Final SOW 614-22-110 Attachment III -A-E Solicitation_Redacted.pdf

Solicitation Number: 36C24922R0056 Project 614-22-110 Complete Building 1 Pool Area Renovation in PM&RS

PART 1 – PROJECT DESCRIPTION

I. GENERAL SCOPE OF WORK: The A/E shall provide all necessary architectural and engineering services as required to prepare complete contract drawings, specifications, cost estimates, and construction period services for the project to Complete Building 1 Pool Area Renovation in Physical Medicine & Rehab Services at the Department of Veterans Affairs Medical Center in Memphis TN.

STATEMENT OF PROJECT OBJECTIVES

It is the intent of the Department of Veterans Affairs to have the A/E fully survey, investigate, and document the existing space and utility systems in order to gain the knowledge and insight necessary to prepare quality, accurate documents in a professional and competent manner. The project work includes but is not limited to the following:

This project will replace the old therapy pool with a new state-of-the-art prefabricated modular therapy pool, renovate the locker/shower/toilet rooms and pool area, fix the structural concerns of the existing pool deck, and renovate and expand the pool maintenance room below to support the new pool and equipment. This project renovates approximately 4,540 square feet and will add approximately 1,840 square feet of recaptured space for maintenance and equipment. The renovations will include all necessary equipment, electrical, mechanical, plumbing, earthwork, structural improvements, paint, fixtures, and finishes to install and deliver a properly working and functional therapy pool, pool area, maintenance room, equipment room, and locker/shower/toilet rooms. Previously procured equipment: therapy pool, HVAC equipment, and electrical lighting will be government furnished items for the construction.

This completes a project that was designed and underway on construction but was not completed due to matters requiring the termination of the contract.

The construction budget for this project is . Deductive alternates are to be identified equal to 20% of the estimated construction cost. Estimating and cost control shall be part of every design phase and submission.

PART 2 – DESIGN PERIOD

1. GENERAL

The A-E shall provide design period services to include drawings and specifications reflecting specific tasks identified in this statement of work document and as identified during project discussion meetings.

A-E shall provide competent design period services using staff and consultants adequately knowledgeable of the various subordinate design disciplines including but not limited to: life safety and other building/utility systems as required for the project.

The A-E shall develop plans and system schematics for actual in-place components from VA-provided drawings and from field verification on site. Verify existing conditions affecting design. Information provided by VA on record drawings shall be verified for critical dimensions and critical components that may affect the design. A-E shall consider adjacent systems and components (architectural as well as utility systems) so as to avoid unforeseen site condition change orders to the construction contract. The A-E shall verify necessary building architectural and utility system components to provide for a full and complete design of replacement architectural elements and utility system components.

During the course of the project the A-E shall be required to attend project meetings. The A-E shall record meeting minutes and furnish meeting minutes and sketches as required to reach concurrence and approval by the design team members. Minutes shall be forwarded to all attendees within 36 hours of the meeting for review and comment. The A-E shall incorporate appropriate comments, finalize the meeting minutes and send out the final meeting minutes within one week of the meeting.

VA is contracting design period services to include Schematic Design (SD) Development, Design Development (DD), Construction Documents (CD), and Bid Documents. All submissions and related work for each design phase shall conform to the requirements in this document and Program Guide (PG)-18- 15, Volume C A-E Submission Instructions as modified in this document. See the Access to VA Standards section of Part 3 for webpage to obtain PG-18-15.

2. PERIOD OF PERFORMANCE

Task Calendar Days Schematic Submission 21 Schematic Review 7 DD1 Submission 56 DD1 Review 14 CD 100% Checkset 35 CD 100% Checkset Review 7 Bid Documents 14 Total Days 154

3. SCHEMATIC DESIGN (SD)

Schematic Design reflects the basic work required to define the design scope of the project; includes options and what-if scenarios to allow VA to consider potential options for final design; and ensures arrangement of space complements the design scope as opposed to contradicting the design scope.

