S02 RFQ 36C25225Q0286_2.pdf

Page 1 of 77 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

None

578-25-2-6121-0018

36C25225Q0286 03-27-2025

Makena James 414-844-4800 04-10-2025

10:00 AM CDT

Department of Veterans Affairs

GLAC (69D)

115 South 84th Street, Suite 101

Milwaukee WI 53214-1476

X 100

X

541350

$11.5 Million

N/A

Edward Hines Junior Hospital

5000 South 5th Avenue

Hines IL 60141

GLAC-MILWAUKEE (69D)

Great Lakes Acquisition Center - HC

115 South 84th Street, Suite 101

Milwaukee WI 53214-1476

Financial Services Center

PO Box 149971

Austin TX 78714-9971 x

See CONTINUATION Page

Periodic Elevator Inspections at the Hines, IL VAMC.

Please see SOW for specifics

This Solicitaion is set aside for VOSBs

See CONTINUATION Page

578-3650162-6121-855100-2543 010050190 x 1

Ashley Johnson

36C25225Q0286

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA (continuation from Standard Form 1449)

OFFERORS MUST COMPLETE AND RETURN ALL INFORMATION DESIGNATED HEREIN PRIOR TO

THE TIME SPECIFIED IN BLOCK 8 OF SF 1449 IN ORDER TO BE CONSIDERED FOR AWARD.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

1. CONTRACT ADMINISTRATION: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

CONTRACTOR NAME _____________________________________

ADDRESS ________________________________________________

CITY-STATE-ZIP __________________________________________

POINT OF CONTACT/TITLE ________________________________

PHONE NUMBER ______________________________________

FAX NUMBER ______________________________________

E-MAIL ADDRESS ______________________________________

SAM UEI NO. ____________________________________________

CAGE CODE _____________________________________________

CONTRACTOR’S PAST PERFORMANCE POINT OF CONTACT

(IF DIFFERENT THAN ABOVE):

NAME: __________________________________________

EMAIL ADDRESS:_________________________________

b. GOVERNMENT: MAKENA JAMES/CONTRACT SPECIALIST

CONTRACTING OFFICE CODE: 36C252

DEPARTMENT OF VETERANS AFFAIRS

GREAT LAKES ACQUISITION CENTER

115 S. 84TH ST., STE 100

MILWAUKEE WI 53214

2. ACQUISITION OF COMMERCIAL ITEMS:

This Request for Quote (RFQ) solicitation is issued under the authority of FAR Part 12 Acquisition of Commercial Items and FAR Part 13 Simplified Acquisition Procedures. FAR Part 15 will not be used. The procedures in Part 12 used in conjunction with Part 13 allow the Government to procure services resembling those in the commercial marketplace and streamline the procurement process. From this RFQ, the Government intends to award a firm fixed price contract where the contractor provides a price that is not subject to any adjustment on the basis of the contractor’s cost experience in performing the contract. (Note:

The terms “offeror” and “quoter” are both used in this Solicitation. For the purposes of this Solicitation, these terms are interchangeable; there is no difference in meaning between the two.)

3. SET-ASIDE (If any): See box 10 of STANDARD FORM 1449

4. SOLICITATION TIMELINE SUMMARY:

A. RFQ QUESTIONS:

In order to maintain integrity of this solicitation and subsequent award date, all offerors are advised that any question-and-answer requests must be submitted in a written form via e-mail to the Contract specialist Makena.James@va.gov no later than Monday April 7th , 2025 at NOON central time.

B. SOLICITATION CLOSES/QUOTES DUE:

See box 8 of STANDARD FORM 1449 or most recent Amendment.

C. SUBMISSION OF QUOTE:

See 52.212-1 Instructions to Offerors—Commercial Products and Commercial Services and addendum for specific instructions to offerors.

5. CONTRACTING OFFICER AUTHORITY:

The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitment or issue changes that will affect price, quantity or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in cost incurred thereof.

6. INVOICES:

a. All payments by the Government to the contractor will be made in accordance with: FAR

52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER – SYSTEM FOR AWARD

MANAGEMENT (OCT 2018)

b. Invoices shall be submitted quarterly in arrears in accordance with: 852.232-72 ELECTRONIC

SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

c. Payments shall be made in arrears upon receipt of a properly prepared invoice

d. Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests.

e. The VA has mandated electronic invoice submission to the Veterans Affairs Financial Services

Center (VAFSC). VAFSC has partnered with Tungsten Network e-Invoicing network, for submissions of all electronic invoices to VA. Tungsten Network electronic invoicing is free to all VA vendors. In order to submit electronic invoices, all VA vendors must register with Tungsten Network by submitting an email to VA.Registration@Tungsten-Network.com or calling 1-877- 489-6135 for Enrollment.

f. Contractor shall submit an electronic invoice by the tenth (10th) of the following month services were performed to the Veterans Affairs Financial Services Center (VAFSC) e-Invoice through the website at https://portal.Tungsten-Network.com/Login.aspx. For questions regarding the submission of VA electronic invoices, Tungsten Network customer service may be contacted at 1-877-489-6135.

mailto:VA.Registration@Tungsten-Network.com https://portal.tungsten-network.com/Login.aspx

g. All invoices shall reference the vendor name and address, customer name, contract number, appropriate obligation/funding order number, description of services provided, quantity, unit price, and total invoice amount (any additional info). Invoices shall also include any payment discount terms.

h. VA’s Electronic Invoice Presentment and Payment System – The Veterans Affairs Financial Services Center (VAFSC) uses a third-party contractor, Tungsten Network e-Invoice, to transition vendors from paper to electronic invoice submission. Please go to this website:

http://www.tungsten-network.com/customer-campaigns/veteransaffairs/ to begin submitting electronic invoices, free of charge.

i. As of July 1, 2020, the VA10091 form has been eliminated and the VAFSC is requiring our vendors to update and add their information in the Customer Engagement Portal (CEP) at https://www.cep.fsc.va.gov/. This is for new vendors being added to FMS only.

j. For assistance setting up e-Invoice, the below information is provided:

* Tungsten Network e-Invoice Setup Information: 1-877-489-6135

* Tungsten Network e-Invoice email: VA.Registration@Tungsten-Network.com

* FSC e-Invoice Contact Information: 1-877-353-9791

* FSC e-invoice email: vafsccshd@va.gov

7. FACILITY REQUIREMENTS: In addition to any other requirements set forth in this Contract, the Contractor, including its employees, agents, and subcontractors (collectively “the Contractor”), shall comply with the following facility requirements. Failure to comply with these requirements shall be considered a material breach of this Contract and may be a violation of Federal law resulting in charges answerable in the United States District Court.

a. Contractor is responsible to follow all on site facility policies

b. All VA property is considered Federal property and all Federal laws are applicable.

c. It is the responsibility of the Contractor to park in the appropriate designated parking areas.

