PWS.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

North Carolina Army National Guard (NCARNG)

Firefighter Medical Exams

Table of Contents

1.0 General

2.0 Definitions and Acronyms

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S)

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

5.0 Requirements

6.0 Applicable Publications

TECHNICAL EXHIBIT 1 - Performance Requirements Summary TECHNICAL EXHIBIT 2 - Deliverables Schedule

Performance Work Statement (PWS)

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary to perform NFPA 1582 Fire Fighter Medical Examinations Non- Personal Services.

1.2 Background: The North Carolina Army National Guard (NCARNG) requires NFPA 1582 Fire Fighter Medical Examinations to determine if workers are medically and physically able to perform assigned duties without substantial risk of harm to themselves, others, or the mission, and/or to determine if the workplace is causing workers injury or illness due to an occupational hazard or exposure.

1.2.1 Examinations are provided to NCARNG Soldiers serving in 12M Firefighter positions.

Personnel not included under these examinations are Civilian Contractors, State Employees, and NCARNG technicians or AGR personnel.

1.3 Period of Performance (PoP): This will be a one-day examination on 08 June 2023 for 19 NCARNG Firefighters.

1.4 General Information:

1.4.1 Place and Performance of Services: The contractor shall provide services on Monday through Sunday, except on recognized US holidays. Services shall be performed at 449th BDE Headquarters, 2050 National Guard Dr., Morrisville, NC 27560. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS. 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 will 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 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:

1.4.2.1 New Year’s Day: January 1st

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: June 19th

1.4.2.6 Independence Day: July 4th

1.4.2.7 Labor Day

1.4.2.8 Columbus Day

1.4.2.9 Veteran’s Day: November 11th

1.4.2.10 Thanksgiving Day

1.4.2.11 Christmas Day: December 25th

1.4.3 Reserved.

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 Designated Gov’t representative. 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 Reserved.

1.4.5.2 Reserved.

1.4.5.3 Reserved.

1.4.5.4 Reserved.

1.4.5.5 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to COMSEC review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DoD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DoD organizations.

Therefore, the contractor is advised that any time contractor personnel place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DoD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

1.4.5.6 Reserved.

1.4.5.7 Reserved.

1.4.5.8 Reserved.

1.4.5.9 Reserved.

1.4.5.10 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.

1.4.5.11 Reserved.

1.4.5.12 Reserved.

1.4.5.13 Reserved.

1.4.5.14 Reserved.

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.

1.4.7 Reserved.

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, Designated Gov’t representative and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will apprise the contractor of how the Government views the contractor’s performance 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 Designated Gov’t representative, 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 Reserved.

1.4.11. 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.

1.4.12 Reserved.

1.4.13 Reserved.

1.4.14 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 mitigate any such OCI. The contractor’s mitigation plan will be determined to be 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.

1.4.15 Reserved.

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 Contracting Officer (KO): A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government.

Note: The only individual who can legally bind the government.

2.1.3 Contracting Officer Representative (COR): An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

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

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

2.1.6 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.

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

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

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

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

2.1.11 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 Infrastructure AFARS Army Federal Acquisition Regulation Supplement AR Army Regulation ARNG Army National Guard AT/OPSEC Antiterrorism/Operational Security AUP Acceptable Use Policy CFP/M/E Contractor Furnished Property, Materials, and Equipment CFR Code of Federal Regulations COMSEC Communication Security CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf DA Department of the Army DFARS Defense Federal Acquisition Regulation Supplement DOD Department of Defense DoDI Department of Defense Instruction FAR Federal Acquisition Regulation FPCON Force Protection Condition GFP/M/E/S Government Furnished Property/Material/Equipment/Services HIPAA Health Information Portability and Accountability Act IA Information Assurance IS Information System(s) JFHQ Joint Force Headquarters JTR Joint Travel Requirement KO Contracting Officer NGB National Guard Bureau NCARNG North Carolina Army National Guard OCI Organizational Conflict of Interest PII Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact PoP Period of Performance PPOM Personnel Policy Operational Message PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program TASS Trusted Associate Sponsorship System TE Technical Exhibit

VA Veterans Administration

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S):

3.1 Property: Physical space outside of the armories/work locations will be provided for the contractor’s mobile units to park.

