Amendment_01_Q0032.pdf

0011372338-0001

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to change the Statement of Work (SOW) specif ically paragraph 5.0.

Paragraph 5.0 FROM: The contractor w ill need to install (3) 6 station hearing booths and (1) 1 station diagnostic booth into the room using existing connections or adjusted connections as is necessary.

TO: The contractor w ill need to install (3) single w all 6 station hearing booths and (1) double w all 1 station diagnostic booth into the room using existing connections or adjusted connections as is necessary.

ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 6

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 29-Aug-2019

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W912PQ19Q0032

X 9B. DATED (SEE ITEM 11)

22-Aug-2019

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

29-Aug-2019

CODE

W912PQ - USP&FO-NY

ATTN: MNPF-PC

330 OLD NISKAYUNA ROAD

LATHAM NY 12110-3514

W912PQ 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W912PQ19Q0032

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

The following have been modified:

HEARING BOOTH DESCRIPTION

NY ARMY NATIONAL GUARD

Medical Detachment

POC SSG QUINN, STEVEN

State Medical Readiness NCO

JFHQ-NY, Medical Command

Office of the State Surgeon

1 Buffington St. BLDG 25, Suite 336

Watervliet, N.Y. 12189

COM: 518-272-4016

FAX: 518-270-1523

steven.e.quinn2.mil@mail.mil

Cell: 518-817-0360

STATEMENT OF WORK

(SOW)

Station Hearing Booth Installation

1.0 General. (3) 6 Station Hearing Booth and (1) 1 Station Diagnostic Booth Installation

2.0 Introduction. This is a requirement for installation of hearing booths at Camp Smith Training Site (CSTS), NY

10567.

3.0 Background. Building 503 on CSTS has been used as a readiness preparation building for many years. The building currently has a room with several single station hearing booths, however, due to greater use of the facility it is necessary to increase throughput by adding hearing test capability.

4.0 Objectives. Install three (3) 6 station hearing booth and (1) 1 station diagnostic hearing booth in Bldg 503 at

CSTS in Cortlandt Manor, NY 10567.

5.0 Scope. The contractor will need to install (3) single wall 6 station hearing booths and (1) double wall 1 station diagnostic booth into the room using existing connections or adjusted connections as is necessary. If existing connections prevent installation of the equipment, contractor should indicate that in response to solicitation.

Upon completion of installation contractor is required to return any functional changes of cosmetic damage made during installation to original state.

5.1 Applicable documentation. Reference the following documents regarding this requirement:

a. DA PAM 40-501 Chapter 3-6 Paragraph g.

b. 9 CFR 1910 App D (Table D-1)

5.2 Specifications. The following specifications apply to this requirement:

Metal construction with insulated material in walls. Should include ventilation and sufficient ports and connections to operate

Electrical connections for operation of fan, lights, and instruments should be US standard 120 volt. Electrical outlets existing in the facility for which this will be installed are US 120 volt.

SALIENT FEATURES FOR CAM-LOCK AUDIOLOGY BOOTH: Any audiology booth provided under the contract shall meet the following features. Contractor shall provide product data sheets that show the booths to be provided meet the salient characteristics and Lab test with-in the last 4 years by an Independent Lab:

Wall and Ceiling Construction: Wall and ceiling panels are 100 mm (4") thick fabricated with 14 swg cold rolled steel frames and 16 swg steel outer surfaces, and framing members spaced not more than 610 mm (24") centers. The inner faces are 22 swg cold rolled steel perforated with 2.4 mm (3/32") holes on 4.0 mm (5/32") staggered centers.

Inside of the outer face, panels are damped with mineral material and dry wall. Panels are filled with incombustible and inert acoustical filler having a density of not less than 1.4 kg per cubic metre (3 lb per cubic foot). Panels interlock and provide an acoustical seal using a minimum of Two Cam-Lock interlocking panel connectors and a minimum of two sets of closed cell acoustic rubber seals.

Floor Construction: Floors are 100 mm (4") thick with 11 swg cold rolled steel walking surfaces, 14 swg cold rolled steel framing members and 16 swg bottom face sheets. Acoustical filler is high density, incombustible mineral wool fill with a minimum density of 1.4 kg per cubic metre (3 lb per cubic foot). The entire floor floats on vibration isolators and rails. Isolators are rated with a natural frequency of 6.5 Hz.

Door Construction: Doors are 75 mm (3") thick, of similar construction to that of the walls and ceiling. Doors are flush mounted on heavy duty cam lift hinges. A double magnetic gasket sealing system and flush sill seal design assures the acoustic seal. Standard door is 927 mm x 1918 mm with an opening of 813 mm x 1873 mm (36-1/2" x

75-1/2" with an opening of 32" x 73-3/4"), and is of out-swinging design.

Window Construction: Double-glazed 610 mm x 762 mm (24" x 30"). Window is constructed using 6 mm (1/4") safety glass and is set in the panel using a viseo-elastic gasket.

Ventilation: Ventilation silencers are wall or ceiling mounted. A total of two silencers, one supply and one exhaust, are provided for each room. Silencers are designed to provide up to 250 cfm each with an entrance velocity of less than 300 cfm. The system will not generate noise levels in excess of those specified by ANSI S-i 1991 standards.

Electricity and Lighting: Rooms are equipped with at least one double head incandescent light and one double socket outlet. Optional additional lighting and electrical outlets are available. All cabling is inside the acoustic wall system wherever possible, and is connected to the outside by way of a surface mounted electrical box.

