PWS Hearing Equipment Calibration Services v2.pdf

PERFORMANCE WORK STATEMENT (PWS)

FOR

Hearing Equipment Calibration Services

1.0 The service requested is for hearing equipment calibration. Location of work is Topeka, Salina and

Lenexa, KS.

2.0 Technical Specifications:

The following technical specifications are provided to help potential contractors better understand the task environment in which the services will be delivered. The following specifications are required to successfully deliver the required service and support contract objectives. The contractor is encouraged to exceed these minimum technical specifications to demonstrate its technical, operational, and administrative expertise in support of customer’s organizational and departmental objectives. All plans and reports shall be reviewed and approved by an authorized government official prior to release.

2.1.0 Calibration Service Technician: Contractor shall:

2.1.1 Provide comprehensive electro-acoustical calibration services for the equipment listed in Annex A.

2.1.2 Ensure that the American National Standards Institute (ANSI) Standard S3.6 is met for all KSARNG audiometers and hearing equipment. Ensure compliance with Occupational Safety and Health Administration (OSHA) Standard 1910.95 Appendix E. Ensure compliance with DA Pam 40-501.

2.1.3 Conduct testing with a Type 1 sound level meter (SLM) with octave band filter/analyzer (OBA). The SLM OBA and microphone must be capable of measuring at least 3dB below the applicable criteria “Max SPL” values listed in the Audiometric Test Booth Certification Form. The SLM, OBA, microphone and calibrator must each have been professionally calibrated within one year.

2.1.4 Obtain measurements inside the booth under normal operational conditions during activity levels that are representative of anticipated use conditions, including internal conditions (lights and ventilation turned on).

2.1.5 Record the sound pressure level at 125 Hertz (Hz) and above if the clinician normally tests at 250Hz and above and record at 500Hz and above otherwise.

2.1.6 Perform pre- and post-measurement field calibrations of the sound level meter.

2.1.7 Obtain octave ban readings in the “Linear” or “All Pass” setting, slow response mode.

2.1.8 Sit in the patient’s chair with sound level meter held away from their body at head height or set up a tripod at this location and permit measurement without their presence in the booth.

2.1.9 Check sound levels at seats closest and furthest from the door and record the higher values.

2.1.10 Have someone talk outside the booth to see if the booth meets certification under that condition. If external conversation precludes valid testing, this will be annotated.

2.1.11 Record all values and document all equipment data on the U.S. Army Public Health Center Audiometric Test Booth Certification Form.

2.1.12 Sign, date, and post the certification on the exterior of each booth or on an adjacent wall and provide a file copy to the KS Army National Guard for each location.

3.0 Security Requirements:

3.1 The Contractor will be responsible for ensuring compliance by its employees with the security regulations of the KSARNG where work is performed under this contract.

4.1 Miscellaneous:

4.1.1 Hours of Operation: The contractor shall perform the services required under this contract within core operating hours which are 0800-1700, Mon thru Fri. However, the contracted services may be needed for varying lengths of time each day.

4.1.2 Additional Requirements:

4.1.3 The Contractor shall provide all equipment, supplies, management, supervision, personnel and transportation necessary to assure that all services are in accordance with the contract and all applicable laws and regulations. The Contractor shall ensure all work meets performance standards specified in this Performance Work Statement.

5.1 Place of Performance: This is requirement is for commercial comprehensive electro-acoustical calibration services for Kansas Army National Guard Audiological test equipment residing in three(3) locations:

18200 W 87th St, Lenexa, KS 66219, 2929 SCANLAN AVE

Salina, KS 67401, BLDG 670 RM 110A

5920 SE COYOTE DR

TOPEKA, KS 66619.

Service Delivery Summary Worksheet W912JC-20- X – XXXX – Hearing Calibration Services

Contract Objective: Provide Hearing Equipment Calibration Services to the KS Army National Guard

Performance Objective

Performance Standard

Acceptable Quality Level (AQL)

Method Used / Frequency

Hearing Equipment Calibration

A trained and experienced technician with past experience in military hearing calibration. Perform requirements of Section 2 of the PWS.

• Perform all calibration requirements as directed in DA Pam 40-501

• Complete all calibration requirements per U.S. Army Public Health Center Audiometric Test Booth Certification Form.

Observation or validated user/customer complaints.

Rating Description Green Yes, performance and technical specifications are being met at AQL.

Yellow

Yes, performance and technical specifications are currently being met at the minimum AQL, but the following service / deliverable needs contractor attention.

The Customer must identify what component of the deliverable and/or service requires attention.

Red

No, performance and technical specifications are not being met at AQL and the following service / deliverable needs immediate contractor resolution.

The Customer must identify what component of the deliverable and/or service is below the minimum AQL.

Period of Performance: From ________________________to___________________________

Reimbursable Expenses (include receipts): _________________

QUALITY ASSURANCE WORKSHEET

Contract#_____________ Data Entry Contractor name:_______________________________

Performance Rating

Deliverable/Service Quality Rating

Causative Factors Effect on Mission Action Required /

Date

Hearing Booth and Equipment Calibration

Green Comments Unnecessary for “Green” QA Rating

Yellow

Red

Timely delivery of Services

Error Free Deliverables

Contract employee(s) has required badges displayed and identify themselves as contractors 98% of the time.

Annex A to PWS – Hearing Equipment Calibration Services

Location: Lenexa KS – 18200 W 87th St, Lenexa, KS 66219

Current Equipment:

Brand Model Quantity

Benson CCA 200 MINI 8 Computer Controlled Audiometer

Benson BAS 200 8 BIO- Acoustic Simulator

Interacoustics AD229E 1 Diagnostic Audiometer

Tracor AR9S 1 Audiometric Booth

Acoustic Systems RE 120 1 Audiology Sound Booth

Acoustic Systems RE 121 4 Audiology Sound Booth

Acoustic Systems RE 125 2 Audiology Sound Booth

Hearing Trailer Equipment:

Benson CCA 200 MINI 7 Computer Controlled Audiometer

Benson BAS 200 4 BIO- Acoustic Simulator

InterAcoustics AC 40M Series 1 Clinical Audiometry

Location: Salina KS – 2929 SCANLAN AVE Salina, KS 67401

Brand Model Quantity

Benson CCA 200 MINI 8 Computer Controlled Audiometer

Benson BAS 200 4 BIO- Acoustic Simulator

Acoustic Systems RE 121 8 Audiology Sound Booth

Location: Topeka KS – 5920 SE COYOTE DR BLDG 670 RM 110A TOPEKA, KS 66619

Brand Model Quantity

Benson CCA 200 MINI 4 Computer Controlled Audiometer

Benson BAS 200 3 BIO- Acoustic Simulator

Acoustic Systems RE 121 4 Audiology Sound Booth