SOW Draft for Equipment Maintenance.docx

PERFORMANCE WORK STATEMENT

1) GENERAL DESCRIPTION:

This SOW is to perform repair/replacement of 6 pieces of housekeeping equipment inside the Omaha and Grand Island VA EVS Department. Below in Section 8 is an outline of the contractual performance requirements the contractor is required to deliver to the VA.

2) PERFORMANCE LOCATION:

a) Department of Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha Division Medical Center, 4101 Woolworth Avenue, Omaha, NE 68105 and Department of Veteran Affairs Nebraska Western Iowa, Grand Island Division, 2201 North Broadwell, Grand Island, NE 68803

3) PERFORMANCE PERIOD:

a) Anticipated Period of performance is 8-13-2025 to 8-12-2026

4) HOURS OF SERVICES:

a) Normal Operational Hours (i.e. 07:00-16:00)

i) Preventive maintenance services and inspections shall be performed on weekdays during normal business hours between 07:00 CST to 16:00 CST unless other arrangements have been made with the appropriate representatives.

ii) Normally, work will not be done on federal holidays. A list of federal holidays is at Federal Holidays (opm.gov).

iii) Any work scheduled outside of normal operational hours must be arranged and approved by the Nebraska-Western Iowa VA Health Care System Engineering with at least 24 hours of advanced notice.

5) EQUIPMENT LIST:

#1 AD-2800ST S/N-40000149867

#2 AD-2800ST S/N-40000149864

#3 AD-3400ST S/N-40000272086

#4 AD-ES4000 S/N-40000272061

#5 AD-3400ST S/N-40000273566

#6 AD-3400ST S/N-40000272286

6) REQUIRED CERTIFICATION

a) TMS Training 20939 No Access

7) CONTRACTUAL REQUIREMENTS AND PERFORMANCE CRITERIA:

a) REPORTING

i) The contractor personnel shall report to the VA site representative to sign in and acquire a badge.

ii) The contractor personnel shall report to the VA site representative to sign out and return the badge before departing the VA facility at the end of each week.

iii) The contractor personnel shall wear an identification badge provided by VA when working under the resulting contract on Federal property.

b) SERVICES:

i) Initial Project Meeting

(1) Site work will commence with a meeting of the contractor and the VA Contracting Officer Representative (COR). The purpose of this meeting will serve to address the following items as may be appropriate.

(a) Review plant safety regulations, and lockout/tag-out procedures

(b) Discuss the nature of the planned repair activities:

REPAIRS:

FL-EV305AA DISCOVER AGM 305 BATTERY EA 16

FL-EVL16A-A BATTERY, AGM, 390AH EA 4

AP-601278 SKIRT BRACKET FRONT 34 EA 1

AP-601451 COVER FLTR BOX W/GSKT EA 4

AP-315296 SOLUTION FILTER ASSY, EA 2

ADPHIBIAN

AP-003824 NUT-WING PLASTIC LOC 1/4-20 EA 8

AP-003828 SCR- CARRIAGE SS 1/4-20 X 1.00 EA 4

AP-009060 WSH FLT SS .260X1.000X.074 EA 4

AP-003715 SCR CARRIAGE SS 1/4-20X.75 EA 4

AP-383489 SKIRT BLADE KIT-RED GUM EA 4

AP-601578 KNOB, YELLOW (OLD # 407334) EA 4

AP-380149 KNOB, BLACK (OLD # 407114) EA 4

AP-383469 SKIRT ASSY KIT-34 IN EA 1

AP-601172 CONNECTOR ASSY EA 4

AP-382739 BLADE KIT-SQUEEGEE-RED GUM 34 EA 1

AP-382735 BLADE KIT-SQUEEGEE-RED GUM 28 EA 2

AP-382697 CLAMP-BAND 28 IN ASSY EA 1

AP-601454 34" SQUEEGEE ASSY EA 2

AP-302164 NYLON BEARING EA 4

AP-003264 RING RET EXT TYPE E EA 4

AP-601580 PIN EA 2

AP-407006 WHEEL ROLLER EA 2

AP-370711 KNOB, SQUEEGEE EA 4

AP-601125 VAC FILTER, ES4000 EA 6

AP-394602 VAC HOSE, ADVENGER OLD # EA 3

601136

AP-383319 RECOVERY DRAIN HOSE ASSY-1.5 EA 3

ES4000 ADVENGER 2810

AP-409485 CABLE EA 12

AP-383240 SEAT KIT EA 2

AP-601522 BLADE FRONT 34 EA 1

AP-003263 RIVET NYLON TREE PUSH-IN.25 EA 6

PD-0TO25MILES PICK UP/DELIVERY CHARGE 0-25 EA 2 70.00 MILES

SH-1 FIELD RATE [QTY: 1 = 1/2HR, EA 22 INCLUDES PORT TO PORT TRAVEL]

MISC4 MISC SHOP SUPPLIES EA 1

FL-EV185A-A BATTERY, 12V, 234AH, AGM EA 3

SH-1 FIELD RATE [QTY: 1 = 1/2HR, EA 14

INCLUDES PORT TO PORT TRAVEL]

MISC3 MISC SHOP SUPPLIES EA 1

WP-86004860 REPLACEMENT KEY (FOR 86007190 EA 4

AND 86007170) CHARIOT

AP-104483 RED RUBBER SQUEEGEE BLADE KIT EA 1

FL-EV185A-A BATTERY, 12V, 234AH, AGM EA 9

AP-315296 SOLUTION FILTER ASSY, EA 1 ADPHIBIAN

FL-EVL16A-A BATTERY, AGM, 390AH EA 4

SH-1 FIELD RATE [QTY: 1 = 1/2HR, EA 10 INCLUDES PORT TO PORT TRAVEL]

