S02 Install Hybrid OR SOW 12_21_22.docx

Install Hybrid OR VA Medical Center West Haven, Connecticut

STATEMENT OF WORK

Supplement A, B & C

Project Number: 689-22-113

INSTALL HYBRID OPERATING ROOM

VA Connecticut Healthcare System (VACHS) – West Haven Campus

West Haven Campus

950 CAMPBELL AVENUE

WEST HAVEN, CT 06516

TABLE OF CONTENTS:

BACKGROUND

SCOPE OF WORK

ADMINISTRATIVE PROCEDURES

MATERIAL TO BE PROVIDED TO THE A/E BY THE VA

DELIVERABLES

DESIGN REVIEWS – SCHEDULES AND REQUIREMENTS

CONSTRUCTION PERIOD SERVICES

APPENDIX A: ENVIRONMENTAL ASSESSMENT SCOPE OF WORK

APPENDIX B: INFECTION PREVENTION MEASURES

APPENDIX C: VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY LANGUAGE FOR INCLUSION INTO CONTRACTS, AS APPROPRIATE

APPENDIX D: RECORDS MANAGEMENT

Drawing 1: VACHS West Haven Campus Site Map

I. BACKGROUND

The VA Connecticut Healthcare System has a design in process to upgrade all utilities within the Operating Room Suite, Project 689-21-111. The 689-21-111 Upgrade OR Utilities design includes locating, and planning through 35% for future integration of a new Hybrid OR into the Operating Room Suite located on the third floor of Building 1 at the West Haven Campus. The 689-21-111 project includes physical location and utility capacity considerations to reduce the impacts of construction of a future Hybrid OR.

Construction of the 689-21-111 Upgrade OR Utilities is scheduled to begin construction in FY 24 and includes approximately 1.5 years of multi-phased construction related activities in interior spaces of Building 1 on the VA West Haven Campus. It is anticipated the OR Suite will be dedicated solely to construction/renovation for 60 days for the 689-21-111 project.

The VA Connecticut Healthcare System seeks Architectural and Engineering services to take the 35% submittal from the 689-21-111 project through completion to design a new Hybrid OR Suite. The new Hybrid OR also known as Transcatheter Aortic Valve Replacement Surgery (TAVRS) design includes reconfiguring and modernizing existing Operating Room space including a new Hybrid OR, control room, equipment room, etc. and storage considerations for Sterile and Reusable Medical Equipment (RME).

The new design shall be planned as a stand-alone project independent of the 689-21-111 Upgrade OR Utilities, however coordinated with the design and construction. The new design shall Include phasing, anticipate construction activities and plans for minimal down time to OR Surgical operations, and impacts to patient care, and the Surgical Residency program.

Construction of the Hybrid OR is anticipated to begin soon after the completion of the 689-21-111 Upgrade OR Utilities project.

Design phasing and construction timeline are critical. A 24-hour/day construction schedule shall be evaluated as an option to reduce impact to the campus and patient care.

II. SCOPE OF WORK

A. Project Scope and Objectives:

Design a Hybrid OR suite and supporting systems. Locations for work are Building 1; 3rd Floor Surgical Suite; Ancillary Spaces and Operating Rooms.

Additional work will be required in mechanical rooms and other areas supporting the OR. New Sterile and RME storage areas shall be created and/or upgraded to allow equipment and supplies from the OR to be stored in the appropriate environment during construction.

Document Review

The Government will provide information as requested and outlined below.

1. The A/E shall review 689-21-111 Upgrade OR Utilities contract documents. The VA strongly recommends engaging Miller Remick Engineers, Designer of Record for the 689-21-111 Upgrade OR Utilities project. The A/E shall have a thorough understanding of this construction package and phasing requirements outlined in this construction package.

2. The A/E shall review the locations of existing architectural and structural, HVAC and Controls, Medical Gas, Mechanical, plumbing, steam, electrical, fire protection, pneumatic tube, nurse call, communications, booms and lights, etc. system’s drawings within the project area. The VA shall provide the A/E with copies of available as-built site plans, master floor plans, elevations, and structural plans in AutoCAD or .pdf format. These drawings will be provided for reference purposes only. The A/E shall be responsible for verifying all such plans for dimensional accuracy and other features and representations critical to the design prior to their use in production of final plans.

3. The A/E shall have a thorough understanding of the latest version of the VA Surgical and Endovascular design guides and all available guidance on the VA Technical Information Library (TIL). Not limited to, but in addition to HVAC, electrical, RME storage, Hybrid OR design standards, the Physical Security Design Resiliency Manual requirements shall be incorporated into the design. Review OR Boom and lights Requirements. Review Sterile Processing Service (SPS) directive 1116 (2) and follow Memorandum Interim Guidance for Heating Ventilation and Air Conditioning Requirements Related to Reusable Medical Equipment Reprocessing and Storage. Specific sections of the VA Master Construction Specifications, Design and Construction procedures, Standard Details and CAD standards, Design Manuals, etc. can be found via the internet for acquisition and editing by the A/E at http://www.cfm.va.gov/TIL/. A/E shall be responsible for providing a design that meets all VA requirements.