Schematic Designs vary to meet the specific design scope of the project. For instance, an architectural renovation may have a few potential designs represented schematically as concepts of patient/staff flow of people, materials, etc. being considered, but may not provide alternatives for utility systems until later discussions, whereas an infrastructure project renovating and/or replacing utility systems may have a few potential schematic designs representing the types of systems available and their application towards the specific project. The A-E shall submit the following in a single package and at one time per date identified in contract Special Provisions:

SD submittal package (PG-18-15 Volume C requirements as modified by this document) Assembled minutes of meetings for work up to SD submission Completed A-E Review Checklist for each applicable design discipline

Schematic comments returned by VA to A-E with:

General Comments Drawing Comments Specifications Comments

4. DESIGN DEVELOPMENT (DD)

Design Development includes initial work of the A-E required to represent the project as a set of drawings conveying the major intent of the project work. At this stage of project design, the physical layout of the new work should be shown. The A-E shall submit the following in a single package and at one time per date identified in contract Special Provisions:

DD submittal package (PG-18-15 Volume C requirements as modified by this document) Assembled minutes of meetings for work up to DD submission Completed A-E Review Checklist for each applicable design discipline

DD review comments returned by VA to A-E with:

General Comments Drawing Comments Specifications Comments One Set of A-E DD drawings with using Service(s) approval signatures Estimate Comments Notes for specification details for sole source items, e.g., Johnson Controls, Notifier, etc.

5. CONSTRUCTION DOCUMENTS (CD)

The Construction Documents submission shall combine updates of all earlier sets of specifications and drawings and any other relevant project information (meetings, other discussions, etc) making up a complete set of project documents. The quality of and level of detail of the CD submission should be such that no further or minimal changes are needed. The CD submission shall incorporate all changes needed from earlier reviews and that a quick review shall show all information is presented in clear and concise format. Discussion of Contractor staging/parking/exterior space usage, management of phasing activities such as control of dust and debris (infection control), etc. shall occur during development of the CD submission. The A-E shall submit the following in a single package and at one time per date identified in contract Special Provisions:

CD submittal package (PG-18-15 Volume C requirements as modified by this document) Assembled minutes of meetings for work up to CD submission Completed A-E Review Checklist for each applicable design discipline Include summary of staff participating in final drawing and specification quality review and date when check set review was completed.

CD review comments returned by VA to A-E with:

General Comments Drawing Comments Specifications Comments One Set of A-E DD drawings with using Service(s) approval signatures Estimate Comments Electronic formats of VA specifications 01 00 00, 01 33 23 and any others required edited specifically for the project Any comments regarding estimate Electronic drawing showing project staging area on VA site plan for A-E to include in drawing package at final submission.

6. BID DOCUMENTS

The reproduction of specifications and prints is a reimbursable item within the contract. If additional sets are required, VA will request these in writing from the A-E and will compensate the A-E for additional reimbursable expenses to the extent the additional sets add expense.

• A-E Provided Project Checklists: A-E shall provide a checklist of all submittals, certifications, tests, and inspections required per drawing and specification section. This checklist will show all products requiring submittals in the form of shop drawings, data sheets, manufacturer cut sheets, etc. as well as all other items shown as required submittal items including, but not limited to, reports, system evaluations, testing, operating and maintenance manuals, etc.

• Submission Requirements: The A-E shall date all material and present the designs on VA standard size drawings that are appropriately labeled, “BID DOCUMENTS”, in large block letters above or beside the VA standard drawing title block. The A-E shall incorporate VA provided front-end solicitation documents.

The A-E shall submit 2 specification books and 1 full size and 3 half size drawing sets of reproduced project packages to VAMC Memphis, TN Engineering Department. The Contractor shall provide 4 Electronic bid set on DVD for the following disposition:

i. 1 ea including Editable Word Format of Specifications and PDF of the drawing set for Contracting Officer (NCO9)

ii. 2 ea in PDF format including drawings only – Marked with “Drawings Only” and Project Number and Title for Contracting Officer.

iii. 1 ea including Editable Word Format of Specifications, and PDF and 2016 (or compatible) AUTOCAD format of the drawing set for Contracting Officer Technical Representative to retain

Items i and iii above may be requested prior to completion of final bid specifications in or for the VA to submit for legal/technical review.

