Exhibits.pdf

Exhibits

List of Attachments

A. Items to be Delivered at Least One Week Prior to Pre-Work Conference

B. Mowing and Cleaning Maps

C. Approximate Quantities by Area

D. Accident Prevention Plan Checklist A-02

E. Partial Listing of Safety Requirements

F. Safety Forms

G. Quality Control Plan

H. Quality Assurance Plan

I. Sample Work Schedule

J. Sample Invoice

K. Government Furnished Equipment List

L. Task Order, SF 1449

M. Reserved

N. Contract Discrepancy Form, DD 2759

O. Contractor Equipment and Inspection Forms

P. Pre-Operation Checklist and Property Control Receipt Forms

Q. Inspection Forms

Exhibit A

Items to be Delivered at Least One Week Prior to Pre-Work Conference

Exhibit A

Contractor shall provide the following at least one (1) week prior to the pre-work conference:

A. Schedule of Cleanings. The schedule provided by the Contractor shall be of sufficient detail to allow the Government to inspect all items of work covered under Section C-3 and Section C-4 of the contract as they are being performed (See Exhibit K). Schedule should include daily and non-daily items.

B. Quality Control Plan. A suggested outline for the Contractor’s Quality Control Plan is contained in Exhibit G.

C. Contractor Representatives. List of names of Contractor Representatives and contact information.

D. Contractor Quality Control Inspector. List of Quality Control Inspectors. E.

Contractor Accident Prevention Plan. A checklist for the Accident Prevention Plan is contained in Exhibit D.

F. Emergency Contacts. A prioritized list, including phone numbers, of those persons (normally Contractor Representatives) to call in case of emergencies.

G. Emergency Work Personnel. A list of names, addresses, and telephone numbers of persons who will be available for emergency work.

H. Operators. A list of qualified equipment operators, their qualifications, experience, and certifications for government furnished equipment.

I. CDL License. A list of individuals with valid CDL operator’s license with endorsements.

J. First Aid and CPR. First Aid and CPR certified individuals on each work crew.

K. SSHO. The contractor shall employ a Site Safety and Health Officer (SSHO) who has completed OSHA 30 hour Construction or General Industry Safety training or its equivalent and has five (5) years experience relative to the work to be performed

Above documents shall be typed and legible

Exhibit B

Mowing and Cleaning Maps

Below Dam Area – Approx. 7.5 Acres

Mowing Limits: Beginning at the gate at the top of the hill mowing the roadway extending 3 feet above the ditch line and 1 foot over the break of the bank. Limits shall be to the wood line or to the water’s edge. In areas where there is a fence, the limit shall be 3 foot beyond the fence line.

Damsite – Approx. 7.5 Acres

Mowing Limits: Beginning at the gate toward the Below Dam area coming back to the office, limit shall be from the wood line to the cliff line, including the road way to the office septic leach area, and the areas behind the office and inside both Maintenance compounds. Mowing area shall extend out Flannagan Dam Road to include all pulloff areas and shall extend 2 foot beyond the break of the bank and also include both parking areas. Limits shall also include the top of the dam on the Left Downstream Abutment and the pulloff areas at the Intake Structure where the limit shall extend 2 foot beyond the break of the bank and include the wide area beside the pulloff behind the guardrail at the Intake Structure.

Damsite – Cont’d

Limits shall include the pulloff overlook area where the limit shall be 2 foot beyond the break of the bank and the Project Sign Area where the limit shall be 20 foot, front and back of the sign and shall extend to the break of the bank and the roadway.

Spillway Area – Approx. 9 Acres

Mowing Limits: Limits shall begin at the traffic island progressing toward the Spillway Launch area, limit shall be 3 feet above the ditch line and 3 feet beyond the fence line. Mowing area does not include the Tennis Court or the Water Plant building, but shall include the ditch line just beyond the Tennis Court. Limits in the Spillway field shall be the water’s edge, the cliff line, the wood line and the Spillway Gates. Also included in these limits is the Project Entrance Sign area, where the limit shall be the roadway to 1 foot beyond the break of the bank and 20 foot in front of the sign to the drain pipe in the curve.

Junction – Approx. 3.5 Acres

Mowing Limits: Limits shall include 5 feet beyond the middle of the ditch line and 5 feet beyond the gate at the back of the parking area, 1 foot over the break of the bank behind the guardrail and to the wood line, taking in the Junction Leach area, and proceeding to the water’s edge and to the entrance of the gas well road.

Lower Twin – Approx. 7 Acres

Mowing Limits: Limits shall be between the wood line and the water’s edge, in areas where there is a ditch line, the limit shall be 3 feet beyond the center of the ditch line, the chain link fence line shall be the limit for the area above the bath house, this shall also include the tent camping area and the day use area just before the campground entrance.

Pound River – Approx. 8 Acres

Mowing Limits: Beginning at the campground entrance, the water’s edge and 3 feet beyond the center of the ditch line on the upper road shall serve as the mowing limit. This shall include the roadway and area around the water tank, which shall be 1 foot over the break of the bank and 3 feet beyond the edge of the roadway up the hill, and shall also include the tent camping area.

Cranesnest - Approx. 9 Acres

Mowing Limits: Limits shall be from water’s edge to wood line, including a 3 foot perimeter around the storage compound, Fishing trail area limit shall be from the water’s edge to 3 feet above the edge of the trail.

Lower Twin Leach Field and Roadway

Mowing Limits: Limits along roadway shall include where regular mowing limits stop to the wood line. Limits for the leach shall begin at the chain link fence area above the bath house and continue to follow the wood line throughout the field. All fallen trees and/or limbs in the leach field area shall be removed and disposed of in an area designated by the COR.

Pound River Access Road and Leach Field

Mowing Limits: Access road limits shall be 12 feet from the road surface edge or 4 feet beyond the center of the ditchline (whichever distance is greater) and 2 foot over the break of the bank, all limbs overhanging the roadway shall be cut to a minimum height of 16 feet. In areas where the upper bank is a rock cliff, cut all vegetation that can be reached.

