Statement of Work.pdf

STATEMENT OF WORK

FOR

OXYGEN, NITROUS OXIDE, CARBONDIXIDE DELIVERY SERVICES

AT

KAYENTA HEALTH CARE CENTER

KAYENTA, ARIZONA

September 22, 2021

KAYENTA SERVICE UNIT

1. Introduction:

1.1. The Kayenta Service Unit (KSU) serves a population of ~20,000 people spread across a remote and sparsely populated area. Services are requested for the old and new, Kayenta Health Center (KHC). The clinic operates year round, 24 hours a day. Kayenta Health Center has crucial role providing medical health care services to the community and medical gas delivery services are vital to its operation. KSU requires professional services and expertise to perform the following work:

a. Provide reliable delivery service of compressed oxygen, liquid oxygen, nitrous oxide, carbon dioxide, and testing of cylinders.

2. PROJECT BACKGROUND

2.1. Kayenta Health Center requires medical gas delivery services to keep health facilities functional.

2.2. Medical gas delivery services are requested on an as needed basis only.

2.3. KHC requires the services from an exceptional provider.

3. PROJECT DESCRIPTION:

3.1. The contractor shall prepare a proposal, and upon award, shall provide details on services for KHC needs.

Contractor/vendor shall provide the following services under regulations required to operate in the community Kayenta. Provider/contractor shall include and provide the following services:

a. Must deliver within one week after notifications.

b. Provide accurate invoicing of delivery and hydrotest of bottles.

c. The services supplied/provided shall be billed to the Ordering Agency at the address specified in each

Authorization.

d. The ordering Agency shall take into effect payment of all bills in accordance with the applicable rate schedule, the Contractor’s terms and conditions and the time normally allowed for payment of bills.

a. All work needs to be safe and adhere to applicable codes.

b. Contractor is to dispose of debris at approved EPA disposal location.

c. Service work needs to function properly, be reliable and completed in a timely fashion to meet KHC needs.

4. CRITERIA:

4.1. Codes and Standards: the contractor shall perform work in accordance with best common practices and standards;

a. Safety and Hazard Awareness (PPE, jobs specific hazards, Electrical isolation and ETC).

b. NFPA criteria

c. The Joint Commission standards and regulations

5. GENERAL REQUIREMENTS:

5.1. Contractor shall develop a set plan and accurate timeline to present to KHC project representative prior to utility services and projects’ start date.

5.2. Delivery hours need to be discussed and agreed upon with facility (contract officer, facility manager, security and ETC.).

5.3. The contractor shall furnish a schedule of the dates agreed upon with the project officer and the facility manager at least one weeks in advance.

5.4. Any foreseen or unplanned costs, workhours or changes that will effect or incur extra costs to KHC, needs to be brought to the attention of the KHC project representative before proceeding with this matter.

5.5. The Contractor must be mindful of keeping normal business and patient care activities uninterrupted.

5.6. Contractor is expected to be professional and efficient with his work.

6. SPECIAL REQUIREMENTS

6.1. Services will be provided on an as-needed-basis. A date and time will be arranged with the contractor to deliver medical gas.

6.2. After each service supplied by contractor, they shall provide a copy of services provided to the Contracting

Office to confirm services were provided.

6.3. Billing must be accurate and in a timely manner sent to Kayenta Health Center’s Accounts Payable:

a. Address: Kayenta Service Unit, Accounts Payable Department, PO Box 1276, Kayenta, AZ 86033.

7. Period of Performance:

7.1. The period of performance from January 1, 2022 through December 31, 2022.

8. Place of Performance:

a. Address: Kayenta Service Unit

Highway 160 MP 394.3 P.O. Box 368 Kayenta, Arizona 86033

9. Contact information:

9.1. Desmond Jones, Facility Manager, (928) 697-4375

9.2. Leo Thinn, Maintenance Supervisor, (928) 697-4374

9.3. Vernon Begay, USRO Supervisor, (928) 697-5194