16T0084_att_01.pdf

Occupational Safety Department Prescription Safety Eyewear Statement of Work (SOW)

1.0 SCOPE.

This Statement of Work sets forth the requirements for prescription safety glasses for Occupational Safety operations at Naval Surface Warfare Center (NSWC). It is NSWC Crane’s intent to provide through an NSWC Crane managed Contract, a source for prescription safety eyewear that provides end-users with consistency and reliability in acquisition, ordering, dispensing, and of prescription glasses. The contractor is encouraged to implement best business practices from the commercial sector to enhance support operations and control costs as appropriate.

1.1 BACKGROUND.

This effort supports the Occupational Safety operations of NSWC Crane which is a tenant of Naval Support Activity (NSA) Crane. NSA Crane is located in south-central Indiana about 75 miles southwest of Indianapolis, IN and about 71 miles northwest of Louisville, KY. NSA Crane is a contiguous block of land (62,799 acres) within Martin, Greene, and Lawrence counties.

In accordance with OSHA standards, everyday use of prescription corrective lenses will not provide adequate protection against most occupational eye and face, hazards, so employees with corrective lenses must wear ANSI Z87.1 eye protection that incorporates the prescription into the design.

2.0 APPLICABLE DOCUMENTS.

The documents listed in this section are applicable to this SOW. While every effort has been made to ensure the completeness of this list, document users are cautioned they must meet all specified requirements documents as cited in this SOW, whether or not they are listed. In the event of conflict between the documents referenced herein and the contents of the SOW, the contents of the SOW shall prevail:

- ANSI Z87.1 (USA Standard for Occupational and Educational Eye and Face Protection)

- OPNAVINST 5100-23G Navy Occupational Safety and Health Program

- CNRMW NOTE 1050 Observed Holidays and Closed Days

- NSACRANEINST 5510.1

- NAVWPNSUPPCENINST 5910.1

- SECNAVINST5370.2J

- NSA CRANE INSTRUCTION 5100.13

- SAFETY EYEWEAR AUTHORIZATION FORM

3.0 REQUIREMENTS.

The contractor shall be responsible for providing all materials, manpower, on-site visits and any other items necessary to support this Prescription Safety Eyewear program. Due to the remote location of the NSA Crane facility, it is not practical for the Navy to send employees to an optometric facility to obtain these services. The contractor shall provide onsite prescription safety eyewear support including the review of safety eyewear prescriptions provided by the employee’s outside optometrists, the placement of orders for ANSI Z87.1 certified prescription safety eyewear through a qualified laboratory, the fitting and adjustment of eyewear as needed and the dispensing of safety eyewear to the end user at the NSA Crane facility. The contractor may propose a schedule for services that fits this situation. Employees request safety glasses on an as needed basis. The service level may fluctuate from month to month. The contractor’s schedule must account for a 15 day turn-around time. This time starts from the time the contractor receives the delivery order and ends once the employee has a valid prescription and selected safety glasses have been fitted for the employee.

Prescription safety glasses repair services are not a requirement of this contract. The contractor may include repair costs in their proposal for consideration if they wish.

The contractor shall specify the method they will use to meet this requirement.

Contractors that wish to use space in a Navy owned facility, coordinate delivery and scheduling of safety glasses with a Navy employee or in any other way expect the support of Navy facilities or personnel in the accomplishment of this contract will make that wish clear in their proposal.

The contractor shall coordinate with subcontractors, lab services and all parties involved to ensure invoices, order forms and all applicable back-up documentation are placed into the Wide Area Workflow (WAWF) government invoicing system – https://wawf.eb.mil for processing.

3.1 PRESCRIPTION SAFETY EYEWEAR

3.1.1 Safety Glasses

The signed Safety Eyewear Authorization form will be used by the contractor to identify when prescription safety glasses may be dispensed.

Only frames with non-detachable side shields will be supplied by the contractor.

The awardee shall make an array of ANSI Z87.1 approved frames and the following approved lenses available for selection:

https://wawf.eb.mil/

Single Vision

Includes ANSI Z87.1-safety glasses with single vision Polycarbonate lens, frame*, permanent side shields, and a carrying case.

