SOW Ergonomic Evaluations DRAFT.pdf

Statement of Work San Francisco VA Health Care System (SFVAHCS)

Ergonomic Evaluations

1. Scope:

The contractor shall provide all necessary expertise, materials, equipment, labor, supervision, transportation, and resources necessary to perform ergonomic task assessments and evaluations including those for any SFVAHCS employee who may qualify for reasonable accommodation under the American with Disabilities Act and related amendments. Ergonomic assessments and evaluations may include the observation of workplace conditions and work processes, workplace surveys and reports, ergonomic job and task analysis, and employee interviews in the identification of potential ergonomic related injury risks.

a. The frequency of these tasks will be determined by Environmental Health and Safety.

b. Preference for national board certification such as Certified Professional Ergonomist or Certified Industrial Ergonomist with clinical assessment experience in the risk identification of potential musculoskeletal disorders (MSD) and injuries in the healthcare industry such as but not limited to the evaluation of safe patient handling, dental operations, sonography, and long-term residential care.

c. Provide month-to-month data and annual reports on ergonomic evaluations performed for the Environmental Health and Safety office.

d. Conduct individual employee ergonomic evaluations and workplace task evaluations that are consistent with the Veterans Health Administration (VHA) and healthcare industry standard practices which assist in redesign or modification of a workstation to control the physical fatigue of the job and reducing the risk of potential MSD.

e. Provide concise ergonomic evaluation reports and where necessary multiple ergonomic solutions where equipment purchasing will be required for an employee. Include practical methods of control and equipment recommendations which are appropriate for an employee’s specific workstation.

f. Provide as requested an evaluation of specific facility workstation designs and work practices from an ergonomics perspective to Environmental Health and Safety for use by Interior Designers for the design or refurbishment of new or existing workstations, offices, or patient care rooms.

g. Present ergonomic evaluation reports to Environmental Health and Safety in a timely, organized manner using the recommended format no later than 10 business days after the completed ergonomic evaluation.

h. Provide follow-up services with the employee after the ergonomic equipment has been provided including training on the products or equipment provided for the employee.

i. Provide on-site ergonomic training and/or ergonomic education classes as requested.

2. Additional Services:

a. Contractor’s Experience: Contractor must be thoroughly knowledgeable with the VHA Ergonomics Guidebook, published by HEFP, dated Nov 2025. Contractor should follow any recommended SOPs and checklists available in the VHA Ergonomics Guidebook.

b. All employees’ records that arise from professional services at SFVAHCS are the property of VA, or respective employees as allowable under applicable laws, and are not the property of the contractor.

3. Period of Performance:

Base Year July 15, 2026 to July 15, 2027 (12 months) plus four Option Years

4. Hours of Work:

a. Work to be performed during normal business hours, 8:00 a.m. to 4:30 p.m., Monday through Friday excluding Federal holidays.

b. Provide SFVAHCS a schedule of availability at least thirty (30) days in advance.

5. Federal Holidays:

New Years Day, Martin Luther King Day, President’s Day, Memorial Day, Juneteenth Day, Independence Day, Labor Day, Columbus Day, Veteran's Day, Thanksgiving Day, Christmas Day, and any other specifically declared by the President of the United States. When a legal holiday falls on a Saturday, the preceding Friday is considered a legal holiday and when the holiday falls on a Sunday, the following Monday is considered a legal holiday.

6. Invoicing:

The contractor shall submit a monthly invoice detailing the services rendered during that month and the total amount payable to for services rendered. SFVAHCS agrees to pay such invoices subject to timely and satisfactory submission of complete monthly invoices. Monthly invoices to SFVAHCS for services rendered must clearly identify the type of services performed and the time spent on furnishing each type of service.

7. Contractor Personnel Security Requirements:

Reference:

VHA Directive 0710, Personnel Security and Suitability Program/ May 18, 2007 VA Handbook 0710, Personnel Suitability and Security Program/ May 2, 2016

Upon contract award, all key personnel shall be subject to the appropriate type of background investigation or screening per VA/VHA directive 0710 and must receive a favorable adjudication from CCA Personnel Security Specialist or VA Security and Investigations Center (SIC) depending on investigation or screening required. This requirement is applicable to all subcontract personnel. If the investigation or screening is not completed prior to the start date of the contract, the Contractor will be responsible for the actions of those individuals they provide to perform work for VA.

Contract personnel who previously received a favorable adjudication as a result of a Government background investigation or screening may be exempt from this contract requirement. They must provide documentation to support the previous adjudication. Proof of previous adjudication must be submitted by the Contractor to the VA Contracting Officer. Proof of previous adjudication is subject to verification. Some positions may be subject to periodic re-investigation/screening.

1. Position Risk/Sensitivity – For all positions required under this contract, the position risk/sensitivity has been designated as: Low Risk

2. Background Investigation/Screening – It is anticipated that the Contractor or contract personnel will be providing services at a VA facility(s) for MORE than 180 days under a single contract or series of contracts or have access to VA computer data systems. The background investigation/screening commensurate with the requirements of this contract is: NACI

3. Contractor Responsibilities

a. The Contractor shall prescreen all personnel to ensure they are able to read, write, speak, and understand the English language.

b. The Contractor shall submit or have their contract personnel submit the following required forms to the Personnel Security Specialist or VA Contracting Officer, through the COTR or Personnel Security Specialist, within five (5) business days of contract award.

4. Low Risk Investigative Requirements

a. All investigations must be completed through the Electronic Questionnaires for Investigations Process (e-QIP). All contractors must complete the Authorization for Investigation Worksheet before they can complete the online e-Qip.

b. Optional Form 306, Declaration for Federal Employment provided by VA point of contact.

c. Electronic Fingerprint Verification or FD 258, U.S. Department of Justice Fingerprint Applicant Chart.

c. Once the items requested are completed, the Contractor is authorized to provide services under the contract. As previously stated, if the investigation or screening is not completed prior to the start date of the contract, the Contractor will be responsible for the actions of those individuals they provide to perform work for VA.

d. The Contractor, when notified of an unfavorable determination by the Government, shall withdraw the contract person from consideration of working under the contract.

e. Failure to comply with these Contractor personnel security requirements may result in termination of the contract for default.

5. Government Responsibilities

a. The VA Contracting Officer will ensure a time for contract personnel to complete the fingerprint portion of this requirement, if any, and the COTR will be responsible for performing any duties assigned by the VA Contracting Officer with regard to fulfilling the Contractor personnel security requirements described herein.

b. Upon receipt, the local VA facility or VA SIC, depending on the type of investigation/screening required, will review the accuracy of the items requested in paragraph above, and forward these items to OPM to conduct their portion of the background investigation or screening, as applicable.

c. The requesting VA facility will pay for any portion of the investigation or screening conducted by OPM, if any.

d. Depending on the type of investigation/screening required, the Personnel Security Specialist, or VA SIC will notify the VA Contracting Officer of the adjudicating results of the background investigation or screening.

e. The VA Contracting Officer and Personnel Security Specialist will ensure that the required investigations or screening have been completed or are in the process of being requested.

Personnel Identity Verification (PIV) of Contractor Personnel

In accordance with FAR 52.204-9 and VA Directive 0735 – Personal Identity Verification of Federal Employees and Contractors, any contract person who requires routine physical access to a Federally-controlled facility and/or routine access to a Federally-controlled information system will be required to verify their identity prior to providing services under the contract. Prior to providing services under the contract, each contract person will be asked to provide two (2) forms of identification from the Accepted Identification Documentation List to the appropriate VA representative to obtain a proper VA-issued identification card. See the Accepted

Identification Documentation List provided below. The COTR, or designee, will be responsible for sponsoring each contract person that requires a VA-issued identification card.

PIV ID Proofing Criteria

The following criteria must be met by all VA employees, contractors, and affiliates prior to being issued a PIV card or Temporary Identity Badge.

No Access to Sensitive Information

The Contractor acknowledges and agrees that, in performance of services under this Agreement, access to sensitive information is neither required nor authorized. Accordingly, the Contractor shall not access, collect, store, process, transmit, or otherwise handle any personally identifiable information (PII), protected health information (PHI), or other confidential or sensitive information.

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 VHA records.

2. does not include personal materials.

3. applies to records created, received, or maintained by Contractors pursuant to their VHA 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, the Contractor shall maintain all records created for Government use or created while 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. VHA 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 VHA or destroyed except 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, the Contractor must report to VHA. 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 vehicle]. 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 VHA 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 VHA 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 VHA policy.

8. The Contractor shall not create or maintain any records containing any non-public VHA information that is 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 VHA 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 VHA 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 VHA-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.

[Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.]

D. Flow down 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.