3.2 Materials: Plain Paper Copier. Both the Government and contractor share this unit. The Government shall provide all service and supplies, including paper, which is mutually used by all parties. Contractor use of the copier shall be limited to that work which is generated in the performance of this contract.

3.3 Equipment: Power Source. Each location identified in Paragraph 1.4.4 contains a 240 Volt, 60 Amp receptacle that may be used as an alternate power source in lieu of a Contractor furnished generator.

3.4 Services: None

3.4 Utilities: All utilities in the facilities wherein the events are hosted will be available for the contactor’s 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

5.0 Requirements: The contractor shall:

5.1 Event Requirements

5.1.1 Exam Documentation: Provide clearance letters for Fire Fighter Medical Examinations within 7 business days if there are no medical issues requiring follow-up. Contractor shall provide the NCARNG POC – The 2-130th AOB AO with a copy of all medical examination results for the 19 NCARNG Firefighters within fifteen (15) working days upon completion of testing services. Results which are questionable and/or of critical clinical significance are to be communicated immediately to the NCARNG POC by telephone or encrypted email, and the employee shall be provided with a written medical referral. Medical Examinations requiring follow-up will be conducted within 30 days. The Contractor will be provided with the 2-130 th AOB AO’s phone number(s) and email address.

5.1.1.1 Medical examination results for all 19 NCARNG Firefighters shall include results of all diagnostic tests, graphs, charts, reports, questionnaires, waivers, employee consent forms, physical findings.

5.1.1.2 Identify all medical records with the employee’s full name, last four digits of social security number, and date of birth. The Contractor shall ensure work / health history forms and medical reports are complete and legible (typed / printed).

5.1.1.3 Provide Privacy Act Statement for each employee to sign during the registration process.

5.1.2 Event Summary Reporting: Provide a final report for all services provided to include the below information regarding all 19 NCARNG Firefighters receiving services. Submit report to the 2-130th AOB AO as designated for each event within 3 business days of each event.

Date Location Total number of patients scheduled Total number of patients examined A by name listing of all employees examined and the tests/exams completed on each employee

5.1.3 Medical Liability Insurance: Maintain medical liability insurance, in a coverage amount acceptable to the Contracting Officer, which is not less than the amount normally prevailing within the local community for the medical specialty concerned. The Contractor is required to ensure that its subcontractors, if any, for provisions of health care services, contain the requirements of the clause at 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance. Indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance. The contractor shall furnish to the Designated Gov’t representative prior to contract award evidence of its insurability concerning the medical liability insurance required by this clause.

5.1.4 Specialized Testing and Exams: Ensure all procedures are conducted in accordance with applicable U.S. Department of Labor (DOL), Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) Standards, CAOHC procedures. NFPA 1582 Standard on Comprehensive Occupational Medical Program for Fire Departments.

5.1.5 Laboratory Services: Ensure all clinical laboratory 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 Pathologies. Laboratory services shall be performed by personnel certified under the American Society of Clinical Pathology.

5.1.6 Bloodborne Pathogens Compliance: Ensure each healthcare worker complies with the requirements of 29 CFR 1910.1030 Bloodborne Pathogens Standard.

5.1.7 Hazardous Waste: Ensure disposal of all infectious waste is in accordance with local, state, and federal regulation and disposed of by the contractor unless other accommodations have been coordinated in writing.

5.1.8 Equipment: Ensure instrumentation must meet or exceed appropriate performance standards, and calibration accuracy in accordance with local, state, and federal regulation, and calibration accuracy must be verified in accordance with current Certification standards.

Supporting documentation indicating equipment compliance shall be provided as requested.

5.1.9 Scheduling of events: Scheduling/coordination shall be a joint effort between the 2-130th AOB AO and the Contractor. Due to the requirement of fasting, all efforts will be made by the Contractor to schedule morning appointments. In the event of Contractor equipment failure, or specific testing and/or required components of examination not completed during the initial exam, the exam will be completed within 2 calendar months at a scheduled time mutually convenient for the Contractor and the Employer/Employee.

