Exhibit A Agency Specific Requirements_Madisonville.pdf

Exhibit A- Agency Specific Requirements

Madisonville, KY Clinic

The Department of Veterans Affairs is interested in leasing 9,375 ABOA square feet of clinic space that could be leased by the VA as clinic space for a community-based outpatient clinic located in Madisonville, KY.

Space shall be available for use by Tenant (VA) for personnel, furnishings, and equipment to meet the needs for a Community Based Outpatient Clinic (CBOC) in the Madisonville, KY area.

The property offered shall be within city limits of Madisonville, KY with the following borders:

North: Highway 281/Highway 41 East: Highway 254/Interstate 69 South: Princeton Rd/Pleasant View Rd West: Bean Cemetery Rd

The facility must be located in Hopkins County, Kentucky.

SQUARE FOOTAGE: The clinic shall be 9,375 ABOA square feet.

Submitted designs must meet Patient Aligned Care Team (PACT) design guide philosophy. Patient Centered Care (PCC) and the PACT model has transformed the way the Department of Veterans Affairs, Veterans Health Administration provides care to our nation’s Veterans. PCC and PACT require focus on the Veteran. Lean operations thinking and lean design combine to support a proactive Veteran-focused approach to aligning operations and space. Lean management ideas must be used to center on the Veteran’s needs, increase quality, and decrease waste.

Space design will provide maximum co-location of the staff providing services for our patients. It will bring the service to the veterans, reduce the number of steps required to deliver services, and simplify the Veteran’s experience.

Design must maximize co-location of the care teams. The team requires a space where they can function as teams. Staff needs to be able to see each other, to frequently interact, share information, coordinate care, plan work, and hand-off patients and tasks. They need to be able to see each other in an acoustically conducive space that supports concentration and conversation.

Not later than 30 days after the acceptance of the Space, the Lessor, at Lessor’s expense, shall furnish to the Government a complete set of Computer Aided Design (CAD) or Building Information Models (BIM) files and PDFs of as-built floor plans showing the Space under Lease, as well as corridors, stairways, and core areas. The plans shall have been generated by 2017 CAD or 2017 Revit program. The required file extension is “.DWG.” or “.RVT”.

Clean and purged BIM and PDF files shall be submitted in a digital format. They shall be labeled with Building name, address, list of drawing(s), date of the drawing(s), and Lessor's architect and architect’s phone number. The Lessor’s operator shall demonstrate the submission on VA equipment, if requested by the LCO.

The leased property offered shall meet the criteria set forth in the Room Specific Requirements document.

Design of the space must follow VA Design Guides found in the VA Technical Information Library, www.cfm.va.gov/TIL. This includes, but is not limited to, all Design Criteria, Leasing Criteria, BIM/CAD standards, and other information for use and inclusion in the design and construction of this leased space.

http://www.cfm.va.gov/TIL

OTHER REQUIREMENTS:

BUILDING COMMISSIONING

Lessor will contract with an independent 3rd party commissioning agent (“Commissioning Agent”) to perform Acceptance and Testing Phase Commissioning in accordance with Chapter 8 of the VA’s Whole Building Commissioning Process Manual dated May 1, 2013 (https://www.cfm.va.gov/til/Cx-RCx/CxManual.PDF).

Systems requiring commissioning include Fire Suppression, Plumbing, HVAC, Electrical, Communications, Electronic Safety and Security, and Integrated Systems Tests as further described in Chapter 3. The cost of the Commissioning shall be paid by the lessor and included in the build out cost.

GENERAL TECHNICAL REQUIREMENTS:

GENERAL: The building must be of sound and substantial construction for use as a modern office and outpatient space. Any corrections or changes must be made prior to VA occupancy. Buildings which have reasonably incurable or functional obsolescence and/or are unsuitable in configuration for medical space floor plan layout may be rejected by the contracting officer. A proposed floor plan will be submitted with the bid package.

ACCESSIBILITY: Facility must be in full compliance with American Disabilities Act (ADA) requirements, including building, building access, and parking. Accessibility for new construction: to be considered for award, building to be constructed must fully meet the new construction requirements of the Americans with Disabilities Act Accessibility Guide (ADAAG) (36 CFR Par 36, App. A), the Uniform Federal Accessibility Standards (UFAS) and Department of Veterans Affairs Barrier Free Design Guide (PG-18-13, June 2024). PDF link below.

Adobe Acrobat Document

Where standards conflict, the more stringent shall apply.

SEISMIC: Seismic Safety for New Construction – If an offeror proposes to satisfy the requirements of this solicitation through the construction of a new building or the construction of an addition to an existing building, then such new building or addition shall fully meet seismic safety standards.

CODES: Structure shall be in compliance with local building codes, and all applicable current NFPA Fire and Life Safety codes. Building shall be fully sprinkled.

GOVERNMENT RESPONSIBILITIES: The VA will provide and install furniture, stand alone equipment such as refrigerators, computers, business office equipment and the medication cabinet. The VA will provide and install bulletin boards and decorative pictures.

THE GOVERNMENT WILL PROVIDE:

- Supplies (soap, hand sanitizer, toilet tissue, paper towels)

- Dispensers (soap, hand sanitizer, toilet tissue, paper towels)

THE LESSOR WILL PROVIDE:

- Janitor and janitorial supplies not mentioned above (including exterior trash pickup within 10-foot radius of outside entrance doors)

- Trash removal

- Snow/ice removal before the open of business (6:00 AM) and throughout the day as needed.

