CONTRACT ADMINISTRATION DATA (SF 1449, Continuation of Block 18) 1. Contract administration matters will be handled by: A. CONTRACTOR'S NAME/ADDRESS/CITY-STATE-ZIP (please print or type): _______________________________________________________________________________ _______________________________________________________________________________ Point of Contact/Title ______________________________________________________________________ Telephone Number ________________________________________________________ Fax Number _____________________________________________________________ Email __________________________________________________________________ DUNS Number:______________________________________________________________________ TIN NO:__________________________________________________________ B. GOVERNMENT: Jamila Nicholas, Contracting Specialist (69D/GLAC) Department of Veterans Affairs Great Lakes Acquisition Center 115 South 84th street Milwaukee, WI 53214-1472 (414) 844-4830 Fax (414) 844-4890 2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with Federal Acquisition Regulation (FAR) Clause 52. 232-34, Payment by Electronic Funds Transfer--Other than Central Contractor Registration (31 U.S.C. 3332). 3. INVOICES: Invoices shall be submitted to the following address by the tenth of the month: DEPARTMENT OF VETERANS AFFAIRS FINANCIAL SERVICES CENTER PO BOX 149971 AUSTIN, TX. 78714-9975 Vendor inquires: Toll Free Number 1-877-353-9791 Payments shall be made monthly in arrears upon receipt of properly prepared invoices. DUE DATE AND AWARD Responses are due by 10:00 am on September 4, 2012 CST. Any questions concerning this solicitation should be submitted to the contracting officer in writing by e-mail to [email protected] by August 30, 2012 at 12:00pm. Oral quotes will not be accepted. DECRIPTION EST UNIT EST ITEM QTY UNIT PRICE TOTAL FOOTSWITCH STANDARD 9 each _______ _______ GEM BIPOLAR FOOTWITCH 9 each _______ _______ FORCETRIAD GENERATOR FORCETRIAD 9 each _______ _______ ESTIMATED GRAND TOTAL $____________ Discount (if applicable): $___________ TOTAL PRICE FOR ALL ITEMS: $____________; Total Price shall include all equipment delivery charges and with Operator manuals, Service manuals and a 1 year warranty on parts and labor. SCOPE OF PROCUREMENT The contractor will provide the Force Triad Energy Platform system, the standard footswitch, GEM Bipolar footswitch, Forcetriad. This system will be acquired for the processing and distribution section located at the following facility: 1. Edward Hines, Jr. VA Hospital) Processing and Distribution Section (578/90E) 5000 South 5th Avenue Hines, IL 60141 DESCRIPTION/SPECS/WORK STATEMENT BACKGROUND The Force Triad Energy Platform is integrates multiple energy source needs into a single package. Currently, frequently used and essential devices such as bipolar cautery, and the Ligasure® utilize separate energy supply units. The energy requirements of multiple platforms are considerably higher even on standby. These current units also require separate training, inspection and maintenance which contribute to costs. In addition, the continued use multiple energy sources require increased space as well as multiple grounding and power cord routing solutions in already crowded OR suites. The force triad system is a single energy source unit that will supply multiple energy based modalities during the same procedure. OBJECTIVES As individual sources for each device currently require maintenance and replacement, consolidation to a single, energy efficient energy platform is consistent with the VA mission of providing high quality cost effective care with reduced overall energy use at this time. DELIVERABLES OR DELIVERY SCEDULE " Contractor shall provide the Force Triad Energy Platform System described in this SOW. " Contractor shall ship Force Triad Energy Platform System to Hines, IL " Contractor should ship Force Triad Energy Platform System in 45 days from date of contract award " Contractor should coordinate with facility for on-site training. " Contractor shall provide any necessary operating manuals and applicable warranty information Delivery shall be FOB DESTINATION to Edward Hines Jr. VA Hospital, 5000 South 5th Ave, Hines, IL 60141-1457. Attention: Janet Dale-Evans; 708-202-2032 EXT 22032. The Contractor is responsible for all freight charges. Offer must include product literature, product samples (if requested), technical features, warranty provisions, and any training and or installation that will be required. The provision at 52.212-1, Instructions to Offeror--Commercial Items, applies to this solicitation. GOVERNMENT -FURNISHED EQUIPMENT OR GOVERNMENT-FURNISHED INFORMATION " No Government-furnished equipment (GFE) or Government-furnished information (GFI) is required SECURITY " No security requirements are necessary for the Force Triad Energy Platform System work to be done PLACE OF PERFORMANCE " The work for the Force Triad Energy Platform System shall be performed at the contractor's site PERIOD OF PERFORMANCE " Contractor shall have 6 weeks from date of contract award to produce Force Triad Energy Platform System. SALIENT CHARACTERISTICS: This is a restricted requirement for the above listed items. SITE VISIT There will not be a Site Visit LOWEST PRICE TECHNICALLY ACCEPTABLE OFFER). All quotes will be evaluated in accordance with technical capability, compliance with the solicitation requirements and price. Price is important as the Government intends to award to the low priced offeror offering the required items. The government intends to evaluate proposals and award without discussions with offerors. Therefore, the offeror's initial proposal should contain the offeror's best terms from a cost or price and technical standpoint. The Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary. The provision at 52.212-3, Offeror Representations and Certification--Commercial Items, applies to this solicitation. The contractor shall return a completed copy of this provision with its quotation. A copy of the provision may be attained from https://www.acquisition.gov/far/current/html/52_212_213.html#wp1179194 or completed at https://orca.bpn.gov/. The resulting firm fixed price award will incorporate the requirements of the clause at FAR 52.212-4, Contract Terms and Conditions--Commercial Items. The clause at FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders--Commercial Items, is incorporated in this requirement, which will include: (1) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553); (2) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Pub L. 108-77, 108-78); (3) 52.203-6, Restrictions on Subcontractor Sales to the Government (SEPT 2006); (4) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns; (5) 52.219-28, Post Award Small Business Program Representation; (6) 52.222-3, Convict Labor ; (7) 52.222-19, Child Labor Cooperation with Authorities and Remedies; (8) 52.222-21, Prohibition of Segregated Facilities; (9) 52.222-26, Equal Opportunity; (10) 52.222-35, Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans; (11) 52.222-36, Affirmative Action for Workers with Disabilities; (12) 52.222-37, Employment Reports on Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans; (13) 52.222-50, Combating trafficking in Persons; (14) 52.225-1, Buy American Act-Supplies; and (15) 52.232-34, Payment by Electronic Funds Transfer--Other than Central Contractor Registration (MAY 1999) (31 U.S.C. 3332). The FAR clauses may be accessed in full text at this address https://www.acquisition.gov/far/ and VAAR clauses may accessed at http://www1.va.gov/oamm/oa/ars/policyreg/vaar/. In addition, FAR 52.247-34 F.O.B. Destination, FAR 52.211-6 Brand Name or Equal, VAAR 852.211-73 Brand Name or Equal, VAAR 852.211-70 Service Data Manuals, VAAR 852.246-70 Guarantee, and VAAR 852.203-70 Commercial Advertising, VAAR 852.215-71 Evaluation Factor Commitments, VAAR 852.237-70 Contractor Responsibilities apply to this acquisition. The Offeror shall also provide its DUNS number and Tax Identification number. All Contractors, both large and small, are required to register in the Central Contractor Registration (CCR) database before an award. Contractors are responsible for the accuracy of information added to CCR. To register, go to http://www.ccr.gov/.

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