PERFORMANCE WORK STATEMENT.docx

PERFORMANCE WORK STATEMENT

Legionella, Dental Water Line & Ground Water Sampling Contract PLACE OF PERFORMANCE: James A. Haley Veterans Administration Medical Center (JAHVAMC) main campus at 13000 Bruce B. Downs Blvd Tampa FL, Primary Care Annex at 1315 Lake Terrace Ln. Tampa FL and New Port Richey VA Dental Clinic at 5138 Deep Park Dr. New Port Richey FL.

SITE VISIT:

A highly encouraged site visit will be conducted prior to quote submissions. The site visit will be conducted over two days as follows:

Day 1:

Date/Time: July 14th 2021 at 10:30 AM. Minimum 5 vendors per site visit, 1 representative from each company allowed.

Location: JAHVA Main campus 13000 Bruce B. Downs Blvd Tampa FL. Meeting at the SCI Bldg #38 main entrance lobby.

Day 2:

Date/Time: July 15th 2021 at 10:30 AM Minimum 5 vendors per site visit, 1 representative from each company allowed.

Location: JAHVA Primary Care Annex at 1315 Lake Terrace Ln. Tampa FL. Main entrance lobby.

SCOPE OF WORK:

Due to COVID -19 all contractors will be required to be pre-screened at the VA and wear arm bands and mask given during screening prior to entry. This PPE is always required to be properly worn while inside, no exceptions. The Contractor will provide all management, supervision, labor, materials, supplies and equipment, and will plan, schedule, coordinate and assure effective performance of all services described herein. This agreement will include the collection of water samples and the laboratory analysis of the collected water samples. Sampling will be conducted at the James Haley VA Hospital and its associated Outpatient Clinics.

This requirement will be ONLY for the quarterly water sampling and testing for Legionella, Dental Water Line and Ground Water Sampling. Vendors selected for this award will be excluded from all sales of products and equipment required to address issues identified associated with testing results.

Period of Performance:

Base year – August 2, 2021 thru August 1, 2022 Option year 1 -- August 2, 2022 thru August 1, 2023 Option year 2 – August 2, 2023 thru August 1, 2024 Option year 3 – August 2, 2024 thru August 1, 2025 Option year 4 – August 2, 2025 thru August 1, 2026

Please note the option years may be exercised after determination that it is in the best interest of the Government and it has been determined that it is the most advantageous method of fulfilling the Government’s need for these services.

Security Requirements:

· The C&A requirements do not apply, and a Security Accreditation Package is not required.

DESCRIPTION OF SERVICE/GENERAL INFORMATION. a. Hours of Operation and Scheduling:

All work shall be accomplished during normal working hours 7:00AM - 4:30PM, Monday through Friday excluding Federal Holidays.

This service is to collect water samples and analyze the collected water samples in a healthcare environment in accordance with current VA standards and directives. The contractor will demonstrate an adequate standard of care when performing the sampling and analysis of water samples by utilizing published or enunciated, peer reviewed industry appropriate standards of practice.

Sampling Requirements

· The collection of samples will be performed in accordance with the protocol established by the laboratory used to analyze the samples and will be collected by person(s) trained/experienced/certified and knowledgeable of appropriate potable and non-portable water sampling standards of practice and laboratory sampling protocol. Samples will be stored and shipped in accordance with the laboratory sampling protocol.

· The contractor will develop an annual schedule to include the dates and times planned to perform each quarterly sampling event. The schedule will consider all federally observed holidays. The schedule will be approved by the James Haley VA Hospital point of contact.

· The contractor will confirm the dates and times of each quarterly sampling event with the James Haley VA Hospital point of contact at least two weeks prior to arrival onsite.

· The contractor will be accompanied by James Haley VA Hospital staff during the course of the sampling as necessary. The contractor will not deviate from the original provisions of the contract unless specifically.

SPECIFIC TASKS

Legionella Specific Sampling

Hot and Cold Potable Water Distribution System Outlet Sampling

· The contractor will sample outlets on designated buildings (Main Campus) hot and cold water distribution system(s) for Legionella on a quarterly basis (once per Federal Fiscal Year quarter).

