PERFORMANCE WORK STATEMENT.pdf

PERFORMANCE WORK STATEMENT(PWS) FOR

Occupational Medical Examination and Laboratory Services 6Aug2025

1.0 General: This requirement is for non-personal health care services contract to perform Occupational Health Medical Surveillance Exams and Laboratory Support Services in accordance with the Occupational Safety and Health Administration (OSHA) and other Department of Defense (DoD) regulations.

The contractor(s) will be required to provide preplacement, baseline, periodic, fit for duty, exposure, respiratory medical clearance and exit exams as required by OSHA law and DoD regulation to Federal Employees of the CAARNG. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. The key personnel selected for contract service shall be accountable solely to the Contractor who, in turn is responsible to the Government. The Government will evaluate the quality of high level professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered.

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary to perform Federal Employee Medical Surveillance Examination and laboratory Services, as defined in this PWS. The contractor(s) is to work with the CAARNG Occupational Health Office (CAOHO) and its staff to develop a screening plan, coordinate schedules of exams and provide results for each employee identified and enrolled in Medical Surveillance IAW 29 CFR 1910 and DoDI 6055.05M and facilitate the implementation and the progress toward the established plan.

1.1.1 Objectives: Contractor(s) shall conduct all portions of exams and laboratory services for federal employees on day of appointment between the times of 7:00 a.m.

through 4:00 p.m.

1.2 Background: The Occupational Medical Examination and Laboratory Services is a statutory federal requirement to monitor the health of federal employees exposed to toxic workplace hazards utilizing Occupational Medical Examinations and Laboratory Services.

The exams will be given to an estimated 425 CAARNG federal employees annually identified by the CAOHO. The number of projected federal employees to be tested may change due to military related obligations. The contractor shall only charge per test and quantity of services rendered. Invoicing is by CLIN number based on the number of tests completed.

1.3 Period of Performance (PoP): The Period of Performance shall be 1 Base Year of 12 months and four (4) 12-month option years.

1.4 General Information:

1.4.1 Place and Performance of Services: The contractor shall provide services between the hours of 7:00 am through 4:00pm, Monday-Friday, except on recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. The contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS.

When hiring personnel, the contractor should keep in mind that the stability and continuity of the work force are essential. Below are the recommended zones provided by CAOHO. The requirement is at least one clinic per zone (North, East, West, and South), located in one of the CA counties within that zone, at a minimum, will be required to perform the services required under this contract.

Zones by CA County for clinics Zone 1 (North)

Zone 2 (East)

Zone 3 (West)

Zone 4 (South)

1.4.1.1 Telework:

The Government does not permit the contractor to telework in support of this requirement. In furtherance of Continuity of Operations Planning (COOP), a telework program may be enacted to ensure that the Government's mission-critical operations stay operational during times of national emergency or incidents of national significance. Telework shall be at no additional cost to the Government.

1.4.1.2 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented.

Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.1.3 The contractor’s employees shall become familiar with and obey the regulations of the installation, including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contract employees shall always carry proper identification with them and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders for the installation, which may affect performance. The Government reserves the right to direct the removal of an employee from Government property or revoke access to Government systems for misconduct, security reasons, or any overt evidence of communicable disease. Removal of contractor employees for reasons stated above does not relieve the Contractor from responsibility for total performance of this contract.

1.4.2 Recognized Holidays: The following are recognized United States (US) holidays. The contractor shall not perform services on these days:

1.4.2.1 New Year’s Day

1.4.2.2 Martin Luther King, Jr.’s Birthday

1.4.2.3 President’s Day

1.4.2.4 Memorial Day

1.4.2.5 Juneteenth National Independence Day

1.4.2.6 Independence Day

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.9 Veteran’s Day

1.4.2.10 Thanksgiving Day

1.4.2.11 Christmas Day

1.4.3 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is how it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary (PRS). A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after the contract award. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

1.4.4 Quality Assurance (QA): The Government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government will do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) or defect rate(s).

1.4.5 Installation Access and Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR.

The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services, or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DoD), Headquarters Department of Army (HQDA) and/or local policy (see PWS 6.0). Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.5.1.4 The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a Government computer network. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.

1.4.5.1.5 For contractors that do not require a CAC, but require access to a DoD facility or installation:

Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05), and applicable installation, facility and area commander installation/facility access, and local security policies and procedures (provided by a Government representative).

