Welcome & Opening Remarks

Transcription

1 Welcome & Opening Remarks

2 Facility Master Plan Recommendations

3 Major Recommendations New Facilities for Centers of Excellence Improved Women s & Children s Facilities Expansion of Centers of Excellence Rehab Transplant Intensive Care Private-Room NICU Maternity Upgrades Enhanced ER Signature Lobby Pediatric ER at JNMC & JSCH Additional beds at JSCH Expansion of Ryder Trauma Children s Ambulatory Center

4 Evolution of Jackson Memorial Campus HIGHLAND PARKING GARAGE HIGHLAND PAVILION MENTAL HEALTH HOSPITAL CENTER Existing Campus PARK PLAZA EAST ACC EAST EAST TOWER (HOLTZ) WEST WING REHABILITATION HOSPITAL RYDER TRAUMA CENTER NW 10 TH AVE INSTITUTE & ANNEX ELLIOT BUILDING NORTH WING NORTH PARKING GARAGE DIAGNOSTICS & TREATMENT CENTER (DTC) NW 12 TH AVE.

5 Evolution of Jackson Memorial Campus HIGHLAND PARKING GARAGE HIGHLAND PAVILION MENTAL HEALTH HOSPITAL CENTER New Construction E PARK PLAZA EAST HOLTZ ENTRANCE EAST TOWER (HOLTZ) WEST WING REHAB HOSPITAL PLAZA A RYDER TRAUMA CENTER NW 10 TH AVE D B C NEW REHAB HOSPITAL INSTITUTE & ANNEX NEW ICU TOWER ED EXPANSION AND RENOVATION NEW MIAMI TRANSPLANT INSTITUTE NORTH PARKING GARAGE EXPANSION DIAGNOSTICS & TREATMENT CENTER (DTC) NW 12 TH AVE. NEW PARKING A NEW REHABILITATION HOSPITAL B ED EXPANSION AND RENOVATION C NEW MIAMI TRANSPLANT INSTITUTE D NEW ICU TOWER E BEHAVIORAL HEALTH HOSPITAL VERTICAL EXPANSION

6 Evolution of Jackson Memorial Campus HIGHLAND PARKING GARAGE HIGHLAND PAVILION MENTAL HEALTH HOSPITAL CENTER H6 Modernization Projects PARK PLAZA EAST HOLTZ ENTRANCE EAST TOWER (HOLTZ) WEST WING REHAB HOSPITAL PLAZA RYDER TRAUMA CENTER H3 NW 10 TH AVE G H2 H4 F H1 NEW REHAB HOSPITAL INSTITUTE & ANNEX NEW ICU TOWER H4 CENTRAL WING RENOVATION NEW ED ENTRANCE NEW MIAMI TRANSPLANT INSTITUTE H6 HIGHLAND PAVILION BUILDING RENOVATION NORTH PARKING GARAGE DIAGNOSTICS & TREATMENT CENTER (DTC) NW 12 TH AVE. H5 NEW PARKING SOUTH WING RENOVATION F INTERVENTIONAL PLATFORM IMPROVEMENTS G NICU/LDR MODERNIZATION H1 WEST WING MODERNIZATION H2 EAST TOWER MODERNIZATION H3 HIGHLAND PROFESSIONAL BUILDING RENOVATION

7 PARKING GARAGE Evolution of Jackson North Campus VITAS MEDICAL OFFICE BUILDING JACKSON NORTH MEDICAL CENTER Construction & Renovation K6 K7 K2 K5 K4 OB/NICU EMERGENCY DEPARTMENT JACKSON NORTH OFFICE BUILDING K3 K1 K1 NEW SURGERY EXPANSION K2 EXISTING SURGERY RENOVATION K3 PREP/PHASE II RECOVERY K4 EMERGENCY DEPT. MODERNIZATION K5 L&D, PEDIATRIC & NICU MODERNIZATION K6 PATIENT UNIT (2ND ) MODERNIZATION K7 PATIENT UNITS (3RD 7 TH ) MODERNIZATION

