This is a service / maintenance or supply contract in Newington, Connecticut. Contact the soliciting agency for additional information.

VA Connecticut Healthcare System Newington Backflow Preventer Inspection and Repair Page 1 of 4 STATEMENT OF WORK VACHS Newington Backflow Preventer Repair VA CONNECTICUT HEALTHCARE SYSTEM (VACHS) VA MEDICAL CENTER NEWINGTON Maintenance, Repair, and Rebuilding of Equipment Plumbing Fixture Fitting and Trim Manufacturing. VA Connecticut Healthcare System Newington Backflow Preventer Inspection and Repair Page 2 of 4 BACKGROUND VA Connecticut Healthcare Systems, Newington Campus, requires repair of backflow preventer devices listed by building and room number in Table 1. VACHS Newington requires the contractor Ameritech to provide services for all labor, materials, transportation, parts, and expertise necessary to provide repair of backflow prevention devices previously failing state of Connecticut mandated testing requirements under the VISN 1 Blanket Purchase Agreement (BPA). JUSTIFICATION Veterans Health Administration (VHA) seeks to continue to improve operational capabilities by establishing services that result in fewer operational problems, improved communications, increased efficiency within the facility and to improve the quality of services to veterans. LOCATION OF SERVICES VA Medical Center Newington 555 Willard Avenue Newington, CT 06111 PERIOD OF PERFORMANCE The Contract Time Period of Performance will be 60 calendar days from Notice to Proceed (NTP) and includes contractor closeout. Coordination of a time schedule will be reflected between VA FMS department and issued Contractor for work to be conducted. QUALIFICATIONS Ameritech shall have a BPA with VISN 1 and knowledge of the VACHS Newington campus and the backflow preventers. SCOPE OF WORK Ameritech shall furnish all labor, materials, equipment, tools, supervision, and all incidentals to provide the repair and certification of the backflow preventer devices and cross connections described in Table 1. 1. The service provider will be coordinating, scheduling, and reporting all work-related activities and will provide necessary information as required by the COR/PM. The responsibilities shall include but are not limited to: a. Directly supervise all repair work and any subsequent testing. b. Repair of backflow preventer devices listed in Table 1. c. Ameritech shall adhere to all applicable VA, state, and federal safety policies. d. Schedule and coordinate areas to be tested with the COR or VA FMS representative and provide a minimum three (3) week notice. 2. Lockout/Tagout Backflow preventer devices IAW applicable contractor and VA policies. a. Acknowledgement of VA LOTO requirements (Attachment C) and contractor LOTO policy. 3. Repair of backflow preventer devices shall be in conformance with the following standards/codes/specifications/regulations to include but not limited to: a. American Backflow Prevention Association (ABPA); b. American Society of Safety Engineers (ASSE); c. VA directives and policies d. National Fire Protection Association (NFPA) 13 and 25 e. American Society for Testing and Materials (ASTM) VA Connecticut Healthcare System Newington Backflow Preventer Inspection and Repair Page 3 of 4 f. Local, municipal, state, and federal regulations pertaining to preservation and maintenance of public water supplies and potable and non-potable water sources. VACHS Newington Backflow Prevention Devices Bldg. # Room / Location Make Model # Serial # Size (in.) 1N 209 Ceiling C/Water Watts 009 12682 0.5 2C 2123 Pharmacy Ceiling H/Water Watts 009 139409 0.75 2E SPD Rm 157 C/Water Sterilizer Watts 909 431484 1 2E SPD Rm 157 H/Water Sterilizer Watts 909 20636 1 2E Mechanical Rm B133 Watts 909 250534 6 2E Mechanical Rm B133 Watts 909 250839 6 3 Water Service Chem Injector Watts 009 306836 2 3 Boiler Rm E/Wall By-Pass Watts 909 164099 2 3 113 Watts 909 179386 4 65 Main Water Rm Wilkins 375 L93326 3 65 Main Water Rm Wilkins 375 L93192 3 Fire Pump Devices 45 Clean linen Rm Febco 826YD A0608 4 Table 1: VACHS Newington Backflow Prevention Devices SUBMITTALS/DELIVERABLES 1. The Service provider shall furnish Certificates of Calibration for all instruments used in conducting testing including, function, minimum range, minimum accuracy, minimum resolution, manufacturer, model, serial number, frequency of calibration, and date of last calibration. a. Contractors shall provide documentation detailing a valid calibration and the instrumentation shall meet the accuracy/calibration requirements established by the state of Connecticut. The contractor shall also provide calibration history of the instrument(s) to be used for test. 2. The contractor shall submit any waste manifest documents as applicable with final reports. 3. Submit names and qualifications of specialists a minimum of ten (10) business days prior to starting annual testing in writing to the COR, PM, and the VA Contracting Officer. Subcontracting of any ensuing award of this solicitation shall not be allowed without written permission of the Contracting Officer. Service response on calls from unauthorized personnel could result in non-payment. 4. Prior to the start of work, the specifications shall require the contractor to develop and submit such plans as required by the VA relating to Safety and Environmental Issues. These may include but are not limited to: a. Job Hazard Analysis (JHA) / Activity Hazard Analysis (AHA) b. Acknowledgement of VA LOTO requirements (Attachment C) and contractor LOTO policy. c. A work plan detailing the devices identified for repair and the dates and times planned for repairs. 5. Work hours for service and corrective maintenance shall be as follows: a. Normal routine service shall occur during normal business hours. 7:30 a.m. to 4:00 p.m., Monday through Friday. b. Authorization to procure and complete corrective/emergency maintenance work shall be per written direction of the VA Contracting Officer or per Purchase Order Number issuance upon VA Connecticut Healthcare System Newington Backflow Preventer Inspection and Repair Page 4 of 4 approval and funding of cost for correction and upon which the contractor shall provide all labor, parts, and or materials necessary for correction/emergency maintenance work. SPECIAL INSTRUCTIONS 1. Contractor Check-in: All employees of the service provider shall comply with VA Security Management Program and obtain permission of the VA Police and restricted from unauthorized access. Upon arrival, the contractor shall sign-in at Building 3, 3rd Floor, FMS office and/or receive a temporary identification badge prior to performing services at VA Connecticut Healthcare System. The contractor shall wear visible identification always displaying the name and company ID while on site. All site visits shall be coordinated with the VA COR. a. The Contracting Officer (CO), Contracting Officer s Representative (COR), and/or Project Manager (PM) specifically reserve the right to reject any of the Contractor s personnel and refuse them permission to work on the equipment outlined herein, based upon credentials provided. 2. Documentation: At the conclusion of each repair and scheduled maintenance visit, the contractor shall provide a written service report indicating the device serial number, tester s name, signature, test date, and test results. 3. Per VA Directive 1805, smoking vaping, and smokeless tobacco are prohibited on the grounds of VA facilities, including in vehicles. This Directive applies to all Service providers and their employees. 4. No photography of VA premises is allowed without written permission of the contracting officer. Patients and staff are not to be photographed at any time. 5. VA reserves the right to close down or shut down the facilities and order Service provider employees off the premises in the event of a national emergency. The Service provider may return to the site only with the written approval of the VA Contracting Officer. 6. Prior to commencing work onsite, all Service providers and provider personnel shall furnish proof of receipt of required COVID vaccinations and boosters in compliance with current VHA Directives. 7. Prior to commencing work onsite, all Service providers and provider personnel shall furnish proof of receipt of required Tuberculosis testing in compliance with VHA Directive 1131(5), dated June 04, 2021. 8. Parking for Service provider and its employees shall be in designated areas only. Service provider to coordinate with COR. 9. The Service provider shall confine all operations (including storage of materials) on government premises to areas authorized or approved by the VA Contracting Officer. The Service provider shall hold and save the government, its officers, and agents, free and harmless from liability of any nature occasioned by the Service provider s performance. Working space and space available for storing materials shall be as determined by the COR. Workers are subject to the rules of the Medical Center applicable to their conduct. Execute work in such a manner as to reduce impacts with work being done by others. 10. Billing: Provide COR and/or PM with a report or statement of work completed and include statements with request for payment. Statement should include service completed and the date each service item was completed. Labor charges shall be billed hourly, and any unused labor totals will be credited back to the VA Medical Center on the next billing cycle, upon receipt of the service report. TERMS AND CONDITIONS 1. User Responsibility: The contractor shall not be held responsible under the terms of this contract for repairs to equipment necessitated by user abuse and/or misuse of equipment. 2. All work is subject to inspection, review and approval by the HVAC Supervisor, Utility System Supervisor, Chief M&O, Chief Engineer, and/or their designees.