1.4.5.1.6 Awareness Training (AT) Level 1: All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, and controlled access areas shall complete AT Level 1 training within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor submit certificates of completion for each affected contractor and subcontractor employee to the COR within 30 calendar days after completion of training by each employee or subcontractor personnel. AT Level 1 awareness training is available at the following website: https://jko.jten.mil/courses/atl1/launch.html.

1.4.5.1.7 iWATCH Training: The contractor and all associated subcontractors with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program (training standards provided by the requiring activity Antiterrorism Officer (ATO)). This local developed training shall be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of the contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each contractor employee and subcontractor employee to the COR, within 30 calendar days after completion of training.

https://jko.jten.mil/courses/atl1/launch.html

1.4.5.1.8 Protection of Personally Identifiable Information (PII). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

1.4.5.1.9 OPSEC Training: In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each contractor employee to the COR within 30 calendar days after completion of training. Level 1 OPSEC training is available at https://securityawareness.usalearning.gov/opsec/index.htm.

1.4.5.1.10 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

1.4.5.1.11 Special Qualifications: Special Qualifications: The contractor shall ensure all employees possess license, certification, or registry in accordance with applicable State laws and regulations to perform physical examinations 49 CFR § 391.43 – Medical Examination; Certificate of Physical Examination. Providers must be trained in or have experience with occupational medicine to conduct job-related medical surveillance examinations. All contracted personnel must be informed and knowledgeable on DoD 6055.05M and OSHA Standards that relate to respective exams of hazard exposures. Those performing audiograms must be certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC) or who has satisfactorily demonstrated competences in administering audiometric examinations. Those performing spirometry testing must be certified through an approved NIOSH training course. Those performing laboratory functions such as blood draws, and urine collection must be certified through American Society for Clinical Pathology (ASCP). This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information. This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information.

(NOTE: The Government does not provide training to contractors. Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified, and otherwise qualified to provide services.)

1.4.5.1.12 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will appraise the contractor of how the Government views the contractor’s performance and the contractor appraises the Government of problems, if any, being experienced. The contractor shall resolve the outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.5.2 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when https://securityawareness.usalearning.gov/opsec/index.htm the CM is absent, shall be designated in writing to the KO. The CM or alternate shall have full authority to act for the contractor on all contract matters relating to the daily operation of this contract. The CM shall work through the COR to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by KO.

The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.6 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor should ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non- Government entities. Contractor personnel wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed.

1.4.7 The contractor shall retrieve all identification media (including vehicle passes) from its employees who depart employment for any reason. The contractor shall return all identification media (i.e., badges and vehicles pass) to the KO within 14 days of an employee’s departure.

1.4.8 Combating Trafficking in Persons: The United States Government has adopted a zero-tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.

1.4.9 Contractor Travel

The contractor shall travel or provide services to specific locations within California during the performance of this contract to perform Occupational Medical and Laboratory Services.

The contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires COR recommendation for approval and/or authorization by the KO prior to travel arrangements being made.

1.4.10 Data Rights: The Government has unlimited rights to all documents/materials produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose.

This right does not abrogate any other Government rights.

2.0 Definitions and Acronyms:

2.1 Definitions:

2.1.1 Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the Government. The term used in this contract refers to the prime.

2.1.2 Defective Service: A service output that does not meet the standard of performance associated with

PWS.

2.1.3 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.4 Key Personnel: Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the people that are listed in the proposal.

2.1.5 Physical Security: Actions that prevent the loss or damage of Government property.

2.1.6 Quality Assurance: The Government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.7 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.8 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of a product or service shall meet contract requirements.

2.1.9 Subcontractor: One that enters a contract with a prime contractor. The Government does not have a contract with the subcontractor.

2.2 Acronyms:

ADA Americans with Disabilities Act AEI Army Enterprise Info structure AR Army Regulation