8 Evolution of Jackson South Campus Development Plan FUTURE PARKING GARAGE HOSPITAL EXPANSION MEDICAL OFFICE BUILDING L5 L4 L2 L1 L6 L3 ORIGINAL HOSPITAL PEDS ED/TRAUMA EXPANSION FUTURE MEDICAL OFFICE BUILDING L1 NEW PEDS ED/TRAUMA ADDITION L2 BEHAVIORAL HEALTH RAD LAB ENTRANCE RENOVATION L3 2 ND ICU UNIT BUILD OUT L4 SOUTH WING A UNIT MODERNIZATION L5 LABOR AND DELIVERY MODERNIZATION L6 4 TH FLOOR PATIENT UNIT BUILD OUT

9 Plan Overview 200+ Projects $1.4 Billion Jackson Health System Capital Plan 10 Years 3 Campuses & Offsite

10 Bottom Line: Great mix of projects of all sizes at multiple locations throughout Miami-Dade County

11 Facilities-Design & Construction

12 Standardization of JHS Construction Specifications Based on CSI Master Format 2014 Division 00 - Procurement and Contracting Requirements Division 01 General Requirements

13 Standardization of JHS Construction Specifications Specifications finalized in November Will be in use next calendar year Will encompass items presented today

14 Procurement Management Strategic Sourcing Division

15 Division Leadership Team Rosa Costanzo Vice President Strategic Sourcing and Supply Chain & Chief Procurement Officer Michelle Romano Procurement Director Goods & Services Kenneth Robertson Procurement Director Construction Services Tessie Wilson Interim Director of Supply Chain

16 JHS Procurement Statistics FY 2014: Leveraged and negotiated contractual savings totaling just short of $57 million Issued more than 95,000 purchase orders Completed 923 contracts with an average cycle time of 15 days

17 Procurement Team Members Procurement Construction Dept. (Construction & A/E) Kenneth Robertson, Director John Ellis III, Senior Procurement Contracting Officer Theo Carrasco, Senior Procurement Contracting Officer Sandra Rico, Procurement Contracting Officer Steven Williams, Procurement Contracting Officer Kevin Guhl, Senior Procurement Specialist Cecelia Wilson, Senior Procurement Specialist

18 How To Do Business With JHS Vendor Registration Process Registration Application *Required within 30 days from receipt of award recommendation REPTRAX Vendor Credentialing On-site kiosks

19 How To Do Business With JHS Supplier Portal An online procurement system which allows vendors to: Receive notification of upcoming procurement opportunities View solicitation documents Submit responses to solicitations To access Supplier Portal: Visit Select Vendors and Businesses Click on link for Supplier Portal

20 Methods of Source Selection Construction Services: 1. Design-Bid-Build 2. Construction Manager/Construction Manager-at-Risk 3. Design-Build 4. Job Order Contracts 5. Miscellaneous Construction Contract 6. Small Purchases Architectural and Engineering Services: 1. Request for Qualifications (price not considered) 2. Equitable Distribution Pool/Small Purchases

21 Responsiveness versus Responsibility

22 Responsiveness Responsiveness is determined based on an offeror s contents at bid/proposal opening. To be considered responsive, a bid/proposal must conform in all material respects with the solicitation s submittal requirements. Minor defects may be cured.

23 Responsibility Responsibility is determined based on whether an offeror is fully capable of meeting all of the requirements of the solicitation and contract. Must possess the full capability, including financial and technical, to perform the contract. Must be able to document the ability to provide good faith performance.

24 Award to the LRR Bidder Confirm both responsiveness and responsibility of the lowest bidder. Award in a manner consistent with the solicitation.

25 Responsive Construction Bids Common responsiveness issues: 1. Bid submitted timely? Late bids will not be considered percent Bid Bond/Security included? -Cashier s check, certified check or bid bond 3. Submitted evidence of CSBE goal compliance? -Completed Form SBD 400 -One form for each CSBE sub used to meet goal -Deemed compliant by Small Business Development?

26 Responsive Construction Bids Common responsiveness issues (cont.): 4. Does bidder meet the ITB s minimum qualification requirements? - Reference ITB Instructional Section (IS) Required licensure, experience, project references 5. Was there a mandatory pre-bid meeting? Did the bidder attend? - Most JHS pre-bid meetings are voluntary 6. Did bidder take any exceptions to the contract s terms and conditions?

27 Bid Submittal Requirements Bid submittal checklist Form IS percent bid security Cover Page Form A-1 (Firm information) Bid Form IS 9.00 (pricing; add/deduct alternates; Schedule of Values division totals; key personnel; signature) Contractor s Qualifications Statement Form A-17 Vendor Experience Form Attachment B (one per reference) Copy of required licenses and/or certificates of competency Risk Assessment Plan Attachment R Value Added Submittals Attachment V

28 Bid Submittal Requirements Acknowledgement of Addendums Form A-3 Acknowledgement of Specifications/Drawings Attachment F Schedule of Intent Form SBD 400 Attachment A (one per CSBE) MDC Domestic Violence Leave Affidavit Form A-9 Community Small Business Enterprise Status Form A-14 Responsible Wage Affidavit Form A-16 Copy of current IRS Form W-9 Copy of current Certificate of Insurance meeting JHS/PHT requirements as identified in General Terms and Conditions, Section 43 GL $1 million/claim, $3 million/aggregate; Auto $500K; Additional insured for GL

29 Bid Submittal Requirements Disability Nondiscrimination Affidavit Form A-4* Local Business Preference Form A-5* Fair Subcontracting Policies Form A-6* Florida Statutes on Public Entity Crimes Form A-7* Current in obligations to Miami-Dade County Form A-8* MDC Business Entity Ownership Disclosure Form A-10* Affidavit of Continued Compliance Form A-11*** (if applicable) If over $1 million Contractor Due Diligence Affidavit, Attachment H Triple check that all documents are completed legibly, signed and notarized, as required.

30 Notice: Bid Submittal Requirements Each individual solicitation may have unique requirements, depending on the project. Thoroughly review the solicitation documents. If you have any questions before submitting a bid, please submit Requests for Information (RFIs) in writing to the contracting officer identified in the solicitation.

31 Contract Requirements User Access Program: -2 percent deduction applied to all invoices -Participation is mandatory -Used to defray the cost of JHS operations Inspector General Review: percent deduction applied to all invoices -Used to pay for random audits performed by the OIG

32 How To Do Business With JHS Take Home Documents: Vendor Registration Application Supplier Portal Flyer Procurement Management Staff Contact List Frequently Asked Questions Current Solicitations

33 Security & Parking

34 Contractor Identification All contractor or sub-contractor employees working at any Jackson facility must wear a JHS issued identification badge (permanent or temporary) while on site. Badge is the property of JHS and must be worn in visible location above waist line at all times while on JHS premises. All contractor permanent badges expire on January 14 th of each year or earlier, depending on the length of the contract. Expired badges must be returned to Public Safety/Photo ID Services. JHS Procurement or Public Safety may request and confiscate a contractor s badge for any act(s) of non-compliance with the Vendor/Contractor/Visitor Access & Activity Policy.

35 How & When to Contact JHS Security Assistance via the Security Command Center is available 24/7. Contact the Command Center by dialing (internal ext ), particularly if any of the following events occurs while on JHS property: Injury Vehicle accident Witness suspicious activity Victim of a crime JHS Security will dispatch an officer to your location to render assistance and request police, fire, medical response as needed.

36 Safeguarding Tools and Equipment Do not leave tools or any moveable equipment unattended at any time. Secure tools, equipment and supplies in designated areas only. JHS Security personnel are not responsible for safeguarding any tools, equipment or vehicles.