Information on parking is available from the VA Police Section. The VA will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

d. All VA facilities are drug free. Possession of drugs, to include Marijuana and all Marijuana bi-products are prohibited. Enclosed containers, including tool kits, shall be subject to search.

Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court.

e. All contractor personnel are required to adhere to all VA rules and regulations.

f. Smoking is prohibited on the entire campus, both inside and outside the VA Facility

g. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court.

h. VHA DIRECTIVE 1192: This Veterans Health Administration (VHA) directive establishes policy and provides guidance for the prevention of seasonal influenza in VHA facilities through the vaccination or masking of health care personnel (HCP). AUTHORITY: Title 38 United States Code (U.S.C.) 7301(b), 7318(b). Contractor is responsible in ensuring that all aspects of this directive are implemented, including providing face masks and influenza vaccines for all employees working at a VA facility.

http://www.tungsten-network.com/customer-campaigns/veteransaffairs/ https://www.cep.fsc.va.gov/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov

8. SECURITY & PRIVACY CONTROL:

The Authorization & Accreditation (A&A) requirements of VHA Handbook 6500.6 do not apply to this requirement, therefore, a Security Accreditation Package is not required. No A&A or MOU/ISA is required. Sensitive information exposure as part of this contract involves applicable security controls within the facility as part of the VA Information Security If there are any questions related to privacy, please have a member of your staff contact the VA Privacy Service at (202) 461-6309. If there are any questions related to the information security, please have a member of your staff contact the Office of Cyber Security at (304) 262-7733.

Visitor Passes:

Issuance of visitor passes is the responsibility and at the discretion of each Facility Director. Visitor passes may be issued to individuals requiring short-term access to a VA facility for a period not to exceed 15 days in a 365-day period. Visitor passes are issued on a daily basis and expire at the end of the day of issuance.

Visitor passes are issued following, at a minimum, review of one valid and current State or Federal government issued photo ID. Visitors must be escorted in areas restricted to the general public.

Statement of Work Periodic Elevator Inspections Edward Hines Jr. VA Hospital

STATEMENT OF WORK

1. GOAL

A. Edward Hines Jr. VA (Veterans Administration) Hospital requires a 3rd party, QEI‐1

Certified Elevator Inspection of all elevators two times per year. The type of tests includes one Periodic Inspection per year, one Annual Safety Test per year, and a Five‐

Year Load Test once every five years.

2. CURRENT CONDITIONS AND JUSTIFICATION

A. There are 47 active elevators and 1 dumbwaiter on the Hines Hospital campus. In addition, there is 1 elevator at the Joliet campus. These elevators vary in age, manufacturer, purpose, and design. For safety, reliability and building code compliance these elevators need to be routinely inspected by a 3rd party inspection group.

