TECHNICAL REPORT OF PRELIMINARY

CONDITIONS
(ITCP)

“CONSTRUCTION, EQUIPMENT AND

INSTALLATION OF THE NEW HOSPITAL
“GASTROENTEROLOGICAL OF PEACE”

La Paz, Bolivia
TECHNICAL REPORT OF PRELIMINARY CONDITIONS
(ITCP)

NAME OF “CONSTRUCTION, EQUIPMENT AND INSTALLATION

PROJECT: OF THE NEW GASTROENTEROLOGICAL HOSPITAL OF THE
PEACE"

1. JUSTIFICATION OF THE PROJECT INITIATIVE:

The need for the implementation of this public investment project is justified within the
framework of:

Political Constitution of the State -Article 35 I. The State, at all levels, will protect
the right to health, promoting public policies aimed at improving the quality of life,
collective well-being and free access of the population to public services. II. The health
system is unique and includes the traditional medicine of indigenous nations and
indigenous peasant peoples.

Economic and Social Development Plan - Chapter III describes the main strategic
policies and guidelines (SAFCI, Unified Health System, Quality of Health Services, Health
Stewardship, Traditional Medicine and Intercultural Health). The life systems identified in
the Macroregions in which the territory is structured are analyzed for comprehensive
planning purposes; The contribution of the health sector is shown.

PATRIOTIC AGENDA 2025. -Our goals of the patriotic agenda in the socialization and
humanization of basic services are the following:• 100% of Bolivian men and women have
health services. Young people, girls and boys, grandmothers and grandfathers, pregnant
mothers, all Bolivians enjoy with joy and happiness permanent health care appropriate to
their requirements and needs. Access to health services is a human right that is fully
fulfilled in Bolivia.

2. PROJECT IDEA:

The idea of implementing this public investment project is justified according to the
following criteria:

Goals: Meet the demand for care and improve diagnosis to reduce
morbidity from GI disorders, through
 construction, equipment of a new 3rd level Hospital.

Beneficiaries: The Department of La Paz (DLPZ) is divided into 20 Provinces and

87 Municipalities. It reaches a total population (potential
beneficiaries of the health system) of 2,719,344 people.

Current: Demand that With project : Satisfy demand

saturates the attention for this of attention and
specialty in the HGBJ reference improve services with adequate
center of La Paz, which was infrastructure and modern
founded in 1979 (infrastructure equipment.

and
deteriorated equipment),
attention to services that double
the capacity for which it was
Location Department: La Paz
built Province: Murillo
Municipality: La Paz Community(ies): Our
Lady of Peace
Current situation: Bolivian Japanese Gastroenterological Hospital It
has:
• 45 beds for hospitalization
• 5 beds for you
• 5 IC beds
• 4 Operating Rooms (2 in maintenance)
• 1 Laboratory unit
• 5 offices of external care

Annual population growth rate of 1.7%

Demanding population Potential: 7 out of 10
M/F people have Gastritis. Dept. Peace
Effective population seeking care: 80 – 100
H/F patients > average 90 patients daily.
Demand = 90 patients daily

Problems/Needs • There is not enough infrastructure to

meet the demand for care
• There is not enough equipment for the
demand for attention
• There is deficient attention in the diagnosis of
these pathologies in the 1st-2nd level health network
• Access to medical facilities and the care that
the population receives is limited by the quantity and
location of them
 Potentials • Improve timely care for this type of
pathologies with an infrastructure for specialized care
• Meet the need for care of the population in the
project lifespan
• Improve the general health conditions of the
population suffering from these pathologies
• The accessibility of treatment for pathologies that
require a medical specialty

Project proposal Improve the capacity of care at the 3rd level for specialized care in
Gastrointestinal pathologies, with the main objective of providing
efficient attention to the existing demand for these pathologies.

Project Type ☐ Productive ☐ Social

Category ☐ Major ☐ Medium ☐ Minor ☐ Not applicable
Project ☐ New ☐ Improvement/Expansion ☐
Rehabilitation
Management Method ☐ Superficial ☐ Technique ☐ Mixed
Pre-investment cost Bs.200,000.00 (Two hundred thousand 00/100 Bolivianos)
3. SOCIAL COMMITMENT:

Documented social commitment

YEAH NO
Letter of request from the beneficiaries and commitment to support for pre-investment and
execution.