· The Contractor will develop a routine sampling plan utilizing appropriate standards of practice to accommodate a stratified, random sampling methodology to ensure that samples are representative of all water lines and outlets during each quarterly sampling event. In addition to the protocol to be used for identifying the random sampling locations, the sampling plan will include, but is not limited to the following content:

· The sampling plan will include a means of easily identifying each sampled location (e.g., drawing, matrix, etc.)

· The sampling plan will include a means of identifying the distribution system (i.e., hot or cold) from which the sample was collected.

· Water Samples will be randomly collected from points in the water distribution systems listed in table 1 where the end user comes in contact with the water (e.g., faucets, showers, ice machines, and drinking fountains) and will be inclusive of all water lines and outlets. Samples will be collected in the quantities listed in table 1.

· The COR shall be notified immediately (within 1 hour) of the any hot water temperatures greater than 110 degrees F.

Cooling Tower System Sampling

· The Contractor will sample the cooling tower system(s) for Legionella on a quarterly basis (once per Federal Fiscal Year quarter).

· The contractor will develop a routine sampling plan utilizing appropriate standards of practice to accommodate an appropriate sampling methodology to ensure that samples are representative of the entire cooling tower system during each annual sampling event. The sampling plan will include, but is not limited to the following content and will be approved by the James Haley VA Hospital point of contact:

· The sampling plan will include a means of easily identifying each sampled location (e.g., drawing, matrix, etc.).

· The sampling plan will include a means of identifying the system from which the sample was collected.

· At a minimum, water samples will be collected from each cooling tower system at the basin or sump of the cooling tower at a location distant from the incoming make-up water.

· At the time each water sample is taken, the contractor will test and document the following for each sample: Water temperature, level of residual biocide, and pH. These water quality parameters will be tested in the field using appropriate test instruments, properly calibrated and traceable to a NIST standard.

Table No. 1 – Test Frequencies and Quantities

Main Hospital and Primary Care Annex & NPR (Dental)

Sample Analysis Once collected, that contractor will have the samples processed by a testing laboratory with experience in microbial testing of potable and non-potable water.

Analysis of water samples will be performed by a laboratory currently certified by the Centers for Disease Control and Prevention (CDC) Environmental Legionella Isolation Techniques Evaluation (ELITE) program as proficient at performing the culture of Legionella from environmental samples. Information about ELITE certified laboratories can be found at https://wwwn.cdc.gov/elite/Public/MemberList.aspx.

In addition to the requirement for current CDC ELITE certification, the laboratory performing the analysis of water samples will have an environmental microbiology accreditation by a nationally recognized accrediting body (e.g., A2LA, NELAP).

The laboratory will analyze each water sample for Legionella by performing the tests listed in the Legionella Test Bundle identified in table 2. The laboratory will have the capabilities of determining if the Legionella pneumophila is serogroup 1.

When appropriate, the laboratory will concentrate water samples prior to plating the samples on selective media to increase the sensitivity of the assay.

The laboratory will neutralize biocides that have been added to the building’s potable water distribution systems prior to analysis.

Rapid testing methods, such as polymerase chain reaction (PCR) and direct fluorescent antibody (DFA), are not permitted for the detection of Legionella in the water samples.

The laboratory shall have the capability to store specimens in the event that molecular testing is required to investigate a possible hospital –acquired Legionella disease case.

Table 2 – Legionella Test Bundle

Temperature

Residual Oxidant pH

Legionella Serotypes - Lpn S1, Lpn S2-14, Legionella spp

Legionella Analysis Reports Once analyzed, the laboratory will prepare and submit an analysis report to the James Haley VA Hospital point of contact.

· The analysis report will include an enumeration of Legionella concentrations for each result above the quantification limit.

· The analysis report will include the serogroup for all results determined to be above the quantification limit.

· All quantifiable/enumerated results will be reported in CFU/ml. All results determined to be below the quantification limit will be reported as “Negative”.

· Analysis reports will be submitted via email and hard copy to the James Haley VA Hospital point of contact.

· Analysis report data in CEOSH Excel spreadsheet format shall be sent via email to James Haley VA Hospital contact.

· The laboratory will have the capability to provide access to all sampling reports and supporting data through an internet-based tool at all times.