Multifocal (i.e. bifocals and trifocals)

Includes ANSI Z87.1-safety glasses with a multifocal Polycarbonate lens, frame*, permanent side shields, and a carrying case.

Progressive Includes ANSI Z87.1-safety glasses with progressive Polycarbonate lens, frame*, permanent side shields, and a carrying case.

*Multiple frames options are acceptable and shall be identified separately by category.

3.1.2 Safety Glasses Accessories

identify when safety glass accessories may be dispensed.

The contractor shall make only the following ANSI Z87.1 approved accessories available for selection:

Cable temples Tints Transition lenses Polycarbonate lenses Roll and/or Polish edges of lenses Scratch resistance/Hard coating Ultraviolet protection (required for tinting or other outdoor use) Sun-Clip Clip-on Sunglasses Sun Clip – Polarized Lens clip on Anti-reflective coating Security strap

3.1.3 Prescription Lens Inserts for Respirators

identify when prescription lens inserts may be dispensed. The authorization form will specify the full face respirator manufacturer and model. The contractor will supply the appropriate frames and lenses for that respirator.

The contractor shall make the following ANSI Z87.1 approved lenses available for selection.

Single Vision Includes ANSI Z87.1 single vision, Polycarbonate lens

Multifocal (i.e. bifocals and trifocals)

Includes ANSI Z87.1 multifocal Polycarbonate lens

Progressive Includes ANSI Z87.1 progressive, Polycarbonate lens.

3.1.4 Prescription Chemical Goggles

identify when prescription chemical goggle may be dispensed. The authorization form will specify the type of chemical goggles requested, vented, non-vented, etc.

The awardee shall make ANSI Z87.1 approved chemical splash goggles and the following ANSI Z87.1 lenses available for selection:

Single Vision Includes ANSI Z87.1 single vision, Polycarbonate lens

Multifocal (i.e. bifocals and trifocals)

Includes ANSI Z87.1 multifocal, Polycarbonate lens

Progressive Includes ANSI Z87.1 progressive, Polycarbonate lens.

3.2 ORDER TRACKING AND DELIVERY.

3.2.1 Supervisor Approval – Employees requesting prescription eyewear will provide a signed Safety Eyewear Authorization form, from their supervisor; approving prescription eyewear.

3.2.2 Order forms shall contain employee name, department code and cost. No Personally Identifiable Information (PII) shall be gathered.

3.2.3 Any dispensing fee(s) shall be added to individual orders. No lump sum dispensing fee(s).

3.2.4 The Contractor shall issue the specified eyewear to government employees listed on Safety Eyewear Authorization form. The form must be completely filled in before it is accepted by the Contractor. The Supervisor’s signature, the printed name and the signature of an employee of the Occupational Safety office is required for eyewear and accessories listed in sections 3.1.1 to 3.1.4 of this SOW. The Contractor shall provide a receipt for each government employee. Each receipt is to list the government employee’s name, item number, price (to include dispensing fee), quantity and the employee’s NSWC department code that the employee will provide on the Safety Eyewear Authorization form. The employee will sign and date the Safety Eyewear Authorization form confirming that their eyewear was received.

3.2.5 Delivery – All orders are to be delivered within 15 days of receipt of delivery order.

4.0 SPECIAL CONDITIONS.

4.1 Technical Point of Contact

Christine Freeman christine.freeman@navy.mil

(812) 854-4423

Steve Mehay steve.mehay@navy.mil

Jennifer Kinder jennifer.kinder@navy.mil

4.2 Control of Contractor Personnel

The Contractor shall comply with the requirements of NSACRANEINST 5510.1 and NAVWPNSUPPCENINST 5910.1. All persons engaged in work while on Government property shall be subject to search of their persons (no bodily search) and vehicles at any time by the Government, and shall report any known or suspected security violations to the NSA Crane Force Protection Department. Assignment, transfer, and reassignment of Contractor personnel shall be at the discretion of the Contractor. However, when the Government directs, the Contractor shall remove from performance any person who endangers life, property, or national security through improper conduct. All Contractor personnel engaged in work while on Government property shall be subject to the Standards of Conduct contained in SECNAVINST 5370.2J. Prior to conducting work under this contract, the contractor shall provide a list of employees that will be working on site. The employee list shall contain full names, security clearance levels, social security numbers, job titles, and original birth certificates. This list shall be updated within forty eight hours after changes occur.

