PWS - Mobile MED1 .pdf

PERFORMANCE WORK STATEMENT (PWS)

Illinois Army National Guard (ILARNG) Springfield, IL.

PROCUREMENT OF MOBILE OCCUPATIONAL MEDICAL SURVEILLANCE

EXAMINATIONS

1.0 General:

1.1 1.1 Scope: The contractor shall provide contract support to Illinois Army National Guard (ILARNG) for Occupational Medical Surveillance Examination Program in accordance with the Occupational Safety and Health Association (OSHA), Department of Defense (DoD), and other regulations. Requirements include Medical Surveillance Exam/CBC/CMP/ Urine /heavy metals blood tests, Chest X-ray, Pulmonary Function Tests, and Respirator Clearance. The submission of test results to the Occupational Health Nurse are also required as well. There are two (2) locations, Springfield and North Riverside Illinois that will require Medical Surveillance Exams to be completed within the one week period. Springfield will have approximately 62 exams and North Riverside will have approximately 41. The total approximate number of personnel to be examined is approximately 103.

1.2 Background: The Illinois Army National Guard (ILARNG) Occupational Medical Surveillance Examination Program requires that all full-time federal employees that are occupationally exposed to hazards receive medical surveillance in order to maintain compliance with the Occupation Safety and Health Association Act of 1970 (OSHA) and other federal and state regulations. The Occupational Medical Surveillance Program is to provide job-related Medical Surveillance Examinations and Occupational Health Services to the ILARNG Full-Time Support (FTS) technicians who are or could potentially be exposed to health hazards in the work environment per DoD 6055.05M.

The medical surveillance program will include pre-placement, periodic, baseline, incidental and termination exams based on the actual occupational hazard.

1.3 Period of Performance (PoP): The Period of Performance shall be conducted one week during September with 3 option years. Dates will be verified after award.

1.4 General Information:

1.4.1 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary. The QCP will be submitted within 14 days after contract is awarded. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO) acceptance in writing of any proposed changes to its

QCP.

1.4.2 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).

1.4.3 Recognized Holidays: The following are recognized United States (US) holidays.

The contractor shall not perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King, Jr.’s Birthday: January 20th

1.4.3.3 President’s Day: February 17th

1.4.3.4 Memorial Day: May 25th

1.4.3.5 Independence Day: July 3th

1.4.3.6 Labor Day: September 7th

1.4.3.7 Columbus Day: October 12th

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day: November 26th

1.4.3.10 Christmas Day: December 25th

1.4.4 Place and Performance of Services: The contractor shall provide services between the hours of 0730-1630 on Monday through Friday at the designated location, 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 held at Camp Lincoln, 1301 North MacArthur Boulevard, Springfield, Illinois 62702 and North Riverside, 8660 West Cermak Road, North Riverside, Illinois 60546. 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.

Teleworking is not authorized.

1.4.4.1 Telework: is not authorized

1.4.4.2 Unscheduled gate closures 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.

1.4.4.3 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 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.

1.4.5 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. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes. Common Access Card is not required.

1.4.5.1 Reserved

1.4.5.2 For contractors that do not require a CAC, but require access to a DoD facility or installation: Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), and applicable installation, facility and area commander installation/facility access, and local security policies and procedures (provided by a government representative).

1.4.5.3 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.

1.4.5.4 Reserved

1.4.5.5 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.

1.4.5.6 AT Level 1 Awareness Training (AT): Not applicable

1.4.5.7 Information Assurance (IA)/Information Technology (IT) Training: Not applicable

1.4.5.8 Information Awareness: Not applicable

1.4.5.9 iWATCH Training: Not applicable

1.4.5.10 OPSEC Training: Not applicable.

1.4.5.11 OPSEC SOP/Plan. Not applicable

1.4.5.12 Classified Information Not applicable

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.

1.4.6.1 Key Control Not applicable

1.4.6.2 Lock Combination: Not applicable

1.4.7 Special Qualifications: Contractor shall provide a Certified Occupational Medicine Physician to conduct job-related medical surveillance physical examinations and occupational health consultation services. Documentation shall be provided 14 calendar days after contract execution or base period and all option periods.

1.4.7.1 Contractor shall provide documentation to OHN that PFT’s are performed by a technician that has completed the 16 hour NIOSH-approved spirometry training course prior to performing tests in the occupational setting.

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 Subpart 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will 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 COR, CW5 Mark Adams 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 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.

1.4.11 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 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 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.