Oxidant Residual Sampling

Hot and Cold Potable Water Distribution System Outlet Sampling

· The contractor will sample outlets on each building’s hot and cold water distribution system(s) for oxidant residual on a quarterly basis (once per Federal Fiscal Year quarter).

· The contractor will develop a routine sampling plan utilizing appropriate standards of practice to accommodate a stratified, random sampling methodology to ensure that samples are representative of all water lines and outlets during each quarterly sampling event. In addition to the protocol to be used for identifying the random sampling locations, the sampling plan will include, but is not limited to the following content and will be by the James Haley VA Hospital point of contact:

· The sampling plan will include a means of easily identifying each sampled location (e.g., drawing, matrix, etc.)

· The sampling plan will include a means of identifying the distribution system (i.e., hot or cold) from which the sample was collected.

· Water samples will be randomly collected from points in the water distribution systems listed in table 1 where the end user comes in contact with the water (e.g., faucets, showers, ice machines, and drinking fountains) and will be inclusive of all water lines and outlets. Samples will be collected in the quantities listed in table 1.

· The contractor will identify the applicable oxidant for which sampling and analysis will be performed and analyze samples for that oxidant only.

Oxidant Residual Sample Analysis

· Once collected, the contractor will have the samples processed by a testing laboratory with experience in testing of potable and non-potable water.

· Analysis of water samples will be performed by a laboratory currently certified by the Florida Department of Health to perform microbiological analysis of public drinking water. The laboratory will be proficient at performing the analysis of oxidant residual using ASTM method D1253-86: Standard Test Method for Residual Chlorine in Water from environmental samples.

· In addition to the requirement for current Florida DOH certification, the laboratory performing the analysis of water samples will have an environmental microbiology accreditation by a nationally recognized accrediting body (e.g., A2LA, NELAP).

· The laboratory will analyze each water sample for oxidant residual using ASTM method D1253-86: Standard Test Method for Residual Chlorine in Water or equivalent method utilized to quantify the residual concentration of the oxidant in use.

Oxidant Residual Analysis Reports

Once analyzed, the laboratory will prepare and submit an analysis report to the James Haley VA Hospital point of contact.

· The analysis report will include an enumeration of oxidant residual concentrations for each result above the quantification limit.

· All qualifiable/enumerated results will be reported in mg/L.

· All results will be compared against the following minimum oxidant residual concentrations as applicable:

1. Chlorine (as free Chlorine) – 0.5mg/L

2. Monochloramine – 0.5mg/L

3. Chlorine Dioxide – 0.3mg/L

· All sample results exceeding the defined action levels will be conspicuously identified in the analysis report.

· Analysis reports will be submitted via email and hard copy to the James Haley VA Hospital point of contact.

· The laboratory will have the capability to provide access to all sampling reports and supporting data through an internet-based tool at all times.

· Oxidant residual results will be reported within 3 days (48-72 hours for analysis and 1 day for handling).

Potable Water Quality Supply Sampling

· The contractor will sample outlets on each building’s potable water supply for water quality on a quarterly basis (once per Federal Fiscal Year quarter).

· The contractor will develop a routine sampling plan utilizing appropriate standards of practice to accommodate an appropriate sampling methodology to ensure that samples are representative of incoming supply of potable water during each annual sampling event. The sampling plan will include, but is not limited to the following content and will be approved by the James Haley VA Hospital point of contact:

· The sampling plan will include a means of easily identifying the sampled location (e.g., drawing, matrix, etc.)

· The sampling plan will include a means of identifying the system from which the sample was collected.

· At a minimum, water samples will be collected from the incoming potable water supply to the buildings.

· Samples will be collected in the quantities listed in table 1.

· The temperature of each sample will be taken at the time of collection.

Potable Water Quality Analysis

· Once collected, that contractor will have the samples processed by a testing laboratory with experience in testing of potable and non-potable water.

· Analysis of water samples will be performed by a laboratory currently certified by the Florida Department of Health (DOH) to perform microbiological analysis of public drinking water. The laboratory will be proficient at performing the water quality test methods listed in table 3.

