36A77620Q0149-0003001.docx

VA Nebraska-Western Iowa Healthcare System Initial Outfitting, Transition & Activation Statement of Work

Surgical Ortho Imaging Tower and Ortho Instruments, including (JSNs: U0011-U0014, U0016 and U0017, U0019-U0028, U0036, U0041 and U0042)

VA Nebraska-Western Iowa Healthcare System 4101 Woolworth Avenue Omaha, NE 68105 Ambulatory Care Center Project

Introduction Veteran Affairs Nebraska-Western Iowa Healthcare System (VANWIHS) has a requirement to purchase Surgical Ortho Imaging Tower and Ortho Instruments, including (JSNs: U0011-U0014, U0016 and U0017, U0019-U0028, U0036, U0041 and U0042) from an authorized vendor to supply, deliver and install the item(s) identified in Table 1 below.

This requirement is in support of a brand name only requirement based on the following need of this Surgical Ortho Imaging Tower and Orthopedic Instruments to be integrated with new ACC OR Video Integration system that already meets all the required VA IT standards.

This requirement is in support of the activation of VA Nebraska-Western Iowa Healthcare System Ambulatory Care Center. The new Ambulatory Care Center has the need for Ortho instruments and Ortho Imaging tower for the Ambulatory Surgery department. The current manufacturer is the basis for design for newly constructed space.

Table 1 – Package Items Summary

Additional Item Requirements

For all equipment, the vendor shall provide 2 user manuals that describe proper use, care and cleaning for users of the equipment.

In addition, the vendor will provide 2 service manuals that includes theory of operation, maintenance requirements, repair information, schematics, part lists and troubleshooting information in electronic format for use by the VA Biomedical Engineering Department.

Date of manufacture must not be greater than 2 years before the purchase order date. The equipment must not be used or refurbished and must have the latest manufacturer’s software/hardware updates installed. Any batteries provided with the unit will not be manufactured more than 12 months before the purchase order issue date.

General Conditions Site Address The address of the VA Nebraska-Western Iowa Healthcare System Ambulatory Care Clinic is provided below.

4101 Woolworth Avenue Omaha, NE 68105

Delivery Schedule Items shall be physically delivered no earlier than the estimated delivery start date and no later than the delivery end date listed in Table 2 below. The site requires initiation of the project management support of this contract immediately in order to coordinate the construction engineering required to support the VA construction management team guiding the site contractor.

Table 2 – Anticipated Building Outfitting Schedule

Schedule and Order Management

Delivery and Receiving

2.4.1 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 Mark Stockstell at (402) 995-5847, mark.stockstell@va.gov, Colin Beal at (402) 930-7775, colin.beal@va.gov, Dan Thompson at (785) 477-2820, dan.thompson@sme-solutions.co, and Derick Lacky at (301) 602-9109, dlackey@hcrmoves.com.

☒ VANWIHS Omaha VA Ambulatory Care Clinic (Direct Delivery to address detailed in paragraph 2.1.1) ☐ IOT&A Contractor-Provided Warehouse Local to the VANWIHS SME Solutions Warehouse: Attn: SME Solutions-VA Project, Gratton Warehouse Co. 11005 E Circle Omaha, NE 68137

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 and IOT&A POC any required coordination requirements.

Clean Up and Disposal

2.6.1 There are no dumpsters available for vendor use.

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

Assembly and Installation Required (Yes ☒ No ☐)

2.7.1 The vendor is required to manage and coordinate installation at the VANWIHS Omaha VA Ambulatory Care Clinic with the COR or his representative IOT&A POC.

2.7.2 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: 8:00 AM to 4:30 PM Central Standard Time, Monday through Friday, and excluding Federal Holidays.

2.7.3 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.

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

2.7.5 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 paying for and repairing any damage or noted deficiencies to finished spaces and surfaces that occur as a result of the vendor’s (or associated sub-contractors) installation.

2.7.6 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 VANWIHS. 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.