Limit on the leach field and the hillside shall be from where regular mowing limits stop to the wood line. All fallen trees and/or limbs shall be removed from the leach field area and disposed of in an area designated by the COR.

Hollow Place Compound – Approx. 2 Acres

Mowing Limits: Beginning at the gate at bottom of the hill, limit shall be 4 feet beyond the center of the ditch line and 1 foot over the break of the bank, leading up the hill, limit around the compound shall be 6 feet from the fence line.

Cranesnest Access Road

Mowing Limits: Access road limits shall be 12 feet from the road surface edge or 4 feet beyond the center of the ditchline (whichever distance is greater) and 2 foot over the break of the bank, all limbs overhanging the roadway shall be cut to a minimum height of 16 feet. In areas where the upper bank is a rock cliff, cut all vegetation that can be reached.

Exhibit C

Approximate Quantities by Area

Items Below Dam

Spillway Damsite/ Office

Junction Lower Twin

Pound River

Cranesnest NFP Overlook/

Dam

NFP

Below Dam

Acres to be Maintained 7.5 9 7.5 3.5 10 9 9

Basketball Courts 1 1 1

Benches 3 2 1 3 4 2 6

Boat Ramps 1 1 1 1 1

Bulletin Boards 1 1 1 1 1 1 1 2

Courtesy Dock/Pier 1 1

Drinking Fountains 2 1 0 1 3 2 2 2

Garbage Cans 17 6 1 2 32 19 30 8 1

Grills/Fire Rings 13 6 0 0 39 28 32 4

Horse Shoe Pits 2 1 0 0 1 2 1

Outside Spigots 1 0 0 0 6 5 4

Picnic Shelters 8 2 0 0 0 0 0 3

Picnic Tables 24 6 1 0 39 28 33 4 1

Playgrounds 2 0 0 0 1 1 1

Restrooms 1 0 0 1 1 1 1 1

Road (Miles) 0.4 0.5 1 2.25 6

Exhibit D

Accident Prevention Plan Checklist A-02

Item Description Yes No N/A

1. Signature sheet

a. Includes the name, signature, and title of the Plan Preparer (Qualified person, i.e. corporate safety staff person, QC )

b. Includes the name, signature, and title of the Plan Approver (e.g. owner, company president, regional vice president ) (HTRW activities require approval of a Certified Industrial Hygienist, a Certified Safety Professional may approve the plan for operations involving UST removal where contaminants are known to be petroleum, oils, or lubricants).

c. Includes the name(s), signature(s), and title(s) for Plan Concurrence (provide concurrence of other applicable corporate and project personnel (contractor)) (e.g. Chief of Operations, Corporate Chief of Safety, Corporate Industrial Hygienist, project manager or superintendent, project safety professional, project

QC. )

2. Background information

a. Includes the Contractor Name.

b. Includes the Contract Number.

c. Includes the Project Name.

d. Includes the Brief Project Description.

e. Includes the Location of the Project (map).

f. Includes the Contractor Accident Experience (Copy of OSHA

g. Includes the Listing of Phases of Work and Hazardous Activities Requiring an Activity Hazard Analyses (AHA).

3. Statement of Safety and Health Policy. Includes a copy of the corporate safety policy. (In addition to the corporate policy statement, a copy of the corporate safety program may provide a portion of the information required by the accident prevention

4. Responsibilities and Lines of Authorities

a. Includes the identification and job responsibilities of personnel responsible for safety - at both corporate and project level – including their resumes.

b. Includes the lines of authority.

CESO Form A-02 Sep 13

Remarks (Any NO or N/A item)

Form A-02 U.S. Army Corps of Engineers

Accident Prevention Plan Checklist

Date of Inspection

Location (Plant or Facility) Contract Number

Contractor Name Project Name

Inspector Name (Print) Inspector Signature

This checklist serves as a guide only, it does not replace or eliminate the need to comply with the requirements set forth in Engineering Manual 385-1-1, Safety and Health Requirements Manual, dated XX Sept 2014. The references included in this checklist correspond to the applicable sections of EM 385-1-1.

5. Training

a. Includes the list of subjects to be discussed with employees at safety indoctrination.

b. Includes the list of mandatory training and certifications applicable to this project (e.g., explosive actuated tools, confined space entry, crane operator, diver, vehicle operator, HAZWOPER training and certification, PPE ) and any requirements for periodic retraining / recertification.

c. Includes the identity requirements for emergency response training.

d. Includes the outline requirements (who attends, when given, who will conduct, etc. ) for supervisory and employee safety

6. Safety and Health Inspections

a. Includes the name(s) of individual(s) responsible for conducting safety inspections. (e.g., PM, safety professional, QC, supervisors, employees )

b. Includes proof of inspector's training / qualifications.

c. Indicates when inspections will be conducted.

d. Furnished sample forms upon which inspections will be recorded.

e. Indicates deficiency tracking system and follow-up procedures.

f. Includes the names of competent and / or qualified person(s) and proof of competency / qualification to meet specific OSHA competent / qualified person(s) requirements.

g. Includes any external inspections / certifications which may be required. (e.g., US Coast Guard )

7. Safety and Health Expectations, Incentive Programs, and Compliance

a. Includes the company's written safety program goals, objectives, and accident experience goals.

b. Includes a brief description of the company's safety incentive programs (if any ).

c. Includes the policies and procedures regarding noncompliance with safety requirements (to include disciplinary actions for violation of safety requirements).

d. Includes the written company procedures for holding managers and supervisors accountable for safety.

8. Mishap Reporting

a. The plan identifies how, when, and who shall complete the Exposure data (man-hours worked).

b. The plan identifies how, when, and who shall complete mishap investigations, reports, and logs.

c. The plan identifies how, when, and who shall make immediate notification of major mishaps.

