Functional Assessment Plans (FAP).pdf

Attachment A: Functional Assessment Plan (FAP)

FUNCTIONAL ASSESSMENT PLAN (FAP)

CUSTODIAL

1503010

CUSTODIAL FAP

Assessment Levels (AL) Assessment Frequency (Freq)

A – Annually

Q – Quarterly

M – Once per month

BW – Once every 13-16 days

W – Once per week

R – As required

Method of Assessment (MOA)

PS – Periodic Sampling

VCC – Validated Customer Complaints

UV – Unscheduled Visits

CE – Customer’s Evaluation

AL1

Start assessment at this Level

AL2

Add this Level if Contractor performance for AL1 is Unsatisfactory

AL3

performance at AL1 or AL2 is Unsatisfactory

Note: Return to appropriate Assessment Level when performance improves.

Note: The first method listed in the MOA column below is the primary assessment method.

Spec Item

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total) Normal Reduced

3.1 Scheduled Services

The Contractor shall provide scheduled custodial services to ensure facilities are clean and sightly.

Facilities are clean and sightly, consistent with the specified COLS and/or service class.

Work is completed in accordance with the Contractor’s schedule.

VCC

N/A

10%

5%

M

3.1.1 Space Cleaning

The Contractor shall clean spaces to ensure they are clean and sightly.

Spaces are clean and sightly consistent with the specified COLS and/or service class.

Furniture and other items moved returned to original position.

3.1.1.1 Emptying Waste Containers

The Contractor shall empty waste containers and ensure they are clean.

Waste containers are empty and clean.

Waterproof liners are provided and replaced when soiled or unserviceable.

Services are performed at the specified

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total) Normal Reduced frequencies.

3.1.1.2 Emptying Recycling Containers

The Contractor shall empty recycling containers and ensure they are clean.

Recycling containers are empty and clean.

frequencies.

3.1.1.3 Low Area Cleaning

The Contractor shall provide low area cleaning services to ensure surface areas are clean.

Surfaces are clean.

Cleaning is performed at the specified

3.1.1.4 Lunch/Break Room Cleaning

The Contractor shall provide cleaning services in lunch/break room areas to ensure areas are clean and sanitary.

Lunch/break room is clean and sanitary.

Lunch/break room waste containers are empty, clean, and waterproof liners have been replaced.

Dispensers are refilled and supplies are stocked.

3.1.1.5 High Area Cleaning

The Contractor shall provide high area cleaning services to ensure surfaces are clean.

Surfaces are clean.

3.1.1.6 Interior Window Cleaning

The Contractor shall clean window surfaces and adjacent areas to ensure that surfaces are clean and sightly.

All interior windows are clean and sightly.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total) Normal Reduced

3.1.1.7 Exterior Window Cleaning

The Contractor shall clean window surfaces and adjacent areas to ensure that surfaces are clean and sightly.

All exterior windows are clean and sightly.

3.1.1.8 Window Blinds Cleaning

The Contractor shall clean window blinds to ensure they are clean and available for use in a timely manner.

Blinds are clean and in the same operational condition as prior to cleaning.

If removed for cleaning, blinds are returned to their original location within two working days.

3.1.1.9 Entrance Cleaning

The Contractor shall clean doors and all associated glass of the entrance to ensure doors and glass surfaces are clean and sightly.

Glass surfaces are clean and sightly on both sides and for the full height of the glass.

Doors are clean and free of all dirt and marks.

3.1.1.10 Interior Glass Surfaces Cleaning

The Contractor shall clean all interior glass to ensure glass surfaces are clean and sightly.

Glass surfaces are clean and sightly on both sides and for the full height of the glass.

3.1.1.11 Drinking Fountains Cleaning

The Contractor shall clean drinking fountains to ensure they are clean, sanitary, and sightly.

Drinking fountains are clean, sanitary, and sightly.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total) Normal Reduced

3.1.2 Floor Care

The Contractor shall provide floor care services to ensure they are clean and sightly.

Floors are clean and sightly consistent with the specified COLS and/or service class.

3.1.2.1 Sweeping and Dust Mopping

The Contractor shall sweep or dust mop uncarpeted floors to ensure floors are free of debris and dust.

Floors are free of debris and dust.

3.1.2.2 Vacuuming Carpets and Rugs

The Contractor shall vacuum carpets and rugs to ensure they are free of debris and dust.

Carpets and rugs are free of debris and dust.

3.1.2.3 Cleaning Walk-off Mats

The Contractor shall clean the walk-off mats and surfaces below the mats to ensure mats and surfaces are clean.

Walk-off mats and surfaces below the mats are clean.

3.1.2.4 Spray Cleaning and Buffing

The Contractor shall spray clean and buff floors to ensure floors are clean and present a sightly appearance.

Floors are clean and have a uniform glossy finish.

Non-slip floors are clean and have a uniform matte finish

3.1.2.5 Damp Mopping

The Contractor shall damp mop floors to ensure that floors are clean.

Floors are clean.

3.1.2.6 Stripping, Coating, and Buffing

The Contractor shall strip, coat and buff floors to ensure that floors are clean and sightly.

Floors are clean, free of previously applied coat, and have a uniform glossy finish.

Floors are properly coated and protected.

Non-slip floors are clean and have a

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total) Normal Reduced uniform matte finish.

Services are performed at the specified frequencies.

3.1.2.7 Carpet and Rug Deep Cleaning

The Contractor shall deep clean carpets and rugs to ensure that floors are clean, sightly and available for use in a timely manner.

Carpets and rugs are clean.

Carpets and rugs are dry and passable in 12 hours.

3.1.3 Restroom Services

The Contractor shall service restrooms to ensure they are clean, sanitary, sightly, and stocked with sufficient supplies.

Restrooms are clean, sanitary, and sightly consistent with the specified service class and COLS.

