees.

4.Responsibilities and Lines of Authorities a.Includes the identification and job responsibilities of personnel responsible for safety - at both corporate and project level - including their resumes.

b.Includes the lines of authority.

5. Training- new hire SOH orientation training at the time of initial hire of each new employee and any periodic retraining/recertification requirements 6.Procedures for job site inspections - assignment of responsibilities and frequency CESO Checklist A-01,Sep 14

U.S.Army Corps of Engineers Safety Inspection Checklist

Abbreviated Accident Prevention Plan

Inspector Name (Print) Inspector Signature

This checklist serves as a guide only. It does not replace or eliminate the need to comply with the requirements set forth in Engineering Manual 385-1-1, Safety and Health Requirements Manual, dated XX September 2014.The references Included In this checklist correspond to the applicablesections of EM 385-1-1.

If service, supply and R&D contracts with limited scopes are awarded, the contractor may submit an abbreviated Accident Prevention Plan. This APP shall address the following areas at a minimum. If other areas of the EM 385-1-1 are pertinent to the contract, the contractor must assure these areas are addressed as well.

Remarks (Any NO or N/A Item)

Date of Inspection

Location (Plant or Facility) Contract Number

Contractor Name Project Name

Date of Inspection

7.Procedures for reporting man-hours worked and reporting and investigating any accidents as soon as possible but not more than 24 hours afterwards to the Contracting Officer/Representative

(CO/COR).

8.Emergency Planning. Employees working alone shall be provided an effective means of emergency communication. This may be cellular phone, two-way radio or other acceptable means. The selected means of communication must be readily available and must be in working condition.

9.Drinking Water provisions, toilet and washing facilities.

10.First Aid and CPR training (at least two employees on each shift shall be qualified/certified to administer first aid and CPR) and provision of first aid kit (types/size).

11.Personal Protective Equipment

a. Work Clothing - Minimum Requirements. Employees to wear clothing suitable for the weather; minimum requirements for work shall be short-sleeve shirt, long pants (excessively long or baggy pants are prohibited) and leather work shoes. If AHA determines safety-toed (or other protective) footwear is necessary (i.e., mowing, weed eating, chain saw use, etc), they shall be wom.

b.Eye and Face Protection. Eye and face protection shall be worn as determined by an analysis of the operations being performed HOWEVER, all involved in chain saw use, chipping,stump grinding, pruning operations, grass mowing, weed eating and blowing operations shall be provided safety eyewear (Z87.1) as a minimum.

c. Hearing Protection. Hearing protection must be worn by all exposed to high noise activities {includes grass mowing/trimming, chainsaw…