CESO Form A-02 Sep 13

Remarks (Any NO or N/A item)

Form A-02 U.S. Army Corps of Engineers

Accident Prevention Plan Checklist (cont’d)

Date of Inspection

9. Plans (Programs, Procedures) required by the Safety Manual

a. Fatigue Management Plan (01.A.20)

b. Emergency response plans:

(1) Procedures & Test (01.E.01)

(2) Spill Plans (01.E.01, 06.A.02)

(3) Fire Fighting Plan (01.E.01; 19.A)

(4) Posting of Emergency Telephone Numbers (01.E.05)

(5) Man overboard/abandon ship (19.A.04)

(6) Medical Support. Outline on-site medical support and off-site medical arrangements including rescue and medical duties for those employees who are to perform them, and the name(s) of on-site Contractor personnel trained in first aid and CPR. A minimum of two employees shall be certified in CPR and first-aid per shift/site (Section 03.A; 03.D)

c. Plan for prevention of alcohol and drug abuse (01.C.02)

d. Site Sanitation Plan (Section 02.B)

e. Medical Support Plan, (03.A.01; 03.A.06; 03.D)

f. Bloodborne Pathogen Plan (03.A.05)

g. Exposure Control Plan (03.A.05)

h. Site Layout Plan (04.A)

i. Access/Haul road Plan (04.B)

j. Hearing Conservation Program (05.C)

k. Respiratory Protection Plan (05.G)

l. Health Hazard Control Program (06.A)

m. Process Safety Management Plan (06.B.04)

n. Lead Abatement Plan (06.C & Specs)

o. Asbestos Abatement Plan (06.C & Specs)

p. Radiation Safety Program (06.F)

q. Abrasive Blasting Plan (06.I)

r. Heat/Cold Stress Monitoring Plan (06.J)

s. Indoor Air Quality Management Plan (06.L)

t. Mole Remediation Plan (06.L.04)

u. Chromium (VI) Exposure Evaluation (06.M)

v. Crystalline Silica Assessment (06.N)

w. Lighting Evaluation (07.A)

x. Lighting Plan for Night Operations (07.A.09)

CESO Form A-02 Sep 13

Form A-02 U.S. Army Corps of Engineers

Accident Prevention Plan Checklist (cont’d)

Date of Inspection

Based on a risk assessment of contracted activities and on mandatory OSHA compliance programs, the Contractor shall address all applicable occupational risks and compliance plans. Using the EM 385-1-1 as a guide, plans may include but not be limited to:

Remarks (Any NO or N/A item)

9. Plans (Programs, Procedures) continued.

y. Traffic Control Plan (08.C.05)

z. Fire Prevention Plan (09.A.01)

aa. Wild Land Fire Management Plan (09.L)

bb. Arc Flash Hazard Analysis (11.B)

cc. Assured Equipment Grounding Control Program (AEGCP), (11.D.05, App D)

dd. Hazardous Energy Control Plan, (12.A.01)

ee. Standard Pre-Lift Plan (LHE) (16.A.03, 16.L.15)

ff. Critical Lift Plan – LHE (16.H)

gg. Naval Architectural Analysis (16.L)

hh. Contingency Plan for Severe Weather (19.A.03)

ii. Man Overboard/Abandon Ship (19.A.04)

jj. Float Plan (19.F.04)

kk. Fall Protection Program, (21.D);

ll. Demolition/Renovation Plan (to include engineering survey), (23.A.02)

mm. Rope Access Program, (24.H.02)

nn. Excavation/Trenching Plan, (25.A.01)

oo. Underground construction fire prevention and protection Plan, (26.D.01)

pp. Compressed Air Plan, (26.I.01)

qq. Formwork and Shoring Erection and Removal plan, (27.C)

rr. PreCast Concrete Plan, (27.D) ss Lift. slab plans, (27.E)

tt. Masonry Bracing Plan, (27.F.01)

uu. Steel Erection Plan, (28.B)

vv. Explosives Safety Site Plan (ESSP) (29.A)

ww. Blasting Plan, (29.A; 26.J)

xx. Underwater Dive Operations Plan, (30.A.14, 16, )

yy. Tree Felling/Maintenance Program, (31.A)

zz. Aircraft/Airfield Construction Safety & Phasing Plan, (32.A.02) aaa. Site Safety and Health Plan (HTRW), (33.B) bbb. Confined Space Entry Program, (34.A.06, 07)

10. Risk Management Processes. Detailed project-specific hazards shall be identified and controls provided via Activity Hazard CESO Form A-02 Sep 13

Form A-02 U.S. Army Corps of Engineers

Accident Prevention Plan Checklist (cont’d)

Date of Inspection

Based on a risk assessment of contracted activities and on mandatory OSHA compliance programs, the Contractor shall address all applicable occupational risks and compliance plans. Using the EM 385-1-1 as a guide, plans may include but not be limited to:

Remarks (Any NO or N/A item)

Other Remarks:

CESO Form A-02 Sep 13

Exhibit E

Partial Listing of Safety Requirements

Exhibit E

PARTIAL LISTING OF SAFETY REQUIREMENTS

1. The following is a clarification of the Corps of Engineers' policy concerning the use of personal protective equipment for contract employees as defined in the EM 385-1-1, Safety and Health Requirements Manual.

This is not meant to be a complete review of required safety equipment, but is simply provided to answer some of the more common questions concerning our safety policy.