B. ELEVATOR LIST

Make Drive Type

Type/Capacity Serial No. Building name # of stops

# of doors

Last 5‐ year test

1 Anderson Traction Passenger/4000lb A69696 Bldg. 1 A 4 1 02\22

2 Otis Traction Passenger/3000lb 322196 Bldg. 1 AB 4 2 02\22

3 Otis Traction Service/7000lb 322600 Bldg. 1 B 4 1 02\22

4 General Traction Passenger/4000lb 1964‐53 Bldg. 1 C 4 1 02\22

5 Mid‐American Traction Passenger/ 263067 Bldg. 1 CD 4 1 02\22

6 General Traction Passenger/4000lb 1964‐53 Bldg. 1 D 4 1 02\22

7 Anderson Traction Passenger/4000lb None Bldg. 1 E 4 1 02\22

8 Anderson Traction Passenger/4000lb None Bldg. 1 EF 4 1 02\22

9 General Traction Service/4000lb 85183 Bldg. 1 F 4 1 02\22

Periodic Elevator

Inspections Edward Hines

Type/Capacity Serial No. Building name # of stops

# of doors

Last 5‐ year test

10 Colley Traction Passenger/4000lb 78158 Bldg. 1 G 4 1 02\22

11 Colley Hydraulic Passenger/4000lb 80‐027 Bldg. 2 P1 3 1 10/15

12 Universal Traction Freight/3500lb U5843 Bldg. 7 F1 2 1 02\22

13 Minnesota Hydraulic Passenger/4000lb 1769 Bldg. 12 P1 3 1 10/15

14 Minnesota Hydraulic Passenger/4000lb 27052 Bldg. 13 P1 3 1 10/15

15 US Elevator Hydraulic Passenger/4000lb 25549 Bldg. 17 P1 3 1 10/15

16 Otis Elevator Hydraulic Passenger 431675 Bldg. 18 P1 3 1 10/15

17 Schindler Hydraulic Passenger 257‐1173 Bldg. 16 P1 3 1 10/15

18 Colley Hydraulic Passenger 80‐072 Bldg. 20 P1 2 1 10/15

19 S. Heller Hydraulic Freight/4000lb 54094 Bldg. 20 F1 2 2 10/15

20 Montgomery Hydraulic Passenger/5000lb CP53298 Bldg. 217 P1 2 1 10/15

21 Montgomery Hydraulic Passenger/5000lb CP53300 Bldg. 217 P2 2 1 10/15

22 Montgomery Hydraulic Passenger/5000lb CP53299 Bldg. 217 P3 2 1 10/15

23 Colley Hydraulic Freight/5000lb 1750 Bldg. 220 F1 2 1 02\22

24 MidAmerican Traction Dumbwaiter/500lb s 2388 Bldg. 200 DW‐1 16 1 10/15

25 Matot Drum Dumbwaiter/500lb 7313‐

DWZ

Bldg. 200 DW‐2 2 1 10/15

26 Mid‐American Traction Passenger/4000lb A72572 Bldg. 228 P1 6 2 02\22

27 Mid‐American Traction Passenger/4000lb A72631‐2 Bldg. 228 P2 6 1 02\22

28 Mid‐American Traction Passenger/4000lb A72681‐1 Bldg. 228 P3 6 1 02\22

29 Mid‐American Gearless Traction

Passenger/4000lb A72630 Bldg. 228 P4 6 1 02\22

30 Montgomery Gearless Traction

Passenger/4000lb 3115302 Bldg. 200 P1 16 1 02\22

31 Montgomery Gearless Traction

Passenger/4000lb 3115303 Bldg. 200 P2 16 1 02\22

Inspections Edward Hines

Type/Capacity Serial No. Building name # of stops

# of doors

Last 5‐ year test

32 Montgomery Gearless Traction

Passenger/4000lb 3115304 Bldg. 200 P3 16 1 02\22

33 Montgomery Gearless Traction

Passenger/4000lb 3200000 Bldg. 200 P4 16 1 02\22

34 Montgomery Gearless Traction

Passenger/4000lb 3200002 Bldg. 200 P5 16 1 02\22

35 Montgomery Gearless Traction

Passenger/5000lb 3115313 Bldg. 200 S6 16 1 02\22

36 Montgomery Gearless Traction

Passenger/5000lb 3115314 Bldg. 200 S7 16 1 02\22

37 Montgomery Gearless Traction

Passenger/5000lb 3115315 Bldg. 200 S8 16 1 02\22

38 Minnesota Hydraulic Freight/5000lb 27049 Bldg. 200 S9 3 1 10/15

39 Allwieler Hydraulic Passenger/4000lb 3115434 Bldg. 200 M‐10 2 2 10/15

40 Minnesota Hydraulic Passenger5000lb 3115482 Bldg. 200 F‐11 2 2 10/15

41 Minnesota Hydraulic Passenger/10000lb 3115484 Bldg. 200 F‐12 2 2 10/15

42 Minnesota Hydraulic Passenger/4000lb 3115490 Bldg. 200 L‐13 2 2 10/15

43 Armstrong Hydraulic Passenger3500lb 3047367 Bldg. 200 P‐14 4 2 10/15

44 Armstrong Hydraulic Passenger3500lb 3047368 Bldg. 200 P‐15 4 2 10/15

45 THYSSEN

KRUPP

Hydraulic Passenger/5000lb ER 9666 Bldg. 128 P1 2 1 10/15

46 THYSSEN

KRUPP

Hydraulic Passenger/5000lb ER 9667 Bldg. 128 P2 2 1 10/15

47 THYSSEN

KRUPP

Hydraulic Passenger/4600lb ER 9668 Bldg. 113 P1 2 1 10/15

48 THYSSEN

KRUPP

Hydraulic Passenger/4600lb ER 9669 Bldg. 113 P2 2 1 10/15

Joliet CBOC

49 Dover Hydraulic Passenger/4000lb EB0592 Joliet

CBOC

P1 2 1 10/15

Fisher House

50 Thyssen Tac‐ 20 Hydraulic Passenger/TBD EAG261‐

TAC20/30

Bldg. 100 P1 2 1 10/15

Total of 49 items to inspect.

Hydraulic elevator with overspeed valve

Inspections Edward Hines

3. SCOPE

A. The contractor shall provide a certified QEI‐1 (Qualified Elevator Inspector) to witness and certify, one periodic inspection per year, one annual safety test per year, and one

5‐year load test, every five years, for all of the traction elevators and all of the

Hydraulic elevators with overspeed valves, marked in green. The other eight unmarked

Hydraulic elevators do not require a five‐year load test.

B. Contractor shall furnish all supervision, labor, equipment, travel and supplies necessary to witness the testing, and provide certification and test report documents.

C. All tests are to be performed by the elevator maintenance company contracted with the Hines VA.

4. REQUIREMENTS AND QUALIFICATIONS OF INSPECTOR

A. The inspector must meet the qualification requirements of the ANSI/ASME QEI‐1 certification and be certified by an ANSI/ASME accredited organization.

B. Offeror/ Contractor must submit with their quote, the names and certifications of the inspectors that would do the work of this contract.

i. Evidence must be provided to show the individuals named have a successful history with the company and are currently employed on a permanent basis.

ii. If changes occur during the life of the contract the contractor must provide updated inspector information at least 60 days prior to the next inspection due date.

Inspections Edward Hines

5. INSPECTIONS

A. There must be two inspections per year, six months apart, for all 49 vertical transport items indicated on the list.

i. The first inspection of the contract year is the Annual Inspection /

Category 1 Safety Inspection. It is a no‐load test and it is to be performed in July.

ii. The second inspection is the Periodic inspection / Routine inspection and it is to be performed in January.

iii. The Five‐year Full Load Test must be performed at the time that the

Annual Test is due, (July). It is done once every five years and fulfills the requirement of the Annual test for that year. The next 5‐year load test for the hydraulic elevators at Hines is due in July of 25, and for all the traction elevators in July of 2027.

a) The time‐of‐day schedule for the tests cannot have a detrimental effect on hospital operations. The inspections schedule needs to be coordinated with and approved by the COR.

b) The 5‐yr. full Load testing for the main elevators in building 200 and

228 is recommended to be done during off‐tour hours, between 5:00pm on a Friday and 8:00am on Monday, or before 7:30 am and after 4:30 pm on weekdays. Any 5‐year inspection done during the regular daytime hours needs to be approved by the COR.

B. Inspections must include but are not limited to: inside of the elevator, elevator machine room, elevator control room, secondary equipment machine room, top of elevator, hoistway, elevator lobbies, and elevator pit.

C. All inspections must be conducted in accordance with the ASME (American Society of Mechanical Engineers) A17.1 code year edition the elevator was installed to comply with and ASME A17.2 Inspectors Guide.

D. The site visit/inspection must include a review of the existing equipment for safety code compliance, firefighters' service, ADAAG (Americans with Disability Act, Accessibility Guidelines) requirements, recommended upgrades, and modernization needs based on long term life expectancy of the current equipment.