7. MODIFICATION TO PG-18-15, VOL C A-E SUBMISSION INSTRUCTIONS

Program Guide PG-18-15, VOL C provides a minimum level for submission compliance, which may not be adequate for certain, types of design. In some instances, in which critical decisions need to be made, sufficient and relevant information has to be provided timely in order for the design to progress to meet certain milestone dates. The level of applicability of the program guide depends upon the scope of work and the exclusions, which are herein specified. Questions in regard to the applicability of specific requirements shall be resolved with the medical center staff prior to any submission deadline. For this project the following modifications to PG-18-15 Volume C are applicable:

Section I - General

1. Section I.A. – Introduction

a. This contract includes Schematic, Design Development, and Construction Documents Submissions.

b. VAMC Memphis will provide existing background material in the form of existing floor plans and previous project record drawings to the extent available.

c. VAMC Memphis will provide VA specific guidance documents affecting project design not within the VA Technical Information Library (TIL). (e.g., VHA Directives, VAMC Memphis Policies, etc.)

d. This project requires a formal approval signature by the using Service(s) at the conclusion of Design Development in regard to architectural layout and space functionality.

e. All electronic drawings submitted shall be in Adobe (PDF) and AutoCAD (DWG) format.

f. All electronic versions of specifications shall be in Microsoft Word and Adobe formats.

g. Final drawings (Bid Documents) and specifications shall be submitted both in hard copy and electronic format on a compact disc.

2. Section I. B. – A-E Responsibilities

a. It is the VA’s intention to hold the AE responsible for “any errors or omissions in its designs, drawings, specifications, and other services.” Such errors or omissions must be corrected without additional compensation. Furthermore, the AE must be and remain liable to the Government for all damages caused by the AE’s negligent performance of any services furnished under the contract, notwithstanding the VA reviews of AE work.

b. There is no Memorandum of Agreement (MOA) for this project.

3. Section I. C. – Submission Policy

a. In addition to items listed, the A-E shall include a copy of a completed A-E Review Checklist for each design discipline within the scope of work. See the Access to VA Standards section of Part 3 for webpage to obtain information on the A-E Review Checklists Program. A-E Review Checklists shall be submitted with each submission package.

4. No modifications to the following.

a. Section I. D. – Quality Assurance/Quality Control

b. Section I. E. – Additional Services

c. Section I. F. – Critical Path Method Phasing Meetings

Section II – Submissions

Make the following changes.

1. Modify the following sections.

a. Section II. C. – Fire Protection & Notes

i. No Floor Plans/Drawings are required with the Schematic submission.

b. Section II. S. – Specifications

i. With the schematic submittal, A-E shall submit a marked-up specifications index table of contents downloaded from the VA TIL Master Specification List with Dates.

ii. The A-E shall ensure the following as edits are made after the design development submission:

1. The date code header, e.g., 12-04, shall be removed from all specification sections,

2. The footer shall remain showing specification section-page, e.g., 21 05 11-1, 21 05 11-2, etc.

3. All references to specifications not needed for the project and thereby not included shall be removed; VA refers to these items as “dead references” which can lead to confusion during the construction period if they remain; VA can’t issue as a final document any specifications having these incorrect (unused) references

4. All “Spec Writer Notes” shall be removed; specific requirements of the Spec Writer Notes shall be noted on the hard-copy edits; VA can’t issue as a final document any specifications having these advice and directional notes

Section III – Distribution of A-E material

PART 3 – DESIGN AND CONSTRUCTION STANDARDS

1. GENERAL

In the development of submissions, the A-E firm shall utilize certain VA and other design and construction criteria, examples of which can be found below. The design is not limited to these items and should be the result of compliance with applicable codes and standards, the user requests, and A-E creativity:

• VA Design and Construction criteria in the Technical Information Library (TIL), including planning, design, and construction items such as: Design Alerts, Design and Construction Procedures, Design Guides, Design Manuals, Equipment Guide List, Master Construction Specifications, Room Finish and Door Hardware Schedule, Space Planning Criteria, etc.

• Joint Commission on Accreditation of Healthcare Organizations (JCAHO) elements shall be considered.

• NFPA Codes including, but not limited to: NFPA 101, Life Safety Code; NFPA 99, Healthcare Facilities; NFPA 70, National Electrical Code (NEC)

• Compliance to all known applicable codes shall be reflected in the completed design and construction contract documents.

Conflicting criteria shall be brought to the attention of the VAMC Engineering Service Project Manager for resolution.

VA continually updates information in the Technical Information Library (TIL) used in project design. The A-E will be responsible for reviewing the guidelines in the TIL and incorporating the applicable criteria into the design and construction documents. The following section, Access to VA Standards, provides World Wide Web addresses for the TIL and commonly used VA standards and references.

2. ACCESS TO VA STANDARDS

The following are World Wide Web addresses to commonly used VA standards and references:

Technical Information Library (TIL) home page ...................................... http://www.va.gov/facmgt/standard/ Accessibility information (PG-18-13) ............................ http://www.va.gov/facmgt/standard/accessibility.asp A-E Design Submission Requirements (PG-18-15) ..................... http://www.va.gov/facmgt/ae/des sub.asp A-E Review Checklists program .................................. http://www.va.gov/facmgt/standard/ae checklist.asp Design Alerts ......................................................................... http://www.va.gov/facmgt/standard/d alert.asp Design & Construction (PG-18-3) ...................................... http://www.va.gov/facmgt/standard/proc idx.asp Design Guides (PG-18-12) .................................................... http://www.va.gov/facmgt/standard/dg idx.asp Design Manuals (PG-18-10) .............................................. http://www.va.gov/facmgt/standard/manuals.asp Energy Conservation & Sustainability Program .................... http://www.va.gov/facmgt/standard/energy.asp Environmental Compliance program (PG-18-17) ............... http://www.va.gov/facmgt/standard/env idx.asp Equipment Guide program (PG-18-5) ............................. http://www.va.gov/facmgt/standard/equipment.asp Master Specifications Index (PG-18-1) ............................. http://www.va.gov/facmgt/standard/spec idx.asp National CAD Standards and Details (PG-18-4) ................... http://www.va.gov/facmgt/standard/details.asp Quality Alerts program ....................................................... http://www.va.gov/facmgt/standard/q alerts.asp Room Finishes, Door and Hardware Schedule ........... http://www.va.gov/facmgt/standard/rooms/rooms.doc Signage Program ................................................................ http://www.va.gov/facmgt/standard/signage.asp Space & Facility Planning (PG-18-9) ................................... http://www.va.gov/facmgt/standard/spacework/ Technical Summaries ....................................................... http://www.va.gov/facmgt/standard/tsum idx.asp

PART 4 – CONSTRUCTION CONTRACT AWARD PERIOD

The A-E shall provide VA with technical design services during the period of Construction Contract award.

These services shall include, but is not limited to:

1. Review of construction contractor’s price proposal

2. Providing technical information needed to answer questions

3. Providing technical information needed to issue amendments.

PART 5 – CONSTRUCTION PERIOD

The A-E shall provide competent construction period services using staff and consultants adequately knowledgeable of the various subordinate design disciplines included in development of the project.

Construction period services shall include:

1. Review of shop drawings and submittals

2. Review of change order proposals

3. On-site construction inspection visits and progress meetings including A-E’s written report of visit or meeting. Once the construction is thoroughly underway, periodic site visits are anticipated.

A/E shall provide up to 9 site visit “units” during the construction period when requested by the Contracting Officer. A site visit “unit” is defined as a visit to the site of the project and any other affected areas by one individual for any part of a day when requested by the Contracting Officer or an authorized representative. On this job, a site visit should last 1-2 hours and may require the use of multiple “units” when more than one individual or an extended period of time is needed to inspect an area of work. Only registered architects and engineers familiar with the project may make these site visits. The Contracting Officer has the prerogative to determine the professional discipline(s) required for each site visit. The A/E shall notify the Project Engineer of their presence on site in order to document the number of individuals who are making the site visit. The A/E shall observe the construction, advise the Project Engineer of any deviations or deficiencies, and recommend appropriate corrective actions.

4. Pre-final and final inspections and preparation of itemized punch-list for project completion requirements

PART 6 – A-E CONTRACT CLOSE-OUT

The construction contractor shall keep a set of hard copy drawings updated to reflect all changes in the field from the bid documents. These hard copy drawings are turned over to VA at the conclusion of the construction contract. VA will provide these drawings to the A-E in order for the A-E to update the Bid Documents to reflect actual completed project conditions.

The A-E shall submit the record drawings showing any changes or modifications to the Bid Documents reflected on the hard-copy set of “as-builts” provided by VA; Drawings shall be individually marked “Record Drawing” and submitted in a single package as follows.

Drawings in AutoCAD (DWG) format of the entire project.

1. All drawing objects shall be removed. (e.g., Revit, Desktop, etc.)

2. All drawings must plot properly using the NCS.ctb plot file.

3. Provide a copy of the A-E firms typical CTB file and user information.

4. Drawings shall represent final project with all demolished and/or removed items deleted from the

.dwg files

5. Provide to VA on disc

Drawings in an Adobe Reader (PDF) format of the entire project.

Printed Copies of the drawing set as follows.

1. None

PART 7 – SECURITY REQUIREMENTS

The A-E is responsible for assuring that all employees and consultant employees working on the project comply with these regulations.