Restrooms are adequately stocked with restroom supplies.

3.1.3.1 Restroom Cleaning

The Contractor shall clean and disinfect restrooms to ensure they are clean, sanitary, and free of offensive odors.

All restrooms are clean, sanitary, and free of offensive odors.

No graffiti present on restroom surfaces.

3.1.3.2 Restroom Servicing

The Contractor shall service restrooms to ensure they are stocked with sufficient supplies and waste containers are emptied.

Restroom supplies are filled to capacity and are available.

Restroom waste containers are empty, clean, and waterproof liners have been replaced.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total) Normal Reduced

3.1.4 Group Shower/Locker Room

Cleaning The Contractor shall provide cleaning services in group shower/locker rooms to ensure areas are clean and sanitary.

All shower/locker rooms are clean, sanitary, and free of offensive odors.

Shower/locker room waste containers are empty, clean, and waterproof liners have been replaced.

Shower/locker room supplies are filled to capacity and are available.

3.1.5 Building Perimeter Services

The Contractor shall provide building perimeter services to ensure that they are sightly.

Building perimeters are sightly and consistent with the specified COLS and/or service class.

3.1.5.1 Debris Removal

The Contractor shall remove debris from the building perimeter to ensure a sightly appearance.

Building perimeters are clear of debris.

3.1.5.2 Emptying Perimeter Waste

Containers The Contractor shall empty perimeter waste containers and ensure they are clean.

Waste containers are empty and clean.

Waterproof liners are provided and replaced when soiled or unserviceable.

3.2 Unscheduled Services

The Contractor shall respond and complete requests for minor cleaning tasks between scheduled service intervals to ensure spaces and surfaces are clean.

Unscheduled services are completed within four hours after notification.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total) Normal Reduced

4 Non-recurring Work Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G. The order will specify the exact locations and types of work to be accomplished. The period of performance will be specified in each order.

Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G. The order will specify the exact locations and types of work to be accomplished. The period of performance will be specified in each order.

EA

100%

As reqd

MONTHLY PERFORMANCE ASSESSMENT SUMMARY

Contract #: N40085-20-D-XXXX Installation/Site:

Annex/sub-annex: 1503010 - Custodial Month/Year:

Title AL 1 AL2 - AL3 VCC SAFETY QMS REVIEW

E M N E M N POS NEG ISSUES SAMPLES A U

3.1 Scheduled Services

3.1.1 Space Cleaning

3.1.1.1 Emptying Waste Containers

3.1.1.2 Emptying Recycling Containers

3.1.1.3 Low Area Cleaning

3.1.1.4 Coffee Mess/Break Room Area

Cleaning

3.1.1.6 High Area Cleaning

3.1.1.7 Interior Window Cleaning

3.1.1.8 Exterior Window Cleaning

3.1.1.9 Window Blinds Cleaning

3.1.1.10 Entrance Cleaning

3.1.1.11 Interior Glass Surfaces Cleaning

3.1.1.12 Drinking Fountains Cleaning

3.1.2 Floor Care

3.1.2.1 Sweeping and Dust Mopping

3.1.2.2 Vacuuming Carpets and Rugs

3.1.2.3 Cleaning Walk-off Mats

3.1.2.4 Spray Cleaning and Buffing

3.1.2.5 Damp Mopping

3.1.2.6 Stripping, Coating, and Buffing

3.1.2.7 Carpet and Rug Deep Cleaning

3.1.3 Restroom Services

3.1.3.1 Restroom Cleaning

3.1.3.2 Restroom Servicing

3.1.4 Group Shower/Locker Room

Cleaning

3.1.5 Building Perimeter Services

3.1.5.1 Debris Removal

3.1.5.2 Emptying Perimeter Waste

Containers

3.2 Unscheduled Services

4 Non-recurring

Annex/sub-annex: 1503010 - Custodial Month/Year:

Comments:

Recommended Actions:

Technical Rating (Mark using X)

E VG S M U

Overall Technical Rating for Recurring Work

Overall Technical Rating for Non-Recurring Work

Spar Signature Date

PEST CONTROL

1503020

PEST CONTROL FAP

A – Annually

Q – Quarterly

M – Once per month

BW – Once every 13-16 days

VCC – Validated Customer Complaints performance at AL1 or AL2 is Unsatisfactory

Note: Return to appropriate Assessment Level when performance improves.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1 Pest Control

The Contractor shall provide pest control services to ensure the appearance and infestation of pests are controlled in a proper and timely manner.

Pests are controlled to levels and within times specified in the Pest Group Requirements in Section J.

Pest surveys are conducted at the Frequencies for Scheduled Work specified in J-1503020-06.

3.1.1 Nuisance Pest Control

The Contractor shall control nuisance pests to ensure facilities are free from nuisance pests.

Pest surveys are conducted at the Frequencies for Scheduled Work specified in J-1503020-06.

Pests are controlled to levels and within times specified for Nuisance Pest Requirements in J-1503020-07.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1.2 Disease Vector or Health Pest

Control The Contractor shall control disease vector or health pests to ensure facilities and breeding areas are free of disease vector or health pests.

Pest surveys are conducted at the Frequencies for Scheduled Work specified in J-1503020-06.

Pests are controlled to levels and within times specified for Disease Vector or Health Pest Requirements in J-1503020- 08.

3.1.3 Structure Damaging Pest Control

The Contractor shall control structure damaging pests to ensure facilities are free of structure damaging pests.

Pest surveys are conducted at the Frequencies for Scheduled Work specified in J-1503020-06.

Pests are controlled to levels and within times specified for Structure Damaging Pest Requirements in J-1503020-12.

3.1.4 Lawn, Turf and Ornamental Plant

Pest Control The Contractor shall control lawn, turf and ornamental plant pests to ensure facilities are free of lawn, turf and ornamental plant pests.

