PWS ELEVATOR MAINTENANCE .docx

PERFORMANCE WORK STATEMENT (PWS)

ON-SITE ELEVATOR MAINTENANCE SERVICE FOR THE WAGNER HEALTH CENTER IN WAGNER, SOUTH DAKOTA.

BACKGROUND:

The Mission of the Wagner Health Center is to provide the best possible healthcare services to the patients on the Yankton Sioux Reservation in South Dakota. To meet this mission, WHC is requesting a base year plus four (4) one (1) year options, firm-fixed price, non-personal service contract to provide on-site elevator maintenance services for the Wagner Health Center.

OBJECTIVE:

The Wagner Health Center currently has one direct plunger hydraulic elevator. This elevator needs routine servicing, inspection and repair in accordance with applicable codes, standards and specifications. The elevator is also tied into the fire detection system and emergency power system.

SCOPE OF WORK:

The elevator is to be serviced regularly and inspected annually in accordance with ASME A17.2 – 2023. The contractor is expected to provide systematic and periodic maintenance that will meet the needs of the Wagner Health Center and result in reliable operation of the elevators.

PERIOD OF PERFORMANCE:

The period of performance of this contract consists of a base year and four option years, beginning on 01/01/2027 to 12/31/2027. The contract schedule is listed below.

Base Year: 01/01/2027 to 12/31/2027 Option Year 1: 01/01/2028 to 12/31/2028 Option Year 2: 01/01/2029 to 12/31/2029 Option Year 3: 01/01/2030 to 12/31/2030 Option Year 4: 01/01/2031 to 12/31/2031

PLACE OF PERFORMANCE:

Wagner Health Center 111 Washington AVE NW Wagner, South Dakota 57380

HOURS OF COVERAGE:

8:00am to 5:00pm Monday through Friday

Contractor will be authorized to perform the work under this purchase order during the time outlined above unless specifically requested by the Facility Manager. The Contractor will not be authorized to work on the equipment at any other times. The equipment cannot be made available at other times due to the nature of the mission at this facility.

Except for emergency calls, the contractor will not be authorized to fragment the work required under this purchase order. Contractor must ensure that work is scheduled in such a manner that when it is started it will be completed without interruption. Contractor’s personnel will not be permitted to leave the installation before completion of service to perform work required by service calls.

SPECIFIC REQUIREMENTS/TASKS

Contractor shall provide full maintenance, inspections and testing of the hydraulic elevator. Routine maintenance shall be made during the normal business hours, Monday through Friday from 8:00am to 5:00pm. Contractor shall notify the Facility Manager or his designee prior to commencement of providing services. Contractor shall utilize a written service receipt to record each visit. This receipt shall indicate date, hours on site, technician name, and elevator serviced. Type of service shall be recorded and shall include specific tasks completed. The receipt shall be signed by the Facility Manager or his designee and a copy shall remain with the Wagner IHS Healthcare Facility.

Contractor shall clean, adjust and lubricate the equipment and determine the nature and extent of any maintenance required to restore the elevator to satisfy service and, if conditions warrant, furnish and install parts as noted herein. All equipment, materials and installation shall conform to the American National Standard Safety Code for Elevators and Escalators, and NFPA 101 Life Safety Code (monthly operations of Fire Fighter’s Emergency Operations in elevator).

Additional work outside of the scope of this purchase order requires a price quote, purchase order, and scheduled start date prior to commencing work. The Government will not be obligated to pay for services performed outside of the scope of this purchase order without an authorized purchase order. Additional work may be bid competitively for cost effectiveness.

Contractor shall provide, along with bid package, proof of current service mechanics certification issued by the International Union of Elevator Constructors.

The contractor shall submit a written plan of action to the Facility Manager whenever unresolved problems re-occur on the same elevator the Wagner IHS Healthcare Facility requires an analysis of the corrective action required to resolve the problem.

Contractor shall provide, along with bid package, the name and telephone number of service technician who will be performing this purchase order work.

CLEANING, LUBRICATION AND ADJUSTMENT SERVICES – ROUTINE MAINTENANCE:

Contractor shall provide a complete checklist of services to be performed. The checklist shall meet or exceed ASME A17.2 – 2023 for Service, Maintenance, and Inspection of Hydraulic Elevators.

Contractor shall correct any observed deficiency. If additional work within the scope of this purchase order is needed, contractor will record additional work requirements on receipt and notify the Facility Manager or his designee. Contractor shall schedule additional work with the Facility Manager or his designee if the work cannot be performed during the visit, in which it was observed.