· In addition to requirement for current Florida DOH certification, the laboratory performing the analysis of water samples will have an environmental microbiology accreditation by a nationally recognized accrediting body (e.g., A2LA, NELAP).

· The laboratory will analyze each water sample for the total suspended solids, pH, and hardness using the approved test methods listed in table 3.

Potable Water Quality Analysis Reports

· Once analyzed, the laboratory will prepare and submit an analysis report to the James Haley VA Hospital point of contact.

· The analysis report will include an enumeration of water quality concentrations for each result above the quantification limit.

· All quantifiable/enumerated will be reported in the following units:

1. TSS - mg/L

2. Hardness – mg/L as CaCO3

3. pH – pH units

· All results will be compared against the following maximum and minimum drinking water quality standards as applicable. All sample results determined to be above or below the drinking water quality standards will be conspicuously identified in the analysis report.

· Water temperatures taken at the time the sample was collected will be included on the analysis report for each sample.

· Analysis reports will be submitted via email and hard copy to the James Haley VA Hospital point of contact.

· The laboratory will have the capability to provide access to all sampling reports and supporting data through an internet-based tool at all times.

· Water Quality results will be reported within 3 days (48-72 hours for analysis and 1 day for handling).

· The laboratory will have the capability to provide access to all sampling reports and supporting data through an internet-based tool at all times.

Table No. 3 – Water Quality Test Bundle

· EPA Method 150.1

· EPA Method 150.2

· EPA Method 130.2

Heterotrophic Plate Count Specific Sampling (Dental Water Line Sampling)

· The contractor will sample the contractor will sample Dental Water Lines for Heterotrophic Plate Count on a quarterly basis (once per Federal Fiscal Year quarter).

· contractor will develop a routine sampling plan utilizing appropriate standards of practice to accommodate a sampling methodology to ensure that samples are representative of all water lines and outlets during each quarterly sampling event. The sampling plan will be consistent with the James Haley VA Hospital Dental Service Waterline Testing and Treatment Standard Operating Procedure.

· Dental Water Line sampling requires the manipulation of instruments and equipment. Special instructions or assistance from James Haley VA Hospital will be necessary to collect the samples appropriately and safety and in order to prevent damage to equipment.

· In addition to protocol to be used for identifying the sampling locations, the sampling plan will include, but is not limited to the following content and will be approved by the James Haley VA Hospital point of contact:

· The sampling plan will include a means of easily identifying each sampled location (e.g., drawing, matrix, etc.)

· The sampling plan will include a means of identifying the distribution system (i.e., hot or cold) from which the sample was collected.

· Samples will be collected in the quantities listed in table 1 and as defined in the James Haley VA Hospital Dental Service Waterline Testing and Treatment Standard Operating Procedure.

Heterotrophic Plate Count Sample Analysis

· Once collected, the contractor will have the samples processed by a testing laboratory with experience in microbial testing of potable and non-potable water.

· Analysis of water samples will be performed by a laboratory currently certified by the Florida Department of Health to perform microbiological analysis of public drinking water. The laboratory will be proficient at performing the analysis of Heterotrophic Plate Count (HPC) using EPA/ELAP method SM 9215B from environmental samples.

· In addition to the requirement for current Florida EPA certification, the laboratory performing the analysis of water samples will have an environmental microbiology accreditation by a nationally recognized accrediting body (e.g., A2LA, NELAP).

· The laboratory will analyze each water sample for Heterotrophic Plate Count (HPC) using EPA/ELAP method SM 9215B.

Heterotrophic Plate Count Analysis Report

Once analyzed, the laboratory will prepare and submit an analysis report to the James Haley VA Hospital point of contact.

· The analysis report will include an enumeration of Heterotrophic Plate Count concentrations for each result above the quantification limit.

· All quantified/enumerated results will be reported in CFU/ml. All results determined to be below the quantification limit will be reported as “Negative”.

· All results will be compared against the action levels listed in the James Haley VA Hospital Dental Service Waterline Testing and Treatment Standard Operating Procedure and identify the appropriate corrective actions. All sample results exceeding the defined action levels will be conspicuously identified in the analysis report.

· Analysis reports will be submitted via email and hard copy to the James Haley VA Hospital point of contact.

