Warren State Hospital, Statement of Work Electrical Distribution Infrared Inspection ANTICIPATED PERIOD OF CONTRACT

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1 ANTICIPATED PERIOD OF CONTRACT The anticipated term of contract: October 1, 2016 (or upon full execution of contract; whichever is later) through June 30, The Inspection Service and Reports will be performed on an annual basis. SCOPE Work Requested: Warren State Hospital (WSH) is soliciting for the inspection and testing of the Electrical Distribution System of the facility. This system includes all of the medium and low voltage equipment, junction boxes, and splices, up to the point of each facility main disconnect, along with any emergency backup generators as identified by the contract monitor. Contractor will infrared scan the connection points and breakers of the main distribution and branch panels, including transfer switches, disconnect switches, and associated equipment for the emergency generators. Contractor will scan approximately 300 (+5%) pieces of equipment. Contractor will remove all necessary covers prior to thermographic inspection. Each piece of equipment will be inspected visually and with an infrared camera for their physical and mechanical condition. Contractor will perform any minor repairs, including but not limited to verifying proper torque tightness of all lugs; before reinstalling panel covers. Images of any anomalies or safety concerns will be documented. Any equipment that is not able to be opened while energized will be noted and reported to the Contract Monitor. Survey Report: Contractor will provide an annual report electronically with two (2) hard copies given to WSH. The report will include, but is not limited to, the following: 1. Description of equipment tested. All equipment will be labeled and identified by location, including building number and name, and room number. 2. Discrepancies. 3. Temperature difference between the area of concern and the reference area. 4. Probable cause of temperature difference. 5. Identification of inaccessible equipment. 6. Identify load conditions at time of inspection. 7. Provide photographs and thermograms of the deficient area. 8. Provide recommended action for repair. 9. Description of repair/maintenance performed. 10. Identification of the testing organization. 11. Identification of the testing technician. 12. Date of the test. Testing Personnel: Warren State Hospital requires a minimum of two (2) personnel to perform this service; one (1) Thermographer must hold a current ANSI/NETA ETT certification, Level II or higher, and a qualified Electrician. Technicians performing these electrical tests and inspections shall be trained and experienced concerning the apparatus and systems being evaluated. These individuals shall be capable of conducting the tests in a safe manner and with complete

2 knowledge of the hazards involved. They must evaluate the test data and make a judgement on the continued serviceability or non-serviceability of the specific equipment. Technicians will wear proper Personal Protective Equipment (PPE) and follow all pertinent safety rules and regulations in accordance with NFPA 70E, OSHA, and all applicable national, state, and local codes and standards. WARREN STATE HOSPITAL RESPONSIBILITIES WSH will be responsible for making all areas accessible. WSH will assist/coordinate power outages if need be. WSH will provide lists, drawings, and diagrams associated with the electrical distribution system. Lists of devices are for estimates only, actual quantities may vary. SERVICE CONTRACTOR RESPONSIBILITIES Contractor will be responsible for the removal and replacement of all covers to complete the inspection. All service for the first year will be scheduled with the contract monitor. All scheduled service for the remaining years will be performed during the months of June, July, or August of each calendar year. All scheduled service will be performed between the hours of 7:00 A.M. and 4:00 P.M., Monday through Friday, not to fall on State or National Holidays. State Holidays : Fourth of July: July 4 Labor Day: September 5 Christmas: December 26 Columbus Day: October 10 New Year s Day: January 2 Veterans Day: November 11 Martin Luther King Day: January 16 Thanksgiving: November 24 Presidents Day: February 13 Day after Thanksgiving: November 25 Memorial Day: May 29 Work schedules to be submitted to Warren State Hospital Contract Monitor prior to start of work. Any changes to be scheduled must be reviewed and approved by Warren State Hospital Contract Monitor. The contractor will sign in and out in the Maintenance Department. Contractor will be responsible for the cleanliness of the area and for any dirt and stains that his or her employees might cause. All tools and equipment must be picked up and/or removed at the end of each work day. Contractor will be responsible for repair for any damage to the building and the surrounding areas, and restore to previous original condition at no additional cost to the facility. Any special keys required for opening of doors or buildings will be furnished to the contractor who will return them immediately after the end of each work day. The keys will be available to sign out in the Maintenance building.

3 BID REQUIREMENTS No work may be scheduled or completed until a valid Purchase Order is in place. No unauthorized work may be done without prior approval from Warren State Hospital Contract Monitor. Contractor will be reimbursed only for services actually accepted by Warren State Hospital Contract Monitor. Travel Time and expenses are considered to be accompanying to the cost of work; no payments will be made for travel time or travel expenses. Warren State Hospital will notify the contractor in writing of any unsatisfactory services rendered and the contractor will correct the deficiency within ten (10) days of such notification. Proof of Visit: Bidders are required to completely inspect project site prior to submitting the bid. The mandatory site visit will be held Wednesday, August 31, 2016 at 10:00 AM. Bidder will be furnished written PROOF OF VISIT SUCH WRITTEN PROOF OF VISIT MUST ACCOMPANY THIS BID PROPOSAL. Bidders are required to attach the following to their bid response: Proof of qualifications/certifications for technicians performing the inspections Five (5) references of prior inspections (names, addresses and telephone numbers) One (1) inspection report example. Signed Proof of Visit METHOD OF AWARD The contract will be awarded to the selected supplier based on best value. Price will be used as the primary best value factor but other considerations such as past performance per references provided will be considered. MISCELLANEOUS ISSUES Contractor will provide a letter on company Letterhead identifying the Contract Monitor on behalf of Vendor. The person selected should be a person who is familiar with the contract and authorized to act on the contractor s behalf in resolving any issues relating to the contract and who will be available to the facility during regular business hours and emergency requests. At a minimum the letter should contain the contractor s contact person name, telephone number, emergency telephone number, and address.

4 Warren State Hospital Contract Monitor: Shane Ackley Medium Voltage Electrician Foreman Warren State Hospital 33 Main Drive Warren, PA Phone: INSURANCE REQUIREMENTS Prior to commencement of the work under this contract and at each insurance renewal date during the term of this contract, the bidder shall provide WSH with current certificates of insurance as stated in the Terms and Conditions. PAYMENTS TO CONTRACTOR Invoices must be summited to: By US Mail: By (Invoices Only) DHS Warren State Hospital Commonwealth of Pennsylvania PO Invoice PO Box Harrisburg, PA A copy of the invoice is also to be mailed to: Department of Human Services Office of Mental Health and Substance Abuse Services Warren State Hospital Accounting Department 33 Main Drive Warren, PA Or Fax to: Invoices should contain at a minimum the information at Attachment A Sample Supplier Invoice.

5 ATTACHMENT A Company Name Supplier Corporate Address: Company Name Street Address City, State, Zip Phone: (123) Fax: (234) SAP Vendor #: INVOICE INVOICE #[100] Customer Account #: Sales Order #: Quote #: Invoice Date: August 22, 2016 Supplier Remit Address: Company Name Street Address City, State, Zip Phone: (123) Fax: (234) SAP Vendor #: Make all checks payable to Company Name BILL TO ADDRESS: Agency/Department Name and Facility/Institution Commonwealth of Pennsylvania PO Box City, PA, Zip Tel #: SHIP TO ADDRESS: Agency/Department Name and Facility/Institution Commonwealth of Pennsylvania PO Box City, PA, Zip Tel #: COMMENTS OR SPECIAL INSTRUCTIONS: SAP P.O. Number Procurement Contact Shipped via F.O.B. Point Terms Net xx days Date of invoice receipt SAP P.O. Line Item # SAP Material # Description Quantity Shipped Unit of Measure Unit Price Total Price

6 TOTAL DUE If you have any questions concerning this invoice, contact: Name: Tel: Fax: Notes: SAP is our enterprise software system. To find out your SAP vendor numbers, please contact your procurement representative. If applicable, shipping and handling must be a line item on the purchase order and invoice. If applicable, additional documentation will be attached to this invoice as required. If applicable, provide service dates within the comments and special instructions. Recommendations when invoicing (not part of invoice template) 1. Do no submit invoices on colored paper (yellow, green, blue, etc.). Please submit on only black and white. Colored paper creates issues when they are imaged and delay the payment process. 2. Please insure that invoices are legible. If paper invoices are barely legible, scanning the invoices make them less so and delay the payment process.