Pest surveys are conducted at the Frequencies for Scheduled Work specified in J-1503020-09.

Pests are controlled to levels and within times specified for Lawn, Turf and Ornamental Plant Pest Requirements in J-1503020-09.

3.1.5 Vegetation Management

The Contractor shall manage vegetation to ensure facilities are free of vegetation pests.

Pest surveys are conducted at the Frequencies for Scheduled Work specified in J-1503020-10.

Pests are controlled to levels and within times specified for Vegetation Management Requirements in J- 1503020-10.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1.6 Vertebrate Pest Control

The Contractor shall control vertebrate pests to ensure facilities are free of vertebrate pests.

Pest surveys are conducted at the Frequencies for Scheduled Work specified in J-1503020-11.

Pests are controlled to levels and within times specified for Vertebrate Pest Requirements in J-1503020-11.

3.2 Unscheduled Pest Control Services

The Contractor shall provide unscheduled pest control services to ensure the appearance and infestation of pests are controlled in a proper and timely manner.

Pests are controlled to levels and within times specified in the corresponding pest group requirements in Section J.

3.2.1 Pest Control Trouble Calls

The Contractor shall perform service trouble calls to ensure the appearance and infestations of pests are controlled in a proper and timely manner.

Pests are controlled to levels and within times specified in the corresponding pest group requirements in Section J

3.3 Pest Management Reporting

The Contractor shall report pest management operations to ensure the effectiveness and safety of control efforts can be monitored in a proper and timely manner.

Reports are accurate, complete and submitted within the time specified in each of the pest group requirements in Section J.

4 Non-recurring Work Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G. The order will specify the exact locations and types of work to be accomplished. The period of performance will be specified in each order.

Refer to Non-recurring ELINs for task listings, descriptions and related requirements. All periods of performance are measured from issue date of order to acceptance of the work.

Performance Standards for Non-recurring work will be the same as those in Spec Item 3 where applicable.

Annex/sub-annex: 1503020 - Pest Control Month/Year:

Title AL 1 AL2 - AL3 VCC SAFETY QMS REVIEW

E M N E M N POS NEG ISSUES SAMPLES A U

3 Recurring Work 3 Recurring Work (FFP)

3.1 Scheduled Pest Control

3.1.1 Nuisance Pest Control

3.1.2 Disease Vector or Health Pest

Control

3.1.3 Structure Damaging Pest Control

3.1.4 Lawn, Turf and Ornamental Plant

Pest Control

3.1.5 Vegetation Management

3.1.6 Vertebrate Pest Control

3.2 Pest Control Services Orders

3.3 Pest Management Reporting

4 Non-recurring Comments:

Recommended Actions:

Technical Rating (Mark using X)

INTEGRATED SOLID WASTE

MANAGEMENT

1503030

INTEGRATED SOLID WASTE MANAGEMENT FAP

A – Annually

Q – Quarterly

M – Once per month

BW – Once every 13-16 days

VCC – Validated Customer Complaints performance at AL1 or AL2 is Unsatisfactory

Note: Return to appropriate Assessment Level when performance improves.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1 Solid Waste Collection

The Contractor shall provide collection of wastes to ensure refuse and recyclables are properly collected

Wastes are collected per the Contractor’s schedule.

Waste collection areas are free of waste following collection operations.

3.1.1 Recyclable Waste

The Contractor shall remove recyclable waste to ensure it is properly collected.

Recyclable waste is removed from waste collection areas per the Contractor’s schedule.

Containers are returned to an upright position and lids are secured.

3.1.2 Bulky Items

The Contractor shall remove bulky items to ensure they are properly collected.

Bulky items are removed from waste collection areas per the Contractor’s schedule.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.2 Vehicles and Equipment

The Contractor shall maintain vehicles and equipment in a manner to ensure a clean appearance, minimal foul odors, and normal working condition.

Vehicles and equipment are clean, have minimal foul odors, and are maintained in normal working condition.

3.3 Solid Waste Containers

The Contractor shall provide containers suitable for the collection and disposal of solid waste.

All containers are of standard commercial-industrial grade and are clean, have minimal foul odors, and maintained in normal working condition.

3.4 Recyclables

The Contractor shall provide containers suitable for the collection and recycling of materials.

All containers are suitable for the collection and recycling of materials and correctly labeled.

Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G.

The order will specify the exact locations and types of work to be accomplished.

The period of performance will be specified in each order.

Periods of performance (measured from the issue date of the order to work completion) have been met.

Work performed meets established expectations. Debris generated is removed and disposed of in accordance with requirements.

Establishment or warranty periods are confirmed.

Annex/sub-annex: 1503030 - Integrated Solid Waste Management Month/Year:

Spec Item

Title AL 1 AL2 - AL3 VCC SAFETY QMS REVIEW

E M N E M N POS NEG ISSUES SAMPLES A U

3 Recurring Work

3.1.1 Recyclable Waste

3.1.2 Bulky Items

3.2 Vehicles and Equipment

3.3 Solid Waste Containers

3.4 Recyclables

4 Non-recurring Comments:

Recommended Actions:

Technical Rating (Mark using X)

Overall Technical Rating for Non-Recurring Work

GROUNDS MAINTENANCE AND

LANDSCAPING

1503050

GROUNDS AND LANDSCAPING MAINTENANCE FAP

A – Annually

Q – Quarterly

M – Once per month

BW – Once every 13-16 days

VCC – Validated Customer Complaints performance at AL1 or AL2 is Unsatisfactory

Note: Return to appropriate Assessment Level when performance improves.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1 Grounds

The Contractor shall maintain improved grounds to ensure a sightly appearance.

Grass is uniform in appearance and is maintained to specify Common Output Level in J-1503050-04.

Fences are free of vegetation.

A six foot clearance is maintained around perimeter fencing.

