PWS_SSO_Medical_Exams_(Jun_2014).pdf

(Ver. Jun 2014)

PERFORMANCE WORK STATEMENT (PWS)

FOR

TECHNICIAN OCCUPATIONAL MEDICAL SURVEILLANCE EXAMINATION

Services

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Technician Occupational Medical Surveillance Examination Services, as defined in this PWS

1.2 Background: The Performance Work Statement (PWS) supports the Pennsylvania Army National Guard (PAARNG) in order to monitor the health of civilian federal technicians exposed to workplace hazards through technician Occupational Medical Surveillance Examinations. The physicals will be given to technicians working in aviation and ground heavy equipment maintenance, mechanics, painters, welders, fire fighters and any other employee exposed to a workplace hazard. The Technician Occupational Medical Surveillance Examination is a regulatory federal requirement.

1.3 Period of Performance (PoP): The Period of Performance shall be one Base Year of 12 months.

1.4 General Information:

1.4.1 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary. After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO) acceptance in writing of any proposed changes to its QCP.

1.4.2 Quality Assurance (QA): The Government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) (defect rate(s)).

1.4.3 Recognized Holidays: The following are recognized US holidays. The contractor shall not perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King, Jr.’s Birthday

1.4.3.3 President’s Day

1.4.3.4 Memorial Day

1.4.3.5 Independence Day: July 4th

1.4.3.6 Labor Day

1.4.3.7 Columbus Day

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day

1.4.3.10 Christmas Day

1.4.4 Place and Performance of Services: The contractor shall provide services between the hours of 0730-1630 on Monday through Friday, except on recognized US holidays or when the Government facility/installation is closed due to local or national emergencies, administrative closings, or similar Government-directed facility/installation closings. Performance shall be at Fort Indiantown Gap, Annville, PA in the medical clinic located in Building 4-114, 4-80, or 4-78 and the Combined Surface Maintenance Shop – West (CSMS-W) located in Coraopolis, PA. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS when the Government facility/installation is not closed for the above reasons.

When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential. Telecommuting is not authorized.

1.4.4.1 Unscheduled gate closures by the Security Police may occur at any time causing all personnel entering or exiting a closed installation to experience a delay. This cannot be predicted or prevented. Contractors are not compensated for unexpected closures or delays. Vehicles operated by contractor personnel are subject to search pursuant to applicable regulations. Any moving violation of any applicable motor vehicle regulation may result in the termination of the contractor employee’s installation driving privileges.

1.4.4.2 The contractor’s employees shall become familiar with and obey the regulations of the installation; including fire, traffic, safety and security regulations while on the installation. Contractor employees should only enter restricted areas when required to do so and only upon prior approval. All contractor employees shall carry proper identification with them at all times. The contractor shall ensure compliance with all regulations and orders of the installation which may affect performance.

1.4.5 Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the Contracting Officer’s Representative (COR). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of

Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.5.1 COMSEC/IT Security. All communications with DOD organizations are subject to communications security (COMSEC) review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DOD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DOD organizations. Therefore, the contractor is advised that, any time the contractor places or receives a call, he/she is subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DOD information.

The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

1.4.5.2 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the AEI. Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall: Not Applicable. Contractor does not require access to government networks.

a. Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.

b. Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil).

c. Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.

d. Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.

e. Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.

1.4.5.3 Protection of Personally Identifiable Information (PII). The contractor shall protect all Personally Identifiable Information (PII) encountered in the performance of services in accordance with DFARS 224.103 and DoDD 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

1.4.5.4. CAC Requirements: The Common Access Card (CAC) is the Department of Defense (DOD) Federal Personal Identity Verification (PIV) credential. In accordance with Directive Type Memorandum (DTM) 08-003, December 1, 2008, incorporating Change 5, October 8, 2013, Initial issuance of a CAC requires at a minimum, the completion of FBI fingerprint check with favorable results reflecting "No Record" and submission of a National Agency Check with Inquiries (NACI) to the Office of Personnel Management (OPM), or a DoD-determined equivalent investigation. The issuance of a CAC will be based on four criteria; (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-1, Personal Identity Verification (PIV) of Federal Employees and Contractors, March 2006, and DOD Regulation 5200.2-R, Department of Defense Personnel Security Program, January 1987, and (d) verification of a claimed identity. CAC eligible personnel must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either an authoritative personnel data feed from the appropriate Service or Agency or Trusted Associate Sponsorship System (TASS). CAC cards are not required for contractor employees.

