Statement of Work

Project Number: 636-26-502 Replace Grand Island Flooring (3rd and 2nd Floors)

Department of Veterans Affairs Nebraska Western Iowa Healthcare System

Grand Island Community Based Outpatient Clinic

Nebraska-Western Iowa Health Care System

A) Mission.

Veterans Health Administration mission: Honor America's Veterans by providing exceptional care that improves their health and well-being.

B) Objectives.

The VA has a need to remove carpeting and rubber cove base in specific areas of corridors, RN stations, alcoves, and waiting areas, and replace with Luxury Vinyl Plank and new rubber cove base. The following areas require replacement.

• Third floor o Main hallway corridors, all wings.

o Includes:

▪ Any Alcoves just slightly off-set of main hallway (some titled as lift areas, some are not)

▪ Public Resident TV & Rec areas at N/NW and S/SW intersections

▪ All backset room entries such as S301,S308,N308 o Nurse stations directly connected to hallways

▪ C303 will be just to first wall behind desk.

▪ NE310, NW301, SW301, SE310

o At elevator lobby C327, existing worn LVP of south and east jog to east hall will be replaced. Main area west and in front of welcome station may be replaced. TBD considering color match of new LVP.

• Second floor:

o Main waiting room N202 o Respiratory Clinic 2NW in its entirety. (rooms 205x, 206 and 207x) o Radiology office & waiting room. SW213A & SW213.

o Physical Therapy MSA office, Waiting room, one Exam room.

(C213,C212,C208,C207)

This project will provide the labor, materials, and management necessary to complete these objectives in Building 1, at 2201 N. Broadwell Ave, Grand Island, NE 68803.

Rough estimations are: a) 9,300SF flooring, and b) 2,500LF cove base. Any dimensions given shall be considered approximate. The contractor will be responsible for quantity take-off. A site visit will be offered. [PDFs as P_15 have been high-lighted to show these general areas. All measurements must be field verified.]

LVP will have a woodgrain pattern , and color matching close to these examples. Actual pattern and color to be approved by VA COR/Staff for approval prior to procurement.

Teknoflor is for reference only and not a required brand.

Rubber cove base will be nominal industry standard 4inch height. Color is a light beige accent between the floor color and existing wall color. Actual color to be approved by VA

COR/Staff for approval prior to procurement.

Upon conclusion of installation, the VA requires additional attic stock of LVP and cove base to be supplied. Actual number of packages will be determined according to SF coverage of approved products per package. Number of packages as necessary to meet nearest coverages noted below, with consideration of normal commercial package quantities, and following manufacturer’s recommended application coverage rate for adhesives. Specific quantities to be approved by COR as close as possible to the below quantities.

• 500SF of Luxury Vinyl Plank Flooring.

o Also appropriate amount of flooring adhesive, in pails no larger than 2gl.

• One Roll Rubber Cove Base. To be at least 120LF.

o Also appropriate amount of cove base adhesive. In ~10oz caulk tubes.

NOTE!: These limitations are for VA benefit to not waste attic stock product long term if additional areas are added, or repairs performed after Project Warranty Period. Contractor is allowed to procure and utilize larger container sizes as they see fit per their level of expertise for usage during project application.

C) Current Conditions.

Hazardous materials records indicate that the work area for this project has been previously abated and no asbestos containing materials are anticipated. If suspected ACM are encountered during this project, stop disruptive work in the area immediately and notify the COR/CO of the discovery.

D) Acronyms and Definitions.

The following is a listing of acronyms and/or definitions to terms used in this document.

CO Contracting Officer

COR Contracting Officers Representative as delegated by the CO

CS Contracting Specialist assigned by the CO

GC General Contractor (firm)

IDIQ Indefinite Delivery Indefinite Quantity

LF Linear or Lineal Feet

NTP Notice to Proceed

NWIHCS Nebraska-Western Iowa Health Care System

OIT Office of Information & Technology

PDT Project Delivery Team – Typically comprised of the CO/CS, the COR, and

NWIHCS staff

RFI Request for Information

RN NM Registered Nurse, Nurse Manager

SF Square Feet

VA Department of Veteran Affairs

E) Requirements.

Where a conflict exists between the Statement of Work (SOW) requirements and the requirements of other associated contract documents, the SOW requirements shall prevail.