4. Review existing documents and testing previously performed to confirm the locations of asbestos containing materials. Identify, collect, and test materials having the potential to contain asbestos within the project area.

Site Inspection

5. The A/E shall conduct on-site observation and inspections of existing conditions within the OR, mechanical spaces, and potential locations for sterile RME and medical supply storage. Site Investigations of the OR suite by the A/E shall occur on Saturdays and Sundays. Site inspections of the campus grounds, mechanical spaces, and other non-surgical areas by the A/E shall occur during regular working hours 7:00am-6:00pm.

6. The A/E shall thoroughly investigate all physical, lighting, glare, noise, vibration, and other impacts to nearby inpatient units or other patient care areas that could be impacted by construction. Proper planning and phasing shall be implemented to minimize or eliminate impacts.

Interviews

7. The A/E shall Interview stakeholders for local needs, requirements, and concerns. The A/E shall also develop an existing and new furniture, fixtures, and equipment (FF&E) list.

8. The A/E shall interview Subject Matter Experts (SMEs) in the areas of utility design, OR Hybrid, and PSDRM requirements within VA Construction Facilities Management and VA Healthcare Engineering. These SMEs shall provide technical direction and oversight.

9. The A/E shall work with VA Biomed/Clinical Engineering and Medical Design Consultant to develop OR Medical Equipment needs, an itemized equipment list for VA Biomed/Clinical Engineering that needs to be removed and reinstalled as part of the construction project; and a management and coordination plan for equipment removal and installation. Identify square footages required for storage of these items.

Preliminary Studies

10. The A/E shall conduct an electrical load study/analysis to investigate and determine the existing loads and new loads required; also provide coordination study and review additional electrical load studies previously performed for the facility.

11. The A/E shall conduct a structural load study to investigate and determine existing loads for all areas impacted by this project.

12. The A/E shall conduct any additional required surveys to research and investigate the entire area of construction and all materials, including the utilities above the ceiling and within the walls for regulated for hazardous materials. Any required destructive testing shall be performed while protecting the occupants of the space.

13. The A/E shall provide a summary of all VA design standards and guides that will be adhered to during design.

Construction, Commissioning and Activation Documents

14. The A/E shall provide initial programming, schematic design concept 35% design documents, design development 65% documents, final 95% and 100% construction documents that meet project objectives.

15. The A/E shall provide a third party Commissioning Plan in accordance with the VA Whole Building Commissioning Process Manual dated May 01, 2013 and with minor revisions 11/01/2013.

16. The A/E shall develop a Furniture, Fixtures, and Equipment (FF&E) Activation Package and Master Inventory List relevant to the needs of the new Hybrid OR. Employ a Medical Equipment Specialist consultant to specify equipment needs for the Hybrid OR. Document all equipment, furnishings, and FF&E needs for the space and develop plans for the relocation and moves of any existing OR equipment/furnishings as required during the build-out to temporary OR space. VA Logistics to purchase in accordance with the activation plan. VA Interior Designer shall approve all FF&E specific to this project.

17. The A/E shall match interior finishes within the OR space to the Upgrade OR Utilities, VA Project 689-21-111. The A/E shall recommend alternate materials and finishes for any that are found to be no longer available and/or discontinued. VA Interior Designer shall approve all interior finishes.

III. Project Objectives:

1. Design a new Hybrid OR. The new Hybrid OR also known as Transcatheter Aortic Valve Replacement Surgery (TAVRS) design includes reconfiguring and modernizing existing Operating Room space including a new Hybrid OR, control room, equipment room, etc. to support the Hybrid OR and storage considerations for Sterile and Reusable Medical Equipment (RME).

2. Upgrade utilities within the Hybrid OR and spaces supporting the Hybrid OR.

a. Architectural

b. Civil/Structural

c. Mechanical, HVAC, plumbing, steam

d. Electrical

e. Fire Protection

f. Medical Gas

g. Pneumatic tube

h. Nurse Call

i. Data and Communications

3. Provide Minimize impacts to the surgical service

a. Detailed phasing plan, considering all material availability and lead times

4. Minimize impacts (noise, vibration, etc.) to surrounding areas of the hospital.

Design Scope – General: The A/E shall develop and provide a set of drawings and Specifications for conceptual, design development and final design purposes which meet the previously stated Project Scope and Objectives. The A/E shall also provide equipment arrangement locations.

1. Design Scope – Architectural: The A/E shall provide necessary plans to meet the Project Scope and Objectives including flooring, doors, and wall protection finishes as required.

2. Design Scope – Civil/Structural: The A/E shall provide for structural design, calculations and documentation as required to evaluate the location of structural members to avoid conflicts. In addition, the A/E shall provide structural design, calculations and documentation as they pertain to other modifications to the space, roof, or other locations supporting equipment.

3. Design Scope – Mechanical, Plumbing, Steam: The A/E shall review all available documents from the facility, planned improvements under the 689-21-111 Upgrade OR Utilities project, and perform site visits as required to evaluate the HVAC equipment, plumbing systems, controls, and components as required. The A/E shall provide design of mechanical, plumbing, steam design, calculations, and documentation.