- Heating system, and heating system maintenance and repair.

- Window washing and window washing supplies (windows to be washed inside and out by lessor every 3 months)

- Lawn and landscaping maintenance (including exterior trash pickup outside 10-foot radius of exterior doors.

- Replacement of exterior light bulbs

- Plumbing maintenance and repair

- Air conditioning, and air conditioning system maintenance and repair

- Electrical maintenance and repair

- Carpet cleaning annually https://www.cfm.va.gov/til/Cx-RCx/CxManual.PDF

- Painting

- Electrical Utility Service

- Water Service

- Heating Fuel Service

- Replacement of interior fixture lamps

- Monthly Heating fuel

- Monthly Electricity

- Monthly Water

- Dumpster service

- Cable/Satellite TV service

- Wi-Fi service (can be combined with cable/satellite service)

- A Fire Alarm and Intrusion System. Include phone/cell service to panel and a Dispatch Service and all Maintenance and Testing in accordance with NFPA

- Recurring Utility bills

ARCHITECTURAL:

VESTIBULES

Vestibules with an air curtain shall be provided at public entrances and exits. In the event of negative air pressure conditions, provisions shall be made for equalizing air pressure.

The Lessor shall provide permanent entryway systems (such as grilles or grates) to control dirt and particulates from entering the Building at all primary exterior entryways.

FLOORS: Space shall be all on one level with direct street/parking lot access. There will be no steps at the main entrance.

SIZES: All room square feet listed are minimums. The facility may have up to 30% larger rooms or 15% additional rooms. Rooms other than storage rooms and corridors may not be over 3 times longer than they are wide.

WALL FINISHES: Wall coverings shall be washable vinyl or washable paint. Lessor shall repaint entire clinic on a 10-year cycle at no extra cost, as well as patch and paint to make “like new” as needed throughout the term of the lease. Any vinyl covered walls to be refinished at a minimum of every 6 years at owner’s expense. VA to select colors. Vendor shall be responsible for moving and returning of furniture to allow painting and vinyl replacement.

Painting/vinyl work shall be done after hours and must be odor free when clinic opens for business. Perimeters of rooms must have rubber or vinyl base cove. All walls shall be finished, no exposed ductwork, conduit or piping.

Chair guards/rail to be installed in all patient waiting areas, clinical spaces, exam rooms, and any other areas where wall damage can be anticipated.

PAINTING: Painted walls shall be washable semi gloss; ceilings shall be flat paint finish. All other painted surfaces shall be washable semi-gloss. The Lessor shall provide interior paints, primers, coatings, stains, and sealers that meet or are equivalent to the Green Seal GS-11 standard that incorporates environmental, health, and performance criteria.

FLOOR FINISH: Entire facility shall be comprised of luxury vinyl tile. VA to select color. Please provide flooring samples to choose from. Behavioral Medicine areas will be carpeted (except for rooms equipped with a sink) for sound deadening purposes. VA to select color. Carpet tiles are preferred for ease of replacement of damaged areas. Some other offices may request carpeting on an as requested basis, but no carpeting is permitted in direct patient care areas due to infection control issues.

CEILING FINISH: Ceilings may be sheetrock or lay in tile. Owner to replace any wet, stained, cut, broken, or damaged ceiling tiles as damage occurs.

INTERIOR DESIGN: Color/Finish proposals to be done by a professional interior design service. A minimum of 3 proposals will be provided to the VA each time new finishes are to be reviewed.

BUILDING DIMENSIONS: Area of building leased to VA must be roughly rectangular in shape and must not be more than 3 times longer than its width.

ASBESTOS / ENVIRONMENTAL HAZARDS: Existing buildings must be asbestos, mold and lead free.

ENERGY CONSERVATION: The windows must be double glazed and the walls and roofs must be insulated.

Entire facility, including doors and windows must be weather tight. Building insulation and HVAC system must be meet minimal DOE recommendations for this region. For water conservation, the faucets shall be 1.0 GPM laminar flow nozzles, and toilets shall be high-efficiency 1.28 GPF.

DOORS: Main entrance exterior doors should be sliding glass style (motion detected) doors with aluminum frames.

Utility rooms and doors leading from main lobby to exam areas are to be equipped with automatic door closers.

Wall mounted door stops are acceptable when proper blocking or stud is in place. Otherwise, a floor mounted door stop is required.

DOORS: HARDWARE

Doors shall have door handles or door pulls with heavyweight hinges. The lessor is encouraged to avoid the use of chrome-plated hardware. All doors shall have corresponding doorstops (wall- or floor-mounted) and silencers. All door entrances leading into the Space from public corridors, exterior doors and restrooms, shall have automatic door openers and closers. Automatic doors are also required on doors leading from the waiting room to the clinic areas. Doors to the clinic area shall be push pad operated on the clinic side and PACS card reader on the waiting room side. Other doors throughout the clinic space will also have PACS card readers. Designated doors will be identified during the design process for the space. Exterior doors with removable hinge pins will be retained with set pins or spot welded. Doors designated by the Government shall be equipped with 7-pin, tumbler cylinder locks and strike plates. All locks shall be master keyed. Furnish at least two master keys for each lock to the Government.