As Arsenic ASCP American Society for Clinical Pathology AT/OPSEC Antiterrorism/Operational Security BI Background Investigation CAOHC Council for Accreditation in Occupational Hearing Conservation CAOHN California Occupational Health Nurse CAOHO California Occupaional Health Office CBC with Diff Complete Blood Count with Differential Cd Cadmium CM Contract Manager CMP Comprehensive Metabolic Panel COR Contracting Officer Representative DA Department of the Army DD254 Department of Defense Contract Security Classification Specification DFARS Defense Federal Acquisition Regulation Supplement DoD Department of Defense FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services Hg Mercury H&P History, physical and mental information that would affect work HIPPA Health Insurance portability and Accountability Act HQDA Headquarters, Department of the Army HSPD Homeland Security Presidential Directive HSS Health System Services IA Information Assurance IS Information System(s) IMR Individual Medical Requirements JFHQ Joint Forces Headquarters KO Contracting Officer MEDPROS Medical Protection System MODS Medical Operational Data System NGB National Guard Bureau NIOSH National Institute for Occupational Safety and Health OCI Organizational Conflict of Interest OHN Occupational Health Nurse OSHA Occupational Safety and Health Administration Pb Lead PFT Pulmonary Function Test PII Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program SCR Service Contract Reporting

SSN Social Security Number TE Technical Exhibit USD (I) Under Secretary of Defense for Intelligence ZPP Zinc Protoporphyrin

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S): The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1 Property: None

3.1 Materials: None

3.2 Equipment: None

3.3 Services: None

3.4 Utilities: All utilities in the facility will be available for the contactors’ use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

4.3 Contractor Security Clearance: None

5.0 Requirements: The contractor shall:

5.1 The contractor shall provide all management. Labor, material, equipment, certifications and supplies necessary to provide all listed services. The contractor shall be a business entity of the sort that can legally exercise ownership and/or control of persons/employees that are licensed/registered and credentialed to practice medicine and/or conduct physical examinations in accordance with all legal and regulatory requirements in the State of California.

5.1.1 The contractor shall ensure that the provider has a facility with an exam room. The contract provider will have the appropriate tables, exam equipment, and supplies available to conduct a thorough exam according to Occupational Medical Surveillance standards per job code and description. The contractor's provider’s clinics or laboratory workplaces must be sanitary, orderly and neat in appearance, abiding by good infection control practices.

5.1.2 Contractor's instrumentation shall meet or exceed appropriate performance standards and accuracy must be verified IAW current Occupational Medicine Certification standards. In the event of the Contractor’s equipment failure, specific testing and/or parts of examinations that are not completed during the testing period shall be completed at a scheduled time mutually convenient for the Contractor and the CAARNG. Unfinished testing/examinations will be completed at no additional cost to the Government. The Contractor shall be directly responsible to cover costs for completing these examinations.

5.1.3 Contractor shall ensure each healthcare worker complies with Federal, State of California, local laws as well as OSHA Law & Regulations 29 CFR 1910.

5.1.4 The contractor shall provide preplacement, baseline, periodic, fit for duty, exposure, respiratory medical clearance and exit exams as required by OSH Act of 1970. The contractor shall be compliant with ADA, ASCP, HIPAA, NIOSH, OSHA, and Privacy Act. Medical written clearance shall be provided in the memorandum format on the Clinic’s letterhead. TOHO will provide the list of service exams by job function to the contractor.

5.15 The contractor shall provide the following services: Physical exams; Standard Components Series: Height & Weight, Vital Signs, & Audiogram; Vision/Ocular Testing: Vision, Color vision, Depth Perception and Field of Vision & Labs. See 5.1.5.1 for a more comprehensive list of services to be provided. The CAOHO will provide a field of work and name of individuals scheduled for exams to determine what tests are to be processed. Medical exam components are listed below.

5.1.5.1 The contractor shall perform an Exam on every federal employee which shall consist of some or all of the following exam components:

CLIN TESTS/ EXAM Standard Components Series

Quantity (Estimate) Number of Tests/Exams per year 0001 Audiogram test 425 0002 Physical Exam (This includes Height &

Weight; Vision (all components); Vital Signs (BP, Pulse, Resp, Pulse Oximetry

0003 Urinalysis test 425 0004 Comprehensive Metabolic Panel 425 0005 CBC w/ Diff 425 0007 Lead & ZPP test 287 0008 Blood Cadmium test 65 0009 Urine Cadmium test 65 0010 Urine Beta 2 Microblobuin test 10 0011 Blood Urea Nitrogen/Creatinine Test 20 0012 Hexavalent Chromium VI 3 0013 PFT Spirometry 243

0014 Respiratory Fit Test 243 0015 Respiratory Clearance 243 0016 Venipuncture 425 0017 Urine Collection 425 0018 Scheduling 425

0019 EXAMQA 425

5.1.5.2 Initial Coordination: The contractor will make appointments for federal employees. CAOHO shall also provide a written authorization to request exams and inform the contractor of each exam component and test. Any applicable job descriptions, medical history, or questionnaires(s) will be provided by CAOHO to the clinic after coordination of appointments. Federal employees who fail to report to scheduled appointments will be reported to CAOHO immediately. Rescheduling appointments shall be made through CAOHO.