4. Design Scope – Electrical: The A/E shall review all available documents from the facility, planned improvements under 689-21-111Upgrade OR Utilities project, and perform site visits as required to evaluate the electrical systems. The A/E shall provide design of electrical, calculations, and documentation.

5. Design Scope – Fire Protection: The A/E shall review all available documents from the facility, planned improvements under the 689-21-111 Upgrade OR Utilities project, and perform site visits as required to evaluate the fire protection system. The A/E shall provide design of fire protection system with documentation.

6. Design Scope – Medical Gas: The A/E shall review all available documents from the facility, planned improvements under the 689-21-111 Upgrade OR Utilities project, and perform site visits as required to evaluate the medical gas systems. The A/E shall provide design of medical gas systems including booms, and equipment to support the Hybrid OR.

7. Design Scope – Pneumatic Tube: The A/E shall review all available documents from the facility, planned improvements under the 689-21-111 Upgrade OR Utilities project, and perform site visits as required to evaluate the pneumatic tube system. The A/E shall provide design of pneumatic tube system to support the Hybrid OR.

8. Design Scope – Nurse Call, Annunciator, Data and Communications: The A/E shall review all available documents from the facility, planned improvements under the 689-21-111 Upgrade OR Utilities project, and perform site visits as required to evaluate the nurse call, annunciator, data, and communications systems. The A/E shall provide design of nurse call, annunciator, data and communications systems to support the Hybrid OR.

9. The A/E Shall work closely with the VA Project Management through the conceptual planning and design phases to ensure coordination with various VA staff through detailed phasing plans. The drawings shall contain boldly printed instructions requiring the same level of coordination by the construction contractor and subcontractors.

IV. General Requirements: The A/E shall produce designs that comply with the latest editions of all applicable DVA guidelines (e.g. Construction Standards, Master Specifications, Standard Details, Special Design Criteria), NFPA, JC, Federal and State codes pertinent to the project scope.

V. Hazardous Materials: The A/E shall have all areas to be impacted by design or construction tested for asbestos and lead containing materials and incorporated into the plans and specifications. This information shall be incorporated into the construction contract documents.

VI. Safety Plan: VA construction projects have requirements for the General Contractor to establish a safety plan per OSHA, AIA, and VA guidelines. The A/E shall specify the applicable standards and method of plan development for both the area of work and interaction of work within the facility. Infection Prevention Measures, and security plan shall also be included in the Safety Plan. The A/E shall also be responsible for developing their own safety for all site investigations, which shall include asbestos awareness training and procedures when encountering asbestos. The A/E shall include COVID-19 related items into their safety plan as required by local and VAMC West Haven campus requirements.

VII. Quality Control Plan: The A/E shall specify the applicable standards and method of development for a Quality Control Plan. The A/E shall not be responsible for the development of the contractor’s plan, but only for identifying and specifying the appropriate standard forms for Quality Control inspections that will become part of the overall construction plan. The A/E shall submit their own QA/QC plan.

VIII. Utility Shutdowns: The VA has a mandatory requirement to obtain approval for utility shutdowns. The A/E shall provide a list of all utility shutdowns required for this project and identify and define the procedure for each shutdown in a Construction Schedule Gant Chart. This will include, but not be limited to, electrical, mechanical and plumbing tie-ins. The A/E shall provide estimated time of each outage and provide a narrative to the impact of the shutdown.

IX. Site Survey: The A/E shall conduct on-site survey(s) within specific timeframes during off hours of the Operating Room located in Building 1, 3rd Floor and any adjacent or support spaces as required. The A/E shall be responsible for providing containment cube, stinky mats, and any other equipment and materials required by the approved Infection Control Risk Assessment plans for destructive testing, suspect material sampling and above ceiling investigations.

X. Code Study: The A/E shall conduct a code study to determine code compliance of the proposed redesign. This shall also include a life safety plan.

XI. Construction Cost and Bid Alternatives: The A/E shall provide a design for this project taking into account phasing. At least 10% of the estimated cost/scope of the project shall be identified as deductive bid alternates to provide some flexibility at the time of construction bid. The specific deductive items shall be developed at the 35% design submission and refined through final design. The construction cost shall not exceed $7,500,000.00.

XII. ADMINISTRATIVE PROCEDURES

A. After award and issuance of the Notice to Proceed, the A/E will coordinate all site visits through the COR. A copy of the COR’s authorized duties and responsibilities will be provided with the Notice to Proceed.

B. All A/E personnel, their sub-contractors and representatives visiting VA sites will be required to sign in upon arrival and sign out upon leaving in a log book which is kept in the Engineering Design and Development section in Building 15. Each visiting individual will be required to enter their name, their company’s name, VA project title, date, reason for the visit, and the times of arrival and departure. Additionally, all persons shall be badged. Arrangements for after-normal-working-hour site visits shall be made in advance and during normal working hours.

XIII. DELIVERABLES

The A/E shall develop and provide to the VA the following:

A. Meeting Minutes: The A/E shall take minutes of all conferences and other meetings with the VA (including site visits) and shall provide a copy to the Contracting Officer for a concurrence signature.

B. Drawings: The A/E shall deliver to the VA fully developed Drawings on current year AutoCAD and a REVIT files using the VA standard BIM Guidelines. Hard Copy drawings shall be plotted at 1:96 scale minimum. Larger more appropriate scales shall be used for sections and details.

C. Specifications: The project specifications shall be prepared in Microsoft Word by the A/E from the VA Master Specifications. The general format shall include; Part 1 – General, Part 2 – Products, and Part 3 – Execution. Part 1 shall include the general requirements, identify applicable standards, and identify submittals required for a particular specification. Part 2 shall include descriptions of the salient characteristics of the products. Part 3 shall include a description of the methods used to install items of construction. The A/E shall identify all VA Master Specification sections applicable to the project and edit them accordingly to fit the scope of work. If additional specification sections are needed that are not listed in the VA Master Specifications, the A/E is responsible to write and edit an appropriate CSI format Specification Section. Specifications shall be printed on 8-1/2”x11” bond paper using 12 pt. Times-New Roman fonts. The A/E shall incorporate into the specifications and its construction site inspection procedures the applicable Infection Control and Dust Control provisions.

D. Construction Cost Estimates: The A/E shall prepare a Construction Cost Estimate in Microsoft Excel using the CSI 34 – division format. The Cost Estimates shall include a copy of the quantity take-offs, breakdown of individual line items that accurately reflect the quantity take-off of the various categories of work involved, unit of measure, quantities, unit cost, 10% overhead, and 10% profit. All cost data shall be taken from the most current version of a recognized industry standard, e.g. Means Estimating Guides. For items that are not in the industry standards, vendor quotes and justification for labor hours shall be provided. Construction Cost Estimates shall be submitted with each design reviews and include a cost breakdown for each alternative.

E. Submittal Register: The A/E shall develop a list of all submittals required by the specifications in Section 1 of each individual specification. The register shall include specification reference, and item to be reviewed approved.

F. Narratives: Written narratives shall be used as part of each design submission. The narrative, or basis of design, should be used to elaborate on and provide an explanation of key design decisions relating to constructability, and in general to communicate all information relevant to the design submission.

G. Construction Schedule: The A/E shall also establish a preliminary construction schedule indicating the entire length of time estimated for the completion of the construction contract, measured in weeks. The A/E shall provide a commensurate Gant Chart for the construction activities to include critical path items. For example, utility shut downs. This schedule shall include pre-construction activities (such as submittals and mobilization), specific construction activities/events, special phasing requirements and final activation of the space.

H. Phasing: The A/E shall develop a phasing plan taking into consideration minimal disruption to current staff, maintaining emergency egress, storage of construction equipment and materials, security and access, debris removal and maintenance of the clean environment. The specific phasing requirements shall be established by the VA prior to the 35% design submission. The VA will notify the A/E on the availability of the entire work area or if partial areas will be required for the duration of construction.

I. Reproduction: The A/E shall be responsible for all reproduction during design; however, only materials which are submitted to the VA for design reviews shall be reimbursable. All other reproduction for in-house reviews, consultants, etc. shall not be reimbursed. Note that all bid administration activities will be performed by the VA Contracting office.

XIV. DESIGN REVIEWS – SCHEDULES AND REQUIREMENTS

The following design submissions will be required:

Programming/Schematic Design Submission – 35% (70 Calendar Days) Design Development Submission – 65% (150 Calendar Days) Construction Documents and Back Check Design Submission – 95% (180 Calendar Days) Final Design Submission – 100% (210 Calendar Days)

The A/E shall examine the schedules set forth below and recommend to the VA any improvements in the allocations of time allowed for each phase, the net effect of which would be to either provide more time for phases needing more time or to shorten the schedule.

A. First Submittal Schematic Design Submission (35%) For this submission, the A/E shall produce a clean and up to date physical schematic.

a. Narrative:

Provide a written narrative with a summary of the meetings with the VA Design Team as well as a presentation, discussion and recommendation of the design alternatives which have been explored and evaluated. Key decisions/choices which were made by the VA Design Team prior to the schematic design submission should be documented. The schematic design narrative shall also identify each and all required systems, utilities (including preliminary HVAC calculations) and major (built-in) equipment with a brief description of its type, location, use and extent.

The A/E shall address constructability issues and their impact on project construction cost.

b. Drawings:

The A/E shall provide preliminary schematic drawings that show improvements within the project limits. Identify and verify as-built conditions in walls and overhead spaces in those areas that will be impacted and propose solutions to re-route existing utilities or avoid utility conflicts.

Review existing environmental reports covering the project area. Identify existing asbestos, lead based paint, and other environmental hazards locations that will be impacted and identify locations that require further testing.

Two C size Drawings and electronic version of CAD work completed to date.

c. Specifications:

The A/E shall provide an index of all VA Master Specifications which are anticipated to be used for this project.

d. Cost Estimates:

The A/E shall provide a complete cost estimate with as detailed a breakdown as possible for this stage of design. Separate cost estimate figures shall be given for design alternatives being presented for consideration as part of the schematic design.

e. Construction Schedules and Phasing Plans:

The A/E shall provide a preliminary construction schedule and phasing plan.

f. The A/E shall provide a completed VA infection control form addressing all areas.

g. The A/E shall provide a completed A/E Review Checklist for all applicable disciplines.

h. The 35% schematic package shall include preliminary concepts of the proposed alternatives. This shall be submitted 70 calendar days after Notice to Proceed (NTP).

The VA will provide 35% review comments to A/E no later than 80 calendar days after NTP.

B. Second Submittal Design Development Submission (65%)

a. Narrative:

Provide a written narrative that builds upon the Schematic narrative and continues to document key decisions and be used to further describe and explain important aspects of the design, especially those not yet appearing in the form of a drawing. As an element of the design development narrative, include an outline of work yet to be completed and included on the drawings as part of the Design Development submission (details, elevations, schedules, etc.). The A/E shall further develop constructability issues and their impacts on project construction cost and schedule. Engineering Calculations shall be included as an appendix.

b. Drawings:

The A/E shall provide design development drawings that show detailed plans to construct a new Hybrid OR and renovations to the adjacent spaces within the project limits. One F size (30” x42”) and two C size Drawings and one electronic version of Cad work completed to date.

c. Specifications:

The A/E shall provide Specifications based on criteria established at the initial design meeting as required for supplementing the construction drawings. The A/E shall provide a list of all proposed specification sections: General Conditions, Submittals, Demolition, and all major electrical, civil, structural, mechanical, plumbing, fire protection, and communication components and hardware.

d. Cost Estimates:

The A/E shall provide an accurate and detailed cost estimate which will show that the scope and the design of the project are within the project budget. Deductive bid alternates shall be broken out separately to show that they account for 20% of the overall budget for construction award.

e. Construction Schedules and Phasing Plans:

The A/E shall provide a detailed construction schedule and phasing plan to support the design.

f. The A/E shall provide a completed VA infection control form addressing all areas.

g. The A/E shall provide a completed A/E Review Checklist for all applicable disciplines.

h. 65% Review Schedule:

The 65% design development package shall include detailed design. This shall be submitted 140 calendar days after Notice to Proceed (NTP).

The VA will provide 65% review comments to A/E no-later than 150 calendar days after NTP.

C. Third Submittal Construction Documents and Back Check Design Submission (95%)

a. Narrative:

The A/E shall provide a written narrative with a concise and complete record of the design process including all key design decisions and the background and reasons for the intent of these design decisions. The narratives shall include all records of the meetings with the VA Design Team as well as a presentation, discussion and recommendation of various design alternatives which have been explored and evaluated. Key decisions/choices which were made by the VA Design Team should be documented. The design narrative shall also identify each and all required systems, utilities, and major (built-in) equipment with a brief description of its type, locations, use and extent. The A/E shall address constructability issues and their impacts on project construction cost and schedule. Engineering Calculations shall be included as an appendix.

b. Drawings:

The A/E shall provide detailed final drawings and calculations based on information collected, and VA comments on the 65% design submittal. One F size (30”x42”) and two C size Drawings and one electronic version of CAD/REVIT work.

c. Specifications:

Provide all Specifications that are required for the construction package. The specifications shall be free of writer’s notes and any editing comments. All information that is not required for this project shall be removed from each individual specification section.

d. Cost Estimates:

A complete takeoff cost estimate based on the Construction Documents Submission.

e. Construction Schedule and Phasing Plans:

Provide a detailed Construction Schedule and Construction Phasing Plan. All utility shutdowns shall be included.

f. Safety Plan:

Provide a list of all applicable standards, method of plan development, a VA Infection Control form, and address all Interim Life Safety Measures.

g. Quality Control Plan:

Provide a list of all applicable standards and method of plan development of a Quality Control Plan.

h. Completed A/E Review Checklist:

Provide a completed A/E Review checklist for all applicable disciplines.

i. 95% Review Schedule:

The 95% final design package shall include final detailed design. This shall be submitted 180 calendar days after Notice to Proceed (NTP).

The VA will provide 95% review comments to A/E no-later than 190 calendar days after NTP.

The 95% review package meeting with the VA at 210 calendar days after NTP.

D. Final Design Submission (100%) One set of original 100% Final Design Drawings to be submitted at 400 calendar days after Notice to Proceed (NTP).

One set of indexed and bound Specifications.

Two CD’s each of:

a. Final Drawings in AutoCAD/REVIT using the VA standard for BIM Guidelines (to include PDF versions of each sheet),

b. Final Drawings in Hard Copy format shall be plotted at 1:96 scale minimum,

c. Specifications,

d. Construction Cost Estimate,

e. Construction Duration Estimate,

f. Phasing Requirements, and

g. Narrative with Engineering Calculations, safety Plan and Quality Control Plan,

h. Equipment List.