Clinical Jack Panel: A pre-wired jack panel is provided with nine (3-wire) phone jacks, and a 25 mm (1") capped pass-through connection. The panel face is removable and does not detract from the room's acoustical performance.

Warranty: State warranty clearly in quote for consideration

This should be able to be occupied by 6 individuals with room for seating per booth and 1 per seating in the diagnostic booth. Stations should be subdivided. External sound should be mitigated to the greatest amount possible per DA PAM 40-501 Chapter 3-6 Paragraph g.

Restrictive factors or environmental considerations for this product and installation can include but are not limited to:

Building dimensions: Review of site and room location to identify and obstacles.

Ventilation: Limited space between top of unit and ceiling may present challenges when attaching ventilation.

External noise: SRP/MRW’s may result in some periods having greater ambient noise levels than others. It will be important to test this sound.

Location of the assembly is on CSTS, Building 503, Cortlandt Manor, NY 10567. Installation site will be on the

West side of the West wing .

For detailed specifications and testing criteria upon install, see referenced document US Army Public Health

Command Audiometric Test Booth Certification Form. Maximum permissible ambient noise level (MPANL) criteria for diagnostic testing from 250 Hz to 8000 Hz is found in this form and will be the standard for completion of the install. That form and document are included in this solicitation package. These standards conform with

OSHA standards for hearing room noise as listed in 9 CFR 1910 App D (Table D-1).

No additional special features are necessary.

The intended use for this system is for testing hearing health.

This system will be used to test six (6) individual’s hearing readiness simultaneously.

This system will need to interface with automated audiometric testing systems.

This purchase includes installation on site. Contractor will be responsible for getting materials to the site and completing all work to meet the standards listed in 29 CFR 1910 App D (Table D-1). Contractor will ensure that, following installation, any cosmetic changes are repaired to their original state to the greatest extent possible.

System should be installed April 2020.

5.3 Place of Performance/Hours of Operation. The contractor will only access Building 503 on CSTS Cortlandt

Manor, NY 10567. Hours of operation for that building are 0700-1630 Monday through Friday. The facility will be closed for all Federal holidays. Please refer to attached excerpt from the technician calendar.

5.4 Period of Performance. Duration of this project is 90 day with a projected start of April 2020 unless Contracting

Officer specifies otherwise in writing.

6.0 Privacy Act. Work on this project may require that personnel have access to Privacy Information. Personnel shall adhere to the Privacy Act, Title 5 of the U.S. Code, Section 552a and applicable agency rules and regulations.

7.0 Personal Service. The client has determined that use of this contract to satisfy this requirement is in the best interest of the government, economic and other factors considered, and this task order is not being used to procure personal services prohibited by the Federal Acquisition Regulation (FAR) Part 37.104 titled “Personal services contract”.

8.0 Key Personnel.

8.1 Points of Contact.

Ordering Contracting Officer

Christine Campbell

330 Old Niskayuna Road

Latham, NY 12210

518-786-4747 christine.i.campbell.civ@mail.mil

9.0 Quality Control. Quality control will be validated by the end user/requestor. Quality will be indicated by acceptance on the SF1449.

10.0 Records/Data. Vendor will supply all applicable instruction manuals and connection/wiring diagrams.

Documents should be formatted as PDFs unless end user indicates that another format would be more effective.

11.0 Packaging/Packing/Shipping Instructions. Vendor may ship items for installation directly to install site. If this is the intention of the vendor, ensure coordination has been made for receipt of items. Address for shipment will be

BLDG 502 CSTS Cortlandt Manor, NY 10567.

12.0 Definitions & Acronyms. All terms that have meaning other than that contained in a dictionary and task-specific acronyms.

SRP- Soldier Readiness Processing

14.0 Contractor Furnished Items.

Connections from hearing booth to electrical outlets.

15.0 Specific Requirements.

mailto:christine.i.campbell.civ@mail.mil

15.1 Task Description. Contractor shall provide and install stations hearing booth. Orientation in the room will be to the NE corner of the room, leaving a reasonable gap, per regulation as referenced in attachment (Specification

Sheet) between existing walls and outer walls of booth.

15.2 Detailed Task Description.

See attachment (Specification Sheet)

16.0 Quote Submission. The Government will request quotes for this task. To receive a potential Request for Quotes

(RFQ), the potential offerors shall register their organization and their authority to submit quotes at www.sam.gov .

The contractor shall submit a written cost and technical quote for consideration before the due date and time for this

RFQ. In addition, the contractor shall submit this quote electronically.

16.1 Travel. None.

16.2 (Un-priced CLINS). None.

16.3 Deliverables and Reports. In addition to the applicable requirements, the contractor shall provide the following deliverables and reports:

16.4 The contractor shall inform the KO in writing of the actual task starting date on or before the starting date.

16.5 The contractor shall bring problems or potential problems affecting performance to the attention of the KO as soon as possible. Verbal reports will be followed up with written reports when directed by the KO.

17.0 Delivery Instructions. Coordinate deliveries with the Point of Contact listed in the contract to ensure that access and personnel are available.

17.1 Inspection and Acceptance. In the absence of other agreements negotiated with respect to time provided for government review, deliverables will be inspected and accepted per the terms of the contract.

http://www.sam.gov/

(End of Summary of Changes)