Exhibits.pdf

PDF 9 MB Posted Feb 10, 2017

Attached to: Cleaning and Janitorial Services Federal contract opportunity
Solicitation number: W91237-17-T-0003
Issued by: Department of the Army Corps of Engineers Engineering District Huntington

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LIST OF ATTACHMENTS

EXHIBITS

EXHIBIT A Items to be Provided at Least One Week Prior to Pre-Work Conference EXHIBIT B Vicinity Map EXHIBIT C Minimum Basic Outline for Accident Prevention Plan EXHIBIT D Activity Hazard Analysis ORH Form 2642 EXHIBIT E Sample Contractor Quality Control Plan EXHIBIT F Quality Assurance Surveillance Plan EXHIBIT G Contract Discrepancy Report (CDR) ORH Form 2759 EXHIBIT H Sample Invoice Format EXHIBIT I Project Maps EXHIBIT J Approximate Quantities by Area EXHIBIT K Partial Listing of Safety and Security Requirements EXHIBIT L Contractor Vehicle Inspection Checklist EXHIBIT M Work Schedule Calendars EXHIBIT N Playground Inspection Form EXHIBIT O Swimming Beach Inspection Checklist EXHIBIT P Accident Investigation Report EXHIBIT Q Security Guidelines and Employment Forms EXHIBIT R Task Order Form (DD Form 1449) EXHIBIT S Minor Maintenance Tracking Form

EXHIBITS

EXHIBIT A

ITEMS TO BE PROVIDED ONE WEEK PRIOR TO PRE-WORK CONFERENCE

Contractor shall provide the following typed documents, at least 1 week prior to the pre-work conference:

a. Quality Control Plan. A sample Contractor's Quality Control Plan is contained as Exhibit E.

b. Contractor Representatives. List of names of Contractor Representatives.

c. Contractor Quality Control Inspectors. List of Quality Control Inspectors.

d. Contractor Accident Prevention Plan. A Contractor Accident Prevention Plan shall be prepared by the Contractor using the outline found in Exhibit C.

e. Emergency Contacts. A prioritized list, including phone numbers, of those persons (normally

Contractor Representatives) to call in case of emergencies.

EXHIBIT A

EXHIBIT B

VICINITY MAP

EXHIBIT C

MINIMUM BASIC OUTLINE FOR ACCIDENT

PREVENTION PLAN

APPENDIX A, EM 385-1-1

EM 385-1-1

30 Nov 14

APPENDIX A

Minimum Basic Outline for Abbreviated Accident Prevention Plans

k. Abbreviated APP for Limited-Scope Service, Supply and R&D Contracts. If service, supply and R&D contracts with limited-scopes are awarded, the contractor may submit an abbreviated APP in lieu of a full APP. The abbreviated APP shall address the following areas at a minimum. If other areas of the EM 385-1-1 are pertinent to the contract, the contractor must assure these areas are addressed as well. The non-mandatory Abbreviated APP Form, Form A-01 (or similar) may be used to insure each area of required information has been provided.

(1) Title, signature, and phone number of the plan preparer.

(2) Background Information to include:

(a) Contractor;

(b) Contract number;

(d) Brief project description, Note: The project description shall provide a means to evaluate the work being done (see AHA requirements in 01.A.14), associated hazards involved and a RAC assigned to each. The overall RAC for the activity must be determined (based on highest task RAC) and accepted at the appropriate level in order for work to proceed.

(e) Description of work to be performed, and

(f) Location of work being performed, to include a map.

(3) Statement of Safety and Health Policy detailing their commitment to providing a safe and healthful workplace for all employees.

(4) Responsibilities and Lines of Authorities – to include a statement of the employer’s ultimate responsibility for the implementation of his SOH program; Identification and accountability of personnel responsible for safety at all levels to include designated site safety and health officer (SSHO) and associated qualifications. The District SOHO will be asked to review the qualifications for acceptance.

(5) Training - new hire SOH orientation training at the time of initial hire of each new employee and any periodic retraining/recertification requirements.

(6) Procedures for job site inspections - assignment of responsibilities and frequency.

(7) Procedures for reporting man-hours worked and reporting and investigating any mishaps required by Section 01.D.

(8) Emergency Planning. Employees working alone shall be provided an effective means of emergency communication. This may be cellular phone, two-way radio or other acceptable means. The selected means of communication must be readily available and must be in working condition.

