SOW Elevator Inspections.pdf

STATEMENT OF WORK (SOW)

Elevator Inspections as of 08/12/2025

Contract Number: (completed by the CO at time of award) Task Order Number: (completed by the CO at time of award if a TO) IFCAP Tracking Number:

Follow-on to Contract and Task Order Number:

1. Contracting Officer’s Representative (COR):

Name: Robert Davis Section: Engineering Address: 10701 East Blvd, Cleveland, OH 44106 Phone Number: 216-791-3800 x62614 Fax Number:

E-Mail Address: Robert.davis6@va.gov

2. Contract Title: Elevator Inspections

3. Background:

The Louis Stokes VA Medical Center, Cleveland, Ohio located at 10701 East Boulevard, Cleveland, Ohio 44106 is a seeking qualified contractor who is QEI-1 Certified to perform on-site Annual, Semi-Annual, and 30-Day Follow-Up Inspection to include a five (5) year Full Load Test on the 19 Traction Elevators and 13 Hydraulic Elevators located at the Wade Park VA Medical Facility.

4. Scope:

Vendor shall provide all labor, materials, equipment, transportation, and supervision necessary to provide Semi-Annual, Annual, 30 Day Follow Up inspections, and Five (5) Year Full- Load Tests, and on the 19 Traction Elevators and 13 Hydraulic Elevators located at the Wade Park VA Medical Facility and Fisher House. Services shall be in accordance with the terms, conditions, provisions, and schedule of the contract. Services shall be for the period of 5/1/2026 through 4/30/2027 with a base plus one (4) option year.

5. Specific Tasks:

5.1. The contractor shall provide all labor, materials, equipment, transportation, lodging, and supervision necessary to perform the required inspections.

5.2. Annual Inspection and No-Load Test must be performed annually.

5.3. A five-year Inspection and Full Load Test must be performed at the time the Annual Test is due in 2030 on all traction and hydraulic elevators.

5.3.1. Full Load Testing may be completed during off-tour hours, at no additional charge to the government, between 5:00pm on a Friday and 8:00am on Monday with prior coordination with COR and elevator maintenance contractor.

5.3.2. The Contractor will be notified in advance by the COR on date and times of the Five-Year Inspection & Test. The five-year inspection and load tests may be performed during or over a weekend or holiday to reduce the impact on the facility.

5.4. 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, hoist way, elevator lobbies, and elevator pit.

5.5. All inspections must be conducted in accordance with the ASME A17.1 code year edition the elevator was installed to comply with and ASME A17.2 Inspectors Guide.

5.6. Site visit/inspection must include a review of the existing equipment for safety code compliance, firefighters' service, ADAAG requirements, recommended upgrades, and modernization needs based on long term life expectancy of the current equipment.

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

5.8. During any inspection which parts must be removed where necessary to determine the exact condition of parts which could not otherwise be determined, and the equipment must be cleaned where necessary to make the proper inspection. All parts must be reinstalled after removal.

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

5.10. Annual and Semi-Annual inspection must be completed in May and November each year after contract award. Annual inspection will be conducted in May of each year. Follow-up onsite inspections will be conducted 30 days after the deficiency list provided to the elevator maintenance contractor.

5.11. In the event a Traction Elevator and/or a Hydraulic Elevator is added or removed from the above 32 elevators, the inspection price will be adjusted per the contract agreement.

5.12. The following is a list of elevators located in the Louis Stokes, VA Medical Facility. This list also outlines the inspection schedule to be followed for annual and semi-annual inspections.

6. Deliverables:

6.1. Within 14 days of elevator inspection, the elevator inspection contractor will provide two (2) copies of the inspection report (1 bounds and 1 unbound) and two (2) electronic CDs of each inspection. One copy is to be delivered to the COR. The other copy is to be mailed directly to the elevator company servicing Wade Park VA Medical Center elevators.

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

ELEVATOR INSPECTION INVENTORY & SCHEDULE PM 19442

1 Monday Cares Tower Service 1 CTSE1 Pass Fail Notes 2 Monday Cares Tower Service 2 CTSE2 3 Monday Cares Tower Service 3 CTSE3 4 Monday Cares Tower Patient 1 CTPE1 5 Monday Cares Tower Patient 2 CTPE2 6 Monday Cares Tower Patient 3 CTPE3 7 Tuesday Main Building PE3 8 Tuesday Main Building PE4 9 Tuesday Main Building PE5

10 Tuesday Main Building PE6 11 Tuesday Main Building PE7 12 Tuesday Main Building PE8 13 Wednesday Main Building SE1 14 Wednesday Main Building SE2 15 Wednesday Atrium AE1 16 Wednesday Atrium AE2 17 Wednesday Atrium AE3 18 Thursday Learning Exchange LXE1 19 Thursday Woman's Health WH1 20 Thursday Patient Garage 1 PPGE1 21 Thursday Patient Garage 2 PPGE2 22 Thursday Patient Garage 3 PPGE3 23 Thursday Patient Garage 4 PPGE4

24 Thursday Sky Bridge SWPE1

Heavily used single service car.