In support of the population and the beneficiary sectors with the future project in support
of the treatment of gastroenterological diseases, the population is urged to support this,
which will carry out different specific actions such as temporary or permanent programs to
support the population, this being the one that generates field initiatives. social that
provide added value to the area, to the social responsibility of the center and its presence
in civil society.
Letter of intent from the Executing Entity to enable the study, execution and technical
assistance (VRHR, GAD and/or GAM)
The study is carried out under the guidance of Article 15.- (Participatory planning ) ☐
☐
Shared management with popular participation in health will be implemented through
participatory planning as a mechanism that guarantees the presence of the Municipal
Government or

Association of Municipalities, SEDES and society organizations in the design and

management of their own development.
In the execution part, the operational expenses
Operational expenses are related to Goods and Services
Food and beverages : The annual consumption of food is considered, which consists of:
vegetables, greens, groceries, legumes, meat, dairy and nutritional formula.
Textiles, clothing and footwear : It is calculated based on the annual consumption of a
hospital center which includes the following items: safety elements such as: boots, ankle
boots and safety shoes, set of disposable clothing for the ward, overalls, chamois, helmet,
jacket , shirt, apron, pants, bedding items, cloth, sanitary pads, etc. Materials of use or
consumption: The costs were considered on the historical basis of the annual
consumption of a hospital center.
Basic services
• Electricity
• Water
• Gas

4. LEGAL SITUATION:

According to the Bolivian Construction Regulations, of the Vice Ministry of Housing and
Urban Planning dependent on the Ministry of Public Works, Services and Housing; In its
Article No. 48 it states that the Real Folio is the document accrediting the ownership right
issued by the Real Rights office, to recognize the owner of a property, building or property.

The Autonomous Departmental Government of La Paz GADLP, is in charge of the

administration of the Third Level Hospitals, through the Departmental Health Service
(SEDES), the latter is the body that performs its functions in accordance with the Political
Constitution of the State. , in charge of complying with Health activities at the
departmental level, so that it contributes to the social well-being of our department.

In this understanding, the GADLP and SEDES are responsible for allocating the land located
within the Miraflores Hospital Complex for the implementation of the project, preferably on
land adjacent to the Institute of Gastroenterology.

The property intended for the construction of the project must have the respective Royal
Folio, the Public Deed in which the transfer from the Municipal Autonomous Government of
La Paz to the Departmental Autonomous Government of La Paz is carried out. Likewise,
having a cadastral certification, the entire property will be in the name of the Autonomous
Departmental Government of La Paz.

Within the framework of Law 412 Law of Intergovernmental Agreements and Agreements
of January 25, 2016, the GADLP will sign an Intergovernmental Agreement with the
Ministry of Health, which establishes the following obligations of the GADLP:

- Legally have a property next to a Health Establishment, for the implementation of the
project.
- Authorize access to the project location.
- Deliver all the legal documentation of the property, duly registered
in DD.RR.
5. IMPACT OF RIGHTS OF WAY:

According to the Bolivian Construction Regulations, of the Vice Ministry of Housing and
Urban Planning dependent on the Ministry of Public Works, Services and Housing; In its
Article No. 50 it indicates that the use of public roads requires authorization to:
a) Carry out works, modifications or repairs on the same public road;
b) Occupying public roads with temporary public service installations, semi-fixed
businesses, temporary constructions, or street furniture;
c) Breaking the pavement, excavating or making cuts in the sidewalks and curbs of public
roads for the execution of public or private works, and
d) Works for underground or aerial installations on public roads.

Municipal Governments can develop specific regulations for the use of roads and public
spaces according to their own characteristics.

The Miraflores Hospital Complex, located in the Miraflores Bajo area, Macro District No. 7
Center of the City of La Paz, has a surface area of 69,728.43 m2. This is made up of 8
Health establishments, the Thorax Institute, and the Japanese Bolivian Gastroenterological
Institute. University Clinical Hospital, Children's Hospital, Women's Hospital, Departmental
Blood Center and the Institute of Nuclear Medicine.
 GRAPH Nº 1 LOCATION OF THE MIRAFLORES HOSPITAL COMPLEX

Institute of
gastroenterology...

Acuity of Women's hospital

Medicine -
UMSA CHILDREN'S
HOSPITAL “DR.
OVIDIO...
National Institute of
Nuclear Medicine

AAavor
Zubieta
Given that the implementation of the project is considered within the center of the city of
La Paz, in an urban area, it must comply with the construction regulations issued by the
Autonomous Municipal Government of La Paz, regarding the planimetry corresponding to
the Bajo Miraflores area.

6. ENVIRONMENTAL ANALYSIS:

Law No. 1333 aims to establish an adequate legal framework to protect and conserve the
environment and natural resources, regulating man's intervention in his environment,
promoting sustainable development.

Within the framework of what is stated in Supreme Decree No. 3549, of the Environmental
Prevention and Control Regulation, the corresponding Environmental License must be
processed through the Regulatory Instruments of Particular Scope (IRAP's), for the
“Construction, Equipment and Installation of the Gastroenterological Hospital of La Paz.”

