S02 - ATTACHMENT 1 - SOW - Audiology Booths.docx

FY23-018 JSN: M0041 Booth, Audio, Double Wall, Suite

VA Pacific Islands Health Care System

Statement of Work Booth, Audio, Double Wall, Suite (JSN: M0041)

VA Pacific Islands Health Care System New Akaka VA Clinic 91-1051 Franklin D. Roosevelt Avenue Kapolei, Hawaii 96707 Introduction The VA Pacific Islands Health Care System has a requirement to purchase Booth, Audio, Double Wall, Suite (JSN: M0041) with an authorized vendor to supply and deliver the item(s) identified in Table 1 below. See salient characteristics below. This is a Brand Name Requirement. This requirement is in support of the activation of New Akaka VA Clinic. The new Akaka VA Clinic has the need for 4 Audio Booths to use in Audiology. ETS-Lingren Model RE-245 is the basis for design.

Table 1 – Package Items Summary

Additional Item Requirements The vendor will provide service manuals that includes theory of operation, maintenance requirements, repair information, schematics, part lists and troubleshooting information in electronic format for use by the VA Engineering Department.

Date of manufacture must not be greater than 2 years before the purchase order date. The equipment must not be used or refurbished and must have the latest manufacturer’s software/hardware updates installed. Any batteries provided with the unit will not be manufactured more than 12 months before the purchase order issue date.

General Conditions Site Address The address of the Akaka VA Clinic is provided below.

91-1051 Franklin D. Roosevelt Avenue Kapolei, Hawaii 96707

Delivery Schedule Items shall be delivered no earlier than the estimated delivery start date and no later than the delivery end date listed in Table 2 below.

Table 2 – Anticipated Building Outfitting Schedule

Schedule and Order Management The above delivery schedule is based upon the current construction schedule due to the nature of activation efforts and construction timelines and dates may vary and shift. Delivery dates need to be flexible. The delivery of items for installation are dependent upon the completion of applicable areas within the building. If there is a delay, the Contractor may be required to adjust the delivery date at no cost to the Government. The Contractor will coordinate with the on-site POC’s before delivery.

The awardee’s actual delivery dates will be confirmed by VA upon award.

Post-award, the vendor will coordinate delivery identified in this document with the VA prior to beginning any work (See Section 2.4). Once the dates have been confirmed, modifications to the schedule are subject to written approval by the CO, COR, and the vendor.

Delivery and Receiving Delivery and receipt of the proposed items is anticipated to be directed to the location identified below. Confirmation of delivery location will be provided post-award.

☒ Akaka VA Clinic (Direct Delivery to address detailed in paragraph 2.1) There is no loading dock available. All delivery vehicles must be equipped with a “Tommy Gate” type lift to facilitate unloading to ground level.

☐ IOT&A Contractor Provided warehouse: Address TBD The vendor is required to define the need for a staging area to accommodate item delivery, if needed. Post-award, this information will be confirmed with the vendor.

The delivery of items identified in this document shall take place during normal loading dock business hours which are defined as: 8:15 AM to 3:00 PM Hawaii Standard Time, Monday through Friday, and excluding Federal Holidays.

Delivery trucks will not be permitted to remain in the receiving area. Trucks shall be unloaded, moved from the receiving area, and then brought back to the receiving area if required to haul out any waste, tools, or excess materials.

Labeling of delivered items shall include the VA facilities contract number and VA purchase order number for identification and reference upon receipt of product.

NOTE: Due to the COVID19 situation, the vendor must follow VA guidelines when on VA property. Any individuals who need to enter the building for installation &/or training will be required to wear a mask and be screened by the site staff prior to entry. Please allow time for this in your schedule.

Clean Up and Disposal There are no dumpsters available for vendor use.

The removal of waste and/or excess material shall be conducted through the loading dock area.

Assembly, Installation, and Calibration Required (Yes ☒ No ☐) The vendor is not required to manage and coordinate installation at the Akaka VA Clinic with the COR or his representative IOT&A POC.

Training Required (Yes ☐ No ☒)

2.7.1 The vendor is not required to provide live clinical training on set up, operation, shut down, and troubleshooting procedures to clinical staff.

Confidentiality and Non-Disclosure This equipment does not connect to a VA network. Therefore, in accordance with Appendix A, Handbook 6500.6 Checklist, block 6, the C&A requirements do not apply to this requirement, and a Security Accreditation Package is required.

Salient Characteristics Booth, Audio, Double Wall, Suite (JSN: M0041) Total Quantity: 4 ☐ Network Required if Checked ☒ Manufacturer Certified Installation Required if Checked ☐ BMET Training Required if Checked ☐ End User Training Required if Checked

Basis of Design is ETS-Lingren MFG P/N: RE-245 Brand Name or Equal Requirement

Salient Characteristics:

Double wall audiometric examination booth. This unit may be prefabricated with interior dimensions of approximately 6’6” Ft high, 10’ Ft wide, and 9’4” Ft long. The composite sheet metal and sound absorbing assembly must have a minimum overall noise-reduction coefficient of 0.95. The door can open to either the right or left. Doctors, nurses, and audiologists use this unit for definitive audiological testing in clinics. This is a single patient booth with the provider controls on the outside

· Unit must but no larger than Exterior Dimensions: 12’ W x 11’4” L x 8’10” H

· Room Dimensions:

· All four (4) Audio Booths must fit in depression space of 11’8” X 52' 3 ¾” and 4 ¾” deep that spans the four Audiometric Exam rooms (1H105, 1H107, 1H109 and 1H111) in the Akaka VA Clinic.

· Allowing wheelchair access into the Audio Booth and duct work under the Audio Booth

· Must have double wall of at least 4” (per wall) for sound proofing isolation

· Must be able to connect and function on a 20amp dedicated circuit

· Must have the option to plug into receptacle or be hardwired

· Booth must have the ability for the facility to connect sprinkler system

· Units must come with variable speed air circulation system and have the option to connect to buildings HVAC

· Booth must have internal LED lighting

· Booth must come with a pre-wired jack panel that will support all modern test equipment requirements

· Booth must have a 36” x 30” (or comparable) observation window for line of site for the provider to see the patient.

· Laminated safety glass

· Booth doors must have window 20” x 60” (or comparable)

· Laminated safety glass

· Booth must have at least 12 hospital grade duplex receptacles

· Internal locations

· 2 by the jack panel

· 3 on each wall (West, East, and North Walls for)

· Outside location

· 1 by the jack panel

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