1.4.5.4.i. HSPD-12 Background Investigation Requirements: The contractor ensure Common Access Cards (CACs) are obtained by all contract or subcontract personnel assigned to work on the Government site and by personnel requiring access to a DoD network (and other eligible populations as specified in DTM-08-003 Attachment 3, paragraph 3a.) are required to, at a minimum, have received a favorable FBI fingerprint check and must have submitted to the Office of Personnel Management (OPM) a National Agency Check with Inquiries (NACI) or equivalent/higher investigation. It is the responsibility of the contractor to ensure that all employees requiring an initial background investigation complete a Personnel Security Investigation Portal (PSIP) form at attachment (TBD), at the earliest possible date and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward to the NGB Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm that the request has been received by the Office of Personnel Management, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e-QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the BI will be initiated.

The contractor shall ensure all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system are complied with immediately. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from 2-6 weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that contractor employees meet

CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.

1.4.5.4.ii. Trusted Associate Sponsorship System (TASS): The contractor is responsible for processing applications for Common Access Cards (CAC) for every contractor employee who deploys with the military force OR who has need to access any government computer network in accordance with FAR 52.204-9, "Personal Identity Verification of Contractor Personnel."

The contractor is responsible for managing requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The norm is at least ten calendar days advance notice to the Trusted Agent (TA), unless there are extenuating circumstances approved by the Contracting Officer's Representative (COR) or Contracting Officer.

The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a government computer network. This can be done by going to: http://www.us.army.mil and register as an "Army Guest," with the sponsor being the COR or a COR designated individual if the COR is ineligible to Serve as an AKO Sponsor. Note: If an employee of a contractor loses the Privilege to access AKO, they lose the ability to renew their CAC. Therefore it is critical that contractor employees maintain their AKO accounts.

It is recommend that a "Corporate Facility Security Officer" (FSO) be designated to serve as your firm's single point of contact for Background Investigation (BI), the TASS application process and other CAC and security related matters. If a FSO is not established, each contractor employee requiring a CAC will be required to process their own applications.

CAC applications shall be processed through the TASS. The contractor's FSO Or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA) before accessing the TASS website. The TASS TA for this requirement will be:

The government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and Password, via email, to the FSO.

The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at:

https://www.dmdc.osd.mil/tass/.

The FSO or contractor employee will submit completed applications in TASS and will follow up to ensure that the TA is processing the request.

A CAC cannot be issued without evidence that the FSO has initiated a National Agency Check with Written Inquires (NACI).

The government will inform the contractor's applicant, via email, of one of the following:

a. Approved.* Upon approval, the information is transferred to the Defense Enrollment Eligibility Reporting System (DEERS) database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a Real-Time Automated Personnel Identification System (RAPIDS) station (RAPIDS Site Locator: http://www.dmdc.osd.mil/rsl/).

b. Rejected.* The Government, in separate correspondence, will provide reason(s) for rejection.

c. Returned. Additional information or correction to the application required by the contractor employee.

*The contractor shall maintain records of all approved and rejected applications.

At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor by SSN and two forms of identification. Identity source Documents must come from the list of acceptable documents included in Form I-9, OMB No. 115-0136, "Employment Eligibility Verification." Consistent with applicable law, at least one document from the Form I-9 list shall be a valid (unexpired) State or Federal Government-issued picture identification (ID). The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS and will then issue a CAC.

Issued CACs shall be for a period of performance not longer than three (3) years or the individual's contract end date (inclusive of any options), whichever is earlier.

The contractor shall return issued CAC's to the DEERS office upon departure or dismissal of each contractor employee. Obtain a receipt for each card and provide to the TA/COR.