The items of equipment listed below should be issued to each employee or made readily available for employee's use, when the work environment requires it:

a. Safety shoes - All employees except park aids performing traffic surveys and clerical personnel are to wear hard-toe safety shoes at all times. For those not required to wear steel toed safety shoes, leather work shoes shall be worn.

b. Hard hats - Hard hats are to be worn when operating or working around equipment that lifts overhead (e.g. backhoe-end loader) or working at ground level around mowing equipment. Hard hats will not be required when operating a riding mower, unless other mowing equipment is present. Hard hats will be required during construction type activities and wildfire suppression.

c. Safety glasses or goggles - Safety glasses with side shields or goggles are to be worn when operating equipment or working around equipment that may cause harm from flying debris (e.g. weed eaters), and when using power or hand tools.

d. Welders - Full face welder's helmets are to be worn during electric arc welding operations, and appropriate shields or warning shall be given or posted to protect other persons from the flash. During oxyacetylene welding or cutting, appropriate goggles or full face shield shall be worn.

e. Gloves - The proper type gloves are to be worn when there is a danger of burns, cuts, scrapes, scratches, wood splinters, or other injury to employee's hands.

f. Ear protection - Ear plugs or muffs shall be worn when operating any device that has been determined to produce 85 decibels or greater on a time-weighted average. It is the Contractor’s responsibility to determine the noise level of your equipment. Each piece of equipment that exceeds 85dB(A) rating should be labeled to indicate the need for hearing protection.

g. Protective leg chaps - Protective leg chaps are to be worn when operating equipment such as a chain saw.

h. P.F.D's (Personal Flotation Device/Life Jacket) - P.F.D's are to be worn at all times when working around the water or on board watercraft.

i. Safety cans - Containers for flammable liquids shall be labeled and meet the requirements specified in Section 9.B.

j. Seat belts - Seat belts are to be worn at all times when operating, or being transported by motor vehicles and when operating mobile equipment with rollover protection.

k. Safety vests - High-visibility apparel meeting, at minimum, ANSI/ISEA 07-2004 Performance Class 2 requirements, shall be worn when employees are working along roadways.

l. Lock-Out/Tag-Out - Lock-Out/Tag-Out procedures will be used in accordance with EM385-1-1, Section 12 and in coordination with project personnel.

m. Respiratory Protection - For work involving hazardous atmospheres, Contractors will provide a written Respiratory Protection Plan, which includes training and medical clearance. Section 05.G

2. The Contractor shall conduct monthly safety meetings and weekly "tool box" safety meetings in accordance with EM 385-1-1, Safety and Health Requirements Manual. The Contractor may contact the COR about upcoming work planned, to determine appropriate subjects for the monthly safety meetings.

The Government makes no guarantee that the list of upcoming work planned, will actually be ordered nor will work ordered be restricted to said list. The Contractor shall inform the COR of the date, time, and place of the monthly safety meeting, a minimum of 7 days prior to the meeting.

3. Great emphasis will be given to the development and proper use of Activity Hazard Analysis (AHA).

When ordered, AHAs will be developed in detail, utilized during job performance, and available to employees at the job site.

4. Transporting employees and equipment to worksites:

a. Vehicles used to transport staff and equipment must be well maintained and never overloaded. Each vehicle occupant must have a seat belt available to him or her and must wear the belt.

b. Personnel and tools must be kept apart during travel. Tools and tool boxes must be secured in a manner which will prevent their causing injury in case of a sudden stop or collision.

c. Tool box lids must be securely latched or locked.

5. Contractor vehicles involved in liter pick-up along project and public roads must be equipped with an orange rooftop revolving light, a rear mounted warning sign and reflective warning tape on the bumper.

Employees performing liter pickup along public and project roads must wear High-visibility apparel meeting, at minimum, ANSI/ISEA 07-2004 Performance Class 2 requirements.

Exhibit F

Safety Forms

Activity Hazard Analysis, CELRH-2796 OSHA’s Form 300 Log of Work Related Injuries and Illnesses

Accident Investigation Report, ENG-3394

ACTIVITY HAZARD ANALYSIS CHECKLIST

1. Are all blocks in the top 1/3 of the form completed including:

Project:

Date:

Job:

Estimated Starting Date:

Prepared by:

Recommended Protective Clothing and Equipment:

Reviewed by:

Page of ______

Positions Assigned to do Job:

2. Does the "Job" block include the job request number and sufficiently descriptive information to understand the tasks to be performed?

3. Is all the protective equipment necessary for all phases of the work listed in PART I?

4. Are all job steps listed and numbered consecutively in Part I including if applicable but not limited to:

a. Inspection of equipment and safety gear.

b. Loading and unloading of personnel and equipment.

c. Transportation to and from the job site.

d. Setting up equipment and safety markers.

e. Performance of tasks.

f. Securing job site while it is unattended.

g. Clean-up and storage of safety gear and equipment.

5. Are all hazards associated with each job step in Part I listed in Part II opposite the appropriate job step?

Hazards may include but are not limited to:

a. Potential injuries during loading and unloading of equipment.

b. Potential injuries from improperly loaded and/or secured equipment and vehicles during transportation to and from job site.

c. Potential injuries from failure to follow defensive driving procedures or wear seat belts and shoulder harnesses to and from job site.

d. Potential electrical shock and/or fire hazards.

Exhibit G

Quality Control Plan

CONTRACTOR QUALITY CONTROL PLAN (OUTLINE)

1. INSPECTION OF SERVICES. Define the method of inspection for each service in the contract including, but not limited to: the individual(s) who shall inspect the service (Quality Control Inspectors); when or with what frequency inspections shall be performed (e.g. at the completion of each task, etc.); and a copy of the Contractor's inspection forms or other documents identifying the specific tasks involved in the service which shall be inspected.

2. DEFICIENCIES AND CORRECTIVE ACTION. Explain the procedures for identifying deficiencies in the quality of services provided and methods of correction, before the level of performance is unacceptable.

3. RECORDS. Define the method for maintaining records of inspections and records of corrective actions taken, the individual(s) responsible for the records, and the location where the records shall be kept.

