Fill in Blanks: TIN (tax ID): ________________ CAGE: ________________ DUNS: __________________ Vendor Point of Contact: ______________________Phone: ____________________ Vendor email: ______________________ Naval Medical Center POC: Orthopedics Dept / HM2 Peel: (757) 953-6320 Payment Monthly, Quarterly, Annually (circle one) in Arrears Note: vendor will be required to provide billing electronically via the WAWF Electronic Invoicing method. For additional information, a review of the following web sites may be required: https://wawf.eb.mil http://wawftraining (email) [email protected] Vendor to reference N00183-04-T-0267 on all Inquires. Government reserves the right to award contract based on an "All or Nothing Evaluation". NAPS 5232.903 PROMPT PAYMENT For Prompt Payment Act Purposes, this contract is: Subject to the 7-calender day constructive acceptance period. “AVAILABILITY OF FUNDS. Pursuant to Section I, Availability of Funds (FAR 52.232-18), of the contract, funds are not presently available for this contract. The Government’s obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing to the Contracting Officer. Pursuant to FAR 52.232-18, the Contracting Officer will provide confirmation of availability of funds at http://www.nmlc.med.navy.mil/acquisitions/services.htm Section B - Supplies or Services and Prices ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 12 Months Lease of Smith & NephewFFPArthroscopy Towers and associated equipment. See Section C for detailsMILSTRIP: N0018305RQAS001PURCHASE REQUEST NUMBER: N0018305RQAS001 NET AMT FOB: Destination Section C - Descriptions and Specifications CLAUSES INCORPORATED BY FULL TEXT THE MINIMUM REQUIREMENTS OF THIS SOLICITATION ARE AS FOLLOWS: · Vendor to provide lease of 3 ea. Smith & Nephew; Arthroscopy Tower surgical system with instruments. (see listing below for minimum item / quantity requirements). Vendor to provide Smith & Nephew products equal or better. The Government reserves the right to determine “equal or better”. o In the event of technology upgrades (during the period of performance) vendor may substitute equal or better items / equipment. The Government shall maintain the final determination of deciding equal / better. The decision of equal / better shall be made by either (1) Director of the Main Operating Room, (2) Director of Orthopedic Clinic or their authorized agent. o Vendors price to be inclusive of all cost including: parts, labor and transportation including Shipping. · Supplied items shall be warranted to be free of manufactures defects. o Faulty items and or items damaged through normal operation, shall be repaired or replaced as soon as possible but no later than 5 business days after notification. o Vendor shall not be responsible for damage as a result of loss (of property), abuse or neglect from Government personnel. o All equipment shall remain the property of Smith & Nephew Inc o Vendor shall be responsible for basic operation maintenance. NMCP shall be responsible for routine maintenance such as cleaning. In addition, NMCP shall be responsible for replacement of damaged and lost items as a result of abuse or misuse. o All items shall be kept / stored on-site at NMCP proper. All items will be made available to the vendor for inventory purposes with a 24-hour advance notice. Upon request (24 hours in advance) the vendor shall be given the right to inspect storage location of items. o Vendor shall not be held responsible for damages or harm caused by the miss-use of any equipment covered by this agreement. o Vendor must supply a written consent prior to any assignment of rights or obligations resulting from this agreement. o The use of reprocessed single-use products shall not be used with supplied equipment without advance approval from the vendor. In the event that the Government violates this requirement, vendor shall maintain the right to remove equipment from use (i.e.: vendor will be no longer required to supply item). · Equipment supplied must be certified for use in US Hospitals adhering to UL and or JACHO requirements as required. · Items Required: Manufacturer