Lawns are healthy and present a uniform appearance and a rich natural color.

3.1.1 Lawn Care

The Contractor shall maintain lawns to achieve a sightly appearance.

Grounds are maintained in a manner consistent with the specified Common Output Level.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1.1.1 Mowing and Trimming

The Contractor shall maintain lawns and fence lines to achieve a uniform grass height and provide ATFP (Anti-terrorist force protection) standards.

Grass is uniform in appearance and is maintained to specify Capability Output Level in J-1503050-04.

Fences are free of vegetation.

A six foot clearance is maintained around perimeter fencing.

Lawns are healthy and present a uniform appearance and a rich natural color.

3.1.1.2 Edging

The Contractor shall maintain an edged cut to achieve a neat appearance.

Edging is uniform in appearance and vegetation does not encroach on ground structures.

3.1.2 Vegetation Control

The Contractor shall control undesired vegetation to ensure areas are free of undesired vegetation.

Areas are maintained clear of undesired vegetation.

3.1.3 Debris Removal

The Contractor shall remove debris to achieve a clean and neat appearance.

Areas when maintained are clear of debris.

3.1.4 Shrub and Hedge Maintenance

The Contractor shall trim shrubs and hedges to maintain a healthy, uniform, well-shaped appearance and to prevent interference with pedestrians, vehicular traffic, and building encroachment.

Trees present a healthy appearance.

Trees do not encroach on structures, pedestrian traffic, or vehicular traffic.

3.1.5 Plant and Plant Bed Maintenance

The Contractor shall maintain plants and Plant Beds to ensure a healthy appearance and to ensure there is no interference with pedestrians, vehicular traffic, and building encroachment.

Plants and Plant Beds are healthy and present a neat appearance.

Plants do not encroach on structures, Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1.6 Tree Maintenance

The Contractor shall provide tree maintenance and care to promote tree health and to prevent interference with pedestrian and vehicular traffic, and structure encroachment.

Trees present a healthy appearance.

Trees do not encroach on structures,

3.2 Storm Drainage Systems

The Contractor shall remove obstructions and control vegetation in storm drainage systems to permit unrestricted flow of storm water runoff.

No evidence of obstructions in the visible area of the drainage systems.

Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G. The order will specify the exact locations and types of work to be accomplished. The period of performance will be specified in each order.

Periods of performance (measured from the issue date of the order to work completion) have been met.

Work performed meets established expectations. Debris generated is removed and disposed of in accordance with requirements.

Establishment or warranty periods are confirmed.

Annex/sub-annex: 1503050 – Grounds Maintenance and Landscaping Month/Year:

Title AL 1 AL2 - AL3 VCC SAFETY QMS REVIEW

E M N E M N POS NEG ISSUES SAMPLES A U

3 Recurring Work

3.1 Improved Grounds

3.1.1 Lawn Maintenance

3.1.1.1 Mowing and Trimming

3.1.1.2 Debris Removal

3.1.1.3 Edging

3.1.1.4 Lawn Services

3.1.1.5 Weed Control

3.1.2 Vegetation Control

3.1.4 Shrub and Hedge Maintenance

3.1.5 Plant and Plant Bed Maintenance

3.1.6 Ornamental Tree Maintenance

3.2 Storm Drainage Systems

4 Non-recurring Comments:

Recommended Actions:

Technical Rating (Mark using X)

PAVEMENT CLEARANCE

1503060

PAVEMENT CLEARANCE FAP

A – Annually

Q – Quarterly

M – Once per month

BW – Once every 13-16 days

VCC – Validated Customer Complaints performance at AL1 or AL2 is Unsatisfactory

a. Note: Return to appropriate Assessment Level when performance improves.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1 Snow and Ice Removal Services

The Contractor shall provide snow and ice removal services to ensure paved surfaces are safe and passable.

Paved surfaces are safe and passable.

3.1.1 Snow and Ice Removal

The Contractor shall remove snow and ice to ensure designated paved surfaces are safe and passable.

Designated paved surfaces are safe and accessible to operations, fire protection, and vehicular and pedestrian traffic.

Snow removal equipment operators have proper qualifications and licensing.

Designated paved surfaces are safe for passage.

Snow/Ice removal begins at a two

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced inch accumulation or after an icing event such as a freezing thawing or a freezing rain event.

Areas are completed to specifications within 12 hours after the snow/ice event.

MSDS sheets sre submitted for deicing agents.

3.2 Deicing Material Container (Building

Occupant Use) The Contractor shall place, maintain and replenish Government provided deicing material, deicing materials containers, and scoops at designated locations to ensure sufficient deicing materials are available to building occupants

Deicing material is continuously available during the snow season.

Deicing material containers are in the proper location, and in a normal working condition.

Deicing material containers are secured at the end of the snow season.

Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G. The order will specify the exact locations and types of work to be accomplished. The period of performance will be specified in each order.

Performance Standards for Non-recurring work will be the same as those in Spec Item 3 where applicable

Annex/sub-annex: 1503060 – Pavement Clearance Month/Year:

Title AL 1 AL2 - AL3 VCC SAFETY QMS REVIEW

E M N E M N POS NEG ISSUES SAMPLES A U

3 Recurring Work

3.1 Snow and Ice Removal Services

3.1.1 Snow and Ice Removal

3.2 Deicing Material Container (Building Occupant Use)

4 Non-recurring Comments:

Recommended Actions:

Technical Rating (Mark using X)

FACILITY INVESTMENT

1502000

FACILITY INVESTMENT FAP

A – Annually

Q – Quarterly

M – Once per month

BW – Once every 13-16 days

VCC – Validated Customer Complaints performance at AL1 or AL2 is Unsatisfactory

Note: Return to appropriate Assessment Level when performance improves.

Note: The first method listed in the MOA column below is the primary assessment method.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1 Trouble Calls

The Contractor shall perform trouble call work in a timely manner and ensure facilities, ground structures, personal property equipment and installed equipment and systems are restored to a safe, normal working condition and function properly.

Trouble calls are completed within specified times.

Facilities, systems, and equipment are restored to normal working condition and function properly.

When repair is complete the facility, system or equipment does not present any hazard or danger to personnel.

3.1.1 Emergency Trouble Calls

The Contractor shall respond to emergency trouble calls and arrest emergent conditions to minimize and mitigate damage to facilities, ground structures, personal property equipment, installed equipment and

Emergency trouble calls are responded to within two hours of receipt of call.

Work is continued without interruption until emergent condition is mitigated.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced systems and danger to personnel.

3.1.2 Service Trouble Calls

The Contractor shall complete service trouble calls in a timely manner and ensure facilities, ground structures, personal property equipment, and installed equipment and systems are restored to a safe, normal working condition and function properly.

Service trouble calls are arrested within 48 hours of receipt of call.

Service trouble calls are completed within 5 calendar days.

3.2 Preventive Maintenance (PM)

Program The Contractor shall develop and implement a PM program for facilities, ground structures, personal property equipment, and installed equipment and systems to ensure proper operation, to minimize breakdowns, and to maximize useful life.

Maintenance is accomplished in accordance with the Contractor’s PM program and work schedule.

3.2.1 HVAC and Refrigeration Systems

The Contractor shall maintain HVAC and refrigeration systems to ensure proper operation, to minimize breakdowns, and to maximize useful life.

Maintenance is performed in accordance with Contractor's PM program and work schedule.

HVAC and refrigeration systems are set to and maintained to the mandated set point.

3.2.2 Interior and Exterior Lighting

Systems The Contractor shall perform maintenance on Interior and Exterior Lighting Systems to ensure proper operation, to minimize breakdowns, Maintenance is performed in accordance with Contractor's PM program and work

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced and to maximize useful life.

3.2.3 Boilers and UPVs

The Contractor shall perform maintenance on boilers, UPVs and associated equipment to ensure proper operation, to minimize breakdowns, and to maximize useful life.

Maintenance is performed in accordance with Contractor's PM program and work schedule.

All required certificates are current and complete.

3.2.4 Lightning Arrestors and

Grounding Devices The Contractor shall perform maintenance in accordance with applicable directives on lightning arrestors and grounding devices to ensure proper operation, to minimize breakdowns, and to maximize useful life.

Maintenance is performed in accordance

3.2.5 Fire Protection Systems

The Contractor shall perform maintenance on fire protection systems to ensure safe, reliable, uninterrupted fire protection service.

Maintenance is performed in accordance with Contractor's PM program and work schedule.

All required certificates are current and complete.

Repairs are made in a timely manner. Fire Panels are free and clear of errors

3.2.6 Plumbing Fixtures and drains

The Contractor shall maintain and repair all plumbing fixtures urinals and head fixtures and associated drains.

All drains are operating properly.

All faucets and flushometers and fully operational and not leaking.

All associated leaks are repaired including floor connections.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.2.7 Automatic Gate Operators

The Contractor shall perform prescriptive maintenance on the automatic gates at all centers.

The Gate and Automatic Openers are functioning in a safe and operational manner.

3.2.8 HVAC Water/Glycol Testing and

Treatment Services The Contractor shall provide and implement a HVAC water testing and treatment program to ensure optimum equipment operation and to maximize useful life.

Sampling and testing is accomplished in accordance with the OEM standards and completed on time. All water testing shall be identified in the Contractors PM Schedule.

Test results confirm that cooling or chilled water meets the chemical residual limits in accordance with the Contractor’s HVAC water testing and treatment program.

3.2.9 Boiler Seasonal Start-Up and

Shutdown The Contractor shall perform seasonal start-up and shutdown to ensure boilers are prepared and activated at the start of each season and deactivated and preserved at the end of each season.

Seasonal start-up work must be completed before heating is needed and shut down after the need for heat is complete.

3.2.10 Boiler Water Testing and

Treatment Services The Contractor shall provide and implement a boiler/HVAC water testing and treatment program to ensure optimum equipment operation and to maximize useful life.

Sampling and testing is accomplished in accordance with the Contractor's program and schedule.

Test results confirm that boiler water meets the chemical residual limits specified in Section 3120 of NAVFACINST 11300.37.

All water testing findings are sent in with the monthly maintenance reports for evaluation.

3.2.11 HVAC Seasonal Start-Up and

Shutdown The Contractor shall perform seasonal start-up and shutdown to

Maintenance is performed in accordance

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced ensure HVAC systems are prepared and activated at the start of each season and deactivated and preserved at the end of each season.

3.2.12 Oil Water Separators (OWS)

prescriptive maintenance on the Oil Water Separator located in Green Bay.

The OWS is fully operational at all times throughout the year.

The Contractor shall submit oils and solids findings to the KO after yearly oil removals in his monthly reports.

3.2.13 Garage Doors and Door Operators

prescriptive maintenance on Garage Bay Doors and Door Operators

All Doors and Operators operate safely and are fully operational.

The Contractor shall immediately inform the Center or the Marines if an unsafe or unoperational door or opener is identified.

3.3 Inspection, Testing, and

Certification Program The Contractor shall provide inspection, testing, and certification services to ensure they are safe, fully functional, and operational.

All certifications are current.

Testing, inspection, and certification services performed and completed in accordance with the inspection, testing, and certification program and schedule.

Testing, inspection, and certification services performed in accordance with applicable references.

3.3.1 Boilers and UPVs

The Contractor shall clean, prepare, and operate boilers and/or UPVs to support certification.

Testing, inspection, and certification of boilers and/or UPVs performed and completed in accordance with the Inspection, Testing, and Certification Program and Schedule.