4. QUALITY CONTROL INSPECTORS. A consolidated list of authorized Quality Control Inspectors.

5. CONTRACTOR REPRESENTATIVES. A list of names and phone numbers of authorized Contractor Representatives.

6. SECURITY. Define and explain the procedures and safeguards which shall be used to protect all equipment, materials, supplies, tools, and other resources provided by the Government to the Contractor including; but not limited to, Contractor audit procedures and inventory systems, if appropriate. Examples of procedures and safeguards include:

a. All pilferable materials shall be kept under constant surveillance and shall be collected at the end of each work day and secured under lock.

b. Keys shall be removed from all vehicles and equipment when not in use.

c. All gates and doors which were opened to allow Contractor personnel access for work shall be closed and locked. Only authorized Contractor personnel or Government personnel shall be permitted to enter secured areas. The COR or his representative shall be informed immediately if any unauthorized person enters a secured area.

Exhibit H

Quality Assurance Surveillance Plan

QUALITY ASSURANCE SURVEILLANCE PLAN

JOHN W FLANNAGAN DAM & RESERVOIR

NORTH FORK OF POUND RIVER LAKE

Date Contracting Officer

Table of Contents

SECTION

SECTION I. Introduction.

A. General B. Acronyms and Definitions

SECTION II. Acceptance/Rejection of Services A. General B. Acceptance C. Rejection

SECTION III. Calculating Deductions A. General B. Examples

1. Random Sampling

2. One-hundred Percent Sampling

3. Planned Sampling

SECTION IV. Performance Requirements Summary Tables

SECTION V. Sampling Guides

SECTION VI. Inspection Checklists A. Examples

1. "Generic" Inspection Form

2. Pesticide Application

3. Cleaning Services, Recreation Areas

4. Grass Mowing and Maintenance of Landscaped

Areas

5. Janitorial Services

6. Park Attendant

7. Contractor's Quality Control Program

8. Emergency Work Orders, Estimated Work

Orders, etc.

SECTION I

INTRODUCTION

SECTION I. Introduction

A. General. This plan will be used to assure the government that work specified under this contract is completed satisfactorily. The plan is included for information purposes only. It does not supersede any of the requirements in other sections of the contract. Surveillance or inspections will be primarily conducted in three ways; however, the Government has the right to change or modify inspection methods at its discretion. The three principle inspection methods are random, one-hundred percent, and planned. In conjunction with describing the principle methods used for providing surveillance (i.e., inspecting), this plan defines common terms and acronyms; summarizes in table form the performance requirements for each contract section; summarizes in table form a "sampling guide" for each contract section; explains how deductions are calculated; and, provides examples of Inspection Checklists.

B. Acronyms and Definitions.

1. List of Acronyms.

a. AQL . . . . . . . . Acceptable Quality Level

b. CDR . . . . . . . . Contract Discrepancy Report

c. COR . . . . . . . . Contracting Officer Representative

d. CO. . . . . . . . . Contracting Officer

e. PRS . . . . . . . . Performance Requirements Summary

f. PWS . . . . . . . . Performance Work Statement

g. QA. . . . . . . . . Quality Assurance

h. QAE . . . . . . . . Quality Assurance Evaluator

i. QASP. . . . . . . . Quality Assurance Surveillance Plan

j. QC. . . . . . . . . Quality Control

k. QCP . . . . . . . . Quality Control Plan

l. N/A . . . . . . . . Non-Applicable

2. Definitions.

a. Acceptable Quality Level. Predetermined value used by the Government to distinguish between satisfactory and unsatisfactory performance. AQL may be stated in percent and is the maximum number of defects per 100 units that can be considered satisfactory. As long as the defective performance does not exceed the AQL, the total service will not be rejected by the Government. The contractor, however, must re-perform the defective service.

b. Defect. Any deficiency determined to be significant as to render the unit unsatisfactory.

c. Deficiency. Any inspection unit which does not meet the Contract requirements in their entirety.

d. Inspection Unit. For statistical sampling the unit is identified in the sampling guide. For all other work the inspection unit is the job. The inspection unit may include several tasks.

e. Inspector. Individual designated by the COR to perform Quality Assurance.

f. Item. The term item, when used with the Contract, refers to the Bid Items contained in Section B of the Contract.

g. Job. A job describes an individual, separate, and defined element of work to be performed.

"Mowing the Below Dam Recreation Area" or "Painting the Number One Picnic Shelter in the Below Dam Area" are examples of jobs.

h. Lot Size. The total number of times the service is performed in a given period of time, such as the total number of cleanings per month. Also called a population.

i. 100% Inspection. An inspection method requiring the examination of each completed job. It is not required that the inspector be at the job site 100 percent of the time while the job is occurring.

This approach is best suited for monitoring contract requirements that occur infrequently or are of great importance.

j. Percent of Sample Found Defective. Determined by dividing the number of defects by the sample size.

k. Planned Sampling. An evaluation method designed to inspect some part but not necessarily all of the contract requirements. Sample selection is based on some subjective rationale and sample size is usually arbitrarily determined.

l. Quality Assurance. Those actions taken by the Government to insure goods or services meet the requirements of the contract.

m. Quality Assurance Evaluator. A Government official responsible for evaluating contractor's performance. Also, known as an inspector.

n. Quality Control. Those actions taken by a contractor to control the production of goods or services to insure that they meet the requirements of the contract.

o. Random Number Table. A table of numbers arranged in a random fashion. A table used to make random samples.

p. Random Sample. A sampling method whereby each service output in a lot has an equal chance of being selected, or where any occurrence of a contract requirement is as likely to be evaluated as any other occurrence.

q. Random Sampling. A method of looking at a few individual items in a lot to determine the quality of that lot against a standard.

r. Reject Level. The number of defects beyond which the total service for that lot is rejected by the Government and deductions are made. The contractor must reperform defective services, when possible, even if the number of defects is less than the reject level.

s. Sample. A sample consists of one or more service outputs drawn from a lot, the outputs being chosen at random. The number of outputs in the sample is the sample size.

t. Sampling Guide. The part of the surveillance plan which contains all the information needed to perform a random sample. A "how to inspect guide" for each type of work to be performed.

u. Service Requirement. A job to be performed to the specified standard and within the acceptable quality level. The contractor must do the specific job, meet the standard, and meet the acceptable quality level before performance is acceptable and contractor will be paid.

v. Surveillance Plan. An organized written Government Document used for quality assurance surveillance.

w. Unscheduled Inspection. Impromptu inspections of contract requirements without a pre-planned schedule.

x. Validated Complaints. An evaluation method utilizing customer awareness.

y. Work. The general scope of services covered under the specifications of this contract.

SECTION II

ACCEPTANCE/REJECTION OF SERVICES

SECTION II. Acceptance/Rejection of Services

A. General. Inspection of all services performed under this contract will primarily be done in accordance with a schedule developed by the Government, and will primarily be done by using one or a combination of the surveillance methods cited in this plan. The purpose of inspection is to document contractor performance and the quality of services or goods produced. Documentation of contractor performance will be done on the appropriate Inspection Checklist (see Section VI of this plan).

B. Acceptance.

1. Statistically Sampled Work. Whenever the number of defects for a lot falls at or below the established reject level the work will be considered satisfactory. However, the contractor is still required to correct the deficiencies.

2. 100% Inspection. When all work is performed in accordance with the Work Order.

C. Rejection.

1. Statistically Sampled Work. Whenever the defects exceed the reject level the Government will issue a CDR and effect a monetary deduction from the Contractor's invoice.

2. 100% Inspection. Whenever the work does not conform to all requirements of the Work Order, the Government will issue a CDR and proceed in accordance with the Inspection of Services Clause of the contract.

SECTION III

CALCULATING DEDUCTIONS

SECTION III. Calculating Deductions

A. General. Whenever work or parts of work are rejected deductions will be made. The following hypothetical examples are given to demonstrate how deductions for deficiencies would be calculated.

B. Examples.

1. Random Sampling. Once a random sample has been taken of a lot or population, and the number of defective items exceeds the AQL for that lot, a deduction will be made. The following example demonstrates how a deduction would be calculated for excessive defects in restroom cleanings. In this example, the lot or population size (i.e., the number of restroom cleanings over a 30 day period) is 125.

IF: Quality of work for cleaning restrooms is found to be unsatisfactory (i.e., the AQL of 5% is exceeded).

AND: Contract price is $2,000 for 30 days of restroom cleaning services.

AND: The deducted percentage for cleaning restrooms is 25% (taken from the Performance Requirements Summary Table).

AND: Sample size is 55 with a reject level of 6.

AND: Number of defects in sample is 10.

THEN: Deductions from the contractor's monthly invoice for performing Level 3 cleanings would be calculated according to the following equation:

Number of documented defects X Deduct Percentage X Contract Price Sample Size For Restroom Cleaning for Cleaning Services

Substituting in the numerical values (from the example) the deducted amount would be calculated as follows:

10/55 X .25 X 2,000 = $90.91

Therefore, $90.91 would be deducted from the contractor's monthly invoice for cleaning services.

2. One-hundred Percent Sampling. Two hypothetical situations involving a fixed price (e.g., mowing) and a negotiated (e.g., replacement of fascia) work order have been selected for demonstrating how a deduction would be calculated where the inspection mode is 100%.

a. Mowing (Fixed Price).

IF: Work Order specifies the mowing and trimming of five recreation areas.

AND: Contract price is $10,000.00 per complete mowing.

AND: By the expiration of the completion date given on the Work Order contractor has successfully mowed and trimmed four areas, but has not begun work on the fifth and last area.

THEN: The contractor shall stop all mowing operations, a CDR may be issued, and the services of another contractor would normally be employed by the Government to complete the mowing and trimming of the fifth area. Actual costs incurred by the Government to obtain the services of another contractor to correct the deficiencies in the fifth area will be deducted from the contractor's invoice amount.

IF: The actual cost to the Government to correct the deficiencies is $2,000.00 which will be deducted from the Contractor's invoice for mowing.

THEN: $2,000.00 will be deducted from the contractor's invoice of $10,000.00.

b. Replacing Fascia Board on Picnic Shelter (Negotiated Price Example).

SITUATION. In this example the Work Order specified the installation and painting of new fascia boards on a picnic shelter. Issuance of the Work Order was preceded by Contractor/Government negotiations which culminated in the issuance of the work order for the negotiated cost of $400. The final inspection revealed the contractor has satisfactorily installed, but failed to complete the painting of, the new fascia by the completion date specified on the Work Order.

GOVERNMENT ACTION. The Government would issue the Contractor a CDR and take the necessary action to correct the deficiency (i.e., paint the new fascia). In this example, the Government exercised the option to correct the deficiency by utilizing Government personnel. The Government would then deduct from the contractor's invoice the actual cost to the Government to correct the deficiency (i.e., paint the fascia).

CALCULATING THE DEDUCTION. Assuming the effective rate of the Government maintenance personnel was $12.50 per hour and it took 2 employees 6 hours to correct the deficiency:

Deduction = (2) (6) (12.50) = $150

Therefore, $150 would be deducted from the contractor's monthly invoice.

3. Planned Sampling. This example shows how a deduction would be calculated when planned sampling documents deficiencies in Janitorial Services. In this example, planned sampling has documented 3 defects in services over a 30 day (month) period. Therefore, the deduction would be calculated as follows:

a. Given factors: The Bid Item Price for Janitorial Services is $30.00/day.

b. Equation:

No. of Defects x Bid Item Price for = Amt. of Deduction Janitorial Services

Substituting in the numerical values from the example the deduction would be calculated as follows:

3 defects x $30.00/service = $90.00 deduction

Therefore, $90.00 would be deducted from the contractor's invoice for Janitorial Services for the month in question.

SECTION IV

PERFORMANCE REQUIREMENTS SUMMARY TABLES

PERFORMANCE REQUIREMENT SUMMARY

Required Services

Section Number

Paragraph Number

Maximum Allowable Degree of Deviation from Requirement (AQL)

Method of Surveillance

Deduction

Initial Mobilization

C-1 C-1.2-1.33 All work must be performed in accordance with contract spec.

100% inspection N/A

Mowing Service (including initial mowing)

C-2 C-2.3.a All work must be performed in accordance with contract spec.

100% Inspection N/A

Trimming C-2 C-2.3.b All work must be performed in accordance with contract spec.

100% Inspection N/A

Weeding C-2 C-2.3.c All work must be performed in accordance with contract spec.

100% Inspection N/A

Raking C-2 C-2.3.d All work must be performed in accordance with contract spec.

100% Inspection N/A

Leaf Removal, Office/Visitor

Center

C-2 C-2.3.e All work must be performed in accordance with contract spec.

100% Inspection N/A

Tree Cutting and Pruning

C-2 C-2.5 All work must be performed in accordance with contract spec.

100% Inspection N/A

Planting or Replacing

Plants

C-2 C-2.6 All work must be performed in accordance with contract spec.

100% Inspection N/A

Restroom Cleanings

C-3 C-3.3.a 5% Random Sampling

35%

Picnic Tables and Park Benches

C-3 C-3.3.b 10% Random Sampling

20%

Grills C-3 C-3.3.c 10% Random Sampling

20%

Waste Receptacles

Cleaning Service

C-3 C-3.3.d 10% Random Sampling

20%

Drinking Fountains

C-3 C-3.3.e 10% Random Sampling

20%

Shelters C-3 C-3.3.f 10% Random Sampling

20%

Signs and Bulletin Boards

C-3 C-3.3.g 10% Random Sampling

20%

Required Services Section Number

Paragraph Number

Maximum Allowable Degree of

Deviation from Requirement

(AQL)

Method of Surveillance

Deduction

Policing Grounds. Roads, Dam and Trails

C-3 C-3.3.h C-3.3.i C-3.3.j C-3.3.k

10% Random Sampling

20%

Playground Equipment C-3 C-3.3.l 10% Random Sampling

20%

Beach Inspections C-3 C-3.3.m 10% Random Sampling

20%

Beach Raking C-3 C-3.3q 10% Random Sampling

20%

Cleaning Office/Visitor Center

C-4 C-4.2 5% Random Sampling

30%

Drinking Fountains C-4 C-4.3.a 5% Random Sampling

30%

Windows and Entrance Doors

C-4 C-4.3.b 5% Random Sampling

30%

Lights and Vents C-4 C-4.3.c 5% Random Sampling

30%

Floors C-4 C-4.3.d 5% Random Sampling

30%

Surfaces C-4 C-4.3.e 5% Random Sampling

30%

Trash Cans C-4 C-4.3.f 5% Random Sampling

30%

Microwave C-4 C-4.3.g 5% Random Sampling

30%

Refrigerator C-4 C-4.3.h 5% Random Sampling

30%

Sinks, Counter tops, and Drain Boards

C-4 C-4.3.i 5% Random Sampling

30%

Cleaning Restrooms C-4 C-4.3.j 5% Random Sampling

30%

Elevator C-4 C-4.3.k 5% Random Sampling

30%

Visitor Center Displays C-4 C-4.3.l 5% Random Sampling

30%

Visitor Center Exterior C-4 C-4.3.m 5% Random Sampling

30%

Minor Maintenance C-4 C-4.3.n 5% Random Sampling

10%

Required Services Section Number

Paragraph Number

Maximum Allowable Degree of

Deviation from Requirement

(AQL)

Method of Surveillance

Deduction

Guardrail, Signs, Barricades, Bumpers, Curbs, and Posts

C-5 C-5.3.a All work must be performed in accordance with contract spec. 100% Inspection N/A

Maintenance and Repair of Roads, Parking Areas, Pull-offs, and Launching Ramps

C-5 C-5.3.b All work must be performed in accordance with contract spec.

100% Inspection N/A

Natural Resource Management

C-5 C-5.3.c All work must be performed in accordance with contract spec.

100% Inspection N/A

Recreation Area Maintenance C-5 C-5.3.c All work must be performed in accordance with contract spec.

100% Inspection N/A

Boundary Marking C-5 C-5.3.c All work must be performed in accordance with contract spec.

100% Inspection N/A

Maintenance of Navigation Aids.

C-5 C-5.3.c All work must be performed in accordance with contract spec.

100% Inspection N/A

Drift, Debris, and Trash Removal

C-6 C-6.1- C- 6.8

All work must be performed in accordance with contract spec.

100 % Inspection

N/A

SECTION V

SAMPLING GUIDES

1. Service Requirement: Initial Mobilization

2. Corresponding Contract Section: C-1.

3. Method of Q.A.: 100% Inspection

4. Acceptable Quality Level: N/A

5. Lot Size for Sampling: N/A

6. Sampling Size: N/A

7. Reject Level: N/A

8. Sampling Procedures: The Government will inspect all work at the completion of mobilization.

9. Inspection Procedures: The inspector will record all aspects of the work on an inspection checklist form.

The Contractor will be informed of deficiencies in his performance.

10. Performance Criteria: The Contractor shall perform all work as specified in Section C-1.2 through Section C-1.3.3. For all identified deficiencies the Contractor will be allowed to re-perform if contract specifications allow. Defects in Contractor performance may be addressed by issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies by re-performance, or for any defects/ rejects in service requirements.

1. Service Requirement: Mowing Service.

2. Corresponding Contract Section: C-2.

3. Method of Q.A.: 100% Inspection.

4. Acceptable Quality Level: N/A

5. Lot Size for Sampling: N/A

6. Sampling Size: N/A

7. Reject Level: N/A

8. Sampling Procedures: The Government will inspect all work at the completion of each area when notified by the Contractor and perform intermediate inspections daily. The COR will determine the times the intermediate inspections will be made.