1.4.5.5 AT Level 1 Awareness Training (AT): All contractor employees requiring access to Army Installations, facilities, and controlled access areas shall complete Level 1 AT within 30 calendar days after contract start date and within 30 calendar days of new employees commencing performance. The contractor shall submit certificates of completion for each affected contractor and subcontractor employee, to the COR, or to the KO if a COR is not assigned, within 15 calendar days after completion of training.

Level 1 AT is available at https://atlevel1.dtic.mil/at/.

1.4.5.6 Information Assurance (IA)/Information Technology (IT) Training: All contractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M , DFARS 252.239.7001 and AR 25-2, contractor employees performing services supporting IA/IT functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award. Not applicable. No contractor employees require network access.

1.4.5.7 Information Awareness: All contractor employees with access to a government information system shall be registered in the ATCTS (Army Training Certification Tracking System) (https://atc.us.army.mil/iastar/index.php) prior to commencement of services, and shall successfully complete the DOD Information Assurance awareness training prior to access to the IS and then annually thereafter.

(https://ia.signal.army.mil/DoDIAA/). Not applicable. No contractor employees require access to a government information system.

1.4.5.8 iWATCH Training. The contractor with an area of performance within an Army-controlled installation, facilities or area shall brief all employees on the local iWATCH program. This local developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR or the KO. This training shall be completed within 30 calendar days of contract award and within 30 calendar days of new employees commencing performance. The contractor shall report completion for each affected contractor employee and subcontractor employee, to the COR, or to the KO if a COR is not assigned, within 15 calendar days after completion of training.

1.4.5.9 OPSEC Training. In accordance with AR 530-1, Operations Security, new contractor employees shall complete Level I OPSEC training within 30 calendar days of their reporting for duty and annually thereafter. The contractor shall submit certificates of completion for each affected contractor employee, to the COR, or to the KO if a COR is not assigned, within 15 calendar days after completion of training. Level 1 OPSEC training is available at http://cdsetrain.dtic.mil/opsec/.

1.4.5.10 OPSEC SOP/Plan. The contractor shall develop an OPSEC Standing Operating Procedure (SOP)/Plan and provide it to the COR or the Contracting Officer within 90 calendar days of contract award, to be reviewed and approved by the responsible Government OPSEC officer, per AR 530-1, Operations Security. This SOP/Plan shall include the government's critical information, why it needs to be protected, where it is located, who is responsible for it, and how to protect it. In addition, the contractor shall identify an individual who will be an OPSEC Coordinator. The contractor shall ensure this individual becomes OPSEC Level II certified in accordance with AR 530-1.

1.4.5.11 Classified Information. For Contracts That Require Handling or Access to Classified Information. The contractor shall comply with FAR Clause 52.204-2, Security Requirements. This clause involves access to information classified “Confidential,” “Secret,” or “Top Secret” and requires contractors to comply with The Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (DoD 5220.22-M) and applicable updates/changes. Not applicable. The contract does not require handling of or access to classified information.

1.4.6 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

1.4.6.1 Key Control. The contractor shall establish and implement methods of ensuring all keys/key cards issued by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE: All references to keys include key cards. No keys issued by the Government shall be duplicated. The contractor shall include procedures covering key control in the QC Plan. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The contractor shall immediately report any occurrences of lost or duplicated keys/key cards to the Contracting Officer’s Representative (COR). Not applicable. No keys or key cards will be issued to contractor.

1.4.6.1.1 In the event keys, other than master keys, are lost or duplicated the contractor shall, upon direction by the KO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the contractor.

1.4.6.1.2 The contactor shall prohibit the use of the Government issued keys/key cards by any persons other than the contractor’s employees. The contractor shall prohibit the opening of locked areas by contractor employees to permit entrance of persons other than contactor employees engaged in the performance of services in those areas, or personnel authorized entrance by the KO.

1.4.6.2 Lock Combinations: The contractor shall establish and implement methods of ensuring all lock combinations are not revealed to unauthorized persons. The contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the contractor’s QC Plan. Not applicable. No lock combinations will be in use by contractor.