Any exterior entrance shall have a high security lock, with appropriate key control procedures, as determined by Government specifications. Hinge pins and hasps shall be secured against unauthorized removal by using spot welds or pinned mounting bolts. The exterior side of the door shall have a lock guard or astragal to prevent tampering of the latch hardware. Doors used for egress only shall not have any operable exterior hardware. All security-locking arrangements on doors used for egress shall comply with requirements of NFPA 101or the International Building Code current as of the Lease Award Date. All doors must be equipped and master keyed to match existing VA locking system (Medeco). Egress doors must be equipped with panic hardware and meet NFPA requirements for exit. Please refer to www.cfm.va.gov/til/spclRqmts.asp#room, VA PG-18-14 Room Finishes/Door and Hardware Schedule for Door Hardware/Privacy Locks specifications. As well as Exhibit I, VA Design Alert for Patient Privacy and Women Veterans’ Health.

LOCKS: All doors must be equipped with cylinder lock locking hardware and master keyed to match existing VA “Medeco” brand, figure 8, 7-pin locking system. Egress doors must be equipped with panic hardware and meet NFPA requirements for exit. Toilets to be equipped with privacy locks that can be unlocked in emergency with coin from outside.

SIGNAGE: All rooms must be equipped with solid plastic identification signs with room function and room number.

Toilet rooms/Restrooms that include Baby Changing Stations must include the appropriate identification on the signage. Restrooms not designated as containing Diaper Changing Tables, signage shall be placed to indicate to users where the nearest available diaper changing table can be accessed. Signage shall be posted outside the restroom, near the restroom entrance and conspicuously within the restroom. Please refer to CFM Signage Manual Requirements, DESIGN MANUALS (PG-18-10) - Office of Construction & Facilities Management (va.gov), Chapter 09: Interior Signs: pages 9-4-3 and 9-5-29.

Lessor to provide overhead directional signage to Lab, restrooms, clinics, and Behavioral Medicine. Emergency egress signage meeting Life Safety code and The Joint Commission (TJC) is required. All signage must be ADA compliant and comply with VA standards. Please refer to VA Design Guides found in the VA Technical Information Library, www.cfm.va.gov/TIL

EXTERIOR SITE SIGNAGE: Lessor must provide internally lighted sign with VA logo and words "Department of Veterans Affairs Clinic" on sign a minimum of 4 ft by 6 ft legible from main serving road. Sign shall be a minimum of 24 inches above finished grade. Please refer to VA Design Guides found in the VA Technical Information Library, www.cfm.va.gov/TIL

PRIVACY: Aural privacy is required between rooms and between rooms and corridor so that private patient information may be discussed without being overheard. For sound privacy, walls of exam rooms, Mental Health rooms and Multipurpose/conference room must go from deck to deck and be sound insulated with an approved http://www.cfm.va.gov/til/spclRqmts.asp#room https://www.cfm.va.gov/til/dManual.asp#SIGN acoustical insulation. All doors must be solid core. There is to be a privacy door(s) between the clinical area and the reception/waiting area. Privacy curtain tracks at doors required in all exam rooms. Track to be provided by owner and curtain by VA. All exam, procedure and treatment rooms shall have a privacy curtain to encompass adequate space for the healthcare provider to perform examination unencumbered by the curtain and provide a visually private patient changing area that allows the provider to remain in the room. Curtain is not to interfere with motion sensors. Curtain track to be coordinated with HVAC and lighting sub-contractors. Acoustical partitions are to be installed to provide visual privacy at multi-patient check-in counters as well as a designated “queue line” designation to provide an identifiable physical distance separation between the person checking in and the queue.

The minimum distance from the front edge of the Check-in/Reception desk to the queue line shall be five (5) feet.

WINDOW COVERINGS

A. Window Blinds. All exterior windows shall be equipped with window blinds in new condition, which shall be provided as part of the TIs. The blinds may be aluminum or plastic vertical blinds, horizontal blinds with aluminum slats of one-inch width or less, solar fabric roller shades, or an equivalent product pre-approved by the Government. The window blinds shall have non-corroding mechanisms and synthetic tapes. Color selection will be made by the Government. If new building, windows must have blinds integrated into windows between panes (horizontal blinds acceptable for enclosed integrated blinds).

B. Draperies:

1. If draperies are required, they shall be part of the TIs and the following minimum specifications shall apply:

a. Fabrics shall be lined with either white or off-white plain lining fabric suited to the drapery fabric weight. Draperies shall be floor, apron, or sill length, as specified by the Government, and shall be wide enough to cover window and trim. Draperies shall be hung with drapery hooks on well-anchored heavy-duty traverse rods.

Traverse rods shall draw from the center, right, or left side.

b. Construction. Any draperies to be newly installed shall be made as follows:

i. Fullness of 100 percent, including overlap, side hems, and necessary returns;

ii. Double headings of 4 inches turned over a 4-inch permanently finished stiffener;

iii. Doubled side hems of 1-1/2 inches; 4-inch doubled and blind stitched bottom hems;

iv. Three-fold pinch pleats;

v. Safety stitched intermediate seams;

vi. Matched patterns;

vii. Tacked corners; and,

viii. No raw edges or exposed seams.

ix. Flame resistant

x. Pull cords to be washable or able to be decontaminated

Use of existing draperies must be approved by the Government.

