36A77619Q0079-0001001.docx

VA Northern California Health Care System 1601 Concord Avenue Chico, CA 95928

VA Northern California Health Care System Initial Outfitting, Transition & Activation Statement of Work Ophthalmology Equipment

Approved By:

Date:

VA Northern California Health Care System 1601 Concord Avenue Chico, CA 95928

Statement of Work Ophthalmology Equipment

Introduction Veteran Affairs Northern California Health Care System (VANCHCS) has a requirement to purchase Ophthalmology Equipment with an authorized vendor to supply and deliver the item(s) identified in Table 1 below. This requirement is in support of a brand name or equal requirement. See below for salient characteristics. This requirement is in support of the activation of Chico VA Clinic. Item(s) are to be delivered and installed to the location specified in section 2.4.1.

Table 1 – Package Items Summary

or

CLIN 0011

CLIN 0012

General Conditions Site Address The address of the VANCHCS Chico VA Clinic is provided below. Further information on delivery is located in section 2.4.

Chico VA Clinic 1601 Concord Avenue Chico, CA 95928 Delivery Schedule Items shall be delivered no earlier than the estimated delivery start date and no later than the delivery end date listed in Table 2 below.

Table 2 – Anticipated Building Outfitting Schedule

Chico VA Clinic

Schedule and Order Management The awardees actual delivery dates will be confirmed by VA upon award. The Government’s Beneficial Use/Acceptance date of the VANCHCS Chico VA Clinic is May 15, 2019. Due to construction timelines and possible delays, the completion date of the VANCHCS Chico Clinic may change.

Post-award, the vendor will coordinate delivery identified in this document with the VANCHCS prior to beginning any work (See Section 2.4). Once the dates have been confirmed, modifications to the schedule are subject to written approval by the CO, COR and the vendor. Schedule changes that are beyond the dates specified in the contract will require approval by the Contracting Officer and a contract modification.

Delivery and Receiving Delivery and receipt of the proposed items is anticipated to be directed to the location identified below. Confirmation of delivery location will be provided post-award. To coordinate delivery, contact Government POC Antonio Homer at (916) 843-7393, Antonio.homer@va.gov and Angela Howard at (217) 274-8933, angela.howard@goenergistics.com or Jack O’Dell at (937) 608-7329, jack.odell@goenergistics.com.

☒ VANCHCS Chico VA Clinic (Direct Delivery to address detailed in paragraph 2.1.1) ☐ IOT&A Contractor-Provided Warehouse Local to the VANCHCS Go Energistics Warehouse: Attn: GoE-VA Project, 13290 Contractor Dr., Chico, CA 95928 The vendor is required to define the need for a staging area to accommodate item delivery, if needed. Post-award, this information will be confirmed with the vendor.

The delivery of items identified in this document shall take place during normal business hours which are defined as: 0800 to 1630 (i.e.: 8:00am to 4:30pm Pacific Standard Time), Monday through Friday, and excluding Federal Holidays.

Delivery trucks will not be permitted to remain at the loading dock. Trucks shall be unloaded, moved from the dock, and then brought back to the dock if required to haul out any waste, tools, or excess materials.

Labeling of delivered items shall include the VA facilities contract number and VA purchase order number for identification and reference upon receipt of product.

Use of Warehouse If the vendor requires the use of the Government’s activation contractor’s warehouse to meet the requirements of this contract the vendor must provide a certificate of insurance prior to the delivery and offloading of the item(s). This insurance certificate must be completed and presented to the activation contractor prior to delivery.

The vendor shall communicate through the VA POC any required coordination requirements.

Clean Up and Disposal There are no dumpsters available for vendor use.

The removal of waste and/or excess material shall be conducted through the loading dock area.

Assembly and Installation The vendor is required to manage and coordinate installation at the VANCHCS Chico VA Clinic with the COR.

On-site assembly and installation of items, and performance of services identified in this document shall take place during normal business hours which are defined as: 0800 to 1630 (i.e.: 8:00am to 4:30pm Pacific Standard Time), Monday through Friday, and excluding Federal Holidays.

The vendor is required to define the need for a staging area to accommodate item assembly and installation, if needed. Post-award, this information will be confirmed with the vendor.

The vendor is required to provide tools, labor and materials to complete assembly and installation of the items detailed in this document.

The vendor shall protect all finished spaces and surfaces as required from delivery and installation damage. The vendor shall use covering and protection to the extent necessary to prevent damage to finished spaces. Any damage occurred during delivery and installation is the responsibility of the vendor. The vendor will be responsible for any damage or noted deficiencies to finished spaces and surfaces that occur as a result of the vendor’s (or associated sub-contractors) installation.

During the entire duration of assembly and installation, the vendor will have a competent representative on-site as the vendor’s contact, and to serve as the interface between the vendor and VANCHCS. On-site representative can be the installer. All instructions provided from COR to the representative will be binding as if given to the vendor’s main contact. The COR may provide specific instructions, however, only the Contracting Officer may change the terms or conditions of the contract.