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.

2.1.1 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:

AAOHN American Association of Occupational Health Nurses

ABOEM American Board of Occupational and Environmental Medicine AR Army Regulation AT/OPSEC Antiterrorism/Operational Security BUN Blood Urea Nitrogen CBC Complete Blood Count CM Contract Manager CMP Comprehensive Metabolic Panel CMRA Contractor Manpower Reporting Application COR Contracting Officer Representative DA Department of the Army DFARS Defense Federal Acquisition Regulation Supplement DHHS Department of Health and Human Services DoD Department of Defense DoDD Department of Defense Directive DoDI Department of Defense Instructions FAR Federal Acquisition Regulation FPCON Force Protection Condition FTS Full Time Support GFP/M/E/S Government Furnished Property/Material/Equipment/Services GGTP Gamma-glutamyl transpeptidase HDL High Density Lipoprotein HQDA Headquarters, Department of the Army IA Information Assurance IAW In Accordance With ILARNG Illinois Army National Guard ILARNG FTS Illinois Army National Guard Full Time Staff IS Information System(s) KO Contracting Officer LDL Low Density Lipoprotein NIOSH National Institute for Occupational Safety and Health OCI Organizational Conflict of Interest OHN Occupational Health Nurse OSHA Occupational Safety and Health Administration PFT’s Pulmonary Function Tests PII Personally Identifiable Information POC Point of Contact POP Period of Performance PPE Personal Protective Equipment PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program SGOT Serum glutamic-oxaloacetic transaminase SGPT Serum Glutamate pyruvate transaminase

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

The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1 Property: The Government will furnish the necessary parking space for the contractor’s mobile unit to perform services outlined in this PWS.

3.2 Materials: Not applicable

3.3 Equipment: Not applicable

3.4 Services: Not applicable

3.5 Utilities: All utilities in the facility 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 section 5.

5.0 Requirements:

5.1 The contractor shall provide documentation of medical liability insurance coverage within 14 days after contract is awarded to OHN.

5.1.1 Contractor shall follow all procedures that are conducted in accordance within the American Board of Occupational and Environmental Medicine (ABOEM), American Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) Standards.

5.1.2 Contractor shall provide documentation to OHN that the laboratory tests will be processed by certified clinical laboratories and performed by personnel certified under the American Society of Clinical Pathology within 14 calendar days prior to contract execution for base period and all option periods.

5.1.3 Contractor shall provide documentation to OHN that their Pulmonary Function machine used during testing is calibrated to meet appropriate performance standards and accuracy with accordance to Occupational Medicine Certification standards within 14 calendar days prior to contract execution for base period and all option periods.

5.1.4 Contractor shall provide and perform the listed components of the basic Occupational Medical Surveillance examinations, document and provide documentation to OHN and ILARNG FTS within 30 calendar days after the event. The components shall consist of the following:

a.. CBC and CMP- Blood chemistry which includes: total bilirubin; BUN;

Creatinine, Serum; Eosinophil count; Hemoglobin and Hematocrit; Peripheral Smear Morphology; Red Blood Cell Indices; Reticulocyte Count; Triglycerides; Total Cholesterol to include HDL and LDL; Alkaline Phosphatse; [Alk P04]; GGTP; SGOT;

SGPT; (either individually or part of a liver profile). Estimated quantity: 103

b. Urinalysis, screening and microscopic. Estimated quantity: 103

c. Blood Lead/ZPP, Beta 2 microglobin. Estimated quantity: 103

d. Blood and Urine Cadmium screening. Estimated quantity: 103

e. Single Chest X-ray single view. Estimated quantity: 103

f. Exam shall include vital signs to include height, weight, blood pressure, pulse and respirations. Estimated quantity: 103

g. Respirator screening and clearance. Estimated quantity: 39

h. Physician Exam including dermatological exam and physical mobility limitations. Estimated quantity: 103

i. Pulmonary Function Tests. Estimated quantity: 103

5.1.5 Medical Surveillance screening shall be accomplished via mobile unit equipped with a self-contained power source. Features of the test site shall include, climate-controlled atmosphere, patient waiting/holding area for registration, changing room, restroom, testing/phlebotomy station, physical examination area and a private consultation office for patient interviews.

5.2 PERSONAL PROTECTIVE EQUIPMENT

5.2.1 Contractor shall provide their own PPE for their healthcare workers.

5.2.2 Contractor shall provide their own resistant sharps containers and dispose of them within their facility.

5.3 MEDICAL REPORTS AND RECORDKEEPING

5.3.1 Contractors shall immediately report to the Occupational Health Nurse (OHN) by telephone at 217-761-3727 if results are questionable and/or of critical significance and/or require follow-up.