Boilers and/or UPV’s are promptly returned to service upon issuance of certification.

Boilers and/or UPVs are prepared for inspection and certification in accordance with UFC 3-410-06 and UFC 3-430-07.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.3.2 Backflow Prevention Devices

The Contractor shall prepare, inspect, and test backflow prevention devices to ensure they are safe, fully functional, and operational.

Testing, inspection, and certification of backflow prevention devices performed and completed in accordance with the inspection, testing, and certification program and schedule.

Backflow prevention devices are certified in accordance with UFC-3-230-02, UG-2029- ENV, and OPNAVINST 5090.1..

3.3.3 Fire Protection Systems

The Contractor shall prepare, inspect, and certify all associated components of the Fire Protections System to ensure they are safe, fully functional, and operational.

The certifications are timely and complete.

The systems meet all requirements for State and Local and NAVFAC requirements.

3.3.4 Weight Handling Equipment

(WHE) The Contractor shall inspect, and certify all associated components of lifting and rigging equipment to ensure they are safe, fully functional, and operational.

The Contractor shall submit certifications with monthly PM reports as the equipment is certified.

Non-recurring Work Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G. The order will specify the exact locations and types of work to be accomplished. The period of performance will be specified in each order.

Required

R

Annex/sub-annex: 1502000 – Facility Investment Month/Year:

Title AL 1 AL2 - AL3 VCC SAFETY QMS REVIEW

E M N E M N POS NEG ISSUES SAMPLES A U

Recurring and Service Order Work

3.1 Service Orders

3.1.1 Emergency Service Orders

3.1.2 Urgent Service Orders

3.1.3 Routine Service Orders

3.2 Preventive Maintenance (PM) Program

3.2.1 HVAC and Refrigeration Systems

3.2.2 Interior and Exterior Lighting Systems

3.2.3 Boilers and UPVs

3.2.4 Lightning Arrestors and Grounding Devices

3.2.5 Fire Protection Systems

3.2.6 Plumbing Fixtures and drains

3.2.7 Automatic Gate Operators

3.2.8 HVAC Seasonal Start-Up and Shutdown

3.2.9 Boiler Seasonal Start-Up and Shutdown

3.2.10 Boiler Water Testing and Treatment Services

3.2.11 HVAC Seasonal Start-Up and Shutdown

3.2.12 Oil Water Separators (OWS)

3.2.13 Garage Doors and Door Operators

3.2.14 Injector Pit Maintenance

3.3 Inspection, Testing, and Certification Program

3.3.1 Boilers and UPVs

3.3.2 Backflow Prevention Devices

3.3.3 Fire Protection Systems

3.3.4 Weight Handling Equipment

(WHE)

4 Non-recurring

Recommended Actions:

Technical Rating (Mark using X)

PROPANE GAS SUPPORT

1503031

PROPANE GAS SUPPORT FAP

A – Annually

Q – Quarterly

M – Once per month

BW – Once every 13-16 days

VCC – Validated Customer Complaints performance at AL1 or AL2 is Unsatisfactory

Note: Return to appropriate Assessment Level when performance improves.

Note: The first method listed in the MOA column below is the primary assessment method.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.1 Propane Tank/Component

Installation The Contractor shall provide one 500 gallon, aboveground, propane fuel tank. The propane tank shall be connected to the existing underground supply piping

The propane tank is installed in the area designated by the activity, and connected to the existing propane supply piping.

3.2 Propane Delivery

The Contractor shall ensure the propane tank is periodically refueled such that propane is available to safely meet fuel service needs in a timely manner to support the activity’s mission.

Propane is available and provided in timely manner to prevent disturbance of facility operations.

The contractor submits a supply schedule within 15 days after award.

Performance Objective Performance Standard MOA Assessment Level Sample Size

Freq

AL1 AL2 AL3

UOM

(total)

Normal Reduced

3.3 Propane Tank Maintenance

The contractor shall inspect the supplied propane tank and connection lines/fittings to prevent safety and environmental concerns due to leaks, corrosion or failure.

The contractor properly maintains the propane tank to ensure there are no environmental or safety concerns.

All maintenance and repairs are completed in a timely manner that prevents any disturbance in service to the designated facility.

3.4 Propane Tank Component

Certification The Contractor shall Inspect the tank and all components of the propane tanks and ensure all necessary Certifications are current

All Certifications are kept current.

Keep records and provide them as requested.

All submittals are provided as per Section F.

All tanks are appropriately certified and comply with regulations.

Non-recurring work may be ordered utilizing DoD EMALL in accordance with Section H or on a task order in accordance with the PROCEDURES FOR ISSUING ORDERS clause in Section G. The order will specify the exact locations and types of work to be accomplished. The period of performance will be specified in each order.

Required

R

Attachment A

Annex/sub-annex: 1502000 – Facility Investment Month/Year:

Title AL 1 AL2 - AL3 VCC SAFETY QMS REVIEW

E M N E M N POS NEG ISSUES SAMPLES A U

3 FFP Work

3.1 Propane Tank Installation

3.2 Propane Delivery

3.3 Propane Tank Maintenance

3.4 Propane Tank/ Component Certification

4 Non-recurring Comments:

Recommended Actions:

Technical Rating (Mark using X)

Overall Technical Rating for Non-Recurring Work

PERFORMANCE ASSESSMENT WORKSHEET

ANNEX/SUB-ANNEX:

Attachment B

Attachment B: Performance Assessment Worksheet

PAW (Indicate Level) 1 2 3 Non-Recurring

CONTRACT NO: PAR NAME:

SAMPLE ID: DATE:

SAMPLE LOCATION:

SPEC ITEM / TO #: TITLE:

SAFETY ASSESSMENT: Issues found? No Yes (document details below)

COMMENTS: (Document findings/observations of how performance complies with contract requirements and detail any value-added or negative performance, and trends)

RATING:

(For AL-2/3) Acceptable Unacceptable

PAR (signature): DATE:

CONTRACTOR (signature): DATE: ______________

REWORK: Acceptable Unacceptable N/A

QMS EVALUATION: (Document effectiveness of contractor’s QMS to detect/correct negative performance and reverse trends. Attach QMS review checklist.)