RESTROOMS: Please refer to VA Design Guides found in the VA Technical Information Library, www.cfm.va.gov/TIL Toilets shall be equipped with soap dispenser, which shall be furnished by the VA. A shelf and mirror provided by the owner shall be installed above each lavatory. Each lavatory shall have a toilet paper dispenser provided by the VA and installed by the owner within easy reach of the toilet. A coat hook shall be installed on inside face of door. A VA-furnished paper towel dispenser shall be installed near the lavatory by the Lessor. The men's toilet shall have a urinal in addition to a commode. All toilets shall meet handicap accessibility codes and will include grab bars at commode. Metal partitions required at urinals and metal partitions with doors at commodes unless otherwise noted. Commodes and urinals to be auto sensor flush. Lessor shall install a sanitary napkin/tampon dispenser and disposal bin(s) in each public woman, unisex and family toilet room/restroom. Non-public toilet rooms/restrooms accessible from or adjacent to examination rooms where pelvic examinations are performed- sanitary napkin/tampon dispensers and disposal bins are required in each restroom. Multi-stall public female toilet rooms/restrooms-disposal bins are required in each stall. All bathrooms shall meet handicap accessibility codes and will include grab bars at commode. Metal partitions required at urinals and metal partitions with doors at commodes unless otherwise noted. All stalls shall be mounted from the ceiling/wall and not floor for infection prevention/cleaning purposes. Lessor to install baby changing station in public female, male and unisex patient/visitor restrooms. Toilet rooms/restrooms that include Baby Changing Stations must include the appropriate identification on the signage.

CORRIDORS: All corridors shall be a minimum of 5 feet wide and will include hospital grade hand rails. VA to select color. Building owner to provide samples to choose from.

FIRE EXTINGUISHERS: Portable 10 lb. fire extinguishers will be provided, hung, and maintained by the lessor. If new building, recessed fire extinguisher cabinets to be installed by the lessor.

SPECIAL FIRE CODE: The storage rooms, laboratory room, mechanical rooms and housekeeping closets will be protected by one-hour fire walls and doors per design guide. Such protection is also required for the mechanical rooms of facilities that use non-electrical heating systems.

WET AUTOMATIC FIRE SPRINKLER: Building will have an NFPA compliant wet automatic sprinkler system.

Building shall be fully sprinklered and contain all necessary fire alarm features.

COUNTERS: All counter tops shall be solid surface material.

PATIENT TRAFFIC FLOW IN BUILDING: Building to be arranged such that patients enter immediately into vestibule, then enter waiting room then go by reception counter and finally enter clinical areas.

CANOPIES: Entrance doors will be recessed 3 feet or a minimum of 3 ft by 3 ft rain canopies will be over each entrance door. The main entrance door will have a minimum size of 20 ft by 20 ft drive under canopy for patient drop off. Vestibule must have 2 sets of doors (offset for wind blockage) separated by at least 8 feet. One door in each set must have an automatic door opener.

SITE CONSIDERATIONS:

LOCATION: Facility must be highly visible and located in a high traffic area accessible to and from main thoroughfares.

PARKING: Adequate, safe-lighted parking on site for a minimum of 60 regular vehicles and 6 handicap vehicle parking spaces shall be provided, with and one designated van drop off/loading area.

CANOPY/DROP OFF AREA: The design shall include a patient drop-off area underneath an extended canopy.

The canopy must extend out and be large enough to, at minimum, cover the entirety of a vehicle. The drop of area must be able to accommodate patients with wheelchairs.

ACCESSIBLE PARKING: The accessible parking spaces must be immediately adjacent to the building, meeting local code but not exceeding a distance of 60 feet of entrance. Accessible spaces will be marked with signage.

Entrance to the clinic must be handicap accessible in accordance with ADA and include one designated van drop off/loading area.

SITE TOPOGRAPHY: Site topography must not have pedestrian traffic grades exceeding 3% slope, 1 ft elevation change in 33 feet.

SITE SIGN: Lessor must provide internally lighted sign with VA logo and words "Department of Veterans Affairs Clinic" on sign a minimum of 4 ft by 6 ft legible from main serving road. Sign shall be a minimum of 24 inches above finished grade.

SITE FLAGPOLE: A flagpole will be provided and installed by the Lessor at a location to be approved by the LCO if the government is the sole occupant of the building. The flag will be provided by the Lessor, as part of shell rent and replaced at all times during the lease term when showing signs of wear. The flagpole will be 25 foot (minimum height). Flagpole shall include adequate lighting to illuminate flag between dusk and dawn. Flagpole shall be protected from vehicular traffic.

SITE MAILBOX: A mailbox will be provided and installed by the lessor in accordance with local codes and requirements.

MARQUEE: Marquee will be required if the property is located within a mall-type area. The Lessor will provide a lighted marquee and design

SIDEWALKS: Accessible minimal 5-foot-wide sidewalks must be available from parking to entrance.

RAMPS: Ramps with over 5% rise, 1:20 slope, must have metal handicap style handrails on both sides.

LANDSCAPING: If site topography permits, site will be equipped with bushes and trees.

MAINTENANCE:

CLEANING: The lessor is responsible for interior cleaning of the VA leased portion of the facility. The Lessor is responsible for exterior cleaning and trash pickup from grounds.

Pest Control Clause:

1. Responsibility: The Lessor shall be responsible for maintaining the Premises free from pests at all times. "Pests" shall include, but not be limited to, insects, rodents, vermin, and other animals that may pose a health risk or cause damage to property.

2. Inspection and Treatment: (a) The Lessor shall contract with a licensed pest control company to perform regular pest inspections and treatments, at a minimum frequency of once per quarter. (b) Additional inspections and treatments shall be conducted as necessary to address any pest infestation promptly upon discovery or notification.

3. Reporting: (a) The Lessee is responsible for notifying the Lessor promptly upon the discovery of any pest activity or infestation within the Premises. (b) The Lessor shall respond to such notifications within 48 hours with an inspection and shall take immediate action to address the reported issue.

4. Health and Safety Compliance: The Lessor's pest control program shall comply with all applicable federal, state, and local health and safety regulations. This includes the use of pest control products that are safe for use in environments occupied by humans and animals and do not interfere with the operations of the Department of Veterans Affairs.

5. Documentation: The Lessor shall maintain accurate records of all pest control activities, including inspection reports, treatment records, and any communications regarding pest management. These records shall be provided to the Lessee upon request.

6. Indemnification: The Lessor shall indemnify and hold harmless the Lessee, and its employees, agents, and contractors, from any and all claims, damages, costs, and expenses arising from the failure to maintain the Premises in a pest-free condition as required under this clause.

7. Contingency Plan: In the event of a severe pest infestation that cannot be resolved within a reasonable timeframe, the Lessor agrees to coordinate with the Lessee to implement a contingency plan, which may include temporary relocation of the Lessee's operations or other measures to ensure the continued health and safety of the Lessee's personnel.

MAINTENANCE: Building equipment and maintenance requirements, interior and exterior, shall be met by the Lessor. The Lessor must have a building superintendent or local designated representative to promptly correct deficiencies or attempt to correct safety deficiencies within 3 hours. Lessor’s representative shall be available via cell phone for emergencies. Cosmetic and non-emergent deficiencies must be corrected within one week. If no attempt is made to correct the deficiency within the required time frame, the cost of the repairs will be deducted from the next month's rental payment. The Lessor is responsible for the total maintenance of the leased property with the exceptions listed specifically in this document. Such maintenance includes but is not limited to exterior care for the building and the site, all sidewalks, parking areas, driveways, private access roads, lawns, shrubbery including all repairs and replacements. All equipment shall be maintained to provide reliable service without unusual interruption, disturbing noises, exposure to fire or safety hazards, unusual emissions of dirt. All maintenance will be done with applicable codes and manufacturer recommendations.

The Lessor will provide all labor and materials and supervision to adequately maintain the structure, roof, necessary building appurtenances to provide watertight integrity, structural soundness and acceptable appearance.

All work done by the Lessor will meet OSHA requirements.

EXTERIOR MAINTENANCE: The Lessor is responsible for snow removal from parking areas and sidewalks.

Snow/ice removal from overnight storms should be completed prior to opening of clinic. Lessor is responsible for removing weeds from around building, parking areas and sidewalks. The Lessor is responsible for mowing, edging, trimming landscaping and watering lawns as well as leaf raking and removal.

PARKING LOT: Lessor shall re-seal parking lot and re-paint parking space lines as damaged. Entire lot to be resealed and painted every three years.

SNOW AND ICE REMOVAL: Lessor shall provide snow/ice removal services for the Government on all days for which this lease has designated normal hours. Lessor shall clear parking lots, sidewalks, walkways and other entrances before accumulation exceeds 0.5 inches of snow or 0.1 inches of ice and shall provide and spread sufficient snow and ice melt product to keep the walkway, sidewalks, and parking lots from freezing over/freezing.

The snow removal shall take place no later than 5:00 AM. Should accumulation continue throughout the day, the Lessor shall provide such additional snow removal services to prevent accumulation greater than the maximums specified in this paragraph. In addition to snow removal, the Lessor shall keep walkways, sidewalks and parking lots free of ice during the normal hours. The Lessor shall remove excess buildup of sand and/or ice melt to minimize slipping hazards. If the building entrance(s) has a northern exposure, then Lessor shall take additional measures to protect the safety of pedestrians.

PLUMBING PROBLEMS: Drain problems that can be solved by simple application of a plunger will be handled by the VA. Drain problems that cannot be solved by simple application of a plunger or require repeated applications will be solved by the Lessor. All other plumbing problems are the responsibility of the Lessor and will be addressed within 24 hours of notification of owner’s representative.

UTILITIES: Availability of utilities is the responsibility of the Lessor. The Lessor is responsible for the cost of utility usage (electricity, gas, water, trash and sewage) based on consumption. If the VA area is co-joined to space leased to others then the Lessor will provide separate metering to measure government usage. The Lessor is required to pay any deposits and hook-up fees relative to utilities.

CABLE TV: Lessor will provide empty 2x4 box for cable TV audio/video wall jack for connection to a VA furnished television within the clinic. Wall jack shall be located within, or adjacent to the waiting area. A 120-volt duplex electrical outlet will be located adjacent to the cable box outlet. Lessor will provide cable tv service as part of the monthly rent. Owner will provide duplex outlet, empty cable box and cable route access.

EMERGENCY CALL SYSTEM: An emergency call system from each toilet to the reception area will be provided.

