SOW for Backflow Prevention Assembly - Testing -Maintenance and Compliance 03.23.2026.docx

Backflow Prevention Assembly Testing, Maintenance, and Compliance VA Southern Oregon Rehabilitation Center & Clinics (VA SORCC), White City, OR Statement of Work

A. GENERAL

A.1 GOAL:

Contractor shall provide White City VA Southern Oregon Rehabilitation Center and Clinic (VA SORCC) located at 8495 Crater Lake Hwy, White City, OR 97503 with annual testing, maintenance and compliance verification of 93 backflow prevention assemblies across campus.

A.2 BACKGROUND

To avoid potable water system contamination and maintain compliance with Medford Water Commission (MWC) Regulations, Oregon Administrative Rules (OAR) 333-061 Cross Connection Program Standards, Veterans Health Administration (VHA) Directive 1061 (4) Water Safety and Legionella Prevention, VA Plumbing Design Manual PG-18-10, annual backflow prevention assembly testing, maintenance, and repairs must be completed across the VA SORCC.

A.2 LOCATION OF SERVICES:

VA Southern Oregon Rehabilitation Center and Clinics 8495 Crater Lake Hwy White City, OR 97503

B. CONTRACTOR TASKS

B.1 DELIVERABLES

· Inventory & Verification of 93 assemblies.

· Annual Testing of all assemblies using Oregon Health Authority (OHA)-approved methods.

· Corrective Maintenance for failed assemblies.

· Installation Compliance Review per OAR and MWC standards.

· Documentation & Reporting to VA and MWC.

· Furnish, install, and commission the Mojave Monitor dry vacuum system or like model.

B.2 SPECIFIC TESTING REQUIREMENTS

1. Certified Tester: Testing must be performed by a state‑approved and currently certified Backflow Assembly Tester (BAT) with proof of valid calibration of differential pressure gauge within the last 12 months.

2. Device Identification Verification: Tester must physically confirm the device’s make, model, type, size, and serial number, matching it to the site inventory or test form.

3. Isolation & Safe Test Setup: The water flow is isolated, and test ports are cleaned/inspected. The test equipment is properly purged of air to ensure valid differential pressure readings.

4. Performance Testing of All Assembly Types:

· Double Check Valve Assembly (DCVA): measures check valve tightness and verifies both checks close at required differential pressures.

· Reduced Pressure Principle Assembly (RP or RPZ): verifies check valve #1 differential pressure, check valve #2 closure, and relief valve opening point.

· Pressure Vacuum Breaker (PVB) / Spill Resistant Vacuum Breaker (SVB): tests air inlet and check valve operation.

5. Pass/Fail Determination Based on Standardized Criteria: Device must meet minimum pressure thresholds defined in USC Foundation for Cross Connection Control requirements (industry standard reference used nationwide).

*If assembly does not pass, tester must immediately report a failed test and recommend repair or replacement to FMS Maintenance/ Operations Supervisor before retesting.

6. Report/ Documentation Requirements. A complete, signed and dated report must be submitted to the MWC within 10–14 days of testing with copy provided to FMS Maintenance/ Operations Supervisor. Report must include:

B.3 SPECIFIC BACKFLOW REPAIR REQUIREMENTS

1. All repairs must be done by a certified Backflow Assembly Tester with use of Manufacturer‑Approved Parts. Internal kits (springs, seats, diaphragms, poppets) must be OEM-approved parts to maintain assembly certification and performance.

2. Internal Component Disassembly & Inspection require the tester to access internal check assemblies, relief valve components, seals, O‑rings, and springs. Following, the components must be cleaned (debris, mineral deposits, sand, scale).

3. Replacement of Worn or Failed Components may include but are not limited to the following:

· Replacing check valve spring or rubber disc

· Replacing relief valve diaphragm

· Replacing seat rings

· Lubricating moving components

· Removing debris that prevents sealing

4. Reassembly Per Manufacturer Specifications requires the tester to ensure proper torque, alignment, and seating of components.

5. Retesting is required After Repair: A complete certified backflow test must be performed after repair to verify that all valves close properly, the relief valve opens at required pressure, and the assembly seals and holds pressures without leakage.

6. Following all retesting and repair types, tested will update the results report and note that repairs were performed, what parts were replaced, and that the assembly passed retesting.

B.3 CONTRATOR SORCC SITE CHECK IN:

The Contractor employees shall check-in at SORCC Facility Management Service (FMS) Building 229 and check out when complete. If after hours, contact Veterans Affairs Police Department (VAPD) in Building 202. Contractors shall always wear a VA identification badge while on station. Badge will be obtained in building 229 when signing in and shall be returned upon completion of the services when signing out.

C. SPECIAL CONTRACT REQUIREMENTS

C.1 QUALITY CONTROL:

The contractor is responsible for maintaining a quality operation to ensure that the services are performed in accordance with commonly accepted commercial practices.

C.2 QUALITY ASSURANCE:

1. Contractor will be here on the appointed times and days, unless necessary to come more often as requested by VA SORCC.

2. The completed services shall be performed in an efficient and reliable manner. The VA SORCC has the right to reject work if the work is not performed in an efficient and reliable manner with the timelines and frequencies outlined above.

C.3 RECOGNIZED HOLIDAYS:

The contractor is not responsible for providing services on the following days but must provide frequent enough service prior to and after these holidays:

New Year’s Day, Martin Luther Kings Day, President’s Day, Memorial Day, Fourth of July, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day, and Christmas.

C.4 PERSONNEL POLICY:

The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide the following for their personnel:

1. Worker’s compensation, Professional Liability Insurance, Income tax withholding, and Social Security payments.

2. The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the Contractor.

C.5 VA SORCC Business Hours:

Work must be accomplished during normal VA SORCC business hours, which are 8 am to 430 pm.

C.7 LAWS & ORDINANCES

The Contractor shall comply with all applicable laws, ordinances, and regulations (Federal, state, city or otherwise) covering his operations under the contract.

C.8 INVOICES

All payments shall be made in arrears upon receipt of a proper invoice. Invoices will provide the following minimum information:

· Contract Number

· Date of Service

· Itemized Charges

· Weight of all waste and recycle (if applicable)

· Authorizing Official