5.1.10 Exam Components

5.1.10.1 ALL Fire Fighter Medical Examinations will include:

5.1.10.1.1 Medical Component

a. Medical History/Medical Examination.

b. Vision Screening Snellen(distance) screening

c. Audiogram.

d. Comprehensive Metabolic Panel.

e. Complete Blood Count (CBC) including differential and blood platelet counts (actual).

f. Lipid Panel.

g. Thyroid Stimulating Hormone

h. Urinalysis (UA), screening and microscopic.

i. Prostate Specific Antigen (PSA) (Males over 40).

j. Cancer Antigen 125 (CA-125) (All females).

k. Hemoglobin A1C.

l. Pulmonary Function Test (PFT)

m. Electrocardiogram (EKG) – 12-lead

5.1.10.1.2 Fitness Component per NFPA 1582 Chapter 8

a. WFI Submaximal Graded Treadmill Evaluation to evaluate aerobic capacity (per NFPA 1582 C.2.1.3)

b. Hand grip strength evaluation (NFPA 1582C.2.1.5)

c. Vertical Jump Assessment (NFPA 1582 C.2.1.8) or Leg Strength Evaluation (C.2.1.6)

d. Arm Strength Evaluation (NFPA 1582 C.2.1.7)

e. Push-up muscle endurance evaluation (NFPA 1582 C.2.1.9)

f. Prone static plank core stabilization assessment (NFPA 1582 C.2.1.11)

g. Sit and Reach Flexibility evaluation (NFPA 1582 C.2.1.12)

5.1.11 Physical Exam will include vital signs, height, weight, blood pressure, and otoscopic exam. Exam findings will be documented on Health History and Physical Examination form.

5.1.12 Pulmonary Function Testing shall include as a minimum Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), comparison with recognized normal for the individual's height and weight, sex, race, age and a documented interpretation by a pulmonologist or certified Occupational Health physician/provider. Contractor will administer required OSHA respirator questionnaire. The Physician/Provider will provide an evaluation letter which either clears the employee for respirator use or withholds the clearance pending further medical evaluation (with explanation of evaluation required for clearance). Letter will be included in Exam Documentation specified in 5.1.1.

5.1.13 Perform respirator fit testing in accordance with 29 CFR 1910.134 and AR 11-34.

Respirator fit test will be included in Exam Documentation specified in 5.1.1.

5.1.14 Perform audiograms in accordance with Standard Testing Procedures for Army Hearing Conservation and Hearing Readiness IAW AR 40-501 and DA-PAM 40-501. Audiometric reports must contain:

a. The examiner’s name and CAHOC certification number

b. The reviewer’s name (audiologist or physician), state license or certification number

c. The make, model, serial number and the most recent electro acoustic calibration date of the audiometer used.

5.2 Key Personnel

5.2.1 Medical Providers with OSHA Standards and NFPA 1582 Firefighter Physical experience.

5.2.2 Medical Technicians: Shall be credentialed but will work under the auspices of the licensed provider. Contractor shall be held liable and is responsible for ensuring and verifying the appropriate level of Credentialing / Privileging (Licensure, Diploma, background checks, etc.)

for all contact providers in support of any NCARNG event.

5.2.3 Pulmonary Function Tests (PFTs) shall be performed by a licensed physician, Certified Pulmonary Function Technologist, or personnel certified through a program approved by the National Institute for Occupational Safety and Health (NIOSH) in accordance with 29 CFR 1910.1001.

5.2.4 Audiogram Screening Technicians: Shall be certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC).

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

Publication (Chapter/Page)

Date of Publication

Mandatory or Advisory

Website

Title 29, Code of Federal

Regulations, Part 1910:

Occupational Safety and

Health Standards current Mandator y https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910Tabl eofContents

NFPA 1582

Standard on

Comprehensive Occupational

Medical Program for

Fire Departments

2022 Mandator y https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=1582

Title 29, Code of Federal

Regulations, Part 1960:

Safety and

Health Provisions for

Federal Employees current Mandator y https://www.osha.gov/dep/ffshc/standards.html

Threshold Limit Values(TLV’s) and Biological Exposure

Indices (BEI’s), American Conference of Governmental Industrial Hygienists (ACGIH), Cincinnati, Ohio.