Inspections Edward Hines

E. Findings and recommendations must be submitted in the required narrative and included with the inspection report.

F. During any inspection where parts must be removed or cleaned to determine the exact condition of other parts, that work needs to be done by the maintenance contractor.

G. All inspections must be performed in the presence of the elevator maintenance technician currently under contract as the Hines VA elevator preventative maintenance contractor.

H. Each site visit/inspection must include an out‐brief meeting with the COR to discuss the inspection violations, findings, immediate needs, and necessary corrections.

6. DOCUMENTATION

A. The VA, TIL (Technical Information Library) provides and requires two inspection documents titled “Hydraulic Elevator Inspection Report” and “Traction Elevator

Inspection Report”. The Contractor is to completely fill in these documents for each elevator inspection and provide an electronic PDF copy of each report to the COR. It is acceptable if the contractor chooses to create a digital program form of these documents and then provide PDF copies to the COR. Reports are due within two weeks of the inspections. The report documents are provided at the end of this statement of work and as an attachment to the solicitation.

B. Each inspection survey/evaluation must include a comprehensive report including the following:

i. summary narrative of the operating performance for each elevator/lift.

ii. description of inspection or test.

iii. deficiencies and recommendations.

iv. any adjustments, repairs, or replacements necessary to correct troubles encountered.

v. Furnish specifications (if requested by the COR) sufficient to enable the VA to

Inspections Edward Hines purchase the materials required for those purposes.

C. Contractor shall provide certificates of inspection that demonstrate compliance with the applicable code and can be posted in the elevator demonstration window. These certificates need to be provided on good quality paper and delivered within two weeks of the inspections.

7. RECOGNIZED HOLIDAYS

A. Unless otherwise indicated the contractor is not required to perform services on these

Federal holidays.

New Year Day Presidents Day Independence Day Veterans Day

MLK Birthday Memorial Day Labor Day Thanksgiving Day

Inauguration Day June 19th Columbus Day Christmas Day

8. HOURS OF OPERATION

A. Except as previously indicated the contractor shall conduct business, between the hours of 6:00AM and 6:00PM Monday thru Friday except Federal holidays or when the

Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings.

9. PLACE OF PERFORMANCE

A. The work to be performed under this contract will be performed at the following government facility:

Edward Hines Jr. VA Hospital. 5000 S. 5th Avenue Hines, Illinois, 60141

10. CHECK‐IN REQUIREMENT

A. Contractor personnel performing work under this contract must check in with the

Inspections Edward Hines

Contracting Officer Representative.

11. INTERFERENCE TO NORMAL FUNCTION

A. Contractor personnel are required to interrupt their work at any time so as not to interfere with the normal functioning of the facility, including utility services, fire protection systems, and passage of patients, personnel, equipment, and carts.

12. SAFETY

A. The Contractor must consider the clinical environment and instruct his/her employees on applicable safety precautions and specific requirements.

13. CONTRACTORS ON SITE RESPONSIBILITIES

A. At all times while performing work under the provisions of this contract, each of the contractor’s employees must wear, in full view, a Hines Hospital contractor’s identification badge. Contractor is responsible to complete the Hines process for the issuance of the badge.

B. It is the responsibility of the Contractor to park in the appropriate designated parking areas. Information on parking is available from the VAMC Police Section. The VAMC will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

C. Contractors, Contractor personnel, subcontractors, and subcontractor personnel shall be subject the same Federal laws, regulations, standards, and VA directives and handbooks as VA and VA personnel regarding information and information security.

D. The Contractor agrees that none of its officers or employees must use or reveal any research, statistical, medical, or security information which may be obtained or observed during the performance of the work or as a result their presence on

Government premises without the written consent of the Government.

E. Smoking is prohibited inside any buildings at the VAMC.

F. Possession of weapons is prohibited.

End

INSPECTOR SIGN BUILDING NAME/# ELEVATOR#

November 1, Page 1 of

TRACTION ELEVATOR INSPECTION REPORT

BUILDING NAME:

BUILDING NUMBER: ELEVATOR NUMBER:

ADDRESS:

BUILDING REPRESENTATIVE:

CONTACT NUMBER:

DATE OF INSPECTON: ASME A17.1 CODE YEAR:

TYPE OF ELEVATOR: PASSENGER SERVICE FREIGHT CARTLIFT DUMBWAITER

MATERIAL LOADING CLASS: A B C1 C2 C3

MACHINE: OVERHEAD GEARED GEARLESS WINDING DRUM BASEMENT GEARED

MANUFACTURER:

CAPACITY (LBS): CONTRACT SPEED(FPM):

1.0 ELEVATOR TEST DATA

1.1 FULL LOAD SPEED: UP DOWN EMPTY SPEED: UP DOWN

1.2 MOTOR VOLTS: UP DOWN MOTOR AMPS: UP DOWN

FULL LOAD: FULL LOAD:

BALANCE LOAD: BALANCE LOAD:

EMPTY CAR:

1.3 TYPE OF SAFETY:

A B

EMPTY CAR:

C

CAR SLIDE DISTANCE: COUNTERWEIGHT SLIDE DISTANCE:

1.4 GOVERNOR TRIP SPEED: CAR COUNTERWEIGHT

1.5 OVERSPEED SWITCH TRIP SPEED: CAR COUNTERWEIGHT

1.6 SPEED REDUCING SWITCH: CAR COUNTERWEIGHT

1.7 GOVERNOR ROPE PULL THROUGH FORCE (LBF): CAR COUNTERWEIGHT

1.8 LOWER AND HOLD WITH 125% RATED LOAD: PASS FAIL

1.9 UNINTENDED MOTION DEVICE STOPPING DISTANCE: 125% LOAD DOWN EMPTY CAR UP

1.10 OIL BUFFER TEST: CAR FULL LOAD PASS FAIL COUNTERWEIGHT EMPTY CAR PASS FAIL

1.11 OIL BUFFER RETURN TEST: CAR BUFFER-PASS FAIL COUNTERWEIGHT PASS FAIL

1.12 ONE HOUR RUN TEST: PASS FAIL MOTOR TEMPERATURE: START FINISH

1.13 DOOR SPEED (SEC): CLOSE OPEN CLOSING FORCE (LBF)

Page 2 of

2.0 ELEVATOR MACHINE ROOM

2.1 ACCESS TO MACHINE ROOM PASS FAIL N/A

2.2 HEADROOM (7 FEET MINIMUM) PASS FAIL N/A

2.3 LIGHTING AND GFCI RECEPTACLES PASS FAIL N/A

2.4 MACHINE SPACE PASS FAIL N/A

2.5 HOUSEKEEPING – CLEANED AND PAINTED PASS FAIL N/A

2.6 HVAC – VENTILATION PASS FAIL N/A

2.7 FIRE EXTINGUISHER PASS FAIL N/A

2.8 GUARDS ON EQUIPMENT PASS FAIL N/A

2.9 PIPE, DUCT, WIRING AND BUSHINGS PASS FAIL N/A

2.10 NUMBER EQUIPMENT PASS FAIL N/A

2.11 FUSED DISCONNECT – SHUNT TRIP BREAKER PASS FAIL N/A

2.12 CONTROLLER FUSES AND OVERLOADS PASS FAIL N/A

2.13 BONDING WIRE AND GROUNDING PASS FAIL N/A

2.14 INSPECTION CONTROL PASS FAIL N/A

2.15 ABSORPTION OF REGENERATIVE DRIVE PASS FAIL N/A

2.16 GOVERNOR, OVERSPEED SWITCH TESTED AND SEALED PASS FAIL N/A

2.17 CODE DATA PLATE PASS FAIL N/A

2.18 DRIVE MACHINE AND SHEAVE PASS FAIL N/A

2.19 DRIVE MACHINE BRAKE PASS FAIL N/A

2.20 WINDING DRUM MACHINE, SLACK ROPE SWITCH AND ROPE FASTENINGPASS FAIL N/A

2.21 GEARS, BEARINGS AND FLEXIBLE COUPLINGS PASS FAIL N/A

2.22 MOTOR GENERATOR SET PASS FAIL N/A

2.23 ROPE GRIPPER/SECONDARY BRAKE PASS FAIL N/A

2.24 SECONDARY LEVEL AND DEFLECTOR SHEAVES PASS FAIL N/A

2.25 DEADEND HITCH PLATES PASS FAIL N/A

2.26 MAINTENANCE CONTROL PROGRAM AND RECORDS PASS FAIL N/A

2.27 MONTHLY FIRE SERVICE TEST LOG PASS FAIL N/A

2.28 EMERGENCY POWER OPERATION (FULL LOAD IN CAR) PASS FAIL N/A

2.29 EARTHQUAKE INSPECTION AND TESTS PASS FAIL N/A

2.30 SMOKE DETECTORS HEAT DETECTORS SPRINKLERS PASS FAIL N/A

3.0 ELEVATOR HOISTWAY – INSIDE

3.1 ACCESS TO HOISTWAY – CARTOP AND PIT PASS FAIL N/A

Page 3 of

3.2 HOISTWAY AND PIT LIGHTING PASS FAIL N/A

3.3 HOISTWAY ENCLOSURE PASS FAIL N/A

3.4 HOISTWAY DEVIDER BEAMS AND LEDGES PASS FAIL N/A

3.5 ENTRANCE FRAMES (FULLY GROUTED) PASS FAIL N/A

3.6 DUST COVERS2, FACIAS, TOP AND BOTTOM SHEAR GUARDS PASS FAIL N/A

3.7 VISION PANELS PASS FAIL N/A

3.8 HOISTWAY DOORS PASS FAIL N/A

3.9 HOISTWAY DOOR LOCKING DEVICES PASS FAIL N/A

3.10 MECHANICAL HOISTWAY DOOR CLOSURE PASS FAIL N/A

3.11 EMERGENCY DOORS IN BLIND HOISTWAY PASS FAIL N/A

3.12 HOISTWAY VENTILATION PASS FAIL N/A

3.13 TRAVELING CABLE SUSPENSION PASS FAIL N/A

3.14 TOP OF COUNTERWEIGHT CLEARANCE AND RUNBY PASS FAIL N/A

3.15 BOTTOM OF CAR CLEARANCE, RUNBY AND REFUGE SPACE PASS FAIL N/A

3.16 COUNTERWEIGHT, FRAME AND ROLLER GUIDES PASS FAIL N/A

3.17 COUNTERWEIGHT SHEAVE OR SHACKLES AND HITCH PLATE PASS FAIL N/A

3.18 COUNTERWEIGHT SAFETIES PASS FAIL N/A

3.19 CAR OVERHEAD AND DEFLECTOR SHEAVE CLEARANCE PASS FAIL N/A

3.20 NORMAL TERMINAL STOPPING DEVICES PASS FAIL N/A

3.21 FINAL TERMINAL STOPPING DEVICES PASS FAIL N/A

3.22 CAR AND COUNTERWEIGHT BUFFERS AND TAGS PASS FAIL N/A

3.23 PIT STOP SWITCHES PASS FAIL N/A

3.24 GOVERNOR ROPE TENSION SHEAVE PASS FAIL N/A

3.25 GUIDE RAILS, BRACKETS AND FASTENERS PASS FAIL N/A

3.26 COMPENSATION CHAINS – ROPES AND SHEAVE PASS FAIL N/A

3.27 FLOOR NUMBERS ANS EMERGENCY IDENTIFICATION PASS FAIL N/A