9. Inspection Procedures: The inspector will get a copy of the work order, maps, and measuring devices needed to verify work and record all aspects of the work on an inspection checklist form. The Contractor will be informed of deficiencies in his performance.

10. Performance Criteria: The Contractor shall perform all work as specified in the individual work orders. For all identified deficiencies the Contractor will be allowed to re-perform if the work order and contract specifications allow. Defects in Contractor performance may be addressed by issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies by re-performance.

1. Service Requirement: Trimming, Weeding, Raking, Leave Removal, Tree Cutting and Pruning and Planting or Replacing Plants.

2. Corresponding Contract Section: C-2.

3. Method of Q.A.: 100% Inspection.

4. Acceptable Quality Level: N/A

5. Lot Size for Sampling: N/A

6. Sampling Size: N/A

7. Reject Level: N/A

8. Sampling Procedures: The Government will inspect all work at the completion of each work order and the COR may elect to have the work periodically inspected during performance.

9. Inspection Procedures: The inspector will get a copy of the work order, scope of work, any measuring devices needed to verify work and record all aspects of the work on an inspection checklist form. The Contractor will be informed of deficiencies in his performance.

10. Performance Criteria: The Contractor shall perform all work as specified in the individual work orders. For all identified deficiencies the Contractor will be allowed to re-perform if the work order and contract specifications allow. Defects in Contractor performance may be addressed by issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies by re-performance.

1. Service Requirement: Restroom Cleaning.

2. Corresponding Contract Section: C-3.

3. Method of Q.A.: Random Sampling.

4. Acceptable Quality Level: 5%

5. Lot Size for Sampling: See Table A Sample Size and Reject Levels

6. Sampling Size: See Table A

7. Reject Level: See Table A

8. Sampling Procedures: The COR will randomly select restrooms or washhouses to be inspected each month, and inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be performed in accordance with the Contractors approved work schedule. Each restroom or washhouse selected will be inspected and results recorded on an inspection checklist. The Contractor will be informed of deficiencies in his performance.

10. Performance Criteria: The Contractor shall perform all work as specified in the work order. For all identified deficiencies the Contractor will be allowed to re-perform if the work order and contract specifications allow. Defects in Contractor performance may be addressed by the issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies by re-performance, or for any defects/rejects in service requirements. Should the reject level be exceeded, a deduction will be made.

1. Service Requirement: Picnic Tables, Park Benches, Grills, Receptacles, Drinking Fountains, Shelters, Bulletin Boards, Signs.

2. Corresponding Contract Section: C-3.

3. Method of Q.A.: Random Sampling.

4. Acceptable Quality Level: 10%

5. Lot Size for Sampling: See Table A Sample Size and Reject Levels

6. Sampling Size: See Table A

7. Reject Level: See Table A

8. Sampling Procedures: The COR will randomly select areas to be inspected each month, and inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be performed in accordance with the Contractors approved work schedule. Each area selected will be inspected and results recorded on an inspection checklist. The Contractor will be informed of deficiencies in his performance.

10. Performance Criteria: The Contractor shall perform all work as specified in the work order. For all identified deficiencies the Contractor will be allowed to re-perform if the work order and contract specifications allow.

Defects in Contractor performance may be addressed by the issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies by re-performance, or for any defects/rejects in service requirements.

Should the reject level be exceeded, a deduction will be made.

1. Service Requirement: Policing Grounds, Roads, Dam, and Trails.

3. Method of Q.A.: Random Sampling.

4. Acceptable Quality Level: 10%

5. Lot Size for Sampling: See Table A Sample Size and Reject Levels

6. Sampling Size: See Table A

7. Reject Level: See Table A

8. Sampling Procedures: The COR will randomly select picnic tables, benches, grills, receptacles, traffic counters and water meters to be inspected each month, and inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be performed in accordance with the Contractors approved work schedule. Each item selected will be inspected and results recorded on an inspection checklist. The Contractor will be informed of deficiencies in his performance.

10. Performance Criteria: The Contractor shall perform all work as specified in the work order. For all identified deficiencies the Contractor will be allowed to re-perform if the work order and contract specifications allow.

Defects in Contractor performance may be addressed by the issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies by re-performance, or for any defects/rejects in service requirements.

Should the reject level be exceeded, a deduction will be made.

1. Service Requirement: Playground Equipment, Beach Inspections and Beach Raking.

3. Method of Q.A.: Random Sampling.

4. Acceptable Quality Level: 10%

5. Lot Size for Sampling: See Table A Sample Size and Reject Levels

6. Sampling Size: See Table A

7. Reject Level: See Table A

8. Sampling Procedures: The COR will randomly select shelters, bulletin boards, signs, and playground equipment to be inspected each month, and inform the inspectors of the schedule.

9. Inspection Procedures: The inspection will be performed in accordance with the Contractors approved work schedule. Each item selected will be inspected and results recorded on an inspection checklist. The Contractor will be informed of deficiencies in his performance.

10. Performance Criteria: The Contractor shall perform all work as specified in the work order. For all identified deficiencies the Contractor will be allowed to re-perform if the work order and contract specifications allow. Defects in Contractor performance may be addressed by the issuance of a CDR. A CDR will be issued should the Contractor fail to correct deficiencies by re-performance, or for any defects/rejects in service requirements. Should the reject level be exceeded, a deduction will be made.

1. Service Requirement: Cleaning Office/Visitor Center, Restrooms, Drinking Fountains, Windows and Entrance Doors, Lights and Vents, Floors, Surfaces, Trash Cans, Microwave, Refrigerator, Sinks, Countertops, Drain Boards, Elevator, Visitor Center Displays, and Visitor Center Exterior.

2. Corresponding Contract Section: C-4

3. Method of Q.A.: Random Sampling

4. Acceptable Quality Level: 5%

5. Lot Size for Sampling: See Table A Sample Size and Reject Levels

6. Sampling Size:…