1.4.7 Special Qualifications:

All personnel must be trained on DoD 6055.05 M and any OSHA Standards that relate to respective hazard exposures. Those performing spirometry testing must have NIOSH-Approved spirometry training. Those performing audiograms must be certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC) or the equivalent military Defense Occupational and Environmental Health Readiness System- Hearing Conservation (DOEHRS-HC) training in accordance with 29 CFR 1910.95.

1.4.8 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with Federal Acquisition Regulations Subpart 42.5. The KO, Contracting Officer’s Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the Contacting Officer will apprise the contractor of how the Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced The contractor shall resolve outstanding issues raised by the Government.

Contractor attendance at these meetings shall be at no additional cost to the Government. Periodic progress meetings are to be scheduled on a biannual basis.

1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO.

The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR, (or the KO if a COR is not assigned), to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings, answering Government telephones and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities/ Contractor personnel shall wear identification badges distinguishing themselves as such. The badges shall have the company name, employee name and the word “contractor” displayed. The contractor shall retrieve all identification media (including vehicle passes) from their employees who depart employment for any reason. All identification media (i.e., badges and vehicles passes) shall be returned to the KO within 14 days of an employee’s departure.

1.4.11. Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. Such actions may include, but are not limited to, removal from the contract, reduction in benefits, or termination of employment. The Contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at FAR 22.17.

1.4.12 Contractor Travel – Not applicable. Contractor travel is not required.

If contractor travel is required, a separate Not To Exceed (NTE) Contract Line Item Number (CLIN) will be added to the contract to pay for travel expenses.) The contractor shall travel to (specify locations) during the performance of this contract to (insert purpose of travel, i.e., “attend meetings, etc”).

If contractor travel is required, the following is mandatory language in the PWS: The contractor shall be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires COR recommendation for approval and authorization by the KO prior to travel arrangements being made.

If the services being provided are training, will the contractor have to travel to locations other than the primary site to perform? If so add, The contractor may be required to travel to off-site training locations and to ship training aids to these locations in the performance of this contract. The cost of shipping training aids shall be borne by (insert either the contractor or the Government. If it’s the Government, insert: The contractor will be reimbursed for the costs of shipping training aids in accordance with the JTR and limitation of funds in this contract.

1.4.13 Data Rights The Government has unlimited rights to all documents/material produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.4.14 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO and in the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may affect other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.4.15 Phase In / Phase Out Periods: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the contractor shall have personnel on board, during the phase in/ phase out periods. During the phase in period, the contractor shall become familiar with performance requirements in order to commence full performance of services on the contract start date. Not Applicable.

1.4.16 Telework: The Government may permit telework by contractor employees when determined to be in the best interest of the Government in meeting work requirements.

The contractor shall have an established telework program subject to review by the Government. All telework agreements shall be authorized and approved by the COR and include the date, time, and description of the tasks to be performed. In furtherance of Continuity of Operations Planning (COOP), a telework program may be enacted to ensure the Government's mission-critical operations stay operational during times of National Emergency or incidents of National Significance. The COR(s) must identify to the Contracting Officer any tasks that are required to ensure continuity of critical supplies and services and at what level those supplies and services must be delivered.

Telework shall be at no additional cost to the Government. Telework is not applicable.

2.0 Definitions and Acronyms:

2.1.1 CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2 CONTRACTING OFFICER (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment shall be in writing and shall state the scope of authority and limitations.

This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.5 DELIVERABLE. Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.6 KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.7 PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.8 QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.9 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10 QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.11 SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.12 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.13 WORK WEEK. Monday through Friday, unless specified otherwise.

2.2 ACRONYMS: (List all acronyms used in the PWS and what they represent. At a minimum, insert the acronyms provided below.)

AFARS Army Federal Acquisition Regulation Supplement ALT alanine aminotransferase AP alkaline phosphatase AR Army Regulation ARNG Army National Guard AST aspartate transferases AT/OPSEC Antiterrorism/Operational Security BUN blood urea nitrogen CBC complete blood count CdB blood cadmium CdU urine cadmium CFR Code of Federal Regulations CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf CSMS Combined Surface Maintenance Shop DA Department of the Army DA PAM Department of the Army Pamphlet dB decibel dBA A-Weighted decibel DD250 Department of Defense Form 250 (Receiving Report) DD254 Department of Defense Contract Security Requirement List DFARS Defense Federal Acquisition Regulation Supplement DOD Department of Defense DoDI DoD Instruction DOEHRS-HC Defense Occupational and Environmental Health Readiness System- Hearing Conservation FAR Federal Acquisition Regulation FEF forced expiratory flow FEV-1 forced expiratory volume in the first second FMS Field Maintenance Shop FTIG Fort Indiantown Gap FVC forced vital capacity g/dL grams/deciliter GFP/M/E/S Government Furnished Property/Material/Equipment/Services GGT glutathione transferases H & H hemoglobin and hematocrit HCP Hearing Conservation Program

HDL high density lipoprotein HIPAA Health Insurance Portability and Accountability Act Hz hertz IA Information Assurance IS Information System(s) KO Contracting Officer NFPA National Fire Protection Association NGB National Guard Bureau OCI Organizational Conflict of Interest ODC Other Direct Costs OSHA Occupational Safety and Health Administration PFT Pulmonary Function Testing PII Personally Identifiable Information PIPO Phase In/Phase Out POC Point of Contact PPD Tuberculosis/Tuberculin Skin Test PPE Personal Protective Equipment PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program STS Significant Threshold Shift TE Technical Exhibit TWA Time-Weighted Average ZPP Zinc Protoporphyrin

(If the Government is to provide any property, material, equipment or services to the contractor, this section is used to describe what will be provided. If the list or lists are fairly extensive, they should be made into technical exhibits or attachments. Complete as appropriate. If no GFP/M/E/S will be provided; delete the subparagraphs below and state NONE. NOTE: If your contract will support the States and a contractor is required on site at a Purchasing and Contracting (P&C) Office, the USPFO will not issue GFP/E/M unless it is specified here.)

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S):

The Government will provide the property, material, equipment, and/or services listed below solely for the purpose of performance under this contract:

3.1 Property: When the Technician Occupational Medical Surveillance examinations are performed at Fort Indiantown Gap, the Government will furnish the medical clinic in Building 4-114, 4-80, or 4-78 for the contractor to perform services outlined in this PWS to include desk space, and other items necessary to maintain an office environment.

When the Technician Occupational Medical Surveillance examinations are performed at the Combined Surface Maintenance Shop – West (CSMS-W) located in Coraopolis, PA, the government will provide parking lot space.

3.2 Materials: Any materials associated with performance of the audiograms at FTIG.

3.3 Equipment: When the Technician Occupational Medical Surveillance examinations are performed at Fort Indiantown Gap, audiometric equipment located in Building 4-114, 4-80, or 4-78 will be used by the Federal Technicians from the State Safety Office who are certified Army Hearing Technicians. Contractors shall not operate the audiological equipment at FTIG.

3.4 Services: When the Technician Occupational Medical Surveillance examinations are performed at Fort Indiantown Gap, annual audiograms will be performed by the Federal Technicians from the State Safety Office who are certified Army Hearing Technicians.

3.5 Utilities: All utilities in the facility will be available for the contactor’s use in the performance of this contract. The contractor shall instruct employees in utilities conservation practices. The contractor shall operate under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount.

(In this section, describe property, material or equipment that the contractor shall provide, if different than those indicated in Paragraph 1.1 above. Complete as appropriate.)

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

4.1.1 The contractor shall provide all management, labor, material, equipment, certifications and supplies necessary to provide all listed services. When the Technician Occupational Medical Surveillance examinations are performed at the Combined Surface Maintenance Shop – West (CSMS-W) located in Coraopolis, PA, the contractor shall provide a mobile, HIPAA, Privacy Act, OSHA & ADA compliant, stand-alone environment.

4.1.2 The contractor shall provide all Medical Equipment necessary to perform Technician Occupational Medical Surveillance examinations either at the Fort Indiantown Gap medical clinic(s) or the Combined Surface Maintenance Shop – West (CSMS-W) located in Coraopolis, PA.

4.1.3. The contractor shall provide Mobile units equipped with a self-contained power source. The Government shall not provide power to the contractor’s mobile unit unless other accommodations have been coordinated in writing.

4.1.4 Medical Surveillance screening that is accomplished via mobile unit shall be designed to ensure complete individual privacy. Features of the unit shall include, but are not limited to, a climate-controlled atmosphere, patient waiting / holding area for registration, changing room, on board restroom, testing / phlebotomy station, individual audiometric testing booth, and physical examination area.

4.2 Secret Facility Clearance: The contractor shall possess or be eligible to receive and maintain a SECRET facility clearance from the Defense Security Services. The contractor’s employees performing work in support of this contract shall have been granted a SECRET security clearance from the Defense Industry Security Clearance Office. Not Applicable. The contractor is not required to have SECRET Security Clearance.

5.0 Requirements:

5.1 The contractor must be a business entity of the sort that can legally exercise ownership and/or control of persons/employees that are licensed/registered to practice medicine and/or conduct physical examinations in the Commonwealth of Pennsylvania.

5.1.2 The government may schedule services 14 days prior to the date on which the services are to be provided. Scheduling notice will include the time, location, and date, and a description of details regarding required services. The Occupational Health Nurse and the Contractor will coordinate to schedule the medical surveillance examinations.

No testing shall be performed between 12:00 – 12:30.

5.1.3 This contract is for “Non Personal” Health Care “Services”, as defined in 37.101.

In accordance with FAR Part 37.4 the Government may enter into a non-personal health care services contract with physicians, dentists and other health care providers under authority of 10 U.S.C. 2304 and 41 U.S.C. 253. The Government shall evaluate the quality of professional and administrative services provided, while the Government retains no control over the medical, professional aspects of services rendered. The Contractor shall indemnify the Government for any liability producing act or omission by the Contractor, its employees and agents occurring during contract performance. The Contractor is required to ensure that its subcontractors, if any, for provisions of health care services, contain the requirements of the clause at 52.237-7, Indemnification and Medical Liability Insurance, including the maintenance of medical liability insurance.

5.1.4 The Contractor shall provide all labor, materials, and equipment necessary for performance of individual examinations. In the event of the Contractor’s equipment failure, specific testing and/or parts of examinations that are not completed during the testing period shall be completed at a scheduled time mutually convenient for the Contractor and the COR. Unfinished testing/examinations will be completed at no cost to the Government. The Contractor shall be directly responsible to cover costs for completing these examinations.

5.1.5 Test Panels. The test panel required for a particular individual shall be determined by the individual’s Job Code Series, and will be indicated by the PAARNG OHN at the time the examination is scheduled. Panels one through nine are further defined in Exhibit “1.”

5.1.6 Contractor shall ensure all procedures are conducted in accordance with applicable American Board of Occupational and Environmental Medicine (ABOEM), American Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) Standards.

5.1.7 Contractor shall ensure all clinical laboratory services are performed by a laboratory licensed through the U.S. Department of Health and Human Services (DHHS), Health Care Financing Administration pursuant to the terms of the Clinical Laboratories Improvement Act of 1967 (42 U.S.C. 263a) and the College of American Pathologies.

5.1.8 Contractor shall provide a Board eligible or Certified Occupational Medicine Physician to conduct job-related medical surveillance physical examinations and occupational health consultation services. Mid-Level providers performing exams must be under the supervision of a Board eligible or Certified Occupational Medicine Physician. All personnel must be trained on DOD 6055.05M and any OSHA Standards relating to the specific hazard exposures. The medical provider is responsible to notify the technician both verbally and in writing when an abnormality in the examination or laboratory results are identified. In the case of an abnormality related to the job hazard exposure, the medical provider shall notify the Occupational Health Nurse both verbally and in writing. Any non-work related abnormality shall include written recommendation for follow-up care.

5.1.9 Contractor shall contact the Occupational Health Nurse directly to resolve issues that might arise before, during, and after the testing period. Should the Occupational Health Nurse not be available all issues shall be directed to the Safety and Occupational Health Manager.