For bidding purposes upon final approval by the VA of all 100% construction documents (as evidenced by a VA authorized signature on the Mylar title-pages), the A/E shall deliver to the VA; one (1) set of C-size Drawings and one (1) set of bound specifications.

XV. CONSTRUCTION PERIOD SERVICES (To be awarded only at the time of construction award) A. General: The Contracting Officer reserves the right to terminate any construction period services, without payment for services completed, if such services are not needed or are not being adequately completed.

B. Response to RFI’s: The A/E shall be responsible for evaluating RFI’s to determine if a change will be required. The A/E shall then provide recommendations to the Contracting Officer. Within 48 hours, the A/E shall provide in writing the information, clarification or revision material needed to properly answer the RFI and to resolve the issue. The A/E shall include a cost/credit estimate for RFI’s which result in a change to contract cost.

C. Submittal Review: The A/E shall review Contractor submittals. The A/E will be required to review contract submittal for adherence to contract requirements and then forward their recommendation of approval/disapproval to the VA Contracting Officer within 7 calendar days. The COR shall take final action of approval/disapproval on each submittal and shall prepare and send a formal return of submittal to the contractor.

D. Commissioning: The A/E shall develop a Commissioning plan to activate the new Hybrid OR.

E. Site Visits: Day to day construction administration will be performed by the COR. The A/E shall make site visits during construction as well.

F. Asbestos and Lead Inspection: The A/E shall perform all inspection and documentation services required during asbestos and lead abatement activities.

G. Photographic Documentation: The A/E shall be required to prepare photographic documentation in accordance with VA master specifications during the period of construction.

H. Record Drawings: The A/E shall verify as-built conditions from contractor supplied marked up prints, and prepare as-built documents for the VA.

I. One E size and one C-size Drawing and one electronic version of CAD/REVIT work.

APPENDIX A

ENVIRONMENTAL ASSESSMENT – SCOPE OF WORK

Section I

1.1 GENERAL:

A. This Scope of Work (SOW) is applicable to renovation and/or remodeling projects that may contain asbestos, lead, mold, and other potentially hazardous or regulated substances in which the VA Industrial Hygienist (VPIH) is hired by the A/E. In this document, the term A/E may also refer to as a contractor.

B. These special instructions cover the A/E and VPIH services for the Design Development and the Construction Documents stages of the VA process and the construction period services of a project. The VPIH hired by the A/E is not only required to have the experience and expertise of all aspects of hazard analysis and abatement but also have experience working as a member of a A/E design team.

C. The assessment and inspection portion of the services shall be completed by VPIH personnel who are licensed by the State of Connecticut Department of Public Health as asbestos inspectors for those performing asbestos inspection or assessment. VPIH personnel who perform lead paint inspection or assessment shall be licensed by the State of Connecticut Department of Public Health as a Lead Inspector or Lead Risk Assessor. VPIH personnel who perform microbial inspection or assessment shall show proof of expertise through experience and training in microbial and mold remediation inspection and assessment techniques.

D. The design documents shall be produced using VA Master Specifications by the VPIH with personnel who are licensed by the State of Connecticut Department of Public Health as an Asbestos Project Designer, Lead Project Planner/Designer, have expertise, experience, and training in microbial and mold remediation techniques, and are reviewed and approved by a Certified Industrial Hygienist (CIH) accredited by the American Board of Industrial Hygiene (ABIH).

E. A/E shall be responsible for providing all design documents related to demolition, phasing and other related documents for the project, (as determined by VA if proposed abatement impacts the specific construction project). The VPIH working for the A/E shall design and produce all hazard analysis and abatement contract documents and fully coordinate these drawings with A/E firm contract documents. Work requirements are listed in SECTION 2.2 for the VPIH.

F. The A/E will employ an independent industrial hygienist (VPIH) consultant and/or use its own qualified personnel to perform various services on behalf of the VA. The VPIH will perform the necessary monitoring, inspection, testing, and other support services to ensure that VA patients, employees, and visitors will not be adversely affected by abatement work, and that abatement work proceeds in accordance with specifications, that the abated areas or abated buildings have been successfully decontaminated. The work of the VPIH consultant in no way relieves the Contractor from their responsibility to perform the work in accordance with contract/specification requirements, to perform continuous inspection, monitoring and testing for the safety of their employees, and to perform other such services as specified. The cost of the VPIH and their services will be borne by the VA except for any repeat of final inspection and testing during monitoring services that may be required due to unsatisfactory initial results, as specified. The VPIH during asbestos abatement oversight shall be licensed by the State of Connecticut Department of Public Health as an Asbestos Project Monitor with project oversight by a Certified Industrial Hygienist (CIH) accredited by the American Board of Industrial Hygiene (ABIH).

Section 2

2.1 Project Scope of Work (SOW)

The VPIH shall perform an environmental assessment of the proposed work areas, and areas adjacent to, directly above and below work areas that will be impacted by the project and any other areas not indicated in this section determined by the A/E that may be impacted during the project. Areas that could be impacted by this project should be carefully inspected including walls, floors, shafts and above ceiling and the precise location and quantity of all hazardous materials including but not limited to asbestos, lead, polychlorinated biphenyls, and mold should be provided. The VPIH will have access to all the historical records available for the areas impacted by the project before the beginning of the inspection.

