The Department of Veterans Affairs intends to negotiate a sole source contract with PROAIM to purchase Zeiss FORUM Software to include the following: FORUM Archive and Viewer Pkg. (v4.0) (incl: 1 Archive, 3 Viewer, 3 DICOM CZM Instr. Connection, ZEISS OS \F\ SCHEDULED FORWARDING LICENSE (V3) (ONE LICENSE\F\ PER FORUM SERVER) \F\ EA\F\, ZEISS OS \F\ FORUM VIEWER LICENSE, FLOATING (V3) \F\ EA, ZEISS OS \F\ FORUM GLAUCOMA WORKPLACE 2.0 (INCLUDES 5X USER\F\ LICENSES AND BASIC HFA/CIRRUS COMBINED REPORT) \F\ EA\F\, ZEISS OS \F\ FORUM GLAUCOMA WORKPLACE USER LICENSE (V3) (QTY\F\ 1) \F\ EA\F\, ZEISS OS \F\ FORUM BI-DIRECTIONAL DICOM INTERFACE LICENSE TO\F\ CZM INSTRUMENT (V3) \F\ EA\F\, ZEISS OS \F\ FORUM INTERFACE LICENSE TO 3RD PARTY DICOM\F\ INSTRUMENTS - INCLUDES LINK NET 1.0 + 3RD PARTY DICOM INSTRUMENT \F\ EA\F\, ZEISS OS \F\ FORUM-HL7 INTERFACES (INCLUDES EMR, HIS, HL7-ADT\F\ AND HL7-ORM) (V3) (ONE LICENSE PER FORUM SERVER) \F\ EA\F\, ZEISS OS \F\ CIRRUS REVIEW SOFTWARE (7.X) WITH LOCAL DATABASE\F\ (INCLUDES FORUM CZM RS CONNECTIONS V3, RPE AND GC ANALYSIS) (10-PACK) WITH REMOTE INSTALLATION \F\ EA\F\, ZEISS \F\ On-Site Installation & Training\F\, ZEISS \F\ Connectivity Service Plan, Annual\F\. The Zeiss Forum software will allow for analysis across medical equipment as well as provide data back-up for current Zeiss ophthalmic instruments. This will provide safer patient care due to efficient longitudinal analysis for patients. Forum facilitates visualization of ophthalmic data and images from disparate sources and gives the clinician greater ability to detect progressive changes in ocular diseases. The North American Industry Classification System Code (NAICS) is 811219. The Government believes that PROAIM is the only provider that can satisfy the agency requirements. Therefore, the Government intends to proceed with a sole source for the required Zeiss FORUM Software. This procurement is being conducted in accordance with FAR 6.302 only one responsible source and no other vendor will satisfy agency requirements. To the best of our knowledge, PROAIM is the only source that provides the above indicated services/supplies. This notice of intent is not a request for competitive quotes. No solicitation document is available; however, any firm that believes it can meet these requirements may give written notification to the Contracting Officer within ten (5) calendar days from the date of publication of this synopsis. Supporting evidence must be furnished in sufficient detail to demonstrate the ability to comply with the above requirements. Information can be sent to Percy Johnson at [email protected]. Responses received will be evaluated however a determination by the Government not to compete the proposed procurement based upon responses to this notice is solely within the discretion of the Government. If no responses are received, the VA Ambulatory Care Center Columbus will proceed with the sole source negotiation with PROAIM. The Contracting Officer is Percy Johnson @ (614) 257-5534. ITEM INFORMATION ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 FORUM Archive and Viewer Pkg. (v4.0) (incl: 1 Archive, 3 Viewer, 3 DICOM CZM Instr. Connectio LOCAL STOCK NUMBER: 306601-8530-001 1.00 EA Funding/Req. Number: 1 0002 ZEISS OS \F\ SCHEDULED FORWARDING LICENSE (V3) (ONE LICENSE\F\ PER FORUM SERVER) \F\ EA\F\ LOCAL STOCK NUMBER: 306601-8530-111 1.00 EA Funding/Req. Number: 1 0003 ZEISS OS \F\ FORUM VIEWER LICENSE, FLOATING (V3) \F\ EA LOCAL STOCK NUMBER: 306601-8530-100 17.00 EA Funding/Req. Number: 1 0004 ZEISS OS \F\ FORUM GLAUCOMA WORKPLACE 2.0 (INCLUDES 5X USER\F\ LICENSES AND BASIC HFA/CIRRUS COMBINED REPORT) \F\ EA\F\ LOCAL STOCK NUMBER: 000000-2078-492 1.00 EA Funding/Req. Number: 1 0005 ZEISS OS \F\ FORUM GLAUCOMA WORKPLACE USER LICENSE (V3) (QTY\F\ 1) \F\ EA\F\ LOCAL STOCK NUMBER: 000000-2020-237 15.00 EA Funding/Req. Number: 1 0006 ZEISS OS \F\ FORUM BI-DIRECTIONAL DICOM INTERFACE LICENSE TO\F\ CZM INSTRUMENT (V3) \F\ EA\F\ LOCAL STOCK NUMBER: 306601-8530-101 1.00 EA Funding/Req. Number: 1 0007 ZEISS OS \F\ FORUM INTERFACE LICENSE TO 3RD PARTY DICOM\F\ INSTRUMENTS - INCLUDES LINK NET 1.0 + 3RD PARTY DICOM INSTRUMENT \F\ EA\F\ LOCAL STOCK NUMBER: 306601-8530-103 4.00 EA Funding/Req. Number: 1 0008 ZEISS OS \F\ FORUM-HL7 INTERFACES (INCLUDES EMR, HIS, HL7-ADT\F\ AND HL7-ORM) (V3) (ONE LICENSE PER FORUM SERVER) \F\ EA\F\ LOCAL STOCK NUMBER: 306601-8530-107 1.00 EA Funding/Req. Number: 1 0009 ZEISS OS \F\ CIRRUS REVIEW SOFTWARE (7.X) WITH LOCAL DATABASE\F\ (INCLUDES FORUM CZM RS CONNECTIONS V3, RPE AND GC ANALYSIS) (10-PACK) WITH REMOTE INSTALLATION \F\ EA\F\ LOCAL STOCK NUMBER: 000000-2076-772-1 1.00 EA Funding/Req. Number: 1 0010 ZEISS \F\ On-Site Installation & Training\F\ LOCAL STOCK NUMBER: 266002-1131-909 1.00 EA Funding/Req. Number: 1 0011 ZEISS \F\ Connectivity Service Plan, Annual\F\ LOCAL STOCK NUMBER: 266002-1130-065 1.00 EA Funding/Req. Number: 1

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