5.1.10 Contractor shall provide a comprehensive review and evaluation of all examinations, which includes a copy of technician’s examination findings, within 10-days following the conclusion of testing. The Contracting Officer’s Representative will contact and schedule a follow-up review and evaluation meeting to discuss positive and negative aspects of testing.

5.1.11 Contractor shall provide vital signs to include measured height, weight, blood pressure, pulse and respirations.

5.1.12 Contractors shall provide a Job Functional Analysis or Kraus-Weber that includes back strength and flexibility. Note any pain or recommended lifting limitations if less than 50 pounds.

5.1.13 Contractor shall ensure audiogram must be performed by technicians who are certified by the Council for Accreditation in Occupational Hearing Conservation (CAOHC) or the equivalent military Defense Occupational and Environmental Health Readiness System-Hearing Conservation (DOEHRS-HC) training in accordance with 29 CFR 1910.95. Audiograms are to be performed when the Technician Occupational Medical Surveillance examinations are performed at the Combined Surface Maintenance Shop – West (CSMS-W) located in Coraopolis, PA The estimated number of personnel to receive audiograms are 75 – 95 technicians.

5.1.13.1 Hearing screenings will be conducted only on employees exposed to occupational noise > 85 dBA or 140 dBA impact noise.

5.1.13.2 Otoscopic Exam.

5.1.13.3 Test Only 500, 1000, 2000, 3000, 4000 and 6000.

5.1.13.4 Hearing aids must be removed.

5.1.13.5 Employee must be noise free for at least 14 hours prior to screening.

5.1.13.6 All hearing screenings besides the baseline will be compared against the employee’s baseline to determine if there is a Significant Threshold Shift (STS) and scheduled for retesting within 30 days.

5.1.13.7Contractor shall provide Audiologist for services based on the DOERHRS-HC specific referral criteria and after DOEHRS-HC follow-up testing has been completed, to validate the existence of a permanent noise-induced threshold shift, determine the cause and type of the hearing loss and/or to determine if further medical referral is required.

5.1.14 Contractor shall ensure Pulmonary Function Tests (PFTs) Performed by a licensed physician, Certified Pulmonary Function Technologist, or Registered Respiratory Therapist in accordance with 29 CFR 1910.1001. The estimated number of personnel to receive PFTs are 50 -60 as identified and requested by COR or authorized caller.

5.1.14.1 Screenings will only be conducted on employees exposed to respiratory hazards that will require a respirator to mitigate their hazards that are above the action level.

5.1.14.2 Test will include as a minimum Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), comparison with recognized normal’s for the individual's height and weight, sex, race, age and a documented interpretation by a pulmonologist or certified Occupational Health physician.

5.1.14.3 Test results are reproducible in that they have the same result from the individual (two largest FVCs are within 0.150 L of each other and two largest FEV1's are within 0.150 L of each other) when the test is repeated several times. Testing is continued until criteria are met or 8 trials are attempted, or the employee being tested cannot or should not continue.

5.1.14.4. Follow NIOSH and ATS-ERS standard requirements:

5.1.14.4.1 Continue testing individual when the patient is improving until improvement is <30ml.

5.1.14.4.2 Test results are acceptable with a minimum of three acceptable maneuvers that are free from a leak, obstructed mouthpiece, hesitation, false starts, cough, glottis closure, early termination, and have a good curve of at least 6 seconds duration.

5.1.14.4.3 Test results are reproducible in that they have the same result from the individual (two largest FVCs are within 0.150 L of each other and two largest FEV1's are within 0.150 L of each other) when the test is repeated several times. Testing is continued until criteria are met or 8 trials are attempted, or the employee being tested cannot or should not continue.

5.1.14.4.4 If three (3) acceptable and two (2) repeatable tests cannot be obtained, the technician performing the PFT must document the reason the standard could not be met.

5.1.14.4.5 Always use measured height not reported height by the nearest half inch without footwear.

5.1.14.4.6 Always indicate source of reference value on reports for adjusted predicted value.

5.1.14.4.7 No smoking within 1 hour prior.

5.1.14.4.8 No cold, flu or allergies within two weeks.

5.1.14.4.9. No inhaler use prior to test that would still be in the patient’s system

5.1.15 Contractor…