EXHIBIT C_QASP_AFFF MATOC.docx

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DRAFT

PERFORMANCE-BASED QUALITY ASSURANCE SURVEILLANCE PLAN (QASP) FOR

AQUEOUS FILM FORMING FOAM (AFFF) REPLACEMENT AND DISPOSAL

{Site Name}

1. INTRODUCTION

This Performance-Based Quality Assurance Surveillance Plan (QASP) has been developed pursuant to the requirements of the Performance Work Statement (PWS) for Contract No. XXXXX, Task Order No. XXXX. This plan sets forth procedures and guidelines that the USACE will use in evaluating the technical and safety performance of the Contractor. A copy of the Performance Metrics is furnished in the PWS so that the Contractor will be aware of the methods that the Government will employ in evaluating their performance on this contract.

2. PURPOSE OF THE QASP

The QASP is intended to accomplish the following:

a. Define the roles and responsibilities of participating Government officials;

b. Define the types of work to be performed with required end results;

c. Document the evaluation methods that will be employed by the Government in assessing the Contractor’s performance;

d. Provide the Surveillance Activity Checklists and Corrective Action Request (CAR) forms that will be used by the Government in documenting and evaluating the Contractor’s performance; and

e. Describe the process of performance documentation.

f. Outline quality assurance procedures to be employed by the Government during performance of this task order to confirm that the site characterization is conducted utilizing proper procedures and in accordance with the approved work and safety plans.

3. ROLES AND RESPONSIBILITIES OF PARTICIPATING GOVERNMENT OFFICIALS

The USACE Project Manager (--------------------------):

· Responsible for overall project direction, including technical, contracting and customer-related issues.

· Reviews vouchers and make recommendations to the Contracting Officer for payment action based on completion of designated milestones.

· Reports problems or discrepancies to the Contracting Officer as soon as possible.

· Oversees the implementation of the QASP.

· Reviews contractor submittals.

· Schedules and provides labor codes and funding for all surveillance activities with the appropriate USACE Supervisor (OE Safety Group, Geotechnical Branch, etc.)

· Initiates periodic contractor evaluations in the Contractor Performance Assessment Reporting System (CPARS).

The USACE Technical Manager (---------------------------):

· Participates in preparation of SOW/PWS to ensure that Technical requirements are adequately addressed.

· Participates in proposal review.

· Coordinates reviews of contractor submittals for compliance with contract requirements.

· Conducts or Supports other surveillance activities as required by the project team.

· Supports all on-site QA activities.

· Develops the final Quality Assurance Report.

The USACE Contract Specialist (----------------------------):

· Monitors contract performance.

· Maintains central repository for all QA tasks required for payment.

· Issues all acceptance/rejection statements.

The USACE Safety Office (------------------------):

· Participates in preparation of SOW/PWS to ensure that Safety requirements are adequately addressed.

· Conducts reviews of contractor submittals for compliance with DOD, DA and USACE, and OSHA safety and health requirements.

· Coordinates with USACE team members to perform periodic inspections of contractor compliance with accepted Accident Prevention Plan, EM 385-1-1, and other DA requirements.

· Makes unscheduled, periodic site visits as part of the Government surveillance.

The CEHNC Fire Protection Engineer (------------------------------)

· Participates in preparation of SOW/PWS to ensure that fire protection requirements are adequately addressed.

· Reviews contractor submittals for compliance, as applicable, with task order fire protection requirements.

· Conducts or supports other surveillance activities as required by the project team.

The USACE Hazardous Waste SME (----------------------------)

· Participates in preparation of SOW/PWS to ensure that hazardous waste storage, labelling, manifesting, placarding, shipping, disposal, and documentation requirements are adequately addressed.

· Reviews the work plan (including the Environmental Protection Plan and Waste Management Plan) for compliance with task order waste management and disposal requirements.

· Reviews waste disposal documentation for compliance with the PWS and work plan.

4. METHODOLOGIES TO BE USED TO MONITOR THE CONTRACTOR’S PERFORMANCE

Even though the Government, through its COR, will be monitoring the contractor’s performance on a continuing basis, the volume of tasks performed by the contractor makes technical inspections of every task and step impractical. Accordingly, USACE will use the Surveillance Activity Table (Attachment C) as the basis for monitoring the contractor’s performance under this contract. The contractor’s performance will be evaluated by the Contracting Officer using the Performance Metrics for CPARS provided as in this PWS.

Quality Assurance Surveillance Activities

In general, the work will be evaluated in terms of how well the requirements of the task order are satisfied, the extent to which the work performed follows the approved Work Plan/Accident Prevention Plan, clarity of documentation, and timeliness of scheduled task accomplishment. At the discretion of the Contracting Officer or COR other Government officials may be asked to evaluate contractor work being conducted or a specific deliverable.

{Instructions: Additional QA of QC items will be added to the Surveillance Activity Table and checklists will be developed as needed by task order to address all aspects of QC.}

Quality Assurance for On-Site Safety/Operations QA The Quality Assurance Surveillance Activities for On-Site Safety/Operations QA are based on the following:

1) Occupational health and safety guidance

2) On-Site Safety Inspections

3) Review of QC documents retained on site during field activities

4) On-Site operations inspections to assess field work compliance with the WP/APP.

