Statement_of_Work_Hearing_Booth_final.pdf

Hearing Booth SOW 2018

13 MARCH 2018

Revision 5

Statement of Work

Hearing Booth Relocation and Equipment Modernization

At the Arizona Army National Guard Medical Detachment

Physical Exam Section

Prepared by:

Arizona Army National Guard State Surgeon Office

POC: MAJ Kevin O’Nan

Table of Contents

1.0 SCOPE

1.1 Background ….........................................................................................………………….3

1.1.1 Calibration………………………………………………………………………………………………4

1.1.2 Period of Performance Calibration…………………………………………………………4

1.1.3 Place and Performance of the Calibration Services…………………………………4

1.1.4 Unscheduled Gate Closure……………………………………………………………………….4

1.1.5 Security Requirements……………………………………………………………………………..4

1.1.5.1 COMSEC/IT Security………………………………………………………………….5

1.1.5.2 Protection of Personally Identifiable Information (PII)……………..5

2.0 APPLICABLE DOCUMENTS

2.1 Department of Defense Standards

2.2 Other Government Documents, Drawings, Handbooks, and Publications ……………….6

3.0 REQUIREMENTS

3.1 Overview

3.2 Calibration ………………

3.2.1 Hearing equipment Maintenance………………………………………………………………7

3.3 Installation………………………………………………………………………………………………………………….7

3.4 Issue Resolution………………………………………………………………………………………………………….8

3.5 Financial Management

3.6 Safety Assessment and Health Hazard Analysis

3.7 Onsite Test……

3.8 Unique Identification (UID) of Tangible Items…………………………………………………………

3.9 Technical Publications

4.0 Deliverables……………………………………………………………………………………………………..………….9

Statement of Work

Hearing Booth Relocation and Modernization At the Arizona Army National Guard Medical Detachment

Physical Examination Section

1.0 SCOPE

This Statement of Work (SOW) reflects an effort to move and set up to standards three (3) EA existing 6 person hearing booths as follows: one (1) EA hearing booth from Camp Navajo Military Reservation building K2068 (Bellmont, Arizona,86015) to the AZ ARNG Wellness Center PPMR building 5650 (Phoenix, Arizona, 85008), and two (2) EA hearing booths from the Arizona Army National Guard (AZ- ARNG) AZ-ARNG Medical Detachment (MEDDET) Physical Examination Section located in building M5502 PPMR (Phoenix, Arizona,85008) to the AZ ARNG Wellness Center building 5650 PPMR (Phoenix, Arizona, 85008). The hearing conservation booths while structurally intact require lifecycle modernization of the acoustic components and simulators In order to meet the mission requirements the contractor will need to buy and install the following: one (1) EA. Benson Medical CCA-200mini Plus System Audiometer, booth mount, USB key, five (5) EA Benson Medical CCA-200mini Expansion Audiometer, booth mount 301 and six (6) EA. Benson Medical BAS-200 Bio-Acoustic Simulators and proceed with the move as per above. This move and restoration will expand the total number of hearing conservation stations from twelve (12) to eighteen (18) in order to meet expanded physical examination requirements of the AZ-ARNG. Furthermore the contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, to perform annual calibration and equipment repair as defined below.

1.1 Background

Department of Defense (DoDI) DoDi 6025-19 (9 JUN 2014), DoDI 6055.12 (5 MAR 2004), Department of the Army Phamphlet (DA PAM) DA PAM 40-501 and Army Regulation (AR) AR 40-501 requires the performance of annual periodic health assessment which include annual audiology exams. The AZ ARNG Hearing Conservation program provides Hearing Readiness Classification (HRC) examinations for over 5,320 AZ-ARNG Service Members annually. Hearing Readiness Classification examinations are part of the Army Individual Medical Readiness (IMR). Lacking a HRC examination can restrict the Service Members ability to deploy World-wide and can result in administrative and punitive actions that restrict the Service Members career advancement and possibly lead to separation.

Defense Occupational and Environmental Health Readiness System Hearing Conservation (DOEHRS-HC) information system and Benson Medical Instrument testing sets are the only authorized DoD audiometry hardware and software combination used to perform audiology exams in accordance with the above referenced regulations.

DOEHRS-HC is an information system designed to support personal auditory readiness and help prevent hearing loss through early detection. It collects, maintains, compares and reports hearing conservation, hearing readiness and deployment data for Department of Defense personnel.