1. Employees shall not be on site without appropriate badge. Employees are responsible for reporting to VA Police with acceptable photo ID to obtain a badge. VA approved badge shall be worn with the identification facing forward and visible above the waist. The employees may also be subject to inspection of their personal effects when entering or leaving the facility.

2. No photography or video recording of VA premises is allowed without prior authorization.

3. VA issued keys are to remain on VA property. Keys that are checked out from the Engineering

Office shall be returned each day.

4. Before starting any work, the A-E shall submit an electronic security memorandum describing the approach to following goals and maintaining confidentiality of “sensitive information”.

5. The A-E is responsible for safekeeping of all drawings, project manual and other project information. This information shall be shared only with those with a specific need to accomplish the project.

6. All paper waste or electronic media such as CD’s and diskettes shall be shredded and destroyed in a manner acceptable to the VA.

7. VA Information Custodial Language

a. The Authorization requirements do not apply, and that a Security Accreditation Package is not required.

b. The following standard items relate to records generated in executing this contract:

i. Citations to pertinent laws, codes and regulations such as 44 U.S.C. Chapter 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C.

552a); 36 CFR Part 1222 and Part 1228.

ii. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

iii. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government ‘IT’ equipment and/or Government records.

iv. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

v. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract.

vi. The Government Agency owns the rights to all data/records produced as part of this contract.

vii. The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data.

viii. Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

ix. No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701.

Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

x. Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under or relating to this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information.

c. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

d. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.

e. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.

f. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.

g. If a VHA contract is terminated for cause, the associated BAA must also be terminated, and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.

h. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.

i. The contractor/subcontractor’s firewall and Web services security controls, if applicable, shall meet or exceed VA’s minimum requirements. VA Configuration Guidelines are available upon request.

j. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA’s prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.

k. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above-mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response.

l. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COTR.

8. Privacy – VA Mandatory Training

a. VA Privacy Training for employees without access to VA computer systems or VA sensitive information.

1. VA Talent Management System (TMS) training course VA20939 provides the mandatory Privacy Training requirements for any contractor without access to VA computer systems or VA sensitive information.

b. VA Privacy Training for employees with access to VA computer systems or VA sensitive information.

1. VA Talent Management System (TMS) training course VA10176 provides the mandatory Privacy Training requirements for any contractor with access to VA computer systems or VA sensitive information.

c. Each employee self-enrolls for a profile on the VA TMS by visiting https://www.tms.va.gov/plateau/user/login.jsp. Once there, employees should follow the steps below to create a profile, launch the mandatory training, and complete the content prior to starting work at VA.

d. Provide the COR with each employee’s printed certificate of completion from the TMS. This certificate displays the employee’s TMS User ID.

Contractor to submit proposal on the following VA Form 10-6298.

ARCHITECT - ENGINEER FEE PROPOSAL Department of Veterans Affairs The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who must complete this form will average 4 hours. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. This form or other agreed upon format, is used by VA COTRs to supervise your work and verify the work progression so that you may be paid.

ESTIMATED NUMBER OF CONTRACT DRAWINGS

DESCRIPTION A/E VA

ARCHITECTURAL

SITE AND LANDSCAPING

STRUCTURAL AND BORINGS

SANITARY

PLUMBING

HEATING AND AIR CONDITIONING

ELECTRICAL

TOTAL NUMBER OF DRAWINGS

DATE OF PROPOSAL

PROJECT

NAME OF ARCHITECT/ENG NEER

PART I - PREPARATION OF CONTRACT DRAWINGS AND SPECIFICATIONS

LINE

NO. A. SALARY COSTS

SUB-TOTAL

ARCHITECTURAL

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

1A 1B 1C 1D 1E 1F 1G 1H 1I

SUB-TOTAL

SITE AND LANDSCAPING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

2A 2B 2C 2D 2E 2F 2G 2H 2I

SUB-TOTAL

STRUCTURAL AND BORINGS

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

3A 3B 3C 3D 3E 3F 3G 3H 3I

SUB-TOTAL

SITE AND LANDSCAPING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

4A 4B 4C 4D 4E 4F 4G 4H 4I

VA FORM

JAN 1999 (R) 10-6298 PAGE 1 OF 9

EMPLOYEE HOURS

A/E VA

HOURLY

SALARIES

COSTS

A/E VA

PART I - PREPARATION OF CONTRACT DRAWINGS AND SPECIFICATIONS

LINE

NO. A. SALARY COSTS

SUB-TOTAL:

PLUMBING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

5A 5B 5C 5D 5E 5F 5G 5H 5I

SUB-TOTAL:

HEATING AND AIR CONDITIONING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

6A 6B 6C 6D 6E 6F 6G 6H 6I

SUB-TOTAL:

ELECTRICAL

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

7A 7B 7C 7D 7E 7F 7G 7H

SUB-TOTAL:

8A 8B 8C 8D 8E 8F 8G 8H 8I

SUB-TOTAL:

9A 9B 9C 9D 9E 9F 9G 9H 9I

VA FORM

JAN 1999 (R) 10-6298 PAGE 2 OF 9

EMPLOYEE HOURS

A/E VA

HOURLY

SALARIES

COSTS

A/E VA

TOTAL SALARY COSTS

B. MISCELLANEOUS SALARY COSTS

11A

11B

11C

11D

11E

NO. REQUIRED

SUPERVISORS

DESIGNERS

DRAFTERS

SPEC. WRITERS

# DAYS # PERS. REQUIRED A/E VA A/E VA SALARIES A/E VA

DESIGN REVIEW TRIPS EMPLOYEE-DAYS EMPLOYEE-HOURS HOURLY COSTS

B. MISCELLANEOUS SALARY COSTS (Continued)

C. INCIDENTAL COSTS

TOTAL MISCELLANEOUS SALARY COSTS

TOTAL SALARY COSTS

OVERHEAD:

PROFIT:

TOTAL SALARY PROPOSALS

- (Lines 10+15)

% OF LINE 16

- (Lines 16+17)

11F

11G

11H

12A

12B

12C

12D

12F

13A

13B

13C

13D

13E

13F

14A

14B

14C

14D

14E

14F

14G

14H

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

DESIGN STAFF SITE TRIPS

NO. REQUIRED

SUPERVISORS

DESIGNERS

PRE-BID(CPM) CONFERENCE

NO. REQUIRED

SUPERVISORS

DESIGNERS

ANSWERING INQ. & ISSUING AMENDMENTS

SUPERVISORS

DESIGNERS

DRAFTERS

SPEC WRITERS

TYPISTS

NO. REQUIRED # DAYS # PERS. REQUIRED A/E VA A/E VA A/E VA

LINE

NO.

DESIGN REVIEW TRIPS EMPLOYEE-DAYS EMPLOYEE-HOURS HOURLY

SALARIES

COSTS

20A

20B

20C

20D

20E

20F

20G

21A

21B

21C

21D

21E

21F

22A

22B

22C

22D

22E

22F

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

DESIGN REVIEW TRIPS

NO. REQUIRED

FIRST

SECOND

THIRD

FOURTH

DESIGN STAFF SITE TRIPS

NO. REQUIRED

SUPERVISORS

DESIGNERS

PRE-BID(CPM) CONFERENCE

NO. REQUIRED

SUPERVISORS

DESIGNERS

# DAYS # PERS. REQU RED

LINE

NO.

EMP. TRIPS EMP. DAYS

A/E VA A/E VA

TRAVEL COSTS

A/E VA

PER DIEM

A/E VA

COSTS

A/E VA

VA FORM

JAN 1999 (R) 10-6298 PAGE 3 OF 9

C. INCIDENTAL COSTS (Continued)

EMP. TRIPS EMP. DAYS

A/E VA A/E VA

TRAVEL COSTS

A/E VA

PER DIEM

A/E VA

COSTS

A/E VA

$ $ 23A

23B

23C

23D

23E

23F

24A

24B

24C

24D

24E

24F

25A

25B

25C

25D

25E

25F

26A

26B

26C

26D

26E

26F

27A

27B

27C

27D

27E

27F

28A

28B

28C

28D

28E

28F

29A

29B

29C

29D

29E

29F

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

LINE

NO.

TOTAL INCIDENTAL COSTS:

*TOTAL PROPOSAL (LINE 19 + LINE 30):

*NOTE: This part of the fee is that which falls within the 6% limitation. See VAAR Section 836.606-73 for definitive information.

REMARKS

JAN 1999 (R) 10-6298 PAGE 4 OF 9

PART II - CONSTRUCTION PERIOD SERVICES

NO.