A call light will be installed above the door to each of these rooms. The call system in the toilet will include a pull cord extending from 30 inches above floor to within 6 inches of the floor at the water closet.

PANIC ALARM SYSTEM: Lessor to propose a panic alarm system for all exam rooms and the mental health offices. Rooms will be equipped with a panic button to activate an alarm visible from the reception workstation.

The emergency Call/Panic systems will be self-monitoring for failures.

SINKS: The VA shall provide wall- mounted soap dispenser and paper towel dispenser for each sink. The lessor shall install the VA-provided dispensers at each sink. Sinks in exam rooms shall be sensor controlled with a temperature control device. Restrooms will utilize sensor-controlled sinks. If sensor sinks cannot be hard wired into the building electrical system, please utilize paddle type on/off sinks.

SHOWER: Safety shower is NOT required. Eyewash station is NOT required.

STAFF CONFERENCE/BREAK/MEETING/STAFF EDUCATION ROOM UTILITIES: This room will be equipped with a small kitchen-type sink, counter with over and under sink storage cabinets along with counter space for a microwave and floor space for a freestanding refrigerator. The microwave and refrigerator will be provided by the

VA.

EMERGENCY LIGHTING: Must have adequate power failure lighting in corridors and waiting room. Lessor responsible to maintain functional power fail lighting including bulbs, batteries and all other parts. Lessor will be responsible for testing the lights monthly for 30 (thirty) seconds and yearly for 90 (ninety) minutes with a copy of the testing report sent to the VA. Yearly test to be conducted during non-office hours. Lights will be periodically tested by VA. Lights will have dual power source and automatic activation to illuminate egress route.

SECURITY ALARM: Automatic security alarm system with autodial to commercial security company or local police department must be provided by and maintained by the lessor. Alarm sensors required on all exterior doors and windows as well as medicine room. A motion detector will be provided in the waiting room, medicine room and the main corridors. A local minimum 80db alarm will be installed by the Lessor. The security alarm will be completely tested by the Lessor as required by the manufacturer. The security system will be completely tested at least once per month by the owner with a copy of the testing report sent to the VA COR. Monthly logs of alarm activity are required form the alarm company and shall be sent to the VA COR. The leased property shall conform to VA’s Physical Security and Resiliency Requirements Design Manual for Life Safety Protected Facilities VA Technical Information Library, www.cfm.va.gov/TIL. The required Intrusion Detection System (IDS), and Video Assessment and Surveillance System (VASS) shall be compliant for use on VA’s OI&T secure network and compatible with the VA current security infrastructure provider (Siemens is used at the main campus). The Lessor shall consult with VA’s security infrastructure provider for compatibility of any IDS or VASS components. The costs associated with connecting the IDS and VASS to the VA’s secure network shall be borne by the Lessor. The alarm will require a dedicated plain old telephone line (POTS line) or cell signal to communicate with the monitoring company which is to be provided and maintained by the lessor.

LIGHTING: All interior and exterior lighting shall be LED lighting. Lessor shall be responsible for replacing failed fixtures, drivers, or other parts on interior and exterior LED fixtures. Lighting requirements such as room foot candles and color rendering index shall follow the VA lighting design guide except for the lighting temperature. All LED lighting temperatures will be 4000 K unless VA agrees to change the temperature in a specific area. Lighting shall be controlled with occupancy/vacancy sensor(s) with a manual switch override. Lighting in all areas shall be dimmable. Building entrances and parking lot to be lighted with high efficiency exterior LED lighting. Lighting design guide website https://www.cfm.va.gov/til/dManual.asp.

Lessor responsible for replacing failed fixtures, ballasts, or other parts. Lessor to replace lamps on interior lights.

Lessor to provide and replace lamps on exterior lights.

The Philips EvoGrid sensor ready (SR) Generation 4 is an excellent example of a LED fixture with built in lighting control. Each fixture can be easily installed with Philips easy sense sensor that can control the LED lamination output, daylight harvesting, and occupancy or vacancy sensing. The Philips EvoGrid with the easy sense sensor uses a phone application that can do individual fixtures or group fixtures to control multiply fixtures at once. Since each fixture has a sensor, the room or corridor will have better sensor coverage, and a regular light switch (manual override) can be installed to turn the room lights on and off.

DRINKING FOUNTAIN: An accessible public refrigerated, wall hung drinking fountain with bottle filling station will be provided in the waiting room or adjacent to the waiting room but not in the corridor.

OUTDOOR SPIGOTS: Lessor to provide at least one lockable outdoor spigot within 10 feet of each exterior door.

Lessor to turn over 3 keys to VA.

WASHER/DRYER HOOKUP: Lessor to provide one set of washer/dryer hookups in the Housekeeping room.