Must be performed before 7am or after 5pm

25 Friday SPD Dirty SPD Dirty

0500 -0700 First need to verify no emergency surgery cases are taking place

26 Friday SPD Clean SPD Clean

0500 -0700 First need to verify no emergency surgery cases are taking place

27 Friday Warehouse Warehouse No machine room access during off hours

28 Friday PALMS LWPE1

29 Friday EMS EMS No Machine room access during off hours

30 Friday Animal Research ARPE1 31 Friday Fisher House 1 FH1 32 Friday Fisher House 2 FH2

6.3. The elevator company servicing the Louis Stokes VAMC is to be notified by the elevator inspection contractor that they have 30 days upon receipt of inspection documentation to perform corrective action. A re-inspection will then take place by the elevator inspector after the 30-day limit has been reached. All coordination between the elevator inspection contractor and the elevator maintenance contractor pertaining to the elevator inspections is the sole responsibility of the vendor.

6.4. The elevator inspection contractor may be requested to write additional reports pertaining to the elevator inspection if the elevator maintenance contractor is not cooperative with making the necessary corrections within the prescribed timeframe.

6.5. This contract will provide the contracting officer with an expert in the field of elevators which will act as a third party along with the electric shop as a basis to build a case upon if necessary.

6.6. The Elevator inspection contractor shall submit a site-specific safety plan outlining how inspections and testing will safely be conducted. This safety plan will be submitted to the VA safety department for approval.

7. Performance Monitoring:

The COR may use Direct Observation and/or Periodic Inspections to evaluate outcomes on a periodic basis. Scheduled or unscheduled inspections may be performed daily, weekly, monthly, quarterly, or annually as required. The COR will utilize a QASP plan to monitor this installation and service.

7.1. Acceptable Performance:

The Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action.

7.2. Unacceptable Performance:

7.2.1. When unacceptable performance occurs, the COR shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in the COR file.

7.2.2. When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR) and present it to the contractor's program manager.

7.2.3. The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor should correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receiving receipt the contractor must present this corrective action plan to the

COR. The Government shall review the contractor's corrective action plan to determine acceptability.

7.2.4. Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

8. Check – In Requirements:

The Contractor Service Personnel and/or representative must report to Sterile Processing Services, Wade Park, Room 120, and check in with the Chief, SPS or designee before work begins. Upon completion of work, the Contractor Service Personnel and/or representative must report to the appropriate department Supervisor to brief that Supervisor or designee, concerning completion of service, and then to sign out.

9. Security Requirements:

The C&A requirements do not apply, and a Security Accreditation Package is not required.

9.1. Dedicated personnel will be assigned solely to observe, interact, assist, and assure protection of VA sensitive information. Vendor will not have access to VA Sensitive Information, patient records, or data.

9.2. Contractor employees providing services at VA facilities may undergo a security clearance in the form of a basic background investigation.

10. General Security:

Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

11. VA Information Custodial Language:

11.1. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).

11.2. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.

12. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI):

The VA Northeast Ohio Healthcare System will not furnish parts and/or test equipment for the performance of this contract. It is the responsibility of the contractor to bring the appropriate equipment and/or supplies necessary to complete the work as required per this contract.

13. Other Pertinent Information or Special Considerations: N/A

13.1. Identification of Possible Follow-on Work:

Any additional repair or replacement work required outside this contract will require the contractor to submit a quote to COR and receive an approved PO before beginning work.

13.2. Identification of Potential Conflicts of Interest (COI): None

13.3. Identification of Non-Disclosure Requirements: Not Applicable

13.4. Packaging, Packing and Shipping Instructions: None

13.5. Inspection and Acceptance Criteria:

Contractor will be responsible for meeting timelines listed in this SOW to include monthly inspection, inspection reports, and response to service call.

14. Risk Control:

Work performed within the medical center may present health risks including exposure to illness and infection control. Contractor will take action to recognize and follow warning information throughout the facility.

15. Place of Performance:

Louis Stokes VA Medical Center 10701 East Blvd Cleveland, Ohio 44106

16. Period of Performance:

Need by date: 5-1-2026

Base Year: 5-1-2026 – 4-30-2027 Option Year One: 5-1-2027 – 4-30-2028 Option Year Two: 5-1-2028 – 4-30-2029 Option Year Three: 5-1-2029 – 4-30-2030 Option Year Four: 5-1-2030 – 4-30-2031