Children's of Alabama Hospital Project Children's of Alabama is a pediatric health system in Birmingham, Alabama. The system's main hospital is located on the city's Southside, with additional outpatient facilities and primary care centers throughout central Alabama. Recently, the Childrens of Alabama received permission from the State Health Planning and Development Agency to expand facilities and services on its downtown medical center campus. A portion of this expansion (hereinafter referred to as the project) includes a fit-up of approximately 4300 SM (46,000 SF) of the 4th floor of the Existing Main Hospital (EMH) for a new 34-bed inpatient Child Psychiatry Center (CPC) and space for outpatient child psychiatry services. The project also includes a renovation of approximately 1500 SM (16,000 SF) of existing space on the 3rd floor of the EMH for Physical Therapy and Occupational Therapy (PTOT) services and replacement of the HVAC unit serving this floor. The scope of work includes infection control provisions, selective demolition; installation of gypsum board partitions and ceilings, lay-in ceilings, and masonry partitions; new finishes including carpeting, sheet flooring, rubber base, painting, new doors, frames, and hardware; millwork; interior and exterior glazing and windows; and modifications and additions to the plumbing, mechanical, electrical and fire protection systems. The total estimated cost is approximately $9 million including the cost of the demolition package and the cost of the renovation/retrofitting package. It will be a design-bid-build project with a demolition package released in the design development phase. The total project duration is 9 months. There are financial incentives for the GCs to complete this project under $9 million and within 9 months. Some of the challenges in this project are as follows: Childrens of Alabama is a continuously operating hospital running daily, serving thousands of patients yearly. Any construction activity must have a minimal impact on the hospitals environment. Since the project area is bounded by two operational floors, every modification to a service that travels between these floors involves a coordinated shutdown in consultation with the hospitals facilities department. Also, various operating departments and circulation are on the same floors. Large ducts and new piping mains are required to be run through the ceilings of these operating areas as part of the project scope of work. The acceptable time to shut down these areas is very small.

2 The first Childrens of Alabama hospital building on the current campus was designed in 1959 and completed in 1960. Since hospitals in the 1960s contained significantly fewer utilities and services above ceilings, the floor-to-floor heights are very small (approximately 327 cm or 108). The majority of the additions to the facility have to be confined to the same spacing as it is extremely difficult to modify the floor-to-floor heights without disrupting hospital activities. Though the major Mechanical, Electrical, and Plumbing (MEP) services are documented on an as-built facility inventory, the information is not sufficient for coordination and prefabrication of a new MEP system. This deficiency results from the nature of traditional as-built drawings - they lack the Z-attribute or elevations of the MEP scope. Exacerbating the problem, many of the facility drawings are prepared for design and Maintenance-related activities, including listing loads, sizing, and equipment identification, but they are not accurate enough for construction-related activities such as coordination and installation of the new MEP system. The inpatient psychiatry area of the project has special requirements beyond normal hospital construction. All building elements in patient rooms should be both tamper-proof and anti-ligature. As a result, maintenance and access equipment such as terminal unit valves, equipment control panels, plumbing zone valves, and electrical boxes must be located in congested hospital corridors to prevent patient access. This will prevent the possibility of a patient accessing and tampering with building systems