Scope of Work.pdf

STATEMENT OF WORK

Tsaile Health Center

Medical Gas Repairs and Upgrades

I. Project Background and Description Statement:

The Contractor will provide equipment, specs and labor to repair and upgrade the Medical

Gas System for the Tsaile Health Center.

II. Scope of Work:

The Contractor shall provide services to include:

• Upgrade Medical Gas repairs based on 2020 annual med gas report. ASSE 6010 certified installation.

• Replace oxygen manifold with fully NFPA compliant system.

• Install new header bars, pigtails, source valve, automatic switch over with alarm, dual regulators.

• Replace old master alarm that is not functioning properly.

• Add appropriate master alarm signals.

• Replace main line pressure switch and add required DISS gas specific demand check fittings & gauge.

• Label zone valves and alarms.

• Comply with ASSE 6030 third party verification, test new components all per

NFPA 99 once installed.

• Include a PDF certification report that will be included.

• Freight, travel, lodging will be included and ensure that the unit is 100% fully operational.

III. Glossary:

COR – Contracting Officers Representative

SPOC – Supervisory Point of Contact

HSA- Health System Administrator

CO – Contracting Officer

THC – Tsaile Health Center

IV. Project Goals:

The Contractor will be authorized to perform the work under this contract only during the time outlined below. The Contractor will not be authorized to work on the Medical Gas

System at any other times unless it is specifically requested in writing from the Contracting

Officer a minimum of 24 hours in advance.

Monday through Friday 8:00a.m. - 5:00p. m., Federal Holidays excluded.

The Contractor must ensure that work is scheduled in such a manner that when it is started it will be completed without interruption. The Contractor's personnel should not leave the work site to perform work required by contractors on other service calls.

V. Project Objectives:

All work shall comply with State and Federal Safety Regulations per C.F.R. (Code of

Federal Regulations) and be compliant with our (NFPA 99), Standard for Health Care

Facilities, and G.1.2.6 (JCAHO) Publications, Joint Commission on the Accreditation for

Healthcare Organization standards.

VI. Period of Performance:

One time delivery of Installation and the visit will be scheduled with the individual service unit Facility Department Supervisor, as listed below, and the schedule will be submitted to the COR for approval prior to commencing the site visit.

Points of contact are as follows:

Tsaile Health Center

Dwayne Thompson

Facility Department Supervisor

P.O. Box 21

Tsaile, Az 86556

(928) 724-3665

VII. Scheduled Status Plan:

Report: Service Ticket

Purpose: (PO) Purchase Order

Location: Tsaile Health Center, PO Box C21, Navajo Route 64 & 12 Tsaile, AZ 86556

Deliverable / Schedule: ARO 30 days

VIII. Contact Information:

Dwayne Thompson, Facility Department Supervisor (928)724-3665

Earl Morris JR, Purchasing Agent, telephone #928-724-3735, email: earl.morris@ihs.gov

Deanna Nelson, COR Representative, #928-724-3657

IX. Project Deliverables will be approved/accepted by:

Contracting Officer: Earl Morris JR, Purchasing Agent

COR: Deanna Nelson

Receiving Agent: Roberta Ashley

Accounts Payable: Roberta Ashley, Accounts.up