37 Contractor Access Contractor and subcontractor employee(s) access is limited to areas related to the work being performed. Access to restricted or secured areas is coordinated through project manager and Public Safety. JHS keys will not be provided to contractors. Contractor personnel are not permitted to meet professional staff in any patient care unit, including inpatient units, nursing stations, physician lounges and outpatient clinics (patient areas). Contractor personnel must have a scheduled appointment to visit JHS Administrative and Executive Offices.

38 Contractor Parking Jackson Memorial Hospital Main Campus Logistics Lot Parking in this location must be approved by the project manager and Public Safety and is subject to availability. A hang-tag will be issued to contractor, it must be displayed while vehicle is parked in this area and will only be valid for length of the contract. Garages - Monthly parking account may be purchased. Approval by project manager and Public Safety is required and will be valid for length of contract. Contractor will incur cost for monthly parking. Garages Daily parking may be purchased. Contractor will incur cost for daily parking.

39 Contractor Parking Jackson Memorial Hospital Main Campus Lot 5/Blue Parking Lot - Contractors are not permitted to park in this lot at any time. Due to limited space availability, contractors are strongly encouraged to create a car/van pool process for their employees and transport workers to the site. JNMC, JSCH and Satellite Facilities Parking locations at these sites will be determined by the project manager and Public Safety.

40 Contractor Parking Contractor vehicles parked in fire lanes; blocking disabled and pedestrian access; in designated no-parking zones; in any other unauthorized areas or occupying more than one parking space, may be subject to immobilization and/or towing. Any cost to release the vehicle will be at the contractor s expense.

41 Environmental Health & Safety and Emergency Management

42 Appropriate Use of Elevators Freight elevators vs. regular patient transport elevators Understand the differences and why not to use the patient transport elevators Obtain list or locations of appropriate elevators to use in each relevant building

43 Appropriate Use of Elevators Reporting Damage: Report damages to the project managers and to Engineering Services JMH: Report your accidental spills by calling Environmental Services/Housekeeping JMH:

44 Hot Works Projects & Permit Review Engineering Services Policy # 730 Activity resulting in sparks, fire, molten slag, or hot material that could cause fire or explosion Includes welding, soldering, cutting, thawing pipes, brazing, grinding, torch applications, etc.

45 Hot Works Projects & Permit Each Hot Works Permit is only good for the specified project and dates on the permit Communicate with project manager when a permit needs to be completed, prior to starting the project OSHA, NFPA, AHCA, and TJC compliance

46 MSDS / SDS Material Safety Data Sheets (MSDS) and/or Safety Data Sheets (SDS) must be obtained for each individual hazardous product used on JHS premises. A copy of the MSDS/SDS must be submitted to the JHS Environmental Health & Safety Department prior to starting the project to be kept on file.

47 MSDS / SDS Each hazardous product container must be labeled accordingly with exact contents Contractor must have all materials necessary to clean up a hazardous spill Contractor must be trained on the procedures required for cleaning up spills of product volumes present on site

48 Required Contractor Specific OSHA Safety Training Controlling Hazardous Energy (Lockout/ Tagout) Ladder safety Confined space entry Smoke/Fire penetrations Hazardous spills clean-up Fall protection Personal Protective Equipment (PPE)

49 Reporting Emergencies at JHS Report fires, strong noxious odors/fumes, uncontrollable hazardous materials spills, and other emergencies to the Emergency Page Operators Jackson Memorial Hospital: Jackson North Medical Center: Jackson South Community Hospital:

50 Fire & Life Safety

51 Life Safety in Health Care During Periods of Construction Overview Before Construction/Renovation During Construction/Renovation

52 Life Safety in Health Care During Periods of Construction Life safety and life safety related findings dominate The Joint Commission (TJC) top deficiencies every year TJC and AHCA Life Safety Survey extends into areas of construction All renovation projects must be assessed for the need to implement Interim Life Safety Measures (ILSM)

53 Life Safety in Health Care During Periods of Construction The goal is to upgrade facilities while continuing to provide a desired level of protection against fire and the products of combustion during periods of renovation From a Life Safety perspective, after renovation, the goal is to provide appropriate building features and components to meet Life Safety Code

54 Before Renovation Begins Assess the project for Interim Life Safety Measures (ILSM) ILSM assessment determines if Life Safety Code deficiencies exist and how they will be mitigated during periods of construction (LS EPs 1-14) Specific mitigating activities are implemented based on the Life Safety Code deficiency that exists ILSM assessment and mitigating activities must be documented Review NFPA 241 Safeguarding Construction, Alteration, and Demolition Operations (2004 Edition)

55 ILSM Required Mitigating Activities Ensure egress-inspect daily Provide additional firefighting equipment, training Prohibit smoking Control combustible loading Increase hazard surveillance (inspection) Ensure operational life safety systems or substitute temporary systems (fire watch) Ensure temporary construction barriers meet specifications Train GC and Subs on fire response procedures

56 During Renovation ILSM mitigation activities must be implemented when necessary ILSM may be based on initial assessment or real time findings requiring ILSM to be re-assessed Maintaining appropriate fire and smoke rated construction partitions Functional existing or temporary Fire Alarm and Detection System Functional existing or temporary Fire Suppression System

57 During Renovation Housekeeping (Combustible Loading) Maintain Means of Egress for: Building Occupants General Contractor and Subs Protect all Fire and Smoke Barrier Penetrations Vertical and Horizontal Penetrations (core drill, cabling sleeves, etc.) Fire Extinguishers must be maintained per NFPA 10 whether they are contractor provided or existing JHS facilities and grounds are smoke free

58 Infection Control Risk Assessment (ICRA)

59 Objectives Explain the purpose of the Infection Control Risk Assessment (ICRA). Identify patient risks of infection related to construction in healthcare settings. Understand the importance of an ICRA.

60 Objectives Prevent and Control invasive fungal infections among our highest risk patients who have: Solid organ transplantation Bone marrow transplantation Severe Immunosuppressed OR: Are newborn patients Surgical patients

61 Infection Control Risk Assessment Determine the risk of patient exposure to construction debris and dust. Identifies classification levels of the work to be done. Explore potential impact to areas above, below and adjacent to work area. Results of the ICRA determine the safest methods to be used during construction activities.

62 Why??? Construction debris and dust can be lifethreatening to a patient with an compromised immune system. To prevent fungal, mold and opportunistic infections. Protect employees, patients and visitors. Required by Agency for Health Care Administration, (AHCA), The Joint Commission (TJC), and other regulatory agencies.

63 Importance of This Activity Infection with these fungi are very serious and oftentimes fatal. High fungal spore counts in air is the most likely source for subsequent infection. Spore containment strategies during construction and remodeling throughout the healthcare environment is critical for infection prevention and control!!

64 Containment Portable Zipper Door Portable Self Contained with Filtration System Tacky Mat Construction Film Personal Protective Equipment

65 Preconstruction Risk Assessment PreConstruction Risk Assessment SECTION 1 - Infection Control Risk Assessment Matrix of Precautions for Construction & Renovation Step One: Using the following table, identify the Type of Construction Project Activity (Type A-D) TYPE A TYPE B TYPE C TYPE D Inspection and Non-Invasive Activities. Includes, but is not limited to: removal of ceiling tiles for visual inspection only, e.g., limited to 1 tile per 50 square feet painting (but not sanding) wallcovering, electrical trim work, minor plumbing, and activities which do not generate dust or require cutting of walls or access to ceilings other than for visual inspection. Small scale, short duration activities which create minimal dust Includes, but is not limited to: installation of telephone, communication, and computer cabling (or similar cabling installation activities) access to chase spaces cutting of walls or ceiling where dust migration can be controlled. Work that generates a moderate to high level of dust or requires demolition or removal of any fixed building components or assemblies Includes, but is not limited to: sanding of walls for painting or wall covering removal of floorcoverings, ceiling tiles and casework new wall construction minor duct work or electrical work above ceilings major cabling activities any activity which cannot be completed within a single workshift. Major demolition and construction projects Includes, but is not limited to: activities which require consecutive work shifts requires heavy demolition or removal of a complete cabling system new construction. Step 1:

66 Location of Construction: Project Coordinator: Contractor Performing Work Supervisor: ICRA Permit Infection Control Construction Permit Permit No: Project Start Date: Estimated Duration: Permit Expiration Date: Telephone: YES NO CONSTRUCTION ACTIVITY YES NO INFECTION CONTROL RISK GROUP TYPE A: Inspection, non-invasive activity TYPE B: Small scale, short duration, moderate to high levels TYPE C: Activity generates moderate to high levels of dust, requires greater 1 work shift for completion TYPE D: Major duration and construction activities Requiring consecutive work shifts CLASS I 1. Execute work by methods to minimize raising dust from construction operations. 2. Immediately replace any ceiling tile displaced for visual inspection. CLASS II 1. Provides active means to prevent air-borne dust from dispersing into atmosphere 2. Water mist work surfaces to control dust while cutting. 3. Seal unused doors with duct tape. 4. Block off and seal air vents. 5. Wipe surfaces with cleaner/disinfectant. GROUP 1: Low Risk GROUP 2: Medium Risk GROUP 3: Medium/High Risk GROUP 4: Highest Risk 3. Minor Demolition for Remodeling 6. Contain construction waste before transport in tightly covered containers. 7. Wet mop and/or vacuum with HEPA filtered vacuum before leaving work area. 8. Place dust mat at entrance and exit of work area. 9. Isolate HVAC system in areas where work is being performed; restore when work completed. 1. Obtain infection control permit before construction begins. CLASS III 2. Isolate HVAC system in area where work is being done to prevent contamination of the duct system. 3. Complete all critical barriers or implement control cube method before construction begins. Date 4. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units. Initial 5. Do not remove barriers from work area until complete project is checked by Infection Prevention & Control and thoroughly cleaned by Environmental Services. CLASS IV Date Initial 1. Obtain infection control permit before construction begins. 2. Isolate HVAC system in area where work is being done to prevent contamination of duct system. 3. Complete all critical barriers or implement control cube method before construction begins. 4. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units. 5. Seal holes, pipes, conduits, and punctures appropriately. 6. Construct anteroom and require all personnel to pass through this room so they can be vacuumed using a HEPA vacuum cleaner before leaving work site or they can wear cloth or paper coveralls that are removed each time they leave the work site. 7. All personnel entering work site are required to wear shoe covers. 6. Vacuum work with HEPA filtered vacuums. 7. Wet mop with cleaner/disinfectant 8. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction. 9. Contain construction waste before transport in tightly covered containers. 10. Cover transport receptacles or carts. Tape covering. 11. Upon completion, restore HVAC system where work was performed. 8. Do not remove barriers from work area until completed project is checked by Infection Prevention & Control and thoroughly cleaned by Environmental. Services. 9. Vacuum work area with HEPA filtered vacuums. 10. Wet mop with disinfectant. 11. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction. 12. Contain construction waste before transport in tightly covered containers. 13. Cover transport receptacles or carts. Tape covering. 14. Upon completion, restore HVAC system where work was performed. Additional Requirements: Date Initials Permit Request By: Date: Exceptions/Additions to this permit Date Initials are noted by attached memoranda Permit Authorized By: Date:

67 Daily ICRA Checklist INFECTION CONTROL RISK SSESSMENT Project Name: Location: JMH Project No.: JMH File No.: BEFORE YES NO N/A ICP PM COMMENTS Construction workers educated in IC practices Preconstruction Meeting Construction barriers are in place Double air curtain at entrance Dust control measures evaluated HEPA vacuum, seal back door Negative airflow and/or filtration systems are in place Negative air machine with HEPA Air quality control measurements done if necessary. Circulation and traffic patterns established Signs posted to identify construction area Patient care items and equipment removed Exhaust fans functioning Plan for debris removal Dry storage of building materials Plan for water filtration DURING Barriers are intact Date Dust accumulation is minimal Negative airflow and filtration is functioning properly Walk-off mats in place Traffic patterns maintained Signs posted No patient care items or equipment in construction area Exhaust fans functioning Debris removal according to plan AFTER Water system flushed Date Vacuum area with HEPA filtered vacuums Wet mop with disinfectant Check for mold and mildew and thoroughly clean to remove HVAC filters cleaned/replaced Verify appropriate ventilation parameters required for the area(s) Remove barriers Transport debris in covered containers Terminally clean construction areas

68 Infection Control Questions Call us: Jackson Memorial Hospital: Jackson South Community Hospital: ext Jackson North Medical Center: Fax number: hour beeper: , for urgent matters after hours/weekends.

69 Facilities Engineering Jaime Cruz Director, Plant Maintenance and Operations Department of Engineering

70 Contractor Safety We strive to prevent all incidents that may lead to injuries or illness. Safety performance is a responsibility of line management and every contractor. We design safety into the work place. Individual behavior is the most important factor in preventing incidents.

71 Contractor Safety We expect and require every contractor to work safely. Working safely is good business. Safety is an integral part of our culture and total quality processes.

72 Contractor Safety Our safety process must react to all incidents, not just accidents. We continually improve our safety process by auditing the process and correcting the root cause of deficiencies. We promote safety, both on and off the job. We prepare for emergencies.

73 Permits Certain types of work cannot be started until approval is given in the form of a signed permit. A written, properly authorized permit may be required before you begin any activities. Facilities can assist contractor personnel in obtaining and completing permit requirement.

74 Current Permit Types Core Drill Permit Confined Space Permit Hot Work Permit

75 Future Permit Types Above Ceiling Permit Wall/Ceiling/Floor Permit Others as needed

76 Finance

77 Contractor Request for Payments Mandatory Forms General contractors shall submit their pay applications using two industry standard American Institute of Architects (AIA) forms. These forms include specific information including the total dollar amount of work completed, retainage, total of payments to date, a summary of change orders, and the current payment requested. G702 Application and Certificate for Payment G703 Continuation Sheet

78 Required on Forms Activity # Five-digit number assigned to each project by Jackson Purchase Order (PO) # Number provided by Procurement to each contract Vendor Number Unique five-digit number assigned to each vendor by Jackson G703 (schedule of values) Breakdown should correspond to line# in PO

79 G702 Application and Certificate for Payment APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF PAGES TO OWNER: PROJECT: APPLICATION NO 0 Distribution to: OWNER FROM CONTRACTOR: CONTRACT FOR: VIA ARCHITECT: PO NUMBER#: VENDOR#: ACTIVITY#: CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet, AIA Document G703, is attached. PERIOD TO: PROJECT NOS: CONTRACT DATE: ARCHITECT CONTRACTOR The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. 1. ORIGINAL CONTRACT SUM $ 2. Net change by Change Orders $ 0.00 CONTRACTOR: 3. CONTRACT SUM TO DATE (Line 1 ± 2) $ TOTAL COMPLETED & STORED TO $ 0.00 DATE (Column G on G703) By: Date: 5. RETAINAGE: a. % of Completed Work $ $0.00 State of: County of: (Column D + E on G703) Subscribed and sworn to before me this day of b. % of Stored Material $Included in above Notary Public: (Column F on G703) My Commission expires: Total Retainage (Lines 5a + 5b or Total in Column I of G703) $ 0.00 ARCHITECT'S CERTIFICATE FOR PAYMENT 6. TOTAL EARNED LESS RETAINAGE $ 0.00 In accordance with the Contract Documents, based on on-site observations and the data (Line 4 Less Line 5 Total) comprising the application, the Architect certifies to the Owner that to the best of the 7. LESS PREVIOUS CERTIFICATES FOR Architect's knowledge, information and belief the Work has progressed as indicated, PAYMENT (Line 6 from prior Certificate) $ the quality of the Work is in accordance with the Contract Documents, and the Contractor 8. CURRENT PAYMENT DUE $ 0.00 is entitled to payment of the AMOUNT CERTIFIED. 9. BALANCE TO FINISH, INCLUDING RETAINAGE 0.00 (Line 3 less Line 6) AMOUNT CERTIFIED $ CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS (Attach explanation if amount certified differs from the amount applied. Initial all figures on this Total changes approved Application and onthe Continuation Sheet that are changed to conform with the amount certified.) in previous months by Owner ARCHITECT: Total approved this Month By: Date: TOTALS $0.00 $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without NET CHANGES by Change Order $0.00 prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702 APPLICATION AND CERTIFICATION FOR PAYMENT 1992 EDITION AIA 1992 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC Users may obtain validation of this document by requesting a completed AIA Document D401 - Certification of Document's Authenticity from the Licensee.

80 G703 Continuation Sheet CONT INUAT ION SHEET AIA DOCUMENT G703 PAGE OF PAGES AIA Document G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing Contractor's signed certification is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply. APPLICATION NO: APPLICATION DATE: PERIOD TO: ARCHITECT'S PROJECT NO: A B C D E F G H I J ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL % BALANCE RETAINAGE NO. VALUE FROM PREVIOUS THIS PERIOD PRESENTLY COMPLETED (G C) TO FINISH (IF VARIABLE APPLICATION STORED AND STORED (C - G) RATE) (D + E) (NOT IN TO DATE D OR E) (D+E+F) 1 General Conditions 2 Finishes 3 Mechanical 4 Electrical 5 Special Construction Breakdown has to match the line items in the Purchase Order GRAND TOTALS $0.00 $0.00 $0.00 $0.00 $0.00 0% $0.00 $0.00 Users may obtain validation of this document by requesting of the license a completed AIA Document D401 - Certification of Document's Authenticity

81 Purchase Order Sample

82 How It Works Payment for work performed, materials and subs must be requested monthly Pay application for previous month is due by the 10 th of the current month (example: work from to must be invoiced no later than )

83 How It Works Two weeks for review by architect and JHS management Accounts Payable will process pay applications from the 1 st to the 15 th of each month

84 Architect/Engineer Request for Payments Architect and engineer invoices must include specific information as follows: Total contract amount Previous billings Percent completed Total billed-to-date Current amount due

85 Activity # Required on Forms Five-digit number assigned to each project by Jackson Purchase Order (PO) # Number provided by Procurement to each contract Vendor Number Unique five-digit number assigned to each vendor by Jackson Standard Invoice Format Breakdown should correspond to line # s in PO

86 [Your Company Name] [Street Address] [City, ST ZIP Code] [Phone] [Fax] [ ] A/E Services Invoice Format A/E Standard Invoice [Your Company Slogan] INVOICE INVOICE NO. [100] DATE October 30, 2014 ACTIVITY# PO# VENDOR# TO JACKSON HEALTH SYSTEM [Street Address] [City, ST ZIP Code] [Phone] PO Line# Description Contract Amount Prior Billed % Complete Total Billed Current Billed 1 Schematic Design - 2 Design Development - 3 Construction Documents - 4 Contract Administration 50% - 5 Contract Administration 100% - Reimbursable Expenses - TOTAL FEE Make all checks payable to [Your Company Name] THANK YOU FOR YOUR BUSINESS! TOTAL $ -

87 Thank you for your interest in doing business with Jackson