The DOEHRS-HC client application uses Benson Medical Instruments (BMI) Audiometers to perform hearing tests and the DOEHRS-HC client application communicates with the audiometer using commercial off-the-shelf (COTS) software, which is a key component used in the functionality of

DOEHRSHC.

AZ-ARNG MEDDET has expanded its hearing examination capabilities within the new AZ ARNG Wellness Center in order to achieve the DA stated IMR goal, improve throughput during high OPTEMPO missions and assist Service Members to fulfill the Army statutory requirements.

Currently, the AZ-ARNG MEDDET Physical Examination Section has 2 fixed hearing booths located in BLDG M5502 - PPMR (Phoenix, Arizona, 85008). An additional hearing booth is located on Camp Navajo Military Reservation building K2068 - (Bellmont, Arizona, 86015). Annual physical examinations were at one time performed on Camp Navajo but are no longer needed in the area of operations.

1.1.1 Calibration

Army Regulation 40-501 states that audiometers are to be calibrated to standards of the International Standards Organization (ISO 8253:1 1989) or the American National Standards Institute (ANSI 1996).

They will be used to test the hearing of all Soldiers, and that all Soldiers are required to complete an annual hearing test. In addition to this the Defense Occupational Environmental Hearing Readiness Application-Hearing Conservation (DOEHRS-HC) audiometer is the only authorized audiometer for conducting and recording DD Form 2215 (Reference Audiogram) and DD Form 2216 (Hearing Conservation Data).

1.1.2 Period of Performance Calibration

The calibration part of this contract will be done annually (No earlier than 30 days from the initial calibration), for one base year plus four additional option years.

1.1.3 Place and Performance of the Calibration Services

Performance shall be conducted at AZ ARNG Wellness Center building 5650 PPMR (East McDowell Road, Phoenix, Arizona, 85008), where the hearing booths will be located.

1.1.4 Unscheduled Gate Closure

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.

1.1.5 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.

1.1.5.1 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 contractor place or receive a call they are 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.

1.1.5.2 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 who’s PII has been compromised.

2.0 APPLICABLE DOCUMENTS

The following documents of issue, shown on the document summary list, form a part of this SOW to the extent specified herein. In the event of a conflict between documents referenced herein (section 2) and the contents of this SOW (section 3), the contents of the SOW shall be the governing requirement.

2.1 Department of Defense Standards

Number Title Link

MIL-STD-130N Identification Markings of U.S.

Military Property https://assist.dla.mil

STANREC-4756 ED.1 Reference Documents on Life-cycle Costs https://assist.dla.mil

DI-TMSS-80527C

Commercial Off-The-Shelf (COTS) Manuals and Associated Supplemental Data https://assist.dla.mil

SAE-AS1390 Level of Repair Analysis (LORA) https://assist.dla.mil https://assist.dla.mil/

2.2 Other Government Documents, Drawings, Handbooks, and Publications

Number Title Link

AR 40-501 Standards of Medical Fitness www.apd.army.mil/pdffiles/r40_501.pdf

AR 750-1 Army Materiel Maintenance Policy 12 SEP 2013 www.apd.army.mil/pdffiles/r750_1.pdf

DA PAM 40-501 Army Hearing Program http://www.apd.army.mil/epubs/DR_pubs/D R_a/pdf/web/p40_501.pdf

HA Policy Letter 96-

Assistant Secretary of Defense, Memorandum 09 JAN 2006 https://health.mil/Policies?daterange=1995- 1999&page=11#pagingAnchor

TB MED No. 750-2 Operating Guide for MTOE Medical Equipment Maintenance www.apd.army.mil/epubs

TB MED No. 7 Maintenance Expenditure Limits for Medical Materiel June 1992 www.apd.army.mil/epubs

DA PAM 385-30 Risk Management 02 DEC 2014 www.apd.army.mil/pdffiles/p385_30.pdf

NGR 385-10

Army National Guard Safety Program 12 SEP 2008 www.ngbpdc.ngb.army.mil/pubs/385/ngr385 _24.pdf

3.0 REQUIREMENTS

3.1 Overview

The AZ-ARNG MEDDET Physical exam section requires a contractor/ Vensor to move and set up to industry and DOD standards (3) EA existing 6 person hearing booths as follows: (1) EA hearing booth from Camp Navajo Military Reservation building K2068 (Bellmont, Arizona,86015) to the AZ ARNG Wellness Center PPMR building 5650 (Phoenix, Arizona, 85008), and (2) EA hearing booths from the AZ- ARNG MEDDET Physical Examination Section located in building M5502 PPMR (Phoenix, Arizona,85008) to the AZ ARNG Wellness Center building 5650 PPMR (Phoenix, Arizona, 85008). The hearing conservation booths while structurally intact require lifecycle modernization of the acoustic components and simulators. Therefore in order to meet the mission requirements the contractor will need to buy and install the following: (1) EA. Benson Medical CCA-200mini Plus System Audiometer, booth mount, USB key, (5) EA Benson Medical CCA-200mini Expansion Audiometer, booth mount 301 and (6) EA.

Benson Medical BAS-200 Bio-Acoustic Simulators and proceed with the move as described above. This move and restoration will expand the total number of hearing conservation stations from twelve to eighteen in order to meet expanded physical examination requirements of the AZ-ARNG.

The hearing booth currently positioned at Camp Navajo requires acoustic equipment modernization in order to function appropriate and pass OSHA 29 CFR 1910.95 compliance standards. The following equipment is required: (1) Benson Medical CCA-200mini Plus System Audiometer, booth mount, USB key, (5) Benson Medical CCA-200mini Expansion Audiometer, booth mount and (6) Benson Medical BAS- 200 Bio-Acoustic Simulators. Appropriate dosimetry testing and calibration is required following installation. Furthermore the contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, to perform annual calibration and equipment repair as defined below.

3.2 Calibration (Deliverable 3)

Complete 100% calibration of all audiometers and extensions annually.

3.2.1 Hearing equipment Maintenance

Maintain the audiometers, headsets, switches and equipment in good working order and perform any needed maintenance and replacement parts. The Benson headset band, ear cushion (red and blue set), earphone cord, hex key, hand switch, pegs for resting the switch and headset, stools and audiometer are items that may need replacing over time with wear and tear.

3.3 Installation

Upon award, the installation schedule shall be developed in conjunction with the AZ-ARNG MEDDET Facilities Management team and the DSS or DSS Representative. The potential contractors shall submit a bar chart with their quote showing in days/ weeks of time of award, order processing, manufacturing time (optional), and shipping time, delivery time and punch list time (DELIVERABLE 1). The Contractor shall coordinate all deliveries and installation times with AZ-ARNG MEDDET Facilities Management team. The contractor shall furnish all labor, supervision, materials, equipment, and related services necessary to perform the work required under this SOW in an orderly and efficient manner, to the complete satisfaction of the Government. The space will be clear of all furniture at the time of installation. Other building tradesman may be in the area, but should not interfere with the installation of the equipment. There may not be space available to allow for staging or storage on the site for the equipment, in which case, delivery coordination and staging must be closely monitored. If space is available, product can be staged and stored on site.

For delays during any phase of installation, which are not due to the fault of the Government, the customer will assess the Contractor for actual damages. The most current installation schedule signed by the contractor and customer will provide the basis for determining delays. Completion of the equipment installation shall require the following minimal tasks:

1. Provide on-site management, coordination and technical assistance by a project manager working with the AZ-ARNG MEDDET Facilities Management team representative throughout the installation phase.

2. Meet all incoming delivery vehicles at the building entrance, unload deliveries, check for damages, and move equipment to the desired areas.

3. Contractor shall provide two copies of each of the following:

a. Product Warranties

b. Installation Instructions

c. Calibration that provides a comprehensive electro-acoustical calibration to ensure it is functioning properly and in accordance with the American National Standards Institute (ANSI) Standard S3.6.

4. The Contractor shall arrange delivery to the client agency location in accordance with the Installation Schedule.

6. The contractor shall clean up and dispose of waste materials or rubbish in accordance with this paragraph and all applicable federal, state & local regulations, standards, codes & laws. The contractor shall make any necessary arrangements with private parties for removal of any material s and rubbish once the installation and testing is complete. This material shall be removed on a daily basis to eliminate the accumulation of debris. Prior to completion of the work, the contractor shall remove from the vicinity of the work all shipping containers, packing, rubbish, unused materials, and other like material, belonging to the contractor or used under the contractor’s discretion. Under no circumstance will eating and drinking be allowed on the installation site. A break area will be provided adjacent to the work sites.

7. At least two weeks prior to the beginning of delivery and installation, the contractor’s representative, supervisor, and members of the installation crew shall provide the following information to the AZ- ARNG Facilities Management team.

a. Company Name, Address, Telephone Number

b. Supervisor’s Name

c. Name of each individual installer

8. The Contractor shall be responsible for confining his crew and work to the designated project areas.

Contractor shall also be responsible for ensuring that the installation personnel are identifiable.

9. Building Utilities: The contractor's work shall not interrupt building utility services without the prior written approval of the AZ-ARNG MEDDET Facilities Management team.

Installation supervision shall be handled by an experienced on-site supervisor trained by the manufacturer:

1. Code Compliance: All products and installation shall comply with all state, local, and federal building codes, local ordinances, and regulations. The responsibility for determining and assuring compliance is that of the successful contractor.

2. Installation Hours: Conducted installation services during regular business hours to the maximum extent possible according to the schedule developed with AZ-ARNG MEDDET Facilities Management team. If required to meet the approved installation schedule, evening and weekend hours may be necessary and determined in advance and with approval from AZ-ARNG MEDDET FM team as based on building requirements and/ or client time requirements. Actual hours of operation: 0730-1600.

3. Verification of Shipments: Parts are to be checked prior to shipping to ensure order is complete and that installation shall not be delayed as a result of missing parts or an incomplete delivery.

4. The Contractor is responsible for any damage to the building and hearing booths which occurs during delivery and installation. It is incumbent upon the successful contractor to identify any existing damage to the building by means of a Pre-Installation and Delivery Walk-Thru. Proper measures (protective runners, pads, etc.) shall be provided and utilized by the contractor to protect the building (walls, floors, etc.). Furthermore the Contractor is responsible for compliance of all products and installation with all applicable state, local and federal building codes, local ordinances and regulations. In addition, if a teaming arrangement is entered into the Prime contractor is responsible to ensure that the same applicable compliances are met by all contractors.

3.4 Issue Resolution:

- Any unexpected conflicts during product installation must be brought to the AZ-ARNG MEDDET FM team for resolution.

-The successful contractor shall correct (at the contractor’s expense) any installation problems, which are the result of insufficient field verification, delivery errors, and damaged product.

-Damaged and/or missing product will be replaced by means that will prevent installation delays.

Damaged product replacements will be at the selected contractor’s expense. All damaged product shall be removed from the job site immediately.

3.5 Financial Management

The contractor shall plan, budget, schedule, and control resources allocated to meet requirements of the contract. This is be awarded as a Firm-Fixed Price Contract.

3.6 Safety Assessment and Health Hazard Analysis

The contractor shall have safety process to identify, evaluate, document and assist in the elimination of, or control hazards throughout the unit’s life cycle. The safety process information shall impose management controls in order to eliminate any hazards or reduce the associated risk of an equipment hazard to a level that is acceptable to the Government. The contractor shall ensure the units are safe for personnel to transport, install, operate, maintain, and support at the time of delivery to the Government entity. The contractor shall identify hazards, assess the risk, track hazards, mitigate hazards, and verify corrective actions have been implemented and the hazards have been eliminated or reduced to acceptable risk levels prior to Government possession of units.

3.7 Onsite Test (Deliverable 2)

After shipping and reassembly of the hearing booths the contractor shall conduct calibration that provides a comprehensive electro-acoustical calibration and dosimetry to ensure the booth and acoustic hardware is functioning properly and in accordance with the American National Standards Institute (ANSI) Standard S3.6. This event shall verify that units meet all requirements specified in this SOW prior to final possession by Government entity.

3.8 Unique Identification (UID) of Tangible Items

If required, the contractor shall provide required unique identification markings including embedded subassemblies, components and parts, and identify the UID to be used for each item associated with the units. The contractor shall provide unique item identification, or a DoD recognized unique identification equivalent, for all identified items delivered. UID marking design for each item shall be both machine readable and human readable in accordance with MIL-STD-130N, paragraph 5.2.

3.9 Technical Publications

All Manuals and Technical Publications shall be provided in English language.

(DI-TMSS-80527) Commercial Off- The-Shelf Manuals & Associated Supplemental Data

4.0 Deliverables

Item SOW Ref

Title Dist. E Initial Subsequent

Deliverable 1 3.5 Installation Timeline

1. FM

2. PM

NTL 7 calendar days after Notification of Award

Deliverable 2 3.8

Onsite Test 1. FM

2. PM

3. Personnel specified in request

NLT 45 Days

As requested by Government

Item SOW Ref

Title Dist. E Initial Subsequent

Deliverable 3 3.2 Calibration Maintenance

1. FM

2. PM

3. Personnel specified in request

Annually - No earlier than 30 Days from the initial calibration

As requested by Government