5.1.5.3 The Contractor shall indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance. The Contractor is required to ensure that its subcontractors, if any, for provisions of health care services, contain the requirements of the FAR 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance as prescribed in FAR 37.403 contract clause. Contractor shall ensure all clinical laboratory/chemistry services are performed by a laboratory licensed through the U.S.

Department of Health and Human Services (DHHS), Health Care Financing Administration pursuant to the terms of the Clinical Laboratories Improvement Act of 1967 (42 U.S.C. 263a) and the College of American Pathologists.

5.1.5.4 The Contractor will inform patients on findings and provide wellness education.

5.2 The Contractor shall notify CAOHO of any abnormal clinical findings on specimens that indicate the possibility of a present danger to the employee. These results will be reported within 24 hours, not to exceed 72 hours to the CAOHO at 916-854-1422 and via email to the COR.If abnormal findings are due to a contractor error, the exam will be repeated at no additional charge.

5.2.1 The contractor shall notify the employee both verbally, and in writing, (within 7 days) if there is abnormality in the exam or laboratory results and recommended medical follow-up. Any non-work-related abnormality should include written recommendations for follow-up.

Complete written reports and diagnostic testing results will be administratively organized and provided to the TOHO via electronic portal. Electronic medical results will be posted within 30 days of the post event, results will be available for the entire contract period and within 365 days after the end of contract. The contractor shall present reports for PFTs that include both graph and data IAW National Health and Nutrition Examination Survey III (NHANES III) Reference Values. Any excel spreadsheets of results, respirator clearances, heavy metal clearances abnormal findings, hearing results with STS and OSHA reportable/recordable notification, vision results with those that need follow-ups, any medical limitations from the functional capacity exam. Access to the repository will be made available to the COR within 30 days of contract award.

The Contractor shall report the required information annually by October 31, for services performed under this contract during the preceding Government fiscal year (October 1-September 30).

The DoD Guidebook for Service Contract Reporting in SAM, available on the DoD Procurement Toolbox at https://dodprocurementtoolbox.com/site-pages/service-contract-reporting-scr. The General Services Administration (GSA) has also posted additional guidance such as quick start guides, informational videos, and frequently asked questions, that can be accessed by going to https://sam.gov and searching the “HELP” section. The SAM Federal User Guide is also available in the “HELP” section for comprehensive instructions on navigating SAM. Contractors requiring assistance using SAM should contact the Federal Service Desk at https://www.fsd.gov.

https://dodprocurementtoolbox.com/site-pages/service-contract-reporting-scr https://www.fsd.gov/

6.0 Applicable Publications: Publications applicable to this PWS are listed below:

Publication

(Chapter/Page) Date of

Publication Mandatory or Advisory

Website

29 CFR 1910.1030, Bloodborne Pathogens

18 January

Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030

29 CFR 1960, Federal Employee Occupational Safety & Health

Programs

5 July 1995 Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1960

5 CFR 339, Medical Qualification Determinations for Federal

Employees

18 Jan 2017 Mandatory https://www.law.cornell.edu/cfr/text/5/part-339

5 CFR 293, Federal Employee Medical File System

9 Nov 1979 Mandatory https://www.law.cornell.edu/cfr/text/5/293.504

DoDI 6055.1, Safety & Occupational Health Program (SOH)

14/10/2014 Mandatory https://www.esd.whs.mil/Portals/54/Documents/DD/is suances/dodi/605501p.pdf

DoDI 6055.05M, DoD Medical Surveillance Program

11/11/2008 with change 08/31/2018

Mandatory https://www.esd.whs.mil/Portals/54/Documents/DD/is suances/dodi/605505p.pdf?ver=2017-11-21-114053-

DA Pam 40-501, The Army Hearing

Program 1/08/2015 Mandatory https://phc.amedd.army.mil/topics/workplacehealth/hrc

/Pages/Hearing-Conservation-(HC).aspx http://www.osha.gov/laws-http://www.osha.gov/laws-http://www.law.cornell.edu/cfr/text/5/part-339 http://www.law.cornell.edu/cfr/text/5/293.504 http://www.esd.whs.mil/Portals/54/Documents/DD/is http://www.esd.whs.mil/Portals/54/Documents/DD/is