A. SHOP DRAWINGS, SUBMITTALS, ETC

SALARY COSTS

SUB-TOTAL:

ARCHITECTURAL

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

32A 32B 32C 32D 32E 32F 32G 32H

SUB-TOTAL:

SITE AND LANDSCAPING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

TYPISTS

ESTIMATORS

33A 33B 33C 33D 33E 33F 33G 33H

SUB-TOTAL:

STRUCTURAL AND BORINGS

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

ESTIMATORS

34A 34B 34C 34D 34E 34F 34G

SUB-TOTAL:

SANITARY

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

ESTIMATORS

35A 35B 35C 35D 35E 35F 35G

SUB-TOTAL:

PLUMBING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

ESTIMATORS

36A 36B 36C 36D 36E 36F 36G

SUB-TOTAL:

HEATING AND AIRCONDITIONING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

ESTIMATORS

37A 37B 37C 37D 37E 37F 37G

SUB-TOTAL:

ELECTRICAL

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

ESTIMATORS

38A 38B 38C 38D 38E 38F 38G

EMPLOYEE HOURS

A/E VA

HOURLY

SALARIES

COSTS

A/E VA

JAN 1999 (R) 10-6298 PAGE 5 OF 9

NO.

A. SHOP DRAWINGS, SUBMITTALS, ETC

SALARY COSTS

B. RECORD (AS BUILT) DRAWINGS AND SPECIFICATIONS

SALARY COSTS

SUB-TOTAL:

39A 39B 39C 39D 39E 39F 39G

SUB-TOTAL:

40A 40B 40C 40D 40E 40F 40G

SUB-TOTAL:

ARCHITECTURAL

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

42A 42B 42C 42D 42E 42F 42G

SUB-TOTAL:

SITE AND LANDSCAPING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

43A 43B 43C 43D 43E 43F 43G

SUB-TOTAL:

STRUCTURAL AND BORINGS

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

44A 44B 44C 44D 44E 44F 44G

SUB-TOTAL:

SANITARY

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

ESTIMATORS

45A 45B 45C 45D 45E 45F 45G

SUB-TOTAL:

PLUMBING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

46A 46B 46C 46D 46E 46F 46G

EMPLOYEE HOURS

A/E VA

HOURLY

SALARIES

COSTS

A/E VA

TOTAL SALARY COSTS:

EMPLOYEE HOURS

A/E VA

HOURLY

SALARIES

COSTS

A/E VA

JAN 1999 (R) 10-6298 PAGE 6 OF 9

NO.

B. RECORD (AS BUILT) DRAWINGS AND SPECIFICATIONS

SALARY COSTS (Continued)

SUB-TOTAL:

HEATING AND AIR CONDITIONING

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

47A 47B 47C 47D 47E 47F 47G

SUB-TOTAL:

ELECTRICAL

SUPERVISORS

DESIGNERS

DRAFTERS

SPECIFICATION WRITERS

48A 48B 48C 48D 48E 48F

SUB-TOTAL:

49A 49B 49C 49D 49E 49F

SUB-TOTAL:

50A 50B 50C 50D 50E 50F

56A 56B 56C 56D 56E

57A 57B 57C 57D 57E

58A 58B 58C 58D 58E

SUB-TOTAL:

SUB-TOTAL:

SUB-TOTAL:

EMPLOYEE HOURS

A/E VA

HOURLY

SALARIES

COSTS

A/E VA

C. INCIDENTAL COSTS

EMP. TRIPS EMP. DAYS

A/E VA A/E VA

TRAVEL COSTS

A/E VA

PER DIEM

A/E VA

COSTS

A/E VA

TOTAL TRAVEL COSTS:

TOTAL PROPOSAL (Lines 55 + 59):

REMARKS

TOTAL SALARY COSTS:

TOTAL SALARY COSTS (Lines 41 + 51):

OVERHEAD:

PROFIT:

TOTAL LABOR PROPOSAL (Lines 52 + 53 + 54):

JAN 1999 (R) 10-6298 PAGE 7 OF 9

PART III - SITE VISITS

EMPLOYEE TRIPS

A/E VA

TOTAL HOURS

A/E VA

HOURLY

SALARIES

COSTS

A/E VA

61A

61B

61C

61D

61E

61F

SALARY COSTS: SITE VISITS:

OVERHEAD: % OF LINE 62:

PROFIT:

TOTAL SALARY COSTS (Lines 62 + 63 + 64):

LINE

NO.

A. SALARY COSTS

PRE-CONSTRUCTION CONFERENCE

SITE VISITS

INTERMEDIATE A/C INSPECTIONS

FINAL INSPECTION

NO. VISITS

NO. VISITS ONE EMPLOYEE-DAY EACH

NO. INSP.