Contractor shall be on-site for the appropriate time necessary to properly complete scheduled routine maintenance. Time spent on callback service and at inspections does not qualify as time required for scheduled maintenance.

PARTS AND MATERIALS:

Contractor shall furnish necessary cleaning supplies, vacuum cleaner, etc.

Contractor shall furnish all lubricants, hydraulic fluid, cleaning supplies and tools necessary to perform the work described herein. All lubricants shall be as recommended by the manufacturer of the individual equipment.

Contractor shall not supply and replace fluorescent lamps for the light fixtures. Contractor shall not supply and replace floor covering on elevator car platforms.

EMERGENCY OR CALL BACK SERVICES:

Proper maintenance of the elevator should eliminate the need for emergency or call back services. It is the contractor’s responsibility to maintain the elevator including emergency or call back services. The contractor shall include in the total price for the contract the need for emergency or call back services for situations within the scope of the purchase order. If needed, emergency or call back services shall be completed during normal business hours. The contractor shall respond to emergencies as soon as possible or practical depending on the extent of the emergency.

The contractor shall provide hourly rates for services outside the scope of the purchase order.

RECORDS:

The contractor shall sign the log-in book in Maintenance upon arrival for each visit.

Contractor shall report to the Facility Manager or designee at the completion of each service and provide a written receipt of services performed that meets the record keeping requirements of ASME A17.2 – 2023. These receipts shall advise the government of any repair or part required which is not covered under this purchase order. The Wagner IHS Healthcare Facility shall provide a logbook in the elevator room for the contractor’s detailed maintenance and callback actions.

The contractor shall maintain a complete, orderly and chronological file including drawings, complete part lists and copies of all reports as required by these specifications. The contractor shall maintain a record of all callbacks and repairs. Records shall indicate any difficulty experienced and the corrective measures taken to eliminate the difficulties. This file shall be available for inspection upon request and a copy furnished to the Wagner IHS Healthcare Facility annually.

PRIVACY ACT & HIPAA:

The Contractor shall not maintain a system of records on Indian Health Service patients; however, the Contractor is bound by the Privacy Act of 1974 in that no information regarding patient prescription may be released to any unauthorized individual. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule is also applicable concerning patient prescription information.

GOVERNMENT FURNISHED PROPERTY/EQUIPMENT/INFORMATION:

None.

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

On-Site Elevator Maintenance Service Wagner Health Center, Wagner, South Dakota Issued: To be completed by the Contracting Officer Period of Performance: Base Year 01/01/2027-12/31/2027, plus four one-year option periods

1 INTRODUCTION

This Quality Assurance Surveillance Plan (QASP) establishes the Government procedures and documentation used to monitor contractor performance for the on-site elevator maintenance service at the Wagner Health Center. It is based on the requirements in the Performance Work Statement (PWS) for the facility's single direct plunger hydraulic elevator.

The QASP is a Government surveillance document. The contractor remains responsible for quality control and for performing all work in accordance with the contract. The QASP does not authorize changes to contract scope, price, terms, or conditions.

1.1 Purpose

The purpose of this QASP is to provide systematic methods for determining whether required elevator maintenance, inspection, testing, callback service, documentation, certifications, and corrective actions meet the performance requirements in the PWS. Surveillance results will support technical acceptance, contract administration, and performance history.

1.2 Scope

The contract requires full maintenance, inspection, and testing of one direct plunger hydraulic elevator at the Wagner Health Center, 111 Washington Avenue NW, Wagner, South Dakota 57380. Routine work is performed during normal business hours, Monday through Friday, 8:00 a.m. to 5:00 p.m., unless otherwise specifically requested by the Facility Manager. The elevator is also connected to the fire detection and emergency power systems.

The PWS requires regular servicing, annual inspection in accordance with ASME A17.2-2023, systematic and periodic maintenance, monthly operation of Fire Fighter's Emergency Operations in the elevator, callback/emergency service within scope, and complete service and maintenance records.

1.3 Goals and Objectives

Maintain reliable and safe operation of the elevator through systematic preventive maintenance, inspection, testing, cleaning, lubrication, adjustment, and repair.

Verify that work and materials conform to applicable elevator safety requirements identified in the PWS, including ASME A17.2-2023 and NFPA 101 requirements stated in the PWS.