2.2 VPIH Services Scope of Work:

1. All areas that may be impacted by this project (as described in General AE Scope Of Work section) shall require environmental assessment for the presence of asbestos-containing materials, lead-based paint, silica, and other environmental hazards (e.g. PCB, mercury, refrigerant, polychlorinated biphenyls, etc.).

In addition, any areas located adjacent to, above, and below these rooms will require assessment if planned project activities impact these areas. This determination of these additional locations should be made prior to initiating field portion of the environmental assessment.

VPIH Services will include:

2. Asbestos Inspection:

a. A State of Connecticut licensed Asbestos Inspector will conduct an asbestos inspection in each impacted area to meet the requirements of EPA NESHAP/AHERA inspection and State of Connecticut regulations.

b. The inspector will collect bulk samples of suspect materials using approved EPA protocol for analysis by polarized light microscopy (PLM) method in a NVLAP accredited laboratory.

c. The inspector will check above ceiling spaces, including the existing HVAC system and all access hatches leading to above ceiling equipment for presence of suspect asbestos-containing materials and/or debris that might have become dislodged from above equipment.

d. The inspector may be required to perform selective demolition to expose concealed potential asbestos containing materials in the following areas, if impacted by the project: below existing flooring, inside wall cavities and chases, and inside ceiling chases.

3. Lead Inspection:

a. A state licensed Lead Inspector/Risk Assessor will test suspect surfaces and building components that may be impacted by the project for lead-based paint or lead-containing materials.

b. An X-ray Fluorescence Analyzer (XRF) will be used to identify the presence of lead or lead-based paint on/in building components prior to project activities.

c. Representative composite TCLP (Toxicity Characteristic Leaching Procedure) lead sample(s) may be collected as necessary to determine if demolition debris is either classified as hazardous waste or solid waste, depending on lead content and/or leachable lead content.

d. Ceiling spaces shall be included in the scope for inspection for the presence of lead-based paint or lead-containing components.

4. Mold Assessment: An inspector shall conduct a visual assessment of existing conditions for any visible mold and water damaged building materials in each area that will be impacted by this project.

5. Other Hazardous or Regulated Materials Assessment: During above inspections, also record any other hazardous or regulated materials noticed in the impacted areas and their conditions, such as mercury-containing equipment or items, refrigerant in any AHU, PCB-containing materials or equipment or items, etc.

6. VPIH Project Monitoring: During any asbestos abatement activities, provide VPIH monitoring services as specified in VA Master Specifications.

7. Written Reports:

a. A written report will be generated to summarize work activities and detail the findings of the each inspection.

b. The asbestos inspection report will include quantities and locations of asbestos-containing materials identified, sample location diagrams, photographs of each homogenous area and any damaged materials as documentation of present conditions, sample log and results, as well as the completed laboratory analysis.

c. The lead inspection report will include locations and components of lead-based paint, a sample location diagram, sample log and results, as well as any laboratory analysis.

d. Two (2) hard copies and one electronic copy of the final report shall be provided, with electronic copy in PDF format. All data tables must be provided in Microsoft Excel format. All sample locations must be identified on a print and marked in the field.

8. Abatement Specifications:

a. A State licensed Project Designer will review all inspection results and visit the site if regulated or hazardous materials have been identified in the impacted area.

b. Develop a written specification in accordance with the VA Master Spec for abatement of all asbestos-containing materials to be impacted by the renovation work and lead compliance during abatement and renovation for each area that requires asbestos and/or lead abatement.

c. The specification shall include the quantity and location of asbestos-containing materials to be removed and CAD drawings shown containment locations.

d. The materials for constructing the containments shall be outlined as well as methods of asbestos removal and disposal requirements, engineering controls during abatement.

e. Regulatory requirements specific to the site and final clearance criteria shall be detailed.

f. The specification will also provide appropriate guidance related to the lead compliance and disposal of lead-contaminated demolition debris, and other regulated or hazardous materials identified in the project impacted areas.

9. Final payment for design services will not be made until all project documents are received during the design phase and final payment will not be made until project close-out documentation including, but not limited to, VPIH site logs, monitoring results, and waste manifests is received after the completion of VPIH construction period services.

END OF APPENDIX

APPENDIX B

INFECTION PREVENTION MEASURES

A. Implement the requirements of VA Medical Center’s Infection Control Risk Assessment (ICRA) team. ICRA Group may monitor dust, in the vicinity of the construction work, and require the Contractor to take corrective action immediately if the safe levels are exceeded.

B. Establish and maintain a dust control program as part of the contractor’s infection preventive measures in accordance with the guidelines provided by ICRA Group as specified here. Prior to start of work, prepare a plan detailing project-specific dust protection measures, including periodic status reports, and submit to Project Manager and Facility ICRA team for review for compliance with contract requirements in accordance with Section 01340, SAMPLES AND SHOP DRAWINGS.