· The laboratory will have the capability to provide access to all sampling reports and supporting data through an internet-based tool at all times.

· Heterotrophic Plate Count results will be reported within 3 days (48- hours for culture growth @35 degrees Celsius and 1 day for handling).

· The laboratory will have the capability to provide access to all sampling reports and supporting data through an internet-based tool at all times.

Supplemental Water Sampling

In addition to the planned sampling previously identified, supplemental water sampling will be performed when determined necessary and only when authorized by the James Haley VA Hospital point of contact. The number of samples to be taken will vary depending on facility need. For the purpose of bidding, the contractor will provide a proposal that considers sampling and analysis.

Table No. 4

Groundwater Sampling and Free Product Recovery Report

· The Contractor shall provide all labor, equipment, tools, material, supervision and other items and services necessary to perform the work. The field work will take place in and around Building 54 (Generator Plant). Please see attached site assessment information which includes well locations (in addition to a copy of the letter from the HCEPC). The work consists of quarterly ground water monitoring of monitoring wells TMW-1, TMW-2, MW-3, MW-4, MW-5, MW-6, MW-7 and DW-1 for BTEX/MTBE, PAHs and TRPH (see attached map). The contractor shall negotiate with Hillsborough County Environmental Protection Commission (HCEPC) which may lead to a change of monitoring frequency or abandoning the monitoring of certain wells. HCEPC will indicate which wells to continue monitoring and what frequency they are required to be monitored. In addition, the contractor will submit Free Product Reports (including free product extent maps) in accordance with the requirements of Rule 62-780.500(7), F.A.C. The contractor will provide written notice to HCEPC within seven days but not less than 24 hours prior to performing field activities, as required by Rule 62-780.220(1) of the Florida Administrative Code (F.A.C.) and by Table A of Chapter 62-780, F.A.C.

· The monitoring will be conducted quarterly as required by HCEPC until negotiations between the contractor and HCEPC leads to a change of monitoring wells or the frequency in which they are monitored. Monitoring will be conducted within the first quarter beginning in July 2021. The monitoring will be completed, and the quarterly free product report will be completed and submitted to the HCEPC as required in the Florida Administrative Code referenced above no later than August 15, 2021. The subsequent monitoring will occur quarterly as required in the Florida Administrative Code unless HCEPC authorizes the facility to monitor with a different frequency from the negotiations with the contractor. The Contractor shall negotiate the terms of sampling frequency and monitoring criteria for the well system with (HCEPC) using the historical data. The quarter will be defined as April-June, July-September, October-December, and January-March. The results and report will be sent to the HCEPC as required and a copy will be provided to the JAH point of contact.

COMPLIANCE. The contractor shall be fully responsible for compliance with all VA, local, state, and Federal occupational safety laws, rules, and regulations. The contractor shall follow life and safety codes and take necessary actions to avoid conditions that may be hazardous to the health and safety of hospital personnel and patients. The contractor is responsible for meeting all applicable OSHA and VA guidelines for safe working procedures; example lockout/tag out if applicable. All work for the duration of the contract shall be performed by certified trained technicians.

CONTRACTOR EMPLOYEES. Contractor personnel shall present a neat appearance and be easily recognized as contract employees.

CHANGES TO STATEMENT OF WORK. Any changes to this SOW shall be authorized and approved only through written correspondence from the CO. A copy of each change will be kept in a project folder along with all other products of the project. Costs incurred by the contractor through the actions of parties other than the CO (or designee) shall be borne by the contractor.

HOURS OF OPERATION AND SCHEDULING:

All work will be completed after “Normal” (8 am to 5 pm) business hours and on weekends National Holidays observed by the Federal Government are:

· New Year’s Day…………………………………………January 1

· Martin Luther King’s Birthday………………………….3rd Monday in January

· President’s Day………………………………………….3rd Monday in February

· Memorial Day……………………………………………Last Monday in May

· Juneteenth………………………………………………… June 19th

· Independence Day………………………………………. July 4th

· Labor Day……………………………………………… 1st Monday in September

· Columbus Day……………………………………………2nd Monday in October

· Veteran’s Day……………………………………………November 11

· Thanksgiving Day………………………………………. Last Thursday in November

· Christmas Day………………………………………........December 25

Note: This includes any other day declared by the President of the United States to be a national holiday

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

The contractor shall be evaluated in accordance with the following QASP.