current Advisory https://www.acgih.org/tlv-bei-guidelines/tlv-chemical-substances-introduction

Army Regulation 40- 5, Army Public Health

Program

12 May 2020 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/p df/web/ARN16450_R40_5_FINAL.pdf

Department of Defense Manual

6055.05, Occupational Medical Examinations

27 July 2022 Mandatory https://safe.menlosecurity.com/doc/docview/viewer /docN89279548EED9a50628bb4c1aed1f83acc107

23b072fe244e13f7d16f44e55dc8dd886b1e4c75

Army Regulation 11- 34, The Army

Respiratory Protection Program

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

Department of the Army Pamphlet (DA PAM) 40-501 Army

Hearing Program

8 January

Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/p df/web/ARN16450_R40_5_FINAL.pdf

DoDM 5200.2 Regulation 5200.02 Procedures for the

DoD Personnel Security Program

(PSP)

04/03/2017 Mandatory http://www.dtic.mil/whs/directives/corres/pub1.ht ml

AR 190-13

The Army Physical Security Program

06/27/2019 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_b/ pdf/web/ARN21433_R190_13_FINAL.pdf

Homeland Security Presidential Directive

(HSPD)-12

Policy for a Common

Identification Standard for Federal Employees and Contractors

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

DoDD 5400.11 Department of

Defense Privacy Program

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

DoD 5400.11-R Department of

Defense Privacy Program

05/14/2007 Mandatory http://www.dtic.mil/whs/directives/corres/pub1.ht ml

DoDD 8140.01 Cyberspace Workforce

Management

08/11/2015 Mandatory 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)

Mandatory http://www.dtic.mil/whs/directives/corres/pub1.ht ml

AR 25-2

Army Cybersecurity

04/04/2019 Mandatory https://armypubs.army.mil/epubs/DR_pubs/DR_a/ ARN37506-AR_25-2-003-WEB-4.pdf

AR 530-1

Operations Security

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

TECHNICAL EXHIBIT 1

Performance Requirements Summary

Note: The tasks below are merely a small sampling of tasks required by the PWS which performance will be tracked by the Designated Gov’t representative. All work within the scope of this PWS remains subject to Government Surveillance at all times

PWS

Paragraph

Task Performance Standard Acceptable Quality Levels

(AQL)

Surveill ance

Method

5.1.1

5.1.2

Documentation & Reporting

Exam documentation and summary event reporting is timely and accurate

97%, corrected within 3 business days if deficient.

100 Percent Inspection by Designated Gov’t representativ e

5.1.10

Phlebotomy Services

Testing is performed in accordance with prescribed Army and NGB policy and

IAW AR 40-501

97%, corrected within 3 business days if deficient.

100 Percent Inspection by Designated Gov’t representativ e

5.1.11 Optometry

Exams accordance with AR 40-501 and DA PAM 40-506

97%, corrected within 3 business days if deficient.

100 Percent Inspection by Designated Gov’t representativ e

5.1.12 Pulmonary

Exams accordance with AR11-34.

Written Respirator Clearances provided in a timely manner.

97%, corrected within 3 business days if deficient.

100 Percent Inspection by Designated Gov’t representativ

5.1.13 Hearing Exams

accordance with Standard Testing Procedures for Army Hearing Conservation and Hearing Readiness.

97%, corrected within 3 business days if deficient.

100 Percent Inspection by Designated Gov’t representativ

TECHNICAL EXHIBIT 2

Surveillance Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.5.5 Initial and

annual HIPAA (Health

Information Portability and Accountability Act) training certificates.

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

Designated Gov’t representative

5.1.1 Examination Documentation

Provide within 30 business days of each event

2 Physical Delivery

Designated Event Gov’t

POC

5.1.2 Event Summary

Report

Provide within 30 business days of each event

1 Electronic Submission

Designated Event Gov’t

POC

5.1.3 Medical Liability

Insurance

Prior to the start of contract performance

1 Electronic Submission

Designated

Gov’t representative

5.1.12 Written Respirator

Clearance

Provide within 30 business days of each event

2 Physical Delivery

Designated Event Gov’t

POC