5.3.2 Contractor shall provide all results with one paper copy to the OHN and mail one copy to the ILARNG FTS (addresses to be given day of event), to include all diagnostic tests, graphs, charts, reports, chest x-rays, questionnaires, waivers, employee consent forms, physical findings, and examination results within 30 days after event.

Illinois Army National Guard Safety and Occupational Health Office ATTN: Michelle L. Kinney, OHN 1301 N MacArthur Blvd Springfield, IL. 62702

5.3.3 Contractor shall provide a digital copy of chest x-rays with name and results for all ILARNG FTS to OHN within 30 days after event.

5.3.4 Contractor shall provide and identify all medical records with the FTS full name, social security number, date of birth, job code, FTS work place, work/health history forms and medical reports that are complete and legible (typed / printed).

5.3.5 Contractor shall have each employee sign the Privacy Act Statement (DD Form 2005) during the registration process provided by the OHN and given to OHN.

5.3.6 Contractor shall provide an excel spreadsheet to the government representative with FTS full name, social security number, date of birth, job code, place of work and type of procedures performed.

5.4 EXAMINATION SCHEDULING

5.4.1 Coordination of scheduling shall be a joint effort between the OHN and the Contractor, a draft copy of the schedule shall be initiated 30 days before agreed upon scheduled week of performance by the OHN and sent to the Contractor for review and any needed adjustments.

5.4.2 In the event of a Contractor equipment failure, specific testing and/or parts of examinations that are not completed during the testing period shall be completed at a scheduled time mutually convenient for the Contractor, Government, OHN and the Facility (ies). Unfinished testing/examinations shall be completed at no additional cost to the Government and can be scheduled through a local occupational medical facility.

5.5 Contractor Manpower Reporting Application (CMRA):

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

5.5.2 The contractor shall completely fill in all required data fields using the following web address: http://www.ecmra.mil/. Reporting inputs shall be for the labor executed during the period of performance during each Government fiscal year (FY), which runs

October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2020. Contractors may direct questions to the help desk at http://www.ecmra.mil.

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

Publication (Chapter/Page)

Date of Publication

Mandatory or

Advisory

Website

Federal Acquisition Regulation Online Mandatory https://www.acquisition.gov

Defense Federal Acquisition Regulation Supplement

Online Mandatory http://www.acq.osd.mil/dpap/dars/dfarsp gi/current/index.html or

DoD 5400.11-R Department of Defense Privacy Program

14 May

Mandatory https://www.esd.whs.mil/Portals/54/Docu ments/DD/issuances/dodm/540011r.pdf

Title 29, Code of Federal Regulations, Part 1910:

Occupational Safety and Health Standards.

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

Army Regulation 40-5, Preventive Medicine

25 May

Mandatory https://armypubs.army.mil/ProductMaps/ PubForm/Details.aspx?PUB_ID=500

American National Standards Institute (ANSI) Z88.2-1992, American National Standard for Respiratory Protection

Online Advisory https://law.resource.org/pub/us/cfr/ibr/00 2/ansi.z88.2.1992.html

Department of Defense 6055.05-M, Occupational Medical Examinations and Surveillance Manual

2 May

Mandatory https://www.esd.whs.mil/Portals/54/Docu ments/DD/issuances/dodm/605505mp.p df?ver=2018-11-19-150151-020

U.S. Department of Labor, Code of Federal Regulations 29 (CFR) 1910.120 (b) (5), (f), Medical Surveillance

Online Mandatory https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1

910.120

Army Regulation 11-34, The Army Respiratory Protection Program

25 July

Mandatory https://armypubs.army.mil/epubs/DR_pu bs/DR_a/pdf/web/r11_34.pdf

National Institute for Occupational Safety and Health

(NIOSH)

December

Mandatory https://www.cdc.gov/niosh/docs/2004- 154c/pdfs/2004-154c.pdf

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

Form Date Website

DD Form 205 Privacy Act Statement-Health Care Records

6-Jun-16 https://www.esd.whs.mil/Directives/forms/dd2000_2499/

TECHNICAL EXHIBIT 1

Performance Requirements Summary (PRS)

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

Performance Objective

Performance Standard Acceptable Quality Levels (AQL)

