TO0001PWS_AttachM_EquipmentReuseChecklist.xlsx
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- W912DY15R0024
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Task Order 0001 PWS Attachment M
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Sheet1 Equipment and Systems Reuse/Relocation Checklist
MEDCOM Policy requires all MILCON/SRM projects to consider existing equipment as the first source of supply when determining equipment requirements (per AR 40-61 / SB-8-75 MEDCASE) Replacing an existing item of equipment that meets reuse criteria requires justification. This checklist will help determine if an item of equipment or system is suitable for reuse and move to the new facility.
Current Facility Information
ECN Room Department/Customer
Nomenclature Serial Number
Hand Receipt Holder Property Book Value POC
Date in Service Life Expectancy OTEL*
Maintenance Costs Overall Condition MEL
New Facility Information
| JSN | End Location Room # | Department/Activity |
| BIM ID# |
Y / N Equipment Assessment Checklist
| 1. Equipment has at least 2 years of useful life expectancy at the time of move to the new facility? | ||
| 2. Equipment has not reached or exceeded it's maximum maintenance expenditure or OTEL* (One Time Expenditure Limit) | ||
| 3. Equipment is current technology and can continue to support an appropriate standard of care until it reaches life expectancy? | ||
| 4. Is equipment currently on the CEEP/MEDCASE list for normal replacement? | ||
| 5. Equipment is in aesthetically good condition - Shows little to no external damage or excessive wear ? | ||
| 6. Finish of equipment (paint or upholstery color) is compatible with other equipment/furniture in the new facility? | ||
| 7. Equipment requires deinstallation/reinstallation by OEM Vendor? | Est. Cost | |
| 8. Equipment may be deinstalled/reinstalled by in-house (or IO&T Contracted) Medical Maintenance? | ||
| 9. Will moving this equipment impact the department's ability to provide patient care? | ||
| 10. Can relocation of this equipment be complete without adversely impacting patient care? | ||
| 11. Has the department/activity considered a work-around to minimize impacts? | ||
| 12. Are dual operations required/planned for this department/activity prior to BOD (e.g. Day in the Life training)? | ||
| 13. Does equipment require third party performance checks (e.g. flow rates)? | ||
| 14. Will retaining this equipment require additional maintenance or license costs? Est. Cost? | ||
| 15. Will retaining this equipment require specialized Routine Diagnostic Testing Equipment? | ||
| 16. Is this equipment consistent with Regional and/or MTF standardization policy/requirements? | ||
| Y / N | Systems Assessment Checklist |
| 1. Is this system compliant with current IAVAs? |
| 2. Does the system connect to the NIPRNET? |
| 3. Does the system have a CoN? Expiration Date? |
| 4. Does the system have any component that mounts in a Communication Closet or Data Center? |
| 5. Will movement of any circuit affect any outlying locations (i.e. remote clinics, satellite pharmacies, etc.)? |
| 6. Will transition of this system or program affect other sites (i.e. outages and/or degraded clinical workflows at other government sites)? |
| 7. Will supported services (internal/external) be interrupted if the system is transitioned? |
| 8. Are there interdependencies that exist with this system? |
| 9. Is this system or program centrally funded? |
| 10. Does the system require preapproval from higher authorities before it can be disconnected and transitioned? |
Determination
| Proposed Equipment | IS | IS NOT | Recommended for Reuse in the New Facility |
| Proposed System | IS | IS NOT | Recommended for Reuse in the New Facility |
Equipment Planner IS IS NOT Signature:
Department/Activity Chief/OIC IS IS NOT Signature:
Hand Receipt Holder or Systems Administrator IS IS NOT Signature:
Chief, Equipment Management Branch IS IS NOT Signature:
CSO / IASO, Information Management Division IS IS NOT Signature:
Health Facility Project Office Representative IS IS NOT Signature:
| Instructions for Hand Receipt Holder or Systems Administrator |
| Equipment or systems identified for movement and reuse in the new facility fulfills a Joint Service Number (JSN) requirement for your department/activity. No new equipment or system will be planned based on this determination. Notify the Health Facility Project Office (HFPO) immediately if the equipment or system is no longer needed, becomes unserviceable, turned in or laterally transferred to another hand receipt. Reuse equipment or systems remain the responsibility of the hand receipt holder or systems administrator, the HFPO is not responsible for items planned for reuse that are not available on move day. |
Requestor Comments
Sheet2
Sheet3
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