S02 - RFQ 3677626Q0240- FPLS SOW Attachment A3 - Report Template.xlsx

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Attached to
R425--VHA Fire Protection and Life Safety Services BPA
Solicitation number
36C77626Q0240
Issued by

About this file

This file is a Fire Protection and Life Safety Project Design Review Report template for the Department of Veterans Affairs. The template is used by third-party fire protection and life safety professionals to document their review of VA facility renovation and construction projects at various design submittal phases. It requires reviewers to identify design comments referencing applicable codes and standards (such as NFPA 101-2024), categorize findings as advisory or mandatory requirements, and document the architect/engineer's resolutions to address identified deficiencies. The template includes fields for the Life Safety Agent (third-party reviewer) to certify completion of the review in accordance with VA requirements and adopted fire protection and life safety codes, as well as certification by the VA Project Manager confirming the reviewer's work meets project requirements and BPA task order specifications. The example provided shows a mandatory comment requiring one-hour fire-rated partition walls for perimeter construction in an Eye Clinic and Primary Care renovation project. This template is an attachment to solicitation 36C77626Q0240 for the VA-wide Blanket Purchase Agreement for Fire Protection and Life Safety Services, which is seeking multiple awardees to provide FPLS services for VA Healthcare Systems across the United States and territories, with task orders to be competed on a firm-fixed-price basis.

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Review Report Template

Reviewed by:First MI. Last, P.E.Phone:(123) 456-7890 Ext 1234Date:Jan 1, 2026VA Project Manager:First MI. Last, Credential
Firm:ZYX Fire Protection Design
VA Facility:VA Anytown HCSProject Title:Renovate Primary CareVA Project Number:101-26-101
Submittal:Schematic Design (SD) / 35%Submittal Date:Jan 1, 2026
ITEM NO:DRAWING NO. / SPEC SECTION / DOC TITLECOMMENTSREFERENCE CODE OR STD (With year of ed.)RESOLUTION (Provided by VA or A/E)
(* Indicates advisory comments)
(** Indicates mandatory requirement)
1(EXAMPLE) A-301(EXAMPLE) ** The drawings provided do not indicate partition types (fire barrier ratings). Ensure that newly constructed perimeter walls for the two departments are 1-hour rated (minimum).(EXAMPLE) NFPA 101-2024, 8.3.1.1(EXAMPLE) Perimeter partitions surrounding the two main areas (Eye Clinic and Primary Care) will be one-hour rated as required for suite construction.
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Review Certifications
(Upon final resolution and acceptance of all review comments, print this report to PDF, sign and add to the project record)

Life Safety Agent Certification: I have completed the third-party fire protection and life safety review for the subject project and submittal phase in accordance with the VA’s requirements. I certify that I have reviewed the comment resolutions and determined they appear to meet VA’s adopted codes and standards for fire protection and life safety, as well as comply with applicable VA fire protection and life safety policies.

First MI. Last, P.E.
ZYX Fire Protection Design

Date: Mon XX, Year

VA Project Manager Certification: I certify that I have reviewed the Life Safety Agent’s work and determined it meets the requirements of the subject project, VA fire protection and life safety policies and the BPA task order.

First MI. Last, Credential
VA Anytown HCS

Date: Mon XX, Year

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FIRE PROTECTION AND LIFE SAFETY PROJECT DESIGN REVIEW REPORT

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