Surveillance Method / By

Whom

1.4.7 Certified

Occupational Medicine Physician

a. Physicians Shall be a Certified Occupational Medicine Physician

b. Certificates shall be provided NLT 14 calendar days prior to contract execution

a. 100% shall be certified and

b. NLT 14 calendar days prior to contract execution

100% inspection by government representative

1.4.7.1 Completed Approved Training

IAW National Institute for Occupational Safety and Health (NIOSH)

100% shall be certified and provide documentation prior to testing

100% inspection by government representative

5.1.2 Certified

Clinical Lab

a. provide documentation of certified lab NLT 14 days prior to contract execution

b. IAW American Society of Clinical Pathology Standards

a. NLT 14 days prior to contract execution

b. 100% shall be certified and provide documentation prior to testing

100% inspection by government representative

5.1.3 Calibration a. IAW Occupational Medicine

Certification standard for instrument calibration

b. NLT 14 days prior to contract execution a.100% Instruments that require calibration.

b. provide documentation of Calibration within 14 days of contract execution

100% inspection by government representation.

5.1.4 letters a through i Medical Surveillance Exams

a. IAW Medical Surveillance per DoD 6055-M

b. Shall provide medical report NLT 30 calendar day after event.

a.100% ILARNG FTS undergoing medical surveillance exams

b. provide medical reports NLT 30 calendar days after event.

100% inspection by physician, OHN, or government representative

5.1.4 letter g Respirator Screening and Clearance

IAW American National Standards Institute (ANSI) Z88.2-1992, American National Standard for Respiratory Protection, and DoD 6055-M page 68

100% ILARNG FTS

identified and cleared to wear respirators

100% inspection by physician, OHN or government representative.

5.3.1 Report

questionable results

IAW DoD6055.05M Medical Surveillance and American Society Of Clinical Pathology standards

100% questionable results that are above or below laboratory limits

100% inspection by physician, OHN or government representative.

5.3.5 Privacy

Act Form

IAW Army Publishing Directorate, Forms, DD Form 2005

100% ILARNG FTS will sign Privacy Act Form

100% inspection by government representative

5.5.2 Labor IAW http://www.ecmra.mil/ 100% Report all labor

executed

100% inspection by Government representative

TECHNICAL EXHIBIT 2

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

1.4.1 Quality Control

Provide within 14 calendar days after contract is awarded

1 Electronic or hard copy

KO

1.4.7 Certified

Occupational Medicine Physician

Provide within 14 calendar days after contract is awarded

1 Electronic or hard copy

KO

1.4.7.1 PFT’s

Performed by Certified technician

Provide document prior to testing dates

1 Electronic or Hard Copy

OHN

5.1 Liability

Insurance

Provide within 14 calendar days after contract is awarded

1 Electronic or hard copy

OHN

5.1.2 Certified

Clinical Lab

Provide 14 calendar days prior to contract execution

1 Electronic or hard copy

OHN

5.1.3 Calibration

Certificate

Provide documentation prior to testing dates that the instruments have been calibrated in Accordance with Occupational Medicine Certification standards

1 Electronic or Hard Copy

OHN

5.3.2 Provide Results of exams

Provide one paper copy of all exams to OHN and mail one copy to the ILARNG

FTS, mailing addresses will be given day of exam.

Provide within 30 calendar days after event

2 Paper copy OHN and ILARNG

FTS

5.3.3 X-ray results Provide within 30 calendar

days after employee completes testing

1 Disc OHN

5.3.4 ILARNG FTS

Identify Medical Reports with listed criteria

Provide within 30 days after employee completes testing

1 Paper OHN

5.3.5 Privacy Act

Form DD 2005

Signed by each ILARNG FTS before being testing and give to OHN after testing completed.

1 Paper OHN

5.3.6 Excel

spreadsheet with FTS testing and personal information

Provide within 30 calendar days after event

1 Electronic OHN

5.5.2 Report all

labor Contracting Hours

Submit no later than October 31st of each calendar year

1 Online http://www.ecmra.mil/

TECHNICAL EXHIBIT 3

Estimated Workload Data

ITEM NAME ANNUAL ESTIMATED

QUANTITY

1 Medical Surveillance Exam/CBC/CMP/ Urine /heavy metals blood tests, Chest X-ray, Pulmonary Function Tests, vital signs

103 (2020) 80 (2021) 60 (2022) 50 (2023

2 Respirator Clearance 40 (2020)

30 (2021) 30 (2022) 20 (2023)