Statement of Work.docx

PERFORMANCE WORK STATEMENT

The Veterans Administration and the Jesse Brown VAMC Dental Clinic and Adam Benjamin Jr., OPC Dental Clinic, seek a contractor to perform Collection and Testing of Dental Waterlines Samples and Reporting Results Analysis. Waterlines Testing is essential and is mandated that the Dental Waterlines and Units and must meet standards and regulations as required by the Department of Veterans Affairs, AAMI, and CMS guidelines.

1. SCOPE OF WORK:

The contractor must provide all labor, travel, materials, and the necessary equipment to provide quarterly dental unit waterlines testing to ensure the water used to deliver dental care is of an optimal microbiologic quality. The contractor will schedule a non-clinical time to perform a water sample collection in sterile collection containers. The samples will be transported to their lab and tested according to established protocols (Certified Environment Testing Lab). Results will be reported back to the Dental Service in a timely manner. This must be done quarterly at both Jesse Brown VA Medical Center Dental Service in Chicago, IL and at the Adam Benjamin, Jr. Outpatient Clinic Dental Crown Point, IN. Contractor will provide written report of test result to the Jesse Brown VA Medical Center Dental Clinic.

Contractor will collect 60 samples from Jesse Brown Dental Clinic and 30 samples from Adam Benjamin Dental Clinic. Samples will be collected in a sterile container with sterility and proper temperature control maintained while in transport to the testing lab. Conduct Heterotrophic Plate Count testing with 1ml samples. All samples will be set up using Standard methods in Water and Wastewater method 9215B, which requires all samples to be plated in duplicate.

All cautionary results (>200 cfu) and all positive results (>500 cfu) must be reported to the Chief, Dental Service or designees via phone or email as soon as the results have been verified. All final results must be reported in digital or written form within 48 hours.

2. CONTRACT DELIVERABLES

a. Quarterly cultures will be collected at a time before patient dental treatment is started (Monday-Friday).

b. Proper identification labels utilized.

c. Samples must be collected in a sterile container and sterility and proper temperature control maintained while transported to the testing lab on the same day.

d. A total of 60 samples per quarter must be collected at Jesse Brown VAMC Dental Clinic.

e. A total of 30 samples per quarter must be collected at Adam Benjamin Jr., OPC Dental Clinic.

f. Heterotrophic Plate Count testing will be done with a 1 ml sample. All samples will be set up using Standard methods in Water and Wastewater method 9215B, which requires all samples to be plated in duplicate.

g. All cautionary results (>200cfu) and all positive results (>500cfu) will be reported to the Chief, Dental Service or designee immediately (by phone and e-mail).

h. All final results must be reported in digital or paper form within 48 hours, to the Chief of the Dental Service or his designee.

3. CONTRATING OFFICER”S REPRESENTATIVE (COR):

Scheduling of work must be arranged with the COR (Contracting Officers Representative).

4. PLACE OF PERFORMANCE:

Sample collections must be taken at:

Jesse Brown VAMC Dental Clinic 820 S. Damen Chicago, IL 60622-3728

Adam Benjamin Outpatient Dental Clinic 9301 Madison Street Crown Point, IN 46307

5. SERVICE HOURS AND FEDERAL HOLIDAYS:

a. Normal hours of coverage are Monday through Friday from 7:00 am to 4:30 pm, excluding holidays. All services will be performed at the JBVA Dental Service during off duty hours from 6:30 a.m. until 7:30 a.m. or from 4:30 p.m. until testing has been completed unless requested or approved by Contracting Officer’s Representative (COR) or their designee. The same hours of service will be performed at the Adam Benjamin Crown Point Outpatient Facility Dental Service.

b. All contract work must be on a date and time mutually agreed upon between the Contractor and the COR.

c. Federal Holidays observed by the VAMC are:

d. Services must be performed outside normal working hours 7:00 am to 4:30 pm until work is completed.

e. The Contractor Technician must sign-in at Police and Security Service to obtain a VA identification badge and return the VA identification badge when the work is complete. Upon completion of all tasks, the contractor’s technician must submit a written report outlining the water testing services performed and the expected date of the results.

f. BJCP Outpatient Dental Service the contractor technician must report to the Police and Security Service to obtain and return the VA Identification badge. The contractor serviceman must report to the ABJCP Outpatient Facility Dental Service room 299, after all work is completed, the contractor’s serviceman must again report in person to Room 299 and submit a written report of water testing services rendered and when the water testing results will be received.

6. CHANGES TO STATEMENT OF WORK

Any changes to this SOW must be authorized and approved only through written correspondence from the CO. Costs incurred by the contractor through the actions of parties other than the CO must be borne by the contractor.

7. CONTRACTOR EXPERIENCE REQUIREMENTS – KEY PERSONNEL

All work must be performed by personnel qualified to work on the specific equipment. All work performed must comply with AAMI and CMS guidelines and must be designed to assure that the Jesse Brown VA Medical Center is providing the best possible water to the patients.

END OF PERFORMANCE WORK STATEMENT