Ensure required service visits and work performed are documented in written service receipts and facility logs.

Ensure observed deficiencies are corrected or promptly documented and coordinated with the Facility Manager when follow-on work is needed.

Ensure recurring unresolved problems are analyzed and addressed through a written plan of action.

Maintain traceable annual records of maintenance, callbacks, repairs, difficulties encountered, and corrective measures.

1.4 Performance Management Approach

Government surveillance will focus on results and evidence of contract performance. The COR and Facility Manager/designee will use service receipts, maintenance and callback logs, annual records, certifications, inspection/test documentation, direct observation, and contractor communications to determine whether requirements are met. Safety-critical and required-documentation events are subject to 100% inspection; recurring routine maintenance may be evaluated through periodic inspection and review of records.

1.5 Performance Management Strategy

The contractor is responsible for the quality of all work performed. The Government will evaluate completed work and required records against the PWS. When a deficiency is identified, the COR or Facility Manager/designee will document the condition and coordinate corrective action within the limits of delegated authority. Only the Contracting Officer may change contract scope, price, terms, or conditions.

2 ROLES AND RESPONSIBILITIES

2.1 Contracting Officer (CO)

The Contracting Officer retains authority to bind the Government and to modify the contract. Issues that could affect price, scope, terms, conditions, funding, or level of effort must be referred to the Contracting Officer.

2.2 Contracting Officer's Representative (COR)

The COR monitors technical progress, interprets the statement of work within delegated authority, performs technical evaluations and inspections/acceptance, and assists with resolution of technical problems. The COR documents surveillance findings and refers contractual matters to the Contracting Officer.

2.3 Facility Manager / Subject Matter Expert

The Facility Manager or designee coordinates access and scheduling, receives pre-service notification, signs service receipts, receives reports of deficiencies and additional work requirements, and supports technical surveillance of elevator service.

2.4 Contractor Representative

The contractor shall provide the name and telephone number of the service technician performing the work and proof of current service mechanic certification as required by the PWS. The contractor representative/technician is responsible for coordinating visits, documenting services, reporting deficiencies, and providing required corrective-action information.

3 IDENTIFICATION OF REQUIRED PERFORMANCE STANDARDS / QUALITY LEVELS

The performance requirements, standards, acceptable quality levels (AQLs), and monitoring methods are summarized in Attachment 1. Contract remedies, acceptance decisions, and any payment action remain subject to the contract and Contracting Officer authority.

3.1 QASP Changes

This QASP may be revised by the Government to improve surveillance effectiveness, provided that the QASP is not used to change the contractor's contractual obligations. Any change affecting contract requirements, price, terms, or conditions requires Contracting Officer action.

4 METHODOLOGIES TO MONITOR PERFORMANCE

4.1 Management Reviews and Reporting

The COR will review surveillance results and supporting documentation at a frequency appropriate to the activity. At minimum, required service receipts and logs should be reviewed as services occur, and the contractor's annual record file should be reviewed when furnished to the Wagner IHS Healthcare Facility.

4.2 Contractor Metrics

Performance will be tracked using objective contract evidence, including completion of scheduled maintenance, annual inspection/testing, service receipt completeness, callback history, recurring deficiencies, corrective actions, and maintenance records. Metrics are for surveillance and trend analysis and do not alter contract requirements.

4.3 Surveillance Methodology

The following methods are used in this QASP:

100% Inspection - used for annual inspection/testing, required service receipts, certifications, reported deficiencies, recurring-problem plans of action, and other safety- or documentation-critical requirements.

Periodic Inspection - used for recurring routine maintenance activities and condition of the elevator/equipment where continuous inspection is not practical.

Customer Input - used as corroborating information for reliability, responsiveness, professionalism, or service concerns.

Records Review - used to verify service receipts, facility logbook entries, callback/repair history, certifications, and annual record files.

4.4 Acceptable Quality Levels

AQLs are assigned in Attachment 1. Requirements tied to safety, annual inspection/testing, required records, and certifications are set at 100% compliance. Routine maintenance performance is expected to meet contract requirements at each scheduled service; documented deficiencies are evaluated based on correction, follow-up, and recurrence.

4.5 Communication

The contractor shall notify the Facility Manager or designee before commencing service, report at completion, and provide the required written service receipt. The COR and Facility Manager/designee may communicate technical findings to the contractor, but no Government representative other than the Contracting Officer may authorize a change to scope, price, terms, or conditions.

5 QUALITY ASSURANCE SURVEILLANCE AND DOCUMENTATION

5.1 Surveillance Process

Review the scheduled service event or requirement to be surveilled.

Observe work when appropriate and/or review the contractor's service receipt and facility log entry.

Compare the result and documentation with the applicable PWS requirement and Attachment 1 standard.

Record the result as Acceptable, Deficient, Not Observed, or Not Applicable.

For deficiencies, document the condition, date, supporting evidence, required follow-up, and resolution.

Escalate recurring, safety-related, unresolved, or contractual issues to the COR and Contracting Officer as appropriate.

5.2 Performance Monitoring and Scheduling

Routine maintenance is authorized during the PWS hours of coverage. Except for emergency calls, work is to be scheduled so that service is completed without interruption. Callback time and inspection time do not count as scheduled routine-maintenance time. The Facility Manager/designee will coordinate scheduling and facility access.

5.3 Government Property Administration

Not applicable. The PWS identifies no Government-furnished property, equipment, or information.

5.4 Surveillance Documentation

Surveillance documentation may include this QASP checklist, contractor service receipts, maintenance-room logbook entries, annual inspection/testing records, certification records, reports of deficiencies, recurring-problem plans of action, callback/repair records, and COR notes. Records should identify the requirement reviewed, date, surveillance method, result, deficiency if any, and follow-up action.

5.5 Resolving Performance Issues

When performance does not meet the PWS, the COR or Facility Manager/designee will document the deficiency and provide the contractor an opportunity to correct it. The PWS specifically requires a written plan of action when unresolved problems recur on the same elevator. Additional work outside the contract scope may not begin without an authorized purchase order and appropriate Contracting Officer action.

6 CONTRACTOR PERFORMANCE ASSESSMENT

Surveillance records developed under this QASP may support contract performance history and any required past-performance evaluation. The PWS expressly states that the Government assessment spreadsheet may be used as a record of contract performance history for evaluation in other acquisitions.

ATTACHMENT 1: PERFORMANCE REQUIREMENTS SUMMARY

ATTACHMENT 2: GOVERNMENT SURVEILLANCE / INSPECTION CHECKLIST

Use one checklist per observed/reviewed service event or records review. Mark A = Acceptable, D = Deficient, N/O = Not Observed, N/A = Not Applicable.

Date

Contract / PO

Technician

Reviewer

Departure Time

Overall Assessment: Acceptable / Deficient / Follow-Up Required Deficiencies / Required Follow-Up:

Reviewer Signature / Date: ____________________________________________ Facility Manager / Designee Acknowledgment (if applicable): ____________________________

ATTACHMENT 3: CONTRACTOR PERFORMANCE STANDARDS

ADMINISTRATIVE:

Contracting Officer’s Representative Designation

The designated COR for this contract is:

Dwight Josh Janis, COR Level 1

The COR is responsible for:

Monitoring the Contractor’s technical progress;

Interpreting the statement of work;

Technical evaluation as required;

Technical inspections and acceptance required by this contract; and Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.

Subject matter expert for this contract is:

Chad Zephier, Facility Manager Wagner Health Center

AUTHORITY:

No person other than the Contracting Officer has the authority to bind the Government with respect to this contract.

No action or omission of any government employee or representative other than the Contracting Officer shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

In no event shall any of the following be effective or binding on the Government or imputed to the Contracting Officer with respect to this contract:

An understanding or agreement between the Contractor and anyone other than the Contracting Officer; A purported modification or change order issued by anyone other than the Contracting Officer; A promise by anyone other than the Contracting Officer to provide additional funding or make payments; or An order, direction, consent, or permission from anyone other than the Contracting Officer to:

Incur costs in excess of a specified estimated cost, allotment of funds, or other ceiling; or Expend hours in excess of a specified level of effort.

INVOICE SUBMISSION AND PAYMENT:

The Contractor shall submit one invoice, monthly, for incurred charges related to on-site elevator maintenance services.

Invoice submission and payment: In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing, directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register, however, we encourage you to make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973- 3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov.

The Contractor shall include the following information on each invoice in accordance with the Prompt Payment Act (5 CFR Part 1315.9(b)):

Contractor/Vendor Name Mailing Address Telephone Number Tax Identification Number (TIN) Invoice Date and Number Purchase Order Number (in Block #3 of the OF-347 form) Data Universal Number (DUNS) Description of services provided, quantity, unit of issue, unit price, and total amount due