NO. DAYS

NO. DAYS EMP. PER DAY

NO. DAY EACH EMP. PER DAY

EMPLOYEES PER DAY

NO. DAYS EMP. PER DAY

NO. DAY EACH EMP. PER DAY

EMPLOYEES PER DAY

EMP. TRIPS

A/E VA

TRAVEL COSTS

A/E VA

EMP. DAYS

A/E VA

PER DIEM

A/E VA

COSTS

A/E VA

65A

66B

66C

66D

66E

66F

PART IV - CAPITULATION OF A/E PROPOSALS

*PART I - CONTRACT DRAWINGS AND SPECIFICATIONS (Line 31): $ $ PART II - CONSTRUCTION PERIOD DUTIES (Line 60): $ $

PART III - SITE VISITS: AT $ PER VISIT

FOR A MAXIMUM OF (Line 68): $ $ TOTAL A/E PROPOSAL (Lines 31 + 60 + 68): $ $

*NOTE: This part of the fee is that which falls within the 6% limitation. See VAAR Section 836.606-73 for definitive information.

PART V - CERTIFICATIONS

CERTIFICATION OF CURRENT COST OR PRICING DATA

This is to certify that, to the best of my knowledge and belief, the cost or pricing data (as defined in section 15.801 of the Federal Acquisition Regulation (FAR) and required under FAR subsection 15.804-2 submitted, either actually or by specific identification in writing to the contracting officer or to the contracting officer's representative in support of ... are accurate, complete, and current as of .... This certification includes the cost or pricing data supporting any advance agreements between the offeror and the Government that are part of the proposal

Firm Name Title

Signature Date of Execution

TOTAL TRAVEL COSTS:

TOTAL PROPOSAL FOR SITE VISITS (Lines 65 + 67):

A. SALARY COSTS

PRE-CONSTRUCTION CONFERENCE

SITE VISITS

INTERMEDIATE A/C INSPECTIONS

FINAL INSPECTION

NO. VISITS

NO. VISITS ONE EMPLOYEE-DAY EACH

NO. INSP.

NO. DAYS

JAN 1999 (R) 10-6298 PAGE 8 OF 9

NOTE: The Architect-Engineer shall check the certification below which is applicable to their enterprise, and if required, provide the necessary substantiating information.

CERTIFICATION OF CONCURRENT SUBMISSION OF DISCLOSURE STATEMENTS

The offeror hereby certifies submission, as part of the proposal under this solicitation, copies of the Disclosure Statements as follows (i) Original and one copy to the cognizant Contracting Officer (ii) one copy to the cognizant contract auditor and (iii) one copy to the Cost Accounting Standards Board, 441 G. Street, NW, Washington, DC 20548

DATE OF DISCLOSURE STATEMENT NAME AND ADDRESS OF COGNIZANT CONTRACTING OFFICERS WHERE FILED

The offeror further certifies that practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices in the Disclosure Statements.

CERTIFICATION OF MONETARY EXEMPTION

The offeror hereby certifies that, together with all divisions, subsidiaries, and affiliates under common control, they did not (1) receive a single CAS-covered contract award if $10 million ore more; (2) Receive $10 million or more in CAS-covered contract awards during its preceding accounting period; (3) Receive less than $10 million in CAS-covered contract awards during its preceding cost accounting period but such awards were 10 percent or more of total sales.

CERTIFICATION OF PREVIOUSLY SUBMITTED DISCLOSURE STATEMENTS

The offeror hereby certifies that the Disclosure Statements were filed as follows

DATE OF DISCLOSURE STATEMENT NAME AND ADDRESS OF COGNIZANT CONTRACTING OFFICERS WHERE FILED

The offeror hereby certifies that practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in this Disclosure Statement

CONCUR - SIGNATURE AND TYPED NAME OF ARCHITECT - ENGINEER

CONCUR - SIGNATURE AND TYPED NAME OF ARCHITECT - ENGINEER

CONCUR - SIGNATURE AND TYPED NAME OF ARCHITECT - ENGINEER

CONCUR - SIGNATURE AND TYPED NAME OF ARCHITECT - ENGINEER

CONCUR - SIGNATURE AND TYPED NAME OF ARCHITECT - ENGINEER

DATE

DATE

DATE

DATE

DATE

DISTRIBUTION:(082A)-CC: AE and Proposed File

JAN 1999 (R) 10-6298 PAGE 9 OF 9