The Environmental License must be processed through the National Environmental

Categorization Form (FNCA), which must be presented by the Governor of the
Department of La Paz, because the project corresponds to a Third Level hospital and is
located in the Miraflores Hospital Complex of the Municipality of La Paz of the
Department of La Paz, so the responsibility falls on the Autonomous Departmental
Government of La Paz within the framework of what is established in Law 031 of
Autonomies.

The Departmental Autonomous Government of La Paz, as Legal Representative of the

Project, must carry out the consultation before the National Competent Environmental
Authority (Ministry of Environment and Water), attaching the corresponding
endorsements to obtain the project category.

7. IDENTIFICATION OF POSSIBLE DISASTER RISKS AFFECTING THE

PROJECT:

Because the Miraflores area of the city of La Paz has a regular topography and good
type of firm soil. According to the Risk Map of the City of La Paz, Miraflores is a low
landslide risk area.
 GRAPH Nº 2 RISK MAP OF THE CITY OF LA PAZ
The delights
Red wine

Villa Fatima Spring

Pure Pure Cosmos

Willa

victory Villa Copacabana

The Tejarr
VILLA SAN ANTONIO 1

Great Power, Santa Barbara 3 Panpahasi________________________________ San

Irpavill
Pedro Octavio Campero J^de-lgFlOTes-
cm * Kellumani'
MiratloresBajoVillaArmoniaKupini
City. Stronguista - eo. -
Los Rosales
Trembler

r- 2
\ ' HWer 4
SEIVerg
1
30-a,Huanu
24
June HuanunrpaviKoani
Baj0 Achumani
elito) 71 Inca Uojeta' 3 32 "SM!
Alpacoma *2/

The corner place

i list
La Paz river margins 19. Former Kantutani dump
20. March 23 - Acuma
Mallasa Sanitary Landfill
21. Juan Sin Miedo - Tejajahuira
Achocada River margins 22. Kupini La Plaqueta
The Pedregal Lilies 23. San Isidro Alto
24. Gudadela Stronguista Norte
Cota Cota street 25 to street 28
Cota Cota street 32 to street 35 Codavisa
Calle 23 Bella Vista - Ventilla Las
25 Vila Armona -N Centauro Germán Jordan 'REFERENCE
Carmelitas 2 G. Villa San Antonio
. July 24 (Segúencoma Alto) Calle 29 Las 27, ñordelrpavi • Very low
Lomas - Achumani
• Low
28. Santa Barbara I Moderate
. Santa Fe de Kessini 29. Octavio Campero 'Jüpapina
30. Irpavi River, right and left bank • High
. 20th Street Bella Vista
31. Valle Hermoso - Villa Copacabana • Very high
. Final Armanza
.. Div. Macrodistricts
Francisco Bedregal I - Figaro Court.
32. Aqua of Life II Lim. Municipal
Green Beach - Adela Zamudio 33. Litoral Plaza
Cotahuma Julio Téllez 34. East Slope – Valley of Flowers
35. San Simón- San José -Santa Catalina
. Alpacoma Llojeta
36. Limanipata

8. ASPECTS OF CONSIDERATION ACCORDING TO THE COMPLEXITY OF THE

PROJECT:

Communication routes

The Miraflores Hospital Complex is located in the lower Miraflores area. Due to its central
location, it has several communication routes that connect the entire city of La Paz with the
project area, such as the South Zone, Sopocachi, Center, Puentes Trillizos, all of these
areas are located within the urban area, they are correctly paved and all roads are two-
way. There are 6 entrances, 6 exits to access the Miraflores Complex, currently, the
entrance to the Institute of Gastroenterology is shared with the Hospital de Clínicas.

Climatology of the city of La Paz

The city of La Paz is influenced by high altitude winds, mainly from the west in the winter
and those from the north and northeast in the summer; however, there is also an
interaction of surface winds with a northeasterly direction caused by orographic factors and
local premises of the city.

The ambient temperature within the sector, according to SENAMI data, is the lowest in the
month of July. The highest temperatures recorded correspond to the month of November
with values of 13.28ºC and 12.76ºC
Precipitation

In terms of rainfall, the region in which the project is located presents a seasonal variation
in the average annual precipitation, with a dry winter and the rainy season that occurs in
the summer. What should be considered in the construction stage of the project

Air Quality

In the Miraflores area there is air pollution in the sector, and it has prospects of increasing
due to the growing number of vehicles, which travel throughout the day and night.
However, in the project area, there is not much traffic for vehicles or other agents that
emit suspended particles or other atmospheric pollutants.

Noise

It is characteristic of motorized vehicles, especially during peak hours, which is also

increased by honking, despite the Municipal Ordinance that prohibits honking. In the
specific case of the Miraflores area, there is said environmental impact during peak hours
on Av. Saavedra because there are activities with a high influx of people such as the
Faculty of Medicine, Faculty of Biochemistry, Pharmacy, the General Staff is located near,
therefore, there is a significant acoustic impact.

Potable water and sewage services

In the city of La Paz, the drinking water and sewage service is operated by the Social
Public Company for Drinking Water and Sanitation (EPSAS), a company regulated by the
Authority for Supervision and Social Control of Drinking Water and Basic Sanitation (AAPS).

The lower Miraflores sector, where the Hospital de Clínicas of the city of La Paz is located,
receives drinking water supply from the Pampahasi system. The water comes from the
Incachaca and Hampaturi basins and is made drinkable at the Pampahasi Drinking Water
Treatment Plant. This system supplies the South and East Zones of the city of La Paz. The
Pampahasi drinking water treatment plant delivers drinking water with the quality
established in the Bolivian Standard NB 512. The offered volume of water covers the
requirements in the coverage area.

Regarding sewerage, in the city of La Paz in general, both the sanitary sewer network and
the storm sewer network discharge directly into the rivers and dams that flow through the
city.

Contamination of the water source or production areas

• Fundamental aspects
• Reduction of the hospital's negative environmental impact by generating less
special and pathogenic waste and with the implementation of recycling.
• Creation of a horizontal Biosafety and Waste Management Committee
participatory.
• Awareness about the participation in the problems of all hospital disciplines.
Electric service

In the DELAPAZ Project sector, it has medium voltage power lines on Av. Saavedra and the
adjacent streets, in addition DELAPAZ manages the medium voltage network in the
Miraflores Hospital Complex.

Telephone and internet service

In the city of La Paz, the landline telephone service is provided by the Cooperativa de
Telecomunicaciones La Paz Ltda. (COTEL). In the project sector, COTEL has telephone
network coverage, and through that network it also offers ADSL internet service.

Likewise, the National Telecommunications Company (ENTEL) in the project sector has a
Fiber Optic distribution box (FTTH), from which it is feasible to provide Internet, IP, TV or
data transmission services, so On the project site you can access these services without
any problem.

Finally, the sector also has VIVA and TIGO mobile telephone services as well as internet
facilities from the same companies and AXL.

Sustainability of social management regarding the project idea

To establish adequate social management, the following parameters must be met

a) Establish human resources planning for effective management linked to the
strategic objectives, mission and vision of the Ministry of Health.
b) Guarantee the appropriate distribution of human resources in quantity and quality
for the organization of services in all health sector establishments.
c) Influence the training of different professional and technical health profiles to
respond to the epidemiological situation in the sector, in coordination with training
institutions and providers of health services.

9. CONCLUSIONS AND RECOMMENDATIONS:

The result of the diagnosis of justification of the initiative; developed in this Technical
Report of Prerequisite Conditions, based on the objectives, goals and purposes of the
project and mainly due to the existing demand that saturates specialized care for the
population, which translates into prolonged hospitalizations, inadequate and inopportune
diagnoses and a high degree of dissatisfaction among users of health services. In addition,
high unquantified morbidity rates are generated that may be attributable to inadequate
processes, given the infrastructure and technology that currently exists, therefore it is
pertinent to improve the quality of specialized care for the population, with the
construction of new infrastructure. specifically designed for: equipment, care, clinics and
training and research considering the factors described in the Technical Report of
Prerequisite Conditions.

PROJECT TYPE ACCORDING TO STANDARD

According to Article No. 11 of Ministerial Resolution 115 of the Basic Pre-investment

Regulation, projects aimed at improving the living conditions of the beneficiary population,
which allow improving human capital in a comprehensive and sustainable manner, through
investments in infrastructure and equipment , and if applicable training; such as:
installation of drinking water, sewage systems, river vaulting, energy supply, construction
and/or renovation of hospitals, educational centers, social housing, sports fields, cultural
centers, etc. Therefore, the project “Construction, Equipment and Installation of the New
Gastroenterological Hospital of La Paz” is classified as a Social Development Project
because it will improve the living conditions of the population affected with gastrointestinal
pathologies.
 TERMS OF REFERENCE
CONSTRUCTION, EQUIPMENT AND INSTALLATION OF
THE
NEW LA PAZ GASTROENTEROLOGICAL HOSPITAL

OBJECT OF CONTRACT:

“Establish the technical scope and budget for the Construction, Equipment and Installation
of the New Gastroenterological Hospital of La Paz, for the start-up
“March of a 3rd Level Hospital for the Gastrointestinal Specialty”

TERMS OF REFERENCE

INDEX

1. JUSTIFICATION.
2. GOALS.
2.1 GENERAL OBJECTIVE
2.2 SPECIFIC OBJECTIVES
3. SCOPE ACTORS AND RESPONSIBILITIES
3.1 SCOPE
3.1.1 MODALITY AND PLACE OF WORK
3.2 LOCATION
3.3 ACTORS AND THEIR RESPONSIBILITIES
4. INDICATIVE METHODOLOGY
5. TASKS TO DO
6. PRODUCTS AND REPORTS TO BE DELIVERED
6.1 PRODUCTS
6.2 REPORTS.
7. ESTIMATION OF WORK TIME
8. KEY PERSONNEL
9. BUDGETTOTAL AMOUNT OF CONSULTING FOR THE STUDY
10. ANNEXES

La Paz, Bolivia
2020
 1. JUSTIFICATION

Third Level hospitals are institutions that are part of the Health Services Network,
with a dynamic with the First, Second and Fourth Level health establishments of
care through the Reference and Counter-Reference System for the care
components, diagnosis, treatment. , rehabilitation, teaching advice, research and
epidemiological surveillance.

The department of La Paz currently has a third-level hospital for the Specialty of
Gastroentrology-GI which, within the framework of autonomy and decentralization,
is under the responsibility and dependence of the Autonomous Departmental
Government of La Paz and is as follows:

• Japanese Bolivian Gastroenterological Institute,

This institution provides services to the entire population of the department,
including the country and other places that require it, especially the low-income
population.

Currently, this tertiary hospital operates with the same infrastructure and
equipment, both in the provision of health services and in the areas of research,
since its creation in 1979, which implies that the capacity for care has currently
been exceeded with which was created, doubling its installed capacity and
decreasing the quality and efficiency in serving current demand.

As can be seen in the following table, the demand for care in the years 2012-2013-
2014 is increasing.

UNIT 2012 2013 2014 Total

No. EXTERNAL CONSULTATION 21600 23500 25700

No. HOSPITALIZATION 11000 12556 13789
No. SURGERY 6789 8657 8907
No. LABORATORY ANALYSIS 8900 9654 10987
No. 5678 6785 7890

No. OF ENDOSCOPIES 12345 13098 14563

No. OF ULTRASOUNDS 10876 11345 12987
TOTAL 70399 85595 94823 250817
Source: LA PAZ Headquarters

The existing demand that saturates the care currently provided by the Japanese
Bolivian Gastroenterological Institute translates into prolonged hospitalizations,
inadequate and inopportune diagnoses and a high degree of dissatisfaction among
users of health services. In addition, high unquantified morbidity rates are
generated that may be attributable to inadequate processes, given the
infrastructure and technology that currently exist.

Therefore, the tertiary hospital project for Gastroenterology-La Paz will improve the
resolution capacity, providing better and efficient care and increasing patient
satisfaction.
2. GOALS

2.10 general objective

The general objective is to establish a Study with the technical scope and
budget for the CONSTRUCTION, EQUIPMENT AND INSTALLATION OF THE NEW
LA PAZ GASTROENTEROLOGICAL HOSPITAL.
This Objective must be framed in a vision aimed at improving the quality of
specialized care for the population, with the construction of new infrastructure
designed specifically for: equipment, care, clinics and training.

2.20 specific objectives

• Prepare calculations, metrics and budget calculations for the work,

execution plans, start-up, maintenance and operation (O&M)
• Perform the Environmental Assessment
• Design architectural, structural plans, electrical and support engineering,
hydrosanitary, data and communication systems, equipment and design
of special facilities for 3rd level hospitals of the GI specialty.
• Develops the Human Resources calculation required for the operation of
the new hospital with its respective operations and procedures manuals.

The Study must be prepared in accordance with the provisions of the Public
Investment and Financing Subsystem , the RBP (Basic Pre-investment
Regulation) and the regulations applicable to the design of Health
Establishments. And international regulations for electrical, hydrosanitary,
communications systems, etc.

3. SCOPE ACTORS AND RESPONSIBILITIES

3.1 Scope

The scope detailed is not limiting. All calculations, assertions, estimates or data
must be conceptually and/or analytically justified and estimates or assessments will
not be accepted without due support.
The Consulting Company and/or the consultant will be responsible for the work to
be carried out within the scope provided in this Document and the content of its
proposal.

3.1.1 Modality and Place of Work

The contracting modality to be applied is Fixed Budget.

The workplace will be limited to the area of influence of the project to

carry out its survey, testing and analysis work. Likewise, the office work
of each of its specialists in their departments or offices, having the city of
La Paz as their work base.
 3.2 Location

The location of the Project will be on the property designated by the

Autonomous Departmental Government of La Paz for the implementation of the
project within the Miraflores Hospital Complex .

3.3Actors and Responsibilities

Actors Responsibility 1 Responsibility 2
Ministry of Health Fund the Study. Provide
thematic advice. Monitor the status of the
study, by appointing a
supervisor and/or supervision
team.
Consulting Responsible for the work to
Company/consultant be carried out within the
scope provided in this
Document and the content of
its proposal.

4. INDICATIVE METHODOLOGY

• The work will be carried out under monitoring and coordination with the
supervisor. All calculations, assertions, projections or data must be conceptually,
technically and analytically justified, and estimates or assessments of the
consultant or the consulting company will not be accepted without due support.
The scope described below is illustrative and not limiting, and may be expanded
where and when deemed necessary, but without modifying the main objective.
• The consultant or consulting company must have permanent coordination with
the Ministry of Health through the Supervisor and/or designated team.
• The consultant or consulting company must present the progress of the study
through slides and dissertation thereof for the validation, socialization and
advancement of the consultancy in coordination with the Supervisor.
• Compliance with the obligations of the consultant or the consulting company will
be carried out in accordance with the deadline established in the Work Plan
proposed and validated by the contracting entity.
• The presentation of progress and reports must be done both in print and
digitally according to the Work Plan and/or at the request of the Supervisor.
• Any document, prepared at the request of the contracting entity, will be the
exclusive property of the Infrastructure and Medical Equipment Agency and may
not be used without prior authorization.

• The Ministry of Health will coordinate other unforeseen activities within the
scope of this consultancy for its proper fulfillment.
• For the engineering design, the consultant will use methodologies based on
technology and updated design standards, supported by the relevant
complementary studies (topography, geology, geotechnics and hydrology).

5. TASKS TO DO

The activities will be the following:

 • Collect and collect data for the technical scope analysis of the project
• Define the size and capacity of the Gastroenterology Hospital Project
• Survey and carry out soil studies
• Prepare project risk analysis
• Prepare and design project engineering
• Determine the equipment needed for the project
• Determine CAPEX and OPEX

An estimated period of 180 CALENDAR DAYS is considered. However, the Total

Term will be adjusted to the offer submitted by the qualified bidder. However, it cannot
be longer than the aforementioned reference period; the times involved in obtaining
other relevant documentation, if applicable, must be considered.

The proposed Term in calendar days will be computed from the date on which the
ASSIGNED Counterparty (SERVICE SUPERVISION) issues the Order to Proceed ,
by order of the CONTRACTING PARTY . If an advance payment is granted, the Order
to Proceed cannot be issued before the total disbursement of the advance payment is
made. Once the Order to Proceed is issued, the execution period of the Consulting
Project will begin to run.

The proposer must present his WORK SCHEDULE appropriate to the period
established for this Consultancy (180 calendar days) according to his resolution and
document management capacity, for the evaluation of THE ENTITY .

• .1Technical Proposal.

Concept: Interpretation made by the proponent of the Contract, demonstrating

the knowledge he or she has of the particular project. It contains an
interpretation and analysis of the technical specifications and conditions of the
Contract, establishing and justifying coincidences and disagreements with them.
Approach: It is the Bidder's explanation to carry out the contracting under
criteria of coherence and logic.
Methodology: Description of the methods that the Proposer will use to achieve
the scope of work in the development of the Project. If the Proponent considers
it so, it will be convenient to highlight which of the proposed methods are novel
and differentiating from the proposed methodology.
The Proponent must explain the reporting methodology, type of forms to be
presented and models for controlling and monitoring the Development of the
Project.

Objective and Scope: The Proponent must describe the appropriate way to
achieve the objective and scope of the work according to the ultimate goal
pursued by the entity.
Work Plan: It is the description of the logical sequence expressed in a work
schedule that the service activities will have and their interrelation with the
intermediate and final activities, described in the scope of work with the
organization, assignment of personnel and equipment offered, to carry out the
project within the offered period.

6. PRODUCTS AND REPORTS TO BE DELIVERED

6.1 Products and Reports

The Consulting Company or the consultant will be responsible for presenting the
following products and reports agreed upon and validated by the contractor.

A) PRELIMINARY STUDIES
Survey of the area to intervene:
i. Survey of the area to intervene.
ii. Survey and determination of project size
iii. Survey of necessary technical data in relation to the
equipment.
iv. Coordination in relation to equipment (coordination meetings with
Eng. Biomedical).
v. Engineering work.
vi. Cost Determination, General Budget, Work Schedule, Unit Price
Analysis, Technical Specifications, Metric Computations.
B) ARCHITECTURE PROJECT
Architectural plan with solution schemes approved by the corresponding
authorities
There must be plans, models and virtual tours of the Project to Final
Design for a better presentation and understanding of it.

C) STRUCTURAL ENGINEERING PROJECT

The study of the structure will contain sufficient information to enable the
design or new arrangement of walls and supports of the structure, as well as
determine the influence on neighboring works. The study must contain at least
the following basic parameters:
i. Bearing capacity of the land
ii. Typology of the current structure to consider modifications,
opening of openings, etc.
iii. Behavior of the structure with the installed equipment.

In the case of soils with special characteristics and/or large structures,

additional parameters will be required such as:
i. Soil resistance modulus
ii. Shear modulus
iii. Poisson 's ratio
iv. Conception of the structure.

v. Choice of materials.
vi. Introduction of security.
vii. Structural calculation memory
viii. Calculation of requests.
ix. Technical specifications sheet.
x. Metric calculations.
xi. Descriptive report of the structural works project.
xii. Steel sheet and reinforcement
xiii. Estimated work execution schedule by activity
D) HYDROSANITARY FACILITIES PROJECT

i. Location of the public drinking water network (connection point(s))

ii. Basic description of the water supply system
iii. Basic description of the storm and sanitary sewer system
iv. Location of public networks of sanitary and rainwater collectors
v. Determination and initial calculation of consumption, pre-sizing of
the drinking water distribution network
vi. Connection and supply network for hot and cold drinking water
vii. Design and calculation of storage and distribution tanks, buried
and/or elevated tanks, pump house and facilities in case of fires
viii. Descriptive report of the project containing the technical
explanation of the solutions adopted, compatible with the
architectural preliminary project

E) ELECTRICAL INSTALLATIONS PROJECT

i. Location and characteristics of the public network, pointing out the
possibility of supplying energy to the new facilities.
ii. Descriptive memory of lighting levels for each service area
iii. Descriptive report, of the scope of the distribution of electrical
energy and location of equipment based on the architectural plan.
iv. Pre-installations for the supply of electrical energy to medical
equipment, air conditioning, sanitary hydro, medical gases
v. Electrical power sources (Public Grid, generators and UPS)
vi. Protection against lightning strikes
vii. Surge protections
viii. Service ground meshes, protection
ix. Luminaire characteristics for each service area
x. Minimum content of the technical specifications of each item
xi. Standards to be applied in the electrical project
xii. Technical description of the performance tests
xiii. In addition to all the required technical instruments, a schedule of
activities for the engineering works will be attached. Electrical,
showing the logical stages of execution and their
interrelationships, perfectly coordinating all aspects of the
systems that, in the construction stage, could be subject to
interference. An operations and maintenance manual for the
facilities must also be included.
xiv. Technical specifications of the items.
xv. Volume of works and estimated budget.

F) COMMUNICATION SYSTEM INSTALLATIONS

i. Location and characteristics of the public network, indicating the

possibility of connection to the new facilities.
ii. Descriptive report of the scope of the security systems
location communication based on the architectural project.
iii. Telephone system with wiring and equipment
iv. IP data network system (LAN), for voice, data and image
management, wiring and equipment.
v. IP data network system for planned medical equipment.
 vi. Work stations
vii. Patch panel, switch, backbone, etc.
viii. Communication data center, air conditioning
ix. Security and surveillance systems, wiring and equipment
x. Access control system, wiring and equipment
xi. Closed circuit television wiring and equipment
xii. Fire alarm, wiring and equipment
xiii. Nurse patient call, wiring and equipment (yes)
corresponds
xiv. Reference budget

G) SPECIAL FACILITIES PROJECT

i. Category to be installed for the provision of Natural Gas

ii. Reference budget for the implementation of these systems
iii. Rush design
iv. Technical memory
v. Metric calculation and works budget definitive
vi. Minimum content of specifications techniquesof each item
vii. Project execution schedule

H) Final Design of Heating and Air Conditioning Installations

i. The heating system will be of the central type, that is, there will
be a Hot Water boiler, this boiler will operate based on Natural
Gas. The boiler will distribute hot water to the different rooms of
the project through a system of special pipes for this type of
heating method.
ii. The heat emission will be based on radiators sized to meet the
needs of the different environments to be heated.
iii. The system must cover the entire Building in its different
environments, both for medical personnel and for patient and
office environments, including the different waiting rooms that
may exist.
iv. Air conditioning systems must be considered in specific areas
required by the project. Based on this, the determination of the
Air Conditioning system to use
v. Technical project report
vi. Minimum content of the technical specifications of each item

I) BIOMEDICAL ENGINEERING PROJECT

The final Biomedical Engineering project must be specified in accordance

with the architectural project and compatible with other engineering
projects in a way that allows the adequate execution of specific works for
the correct and comfortable location of the equipment, especially those
that require mechanical installations and electrical, which must be
compatible with the specifications and characteristics of the equipment
available on the market.

The service must have the appropriate infrastructure necessary for its
 operation in accordance with standards recommended by all health
organizations; it must have an infrastructure in accordance with the
complexity and benefits determined in the approach section.

There must be a person in charge who channels the needs, uses and
requirements of each space, especially in the operating room area,
making a detailed description of the minimum elements necessary to
install, uses of each operating room and each space, based on these
plans. the design of the different installation systems.

The most relevant aspects, including the regulations, regarding the

complex installations of:
i. Electricity
ii. Air conditioning
iii. mechanical installations
iv. Start up
v. Maintenance of the installations
vi. The functionality box HE will be based on the following
environments
surgical area:
• Waiting room
• Gray area- Transfer
• Surgical staff clothing
• doctors room
• Bathrooms with showers
• Pre-anesthesia room
• Washed
• Recovery room
• White area- Corridor, operating rooms, anesthesia room
• Operations room
• Emergency operating room
• Operating room nursing service
• Nursing material deposit
• intermediate care unit

J) Medical Equipment.

The fundamental requirements for the acquisition of equipment are:

i. Comply with the required characteristics
ii. Get the right capacity
iii. Cost adjustable to budget
iv. Offer full service guarantee
v. Provide a good service life
vi. Guarantee permanent maintenance

The identification of the equipment that is needed must be made

by the professional who is going to use it. In the equipment
requirement, extreme details must be taken so that errors are not
made.

Unit price . Defined as total compensation for all work, materials, tools,
equipment, transportation, labor, controls, precautions and all direct costs
 that affect the cost of the item, as well as indirect costs, such as general
expenses, social benefits , utilities, taxes, and others, that could affect the
cost of executing the item.

6.2Reports

All documentation resulting from this Study must be presented in printed form in
2 copies and in digital format. The printed product must conform to local
presentation standards.

The proponent must present all the recommendations and conclusions that it
considers appropriate according to its experience, which, although not included
in these Terms of Reference, may constitute a significant contribution to the
optimization of the Project for its operation stage.

The proponent will determine based on a Work Plan presented and approved
the delivery dates of the partial and final reports and what elements will be
contained in each report.

7. ESTIMATION OF WORK TIME

The work will be carried out in the city of La Paz – Department of La Paz. A period of
180 Calendar Days is considered.

The proposed Term in calendar days will be computed from the date on which the
Supervision and/or designated supervision team issues the Order to Proceed .

If an advance payment is granted , the Order to Proceed may not be issued

before the total disbursement of the advance payment is made . Once the
Order to Proceed is issued, the execution period for the Work will begin to run.
 8. KEY PERSONNEL

AREA OF SPECIALIZATION
No. TRAINING POSITION TO BE CARRIED OUT
TRAINING MINIMUM TIME
OF GENERAL EXPERIENCE
(YEARS)

1 PROJECT MANAGEMENT PROJECT MANAGER 4

2 ARCHITECT SPECIALIST 4

ING. CIVIL WITH MENTION IN

3 SPECIALIST 4
ING. SANITARY

4 ING. ELECTRIC SPECIALIST 4

ING. CIVIL WITH STRUCTURAL

5 SPECIALIST 4
MENTION

ING. MECHANICAL OR
6 ENGINEER.. SPECIALIST 4
ELECTROMECHANICAL

7 ING. ELECTRONIC SPECIALIST 4

 ING. ENVIRONMENTAL (WITH
8 SPECIALIST 4
VALID RENCA REGISTRATION)

9 BIOMEDICAL ENGINEERING SPECIALIST 4

10 Technical specialists Areas required by type of Project 4

9. BUDGET TOTAL AMOUNT OF THE CONSULTING FOR THE STUDY AND

DESIGN WORK

The Reference Amount of the consultancy amounts to the sum of Bs.200,000.00

(Two hundred thousand 00/100 Bolivianos).
9.1 WAY TO PAY

• Payof the 25%tothepresentationandaccordanceof the 1st Partial Report.

• Payof the 25%tothepresentationandaccordanceof the 2nd Partial Report
• Payof the 50%tothepresentationandaccordanceof the Final Report.

10. ANNEXES

In accordance with what is expressed in these Terms of Reference, the Consultant

and/or Consultant will develop their activities based on compliance with the objectives
of the proposed study.

10.1 Prevented from Participating

In order to ensure the quality of the execution of the Consulting and obtain
an impartial, independent opinion, proposers who have a relationship with
what is established in the subsections of Article 43 of Supreme Decree 0181
may not participate in this contracting process.

10.2 OTHERS:
Immediate disposition of the proponent.
 Nature of contracting: Exclusively subject to the scope of administrative and
civil law.
Taxes: Depending on the Regime of the Consulting Company hired
(essential).

THE TERMS OF REFERENCE ARE ENUNCIATIVE AND GUIDANCE, THEY ARE NOT
LIMITATIONAL, SO THE PROPOSER, IF THEY WISH SO, AND IN ORDER TO
DEMONSTRATE THEIR ABILITY IN PROVIDING THE SERVICE, MAY IMPROVE IT,
OPTIMIZING THE USE OF RESOURCES .