3.28 PIPE, DUCT, WIRING AND BUSHINGS PASS FAIL N/A

3.29 EARTHQUAKE INSPECTION AND TESTS PASS FAIL N/A

3.30 SMOKE DETECTORS HEAT DETECTORS SPRINKLERS PASS FAIL N/A

4.0 ELEVATOR CAR – OUTSIDE

4.1 CROSSHEAD DATA, HOIST ROPE AND GOVERNOR ROPE TAGS PASS FAIL N/A

4.2 STOP SWITCH PASS FAIL N/A

4.3 LIGHT AND GFCI RECEPTACLES – TOP AND BOTTOM PASS FAIL N/A

Page 4 of

4.4 CARTOP OPERATING DEVICE PASS FAIL N/A

4.5 DOOR REOPENING DEVICE PASS FAIL N/A

4.6 DOOR OPENING RESTRICTOR PASS FAIL N/A

4.7 CLEARANCE, REFUGE SPACE AND CARTOP RAILING PASS FAIL N/A

4.8 CAR LEVELING DEVICE PASS FAIL N/A

4.9 CARTOP EMERGENCY EXIT AND SAFETY SWITCH PASS FAIL N/A

4.10 ELEVATOR NUMBER – TOP, BOTTOM AND COUNTERWEIGHT GUARD PASS FAIL N/A

4.11 PIPE, DUCT, WIRING AND BUSHINGS PASS FAIL N/A

4.12 HOISTWAY RUNNING CLEARANCE PASS FAIL N/A

4.13 CAR DOOR OPERATOR PASS FAIL N/A

4.14 TRAVELING CABLE SUSPENSION AND RUNNING CLEARANCE PASS FAIL N/A

4.15 CROSSHEAD, SIDE STILES AND SAFETY PLANK PASS FAIL N/A

4.16 CAR SAFETIES PASS FAIL N/A

4.17 GOVERNOR ROPE AND RELEASE CARRIER PASS FAIL N/A

4.18 HOIST ROPES, CARTOP SHEAVE OR SHACKLES AND HITCH PLATE PASS FAIL N/A

4.19 CAR PLATFORM GUARD – TOE GUARD PASS FAIL N/A

5.0 ELEVATOR CAR – INSIDE

5.1 CAR DOOR OR GATE PASS FAIL N/A

5.2 DOOR CLOSING FORCE PASS FAIL N/A

5.3 POWER OPENING OF DOOR OR GATE PASS FAIL N/A

5.4 POWER CLOSING OF DOOR OR GATE PASS FAIL N/A

5.5 CAR ENCLOSURE, INTERIOR FINISHES, SILL, FLOOR AND CEILING PASS FAIL N/A

5.6 CAR VISION PANELS AND GLASS DOORS PASS FAIL N/A

5.7 STOP SWITCHES PASS FAIL N/A

5.8 OPERATING CONTROL DEVICES PASS FAIL N/A

5.9 CAR LIGHTING AND GFCI RECEPTICLE PASS FAIL N/A

5.10 EMERGENCY LIGHT AND ALARM PASS FAIL N/A

5.11 EMERGENCY EXIT SECURED FROM OUTSIDE PASS FAIL N/A

5.12 VENTILATION PASS FAIL N/A

5.13 ELEVATOR NUMBER PASS FAIL N/A

5.14 DATA PLATE: CAPACITY, LOADING CLASS AND NUMBER OF PASSENGER PASS FAIL N/A

5.15 SIGNAGE AND BRAILLE PLATES PASS FAIL N/A

5.16 MEDICAL EMERGENCY PASS FAIL N/A

Page 5 of

5.17 CAR RIDE QUALITY PASS FAIL N/A

5.18 EARTHQUAKE INSPECTION AND TEST PASS FAIL N/A

5.19 FIREFIGHTER’S PHASE 2 OPERATION PASS FAIL N/A

6.0 ELEVATOR HALL FIXTURES AND HOISTWAY ENTRANCES

6.1 HALL LANTERNS PASS FAIL N/A

6.2 POSITIONS INDICATORS PASS FAIL N/A

6.3 HALL CALL PUSH BUTTONS PASS FAIL N/A

6.4 COMMUNICATION (LIGHT ANNUNCIATOR AND KEY SWITCH) PASS FAIL N/A

6.5 MEDICAL EMERGENCY CALL – KEY SWITCH OR CARD READER PASS FAIL N/A

6.6 BRAILE PLATES AND EMERGENCY EVACUATION PLATES PASS FAIL N/A

6.7 ELEVATOR NUMBER ON ENTRANCE FRAMES PASS FAIL N/A

6.8 FIREFITHER’S PHASE 1 OPERATION AND INDICATOR LIGHT PASS FAIL N/A

6.9 SMOKE DETECTORS HEAT DETECTORS SPRINKLERS PASS FAIL N/A

6.10 EMERGNECY POWER INDICATOR LIGHT PASS FAIL N/A

6.11 EMERGENCY POWER SELECTOR KEY SWITCH PASS FAIL N/A

ITEM # COMMENT CODE REFERENCE

Page 6 of

DATE OF INSPECTION

COMPANY NAME:

CODE EDITION ADDRESS:

CITY, STATE, ZIP:

PASS FAIL INSPECTOR’S QEI-1:#

PRINT NAME:

SIGNATURE:

HYDRAULIC ELEVATOR INSPECTION

REPORT

BUILDING NAME:

BUILDING NUMBER: ELEVATOR NUMBER:

ADDRESS:

BUILDING REPRESENTATIVE:

CONTACT NUMBER:

DATE OF INSPECTON: ASME A17.1 CODE YEAR:

TYPE OF ELEVATOR: PASSENGER SERVICE FREIGHT CARTLIFT DUMBWAITER

MATERIAL LOADING CLASS: A B C1 C2 C3

TYPE OF PUMP UNIT: INTANK V-BELT VALVE AND MOTOR ABOVE TANK

MANUFACTURER:

CAPACITY (LBS): CONTRACT SPEED(FPM):

1.0 ELEVATOR TEST DATA

1.1 FULL LOAD SPEED: UP DOWN EMPTY SPEED: UP DOWN

1.2 MOTOR VOLTS: UP DOWN MOTOR AMPS: UP DOWN

FULL LOAD: FULL LOAD:

EMPTY CAR: EMPTY CAR:

1.3 STATIC PRESURE (PSI): EMPTY CAR FULL LOAD

1.4 WORKING PRESURE (PSI):EMPTY CAR FULL LOAD

1.5 RELIEF VALVE PRESURE (PSI): FULL LOAD ON STOP RING

1.6 DOWN OVERSPEED/RUPTURE VALVE: 10% ABOVE CONTRACT SPEED PASS FAIL

1.7 ROPED HYDRAULIC SAFETIES: A B C N/A

1.8 CAR SLIDE DISTANCE: N/A

1.9 GOVERNOR TRIP SPEED (FPM):

1.10 OVERSPEED SWITCH TRIP SPEED (FPM):

1.11 GOVERNOR ROPE PULL THROUGH FORCE (LBF): N/A

1.12 ONE HOUR RUN TEST:PASS FAIL

1.13 MOTOR TEMPERATURE: START FINISH

1.14 OIL TEMPERATURE RISE: START FINISH

1.15 DOOR SPEED (SEC): CLOSE OPEN CLOSING FORCE (LBF)

2.0 ELEVATOR MACHINE ROOM

2.1 ACCESS TO MACHINE ROOM PASS FAIL N/A

2.2 HEADROOM (7 FEET MINIMUM) PASS FAIL N/A

2.3 LIGHTING AND GFCI RECEPTACLES PASS FAIL N/A

2.4 MACHINE SPACE PASS FAIL N/A

2.5 HYDRAULIC POWER UNIT – MOTOR, PUMP AND TANK PASS FAIL N/A

2.6 CONTROL AND RELIEF VALVE PASS FAIL N/A

2.7 PRESURE SWITCH PASS FAIL N/A

2.8 SUPPLY LINE AND SHUTOFF VALVE PASS FAIL N/A

2.9 FLEXIBLE HOSE AND FITTINGS PASS FAIL N/A

2.10 HOUSE KEEPING – CLEANED AND PAINTED PASS FAIL N/A

2.11 HVAC - VENTILATION PASS FAIL N/A

2.12 FIRE EXTINGUISHER PASS FAIL N/A

2.13 GUARDS ON EQUIPMENT PASS FAIL N/A

2.14 PIPE, DUCT, WIRING AND BUSHINGS PASS FAIL N/A

2.15 NUMBERING OF EQUIPMENT PASS FAIL N/A

2.16 FUSED DISCONNECT – SHUNT TRIP BREAKER PASS FAIL N/A

2.17 CONTROLLER FUSES AND OVERLOADS PASS FAIL N/A

2.18 LOW OIL PROTECTION PASS FAIL N/A

2.19 BONDING WIRE AND GROUDING PASS FAIL N/A

2.20 INSPECTION CONTROL PASS FAIL N/A

2.21 CODE DATA PLATE PASS FAIL N/A

2.22 MAINTENANCE CONTROL PROGRAM AND MAINTENANCE RECORDS PASS FAIL N/A

2.23 MONTHLY FIRE SERVICE TEST LOG PASS FAIL N/A

2.24 EMERGENCY POWER OPERATION (FULL LOAD IN CAR) PASS FAIL N/A

2.25 EARTHQUAKE INSPECTION AND TESTS PASS FAIL N/A

2.26 SMOKE DETECTORS HEAT DETECTORS SPRINKLERS PASS FAIL N/A

3.0 ELEVATOR HOISTWAY – INSIDE

3.1 ACCESS TO HOISTWAY – CARTOP AND PIT PASS FAIL N/A

3.2 HOISTWAY AND PIT LIGHTING PASS FAIL N/A

3.3 HOISTWAY ENCLOSURE PASS FAIL N/A

3.4 HOISTWAY DEVIDER BEAMS AND LEDGES PASS FAIL N/A

3.5 ENTRANCE FRAMES (FULLY GROUTED) PASS FAIL N/A

3.6 DUST COVERS2, FACIAS, TOP AND BOTTOM SHEAR GUARDS PASS FAIL N/A

3.7 VISION PANELS PASS FAIL N/A

3.8 HOISTWAY DOORS PASS FAIL N/A

3.9 HOISTWAY DOOR LOCKING DEVICES PASS FAIL N/A

3.10 MECHANICAL HOISTWAY DOOR CLOSURE PASS FAIL N/A

3.11 EMERGENCY DOORS IN BLIND HOISTWAY PASS FAIL N/A

3.12 HOISTWAY VENTILATION PASS FAIL N/A

3.13 TRAVELING CABLE SUSPENSION PASS FAIL N/A

3.14 TOP OF COUNTERWEIGHT CLEARANCE AND RUNBY (ROPED) PASS FAIL N/A

3.15 BOTTOM OF CAR CLEARANCE, RUNBY AND REFUGE SPACE PASS FAIL N/A

3.16 COUNTERWEIGHT, FRAME AND ROLLER GUIDES (ROPED) PASS FAIL N/A

3.17 COUNTERWEIGHT SHEAVE OR SHACKLES AND HITCH PLATE (ROPED) PASS FAIL N/A

3.18 CAR OVERHEAD CLEARANCE PASS FAIL N/A

3.19 NORMAL TERMINAL STOPPING DEVICES PASS FAIL N/A

3.20 FINAL TERMINAL STOPPING DEVICES PASS FAIL N/A

3.21 CAR AND COUNTERWEIGHT BUFFERS AND TAGS PASS FAIL N/A

3.22 PIT STOP SWITCHES PASS FAIL N/A

3.23 GOVERNOR ROPE TENSION SHEAVE (ROPED) PASS FAIL N/A

3.24 GUIDE RAILS, BRACKETS AND FASTENERS PASS FAIL N/A

3.25 FLOOR NUMBERS ANS EMERGENCY IDENTIFICATION PASS FAIL N/A

3.26 PIPE, DUCT, WIRING AND BUSHINGS PASS FAIL N/A

3.26 EARTHQUAKE INSPECTION AND TESTS PASS FAIL N/A

3.27 SMOKE DETECTORS HEAT DETECTORS SPRINKLERS PASS FAIL N/A

4.0 ELEVATOR CAR – OUTSIDE

4.1 CROSSHEAD DATA, HOIST ROPE AND GOVERNOR ROPE TAGS PASS FAIL N/A

4.2 STOP SWITCH PASS FAIL N/A

4.3 LIGHT AND GFCI RECEPTACLES – TOP AND BOTTOM PASS FAIL N/A

4.4 CARTOP OPERATING DEVICE PASS FAIL N/A

4.5 DOOR REOPENING DEVICE PASS FAIL N/A

4.6 DOOR OPENING RESTRICTOR PASS FAIL N/A

4.7 CLEARANCE, REFUGE SPACE AND CARTOP RAILING PASS FAIL N/A

4.8 CAR LEVELING DEVICE PASS FAIL N/A

4.9 CARTOP EMERGENCY EXIT AND SAFETY SWITCH PASS FAIL N/A

4.10 ELEVATOR NUMBER – TOP, BOTTOM AND PIT SWITCH PASS FAIL N/A

4.11 PIPE, DUCT, WIRING AND BUSHINGS PASS FAIL N/A

4.12 HOISTWAY RUNNING CLEARANCE PASS FAIL N/A

4.13 CAR DOOR OPERATOR PASS FAIL N/A

4.14 TRAVELING CABLE SUSPENSION AND RUNNING CLEARANCE PASS FAIL N/A

4.15 CROSSHEAD, SIDE STILES AND BOLSTER CHANNEL/SAFETY PLANK PASS FAIL N/A

4.16 CAR SAFETIES (ROPED) PASS FAIL N/A

4.17 GOVERNOR ROPE AND RELEASE CARRIER (ROPED) PASS FAIL N/A

4.18 HOIST ROPES, CARTOP SHEAVE OR SHACKLES AND HITCH PLATE (ROPED)PASS FAIL N/A

4.19 CAR PLATFORM GUARD – TOE GUARD PASS FAIL N/A