AR 11-34, The Army Respiratory Protection Program

07/25/2013 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/p df/web/r11_34.pdf

TB Med 509, Spirometry in Occupational Health Programs

02/25/2016 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/ web/tbmed509.pdf

DA Pam 40-506, The Vision Conservation and Readiness

Program

07/15/2009 Mandatory https://phc.amedd.army.mil/topics/workplacehealth/vcr /Pages/1.-Local-Vision-Conservation-and-Readiness-

Program-Support.aspx TG 006, Vision & Safety Eyewear

Guide for US Army Civilian & Military Job Series

January 2016 Advisory https://phc.amedd.army.mil/PHC%20Resource%20Lib rary/TG006_VisionandSafetyEyewearGuideforU.S.Ar myCivilianandMilitaryJobSeries_January2016.pdf AR 40-66, Chapter 7, Medical Record

Administration & Healthcare Documentation

06/17/2008

RAR:

1/4/2010

Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/ web/r40_66.pdf

Federal Acquisition Regulation February

Advisory https://www.acquisition.gov/?q=browsefar or http://farsite.hill.af.mil/

Defense Federal Acquisition Regulation Supplement

24 February

Advisory http://www.acq.osd.mil/dpap/dars/dfarspgi/current /index.html or http://farsite.hill.af.mil/

Federal Information Processing Standards (FIPS) Publication 201-2 Personal Identity Verification (PIV) of Federal Employees and Contractors

(paragraph 9)

August 2013 Advisory http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.2 01-2.pdf

DoDM 5200.2 Regulation 5200.02 Procedures for the DoD Personnel

Security Program (PSP)

04/03/2017 Advisory http://www.dtic.mil/whs/directives/corres/pub1.htm l

AR 190-13

The Army Physical Security Program

02/25/2011 Advisory http://www.apd.army.mil/ProductMaps/PubForm/ AR.aspx

Homeland Security Presidential Directive (HSPD)-12

Policy for a Common Identification Standard for Federal Employees and

Contractors

08/27/2004 Advisory https://www.dhs.gov/homeland-security-presidential-directive-12

DoDD 5400.11 Department of Defense Privacy

Program

10/29/2014 Advisory http://www.dtic.mil/whs/directives/corres/dir.html#

DoD 5400.11-R Department of Defense Privacy

Program

05/14/2007 Advisory http://www.dtic.mil/whs/directives/corres/pub1.htm l

DoDD 8140.01 Cyberspace Workforce Management

08/11/2015 Advisory http://www.dtic.mil/whs/directives/corres/dir.html

DoD 8570.01-M Information Assurance Workforce

Improvement Program

12/19/2005 (Change 4:

11/10/2015)

Advisory http://www.dtic.mil/whs/directives/corres/pub1.htm l

AR 25-2

Information Assurance

10/24/2007 Advisory http://armypubs.army.mil/ProductMaps/PubForm/ AR.aspx

AR 530-1

Operations Security

09/26/2014 Advisory http://armypubs.army.mil/ProductMaps/PubForm/ AR.aspx

DoD 5220.22-M National Industrial Security Program

Operating Manual

02/28/2006 (Change 2:

05/18/2016)

Advisory http://www.dtic.mil/whs/directives/corres/pub1.htm l

AR 381-12

Threat Awareness and Reporting

Program (TARP) (Section II, ¶ 2-4.b)

06/01/2016 Advisory http://armypubs.army.mil/ProductMaps/PubForm/ AR.aspx http://www.acquisition.gov/?q=browsefar http://farsite.hill.af.mil/ http://www.acq.osd.mil/dpap/dars/dfarspgi/current http://farsite.hill.af.mil/ http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.2%2001-2.pdf http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.2%2001-2.pdf http://www.dtic.mil/whs/directives/corres/pub1.htm http://www.apd.army.mil/ProductMaps/PubForm/ http://www.dhs.gov/homeland-security-http://www.dtic.mil/whs/directives/corres/dir.html http://www.dtic.mil/whs/directives/corres/pub1.htm http://www.dtic.mil/whs/directives/corres/dir.html http://www.dtic.mil/whs/directives/corres/pub1.htm http://armypubs.army.mil/ProductMaps/PubForm/ http://armypubs.army.mil/ProductMaps/PubForm/ http://www.dtic.mil/whs/directives/corres/pub1.htm http://armypubs.army.mil/ProductMaps/PubForm/

6.1 Applicable Forms: Forms applicable to the PWS are listed below:

Form Date Website

DD 1172-2

Application for Identification Card/DEERS Enrollment

Mar 2017 http://www.dtic.mil/whs/directives/forms/index.htm

I-9 Employment Eligibility Verification

10/21/2019 https://www.uscis.gov/sites/default/files/files/form/i-9.pdf

DD 441

Department of Defense Security

Agreement

Feb 2020 http://www.dtic.mil/whs/directives/forms/dd/ddforms0001- 0499.htm

DD 250

Material Inspection and Receiving

Report

Aug 2000 https://www.esd.whs.mil/Directives/forms/dd0001_0499/ http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/forminfo/forminfopage2479.html http://www.dtic.mil/whs/directives/forms/index.htm https://www.uscis.gov/sites/default/files/files/form/i-9.pdf http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm http://www.dtic.mil/whs/directives/forms/dd/ddforms0001-0499.htm https://www.esd.whs.mil/Directives/forms/dd0001_0499/

TECHNICAL EXHIBIT 1

Performance Requirements Summary (PRS)

This PRS includes performance objectives the Government will use to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

Performance Objective

Performance Standard Acceptable Quality Levels (AQL)

Surveillance Method / By Whom

5.1 Contractor personnel

The contractor shall provide all management for provider and personnel performing exams.

Provide employees that are properly licensed and registered to perform needed exams.

Periodic Inspection / COR

5.1.1 Medical Exam(s)

Facility

The contractor shall ensure the provider has an adequate facility for exams that meet

IAW with federal regulations.

Provide a sanitary, orderly, and neat appearance facility with exam space, tables, equipment, and supplies.

Periodic Inspection / COR

5.1.5 Medical

Surveillance Exam requirements

The contractor shall perform occupational medical surveillance examinations IAW with federal regulations.

Provide all services in accordance with DoD & OSHA Regulations, and Job description with no more than 5% error rate annually.

Periodic Inspection / COR

5.1.6 Exam

Scheduling with

TOHO

The contractor shall coordinate with CAOHO, and alert said office of missed appointments.

Errors in notification reporting should be no more than 5%.

Random monitoring / COR

5.2 Contractor

Notification of Health Risk Findings to

TOHO

The contractor shall notify TOHO immediately, within 24 to 72 hours, when results are received that may present a health risk to the federal employee.

Notification reporting should be accurate and timely with no more than 3% errors.

Random monitoring / COR

5.3 Written Reports Exam Result Reporting to

TOHO

The contractor shall provide all exams, and diagnostic test results electronically or in writing within 7 days of the exam. Results to Occupational Health.

Errors in notification reporting should be no more than 5%.

Random monitoring / COR

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.5.1.5 Receipt for

each CAC card returned to the DEERS office

Within 15 calendar days of returning issued CACs to the DEERS office upon departure or dismissal of each contractor employee

1 Electronic Submission

TA/COR

1.4.5.3 AT Level 1

Awareness Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.5.4 iWATCH Training Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.5.11 OPSEC

Training Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.5.12 OPSEC

Level II Certification for OPSEC Coordinator

Provide NLT 15 days after employees completed certification

1 Electronic Submission

COR

1.4.5.12 TARP

Training Certificates

Provide within 15 calendar days after training completion.

1 Electronic Submission

COR

1.4.10 Identification

Media

Return within 14 days of employee’s departure from contract performance.

Original(s) Hard Copy KO

3.1 Property Timeframe identified in 3.1 1 Electronic

Submission

TA/COR

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

5.1.6 Examination

Appointment No- Show/Cancellations

W/Reason

NLT 7 workdays after missed appointment

1 Electronic Submission CAOHO

5.2 Health Risk

Findings Notification

NLT 24 to 72 hours after examination results are received

2 Electronic Submission/Hardcopy

CAOHO

5.2.1 Abnormal Findings

Notification

NLT 7 workdays after abnormal result are received

2 Electronic Submission/Hardcopy

CAOHO

5.3 Exam

Documentation

NLT 7 workdays after examination results are received

2 Electronic Submission/Hardcopy

CAOHO

TECHNICAL EXHIBIT 3

Estimated Workload Data

This information is provided for historical background only. It is no guarantee of workload quantities.

Estimated Workload Data

Zone 1

172 Technicians

Zone 2

130 Technicians

Zone 3

123 Technicians

Zone 4

51 Technicians

(End of PWS)