HVAC: The heating, air conditioning and ventilating systems shall meet city, state and national codes and be designed to ASHRAE minimum recommendations. The repair and maintenance of the HVAC system including replacement/cleaning of filters according to manufacturer recommendations shall be maintained by the lessor. At a minimum, equipment shall be serviced two times per year, once in the fall season prior to the heating season and once in the spring prior to the cooling season. Failure of the HVAC system shall be treated as an emergency with response within 3 hours. Equipment must maintain temperature ranges between 70‐75 degrees, relative humidity range between 60% and 30%, and a minimum of 6 air changes regardless of weather conditions according the VA HVAC design guide. For the equipment to maintain a relative humidity of 60% to 30%, the equipment shall have a dehumidification process and a humidifier to ensure the minimum of 30%. Normal hours of operation are established as 6:00AM to 5:00PM. Thermostats shall be able to be automatically switch between heating and cooling modes to maintain the temperature range, be capable for nighttime and weekend setbacks, and the thermostat shall have a lock box. Certain space types, such as Medical Supply, Clean Storage, etc., require temperature tracking and have specific HVAC requirements (number of air exchanges per hour, relative humidity and temperature range, positive or negative pressure to surrounding spaces, no nighttime and weekend setbacks, etc.) for a healthcare facility (refer to VA Design Guides found in the VA Technical Information Library, www.cfm.va.gov/TIL). These spaces shall have their own zones and will be identified during the design process.

The building will be provided with enough thermostats and controls to adequately control the space with a minimum of 15 zones. HVAC shall be a certified system and Lessor will provide a room by room listing of supply and return CFM. The data closet will be provided a separate, thermostatically controlled cooling unit capable of maintaining a https://www.cfm.va.gov/til/dManual.asp year round temperature of 70 degrees F with computer equipment producing a minimum of 12,000 btu heat load.

The building will have adequately zone control to maintain the room requirements. Each zone shall be control separately from other zones, and have a minimum of one zone control in each in zone. Lessor shall provide fully ducted supply, return, and exhaust air systems between the fans and inlets/outlets.

Use of partial or common ducted supply air arrangement and use ceiling space between the structural ceiling and suspended ceiling space as the supply or return air plenum is not acceptable. Toilets, procedure rooms, and housekeeping closet will all include exhaust venting to the outside to create a negative pressure in these rooms.

The lessor shall provide a balancing report to ensure that the rooms meet the design criteria at the finish design, and provide another balancing report six months after the finished construction to ensure the design flow is still met.

Flexible Ducts

(a) Use of flexible ducts shall be restricted to connections between the VAV and/or CV air terminals and the medium or high pressure supply air duct and connections between the supply air diffusers and the low‐pressure supply ductwork.

(b) Maximum length of flexible ductwork shall not exceed 5 ft [2 m].

(c) Maximum length of flexible ductwork to connect a VAV and/or CV air terminal to the medium or high pressure supply ductwork shall not exceed 3 ft [0.9 m].

(d) Maximum change in direction allowable in flexible ductwork is 45 degrees.

(e) Do not use flexible duct on exposed ductwork.

ELECTRIC: Electric panels must be circuit breaker type with 25% excess capacity. Circuit breakers must be identified as to area served. Bathrooms and other wet locations must be equipped with GFCI outlets. All items must be U.L. approved. Rooms must be equipped with at least one duplex outlet on each of four walls of rooms and an additional outlet for walls longer than 12 feet. Smaller rooms must have at least two outlets. No more than 8 outlets per circuit. Data closet to have at least 5 120Vduplex outlets on 2 circuits and 1 dedicated 30 amp, 208V, 2 pole, 3 wire circuit with a L6‐30R outlet. Lessor to provide one 120 V duplex in the center of the group clinic rooms, above the ceiling for future projector mounting provided and installed by the VA. Corridors will have outlets at least every 25 feet. All outlets in all rooms to be set ground plug up. All electrical systems shall meet and be in compliance with the National Electric Code (NFPA 70). Standard size ¾” conduit or above shall be used throughout entire space leased by the VA. Flexible whips are permitted only for lighting of type MC Cable and shall be used in accordance with NFPA 70. Outlet placement will be indicated by the VA during design review.

All receptacles rated 150 volts or less to ground, 50 amperes or less installed in locations specified in NEC 210.8 (B)(1) through (B)(12) shall have ground fault circuit interrupter protection installed.

SPECIAL ELECTRICAL OUTLETS: Data closet to have at least 5 120Vduplex outlets and 1 dedicated 30 amp, 208V, 2 pole, 3 wire circuit with a L6-30R outlet. Lessor to provide 10 additional 120 V duplex outlets, beyond what is required by code, in locations to be designated by the VA during drawing reviews. Exam rooms, lab and other patient care areas will have hospital grade “green dot” outlets. VA requires all 20 amp hospital grade. Please refer to the VA Design Guides found in the VA Technical Information Library, www.cfm.va.gov/TIL.

CHANGES: As part of the lease, the Lessor will provide the VA with a cost per electrical outlet for the Lessor to install electrical outlet additions to the facility beyond the previously listed requirements.

FIRE ALARM: Building to be equipped with fire alarm system that meets city, state and NFPA code requirements and remote annunciation to local fire department. Fire alarm testing as required by the manufacturer and fire code is the responsibility of the Lessor. Complete testing will be done at least once per year. Copies of all test reports will be sent to the VA COR. At a minimum there will be pull stations at each exit and smoke detectors in waiting areas, corridors, furnace/HVAC rooms and storage rooms. Fire sprinklers will have tamper and flow alarms and be tested in accordance with NFPA standards.

Lessor to provide dedicated phone line for fire alarm communication. Fire Alarm communication can’t piggyback on VA network.

UTILITIES: Availability of utilities is the responsibility of the Lessor. The owner is responsible for the cost of utility usage (electricity, gas, water, sewage, and telecommunications). If the VA area is cojoined to space leased to others then the Lessor will provide separate metering to measure government usage. The Lessor is required to pay any deposits and hook-up fees relative to utilities. The Lessor shall provide a yearly summary report of the buildings usage and cost by utility (electricity, gas, water, and sewage) by month or copies of all the utility invoices.

