P09_PWS.docx

Department of Veterans Affairs Performance Work Statement Annual Medical Gas and Vacuum Evaluation/Source Evaluation The purpose of this contract is to establish an Annual Medical Gas and Vacuum Evaluation/Sources Evaluation contract. A contract shall be awarded for a base year (12 months) with four (4) potential annual option years to be exercised at the discretion of the government.

Location of Services:

West Haven VAMC 950 Campbell Ave West Haven, CT 06516 Scope of Work The Contractor shall provide all labor, specialized services, and travel necessary to provide an Annual Medical Gas and Vacuum Evaluation/Sources Evaluation contract. Services shall be provided during normal working hours between 7:00 AM to 4:00 PM EST, Monday through Friday. Service dates and times shall be coordinated between VA and contractor at the convenience of the government.

1. INLET/OUTLET EVALUATION (APPROXIMATELY 1500 OUTLETS)

Medical Gas Outlets/Inlets

· Complete inventory of all outlets/inlets shall be produced

· Area, floor & room numbers shall be identified

· Manufacturer/Model of outlets/inlets shall be identified

· Flow rate & gas concentration shall be tested on each available outlet

· Flow rate shall be tested on each available vacuum/WAGD inlet

· .45 micron filter sample shall be collected at one outlet in each critical care zone

· .45 micron filter sample shall be collected in 20% of non-critical care zones

· Pressure drop shall be tested once per zone

· Average flow rate in each zone shall be documented

· Pressure or Vacuum level shall be documented on each zone

· Mechanical integrity, adaptation shall be verified on each available outlet and inlet

· All leaks, missing parts or other relevant observations shall be noted Note: Evaluating Personnel shall not disconnect any patient care device that is actively providing gas or vacuum service to a patient.

2. Master Alarm Panels

· Locate each Master Alarm Panel

· List each individual existing signal as labeled on panel

· Identify all required signals that are missing

· Test button on each panel shall be activated

· Verify function of audible alert

· Note any nonfunctional LED’s or Lights

· Document Manufacturer/Model information

· Note number and blank modules & spare signals

· Provide documentation of all inspection results

3. Area Alarm Panels

· Locate each Area Alarm panel

· Test button on each panel

· Document manufacturer information

· Note gas, pressure displayed on panel

· Verify function of audible alert

· Provide documentation of all inspection results

4. Medical Gas Zone Valves

· Locate each medical gas zone valve

· Document manufacturer information

· Note pressure displayed on gauge

· Document valve type, size, gauge & indicated pressure

· Valves shall be checked for external leaks

· Identify rooms served by each valve to the extent possible during the Inspection process Source Evaluation

5. Medical Air Systems

· Visually inspect medical air system

· Compare system to current NFPA 99 standard

· Capacity

· Visually observe system for proper operation

· Document Manufacturer/Model information

· Verify intake piping location

· Check system components for leakage

· Provide documentation of all inspection results

6. Medical Gas Manifolds

· Visually inspect all medical gas supply manifolds

· Compare manifold to current NFPA 99 Standard

· Enclosure/Location

· Capacity

· Document Manufacturer/Model information

· Check cylinder connections for leakage

· Check manifold components for leakage

· Provide documentation of all inspection results

7. Medical Vacuum Systems

· Visually inspect vacuum system

· Compare system to current NFPA 99 standard

· Capacity

· Visually observe system for proper operation

· Document Manufacturer/Model information

· Verify exhaust piping location

· Provide documentation of all inspection results Interference to Normal Functions:

The contractor may be required to interrupt their work at any time as not to interfere with the function of the facility, including facility repair etc..

· In the event of an emergency, contractor services may be stopped and rescheduled at no additional cost to the Government.

Documentation:

Documentation shall be provided to West Haven Facilities Management Representative at the conclusion of the inspection and be maintained by the Facilities Management and the Vendor.