4.3 Identification Badges

The Contractor shall be required to obtain identification badges from the Government for Contractor personnel who will be repeatedly accessing Government property to fulfill requirements. The identification badge shall be visible at all times while employees are on the requiring activities property. The Contractor shall furnish all requested information required to facilitate issuance of identification badges and shall conform to applicable regulations concerning the use and possession of the badges. The Contractor shall be responsible for ensuring that all identification badges issued to Contractor employees are returned to the NSA Crane Force Protection Department within forty eight hours following the completion of all delivery order under this contract, relocation or termination of an employee issued an identification badge, or upon request by the Contracting Officer.

mailto:christine.freeman@navy.mil mailto:steve.mehay@navy.mil

4.4 Smoking Regulations

Smoking on Government property shall be in approved areas only in accordance with NSA CRANE INSTRUCTION 5100.13. Smoking in vehicles is prohibited.

4.5 Hours of Operation

4.5.1 Closed Days. All closed days will be designated by the Commanding Officer, NSA Crane. Closed days will be associated with holidays, National Security and/or inclement weather/dangerous conditions. The Contractor will not be allowed to work on board NSA Crane during designated closed days, unless they are deemed to be essential personnel. Essential personnel will be identified by the Government, and communicated to the contractor prior to the designated closed day, and will be authorized by Contracting Officer.

4.5.2 Inclement Weather. When the Government Agency is closed by the Commanding Officer because of inclement weather conditions and/or dangerous conditions, notification of the closing will be broadcast over local radio and television stations.

4.5.3 Holidays. A list of Government Agency observed holidays and/or closed days in conjunction with holidays will be published at the beginning of each calendar year. Contractor employees will not be allowed to work on Government property on a holiday and/or closed day unless they are deemed to be essential personnel. The contractor is advised that access to the Government installation may be restricted on these holidays:

New Year’s Day Birthday of Martin Luther King, Jr.

Washington’s Birthday Memorial Day Independence Day Labor Day Columbus Day Veteran’s Day Thanksgiving Day Christmas Day

Holidays occurring on Saturday will be observed the proceeding Friday. Those occurring on a Sunday will be observed the following Monday.

4.6 Information Non-Disclosure

The contractor shall not disclose any information provided or developed under this Contract outside the Government without prior approval from the Government.

NSWCCRANEINST 5100.1A

26 DEC 2013

20-6

REQUEST PRESCRIPTION GROUND SAFETY EYEWEAR FOR EMPLOYEE BY FILLING IN ALL BLANKS BELOW.

SEND ONE COPY TO MEDICAL, BLDG. 2516

EMPLOYEE NAME:

SOC. SEC. NO. (Last Four ONLY):

DATE OF BIRTH (MM/DD/YYYY):

DEPARTMENT/ORG CODE:

BUILDING NUMBER:

PHONE:

OCCUPATION:

UIC (Check One):

NSWC NAVFAC Army

FISC DRMO EOD

SHIFT: FIRST

SECOND

THIRD

WORKS IN EYE HAZARDOUS AREA: FULL TIME

PART TIME

DOES EMPLOYEE NOW WEAR CORRECTIVE GLASSES? YES NO

IF YES, ARE THEY PRESCRIPTION SAFETY GLASSES? YES NO

IF WEARING GLASSES, WHAT WAS THE DATE OF LAST EYE EXAM?

ENSURE A COPY OF THE PRESCRIPTION (NO MORE THAN ONE YEAR OLD) IS ATTACHED TO THIS FORM

DOCTOR’S NAME:

REMARKS: SPECIAL REQUIREMENTS FOR SAFETY EYEWEAR MUST BE STATED AND JUSTIFIED BY THE SUPERVISOR. (STYLE TM6 CAN ONLY BE REQUESTED IF THE EMPLOYEE IS A FULL TIME WELDER.)

SUPERVISOR NAME:

DIVISION MANAGER NAME:

SUPERVISOR SIGNATURE:

DIVISION MANAGER SIGNATURE:

DATE SUBMITTED:

Appendix B

Prescription Safety Eyewear Request Form (R)

DATE SUBMITTED: