PWS_Updated_15_May_2017_Without_Tracking.pdf

PERFORMANCE WORK STATEMENT

SCARNG ANNUAL OCCUPATIONAL MEDICAL

SURVEILLANCE EXAMINATIONS

Section A – Descriptions and Specifications

PERFORMANCE WORK STATEMENT

1.1 General: The purpose of the Occupational Medical Surveillance Examination Program is to provide job-related Medical Surveillance Examinations and Occupational Health Services to the South Carolina Army National Guard full time support (FTS) and/or temporary personnel who are or potentially could be exposed to health hazards in the work environment. The examination shall include personnel assigned to positions requiring specific standards of physical fitness.

1.2 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 Annual Medical Surveillance Services, as defined in this PWS.

1.3 Background: The purpose of the South Carolina Army National Guard (SCARNG) Mobile Occupational Medical Surveillance Examination Program is to provide job-related medical surveillance examinations and occupational health services to SCARNG full-time support (FTS) and temporary personnel who are potentially exposed to health hazards in the work environment or who are assigned to positions requiring specific standards of physical fitness. Some personnel will receive comprehensive exams; others will receive limited testing. The Contractor shall conduct each test for the price of that test as stated in the schedule. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical professional aspects services rendered (e.g., treatment, etc.). The contractor will provide all labor, tools, supervision and supplies to conduct mobile medical surveillance/occupational health services for the SCARNG.

1.3 Period of Performance (PoP): The Period of Performance shall be one Base Year of 12 months and two 12-month option years.

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.

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 – 1600 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 Joint Armed Forces Readiness Center at McEntire Joint National Guard Base. 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 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.

1.4.5.2 Reserved

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 who’s PII has been compromised.

1.4.5.4. Reserved

1.4.5.5 Reserved

1.4.5.6 Reserved

1.4.5.7 Reserved

1.4.5.8 Reserved

1.4.5.9 Reserved

1.4.5.10 Reserved

1.4.5.11 Reserved

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 Reserved

1.4.7 Special Qualifications: The contractor shall ensure all employees possess all required licenses for operating equipment used in the performance of this contract. This does not include education or other qualifications for the position in which the contractor employee is performing, dress codes, or other information. The Government does not provide training to contractors. Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified and qualified to provide services.

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.

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., badge 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 Reserved

1.4.13 Reserved

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 Reserved

1.4.16 Reserved

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

2.1.10 SUBCONTRACTOR. One that enters into a contract with a prime contractor.

The Government does not have privity of contract with the subcontractor.

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

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

2.2 ACRONYMS:

AFARS Army Federal Acquisition Regulation Supplement AGR Active Guard Reserve AHP Army Hearing Program AHRC Army Human Resources Command AIPH Army Institute of Public Health AKO Army Knowledge Online ALB Albumin ALT Alanine Aminotransferase AMEDD Army Medical Department ANSI American National Standards Institute APD Army Publishing Directorate APFT Army Physical Fitness Test AR Army Regulation ARC Army Reserve Command ARNG Army National Guard ARNGUS Army National Guard of the United States AST Aspartate Aminotransferase AT/OPSEC Antiterrorism/Operational Security BUN Blood Urea Nitrogen

CBC Complete Blood Count CFR Code of Federal Regulations CK Creatinine Kinase CM Centimeter CMP Comprehensive Metabolic Panel CFP/M/E Contractor Furnished Property, Materials, and Equipment CMRA Contractor Manpower Reporting Application CO2 Carbon Monoxide CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTS Commercial-Off-the-Shelf DA Department of the Army DD250 Department of Defense Form 250 (Receiving Report) DD254 Department of Defense Contract Security Requirement List DFARS Defense Federal Acquisition Regulation Supplement DHS Director of Health Services DOD Department of Defense DODI Department of Defense Instruction FAR Federal Acquisition Regulation FTS Full Time Support GFP/M/E/S Government Furnished Property/Material/Equipment/Services GGT Gamma-Glutamyl Transferase GLOB Globulin IA Information Assurance IS Information System(s) KO Contracting Officer

LFT Liver Function Tests MED Medical MEDS Medications MEDPROS Medical Protection System MODS Medical Operational Data System MOS Military Occupational Specialty MWDE MEDPROS Web Data Entry NIHL Noise-induced hearing Loss OCCUP Occupational OCI Organizational Conflict of Interest ODC Other Direct Costs OEH Occupational & Environmental Health OH Occupational Health OHN Occupational Health Nurse OSHA Occupational Safety and Health Administration PFT Pulmonary Function Test PII Personally Identifiable Information PIPO Phase In/Phase Out PMOS Primary Military Occupational Specialty POC Point of Contact PRS Performance Requirements Summary PTS Permanent Threshold Shift PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Program QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program RAC Risk Assessment Code RESP Respiratory RHL Reportable Hearing Loss RX Treatment SGOT (AST) Aspartate Aminotransferase SGPT (ALT) Alanine Aminotransferase TE Technical Exhibit TOC Tactical Operations Center TOE Table of Organization and Equipment TWA Time-Weighted Average USAPHC U.S. Army Public Health Command USAR U.S. Army Reserve ZPP Zinc Protoporphyrin

3.1 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:

3.2 Property: The Government will furnish the necessary workspace for the contractor to perform services outlined in this PWS to include tables, chairs, 1-2 phlebotomy chairs, and space to perform services.

3.3 Materials: NONE.

3.4 Equipment: NONE.

3.5 Services: NONE.

3.6 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.

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.

4.2 Reserved

5.0 Requirements:

5.1 The Contractor shall have had previous knowledge and experience with the Army National Guard.

5.2 Contractor must ensure all procedures are conducted in accordance with applicable American Board of Occupational and Environmental Medicine (ABOEM), U.S. Department of Labor (DOL), Occupational Safety and Health Administration (OSHA), and National Institute for Occupational Safety and Health (NIOSH) Standards.

5.3 Contractor must ensure all clinical laboratory/chemistry services are performed by a laboratory licensed by the U.S. Department of Health and Human Services 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 Pathologists. A copy of that certification/license shall be provided to the Government with the Contractor’s bid.

5.4 Contractor shall provide a Board Certified Occupational Medicine Physician to conduct job-related medical surveillance physical examinations AND occupational health consultation services for approximately SCARNG personnel at one (1) SCARNG work-site for the base year. A copy of that certification/license (i.e., that the person is a licensed Board Certified Occupational Medicine Physician) to the Government. The Contractor will provide a Board Certified Occupational Health Physician for overall supervision of the services rendered, however, a Physician, Physician Assistant or Nurse Practitioner may perform a hands-on physical examination for every selected employee. Special attention will be given to the integumentary system, the teeth/gums, cardiovascular, respiratory, neurological musculoskeletal systems, (especially flexibility and strength) as well as the status of the liver, kidneys and psychological condition. Specialized back screening such as Isokinetic or Cybek is not necessary. The examiner will determine the examinee’s ability or inability to perform, with our without limitations, the duties required by their position. The government will furnish position descriptions whenever examinations are ordered.

5.5 During the option years, the Contractor shall provide an Occupational Health Nurse (OHN) upon request to conduct occupational health consultation services for the duration of the contract conduct telephonic consultations: The contractor will ensure the availability of occupational health nursing consultation by telephone to coordinate and resolve issues which might arise during the testing period. While the Contractor has the prerogative to establish its management structure, the Government would expect the OHN to have authority and direct accountability and responsibility for supervising the unlicensed personnel performing work under this contract. Nonetheless, under no circumstances shall an unlicensed individual supervise unlicensed personnel under the contract while examinations or other services called for by the contract are underway. The Contractor must disclose to the Government with the Contractor’s bid its approach to managing and supervising the unlicensed practitioners under this contract. A copy of certification/license of the OHN shall be provided to the Government after contract award and upon request by the COR.

5.6 Certified/licensed medical technicians to administer medical surveillance screening/testing. Personnel conducting spirometry will be certified by a National Institute for Occupational Safety and Health (NIOSH) approved program. By “certification” and “license” the Government means that the individual has undergone a program of instruction qualifying the person to perform the medical procedure(s) for which the certification/license was granted. The training must have been conducted by a recognized (e.g., a hospital, a state-certified laboratory, state-certified school system, etc.) third party (i.e., other than the contractor or a parent organization or any subcontractor to this contract) authority. A copy of these certifications/licenses shall be provided to the Government at least 14 days prior to the beginning of the conduct of the examinations and services.

5.7 Instrumentation must meet or exceed appropriate performance standards and accuracy must be verified IAW current Occupational Medicine Certification standards.

5.7.1 The contractor will draw blood samples and collect urine specimens on-site at the time of testing. Laboratory analysis will included blood chemistry albumin, albumin/globulin ratio, alkaline phosphatase, blood urea nitrogen (BUN), creatinine, lactic dehydrogenase, aspartate transaminase (AST), and alanine aminotransferase (ALT), complete blood count with differential (CBC with diff), white blood cell count (WBC), red blood cell count (RBC), hematocrit (HCT), hemoglobin (HGB), and counts of polys, bands, lymphocytes, eosinophil, basophil and platelets, lipid profile (total cholesterol, triglycerides, high density lipoprotein (HDL) and low density lipoprotein (LDL), urinalysis (color, appearance, pH, specific gravity, ketone, blood protein, glucose), with microscopic analysis (WBCs, RBCs, epithelial cells, casts, crystals, bacteria, mucus and nitrate, if present) if abnormal. The chemistry, CBC and urinalysis will be performed by a Centers for Disease Control and Prevention (CDC) accredited laboratory using standard techniques and procedures.

5.7.2 The contractor will draw blood samples on-site at the time of testing for laboratory analysis of zinc protoporphyrin for each employee having a blood level drawn.

Quantitative results will be reported. The contractor will run labs drawn each day and submit obtained results to the COR on a daily basis during the testing period.

5.7.3 Contractor will obtain 12 lead electrocardiogram for all employees age 40 or over who are required to wear a respirator to perform their duties. Each EKG will be interpreted by a board-certified physician qualified to interpret electrocardiograms and issued in a format that can be easily scanned into an electronic record.

5.7.4 A physician or occupational health nurse experienced and qualified in the medical aspects of respirator use will evaluate the appropriate test results for any medical limitations on the use of the respirator. Contractor will use required OSHA respirator questionnaire or current evaluative tool that is acceptable to the SCARNG OHN. The physician or occupational health nurse will provide an evaluation letter which either clears the employee for respirator use or withholds the clearance pending further medical evaluation (with explanation of evaluation required for clearance.) The technician will classify the examinee in one of 3 classes:

Class I No restrictions for respirator Class II Some restrictions (list restrictions) Class III No respirator use under any circumstances

5.8. EXAMINATIONS:

5.8.1. TYPES OF PHYSICALS AND COMPONENTS OF EACH

TYPE A

Height, Weight, Body Mass Index (BMI), Blood Pressure, Pulse, Physician’s exam (as listed in 5.4), Blood Chemistry and Urinalysis (as listed in 5.7.1), Visual Acuity, and Home Mailings of Individual Employee Reports.

TYPE B (respirator wearers) All of type A plus: Spirometry, Respirator clearance, and EKG if older than 40 years of age (billed separately)

TYPE C (respiratory wearers exposed to lead) All of type B plus: Blood lead level, ZPP

SUPPLIES AND SERVICES

Item Description Quantity Each*

001 Type A Physical 002 Type B Physical 003 Type C Physical 004 EKG as ordered 005 Employee Reports copy to OH Office 006 Master Summary Report

*Quantities will be provided upon contract award.

5.9 Contractor Manpower Reporting Application (CMRA):

5.9.1 The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the South Caro l ina Army National Guard Bureau via a secure data collection site.

5-8.2.The contractor shall completely fill in all required data fields using the following web address: http://www.ecmra.mil/. Reporting inputs shall be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013.

Contractors may direct questions to the help desk at http://www.ecmra.mil.

6.0 Applicable Publications: Publications applicable to this PWS are listed below:

Publication (Chapter/Page)

Date of Publication

Mandatory or Advisory

Website

Army Regulation AR 40-5 Preventive Medicine Chapters 1&2 - all

25 May 2007 Mandatory http://www.apd.army.mil/epub s/DR_pubs/DR_a/pdf/web/r40 _5.pdf

Army Regulation 385-10 The Army Safety Program Chapter 1-4 n. (10) Chapter 3-4 d. (2) Chapter 7-8 i. (3) Chapter 19-7 h.

Chapter 19-7 i.

Section II Terms – Medical Surveillance

27 Nov 2013 Mandatory http://www.apd.army.mil/epub s/DR_pubs/DR_a/pdf/web/r38 5_10.pdf

National Guard Supplement 1 to AR 385-10 The Army Safety Program Section II, 1-5 h. (1) thru (4)

12 Feb 2015 Mandatory http://www.ngbpdc.ngb.army.

mil/pubs/NG%20Sup%20Seri es/NG%20Supplement%201 %20to%20AR%20385-10.pdf

U.S. Department of Labor (DOL) Code of Federal Regulations 29 (CFR) 1910, Occupational Safety and Health Standards for General Industry 1910 Subpart G – 1910.95 App A - I;

1910 Subpart I – 1910.134 App A – D;

1910 Subpart Z – 1910.1025 Lead;

1910 Subpart Z – 1910.1026 App A Chromium;

1910 Subpart Z – 1910.1027 Cadmium

Internet – no date

Mandatory https://www.osha.gov/pls/osh aweb/owasrch.search_form?p _doc_type=STANDARDS&p_ toc_level=1&p_keyvalue=191

Army Regulation 40-501 Standards of Medical Fitness 8-20.b(9); 8-21.b.; 10-19.c.

