SF 1449(3_2005)-CT SCANNER ZUNI-IHS.pdf

OMB No. 0990-0115

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Albuquerque NM 87110 5300 Homestead Road NE Albuquerque Indian Health Service

CODE 16. ADMINISTERED BYCODE

X

X

423450

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

05/25/2010 1630 MD

04/21/2010

VERONICA ZUNI

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

10-242-SOL-00014

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEM 1. REQUISITION NUMBER PAGE OF

1 9 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Albuquerque NM 87110 5300 Homestead Road NE

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS

HUBZONE SMALL

BUSINESS

EMERGING SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

SOLE SOURCE

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

This acquisition is funded in whole with funds made available from the American Recovery and Reinvestment Act of 2009 (ARRA). The Vendor shall be responsible for all reporting requirements of

ARRA.

The Albuquerque Area Indian Health Service (IHS) has a requirement for purchase, installation and calibration of a 16 Slice Computerized Tomography (CT) Scanner for the Zuni Indian Hospital, Zuni Pueblo Indian Reservation, New Mexico. The Zuni

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

VERONICA ZUNI

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDEND

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 3/2005)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS

NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 3/2005) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Indian Reservation is located approximately 150 miles southwest of Albuquerque, New Mexico and approximately 40 miles south of Gallup, New

Mexico.

The vendor shall be responsible for all travel expenses to the health facility site, personnel, labor, test equipment, tools to install, program, and calibrate, and end user training, for the new

CT machine to required specifications.

Cost or Pricing:

The vendor's cost shall be inclusive of the equipment purchase, installation, calibration, end user training; and all shipping and handling cost.

Total cost: $_____________

Scope of Work:

The vendor shall provide a complete and detailed description of requirements for facility preparation. This shall include, but not be limited to; shielding, electrical, mechanical

(HVAC and plumbing), structural, and access requirements. Provide a complete description of environmental conditions required; ceiling, wall, Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

9 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 9

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10-242-SOL-00014

and floor loading, and any special utility and electrical power systems needs. Include any published site-planning guides for proposed equipment and all equipment space requirements.

The vendor shall be responsible for all unloading of equipment and rigging in to place of same.

The vendor shall have total control and responsibility for the assembly, installation, interconnection, calibration, and start-up of all equipment mounting.

The vendor shall complete any and all procedures and documentation for tests required by national or local Government agencies or accrediting organizations for required tests of the equipment.

The vendor shall provide to the IHS; original and backup copies of all software, schematics, parts list, troubleshooting manuals, operator's instruction manuals

The vendor shall provide operator training to end user radiology staff. The training will define operator use, operator programming, and operator maintenance requirements for optimal daily/routine operations.

The IHS will provide access to required locations for equipment installation, and will provide space, electrical, required utilities, communication, data lines per equipment manufacturer's specifications as required for successful installation of system components.

For clarification of technical specifications under this solicitation, contact Ken Garvin at telephone 505-248-4596. Discussion/negotiation of pricing is strictly prohibited during technical inquries.

Period of Performance:

Performance shall commence upon award of a contract; equipment shall be installed, calibrated, and operational including the

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NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

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radiology staff trained within 180 from date of contract award.

Designation of Project Officer: Ken Garvin, BioMedical Engineer, located at Office of

Environmental Health and Education, 5300

Homestead Road NE, Albuquerque, New Mexico 87110, is hereby designated the Project Officer to monitor the performance of this order on behalf of the Government. The Project Officer will provide no supervisory or instructional assistance to Contractor personnel. The Project

Officer's function is primarily to provide the

Contractor with working data. The Project Officer is not empowered to make any commitments, nor authorized to make any changes which affect prices, terms, or delivery as specified on this order. Any such proposed changes shall be brought to the immediate attention of the Contracting

Officer for action. The acceptance of any change by the Contractor without specific approval and written consent of the Contracting Officer will be at the Contractor's own risk.

Project Officer Autority:

The Project Officer listed above is hereby designated to monitor the performance of this order on behalf of the Government. The Project

Officer will provide no supervisory or instructional assistance to Contractor personnel.

The Project Officer's function is primarily to provide the Contractor with working data. The

Project Officer is not empowered to make any commitments, nor authorized to make any changes which affect prices, terms, or delivery as specified on this order. Any such proposed changes shall be brought to the immediate attention of the Ordering Officer for action.

The acceptance of any change by the Contractor without specific approval and written consent of the Contracting Officer will be at the

Contractor's own risk.

Invoice Submission:

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Invoice(s) shall be submitted directly to the

Albuquerque Area Indian Health Service, Division of Accounting Services, 5300 Homestead Road NE, Albuquerque, NM 87110, upon completion of the entire installation, and final inspection and acceptance by the Government.