5.0 ELEVATOR CAR – INSIDE

5.1 CAR DOOR OR GATE PASS FAIL N/A

5.2 DOOR CLOSING FORCE PASS FAIL N/A

5.3 POWER OPENING AND CLOSING OF DOOR OR GATE PASS FAIL N/A

5.4 CAR ENCLOSURE, INTERIOR FINISHES, SILL, FLOOR AND CEILING PASS FAIL N/A

5.5 CAR VISION PANELS AND GLASS DOORS PASS FAIL N/A

5.6 STOP SWITCHES PASS FAIL N/A

5.7 OPERATING CONTROL DEVICES PASS FAIL N/A

5.8 CAR LIGHTING AND GFCI RECEPTICLE PASS FAIL N/A

5.10 EMERGENCY LIGHT AND ALARM PASS FAIL N/A

5.11 EMERGENCY EXIT SECURED FROM OUTSIDE PASS FAIL N/A

5.12 VENTILATION PASS FAIL N/A

5.13 ELEVATOR NUMBER PASS FAIL N/A

5.14 DATA PLATE: CAPACITY, LOADING CLASS AND NUMBER OF PASSENGER PASS FAIL N/A

5.15 SIGNAGE AND BRAILLE PLATES PASS FAIL N/A

5.16 MEDICAL EMERGENCY PASS FAIL N/A

5.17 CAR RIDE QUALITY PASS FAIL N/A

5.18 EARTHQUAKE INSPECTION AND TEST PASS FAIL N/A

5.19 FIREFIGHTER’S PHASE 2 OPERATION PASS FAIL N/A

6.0 ELEVATOR HALL FIXTURES AND HOISTWAY ENTRANCES

6.1 HALL LANTERNS PASS FAIL N/A

6.2 POSITIONS INDICATORS PASS FAIL N/A

6.3 HALL CALL PUSH BUTTONS PASS FAIL N/A

6.4 COMMUNICATIONMONITORING LIGHT - ANNUNCIATOR AND KEY SWITCHPASS FAIL N/A

6.5 MEDICAL EMERGENCY CALL – KEY SWITCH OR CARD READER PASS FAIL N/A

6.6 BRAILE PLATES AND EMERGENCY EVACUATION PLATES PASS FAIL N/A

6.7 ELEVATOR NUMBER ON ENTRANCE FRAMES PASS FAIL N/A

6.8 FIREFITHER’S PHASE 1 OPERATION AND INDICATOR LIGHT PASS FAIL N/A

6.9 SMOKE DETECTORS HEAT DETECTORS SPRINKLERS PASS FAIL N/A

6.10 EMERGNECY POWER INDICATOR LIGHT PASS FAIL N/A

6.11 EMERGENCY POWER SELECTOR KEY SWITCH PASS FAIL N/A

COMPANY NAME:

ADDRESS:

CITY, STATE, ZIP:

INSPECTOR’S QEI-1:#

PRINT NAME:

SIGNATURE:

PASS FAIL DATE OF INSPECTION

B.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1.00 YR __________________ __________________

QEI-1 Certified Elevator Inspection of all elevators two times per year. The type of tests includes one Periodic Inspection per year, one Annual Safety Test per year, and a Five- Year Load Test once every five years.

Contract Period: Base POP Begin: 06-01-2025 POP End: 05-31-2026 PRINCIPAL NAICS CODE: 541350 - Building Inspection Services PRODUCT/SERVICE CODE: H339 - Inspection - Materials Handling Equipment per year. The type of tests includes one Periodic Inspection per year, one Annual Safety Test per year, and a Five- Year Load Test once every five years.

Contract Period: Option 1 POP Begin: 06-01-2026 POP End: 05-31-2027 PRINCIPAL NAICS CODE: 541350 - Building Inspection Services per year. The type of tests includes one Periodic Inspection per year, one Annual Safety Test per year, and a Five- Year Load Test once every five years.

Contract Period: Option 2 POP Begin: 06-01-2027 POP End: 05-31-2028 PRINCIPAL NAICS CODE: 541350 - Building Inspection Services per year. The type of tests includes one Periodic Inspection per year, one Annual Safety Test per year, and a Five- Year Load Test once every five years.

Contract Period: Option 3 POP Begin: 06-01-2028 POP End: 05-31-2029 PRINCIPAL NAICS CODE: 541350 - Building Inspection

Services per year. The type of tests includes one Periodic Inspection per year, one Annual Safety Test per year, and a Five- Year Load Test once every five years.

Contract Period: Option 4 POP Begin: 06-01-2029 POP End: 05-31-2030 PRINCIPAL NAICS CODE: 541350 - Building Inspection Services

GRAND TOTAL __________________

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (NOV 2023)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The

Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered;

and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims

Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the

Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the

Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the

Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by

Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt

Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-

5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting

Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the

Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the Contracting Officer (see 32.607-2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or

(C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor.

(vii) The interest charge made under this clause may be reduced under the procedures prescribed in FAR 32.