Qty Model Description 1 Smith & Nephew 3 720001 CCU, 3 Chip, NTSC, 360 2 Smith & Nephew 9 7210257 CAM HD, Angled, 12' NTSC, 370 3 Smith & Nephew 9 7207905 O Camera Coupler, ACLV, 18MM F.L. 4 Smith & Nephew 3 7207407 System, 300XL Light Sougce 5 Smith & Nephew 9 3894 Arthoscope, ACLV 4.0 x 30 Deg 6 Smith & Nephew 2 3895 Arthoscope, ACLV 4.0 x 70 Deg 7 Smith & Nephew 4 7205682 Arthoscope, ACLV 2.7 x 30 Deg Short 8 Smith & Nephew 1 7205681 Arthoscope, ACLV 2.7 x 30 Deg 9 Smith & Nephew 1 4184 Arthoscope, ACLV 1.9 mm x 30 Deg 10 Smith & Nephew 3 720235 System, IMS 640 Domestic 11 Smith & Nephew 3 7210344 touch Panel, LCD 15" US 12 Smith & Nephew 3 7210514 Video Monitor, PVM-20L2MD, Sony 13 Smith & Nephew 2 4662 MTO, Arthroscope, autoclavable 14 Smith & Nephew 2 7205785 Dyonics Power Drill 15 Smith & Nephew 2 7205786 Dyonics Power Sagittal Saw 16 Smith & Nephew 2 7205787 Sterilization Case W/5 17 Smith & Nephew 2 7205789 Dyonics Power Wire Driver 18 Smith & Nephew 2 7205790 Dyonics Power Pin Driver 19 Smith & Nephew 2 7205793 Dyonics Power Keyless Chuck 20 Smith & Nephew 2 7205795 Dyonics Power Keyless Chuck, 1/4" 21 Smith & Nephew 4 7205788 Dyonics Power Cable Assembly 22 Smith & Nephew 1 7205792 Dyonics Power Jacobs Chuck 23 Smith & Nephew 1 7205794 Dyonics Power Jacobs Chuck 24 Smith & Nephew 3 7210172 Cart, Sliding Articulating Arm 25 Smith & Nephew 3 7210529 Printer, HP 6122, US 26 Smith & Nephew 1 4294 Operative Set 2.2 mm 27 Smith & Nephew 3 7210432 MTO, Kit, Single Arm, Vertical Mount 28 Smith & Nephew 9 7205180 Gemini Universal LT Guide 4mm 29 Smith & Nephew 9 2147 Dyonics / Wolf Source Versitip 30 Smith & Nephew 9 2143 Veritip, STO / OLY Ins 31 Smith & Nephew 4 012045 PCH, BSKT, DCKLING, UPBTR 32 Smith & Nephew 4 012047 PCH, BSKT, DCKLING, CRVD, R 33 Smith & Nephew 4 012046 PCH, BSKT, DCKLING, CRVD, L 34 Smith & Nephew 4 012039 PCH, SCSR, UPBTR, CRVD,R 35 Smith & Nephew 4 012038 PCH, SCSR, UPBTR, CRVD,L 36 Smith & Nephew 4 011024 GRSPR, ALGTR, MAX 37 Smith & Nephew 4 011022 GRSPR, FRCP, Loosebody, PTBLL 38 Smith & Nephew 4 7207201 PCH, OVAL, STR 39 Smith & Nephew 4 012029 PCH, BSKT, SCP, STR, 1.0 mm 40 Smith & Nephew 4 012036 PCH, SCSR, STR 41 Smith & Nephew 4 011014 GRSPR, CUPD, 3.4mm 42 Smith & Nephew 4 010913 PCH, BSKT, RTRY, 90 Degree, 2.2mm RT.LP 43 Smith & Nephew 4 010912 PCH, BSKT, RTRY, 90 Degree, 2.2mm L.LP 44 Smith & Nephew 4 014720 Rongeur, Raptor 45 Smith & Nephew 4 7207162 Tray Arthoscopic Manual Inst. 46 Smith & Nephew 4 012020 PCH, BSKT, SCP,UPBTR, 1.5mm 47 Smith & Nephew 9 7205683 Sterilization Tray, Multi-Use 48 Smith & Nephew 17 7204737 Steri-Tray 3" x 9", 4.0 mm Scope 49 Smith & Nephew 2 012310 Holder, Leg 50 Smith & Nephew 2 7207340 Shoulder Holder 51 Smith & Nephew 1 7207079 SYS, Non-Invasive Ankle Distraction 52 Smith & Nephew 1 014797 Chondral Picks:SML Assy 20 Degree 53 Smith & Nephew 1 014799 Chondral Picks:LRG Assy 20 Degree 54 Smith & Nephew 1 014796 Chondral Picks:SML Assy 40 Degree 55 Smith & Nephew 1 014798 Chondral Picks:LRG Assy 40 Degree 56 Smith & Nephew 1 014800 Chondral Pick, Handle Assy 57 Smith & Nephew 3 011703 Tray Sterilization, Small W/Mat 58 Smith & Nephew 2 014549 Diamond Rasp 45 Deg 59 Smith & Nephew 2 014550 Diamond Rasp 90 Deg 60 Smith & Nephew 4 4356 Obturator, Intel 4mm A'SP FOR 61 Smith & Nephew 4 3673 Cannula, Oper, P.P.OPP Dov, 4.5 62 Smith & Nephew 4 1992 Obturator, 4.5 63 Smith & Nephew 4 2711 Cannula, Finger Posted, 5.5mm 64 Smith & Nephew 4 2209 Obturator, 5.5mm 65 Smith & Nephew 4 7204864 Infuision Adapter, W/ Stopcock 66 Smith & Nephew 4 7204863 Cannula, Outflow, 3mm 67 Smith & Nephew 4 3868 Cannula, Sys, 5.8 HIFLO, ROT, DIAG 68 Smith & Nephew 8 010001 Probe, Straight 69 Smith & Nephew 2 012724 Gouge, Notchplasty, Curved, 6.4mm 70 Smith & Nephew 2 012717 Curette, Open, 7mm 71 Smith & Nephew 2 012710 Curette, Closed, 5mm 72 Smith & Nephew 2 012705 Rasp, Cux 73 Smith & Nephew 2 013569 Rasp, TNL, Bone 74 Smith & Nephew 2 013571 Rasp, RND, HF, 8mm 75 Smith & Nephew 2 013572 Rasp, RND, HF, 7mm 76 Smith & Nephew 2 011694 Tray Sterilization, A'Plasty

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