1. All personnel involved in the construction or renovation activity shall be educated and trained in infection prevention measures established by the medical center.

C. Medical Center Infection Control personnel shall monitor for airborne disease (e.g. aspergillosis) as appropriate during construction. A baseline of conditions may be established by the medical center prior to the start of work and periodically during the construction stage to determine impact of construction activities on indoor air quality. In addition:

1. The Project Manager and VAMC Infection Control personnel shall review pressure differential monitoring documentation to verify that pressure differentials in the construction zone and in the patient-care rooms are appropriate for their settings. The requirement for negative air pressure in the construction zone shall depend on the location and type of activity. Upon notification, the contractor shall implement corrective measures to restore proper pressure differentials as needed.

2. In case of any problem, the medical center, along with assistance from the contractor, shall conduct an environmental assessment to find and eliminate the source.

D. In general, following preventive measures shall be adopted during construction to keep down dust and prevent mold.

1. Dampen debris to keep down dust and provide temporary construction partitions in existing structures where directed by Resident Engineer. Blank off ducts and diffusers to prevent circulation of dust into occupied areas during construction.

4. High risk patient care areas may require additional measures like air locks, special signage, smoke and negative pressure alarms.

5. Identify these areas clearly on the drawings and work with Medical Center personnel to achieve desired level of isolation suited to the scope of risk involved.

6. Do not perform dust- producing tasks within occupied areas without the approval of the Project Manager. For construction in any areas that will remain jointly occupied by the medical Center and Contractor’s workers, the Contractor shall:

a. Provide dust proof fire-rated temporary drywall construction barriers to completely separate construction from the operational areas of the hospital in order to contain dirt debris and dust. Barriers shall be sealed and made presentable on hospital occupied side. Install a self-closing rated door in a metal frame, commensurate with the partition, to allow worker access. Maintain negative air at all times. A fire retardant polystyrene, 6-mil thick or greater plastic barrier meeting local fire codes may be used where dust control is the only hazard, and an agreement is reached with the Resident Engineer and Medical Center.

b. HEPA filtration is required where the exhaust dust may reenter the breathing zone. Contractor shall verify that construction exhaust to exterior is not reintroduced to the medical center through intake vents, or building openings. Install HEPA (High Efficiency Particulate Accumulator) filter vacuum system rated at 95% capture of 0.3 microns including pollen, mold spores and dust particles. Insure continuous negative air pressures occurring within the work area. HEPA filters should have ASHRAE 85 or other pre-filter to extend the useful life of the HEPA. Provide both primary and secondary filtrations units. Exhaust hoses shall be heavy duty, flexible steel reinforced and exhausted so that dust is not reintroduced to the medical center.

c. Adhesive Walk-off/Carpet Walk-off Mats, minimum 24” x 36”, shall be used at all Interior transitions from the construction area to occupied medical center area. These mats shall be changed as often as required to maintain clean work areas directly outside construction area at all times.

d. Vacuum and wet mop all transition areas from construction to the occupied medical center at the end of each workday. Vacuum shall utilize HEPA filtration. Maintain surrounding area frequently. Remove debris as they are created. Transport these outside the construction area in containers with tightly fitting lids.

e. The contractor shall not haul debris through patient-care areas without prior approval of the Resident Engineer and the Medical Center. When, approved, debris shall be hauled in enclosed dust proof containers or wrapped in plastic and sealed with duct tape. No sharp objects should be allowed to cut through the plastic. Wipe down the exterior of the containers with a damp rag to remove dust. All equipment, tools, material, etc. transported through occupied areas shall be made free from dust and moisture by vacuuming and wipe down.

f. Using a HEPA vacuum, clean inside the barrier and vacuum ceiling tile prior to replacement. Any ceiling access panels opened for investigation beyond sealed areas shall be sealed immediately when unattended.

g. There shall be no standing water during construction. This includes water in equipment drip pans and open containers within the construction areas. All accidental spills must be cleaned up and dried within 12 hours. Remove and dispose of porous materials that remain damp for more than 72 hours.

h. At completion, remove construction barriers and ceiling protection carefully, outside of normal work hours. Vacuum and clean all surfaces free of dust after the removal.

E. Final Cleanup:

1. Upon completion of project, or as work progresses, remove all construction debris from above ceiling, vertical shafts and utility chases that have been part of the construction.

2. Perform HEPA vacuum cleaning of all surfaces in the construction area. This includes walls, ceilings, cabinets, furniture (built-in or free standing), partitions, flooring, etc.

1. All new air ducts shall be cleaned prior to final inspection. SPEC WRITER NOTE: On small projects developed at Medical Center, Engineering Officer may tag items to be removed and stored, instead of noting such items on drawings or in specifications.

APPENDIX C

VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY LANGUAGE FOR INCLUSION INTO CONTRACTS, AS APPROPRIATE

1. GENERAL

Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security. Contactor policies and procedures shall comply with all VA Privacy & Security, the Privacy Act and Health Insurance Portability and Accountability Act (HIPAA).

2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS

a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to…