QMS RATING: Acceptable Unacceptable N/A

PERFORMANCE ASSESSMENT RATING: (FOR AL-1 or Non-Recurring)

Exceptional Very Good Satisfactory Marginal Unsatisfactory

QUALITY MANAGEMENT SYSTEM

PRE-PERFORMANCE REVIEW CHECKLIST

Attachment C

Attachment C: QMS Pre-performance Review Checklist

GENERAL INFORMATION

NAME PHONE EMAIL

CONTRACTOR Project Manager CONTRACTOR Quality Manager

SUB-CONTRACTOR QC

SUB-CONTRACTOR QC

PERFORMANCE ASSESSMENT

REPRESENTATIVE (PAR)

SUPERVISORY PAR / COR

CONTRACT INFORMATION

TITLE:

Contract #: TO# LOCATION:

START: END: CONTRACT PRICE:

ACCEPTANCE OF CONTRACTOR’S QUALITY APPROACH DOES NOT LIMIT CONTRACTING

OFFICER FROM REQUIRING ADDITIONAL MEASURES IF PERFORMANCE IS UNACCEPTABLE.

QUALITY MANAGEMENT BRIEFING CHECKLIST

CHECKPOINT (Y/N) COMMENTS

QUALITY ORGANIZATION:

Is the QM plan submitted in accordance with Annex 0200000 and Section F requirements?

Is the Quality organization clearly identified (e.g., org chart) and a list of all Quality personnel provided?

Are the responsibilities of Quality personnel detailed and lines of authority explained (e.g., Quality staff and Quality Manager reports directly to Prime Contractor management)?

Are the training and qualification requirements for Quality staff specified and does the Contractor’s staff meet these requirements?

Does the Quality organization show relationship between the Prime Contractor’s Quality staff and Subcontractor’s management or Quality?

QUALITY APPROACH:

Is the QM plan current and specifically tailored for this contract?

Does the Contractor’s Quality Management System and management approach indicate a clear understanding of the contract requirements?

METHODS AND PROCEDURES FOR PERFORMANCE OF WORK:

Does the Contractor provide detail of their work planning and control to ensure first time quality?

This could include:

a. Proper selection and training of personnel

b. Tracking and verification of training and certification requirements

c. Work center supervisor/lead personnel oversight of work performance

d. Detailed SOPs and procedures for work requirements

e. Routine training and meetings

f. Selection procedures for subcontractors

g. Management control of subcontracted work

SURVEILANCE AND INSPECTION PROCEDURES:

Does the Contractor provide detailed procedure for the selection of samples (e.g., percentage of work inspected, process for selection of samples, in-process vs. completed work.)?

Does the QM plan detail procedures for the collection, recording, and analysis of inspection and surveillance results?

Does the QM plan include processes for utilization analysis of inspection and surveillance results to determine cause and implement corrective actions?

Does the QM plan provide a process for preventing recurrence of quality issues and continuous improvement of work performance?

Does the QM plan detail specific procedures for the oversight of subcontracted work or the review and analysis of subcontractor quality?

DOCUMENTATION AND RECORDS MANAGEMENT:

Does the Contractor have a process for the control and retention of Quality documentation and records?

Does the Contractor provide the controls in place to ensure all Quality records are documented, maintained reviewed and properly filed?

Does the QM plan have a process for the review of documentation for completeness, accuracy, and consistency?

(This may include management reviews or internal audit plan.)

Does the QM Plan provide a process for tracking and ensuring all submittal requirements are met?

COMMUNICATION WITH GOVERNMENT:

Does the QM plan address the level, format, and frequency of communications with the government? This could include:

a. Routine, yet informal communications between contractor, quality staff, and Government PARs

b. Established meeting requirements between Contractor Quality and/or management staff with Government PA and/or contracting personnel.

c. Progressive reporting and communication based on the frequency or severity of the issue being addressed (e.g., Quality staff to PAR, Quality Manager to SPAR/FSCM, Project Manager to PWO

d. Details of protocol for attendance at meetings required by contract, including partnering sessions.

REVIEW SIGNATURES

PAR:

DATE:

SPAR/COR: DATE:

CONTRACTOR QUALITY MANAGER: DATE:

CONTRACTOR PROJECT MANAGER:

SUBCONTRACTOR:

SUBCONTRACTOR:

CUSTOMER COMMENT RECORD

Attachment D

Attachment D: Customer Comment Record

CONTRACT NO:

DATE/TIME RECEIVED:

RECEIVED BY:

SOURCE OF COMMENT

ORGANIZATION: INDIVIDUAL: PHONE:

LOCATION:

SPEC ITEM: TITLE:

DETAILS OF OBSERVATION: (Provide specific details of the requirement observed.)

Comment Validation: Valid Non-valid

COMMENTS:

CONTRACTOR (signature): DATE:

REWORK: Acceptable Unacceptable N/A

QMS IN-PROCESS REVIEW CHECKLIST

Attachment E

Attachment E: QMS In-process Review Checklist

CONTRACT #: TITLE:

PAR NAME: DATE:

SPEC ITEM: TITLE:

QMS REVIEW CHECKLIST

If observed defects warrant evaluation of QMS, the initial review should be limited to the Spec Items and/or location where defects have been found. This process begins with Part A & B below.

CHECKPOINT (Y/N) COMMENTS

A. QUALITY SURVEILLANCE AND INSPECTION SCHEDULES

1. Is there a quality surveillance and inspection schedule?

Does it include:

a. Surveillance and inspections to be performed?

b. Frequency of surveillance and inspections?