TELECOMMUNICATIONS:

(1) Distribution Facility (communications/data closet): The Lessor shall install a 4 ft by 8-foot ¾ inch thick fire-retardant plywood panel on the wall of the telephone closet for the mounting of equipment. The lessor shall terminate cable on RJ-45, Category 6A, high density modular 110 patch panels. Each path panel shall have a channel identification system that allows numbering or labeling the jacks. (Ortronics Series or equal). All DMARC equipment should terminate in this room. Room shall have a dedicated HVAC system.

(2) Data Wire: Cable shall be Category 6A (4 pair) plenum rated data twisted pair.

(3) Jacks: Jacks shall be triplex with a 3-position faceplate, Category 5 compliant, eight position RJ-45 jack designed for Voice/Data (jacks wired for 568B Category 5 standards), Ortronics Series or equal.

The Lessor shall provide two triplex jacks for each exam room, nurse office, mental health rooms, Multipurpose/conference room, lab waiting area, general storage/work room for Biomed, veteran service officer office, and staff break room. Three triplex jacks for the lab, eight triplex jacks for the clerk area; and one triplex jack for the phone room, 14 triplex jacks for the staff resource room.

Locations to be provided by the VA.

(4) Conduit: A conduit is required from the DMAR into a mechanical room or directly into the telecom room.

(5) Hardware: Telecom room requires digital keypad, door handle, deadbolt, and tamperproof hinges.

The Data closet will not be used for any other electrical, mechanical, or facility purposes.

Other telecommunications regulations and guidance will be provided in separate attachments/exhibits. Please review this material carefully.

OTHER:

CONDITION: Facility must be in a like new condition prior to VA occupancy. If the space is to undergo any construction, refinishing or remodeling prior to VA occupancy, Lessor to provide VA with color boards for selection of finishes and colors.

DRAWINGS: Lessor to provide drawings of facility building, site and location plan as part of bid and will provide “as-builts” as well as CAD drawings to the VA when the facility is turned over to the VA for occupation.

DOCUMENTS: In addition to regular contract documents, test results described above and proof that the construction meets contract requirements, the contractor must provide MSDS sheets on chemicals used in maintenance such as pest control products, etc.

CONSTRUCTION DESIGN LINKS:

1. https://www.cfm.va.gov/til/Prototypes.asp#CBOC

2. http://www.cfm.va.gov/til/room/RoomFinishes.pdf https://www.cfm.va.gov/til/Prototypes.asp#CBOC http://www.cfm.va.gov/til/room/RoomFinishes.pdf

Attachment #1: Sample floor plan layouts.

Attachment #2: Sample exam room layout, more sample layouts can be found at the following link;

http://vaww.va.gov/facmgt/standard/dg_primary.asp

JULY 2005

VA DESIGN GUIDE APPENDIX B

LEASE BASED OUTPATIENT CLINICS 2-2.3

Design Standards Examination Room

ARCHITECTURAL

Coordinate with SFO; refer to Template SFO Section 7, and Schedule C.

Ceiling: GWB Lay-in Panels Ceiling Height: 2740 mm (9’-0”) Wall Finish: Painted GWB Wainscot: -- Base: Resilient Base Floor Finish: Vinyl Composition Tile Slab Depression: -- Sound Protection: STC 40 Notes: --

LIGHTING

Coordinate with SFO; refer to Template SFO

Section 6.7, 6.7.1, 6.7.5.

General: 50-100 FC Special: -- Notes: Portable Examining Light

POWER

Coordinate with SFO; refer to Template SFO Section 6.7, 6.71, 6.73, 6.7.4 and Schedule B.

General: Yes Emergency: -- Notes: --

COMMUNICATION/SPECIAL SYSTEMS

Coordinate with SFO; refer to Template SFO Sections 6.7, 6.7.1, 6.7.8, 6.7.9, and Schedule

B.

Data: Yes Telephone: Yes Intercom: -- Nurse Call: Yes Public Address: -- Radio/Entertainment: --

MATV: --

CCTV: --

MID: --

Security/Duress: Yes

VTEL: --

VA Satellite TV: -- Notes:

HEATING, VENTILATING AND AIR

CONDITIONING

Coordinate with SFO; refer to Template SFO Section 6.5.

Dry Bulb Temp Cooling: 23°C (75°F) Dry Bulb Temp Heating: 26°C (78°F) Minimum % Outside Air: 15% 100% Exhaust Air: -- Noise Criteria: NC-40 Steam: -- Relative Humidity/Cooling: Refer to HVAC section Relative Humidity/Heating: Refer to HVAC section Minimum Air Changes/Hr.: 6

Room Pressure: 0 AC Load-Equipment: 2.9 W/SF AC Load-Lighting: 2.0 W/SF Number of People: 2 Special Exhaust: -- Notes: --

PLUMBING AND MEDICAL GASES

Coordinate with SFO; refer to Template SFO Section 6.6 and Schedule B Cold Water: Yes Hot Water: Yes Laboratory Air: -- Laboratory Vacuum: -- Sanitary Drain: Yes Reagent grade Water: -- Medical Air: -- Medical Vacuum: -- Oxygen: -- Notes: --