Section A - Solicitation/Contract Form CLAUSES INCORPORATED BY FULL TEXT Fill in Blanks: TIN: ________________ CAGE: ________________ DUNS: __________________ Vendor Point of Contact: ______________________Phone: ____________________ Vendor email: ______________________ Naval Medical Center POC: Payment in Arrears Vendor to reference contract number ________________ on all inquires including invoices and shipping documents. NAPS 5232.903 PROMPT PAYMENT For Prompt Payment Act Purposes, this contract is: Subject to the 7-calendar day constructive acceptance period. Section B - Supplies or Services and Prices ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 2 Each Duckbill Upbiter PunchFFPREF# 7207058MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0002 2 Each Oval Srtaight PunchFFPREF# 7207181MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0003 2 Each Mini Upbiter PunchFFPREF# 7207052MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0004 2 Each Mini Straight PunchFFPREF# 7207053MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0005 5 Box Green Cannula 5x 76FFPREF# 012405MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0006 2 Box 2.9 Barral AbraderFFPREF# 3553MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0007 3 Box 2.9 Full RadiusFFPREF# 3419MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0008 3 Box 4.5 IncisorFFPREF# 7205313MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0009 3 Box 3.5 IncisorFFPREF# 7205312MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0010 6 Each 4.5mm Cannulated DrillFFPREF# 7207315MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0011 2 Each BioRci-HA 7x20mmFFPREF# 7207686MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0012 2 Each BioRci-HA 7x25mmFFPREF# 7207675MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0013 4 Each BioRci-HA 7x30mmFFPREF# 7207676MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0014 5 Each BioRci-HA 8x20mmFFPREF# 7209012MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0015 2 Each BioRci-HA 8x25mmFFPREF# 7207678MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0016 4 Each BioRci-HA 8x30mmFFPREF# 7207679MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0017 4 Each 2.4mm Guide PinFFPREF# 014604MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0018 2 Box Gold PlugFFPREF# 014477MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0019 4 Each 2.4mm Guide PinFFPREF# 013978MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0020 4 Each 1.2mm Nitinol Guide WireFFPREF# 7205395MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0021 1 Each Notchmaster CuretteFFPREF# 7205672MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0022 2 Each Acufex Screw StarterFFPREF# 7207359MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0023 2 Each Acufex Tendon StripperFFPREF# 013550MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0024 2 Each Acufex Tendon StripperFFPREF# 013554MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0025 2 Each Acufex Director Bullet PCLFFPREF# 7205525MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0026 2 Each Acufex Grasping ClampsFFPREF# 014412MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0027 1 Each Acufex Endobutton Depth GaugeFFPREF# 015185MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0028 1 Each Acufex Ratchet DriverFFPREF# 7207707MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0029 1 Each Acufex Rci DriverFFPREF# 7207754MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0030 1 Each Acufex PCL Femoral DirectorFFPREF# 7207283MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0031 1 Each Acufex PCL Tibial DirectorFFPREF# 7207282MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0032 2 Each Dyonics 5/32 Jacobs DrillFFPREF# 7205792MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0033 2 Each Dyonics 1/4 Jacobs DrillFFPREF# 7205794MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0034 1 Each Acufex 7mm Screw StarterFFPREF# 7209371MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0035 1 Each Acufex 8mm Screw StarterFFPREF# 7209373MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0036 1 Box Acufex Meniscal KnivesFFPREF# 010610MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0037 1 Box Acufex Meniscal KnivesFFPREF# 010620MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0038 1 Box Acufex Meniscal KnivesFFPREF# 010630MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0039 1 Box Acufex Meniscal KnivesFFPREF# 010600MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0040 1 Each Acufex TMJ Wrist ProbeFFPREF# 3312MILSTRIP: N0018305RQAP009PURCHASE REQUEST NUMBER: N0018305RQAP009 NET AMT FOB: Destination Section C - Descriptions and Specifications CLAUSES INCORPORATED BY FULL TEXT 1. The Naval Medical Center, Portsmouth, VA Ambulatory Surgery Unit (ASU) will purchase items and quantities as described on section B. These items are presently in use at the ASU. in conjunction with the Smith & Nephew Arthroscopy Tower Surgical System, therefore items must be from the Original Equipment Manufacturer (OEM) as stated on DFAR 217.7501 (Replenishment parts must be acquired so as to ensure the safe, dependable, and effective operation of the equipment. Where this assurance is not possible with new sources, competition may be limited to the original manufacturer of the equipment or other sources that have previously manufactured or furnished the parts as long as the action is justified). Part Number and description are from the Smith & Nephew Catalog. No substitutes will be accepted. „h Vendor to warrant that all supplied items are free of manufacturers defect. „h Vendor price to be inclusive of all costs including shipping. Section E - Inspection and Acceptance INSPECTION AND ACCEPTANCE TERMS Supplies/services will be inspected/accepted at: CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY 0001 Destination Government Destination Government 0002 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 Destination Government Destination Government 0006 Destination Government Destination Government 0007 Destination Government Destination Government 0008 Destination Government Destination Government 0009 Destination Government Destination Government 0010 Destination Government Destination Government 0011 Destination Government Destination Government 0012 Destination Government Destination Government 0013 Destination Government Destination Government 0014 Destination Government Destination Government 0015 Destination Government Destination Government 0016 Destination Government Destination Government 0017 Destination Government Destination Government 0018 Destination Government Destination Government 0019 Destination Government Destination Government 0020 Destination Government Destination Government 0021 Destination Government Destination Government 0022 Destination Government Destination Government 0023 Destination Government Destination Government 0024 Destination Government Destination Government 0025 Destination Government Destination Government 0026 Destination Government Destination Government 0027 Destination Government Destination Government 0028 Destination Government Destination Government 0029 Destination Government Destination Government 0030 Destination Government Destination Government 0031 Destination Government Destination Government 0032 Destination Government Destination Government 0033 Destination Government Destination Government 0034 Destination Government Destination Government 0035 Destination Government Destination Government 0036 Destination Government Destination Government 0037 Destination Government Destination Government 0038 Destination Government Destination Government 0039 Destination Government Destination Government 0040 Destination Government Destination Government Section F - Deliveries or Performance DELIVERY INFORMATION CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC 0001 31-MAR-2005 2 NAVAL MEDICAL CENTERRECEIVING DEPARTMENTMMD54 LEWIS MINORS STREETPORTSMOUTH VA 23708-2297757-953-5770FOB: Destination N00183 0002 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0003 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0004 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0005 31-MAR-2005 5 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0006 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0007 31-MAR-2005 3 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0008 31-MAR-2005 3 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0009 31-MAR-2005 3 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0010 31-MAR-2005 6 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0011 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0012 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0013 31-MAR-2005 4 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0014 31-MAR-2005 5 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0015 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0016 31-MAR-2005 4 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0017 31-MAR-2005 4 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0018 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0019 31-MAR-2005 4 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0020 31-MAR-2005 4 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0021 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0022 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0023 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0024 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0025 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0026 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0027 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0028 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0029 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0030 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0031 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0032 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0033 31-MAR-2005 2 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0034 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0035 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0036 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0037 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0038 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0039 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0040 31-MAR-2005 1 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 CLAUSES INCORPORATED BY REFERENCE 52.211-17 Delivery of Excess Quantities SEP 1989 52.247-34 F.O.B. Destination NOV 1991 Section G - Contract Administration Data CLAUSES INCORPORATED BY FULL TEXT Invoices for supplies rendered under this Task Order shall be submitted electronically through Wide Area Work Flow ¡V Receipt and Acceptance (WAWF): The vendor shall self-register at the web site https://wawf.eb.mil. Vendor training is available on the internet at http://wawftraining.com. One or more separate invoices will be prepared per order. Do not combine the payment claims for supplies provided under this contract ordered through multiple orders within one invoice. Select the Create Invoice And Receiving Report combo within WAWF as the invoice type (destination/destination). The Invoice and Receiving Report combo prepares the Material Inspection and Receiving Report, DD Form 250, and the Invoice at the same time. Back up documentation (such as delivery receipts, etc.) can be included and attached to the invoice in WAWF. Attachments created in any Microsoft Office product are attachable to the invoice in WAWF. The following information regarding Naval Medical Center Portsmouth is provided for completion of the invoice in WAWF: Issuing Office DODAAC: N00183 Admin DODAAC: N00183 Ship To DODAAC: N00183 LPO DODAAC: N00183 Pay DODAAC: N68688 The contractor shall submit invoices for payment per contract terms. The Government shall process invoices for payment per contract terms. For more information on Wide Area Workflow, please contact the Wide Area Workflow Implementation Team at [email protected] Section I - Contract Clauses CLAUSES INCORPORATED BY REFERENCE 52.203-3 Gratuities APR 1984 52.222-20 Walsh-Healey Public Contracts Act DEC 1996 52.222-35 Equal Opportunity For Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans DEC 2001 52.222-36 Affirmative Action For Workers With Disabilities JUN 1998 52.226-1 Utilization Of Indian Organizations And Indian-Owned Economic Enterprises JUN 2000 52.232-1 Payments APR 1984 52.232-8 Discounts For Prompt Payment FEB 2002 52.233-3 Protest After Award AUG 1996 52.246-1 Contractor Inspection Requirements APR 1984 252.204-7004 Alt A Central Contractor Registration (52.204-7) Alternate A NOV 2003 252.232-7003 Electronic Submission of Payment Requests JAN 2004 CLAUSES INCORPORATED BY FULL TEXT 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): www.arnet.gov/far (End of clause)

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