(9) Drinking Water provisions, toilet and washing facilities.

(10) First Aid and CPR training (at least two employees on each shift shall be qualified/certified to administer first aid and CPR) and provision of first aid kits (types/size).

(11) Personal Protective Equipment (PPE).

(a) Work Clothing - Minimum Requirements. Employees shall wear clothing suitable for the weather however minimum requirements for work shall be short-sleeve shirt, long pants (excessively long or baggy pants are prohibited) and leather work shoes. If analysis determines that safety-toed (or other protective) footwear is necessary (i.e., mowing, weed eating, chainsaw use, etc), they shall be worn.

(b) Eye and Face Protection. Eye and face protection shall be worn as determined by an analysis of the operations being performed, however, all involved in chainsaw use, chipping, stump grinding, pruning operations, grass mowing, weed eating and blowing operations shall be provided safety eyewear (Z87.1) as a minimum.

(c) Hearing Protection. Hearing protection must be worn by all those exposed to high noise activities (to include grass mowing and trimming, chainsaw operations, tree chipping, stump grinding and pruning).

(d) Head Protection. Hard hats shall comply with ANSI Z89.1 and shall be worn by all workers when a head hazard exists, per Section 05.D.

(e) High Visibility Apparel shall comply with ANSI/ISEA 107, Class 2 requirements at a minimum and shall be worn by all workers exposed to vehicular or equipment traffic.

(f) Protective Leg chaps shall be worn by all chainsaw operators.

(g) Gloves of the proper type shall be worn by persons involved in activities that expose the hands to cuts, abrasions, punctures, burns and chemical irritants.

(h) If work is being performed around water and drowning is a hazard, PFDs must be provided and worn as appropriate.

(12) Machine Guards and safety devices. Power tools/equipment must have appropriate guards and safety devices in place and operational.

(13) Hazardous Substances. When any hazardous substances are procured, used, stored or disposed, a Hazard Communication Program must be in place and MSDSs (SDSs) shall be available at the worksite. Employees shall have received training in hazardous substances being used. When the eyes or body of any person may be exposed to corrosives, irritants or toxic chemicals, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within 10 seconds of the worksite.

(14) Traffic control shall be accomplished in accordance with DOT’s MUTCD.

(15) Control of Hazardous Energy (Lockout/Tagout). Before an employee performs any servicing or maintenance on any equipment where the unexpected energizing or startup of the equipment could occur, procedures must be in place to ensure adequate control of this energy. > See Section 12.

(16) High hazard activities should not be encountered on these types of jobs. If they are (i.e., driving/operating equipment on slopes, working from/in boats, etc), a determination shall be made by the KO and local SOH Office as to whether an abbreviated APP is applicable. If so, they shall be fully addressed in the APP. AHAs are required on work activities which include high hazard activities.

U.S. Army Corps of Engineers Safety

Inspection Checklist Abbreviated

Accident Prevention Plan

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 September 2014.The references Included In this checklist correspond to the applicable sections of EM 385-1-1.

If service, supply and R&D contracts with limited scopes are awarded, the contractor may submit an abbreviated Accident Prevention Plan. This APP shall address the following areas at a minimum. If other areas of the EM 385-1-1 are pertinent to the contract, the contractor must assure these areas are addressed as well.

Item Description Yes No N/A Remarks (Any NO or N/A Item)

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

c. Includes the name{s), signature(s), and title{s) for Plan

Concurrence (provide concurrence of other applicable corporate and project personnel(contractor))

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 a means to evaluate the work being done (see AHA requirements in 01.A.13) and associated hazards involved.

g. Addresses the identified hazards involved and the control measures to be taken.

3. Statement of Safety and Health Policy detailing their commitment to providing a safe and healthful work place for all employees.

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.

5. Training- new hire SOH orientation training at the time of initial hire of each new employee and any periodic retraining/recertification requirements

6.Procedures for job site inspections - assignment of responsibilities and frequency

U.S. Army Corps of Engineers Safety

Inspection Checklist Abbreviated

Accident Prevention Plan

Date of Inspection

Item Description

Yes No N/A Remarks (Any NO or N/A item)

7.Procedures for reporting man-hours worked and reporting and investigating any accidents as soon as possible but not more than

24 hours afterwards to the Contracting Officer/Representative

(CO/COR).

8.Emergency Planning. Employees working alone shall be provided an effective means of emergency communication. This may be cellular phone, two-way radio or other acceptable means. The selected means of communication must be readily available and must be in working condition.

9. Drinking Water provisions, toilet and washing facilities.

10. First Aid and CPR training (at least two employees on each shift shall be qualified/certified to administer first aid and CPR) and provision of first aid kit (types/size).

11.Personal Protective Equipment

a. Work Clothing - Minimum Requirements. Employees to wear clothing suitable for the weather; minimum requirements for work shall be short-sleeve shirt, long pants (excessively long or baggy pants are prohibited) and leather work shoes. If AHA determines safety-toed (or other protective) footwear is necessary (i.e., mowing, weed eating, chain saw use, etc), they shall be worn.

b. Eye and Face Protection. Eye and face protection shall be worn as determined by an analysis of the operations being performed

HOWEVER, all involved in chain saw use, chipping, stump grinding, pruning operations, grass mowing, weed eating and blowing operations shall be provided safety eyewear (Z87.1) as a minimum.

c. Hearing Protection. Hearing protection must be worn by all exposed to high noise activities {includes grass mowing/trimming, chainsaw operations, tree chipping, stump grinding and pruning)

d. Head Protection. Hard hats shall comply with ANSIZ89.1 and shall be worn by all workers when a head hazard exists. At a minimum, hard hats shall be worn when performing activities identified in {b)

e. High Visibility Apparel shall comply with ANSI/ISEA 107, Class

2 requirements at a minimum and shall be worn by all workers exposed to vehicular or equipment traffic.

f. Protective Leg chaps shall be worn by all chainsaw operators.

g. Gloves of the proper type shall be worn by persons involved in activities that expose the hands to cuts, abrasions, punctures, bums and chemical irritants.

h. If work is being performed around water and drowning is a hazard, PFD's must be provided and worn as appropriate.

12. Machine Guards and safety devices. Lawn maintenance equipment must have appropriate guards and safety devices in place and operational.

U.S. Army Corps of Engineers Safety

Inspection Checklist Abbreviated

Accident Prevention Plan

Date of Inspection

Item Description

Yes No N/A Remarks (Any NO or N/A Item)

13. Hazardous Substances. When any hazardous substances are procured, used, stored or disposed, a hazard communication program must be in effect and MSDSs shall be available at the worksite. Employees shall have received training in hazardous substances being used. When the eyes or body of any person may be exposed to corrosives, irritants or toxic chemicals, suitable facilities for quick drenching or flushing of the eyes and body shall be provided within 10 seconds of the worksite.

14. Traffic control shall be accomplished in accordance with DOT’s

MUTCD.

15. Control of Hazardous Energy (Lockout/Tagout). Before an employee performs any servicing or maintenance on any equipment where the unexpected unergizing or startup of the equipment could occur, procedures must be in place to ensure adequate control of16. Driving, working on (i.e., working with equipment, mowers) while on slopes, working from/in boats/skiffs, etc shall also be considered and dealt with accordingly.

Other Remarks

EXHIBIT D

SAMPLE SAFETY FORMS:

OSHA 300 Log Instructions

OSHA 300 Log

OSHA 300A Log

Activity Hazard Analysis

Examples of Job Steps

Exhibit D

JOB TASK

1.Operating Vehicles

2.Operating Power Tools

HAZARDS

1.1 Vehicle collision

and/or rollover

1.2 Caught between

injuries

1.3 Operation

around the public

2.1 Electric shock

2.2 Eye injury

2.3 Hearing loss

CORRECTIVE ACTION

1.1.1 Only qualified, licensed personnel shall operate vehicles. All vehicles shall receive a pre-operational check prior to operation. Should any problems be discovered which would adversely affect safe operation they shall be corrected before operation. Seat belts shall be worn at all times during operation by both the operator and passengers. Defensive driving practices shall be followed at all times. Cargo items shall be secured to prevent hazardous contact with the operator and passengers.

First aid kits shall be fully stocked and readily accessible. Fire extinguishers shall be charged and readily accessible.

1.2.1 Vehicle and equipment operators shall be alert to their surroundings at all times. Workers shall be aware of equipment operation and direction of travel at all times. Warning devices such as lights, horns, back-up alarms and 4-way flashers shall be utilized as conditions dictate.

1.3.1 Defensive driving practices shall be followed at all times. Workers shall constantly be alert for vehicles, children, pedestrians, bicyclists, animals, utility lines, public or private property, fallen tree limbs, physical obstacles and other hazards in roadways and be prepared to make sudden stops. Workers shall be aware of direction of travel as well as traffic patterns at all times. Spotters shall be used anytime there is potential for contact with vehicles and/or the public. Workers shall wear orange safety vests for increased visibility. Warning devices such as 4-way flashers, horns and lights shall be utilized as conditions dictate.

2.1.1 Only properly trained employees shall operate power tools. All tools shall be inspected before use to insure they are in good operating condition with all safety features in place. Power tools shall be double insulated and/or properly grounded utilizing GFCI’s. Personal protective equipment such as grounding mats, insulated gloves or rubber boots shall be utilized.

2.2.1 Eye protection such as safety goggles or safety glasses w/side shields shall be used when operating power tools. Likewise, adjacent workers who have the potential to be struck by flying objects shall wear eye protection as well.

2.3.1 Hearing protection is required when exposed to noise levels in excess of 85 dB. Equipment shall be tested and labeled to indicate the need for hearing protection.

2.Operating Power Tools, (cont)

3.Clean-ing of Rec.

Areas, Restrooms

2.4 Struck-by injuries

2.5 Slips, trips and

falls

3.1. Handling of

Hazardous Chemicals and Cleaning Compounds

3.2 Transmission of

disease from unsanitary conditions

3.3 Eye injuries

3.4 Slips, Trips and

Falls

2.4.1 Operators shall be alert to their surroundings at all times. If conditions create the potential to either be struck by adjacent workers, falling or flying objects, passing vehicles or members of the public or to strike bystanders or adjacent workers, signs, barricades, guards or spotters shall be utilized. Personal protective equipment such as hats, goggles and safety shoes shall be worn.

2.5.1 Workers shall be conscious of surface footing and walking conditions. Non-slip safety-toed shoes or boots shall be worn at all times. Good housekeeping practices shall be followed to eliminate obstacles in the work area and tripping hazards.

3.1.1 All workers shall be trained in handling hazardous chemicals and cleaning compounds prior to their use. Tool box safety meetings shall be conducted prior to beginning work to orient workers with conditions and operations. Material safety data sheets (MSDS’s) shall be obtained and re-viewed prior to the use of any hazardous chemicals/ compounds.

Manufacturers instructions on all labels shall be closely adhered to. Work areas shall be adequately ventilated at all times. Personal protective clothing such as long sleeved shirts, gloves, safety shoes and goggles shall be worn as required. Workers shall be well acquainted with first aid and emergency procedures should a problem occur.

3.2.1 There is the potential for disease transmission to both cleaning personnel and the public from improper cleaning methods. Personal protective clothing such as long sleeved shirts, gloves, goggles, face shields and respirators shall be utilized as needed to prevent contact with disease organisms. All specified facilities, surfaces and fixtures shall be properly cleaned as specified in the contract. Cleaners shall ensure that all shower stalls, toilets, sinks, urinals and restroom floors are sanitized during each cleaning. Buckets and brushes used to clean toilets, urinals and receptacles shall be color coded and not used for any other purpose.

3.3.1 Eye protection such as safety goggles or safety glasses w/side shields shall be used where the potential for splashing chemicals into eyes exists.

3.4.1 Workers must be conscious of surface footing and walking conditions at all times. Non-slip, safety-toed shoes or boots shall be worn at all times. Good housekeeping practices shall be followed to eliminate obstacles in the work area and tripping hazards. Excess water and spills shall be removed from floors to reduce slipping hazards to the public.

Cleaners shall only clean from ladders or in elevated positions when additional ground personnel are available to stabilize the ladder and hand up materials and supplies. Special precautions shall be taken when working on wet grass, mud, loose ground and steep slopes.

3.Clean-ing of Rec.

Areas, Rest-rooms (Cont)

3.5 Sprains, strains

and back injuries

3.6 Cuts, bruises, abrasions and punctures

3.7 Burns

3.8 Electrocution

3.9 Contact with the

public

3.10 Bee stings, spider bites, dog bites and other animal related injuries

3.5.1 Safe lifting procedures shall be followed at all times. Workers should avoid sudden jerking or twisting movements while lifting, setting or tossing loads. Care shall be taken not to overfill buckets, trash bags and containers. Workers shall request assistance or use mechanical lifting aids whenever possible.

3.6.1 Care shall be used when handling all trash and debris to avoid cuts and punctures from broken glass, splinters and sharp or jagged metal edges. Leather gloves and safety shoes shall be worn when handling these materials.

3.7.1 All fires and burning or burnt materials shall be extinguished and allowed to cool before attempting to remove them from fire rings, grills and cookers. Tools, leather gloves and fire resistant containers shall then be utilized to handle coals and burnt fragments.

3.8.1 Power shall be turned off, locked out and tagged out before cleaning any electrical fixtures. Only wooden or fiberglass ladders shall be used when cleaning lights and other electrical fixtures to avoid electrocution. Electric pressure cleaners and other power cleaning equipment shall be inspected before use to insure safe condition. GFCI protection shall be utilized. Special attention shall be given to electrical equipment, cords, etc. around water.

3.9.1 It is the cleaners responsibility to be aware of surrounding conditions at all times. Special attention shall be given to people entering potentially hazardous areas. Signs and barricades shall be used. Work areas shall be restricted to workers. Assurance shall be made that no hazardous conditions, such as excess water on floors, tripping hazards, hazardous chemicals or unsanitary conditions are left unattended.

3.10.1 Cleaners shall be alert for bees, spiders, snakes and other animals in or around the work area. Special attention shall be given cleaning under eaves of buildings, shelters, tables, windows and in poorly lit or enclosed spaces. Caution shall be exercised when approaching campsites with pets. First aid kits shall be readily accessible.

EXHIBIT E

SAMPLE CONTRACTOR QUALITY CONTROL

SAMPLE CONTRACTORS QUALITY CONTROL PLAN

1. INSPECTION OF SERVICES.

a. Scheduled Inspections. At the conclusion of each cleaning, the QCI shall inspect the cleanings and record and correct all deficiencies.

b. Unscheduled Inspections. If the Contractor is not the primary Cleaner, the Contractor or his Representative shall make unscheduled inspections as necessary to insure work is performed in compliance with the contract. Inspections shall be conducted a minimum of once each week services are ordered. The frequency shall be increased if deficiencies are noted. Deficiencies shall be documented and corrected.

The Contractor shall track deficiencies to identify and correct re-occurring problems.

c. Records and Filing. All inspections shall be documented and maintained in a file, which shall be available for COR inspection at any time.

2. DEFICIENCIES AND CORRECTIVE ACTION. All aspects of cleaning services shall be inspected. Deficiencies shall be corrected. Re-occurring deficiencies and Government documented deficiencies shall be immediately discussed with employee(s) responsible for the deficiency and with all employees within 7 days.

3. INSPECTORS and CONTRACTOR REPRESENTATIVES. A list of names and phone numbers of authorized Inspectors and Contractor Representatives shall be provided at the Pre-Work Conference.

4. SECURITY.

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.

QUALITY CONTROL CHECKLIST FOR CLEANING SERVICES

INSPECTION ITEM RATING COMMENTS

Restrooms / Washhouse

Fixtures

Toilet Tissue

Walls, Windows Mirrors

Insects

Cleaning Compounds/Methods

Tables and Benches

Grills

Trash Cans

Drinking Fountains

Shelters

Bulletin Boards, Signs, Etc.

Grounds – Rec Area

Grounds - Roadways

Grounds – Shoreline, Beach

Grounds - Trails

Beach & Playground Inspections Accurate

Minor Maintenance

Safe Work Habits and Equipment

Maintain Facility Security

1 – Work Done Correctly 2 – Deficiencies Found (Explain problem, correction, and prevention of repeat problem) 3 – Work Not Begun

EXHIBIT F

QUALITY ASSURANCE SURVEILLANCE PLAN

CLEANING AND JANITORIAL SERVICES

BURNSVILLE LAKE

Table of Contents

SECTION PAGE NO.

SECTION I. Introduction.

A. General B. Roles and Responsibilities C. Authority D. Acronyms and Definitions

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

SECTION III. Performance Requirements Summary Table

SECTION IV. Sampling Guides

SECTION V. Inspection Checklists A. Examples

1. Cleaning

2. Janitorial

3. Contractor's Quality Control Program

EXHIBIT F

SECTION VII. Random Sample Tables Table 1. Normal Surveillance Table 2. Tightened Surveillance Table 3. Reduced Surveillance

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 for unsatisfactory performance are calculated; and, provides examples of Inspection Checklists.

B. Roles and Responsibilities

The following personnel shall oversee and coordinate surveillance activities.

Procuring Contracting Officer (PCO) – The PCO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The PCO shall also ensure that the contractor receives impartial, fair, and equitable treatment under this contract. Determine the final assessment of the contractor’s performance.

Assigned PCO: Mary L. Newman Organization or Agency: US Army Corps of Engineers, Huntington District Telephone: 304-399-5228 Email: mary.l.newman@usace.army.mil

Contracting Officer’s Representative (COR) The COR is responsible for providing continuous technical oversight of the contractor’s performance. The COR uses the QASP to conduct the oversight/surveillance process. The COR shall keep a Quality Assurance file that accurately documents the contractor’s actual performance. The purpose is to ensure that the contractor meets the performance standards contained in the contract. The COR is responsible for reporting early identification of performance problems to the KO. The COR is required to provide an annual performance assessment to the KO which will be used in documenting past performance. The QASP is the primary tool for documenting contractor performance. The COR is not empowered to make any contractual commitments or to authorize any contractual change on the Government’s behalf.

Other Key Government Personnel This may include performance monitors, inspectors, or others who provide information that helps the COR monitor contractor performance.

C. Authority

Authority for issuance of this QASP is provided under Part 46 of the Federal Acquisition Regulation, Inspection of Services clauses, which provides for inspection, acceptance and documentation of the service called for in the contract or order. This acceptance is to be executed by the contracting officer or a duly authorized representative.

D. 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" is an example of a job.

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.

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 for unsatisfactory performance. The contractor must re-perform 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

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. Tables are included at the end of this plan to show the surveillance methods.

Generally reduced surveillance is used, but if performance is not acceptable, normal or tighened surveillance may be used. 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 Task 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 for unsatisfactory performance from the Contractor's invoice based on SECTION III B1 or B2

2. 100% Inspection. Whenever the work does not conform to all requirements of the Task Order, the Government will issue a CDR and proceed in accordance with the contract clause 52.246-4.

SECTION III. Calculating Deductions

A. General. Whenever work or parts of work are not performed or are rejected, deductions will be made.

The following examples are given to demonstrate how deductions could 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: The calculated value of a restroom cleaning is $25 (based on Performance Requirements Summary Table, Bid Prices, and other factors).

AND: Sample size is 18 with a reject level of 3.

AND: Number of defects in sample is 5.

THEN: Deductions from the contractor's monthly invoice for performing Level 2 cleanings would be calculated according to the following equation:

No. of Defects No. of Contract Price Amount -------------------- X Cleanings X for = of Sample Size in Period Cleaning Services Deduction

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

5/18 X 125 X $25 = $868.05

Therefore, $868.05 would be deducted from the contractor's monthly invoice.

2. Planned Sampling. This example shows how a deduction would be calculated when planned sampling documents deficiencies in Cleaning Services. In this example, planned sampling has documented non-performance on a beach cleaning. A CDR was issued and the Government chose to have the services performed by another contractor. The actual cost to the government to correct the deficiency will be deducted from the Contractor’s invoice.

For example, if the actual cost to the Government to correct the deficiencies at the beach is $120.00, then $120.00 will be deducted from the Contractor's invoice for cleaning.

SECTION III

PERFORMANCE REQUIREMENTS SUMMARY TABLE

Performance Requirements Summary

Required Services Section Number Paragraph Number

Maximum Allowable Degree Of Deviation

From Requirement (AQL)

Method of Surveillance

Scheduled Restroom and Washhouse Cleaning

Scheduled Office Restroom Cleaning

Scheduled Full-Service Grounds Cleaning

Scheduled Litter Pickup

Scheduled Shelter Cleaning

Non-Scheduled Restroom and Washhouse Cleaning

C-2

C-2.2

All work must be performed in accordance with the specifications

Random Sampling

100% Inspection

SECTION IV

SAMPLING GUIDES

1. Service Requirement: Scheduled Restroom and Washhouse Cleaning

2. Corresponding Contract Section: C-2

3. Method of Q.A.: Random Sampling

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 COR will randomly select times and/or dates for restrooms and washhouses to be inspected each year and will inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be performed in accordance with the Contractor's 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 Section C-2 and as scheduled on the calendars. For all identified deficiencies the Contractor will be allowed to re-perform if the Task 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 for unsatisfactory performance will be made.

1. Service Requirement: Scheduled Office Restroom Cleaning

2. Corresponding Contract Section: C-2

3. Method of Q.A.: Random Sampling

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 COR will randomly select times and/or dates for restrooms to be inspected each year and will inform inspectors of the schedule.

1. Service Requirement: Scheduled Full-Service Grounds Cleaning

2. Corresponding Contract Section: C-2

3. Method of Q.A.: Random Sampling

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 COR will randomly select times for the inspection to be done each year and inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be performed in accordance with the Contractor's 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.

1. Service Requirement: Scheduled Litter Pickup

2. Corresponding Contract Section: C-2

3. Method of Q.A.: Random Sampling

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 COR will randomly select times for the inspection to be done each year and inform inspectors of the schedule.

The Contractor will be informed of deficiencies in his performance.

1. Service Requirement: Scheduled Shelter Cleaning

(Note: Routine Shelter Cleaning is included in Full-Service Grounds Cleaning. This requirement is extra shelter cleanings scheduled on the calendars not included under Full-Service Grounds Cleaning).

2. Corresponding Contract Section: C-2

3. Method of Q.A.: Random Sampling

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 COR will randomly select times for the inspection to be done each year and inform inspectors of the schedule.

9. Inspection Procedures: The inspection will be performed in accordance with the Contractor's approved work schedule. Each shelter selected will be inspected and results recorded on an inspection checklist.

The Contractor will be informed of deficiencies in his performance.

1. Service Requirement: Non-Scheduled Cleaning of Restrooms and Washhouses.

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 the job, and the COR may elect to have the work periodically inspected during performance.

9. Inspection Procedures: The inspector will get a copy of the scope of work, and technical instruments 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 ordered. For all identified deficiencies the Contractor will be allowed to re-perform if the Task 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.

SECTION V

INSPECTION CHECKLISTS

Inspection Checklist Project: Contract No: Delivery Date:

Contractor: Task Order No.: Weather:

Service Requirement: Rating Code: (1) Acceptable (2) Unacceptable (3) Work in Progress (4) Work Not Started Work Areas

Cleaning Services, Recreation Areas Specific Task(s) or Item(s)

Safe Work Habits / Equipment Complete Following Only If

Deficiencies Noted:

Signature of CR or QCI who Reviewed

Date Time

Signature of CR or QCI who

Received a Copy

Date Time

Uniformed Employees / Marked Vehicles

Restrooms / Picnic Shelters

Comodes, Urinals, Lavatories / Toilet Tissue

Plumbing Fixtures, Lighting Fixtures

Walls (Inside / Outside), Floors, Ceilings, Roofs, Sidewalks

Windows, Mirrors

Cleaning Compounds / Sanitary Methods

Insects / Insect Nests

Grounds, Roads, Parking Lots and Paved Areas

Creek Banks, Riprap, Shoreline

Fishing Piers

Receptacles

Grills or Cookers

Picnic Shelters, Picnic Tables and Park Benches

Drinking Fountains

Bulletin Boards / Signs

Playground Equipment and Ball Parks

Trails

Reporting of Damaged or Malfunctioning Equipment

Time

Defect Acceptable See back for description of deficiency

Inspector's Signature Date COR Signature Date

Contractor: Task Order No.: Weather:

Service Requirement: Rating Code: (1) Acceptable (2) Unacceptable (3) Work in Progress (4) Work Not Started

Work Areas

Janitorial Services

Specific Task(s) or Item(s)

Safe Work Habits / Equipment Complete Following Only If

Deficiencies Noted:

Signature of CR or QCI who Reviewed

Date Time

Signature of CR or QCI who

Received a Copy

Date Time

Uniformed Employees / Marked Vehicles

Serviceable Equipment

Remove Trash and Replace Receptacle Liners

Vacuum Carpet

Sweep and Mop Floors

Sidewalks

Clean Mats

Dusting

Cleaning Glass, Window Sills, and Hardware

Drinking Fountains

Displays

Spot Cleaning

Clean Grounds

Insect Nests and Cob Webs

Parking Lots Swept

Lights

Restrooms

Kitchen Area

Reporting of Damaged or Malfunctioning Equipment

Time

Defect Acceptable See back for description of deficiency

Contractor: Task Order No.: Weather:

Service Requirement: Rating Code: (1) Acceptable (2) Unacceptable (3) Work in Progress (4) Work Not Started Work Areas

Contractor's Quality Control Program

Specific Task(s) or Item(s)

Safe Work Habits / Equipment Complete Following Only If

Deficiencies Noted:

Signature of CR or QCI who Reviewed

Date Time

Signature of CR or QCI who

Received a Copy

Date Time

Contractor's Inspection System

Contractor's Method of Identifying Deficiencies

File of Contractor Conducted Inspections

Uniformed Employees / Marked Vehicles

Time

See back for description of deficiency

This notice is to advise you of deficiencies found during inspection. The deficiencies found are in the performance and/or quantity of work. The deficiencies are to be corrected as specified.

Location

Comments and deficiencies which shall be corrected before work will be acceptable and satisfactory are as follows:

Comments on correction of deficiencies:

Inspector

Date

SECTION VII

RANDOM SAMPLE TABLES

Table A-1

Sample Sizes and Reject Levels

Population Size

Normal Surveillance

AQL 5% AQL 10%

Sample Size Reject Size Sample Size Reject Size

2-8

9-15

16-25

26-50

1,000

1,200

1,400

1,600

1,800

2,000

2,500

3,000

3,500

4,000

5,000

6,000

8,000

10,000

Table A-2

Population Size

Tightened Surveillance

AQL 5% AQL 10%

Sample Size Reject Size Sample Size Reject Size

2-8

9-15

16-25

26-50

1,000

1,200

1,400

1,600

1,800

2,000

2,500

3,000

3,500

4,000

5,000

6,000

8,000

10,000

Table A-3

Population Size

Reduced Surveillance

AQL 5% AQL 10%

Sample Size Reject Size Sample Size Reject Size

2-8

9-15

16-25

26-50

1,000

1,200

1,400

1,600

1,800

2,000

EXHIBIT G

CONTRACT DISCREPANCY REPORT (CDR)

(ORH Form 2759)

EXHIBIT H

SAMPLE INVOICE FORMAT

EXHIBIT H

SAMPLE INVOICE FORMAT

FROM: Contractor's Name INVOICE NO:

Address

City, State Zip

Phone Number

INVOICE FOR MONTH OF: _____ DATE OF INVOICE:

CONTRACT NUMBER:

TO: Resource Manager

Burnsville Lake

2550 South Main Street

Burnsville, WV 26335

DATE ITEM AMOUNT

3-1-17 $000.00 Line Item 0001, Cleaning February

Line Item 0003, Extra Restroom

Cleaning

0.00

TOTAL INVOICE $000.00

EXHIBIT H

TASK ORDER NUMBER:

EXHIBIT I

PROJECT MAPS

Vicinity Map

Riffle Run Areas

Bulltown Areas

Falls Mill Areas

Burnsville, WV Interstate 79, Exit 79

Napier, WV Heaters, WV To Flatwoods

Downstream Area

Map A

Gaging Station

Project Boundary

Shelter #1

Shelter #2

Playground

Restroom

Riprap Trimmed Each Time Grass is Mowed

Riprap in this area will be herbicided as needed and will be ordered on a separate contract.

Contractor Compound

Government Compound

Map is drawn to scale. This map is for illustration purposes only. For exact measurements, refer to the Contract maps in the Project Office.

Reduced Mowing This area will be mowed when a full mowing is ordered.

Mow 4’ Around Banner Each Time Grass is

Mowed

Project Office Building / Visitor Center

Map B

Office

McCauley Run Rd.

To Burnsville

To Riffle Run Campground

Map is drawn to scale. This map is for illustration purposes only. For exact measurements, refer to the Contract maps in the Project Office.

Damsite Map C

Office

Map is drawn to scale. This map is for illustration purposes only. For exact measurements, refer to the Contract maps in the Project Office.

McCauley Run Rd.

To Burnsville

To Riffle Run Campground

Riprap in this area will be herbicided as needed and will be ordered on a separate contract.

Reduced Mowing This area will be mowed when a full mowing is ordered.

Maintenance Area

Map D

Office

Map is drawn to scale. This map is for illustration purposes only. For exact measurements, refer to the Contract maps in the Project Office.

McCauley Run Rd.

To Burnsville

To Riffle Run Campground

Maintenance Building

Equipment Building

Reduced Mowing

Riffle Run Marina / Launch Area

Map E

Office

Map is drawn to scale. This map is for illustration purposes only.

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Nov 14, 2017.