2. Is there a current schedule?

3. Does the schedule reflect all contractual requirements?

4. Are the number and frequency of surveillance and inspections sufficient?

5. Do the schedules match the QM plan?

6. Is the schedule being followed?

B. DOCUMENTATION AND ANALYSIS OF QUALITY DATA

1. Are the results of all surveillance and inspections properly documented?

2. Are quality deficiencies properly resolved and tracked?

3. Is quality documentation of deficiencies analyzed for trends and root cause?

4. Is appropriate action taken or planned to prevent recurrence of quality issues?

5. Is there verification process to ensure corrective and preventative actions are effective?

6. Are appropriate continuous improvement plans in place and communicated to workforce?

Comments: (Document corrective actions taken or QMS changes being implemented. If QMS is unsatisfactory, document findings and rationale for additional review conducted below.)

If review conducted above identifies deficiencies in the Contractor’s QMS with insufficient planned corrective actions or QMS changes, or, if corrective actions and QMS changes planned during previous QMS reviews have been ineffective, then continue review with Parts C through F below.

CHECKPOINT (Y/N) COMMENTS

C. QUALITY MANAGEMENT PLAN

1. Is the written QM plan available on site?

2. Is the QM Plan current?

3. Does the QM staff meet the requirements designated in QM plan (in terms of staff provided and qualifications and training)?

D. WORK PROCESSES AND PROCEDURES

1. Are work instructions, processes and procedures documented?

2. Are work instructions, processes and procedures available and used by affected personnel?

3. Is there a process to communicate work instructions, processes and procedures throughout the project and organization?

4. Are training records properly maintained for employees who are performing the work?

E. SURVEILLANCE AND INSPECTION PROCESS

1. Does the documented surveillance and inspection system match the requirements of the QM plan?

2. Are surveillance and inspection forms used systematically that document both conformances and non-conformances?

3. Are the surveillance and inspection criteria linked to the performance objectives and standards of the contract?

4. Does the communication and follow-up on deficiencies follow the process detailed in the QM plan?

5. Is analysis performed on surveillance and inspection data to identify trends and opportunities for improvement?

6. Are there examples of process improvements based on surveillance and inspection data?

CHECKPOINT (Y/N) COMMENTS

F. CUSTOMER COMMUNICATION

1. Are required meetings being held and attended as scheduled?

2. Is there documentation of the meetings and associated follow-up activities, i.e. action registers, meeting minutes, agendas?

3. Is there proper response and tracking of issues identified by Government personnel?

4. Is there a written documentation of issues, e.g., complaint/compliments logs, registers, records?

5. Is there a system for correction of defects/problems to satisfy customers?

6. Is there an escalation procedure if defects/problems are not addressed satisfactorily?

Comments: (Document corrective actions taken or QMS changes being implemented. If QMS is unsatisfactory, document recommendation to move to a lower assessment level or take appropriate administrative action.)

QMS RATING: Acceptable Unacceptable N/A

REVIEW SIGNATURES

PAR:

CONTRACTOR QUALITY REPRESENTATIVE: DATE:

Attachment F

Attachment F: Contract Discrepancy Report (CDR)

CONTRACT DISCREPANCY REPORT

1. CONTRACT NUMBER

GOVERNMENT ACTION

2. TO (Contractor and Manager Name) 3. FROM (Name of Government Representative)

4. DISCREPANCY OR PROBLEM

5. CONTRACTOR NOTIFIED (Date, Time, Contact Name)

6. SIGNATURE OF CONTRACTING OFFICER 7. DATE

CONTRACTOR ACTION

8. TO (Contracting Officer) 9. FROM (Contractor)

10. CONTRACTOR RESPONSE (Cause, corrective actions to prevent recurrence. Attach continuation sheet if necessary.)

11. SIGNATURE OF CONTRACTOR REPRESENTATIVE 12. DATE

GOVERNMENT CLOSE OUT

13. GOVERNMENT EVALUATION (Acceptance, partial acceptance. Attach continuation sheet if necessary.)

14. GOVERNMENT ACTIONS (Payment deduction, cure notice, show cause, other.)

15. SIGNATURE OF CONTRACTING OFFICER 16. DATE

17. SIGNATURE OF REVIEWING OFFICIAL 18. DATE

FSC SAFETY ASSESSMENT CHECKLIST

Attachment G

Attachment G: FSC Safety Assessment Checklist

CONTRACT NO: PAR NAME:

SAMPLE ID: DATE:

SAMPLE LOCATION:

SPEC ITEM / TO #: TITLE:

SAFETY ASSESSMENT: Issues found? No Yes (indicate area of safety deficiency below)

Administrative

Issue No

Issue N/A

Is the Contractor staff knowledgeable of Activity Hazard Analyses (AHAs) and Occupational Risk and Compliance Plans and Programs related to the work performed?

Is the Contractor Site Safety Plan (AHA) on site?

Have all potential hazards been identified and appropriate controls implemented?

Are there Emergency Planning/Communication procedures in place?

Are there First Aid and CPR Trained personnel on site as required?

Safety Hazards

Issue No

Issue N/A

Safety Hazards Issue

No Issue

N/A

Chemical hazards/MSDS Accident Prevention (signs, tags, barricades, covers, etc)

Site Cleanliness (floor care, signage removal, etc)

Hot Work (Welding/Grinding)

Environmental Conditions (Heat/Cold stress, weather)

Fall Protection/Working at Heights (Ladder Safety, Scaffolding/Staging, Aerial Lifts, etc)

Lead Paint/Asbestos Slips, Trips, and Falls

Biological Hazards (Animals, insects, etc)

Personal Protective Equipment

(PPE)

Soil Disturbance Respirator Protection

Underground…