MISC5 MISC SHOP SUPPLIES EA 2

PD-126TO200MILE PICK UP/DELIVERY CHARGE EA 1 126-200 MILES

8) REPAIR WORK:

a) If additional repairs not included under the definitions laid out in this document are required to complete the services, the contractor shall provide the nature of the repair and a budgetary cost estimate in the format of a quote (including line items for labor, materials, and all other related costs) needed to complete repairs in an inspection summary report. Any additional charges and repair work claimed must be approved by the contracting officer before service commences. Any additional work performed by the contractor without the prior written approval of the CO will be performed by the contractor at no additional cost to the government.

b) Once it has been determined and agreed upon both by the VA and the contractor that the additional services needed to affect repairs are not included in this contractual performance work statement, monetary funds will need to be requested and approve by means of a PO if total repair expenses are less than $2500.00 or through means of a contract modification if total repair expenses are greater than $2500.00. The COR does not have the authority to approve the work outside of the SOW and any work performed by the contractor in good faith outside of the SOW. Any work performed by the contractor without the approval of the contracting officer or an approved purchase through a credit card PO will be completed or resolved at the expense of the contractor and not the VA.

9) HOURS OF WORK:

a) Routine Work: Routine work connected with this contract shall be performed between the times of 07:00 and 16:00 local time defined as normal working hours unless explicitly stated in the SOW.

b) Emergency Work: Emergency work is defined as work performed after normal working hours. As specified earlier, the contractor shall be required in some instances to work other than normal working hours. Approval of the COR shall be obtained prior to starting work during other than normal working hours to ensure services are needed after hours and are included in this SOW.

10) CONTACT INFORMATION:

a) The contractor shall provide to the contracting officer specific mobile number(s), email address (es) and/or SMS texting number(s) which can always be used to alert the contractor, including weeknights, weekends, and holidays. In addition, the Government shall provide the contractor the names of the agency personnel authorized to initiate medical gas and vacuum system service calls, contracting officer, contract monitor, alternate contract monitor. Both parties entering the contractual agreements will include three points of contact as a double redundancy for communication and information relaying.

11) REPORTING AND DOCUMENTATION:

a) The contractor will be responsible for providing documentation of incremental work completed to the primary and secondary points of contact listed prior. Documentation should be submitted to the VA representatives when maintenance of any kind is performed, inspections of equipment is completed, inventory of materials is certified, or emergency repair work is finished. The documents (in the form of electronic documents, preferably PDFs) should regularly be emailed to the VA representatives at least one week after inspection to include maintenance provided, whether or not the unit passed, and any other deficiencies with the equipment to include cost line items and weekly so that a comprehensive schedule of the contractor’s work is retained for records as required by government records agencies.

12) GENERAL REQUIREMENTS

a) The contractor’s personnel, while on VA property, shall adhere to all requirements and regulations that govern the VA Health Care System and its property. Among all other requirements, the VA Health Care System and its property is now entirely smoke-free. No weapons are permitted on the premises.

Records Management Language for Contracts When Federal agencies acquire goods or services, they need to determine what Federal records management requirements should be included in the contract. Federal contractors often create, send, or receive Federal records. Federal contracts should provide clear legal obligations describing how the contract employees must handle Federal records.

Agency records officers, procurement counsel, and acquisitions officers must discuss how to integrate records management obligations into their existing procurement processes. NARA has developed the following language to be included as an agency-specific term and condition in Federal contracts for a variety of services and products. The majority of contracts should include language on records management obligations, but each contract should be evaluated individually. For example, the data-rights paragraph (Paragraph 10 below) may not be appropriate for all contracts. Instead, agencies may be better served by one of the established data-rights clauses in the Federal Acquisition Regulations.

This language should not replace specific records management requirements included within Federal information system contracts.

RECORDS MANAGEMENT OBLIGATIONS

A. Applicability This clause applies to all Contractors whose employees create, work with, or otherwise handle Federal records, as defined in Section B, regardless of the medium in which the record exists.

B. Definitions “Federal record” as defined in 44 U.S.C. § 3301, includes all recorded information, regardless of form or characteristics, made or received by a Federal agency under Federal law or in connection with the transaction of public business and preserved or appropriate for preservation by that agency or its legitimate successor as evidence of the organization, functions, policies, decisions, procedures, operations, or other activities of the United States Government or because of the informational value of data in them.

The term Federal record:

1. includes Department of Veteran Affairs Omaha VA Medical Center records.

2. does not include personal materials.

3. applies to records created, received, or maintained by Contractors pursuant to their Department of Veteran Affairs Omaha VA Medical Center records contract.

4. may include deliverables and documentation associated with deliverables.

C. Requirements

1. Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

2. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

3. In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

4. Department of Veteran Affairs Omaha VA Medical Center records and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of Department of Veteran Affairs Omaha VA Medical Center records or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to Department of Veteran Affairs Omaha VA Medical Center records. The agency must report promptly to NARA in accordance with 36 CFR 1230.

5. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the contract. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government’s behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to Department of Veteran Affairs Omaha VA Medical Center records control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

6. The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub-contractor) is required to abide by Government and Department of Veteran Affairs Omaha VA Medical Center records guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

7. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with Department of Veteran Affairs Omaha VA Medical Center records policy.

8. The Contractor shall not create or maintain any records containing any non-public Department of Veteran Affairs Omaha VA Medical Center records information that are not specifically tied to or authorized by the contract.

9. The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.

10. The Department of Veteran Affairs Omaha VA Medical Center records owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which Department of Veteran Affairs Omaha VA Medical Center records shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20.

11. Training. All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take Department of Veteran Affairs Omaha VA Medical Center records-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.

D. Flowdown of requirements to subcontractors

1. The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same.

2. Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor.