Performance Work Statement- CEF SCBA Air Compressor-SAM.pdf

Ver. October 2022

CUI

CUI

PERFORMANCE WORK STATEMENT (PWS)

FOR

Removal and Installation of SCBA Air Compressor

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform the removal of an old SCBA compressor and the installation of a new SCBA compressor, as defined in this PWS.

1.1.1 Objectives: To perform the removal of an old SCBA compressor and the installation of a new SCBA compressor at the fire station (Building 800).

1.2 Background: Currently, the SCBA compressor at the fire station is a discontinued model that they no longer make parts for. Therefore, maintenance on the current compressor is questionable and costly

1.3 Period of Performance (PoP): The Period of Performance shall be based upon the work to be done. Based on other bases that have had a new compressor installed, it would be roughly 2 weeks.

1.4 General Information:

1.4.1 Place and Performance of Services: The contractor shall provide services between the hours of 0730 and 1630, Monday through 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. Performance shall be at building 800 (fire station). The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential.

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

CUI

CUI

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 re privileges.

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 contractor employees shall carry proper identification with them at all times, and shall be subject to such checks as may be deemed necessary. The contractor shall ensure compliance with all regulations and orders of 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:

1.4.2.4 Memorial Day

1.4.2.5 Juneteenth National Independence Day: June 19th

1.4.2.6 Independence Day: July 4th

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.10 Thanksgiving Day

1.4.2.11 Christmas Day: December 25th

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.

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 contract award.

acceptance in writing of any proposed changes to its QCP.

performance under this contract in accordance with the Quality Assurance Surveillance

CUI

CUI

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 Access and General Protection/Security Policy and Procedures. The contractor shall comply with all applicable installation/facility access and local security policies and

(COR). The contractor shall also provide all information required for background checks

Security Forces, Director of Emergency Services or local Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by DoD, Headquarters Air Force (HAF) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1. The contractor shall obtain base identification and vehicle passes, if required, for all contractor personnel who make frequent visits to or perform work on the Air Force installation(s) cited in the contract. Contractor personnel are required to wear or prominently display installation identification badges or contractor-furnished, contractor identification badges while visiting or performing work on the installation.

2. The contractor shall submit a written request on company letterhead to the contracting officer listing the following: contract number, location of work site, start and stop dates, and names of employees and subcontractor employees needing access to the base. The letter will also specify the individual(s) authorized to sign for a request for base identification credentials or vehicle passes. The contracting officer will endorse the request and forward it to the issuing base pass and registration office or Security Forces for processing. When reporting to the registration office, the authorized contractor individual(s) should provide a valid driver s license, current vehicle registration, valid vehicle insurance certificate, and [insert any additional requirements to comply with local security procedures] to obtain a vehicle pass.

2.1 Full enforcement of REAL ID goes into effect on 7 May 2025. At this time, DHS has not extended REAL ID enforcement beyond that date. REAL ID criteria has already been written into DoDM 5200.08v3. State issued identification not in compliance with

CUI

CUI

REAL ID may no longer be accepted for identity proofing effective 7 May 2025. This is in accordance with REAL ID Act of 2005, H.R. 418, 109th Cong. (2005) and "REAL ID," Department of Homeland Security, accessed 30 March 2025, https://www.dhs.gov/real-

id. It is federal policy for compliance after 07 May 25 and individuals who do not possess a REAL ID Act compliant form of identification, must be escorted or denied access.

3. During performance of the contract, the contractor shall be responsible for obtaining required identification for newly assigned personnel and for prompt return of credentials and vehicle passes for any employee who no longer requires access to the work site.

4. When work under this contract requires unescorted entry to controlled or restricted areas, the contractor shall comply with AFI 31-101, Integrated Defense, and DODMAN5200.02_AFMAN 16-1405, Air Force Personnel Security Program, citing the appropriate paragraphs as applicable.

5. Upon completion or termination of the contract or expiration of the identification passes, the prime contractor shall ensure that all base identification passes issued to employees and subcontractor employees are returned to the issuing office.