Training

0. The vendor shall coordinate training through the VA POC to provide a hands-on training session to staff selected by the VA. Training shall be completed within 45 days after final installation of equipment. The vendor will provide a copy of training materials used or other information from the training to the VA POC for VA to use to train additional personal at a future date.

Grey Market Prevention Gray market items are Original Equipment Manufacturers (OEM) goods sold through unauthorized channels in direct competition with authorized distributors. This procurement is for new OEM medical supplies, medical equipment and/or services contracts for maintenance of medical equipment (i.e. replacement parts) for VA Medical Centers. No remanufactures or gray market items will be acceptable.

Vendor shall be an OEM, authorized dealer, authorized distributor, or authorized reseller for the proposed medical supplies, medical equipment, and/or services contracts for maintenance of medical equipment (i.e. replacement parts), verified by an authorization letter or other documents from the OEM, such that the OEM’s warranty and service are provided and maintained by the OEM. All software licensing, warranty and service associated with the medical supplies, medical equipment, and/or services contracts for maintenance of medical equipment shall be in accordance with the OEM terms and conditions.

The delivery of gray market items to the VA in the fulfillment of an order/award constitutes a breach of contract. Accordingly, the VA reserves the right enforce any of its contractual remedies. This includes termination of the contract or, solely at the VA’s election, allowing the Vendor to replace, at no cost to the Government, any remanufactured or gray market item(s) delivered to a VA medical facility upon discovery of such items."

VA Northern California Health Care System M5510A

Project: Chico VA Clinic

Total Quantity: 1 ☐ Finish Sample Required if Checked ☐ Manufacturer Certified Installation Required if Checked ☐ BMET Training Required if Checked ☒ End User Training Required if Checked

Item Name: Camera, Retinal, Non-mydriatic – Canon USA, Inc. Medical Division CR-2 AF or equivalent

Salient Characteristics:

The digital fundus camera system is designed for use in diagnosing and recording ocular disorders It shall consist of a digital imager, computer, monitor, chin rest, joy stick and software to record, store, edit and print digital images Digital retinal camera used in tele retinal settings Includes travel case Images created via EOS camera for retinal imaging creating high resolution images Includes digital filters Red free and Cobalt, Green and Red Channel Flash: LED View Angel: 45 degrees Light Source: LED Built in LCD monitor Includes chin rest Approximate Dimensions (+/- 2”): 15" W 21" D 32" H Power: 120 Volts, 60 Hertz, 1 Phase, 5 Amps, 600 Watts

VA Northern California Health Care System M5520

Project: Chico VA Clinic

Total Quantity: 4

Item Name: Lensometer – Topcon Medical Systems, Inc. 10053 or equivalent

Salient Characteristics:

Lensometer Unit includes lamps, prism measuring lens marking device, cylinder axis wheel calibrated in two 180 degree segments and a green filter for tinted glass The instrument may be inclined between 25 to 90 degrees Used for measuring lens Computerized lensometer Features:

· Large LCD color touchscreen monitor

· Inboard printer

· UV Transmittance measurement

· Green measurement Light Beam

· Auto Focal Detection for single and progressive lenses

· Can measure hard and soft contact lenses Vendor to install equipment Electrical 120V with cord and plug Approximate Dimensions (+/- 2”): 8" W 9" D 16" H Power: 120 Volts, 60 Hertz, 1 Phase, 1 Amps, 120 Watts

VA Northern California Health Care System M5535

Project: Chico VA Clinic

Total Quantity: 3

Item Name: Ophthalmoscope, Binocular, Indirect – Keeler Instruments, Inc. 1205-P-1020 or equivalent

Salient Characteristics:

Binocular indirect ophthalmoscope Unit consists of headband and crown, halogen quartz lamp, multi-coated aspherical lenses, scleral depressor and mirror It also includes a control switch that regulates the illumination from 2 to 6 volts Used to examine presence of blood vessels in patient's pupils Imaging: Digital Light source LED Camera Resolution: Conforms to MIL STD 150A standard Driver: Compatible with any video package able to receive video Working Range: 11-24 inches Adjustment-Vertical and Horizontal System shall be wireless Interface: Any laptop with Windows 7 or XP.