22 December

Mandatory http://www.apd.army.mil/Prod uctMaps/PubForm/AR.aspx

Department of Defense (DOD) 6055.5-M Occupational Medical Surveillance Manual;

all

May 1998 Mandatory http://www.gulflink.osd.mil/pe sto/pest_refs/n53en108/manu al.html

Department of Defense Instruction (DoDI) Number

6055.05 Occupational &

Environmental Health (OEH) All

11 November

Mandatory http://www.dtic.mil/whs/directi ves/corres/pdf/605505p.pdf

ANSI/ASSE Z88.2 – 2015 -

American National Standard Practices for Respiratory Protection - This standard sets forth minimally accepted practices for occupational respirator use; provides information and guidance on the proper selection, use and maintenance of respirators and contains requirements for establishing, implementing and evaluating respirator programs. The standard covers the use of respirators to protect persons against the inhalation of harmful air contaminants and against oxygen-deficient atmospheres in the workplace.

2015 Mandatory http://www.asse.org/ansi/asse -z88-2-2015-american-national-standard-practices-for-respiratory-protection/

Exhibit “2”

ACCEPTABLE QUALITY LEVELS AND GOVERNMENT’S QUALITY ASSURANCE

SURVEILLANCE PLAN

Rating

Specification or Deliverable

Performance Objective AQL Red Yellow Green

Examination Components

All services are performed in accordance with the PWS and all applicable regulations.

98%

Insurance Contractor maintains insurance required by the PWS and provides copies of proof of insurance to the Contracting Officer and COR.

98%

Licensing Services required to be performed by individuals with designated licenses, certifications, or credentials comply with the PWS for all examiners, physicians, and

100%

Records and Documentation

Test results, letters, and reports are accurate and complete.

Government forms are complete and accurate, when use of Government forms is required by the PWS.

98%

Timeliness of Deliveries

Test results, letters, reports, and other documentation are transmitted to the employee and the Government in the format and timeframe required in the PWS.

98%

Communication of Questionable or Critical Results.

Results that are questionable or of critical significance are communicated in the manner and timeframe set forth in the PWS.

98%

Performance Requirements Summary

This Performance Requirements Summary includes performance standards. The Government will use these standards to determine contractor performance and will compare contractor performance to the Acceptable Quality Level (AQL).

PWS Paragraph Task Performance

Standard Acceptable

Quality Levels Surveillance Method

/ By Whom Step 1:

Determine the important task of the contract to be monitored over the course of the performance period, ensure this task is captured in the

PWS and reference the specific subparagraph in the PWS where the task can be found.

Step 2: State the specific task to be monitored, as stated in the

PWS.

Step 3:

Determine the performance standard for the task (NOTE: Be careful setting the standard of 100% or zero defects.

This requires the Government to do 100% inspection as a surveillance method which is administratively burdensome and often unnecessary.

Step 4:

Determine the AQL (or defect rate) for each task to be monitored

Step 5: Determine how this task will be monitored and by whom. (NOTE:

The individual monitoring contractor performance should always be the COR unless there is sufficient rationale why it should be the KO.)

5.1.3 The contractor

shall perform restorative maintenance within the established timeframes

The contractor shall perform restorative maintenance within the established timeframes 98%

2% failure to perform restorative maintenance within the established timeframes

Periodic Inspection

- COR will review monthly work order logs.

(Ver. Jun 2014) 1

Deliverables Schedule

PWS Reference / Deliverable Title

Frequency Number of Copies

Medium/Format Submit To

Reference PWS paragraph where deliverable is required and the title of the deliverable.

When is deliverable due?

Self- Explanatory

How should deliverable be provided?

Who is deliverable submitted to?

(NOTE: Submission should always be to the COR or KO unless there is sufficient justification otherwise.)

1.4.5.6 AT Level 1

Awareness

Training Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR

1.4.10 Identification

Media

Return within 14 days of employee’s departure from contract performance.

Original(s) Hard Copy KO

1.4.5.11 OPSEC

Training

Certificates

Provide within 15 calendar days after employee completes training.

1 Electronic Submission

COR