6. Failure to comply with these requirements may result in withholding of final payment.

1.4.5.1 For Contractors that do not require CAC, but require access to a DoD Facility and/or Installation. Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Air Force Instruction (AFI) 10-245, AFI 31-101 and Air Force Manual (AFMAN) 31-113), applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by Government representative)

1.4.5.2 Antiterrorism Awareness Level I Training (AT Level I). All contractor employees, to include subcontractor employees, requiring access to US Government installations, facilities and controlled access areas shall complete AT Level I training within 15 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. AT Level I may be accomplished by a Level I qualified instructor; completing the Force Protection computer-based training (CBT) course on Joint Knowledge Online (JKO) at https://jkodirect.jten.mil/Atlas2/page/login/Login.jsf. For those without a CAC, select" Non-CAC" user on the JKO site. Tracking for each contractor or subcontractor employee is the responsibility of the COR or unit AT Representative.

1.4.6 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.

CUI

CUI

1.4.7 Special Qualifications: The contractor shall ensure all employees possess all required licenses for operating all tools and equipment used in the performance of this contract. 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.)

1.4.8 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 con and the contractor shall apprise the Government of problems, if any, being experienced.

The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.9 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 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 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 the 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.

1.4.10. 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 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.

1.4.11 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 the KO. All materials supplied to the Government shall be the sole property of the Government and may not

CUI

CUI

be used for any other purpose. This right does not abrogate any other Government rights.

1.4.12 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or acceptable solely at the discretion of the KO. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

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 the 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 the 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 persons 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.

CUI

CUI

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

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

2.2 Acronyms:

AEI Army Enterprise Infostructure AR Army Regulation AT/OPSEC Antiterrorism/Operational Security BI Background Investigation CM Contract Manager 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 DSCA Defense Counterintelligence and Security Agency FAR Federal Acquisition Regulation GFP/M/E/S Government Furnished Property/Material/Equipment/Services HQDA Headquarters, Department of the Army HSPD Homeland Security Presidential Directive IA Information Assurance IS Information System(s) KO Contracting Officer NGB National Guard Bureau OCI Organizational Conflict of Interest 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

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:

CUI

CUI

3.1 Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS.

3.2 Materials: None.

3.3 Equipment: None.

3.4 Services: None.

3.5 Utilities:

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.

5.0 Requirements: The contractor shall:

5.0.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the 152nd AW via a secure data collection site.

5.1 Contractor will clean the job site at the end of each day of work. Ensuring a safe workspace. The contractor shall clean up all work areas to ensure all debris and unused components are removed. The area should match the pre-demo cleanliness conditions.

5.2 Remove and dispose of entire existing system. Provide the government of the waste manifest(s).

5.2.1 Compliance with local Contractor Environmental Guide.

5.2.2 Submit SDS of all chemicals that are estimated to be brought onto the federal installation for this project to include an estimate of amounts of chemicals and submit a safety plan outlining the safety procedures that will be followed during the course of project completion.

5.3 Install new Breathing Air Compressor Systems Stationary Compressor in designated space in building 800. New compressor shall comply with the following salient characteristics:

5.3.1 Built in the USA

CUI

CUI

5.3.2 Two Year Warranty.

5.3.3 Available sizes and pressures 20 or 30 HP, 6 or 7000 PSI.

5.3.4 PLC 24vdc Controls System Design

5.3.5 Compressor Pump Five stages

5.3.6 Five Cylinder Radial up to 7000 Psi Compressor

5.3.7 Automatic or Manual Mode

5.3.8 Gauges on all stages

5.3.9 High Pressure and Oil Transducers

5.3.10 High Temperature Shutdown

5.3.11 Low Oil Pressure Shutdown

5.3.12 Emergency Stop

5.3.13 External Main Power Disconnect

5.3.14 Enclosed Compressor Frame

5.3.15 Removable Doors for Serviceability

5.3.16 Self-Tightening Drive Belt

5.3.17 Design to Provide Remote Intake Hook-up

5.3.18. 6K or 7K Tilt Filtration, ease of Cartridge Installation 6K Upgradable to 7K on Site

5.3.19 Cast iron Block.

5.3.20 Pressurized Oil lubrication system

5.3.21 Radial layout for reduced vibration

5.3.22 Connecting rods with need bearings.

5.3.23 ASME Relief Valves on 2nd, 3rd & 4th Stages

CUI

CUI

5.3.24 Spin-on type oil filter

5.3.25. 5 Quart Oil Capacity

5.3.26 Replaceable Piston and Sleeve on 3rd, 4th and 5th Stages

5.3.27 Inter-coolers on 1st, 2nd, 3rd & 4th stages

5.3.28 Stainless Steel After-cooler on 5th stage

5.3.29 High discharge air temperature -

5.3.30 Low oil pressure -

5.3.31 CO / Moisture Capable with Shutdown

5.3.32 High discharge air carbon monoxide -

5.4 Install new SCBA Fill Station in designated space in building 800. New fill station shall comply with the following salient characteristics:

5.4.1 Built in the USA

5.4.2 Constructed in accordance with: OSHA 29, CFR 1910.169, NFPA 1901, NFPA 1989 Standards.

5.4.3 Two Year Warranty.

5.4.4 Fill station controls rated as 7000 psi.

5.4.5 The ability to fill up to 5500 PSI SCBA cylinders. 4500 PSI required

5.4.6 The ability to fill two (2) SCBA cylinders while loading next (2).

5.4.7 Constructed of heavy duty welded steel.

5.4.8 Safety interlocks, charge and bleed valves.

5.4.9 Regulated auxiliary air outlet.

5.4.10 Un-regulated auxiliary air outlet.

5.4.11 Compressor pressure gauge.

5.4.12 Storage cylinder gauge.

CUI

CUI

5.4.13 SCBA cylinder fill pressure gauge.

5.4.14 Auto Storage Bypass.

5.4.15 Adjustable fill pressure regulator with 7000 PSI final inlet pressure and maximum fill pressure relief valve set to 5700 PSI +/- 100 PSI. 4500 PSI required

5.4.16 Station mount.

5.4.17 Smart Fill (Fully Automatic Cascade Filling System).

5.4.18. 2, 4 or 6 bank cascade storage cylinder controls with pressure gauges for each cylinder.

5.5 Provide site survey, install, operate, leak test, train & perform air sample with written report. The system shall be assembled and tested as a complete system at the factory prior to shipment. A factory test certificate shall be shipped with the system.

5.5.1

5.5.2 the distributor

5.5.3 The user shall receive training by the distributor on the operation and maintenance of the system as required

5.6 Provide Compressor Preventative Maintenance for one year.

5.7 Provide equipment warranty for 2 years. The equipment supplied shall be guaranteed to be new, of current design, and free of all defects in material and workmanship for a period of two years based on prescribed service and maintenance.

5.8 Provide all relevant Operation & Maintenance manuals for all installed systems/components and all applicable warranty information.

5.8 HEALTH AND SAFETY ON GOVERNMENT INSTALLATIONS. In performing work under this contract on a Government installation, the contractor shall take all reasonable steps and precautions to prevent accidents and preserve the health and safety of contractor and Government personnel performing or in any way coming in contact with the performance of this contract; and take such additional immediate precautions as the contracting officer may reasonably require for health and safety purposes. The contracting officer may, by written order, direct Department of the Air Force Occupational Safety and Health (AFOSH) Standards and/or health/safety standards as may be required in the performance of this contract and any adjustments resulting from such direction will be in accordance with the Changes clause of this contract. Any violation of these health and safety rules and requirements, unless promptly corrected

CUI

CUI

as directed by the contracting officer, shall be grounds for termination of this contract in accordance with the Default clause of this contract.

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

Publication (Chapter/Page)

Date of Publication

Website

Federal Acquisition Regulation https://www.acquisition.gov/?q=browsefar Defense Federal Acquisition

Regulation Supplement http://www.acq.osd.mil/dpap/dars/dfarspgi/current/in dex.html or https://www.acquisition.gov/dfars Joint Travel Regulation (JTR) https://www.defensetravel.dod.mil/site/travelreg.cfm

DoDM 1000.13-M-V1 DoD Identification (ID) Cards (Enclosure 2, paragraph 3.b)

01/23/2014 (Change 1:

07/28/2020) http://www.esd.whs.mil/Directives/issuances/dodm

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

(paragraph 9)

August 2013 http://nvlpubs.nist.gov/nistpubs/FIPS/NIST.FIPS.201 -2.pdf

DoDM 5200.2 Procedures for the DoD Personnel Security Program

(PSP)

04/03/2017 https://www.esd.whs.mil/Directives/issuances/dodm/

DoDI 5200.46 DoD Investigative and Adjudicative Guidance for Issuing the Common

Access Card (CAC)

09/09/14 (Change 1:

05/04/2018) https://www.esd.whs.mil/Directives/issuances/dodi/

Homeland Security Presidential Directive (HSPD)-12

Policy for a Common Identification Standard for Federal Employees and

Contractors

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

DoDI 5400.11 Department of Defense Privacy and

Civil Liberties Programs

01/29/2019 https://www.esd.whs.mil/Directives/issuances/dodi/

DoD 5400.11-R Department of Defense Privacy

Program

05/14/2007 https://www.esd.whs.mil/Directives/issuances/dodm/

DoDD 8140.01 Cyberspace Workforce Management 10/05/2020 https://www.esd.whs.mil/Directives/issuances/dodd/