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

a. What shall be monitored.

b. How monitoring shall take place.

c. Who shall conduct the monitoring.

d. How monitoring efforts and results shall be documented.

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the Department of Veteran Affairs (VA) in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned Contracting Officer: Clarelle Sylvain Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned COR: James Watson and Jennifer Eakes

3. CONTRACTOR REPRESENTATIVES

The following employees of the contractor serve as the contractor’s program manager for this contract.

1. Program Manager -

2. Other Contractor Personnel -

4. PERFORMANCE STANDARDS:

Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets, or does not meet these standards.

The Performance Requirements are listed below. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

knowledgeable and experienced in water sampling protocols established by the laboratories and applicable field analysis parameters.

· Disincentive: Unfavorable contractor performance evaluation

· Repeated violation may result in termination of services

· Disincentive: Unfavorable contractor performance evaluation

Repeated violation may result in termination of services

· Disincentive: Unfavorable contractor performance evaluation

Repeated violation may result in termination of services

5. INCENTIVES/DISINCENTIVES

The Government shall use favorable contractor performance evaluations as incentives. Incentives/Disincentives shall be based on exceeding, meeting, or not meeting performance standards.

6. PROCEDURES/METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

a. Direct Observation. Direct observation can be performed periodically or through 100% surveillance.

b. Students complaints. Any complaint data is reviewed by the CO/COR and any validated complaints against a contractor will be further investigated.

7. RATINGS

Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used:

Positive Outcome: No more than 1incident of not meeting the performance standard during the period of performance.

Neutral Outcome: No more than 3 incidents of not meeting the performance standard during the period of performance.

Negative Outcome: More than 3 incidents of not meeting the performance standard during the period of performance.

8. DOCUMENTING PERFORMANCE

a. ACCEPTABLE PERFORMANCE The Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action.

b. UNACCEPTABLE PERFORMANCE When unacceptable performance occurs, the COR shall inform the Contracting Officer (CO). This shall normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in their respective file.

When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the CO. The CO will in turn review and submit to the contractor’s program manager for corrective action.

The contractor shall acknowledge receipt of the CDR in writing. The CDR shall specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR shall also state how long after receipt the contractor has to present this corrective action plan to the COR. The Government shall review the contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

9. FREQUENCY OF MEASUREMENT

a. Frequency of Measurement.

During contract performance, the COR will periodically analyze whether the frequency of surveillance is appropriate for the work being performed.

b. Frequency of Performance Assessment Meetings.

The COR shall conduct a performance assessment meeting with the contractor if negative trends are identified, otherwise an annual performance assessment report will be completed and uploaded into the Contractor Performance Assessment Reporting System (CPARS).

(Attachment 1)

QUALITY ASSURANCE

MONITORING FORM

SERVICE or STANDARD:

SURVEY PERIOD:

SURVEILLANCE METHOD (Check):

Random Sampling 100% Inspection Periodic Inspection Customer Complaint LEVEL OF SURVEILLANCE (Check):

Monthly Quarterly As needed

PERCENTAGE OF ITEMS SAMPLED DURING SURVEY PERIOD: ______ %

ANALYSIS OF RESULTS:

Observed Service Provider Performance Measurement Rate: ______%

Narrative of Performance During Survey Period:

PREPARED BY: ___________________________________ DATE: _________________

Contract Discrepancy Report (Attachment 2)

Contract No.

Report No. for this Discrepancy:

Contractor/Manager’s Name:

From: (Name of Project Officer)

Dates

Prepared:

Returned by Contractor:

Action Complete:

Discrepancy or Problem:

Signature of Contracting Officer:

To: (Contracting Officer)

From: (Contractor)

Contractor Response as to Cause, Corrective Action and Actions to Prevent Recurrence (Attach Continuation Sheet if Necessary)

Signature of Contractor Representative:

Date:

Government Evaluation:

Government Actions:

Close Out

Contractor Notified

Project Officer

Contracting Officer