SOW Attachment 06 - Engineering Deviation Request Template.docx

DOCX document 48 KB Posted

Attached to
C1DA--Copy of AE-NRM-687-26-100 Modernize Physical/Electronic Security Systems
Solicitation number
36C26026Q0147
Issued by

About this file

This document is an Engineering Deviation Request Template from the Department of Veterans Affairs. The template is designed for submitting code/design deviation requests to the Office of Healthcare Engineering, allowing requestors to propose waivers, equivalencies, or abeyances for specific project requirements. The template requires detailed information including the source of the requirement, a summary of the deviation, justification, potential risks, and supporting documentation. Requestors must agree to adhere to monitoring/mitigation strategies and understand that the Deviation Review Committee may require additional approvals depending on the potential impact and risks of the proposed deviation.

The template is associated with a VA Sources Sought announcement (Solicitation Number: 36C26026Q0147) for a project to modernize physical and electronic security systems, specifically Project 687-26-100. This is a market research effort to identify capabilities of small business firms for an Architect-Engineer (A-E) contract, with the intent of shaping the future acquisition strategy. The project involves site visits, field investigations, reports, studies, and user interviews to prepare drawings, specifications, and cost estimates for security system modernization.

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Text version

Department ofMemorandum

Veterans Affairs

Date:
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From:
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Subj:
Code/Design Deviation Request

Project Number / Project Name

To:
Office of Healthcare Engineering (19HEFE)
Category of Request
Choose an item.
Source of Requirement, e.g. Directive, Design Guide, or Specifications; including section
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Summary of Requirement

Type of Deviation Requested: ☒ Waiver ☐ Equivalency ☐ Abeyance

Summary of and Justification for Request (Include project details, location of request, other implications. Identify risks associated with this deviation including if the deviation is not approved AND if the deviation is fully implemented.)

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List of Attachments and Supporting Documents (e.g., specifications, drawings, etc.)

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By signing this memorandum, the requestor(s) agree to adhere to all monitoring/mitigation strategies identified by the facility as well as additional conditions imposed by OHE if this or a modified deviation is approved. The requestor(s) understand that the Deviation Review Committee may request Medical Center or Network Director signature approval based on the impacts and risks associated with this request.
Signed (Request)
Signed (if requested)

Name Title (Chief Engineer)

Date
Name

Title Date https://dvagov.sharepoint.com/sites/VHA10NA5E/waiver/Pages/Waiver%20Requests.aspx

File details come from the government source that posted it. Updated .