This SOW presumes the contractor will not need access to the NWIHCS LAN or any VA

Sensitive Information to execute the contract.

The awarded Contractor will adhere to all codes, standards, guidelines and design requirements found in the VA’s Technical Information Library (TIL) including but not limited to the following:

1) Pre-bid site visit:

a. A pre-construction site walk through is encouraged and should be coordinated by the CO. The intent of this walkthrough is to give the contractor access to the project site so that an accurate evaluation of the project requirements and site assessment can be made.

2) RFI Submittals.

a. The contractor(s) shall submit any RFI’s resulting from the site visit within five (5) working days in writing to the CO.

b. Unless otherwise stated the contractor shall allow the CO and COR ten (10) working days to respond to any RFI.

3) Infection Control Barrier (ICB).

a. Temporary construction partitions shall be smoke-tight, built of noncombustible materials that will not contribute to the development or spread of fire, and maintain a one-hour fire rating.

b. Barriers shall not obstruct access to emergency services and for fire, police, and other emergency forces.

c. The Contractor shall provide and install a rigid infection control panel system.

Salient details of the infection control barrier are:

i. The ICB must be fire-resistant.

ii. The barrier should include an anteroom for infection control purposes while maintaining a negative air pressure for the construction area.

iii. The barrier must be water resistant; capable of being cleaned and sanitized.

iv. The ICB should include interior and exterior item that reduces and removes the transfer of dust and debris by personnel exiting the construction site.

v. Installation of the barrier shall not:

1. Generate dust outside the barrier.

2. Generate excess noise outside the barrier.

3. Generates excess fumes outside the barrier.

vi. Demobilization of the barrier shall not:

1. Generate dust outside the barrier.

2. Generate excess noise outside the barrier.

3. Generates excess fumes outside the barrier.

4. Require floor, wall, or ceiling repairs upon removal.

vii. The barrier should be environmentally responsible.

1. The materials should be reusable.

2. The materials should not contribute to unnecessary waste to our landfills.

d. Rigid infection control panel system and manometers are to be submitted and approved by the COR prior to installation.

e. Fire-resistant plastic sheeting may be used to supplement the rigid infection control panel system. Provide submittal RFI details for COR approval.

f. Wood studs, plywood, OSB, particle board, pressboard, or other flammable materials are not allowed.

g. Manometers shall be installed on the ICB adjacent to every entrance of the work zone to monitor negative pressure within the work zone.

h. All doors to rooms inside the work zone but directly impacted by the work shall have their doors shut and the perimeters taped to prevent the migration of dust and debris into these rooms.

i. Cover all sprinkler heads (daily), signs, data transmitters, and light fixtures.

Cover the supply and return diffusers within the work zone to prevent the spread of dust and fumes to other areas outside the work zone.

j. The following is a manner acceptable to NWIHCS Infection Control to maintain negative pressure inside an infection control barrier with no reasonable access to discharge air to the exterior.

i. Install a floor-to-ceiling infectious control barrier (ICB) meeting the fire-rating required.

ii. Cover all sprinkler heads (daily), signs, data transmitters, and light fixtures.

Cover the supply and return diffusers within the work zone to prevent the spread of dust and fumes to other areas outside the work zone.

iii. Place the air scrubber inside the ICB with a HEPA filter. The air scrubber will draw air from inside the ICB.

iv. Place a flapper valve connection on the ICB near to the ceiling.

v. Route the filtered air from the scrubber via a collapsible duct to the flapper valve thus maintaining negative pressure inside the ICB.

vi. If the power should accidently get cutoff, the flapper valve will swing close thereby maintaining the integrity of the ICB.

4) The Contractor shall post and maintain the final signed PCRA, ICRA, ILSM and

Emergency Contact Information (when issued) at the entrance to the ICB for the duration of the project. The Contractor will update the postings when new documents are issued.

5) The Contractor shall cover fire and life safety smoke and/or heat detector heads inside and possibly nearby outside of the work areas during demolition and installation. This may require daily install and removal during non-work hours. The COR, Safety Mgr, and FacMaint Mgr will determine specific area requirements with the Contractor.

6) Due to excessive wear of carpet in high traffic areas, be prepared for light wetting to minimize dust during removal. And waste dumpsters need to be covered during transport out. Coordinate with COR for waste routing plans for each work area.

Routes may require laydown of rolled contractor cardboard taped for safety to prevent trip hazard, and cleaned daily or more frequently if necessary.

7) Equipment Lead time:

a. Equipment lead times line shall be incorporated into the project schedule and used in conjunction with the baseline for the project start date.

8) NWIHCS Permits:

a. Unless otherwise stated the contractor shall submit for all required VA permits

(i.e. dig) fourteen (14) calendar days prior to the event based on the approved project schedule with the COR.

9) Project Pay Applications:

a. All submitted project pay applications require certified payroll and waste report documents to be current with each pay submission.

b. Approval of all invoices will require documents to be current.

c. Certified Payroll documents shall be submitted to the CO and COR weekly.

d. Pay Applications are not to be sent to the CO for certification approval.

e. First, COR, Site Superintendent, and GC’s PM must pre-review and agree on completed content for Project Pay Applications, and any potential adjustments.

f. Once COR, Site Superintendent, and GC’s PM reach agreement, COR will email the CO that a Pay Application has been reviewed and concurs for certification for payment.

10) Submittals and Shop Drawings:

a. Unless otherwise stated the contractor shall provide shop drawings and equipment submittals for review and approval by the CO and COR seven (7) calendar days prior to the start of construction.

b. No work shall be started prior to review and approval by the COR.

11) OSHA Certification:

a. The contractor shall have an OSHA certified site superintendent on site whenever any work is being performed.

b. A copy of the OSHA certification shall be supplied to the COR prior to the start of any work and retained as part of the project folder.

12) Post-Award meeting:

a. The meeting shall be coordinated through the COR and CS/CO.

b. The meeting shall take place after the Notice to Proceed has been issued but prior to the start of demolition/construction.

c. The Contractor shall schedule and attend a “Page-Turn” meeting in which the

COR will be in attendance. The goal of this meeting is to clarify any confusion the Contractor may have regarding the contract documents in advance of commencing construction activities, delivery of project submittals, submission of the project schedule, the coordination of project phasing, etc.

Scope of Work.

The Scope of Work (SOW) for this project includes all labor, management, and materials to replace the existing carpet and base with Luxury Vinyl Plank and new Rubber Cove

Base in Building 1,on the 3rd and 2nd Floors. All measurements/dimensions existing blueprints are approximate. Contractor must verify all measurements/dimensions.

The Contractor shall inspect the area under contract prior to commencing work and identify any pre-existing damage and provide an Existing Site Conditions report with related photos to the Contracting Officer for review and approval.

The Contractor shall match existing conditions at each location. The contractor will be responsible for and shall repair any excessive damage caused by the removal/demolition of existing materials or the installation of new materials.

Any deviation from this scope of work requires the express authorization of the

Contracting Officer. The Contracting Officer Representative (COR) does not hold the authority to authorize changes to this scope of work.

F) Constraints.

1) Photographs may be taken of the work performed at the jobsite. However, photographs containing patients and/or staff are a violation of the Patient Privacy and hospital policy.

2) VHA Directive 1085 implements a smoke-free policy for patients, visitors, contractors, volunteers, and vendors at VA health care facilities.

G) Tasks and Responsibilities.

A pre-construction (kick-off) meeting between the Contracting Officer (CO) or

Contracting Specialist (CS), the Contracting Officers Representative (COR), and key GC team members will be conducted to review project objectives, scope, deliverables, communication, site access, schedule, and responsibilities. During this meeting the Notice to Proceed (NTP) should be signed. After this meeting the awarded GC firm shall provide their services according to the approved project schedule.

1) Preconstruction Period: The Contractor shall provide the following:

a. Logistics Plan: A comprehensive narrative describing the chronological planned development of the project. The Logistics Plan includes an organizational chart, hourly rates, staging plan, description of means and methods, and hours of work.

b. Construction Security Plan: Defines both physical and administrative security.

c. Construction Phasing Plan: The VA views this project content as a singular effort. Specific sequence and timing with individual clinics areas and major sections, will require coordination with Clinical Nurse managers, COR, and

Contractor. Consideration will focus on patient loads at the time of award and

NTP, and best efficiencies between Contractor to best perform work and get areas back into normal operation as quickly as possible, while maintaining necessary work area isolation etc per requirements defined in SOW.

d. Submittal Submission: The VA does not expect the need for a submittal registry to be used. Utilization of email should support any RFIs and routine transferal of documentation between CO, COR and Contractor. If any issues arise, the COR will obtain input with VA OIT.

e. Accident Prevention Plan: The APP (aka Construction Safety & Health Plan) shall interface with the Contractor's overall safety and health program.

f. Activity Hazard Analyses: AHAs are also known as Job Hazard Analyses, Job

Safety Analyses, and Activity Safety Analyses.

g. Construction Schedule: WBS schedule including start/end dates, duration and sequencing, preferably in MS Project or Primavera format (include floats).

h. Schedule of Values: A detailed Breakdown for Payment, including design stages, work performed and work invoiced per Progress Payment submission.

i. Infection Control Plan (ICP): Narrative description of the dust control and debris disposal process including disposal destination and methodology.

j. Quality Control Plan (QCP): Describes the methods by which the Contractor will ensure all work is being accomplished in accordance with specifications and this SOW.

k. Environmental Protection Plan: The Contractor shall meet with the COR to discuss the proposed Environmental Protection Plan and to develop mutual understanding relative to details of environmental protection.

l. Document Submissions. All documents included as Attachments to this SOW that are required to be filled out and signed or jointly signed by the Contractor.

m. Demolition Debris Management Plan.

n. All Contractor personnel are required to wear identification (I.D.) badges issued by the NWI.

2) Construction Period: The Contractor shall provide the following during construction services:

a. Display the signed PCRA, ICRA, ILSM and Emergency Contact Information in a location coordinated with the COR.

b. Attending biweekly construction meetings which are facilitated by the COR.

c. Submit RFI’s during construction as necessary.

d. Issue weekly field reports of construction progress to the CO and COR.

e. Attend field inspections and punch list inspections as requested by the COR.

f. Full Completion, Joint Inspection, and Beneficial Occupancy procedures will be required for each portion or primary sub-section, before moving on and beginning work in another area. Intention is to focus fully on individual areas for renovations explained here-in, and return them to full use as quickly as possible.

a. This is not intended to conflict with a few small areas that may be fastest handled by including with a nearby area of work. However, those will be closely coordinated with COR, VA Staff, & Contractor.

3) Construction Close-out Period:

a. The Contractor shall provide the following:

1. Inspection and Approval by the COR and/or the CO.

2. Final Approval and Beneficial Occupancy when applicable.

3. Warranties documents and O&M Manuals.

4. As-built drawings and record submittals.

5. Contractor Release of Claims.

6. All Waste Reports submitted per Safety and Health during Construction

Activities.

b. The COR shall review the contractor’s close-out submissions for thoroughness and conformance with the contract document requirements. The COR shall also review field-marked as-built drawings for conformance with final installations.

c. The COR shall utilize these as-built drawings and specifications from the contractor and generate as recorded drawings and specifications.

H) Period of performance and scheduling

1) This project shall be completed within one hundred and fifty (150) calendar days once

NTP is issued.

2) This project shall be phased to minimize impact on the medical center.

a. Third floor, north and south corridors may be made available as single phases.

ICRA barriers shall be erected at the project boundary.

b. Third floor, east corridor shall be completed between the hours of 1900-2400.

Noisy work should be scheduled prior to 2100 whenever possible. ICRA barriers will be set up and removed at the end of each shift. The site shall be left clean and safe for veteran traffic at the end of each work period.

c. Second floor –

i. Respiratory Clinic must be completed as quickly as possible to be returned to full service. Scheduling will be coordinated with RN Mgr, COR, and

Contractor for maximum efficiency.

d. In advance of construction, VA Staff are considering and preparing for alternative methods for both parties to accommodate patient care flow, and enable contractor maximum efficiency to complete upgrades. [Refer to coordination section

G),1),c., above.] Work areas will be managed similarly in sections and schedule coordination with RN Mgrs.

3) Unless noted otherwise stated Work hours for this project shall be between 0800 and

1630, M-F excluding federal holidays. Work outside of these hours shall be coordinated with the COR.

I) Other Pertinent Information or Special Considerations.

1) All Contractor personnel shall be certified by appropriate federal and state regulatory agencies to meet federal and local certification requirements as applicable. All licenses, permits, and welding certifications shall be kept current throughout the period of performance of the contract. The Contractor shall provide the Government copies of such certificates.

2) All work shall be scheduled to meet requirements of NWIHCS. All work shall be coordinated through the Contracting Officer. Local coordination shall be routed through the Contracting Officer’s Representative.

3) The contractor shall provide to the Contracting Officer record of work certifications for all trades relative to this contract 5 calendar days prior to beginning work.

Certifications shall include welders, pipe installers, machine operators, electrician, etc.

4) Contractor is responsible for repairing any damages to existing utilities incurred during construction or demolition.

5) Utilities within the area and identified on existing drawings are not to be interpreted as the exact location, or as the only existing site conditions. Contractor shall verify all existing conditions and proceed with caution around any anticipated obstructions.

6) Where any work disturbs the grass areas, sod, walls, ceilings, floors, windows, entrances or building structures, etc. or where new and old work join, the Contractor shall restore, repair or refinish affected areas or surfaces to their original condition, or as existed before the commencement of this project. Upon completion of the contract, the Contractor shall deliver all work complete and undamaged. Any damage that may be caused by the Contractor or his work crews or subcontractors to any existing structure, grounds and utilities shall be repaired or replaced to their original condition.

7) Should a conflict exist between VA requirements and VA adopted nationally recognized codes and standards, the conflict shall be brought to the attention of the

Contracting Officer. The resolution of the conflict shall be made by the authority having jurisdiction for VA to ensure system-wide consistency. All work conducted under this scope of work shall comply with the Department of Veterans Affairs Master

Specifications and all applicable state and federal regulations and codes.

J) Risk Control.

1) ICRA (Infection Control Risk Assessment) and PCRA (Patient Care Risk Assessment) requirements and procedures will vary depending upon each area of work. They will also be adjustable depending upon the degree that VA Staff RNs may be able to relocate patient flow at time of renovation in particular areas. Therefore, Contractor must be prepared to participate in cooperative planning with COR and VA Staff, and implement barriers or segregation accordingly, to meet requirements or patient safety.

K) RECORDS MANAGEMENT OBLIGATIONS

A. Applicability

This clause applies to all Contractors whose employees create, work with, or otherwise handle Federal records, as defined in Section B, regardless of the medium in which the record exists.

B. Definitions

“Federal record” as defined in 44 U.S.C. § 3301, includes all recorded information, regardless of form or characteristics, made or received by a Federal agency under Federal law or in connection with the transaction of public business and preserved or appropriate for preservation by that agency or its legitimate successor as evidence of the organization, functions, policies, decisions, procedures, operations, or other activities of the United

States Government or because of the informational value of data in them.

The term Federal record:

1) includes [Agency] records.

2) does not include personal materials.

3) applies to records created, received, or maintained by Contractors pursuant to their

[Agency] contract.

4) may include deliverables and documentation associated with deliverables.

C. Requirements

1. Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C.

chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy

Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

2. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the

Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy

Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

3. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

4) [Agency] and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of [Agency] or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to [Agency]. The agency must report promptly to NARA in accordance with 36 CFR 1230.

5) The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from

Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the

Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to [Agency] control or the

Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the

Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

6) The 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, contracts. The Contractor (and any sub-contractor) is required to abide by Government and [Agency] guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

7) The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with [Agency] policy.

8) The Contractor shall not create or maintain any records containing any non-public

[Agency] information that are not specifically tied to or authorized by the contract.

9) The 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 from public disclosure by an exemption to the Freedom of Information Act.

10) The [Agency] owns the rights to all data and records produced as part of this contract.

All deliverables under the contract are the property of the U.S. Government for which

[Agency] shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-

20.

11) Training. All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take [Agency]-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.

[Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.]

{NOTE: COR has hard copy Rules of Behavior which will be Read and Signed by all

Contractor’s and Sub-Contractor’s employees.}

D. Flowdown of requirements to subcontractors

1) The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same.

2) Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor.

L. ATTACHMENTS

1) Attachment 1: FY25 Updated Rules of Behavior (ROB) for Non-Organizational Users -printable

-----------------(End of SOW)-----------------