SOW Dental Department Service Contract.docx

STATEMENT OF WORK

FOR

SERVICE OF DENTAL EQUIPMENT

Introduction

The Rosebud Hospital has an 8 Chair dental department in the facility. The Equipment are used throughout the department and located in the Rosebud Hospital on the First Floor of the facility.

Purpose

The contractor shall provide servicing to the 8 Adec dental chairs, 8 Adec delivery units, 1 RamVac Bison dental vacuum system, and 1 Osprey Dental Compressor at the Rosebud Hospital annually. The period of performance for this contract is 365 days, with 4 option years potentially to follow.

Scope of Work

Contractor shall travel to the Rosebud Hospital in Rosebud SD to do annual maintenance as follows.

A-DEC 532 DELIVERY SYSTEM & 545 DELIVERY ASSISTANT INSTRUMENTAION

Preventative maintenance of systems annually or after 1500 hours of clinical use.

Delivery System

1. Replace the doctor’s syringe button-valve assemblies, lubricate with A-dec silicone lubricant, and verify operation.

1. Check the expiration date on the bottom of the self-contained water bottle and replace if needed.

1. Lubricate the self-contained water bottle O-rings with A-dec silicone lubricant.

1. Check for damaged, brittle, or stiff handpiece tubing and recommend replacement if needed.

1. Check the condition of handpiece coupler O-rings and recommend replacement if needed.

1. Check handpiece pressures and adjust to manufacturer’s specification as needed.

1. Check intraoral light source voltages and adjust to handpiece manufacturer’s specification as needed.

1. Continental delivery system only: check whip arm movement and adjust spring tension as needed.

1. Check the handpiece holder bar tension and adjust as needed.

1. Check that the handpiece flush valve system is operating normally.

1. Check operation of air brake and tension of flex-arm spring and adjust as needed.

1. Check for oil or water accumulation in oil collector, replace gauze, and clean as needed.

1. Use the touchpad and foot control to check the operation of handpiece identification and activation.

1. Check that the delivery system is level and balanced. If the delivery system drifts or does not hold position, adjust the rigid arm first (A-dec 511A systems manufactured after April 2011 only), then level the control head.

1. Check the tubing strain relief on the warm water syringe and handpiece tubing.

Foot Control

1. Check the condition of the foot control tubing and recommend replacement if needed.

1. Lever foot control only: clean and recommend replacement if needed.

1. Check for loose screws and tighten as needed.

1. Check for chip air function if applicable.

1. Check for coolant water on/off toggle function.

Assistant’s Instrumentation and Vacuum

1. Replace the assistant’s syringe button-valve assemblies, lubricate with A-dec silicone lubricant, and verify operation.

1. Replace the HVE O-rings and spring clip, confirm that tailpieces are secure, lubricate with A-dec silicone lubricant, and verify operation.

1. Service the saliva ejector using SE PM kit, confirm that tailpieces are secure, lubricate with A-dec silicone lubricant, and verify operation.

1. Replace the vacuum canister O-rings and solids trap screen, lubricate O-rings with A-dec silicone lubricant, and verify operation.

1. Inspect vacuum tubing for damage or leaks and recommend replacement if needed.

1. Check for damaged or brittle tubing and recommend replacement if needed.

1. Check amalgam levels and the operation of the amalgam separator.

1. Check the operation of the lower support arm and rear support link stop switch.

1. Check that the assistant’s instrumentation arm is level. If adjustment is required, start with the lower arm and move up to the holder bar.

Floor Box

1. Check incoming air and water pressures and adjust as necessary. Check incoming air to ensure clean and dry air is being delivered to the delivery system.

1. Check for air and water leaks.

1. Check for damaged, brittle, or stiff tubing and recommend replacement if needed.

1. Check the moisture separators at the floor box and compressor and replace or advise when to replace as needed.

1. Replace water regulator filters and rebuild regulators using instructions included with kit.

A-DEC 511 DENTAL CHAIR

Check out Unit and assure it is operational and safe Check out controller and assure working Check swivel brake tension Check Glide Bar Tension Monitor Mount Drift and Tension Check out Upholstery and replace damaged items Check Floor Box

A-DEC LED DENTAL LIGHT

Check operation of all LED lights and assure properly working Check controllers and assure properly working Check and assure all lights work and light shields in place for safety

OSPREY DENTAL COMPRESSOR

Change Filters, Particulate, Coalescing Change Oil

RAMVAC VACUUM SYSTEM (BISON 5)

MODEL 818E 1053 5/

SERIAL BN1906124

Change Air Filters Check Drip Rate Change Oil & Filter—5 quarts of 15W50 oil Change V-Belt Replace S-Type Exhaust filter Clean unit and Vacuum lines Check the treatment room solids separator

EMERGENCY SERVICES

There shall be emergency services built into this contract for instances when equipment breaks down and we need a service representative to come out and get the equipment up and running so we do not have down time for patient care.

Collection and Deliveries:

Servicing is required on an annual basis or at 1500 hours and shall be arranged by the COR, Terry Yellow Hawk or designee, and will be responsible for signing the receipt upon completion of servicing of Equipment.

Government Furnished Equipment

The government shall provide the Dental Equipment to be serviced.

Contractor Submittal Requirements

Submittals have no format requirement but shall contain the following:

· Annual service charge for Hourly wage and time.

· Total cost to travel to the site for servicing.

· Total cost of all parts needed for machine.

· Total cost for the contract period.

Clean Up

Contractor is responsible for any spillage or messes made while servicing the floor scrubber.