5) QA checks as requested by PM or government PDT members

{Dependent upon the complexity of the site the System Safety Office may perform a site inspection. Consult your PM on whether this is needed at your site.}

Quality Assurance for Safety Office/Operations QA The Quality Assurance Surveillance Activities for Site Safety/Operations QA are based on the following:

1) Occupational health and safety guidance

2) Periodic site visits to assess field work compliance with the WP/APP.

5. QUALITY ASSURANCE REPORTING FORMS

The forms used to document surveillance activities include Daily Quality Assurance Report, Memorandum for Record, and Quality Assurance Forms. Non-conformances will be documented on a Corrective Action Request (CAR). Non-conformances are documented at the discretion of the person conducting the surveillance activity subject to Contracting Officer or COR validation. Each CAR will be annotated as a Critical nonconformance, Major nonconformance, or Minor nonconformance. CARs will be issued to the contractor by the Contracting Officer/COR. The Contracting Officer/COR will provide a reasonable suspense date for the contractor to review and take appropriate action, usually 15 calendar days. The contractor is required to provide written responses to all CARs.

Completed forms will be consolidated and provided to the Contracting Officer at the end of each month for that month's surveillance activities. These forms, when completed, will document the contractor's compliance with contract requirements and completion of milestone activities. The Contracting Officer will evaluate contractor performance using the definitions contained in the CPARS and the metrics identified in the PWS.

6. ATTACHMENTS

Attachment A Daily Quality Assurance Report (DQAR).

(Included in this document)

Attachment B Corrective Action Request (CAR) (Included in this document)

Attachment C Surveillance Activities Table (Excel file provided separately)

Attachment D On-Site Safety/Operations Table (Excel file provided separately)

Attachment E Final Quality Assurance Report (Included in this document) Attachment A Daily QA Report

USACE ORDNANCE AND EXPLOSIVE PROJECT

DAILY QUALITY ASSURANCE REPORT

CONTRACT WITH DELIVERY ORDER: XXXXXXXX, Task Order # XX, Contractor

SITE:

WEATHER:

USACE PROJECT TEAM MEMBER & TITLE: i.e., Joe Smith Safety Specialist, Jill Jones, USACE QA Rep, etc.

GRIDS COMPLETED BY CONTRACTOR:

SURVEILLANCE ACTIVITY or ACTIVITIES:

GRIDS THAT PASSED GOVERNMENT QA:

CORRECTIVE ACTION REQUESTS (CAR) and/or Form 948 ISSUED:

CONTRACTOR KEY PERSONNEL ON-SITE:

GENERAL OBSERVATIONS:

LESSONS LEARNED:

DISTRIBUTION:

1-CEHNC-OE-CWM-DC (Project Manager)

1-CEHNC-OE-S (FILE)

1-CEHNC-ED (Project Engineer) 1-CEHNC-CT (Contract Specialist)

Attachment B Corrective Action Request

CORRECTIVE ACTION REQUEST | NO. (1,2,3, etc.for the T.O.)

USACE Representative:

Date Issued:

Issued to:

Response Due: (Based on type of nonconformance) Contract# and T.O.

Project Name/Location:

Nonconformance Type (circle one): Critical Major Minor

Description of Condition Found:

Contractor Representative Signature (Noting that CAR Received):

(The Contractor will provide the following information to the Contracting Officer and USACE PM by the “Response Due” date above. Please contact the USACE Representative listed above if you have any questions)

Actual Cause: (Contractor will investigate and determine cause of condition reported above. Actual cause should be stated as specifically as possible)

Action Taken to Correct Condition: (Corrective Action should address root cause, not the symptom)

Action Taken to Prevent Recurrence:

Action Taken to Monitor Effectiveness of Corrective Action: (Generate data as proof. State the monitoring method put in place and who is responsible for reviewing data.)

Contractor Representative Signature/Title/Date Signed: (Form must be signed before returning)

(USACE Project Team Use Only) Review of Corrective Action:

1) Has condition improved? ___ Yes ___ No

2) Additional corrective action required? ___ Yes ___ No Comments:

Completed form provided to Contracting Officer: (Date)

Attachment E Final Quality Assurance Report

Final Quality Assurance Report For At Former XXXX Contract Number: 00000000 Task Order: 0000

1. Describe QA methods used (or reference where they are documented) and pass/fail criteria.

2. Summarize field QA activities performed and describe any special conditions encountered or special circumstances.

3. Describe any constraints or problems encountered.

4. Summarize data quality assurance activities performed and describe any special conditions encountered or special circumstances.

5. Provide list of all CEHNC 948s issued for QA failures and describe corrective actions taken.

6. List/describe lessons learned.

7. Include a final statement that contract requirements were met regarding quality of services provided.

8. Signature of Project Engineer preparing the report.

9. List supporting data/references and where they are filed.