DoD 8570.01-M Information Assurance Workforce

Improvement Program

12/19/2005 (Change 4:

11/10/2015) https://www.esd.whs.mil/Directives/issuances/dodm/

DoD 5220.22-M National Industrial Security Program

Operating Manual (NISPOM)

02/28/2006 (Change 2:

05/18/2016) https://www.esd.whs.mil/Directives/issuances/dodm/

Army Directive 2014-05 Policy and Implementation

Procedures for Common Access Card Credentialing and Installation Access for Uncleared Contractors

03/07/2014 https://armypubs.army.mil/ProductMaps/PubForm/A rmyDir.aspx

AR 25-2

Information Assurance

04/04/2019 http://armypubs.army.mil/ProductMaps/PubForm/AR .aspx

CUI

CUI

AR 530-1

Operations Security

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

AR 525-13

Antiterrorism

12/09/2019 http://armypubs.army.mil/ProductMaps/PubForm/AR .aspx

AR 381-12

Threat Awareness and Reporting

Program (TARP) (Section II, ¶ 2-4.b)

06/01/2016 http://armypubs.army.mil/ProductMaps/PubForm/AR .aspx

AFI 10-245

Antiterrorism

03/28/2013 (Certified current

03/30/2017) https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series

=-1&modID=449&tabID=131

AFI 31-101

Security Forces Standards and

Procedures

08/18/2020 https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series

=-1&modID=449&tabID=131

AFMAN 31-113

Security Forces Standards and Procedures

03/05/2013 Change 1:

12/02/2015 https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series

=-1&modID=449&tabID=131

AFPD 17-1

Information Dominance Governance and Management

04/12/2016 https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series

=-1&modID=449&tabID=131

AFMAN 17-1301

Computer Security (COMPUSEC) 02/12/2020 https://www.e-publishing.af.mil/Product-

Index/#/?view=pubs&orgID=10141&catID=1&series =-1&modID=449&tabID=131

AFI 10-701

Operations Security

7/24/2019 (Change 1:

06/09/2020) https://www.e-publishing.af.mil/Product- Index/#/?view=pubs&orgID=10141&catID=1&series

=-1&modID=449&tabID=131

AFMAN 32-7002

Environmental Compliance and Pollution Prevention

6/13/2025 https://static.e-publishing.af.mil/production/1/af_a4/publication/daf man32-7002/dafman_32-7002.pdf

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/

152 AW Base Access Request Form

N/A See attached

Contractor Environmental Guide 2/18/2026 See attached

TECHNICAL EXHIBIT 1

CUI

CUI

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

5.0-5.3 Perform all tasks within the time frame they assumed as well as keeping a safe work environment.

100% COR

5.0-5.3 Testing of the new SCBA compressor shall be completed and certified after installation.

100% COR

5.3 Contractor shall provide all waste manifests to

KO and COR within 5 business days after disposal.

100% completion COR

Clean work areas

The contractor shall clean up all work areas to ensure all debris and unused components are removed.

The area should match the pre-demo cleanliness conditions.

100% Inspection (Testing)/COR

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.5.3 AT Level 1

Awareness Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

5.3 Submit all applicable

waste receipts/manifests showing where material was disposed of or recycled and amounts/weights.

Submit within 5 business days of final delivery.

1 Electronic Submission

COR/KO

5.4 Submit acknowledged

Contractor Environmental

Guide

Submit prior to commencing work.

1 Electronic Submission

COR/KO

Submit SDS of all chemicals that are estimated to be brought onto the federal installation for this project to include an estimate of amounts of chemicals and submit a safety plan outlining the safety procedures that will be followed during the course of project completion.

Submit within 10 business days prior to starting demolition

1 Electronic Submission

COR/KO

CUI

CUI

Submit refrigerant disposal receipts showing amounts and type of refrigerant.

Submit within 5 business days of disposal

1 Electronic Submission

COR/KO

Submit data on the type and amount of refrigerant that is introduced into the new system.

Submit within 5 business days of final system testing

1 Electronic Submission

COR/KO

Submit test and balance report results

Submit within 5 business days of final system testing

1 Electronic Submission

COR/KO

Submit all applicable O&M manuals and warranty information

Submit within 5 business days of final system testing

2 Hard Copy and Electronic

Submission

COR/KO