Package to include scope, docking station, power supply, battery software, remote control, carrying case Accessories to include:

· 20D Large Aspheric Lens Clear (50mm)

· 28 Large Aspheric Lens Clear (41mm) Vendor to install equipment Approximate Dimensions (+/- 2”): 10" W 11" D 8" H Electrical 120V with cord and plug Power: 120 Volts, 60 Hertz, 1 Phase, 1 Amps,120 Watts

VA Northern California Health Care System M5545

Project: Chico VA Clinic

Total Quantity: 1

Item Name: Ophthalmometer/Keratometer – Topcon or equivalent

Salient Characteristics:

Keratometer/ophthalmometer Unit features a focusing system, engraved focusing scale, positive fixation for rapid measurements, center and peripheral corneal measurements scale with a range from 30D to 60D Unit is used for measuring corneal astigmatism Approximate Dimensions (+/- 2”): 7" W 19" D 16" H Electrical: 120V with cord and plug

VA Northern California Health Care System M5562

Project: Chico VA Clinic

Total Quantity: 3

Item Name: Tester, Visual Acuity, Video/Microprocessor Based – Lombart Instrument CVS iMac Acuity or equivalent

Salient Characteristics:

Visual acuity tester using microprocessor technology Mounts behind the patient and the images are reflected through a mirror for the patient to read/view Remote controlled Macintosh wall mounted based acuity system CPU integrated into the wall mounted screen for an all in one instrument Screen: LCD 21" Optotypes: Snellen Letters, Tumbling E, Landolt Rings, Numbers, HOTV, Crowding Bars, Children's charts, Red/Green Testing, ETDRs and Contrast Testing Vendor to install equipment Electrical: 120V cord and plug Approximate Dimensions (+/- 2”): 14" W 3" D 17" H Power: 120 Volts, 60 Hertz, 1 Phase, 2 Amps, 240 Watts

VA Northern California Health Care System M5575A

Project: Chico VA Clinic

Total Quantity: 5

Item Name: Tonometer, Hand Held – Reichert Technologies Ophthalmic Instruments 230650 or equivalent

Salient Characteristics:

Hand held applanation tonometer Provides IOP measurements used to determine the risk of glaucoma Measurements strongly correlate with Goldmann Unit is handheld, one button operation, no calibration, battery operated, dual digital display Kit includes:

· Tonopen

· Carry case

· Tip covers

· Battery pack Measurement Range 5-55 mmHg Approximate Dimensions (+/- 2”): 11" W 20" D 20" H

VA Northern California Health Care System M5599

Project: Chico VA Clinic

Total Quantity: 3

Item Name: Phoropter – Reichert Technologies Ophthalmic Instruments 11637 or equivalent

Salient Characteristics:

This digital instrument is operated via touch screen, both with an optional medical grade panel PC or an iPad Features include multiple lenses, fully integrated GUI, preconfigured workflows or individually configured. Compatible with HER The instrument is mounted on an arm extended from an optical instrument stand Compatible with mounting on instrument stand M5730 Phoropter shall be LED illuminated plus cylinder Included with phoropter: +-.25 Flip Cylinder, +1.5 Retinoscopic lenses, face shields, reading rod with card holder Sphere Range: -19.D to +16.75 Cylinder Power: 0.0D to 6.0D Cylinder Axis: 360 degrees Cross Cylinder: +-.25 Prism: 0 to 20 P.D.: 48 mm to 75 mm Vertex Distance: 13.75 mm Reading Distance: 5 to 28 Vendor to install equipment Approximate Dimensions (+/- 2”): 13" W 4" D 12" D Electrical: 120V cord and plug

VA Northern California Health Care System M5605

Project: Chico VA Clinic

Total Quantity: 3

Item Name: Retinoscope, Streak – Welch Allyn, Inc., A Hill-Rom Company 18245 or equivalent

Salient Characteristics:

Streak retinoscope Lightweight instrument with interchangeable heads, rechargeable battery handle, mirror, forehead rest and one halogen lamp Continuous 360-degree streak rotation Features:

· External focusing sleeve

· Optics sealed within scope

· Polarizing filter

· Well rechargeable handle Approximate Dimensions (+/- 2”): 2" W 2" D 8" H

VA Northern California Health Care System M5700

Project: Chico VA Clinic

Total Quantity: 4

Item Name: Frame Set, Lens, Trial – Lombart Instrument TL0LOFDTLSPMFG

Salient Characteristics:

Trial lens frame set Set consists of light weight and color-coded marked lenses, holding tray, and a complete assortment of other accessories It is used to determine visual acuity Set features horizontal and vertical bridge adjustments with individual adjustments for temple length and angle

(266) Piece set including: sphere lenses concave and convex (0.25-20.00), cylinder lenses concave and convex (.25-6.00), prism lenses (0.5-10.00), accessory lenses (11 types) Set comes with case Approximate Dimensions (+/- 2”): 21" W 13" D 2" H

VA Northern California Health Care System M5710

Project: Chico VA Clinic

Total Quantity: 3

☐ BMET Training Required if Checked ☐ End User Training Required if Checked

Item Name: Mirror, Front Surface Reflector, Eye Exam – Lombart Instrument MIRL or equivalent

Salient Characteristics:

12x12 framed mirror to display the Acuity System information to the patient in an eye exam/treatment room Vendor to install equipment.

Wood Framed Approximate Dimensions (+/- 2”): 15" W 2" D 15" H image1.jpeg