Request for Quotation: VA250-17-Q-0125 Vendor Response Due Date/Time: Responses are due NO LATER THAN 1400 Eastern Standard Time on Tuesday, December June 6, 2016 Contact Information: Percy Johnson, Contract Specialist, (614)257-5534, [email protected] This is a Combined Synopsis/ Solicitation for brand name or equal requirement commercial items- one MULTI-COLOR LASER PHOTOCOAGULATOR, which the Department of Veteran Affairs, Veterans Health Administration intends on soliciting as a Service Disabled Veteran Owned Small Business total set-aside under the authority of Federal Acquisition Regulation (FAR) 6.203, with NAICS code: 339112. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. Paper copies of this solicitation will not be available. The RFQ number for this solicitation is VA250-17-Q-0125. This solicitation document and incorporated provisions and clauses are those in effect through the FAR. It is the contractor s responsibility to be familiar with the applicable clauses and provisions. The clauses may be accessed in full text at the following addresses: www.acquition.gov. and http://www.va.gov/oal/library/vaar/. Quotations will be accepted from the responsible sources that can provide the following like or comparable commercial items: ITEM INFORMATION ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 MULTI-COLOR LASER PHOTOCOAGULATOR LOCAL STOCK NUMBER: 1.00 EA Funding/Req. Number: 1 STATEMENT OF WORK (SOW) as of November 28, 2016 Contract Number: (completed by the CO at time of award) Task Order Number: (completed by the CO at time of award if a TO) IFCAP Tracking Number: 541-43L-16-00020 Follow-on to Contract and Task Order Number: (If this is a follow-on order to a previous contract or TO, insert the contract number or the TO number to which it is a follow-on. If this is not for a follow-on, state Not Applicable ) 1. Contracting Officer s Representative (COR). Name: Section: Address: Phone Number: Fax Number: E-Mail Address: 2. Contract Title. ENT surgical drill 3. Background. The Louis Stokes Cleveland VA Medical Center Optometry and Ophthalmology sections are in need of a multicolored laser photocoagulator. Over 75% of our veterans have one or more of the following conditions: Macular degeneration, Glaucoma, and Diabetic eye disease. This is a significant increase from a decade ago, due to increased longevity, increased healthcare access and greater primary care and patient awareness of the importance of eye screenings. This equipment facilitates and translates in to enhanced efficiency, which increase the quality and volume of care we can provide. 4. Scope. The Louis Stokes Cleveland VAMC is requesting the following items for Ophthalmology and Optometry Clinics located at the main Medical Center: Item # Description/Part Number* Qty Price Extended Amount 1 Multi-Color Laser Photocoagulater MC5-G 532 nm Green Laser for MC-500 SL-1800 Slit Lamp 34530-0X10 MC50PS-2 Nidek SL-1800 Pattern Scan Adapter for MC- 500 Vixi MC50Bo-3 BIO Heine Omega 500 for MC-500 MC50-00100 3D Mouse for MC-500 2 year warranty Onsite install and staff training 1   Total   5. Specific Tasks. 5.1 Task 1 Delivery of Equipment and Supplies The vendor will deliver the above items to the Cleveland VAMC within 1-2 weeks or order placement Deliverables: The equipment will be delivered to the facility: Louis Stokes Cleveland VA Medical Center 10701 East Boulevard Cleveland, OH 44106 5.2 Task 2. Installation and Assembly On site installation and 2 operator and service manuals included Deliverables: Installation and assembly of equipment will be complete and approved for use by the vendor, the medical staff, biomed, and any other applicable groups. 5.3 Task 3. Warranty Two year warranty included 6. Performance Monitoring The COR will monitor the successful delivery of the equipment by maintaining contact with the vendor and coordinating with the VA Warehouse and Biomedical Engineering personnel. The COR will also ensure the equipment is assembled and all installation of hardware and software is done to contract specifications. 7. Security Requirement The equipment and accessories will not connect to the VA network. 8. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI). There will be no Government-Furnished Equipment or Government furnished Information provided to the vendor. 9. Other Pertinent Information or Special Considerations. a. Identification of Possible Follow-on Work. Possible follow-on work could be contact with the Vendor for troubleshooting problems. Also, vendor may be notified if the product is not functioning properly. b. Identification of Potential Conflicts of Interest (COI). There are no known potential conflicts of interest. c. Identification of Non-Disclosure Requirements. The vendor will not have access to any VA patient sensitive information or proprietary information. d. Packaging, Packing and Shipping Instructions. Packaging and shipping will be at the discretion of the vendor. e. Inspection and Acceptance Criteria. Products will be inspected upon arrival by the COR and the Surgical Service 10. Risk Control The Surgical Service will follow any safety recommendations given by the vendor for the equipment. 11. Place of Performance. The equipment will be used in the Wade Park Podiatry Outpatient Clinic. Louis Stokes Cleveland VA Medical Center 10701 East Boulevard Cleveland, OH 44106 12. Period of Performance. N/A 13. Delivery Schedule. The items listed above shall be delivered to the Louis Stokes Cleveland VA Medical Center once the purchase has been finalized.

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