The payment office is:

Albuquerque Indian Health Service

Division of Accounting Services

5300 Homestead Road, NE

Albuquerque, New Mexico 87110

EFT Disbursed by:

U. S. Department of Treasury

Office of Disbursements

Austin, TX

52.252-2 Solicitation Clauses Incorporated by

Reference

This solicitation incorporates one or more solicitation 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 solicitation provision may be accessed electronically at this/these address(es):

www.arnet.gov

52.202-1 Definitions (July 2004)

52.203-3 Gratuities (Apr 1984)

52.204-11 American Recovery and Reinvestment Act-

Reporting Requirements (Mar 2009)

52.203-5 Covenant Against Contingent Fees (Apr

1984)

52.203-7 Anti-Kickback Procedures (Jul 1995)

52.203-8 Cancellation, Rescission, and Recovery of Funds for Illegal or Improper Activity (Jan

1997)

52.203-10 Price or Fee Adjustment for Illegal or

Improper Activity (Jan 1997)

52.203-12 Limitation on Payments to Influence

Certain Federal Transactions (Sept 2007)

52.203-15 Whistleblower Protections Under the

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American Recovery and Reinvestment Act of 2009

(MAR 2009)

52.212-1 Instructions to Offerors-Commercial Items

(June 2008)

52.212-3 Offeror Representations and

Certifications?Commercial Items (Aug 2009)

52.212-4 Contract Terms and Conditions-Commercial

Items (Mar 2009)

52.212-5 5 Contract Terms and Conditions Required to Implement Statutes or Executive

Orders-Commercial Items (Feb 2010)

52.215-2 Audit and Records-Negotiation (Mar 2009)

52.244-6 Subcontracts for Commercial Items (Dec

2009)

52.246-19 Warranty of Systems and Equipment under

Performance Specification or Design Criteria

52.204-1 Approval of Contract (Dec 1989)

The contract is subject to the written approval of the Contracting Officer, and shall not be binding until so approved.

Health & Human Service Acquisition Regulation

(HHSAR)

352.202-1 Definitions (Jan 2006)

352.232-9 Withholding of Contract Payments (Jan 2006)

352.270-2 Indian Preference(Jan 2006)

352.270-3 Indian Preference Program (Jan 2006) 352.270-6 Publications and Publicity(Jan 2006)

352.270-7 Paperwork Reduction Act(Jan 2006)

352.270-10 Anti-lobbying(Jan 2006)

The Zuni Indian Hospital is a Smoke Free

Environment.

352.270-13 Tobacco-Free Facilities (Jan 2006)

In accordance with Department of Health and Human

Services (HHS) policy, the Contractor and its staff are prohibited from using tobacco products of any kind (e.g., cigarettes, cigars, pipes, and smokeless tobacco) while on any HHS property, including use in personal or company vehicles operated by Contractor employees while on an HHS property. This policy also applies to all

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subcontracts awarded under the contract or order.

The term "HHS properties" includes all properties owned, controlled and/or leased by HHS when totally occupied by HHS, including all indoor and outdoor areas of such properties. Where HHS only partially occupies such properties, it includes all HHS-occupied interior space. Where HHS leases space in a multi-occupant building or complex, the tobacco-free HHS policy will apply to the maximum area permitted by law and compliance with the provisions of any current lease agreements.

The Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understand, and comply with this policy.

52.212-2 Evaluation-Commercial Items (Jan 1999)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the

Government, price and other factors considered.

The following factors shall be used to evaluate offers:

a. Vendor price offer for their standard 16 Slice

CT Scanner Unit. Offerors must minimally include the following specifications for the listed performance and operational characteristics.

Option items such as advanced image acquisition software or does reduction mechanisms should be listed as separate line items.

i. Total detector width

ii. Reconstructed slice widths available iii.Standard rotation times

iv. Image reconstruction rate

v. Gantry aperture

vi. Maximum patient load vii.Table movement range

viii. Scannable range

ix. X-ray tube cooling type

x. X-ray heat storage

xi. X-ray tube heat dissipation xii.Power requirements

xiii. DICOM compliance for Storage

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Commitment/Image storage, Modality worklist, Query/Retrieve, and Print

xiv. Included operator training with detailed description of length, content and provided training materials

xv. Promotional discounts and expiration of discount terms

xvi. Warranty Coverage

b. Vendor shall include the listed documentation for evaluation:

i. Recurring annual service contract cost with options include glassware

ii. Preliminary room plans for proposed system

iii. Vendor confirmation that proposed equipment will be fully functional within allocated space.

iv. Availability/typical response of service personnel (Primary service center location and number of assigned service engineers)

v. Cost for additional or follow-up operator training

vi. Written requirements for possible future field upgrades to 32 Slice vii.Reference list and content information for installations in local region with similar installed systems.

viii. Line item and separate costs for vendor recommended contrast media injector. Supporting documents should include manufacturer's sales literature and specifications.

c. All proposed equipment shall be new condition and current production models. Vendor shall notify the IHS- Acquisition Office of any plans to halt production of proposed system before delivery date and provide option of upgrading to newer model.

d. Provide a written statement of minimum guaranteed period of time for parts availability and service support.

e. No equipment shall be delivered to the Zuni

Indian Hospital site location before such time that the facility is ready for immediate installation of the equipment. IHS delivery

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date will be approximately no later than July 1, 2010.

Technical and past performance; when combined, are of equal value with price being the determining factor.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the options,

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party.

Before the offer's specified expiration time, the

Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

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