1. SCOPE OF WORK

VA Nebraska-Western Iowa Healthcare System U0011

Omaha, NE 68105

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

JSN Nomenclature: JSN U0011 - ACL Screwdriver and Taps Salient Characteristics: Surgical Grade Stainless Steel and Etched for Censitrac (preferred)

INTERFERENCE SCREW, DRIVER QTY 3

Part No. 72201887

7MM TAP QTY 3

Part No. 72201890

8MM TAP QTY 3

Part No. 72201891

9MM TAP QTY 3

Part No. 72201892

10MM TAP QTY 3

Part No. 72201893

6MM TAP QTY 3

Part No. 72201889

TAP TRAY QT 3

Part No. 72201938

VA Nebraska-Western Iowa Healthcare System U0012

Total Quantity: 1

JSN Nomenclature: JSN U0012 - ACL Sets Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

CANN DRILL BIT 5MM QTY 2

Part No. 013498

ENDOSCOPIC CANN DRILL BIT 6MM QTY 2

Part No. 013499

TUBE, SIZING, 6MM QTY 2

Part No. 013522

TUBE, SIZING, 7MM QTY 2

Part No. 013523

TUBE, SIZING, 8MM QTY 2

Part No. 013524

TUBE, SIZING, 9MM QTY 2

Part No. 013525

TUBE, SIZING, 10MM QTY 2

Part No. 013526

TUBE, SIZING, 11MM QTY 2

Part No. 013527

TUBE, SIZING, 12MM QTY 2

Part No. 013528

CANNULATED DRILL BIT, 6MM QTY 2

Part No. 013542

CANNULATED DRILL BIT, 7MM QTY 2

Part No. 013543

CANNULATED DRILL BIT, 8MM QTY 2

Part No. 013544

CANNULATED DRILL BIT, 9MM QTY 2

Part No. 013545

CANNULATED DRILL BIT, 10MM QTY 2

Part No. 013546

CANNULATED DRILL BIT, 11MM QTY 2

Part No. 013547

CANNULATED DRILL BIT, 12MM QTY 2

Part No. 013548

TENDON STRIPPER, CLOSED QTY 2

Part No. 013550

BONE TUNNEL PLUG, SMALL, 7MM 3/BX QTY 4

Part No. 013560

PLUG, BONE TUNNEL, 9/10, MED 3/BX QTY 4

Part No. 013561

BONE TUNNEL PLUG, LARGE, 10-11MM 3/BX QTY 4

Part No. 013562

RASP, CHMFRG QTY 2

Part No. 013570

RASP, RND, HF, 7MM QTY 2

Part No. 013572

ENDOSCOPIC CANN DRILL BIT 7MM QTY 2

Part No. 013660

ENDOSCOPIC CANN DRILL BIT 8MM QTY 2

Part No. 013661

ENDOSCOPIC CANN DRILL BIT 9MM QTY 2

Part No. 013662

ENDOSCOPIC CANN DRILL BIT 10MM QTY 2

Part No. 013663

ENDOSCOPIC CANN DRILL BIT 11MM QTY 2

Part No. 013664

ENDOSCOPIC CANN DRILL BIT, 12MM QTY 2

Part No. 013665

DIAMOND RASP 90 DEG QTY 2

Part No. 014550

DRIVER, SILK SCREW, 1.5MM QTY 2

Part No. 014815

GAUGE, DEPTH, ENDO-BUTTON QTY 2

Part No. 015185

HDL, ASSY, DIRECTOR ACL GUIDE QTY 2

Part No. 7205517

AMR, TIP, ARM, DIRECTOR, ACL GUIDE QTY 2

Part No. 7205519

GDE, OFFS DRILL, 3.9MM QTY 2

Part No. 7205522

BLT ASSY 4 POINT DIRECTOR QTY 2

Part No. 7205525

STIPPER, TENDON, LARGE EA QTY 2

Part No. 7207179

DRILL, UNIVERSAL ENDO CANN 5.0MM QTY 2

Part No. 7208686

SLOTTED GRAFT SIZING BLOCK QTY 2

Part No. 7209214

SYS, TRAY DIRECTOR GUIDE QTY 2

Part No. 72201731

VA Nebraska-Western Iowa Healthcare System U0013

Total Quantity: 1

JSN Nomenclature: JSN U0013 – Ankle Distractor Salient Characteristics:

CLAMP, TABLE QTY 3

Part No. 013227

FOOT STRAP, ANKLE DISTRACTOR, STERILE 6 BX QTY 1

Part No. 014407

BAR, SUPPORT, GUHL, ANKLE DISTRACTOR QTY 3

Part No. 014459

DISTRACTOR, ANKLE, GUHL, NON-INVASIVE QTY 3

Part No. 7207023

TRAY LID AND MAT, GUHL ANKLE QTY 3

Part No. 7207032

VA Nebraska-Western Iowa Healthcare System U0014

Total Quantity: 1

JSN Nomenclature: JSN U0014 – Arthroscopy Equipment Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

OBTURATOR, 4.5MM QTY 2

Part No. 1992

TROCAR, 4.5MM QTY 2

Part No. 1995

OBTURATOR, 5.5MM QTY 2

Part No. 2209

PCH , BSKT, SCP, STR 1.0MM QTY 2

Part No. 012029

4.5MM OPERATIVE CANNULA QTY 2

Part No 3673

SWITCHING STICK QTY 4

Part No. 3801

SWITCHING SLEEVE QTY2

Part No. 3802

INTEL 4MM A'SP FOR OBTURATOR QTY 2

Part No. 4356

BASKET PUNCH 90D ROTARY 2.2MM, LEFT QTY 2

Part No. 010912

BASKET PUNCH 90D ROTARY 2.2MM, RIGHT QTY 2

Part No. 010913

BASKET PUNCH, ,DCKBL,UPBITER QTY 2

Part No 012014

PUNCH, BASKET, DUCKLING, STRAIGHT QTY 2

Part No. 012044

PUNCH, BASKET, DUCKLING, UPBITER QTY 2

Part No. 012045

POSTERIOR PUNCH, UPBITER, CURVED LEFT QTY 2

Part No. 012204

POSTERIOR PUNCH, UPBITER , CURVED RIGHT QTY 2

Part No. 012205

CANNULA, OPERATIVE 5.5MM FINDGERPOST QTY 2

Part No. 7204708

INFUSION ADAPTER, W/STOPCOC QTY 2

Part No. 7204864

HEAVY HOOK PROBE W/ HANDLE QTY 2

Part No. 7204869

OVAL PUNCH, UPBITER QTY 2

Part No. 7207200

CANNULA, HIGH FLOW, DIAGNOSTIC, 6MM, ROTABLE, DOUBLE VALVE QTY 2 Part No. 72200829

IRR. EXT'R, HIGH FLOW, SINGLE VALVE QTY 2

Part No. 72200832

GRSPR,ALGTR,MAX Qty 8 Part No. 011024

WISSINGER ROD,4.5MM Qty 2 Part No. 2787

VA Nebraska-Western Iowa Healthcare System U0016

Total Quantity: 1

JSN Nomenclature: JSN U0016 – Biters Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

TRAY, STERILIZATION, LINEAR QTY 2

Part No. 011673

PUNCH, BASKET, DUCKBILL, UPBITER, 1.5MM QTY 2

Part No. 012013

PUNCH, BASKET, SCOOP, UPBITER, 1.3MM QTY 2

Part No. 012030

PUNCH, BASKET, SCOOP, UPSWEPT, 1.3MM QTY 2

Part No. 012031

PUNCH, SCISSOR, STRAIGHT QTY 2

Part No. 012036

PUNCH, SCISSOR, UPBITER, CURVED, LEFT QTY 2

Part No. 012038

PUNCH, SCISSOR, UPBITER, CURVED, RIGHT QTY 2

Part No. 012039

PUNCH, BASKET, DUCKLING, STRAIGHT QTY 2

Part No. 012044

PUNCH, BASKET, DUCKLING, CURVED, LEFT QTY 2

Part No. 012046

PUNCH, BASKET, DUCKLING, CURVED, RIGHT QTY 2

Part No. 012047

PUNCH, STINGRAY, RIGHT QTY 2

Part No. 012058

PUNCH, STINGRAY, LEFT QTY 2

Part No. 012059

PUNCH, BASKET, DUCKLING, ELEVATED QTY 2

Part No. 014765

PUNCH, OVAL, UPSWEPT QTY 2

Part No. 7207296

GRSPR,FRCP,LOOSEBODY,PTBLL QTY 3

Part No. 011022

GRSPR,ALGTR,UPBTR QTY 3

Part No. 011021

VA Nebraska-Western Iowa Healthcare System U0017

Total Quantity: 1

JSN Nomenclature: JSN U0017 – Compaction Pliers Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

TRAY, STERILIZATION, MEDIUM QTY 1

Part No. 7207369

PLIERS, COMPACTION, 7MM (REF IM P/N13499) QTY 1

Part No. 7209441

PLIERS, COMPACTION, 8MM (REF IM P/N13500) QTY 1

Part No. 7209442

PLIERS, COMPACTION, 9MM QTY 1

Part No. 7209443

PLIERS, COMPACTION, 10MM (REF P/N13502) QTY 1

Part No. 7209446

PLIERS, COMPACTION, 11MM (REF P/N13503) QTY 1

Part No. 7209447

VA Nebraska-Western Iowa Healthcare System U0019

Total Quantity: 1

JSN Nomenclature: JSN U0019 – Shoulder Set Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

SWITCHING STICK QTY 4

Part No. 3801

SHOULDER ELEVATOR QTY 4

Part No. 013949

SCISSOR DOUBLE HOOK QTY 4

Part No. 7209491

SUTURE MANIPULATOR QTY 4

Part No. 7209494

ARTHROPIERCE STRAIGHT QTY 4

Part No. 7209496

ARTHROPIERCE 45 DEG RIGHT QTY 4

Part No. 7209497

ARTHROPIERCE 45 DEGREE LEFT QTY 4

Part No. 7209498

ARTHROPIERCE 35 DEGREE UP QTY 4

Part No.7209499

KNOT MANIPULATOR QUICK-T QTY 8

Part No. 7210116

REUSABLE OBTURATOR, 8.5X72M W/4.3CANN QTY 4

Part No. 7200911

ELITE PREMIUM CROCHET HOOK QTY 4

Part No. 72201177

ELITE PREMIUM ALLIGATOR GRASPER QTY 4

Part No. 72201180

ELITE PREMIUM COMBINATION GRASPE QTY 4

Part No. 72201181

BANKER RASP QTY 4

Part No. 72201660

KNIFE RASP QTY 4

Part No. 72201661

AWL, TAPERED, 3.8MM QTY 4

Part No. 72201915

TRAY, ELITE PREMIUM II HLDR ARTHROSYSTEM QTY 4

Part No. 72202042

SUTURE CUTTER QTY 4

Part No. 72202589

4.5MM AWL/DILATOR QTY 4

Part No. 7220633

5.5MM AWL/DILATOR QTY 4

Part No. 72202634

DRILL GUIDE, CROWN TIP, REUSABLE, STD QTY 4

Part No. 72203857

SUTUREFIX FISHMOUTH GUIDE QTY 4

Part No. 72203859

OBTURATOR, S, BLUNT, REUSABLE QTY 4

Part No. 72203861

Obturator S Cannulated Reusable QTY 4 Part No.72203862

Obturator S Trocar Tip Reusable QTY 4 Part No. 72203863

VA Nebraska-Western Iowa Healthcare System U0020

Total Quantity: 1

JSN Nomenclature: JSN U0020 – Hip Arthroscopy Set Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

SWITCHING STICK 4.3MM QTY 4

Part No. 3801

MTO 3.0 MM PROBE QTY 2

Part No. 6900221

PUNCH, 90 ROTARY RIGHT, EXTENDED, LOOP HANDLE QTY 2

Part No. 7207545

PUNCH, 90 ROTARY LEFT, EXTENDED, LOOP HANDLE QTY 2

Part No. 7207544

GRASPER, ALLIGATOR MAX, EXTENDED QTY 2

Part No. 7207699

GRASPER, EXTENDED 2.25' QTY 2

Part No. 7207731

PUNCH, NARROWLINE UPBITER EXT 2.25' QTY 2

Part No. 7207733

PUNCH SCOOP UPBITER 1.5MM, EXT 2.25' QTY 2

Part No. 7207735

PUNCH, DUCKLNG, UPBITER EXTENDED 2.25' QTY 2

Part No. 7207736

DUCKLING, UPSWEPT EXTENDED 2.25' QTY 2

Part No. 7207737

TRAY, STERILIZATION, HIP ARTHROSYSTEM QTY 2

Part No. 7207934

KNOT MANIPULATOR QUICK-T QTY 2

Part No. 7210116

STINGRAY PUNCH, RIGHT EXTENDED 2.25' QTY 2

Part No. 7210730

STINGRAY PUNCH, LEFT EXTENDED 2.25' QTY 2

Part No. 7210731

4.5MM CANNULATED OBTURATORW/DELRIN QTY 2

Part No. 72200096

5.0MM CANNULATED OBTURATORW/DELRIN QTY 4

Part No. 722200097

5.5MM CANNULATED OBTURATORW/DELRIN QTY 2

Part No. 72200098

CLEAR-TRAC COMPLET CANNULAS. HIP.7.0MMX110MM REUSABLE OBTURATOR QTY 2

Part No. 72200445

ARTHROGRADE SLOTTED CANNULA, HIP QTY 2

Part No. 72201590

ASSEMBLY, 5.5MM HIP CANNULA QTY 6

Part No. 72201743

MTO ARTHRO GUARD 4.5M J LOCK HIP CANNULA QTY 6

Part No. 72202003

MTO ARTHRO GUARD 5MM J LOCK HIP CANNULA QTY 6

Part No. 72202004

HIP REPAIR MICROFRACTURE PICK, 30DEG QTY 2

Part No. 72202119

MICROFRACTURE PICK, HIP, 45DEGREES QTY 2

Part No. 72202120

HIP REPAIR MICROFRACTURE PICK, 60DEG QTY 2

Part No. 72202210

IRRIGATION EXTENDER WITH A J SNAPAND A DOUBLE VALVE QTY 4

Part No. 72202449

OPEN CURETTE, 4.5MM, XL QTY2

Part No. 72202583

OPEN CURETTE, 6MM, REVERSE CUT, XL QTY 2

Part No. 72202584

ARTHRO-ROUND, XL QTY 2

Part No. 72202586

KNOT MANIPULATOR, XL QTY 2

Part No. 72202587

SUTURE CUTTER XL QTY2

Part No. 72202588

ELEVATOR, XL QTY 2

Part No. 72202628

RASP, XL QTY 2

Part No. 72202629

INSTRUMENT TRAY HIP ARTHROSCOPY QTY 2

Part No. 72202732

VA Nebraska-Western Iowa Healthcare System U0021

Total Quantity: 1

JSN Nomenclature: JSN U0021 – Hip Positioner Salient Characteristics:

UNIVERSAL HIP DISTRACTOR QTY 2

Part No. 72200626

PERONEAL POST QTY 1

Part No. 72200631

RAIL CLAMP | 2/BX QTY 1

Part No. 72200636

BOARD, PATIENT TRANSFER QTY 1

Part No. 72200638

PAD, PATIENT TRANSFER QTY 1

Part No. 72200639

STORAGE CART, SUPINE SYSTEM QTY 1

Part No. 72200669

SUPINE TABLE ATTACHMENT W/PAD QTY 1

Part No. 72201725

VA Nebraska-Western Iowa Healthcare System U0022

Total Quantity: 1

JSN Nomenclature: JSN U0022 – XL Hip Scope Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

HIP ASCOPE, 4MM, 30DEG DIR VIEW, 278MM WORKING LENGTH, 115DEG FIELD OF VIEW QTY 1 Part No. 72201597

HIP ASCOPE, 4MM, 70, 280MM WORKING LENGTH, DV, AC QTY 1

Part No. 72201598

STERILIZATION TRAY 3' X 19' QTY 2

Part No. 7208209

MTO, 5.0NN CAN OBTURATOR, W/DEL HANDLE, EXTENDED QTY 2

Part No. 72203329

MTO, 5.0MM ARTHROGARDE HIP CAN, EXTENDED QTY 3

Part No. 72203327

VA Nebraska-Western Iowa Healthcare System U0023

Total Quantity: 1

JSN Nomenclature: JSN U0023 – Resection Equipment Salient Characteristics: (Smith & Nephew basis of design)

SHAVER CONTROL UNIT QTY 2

-SOFT TISSUE CUTTING MODES (SOFT TISSUE/BONE RESECTION)

-DUAL POTS FOR SHAVER AND POWER HANDPIECES

Part No. 72200873

CART, PROCEDURE, W. ISOL.TRANSFORMER QTY 2

Part No. 72200747

MOTOR DRIVE UNIT, HAND CONTROL, ELECTRIC, WITH SUCTION LEVERS AND MULTI BLADE POSITIONING QTY 6 Part No.72200616

KIT, U.S., SHAVER CONTROL UNIT QTY 2

Part No. 72201029

SHAVER FOOTSWITCH QTY 2

Part No. 72201092

FLUID MANAGEMENT PUMP QTY 3

-MAX FLOW: 1.5L/MIN

-PRESSURE RANGE: 5-150MMHG

-USES RFID TUBE RECOGNITION TO PREVENT REPROCESSING

-WASH FUNCTION

Part No. 72204968

COBLATION CONTROLLER QTY 3

-5 Operation Modes based on procedure/tissue type (Coag, Low, Medium, High, and Vac) -Temperature monitoring/over-ride -Personal Settings Part No. 72290105

WIRELESS FOOT PEDAL QTY 3

Part No. 72290008

VA Nebraska-Western Iowa Healthcare System U0024

Total Quantity: 1

JSN Nomenclature: JSN U0024 – Small Joint Scope Set Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

INSTRUMENT VERSITIP ADAPTOR - Intended to interface Universal Fiber Optic Light Cables with endoscopes Qty 2 Part No. 2146

SOURCE VERSITIP - Intended to interface Universal Fiber Optic Light Cable with light sources Qty 2 Part No. 2147

HOOK PROBE, 2.2MM Qty 2 Part No. 3312

2.9MM SHORT CANNULA WITH FLOW PORT Qty 2 Part No. 3781

2.9MM SHORT OBTURATOR, BLUNT TIP Qty 2 Part No. 3786

2.9MM SHORT OBTURATOR, CONICAL TIP Qty 2 Part No. 3807

LIGHT POST ADAPTOR SLEEVE TO FIT ALL ARTHROSCOPES, HYSTEROSCOPES/CYSTOURETHEROSCOPES, AND LAPAROSCOPES WITH 4MM LIGHT POST Qty 2 Part No. 4347

STERI-TRAY, 3' X 9',4.0MM SCOPE Qty 2 Part No. 7204737

DIRECT VIEW ARTHROSCOPE, AUTOCLAVABLE 2.7MMX30DEG, FIELD OF VIEW 90DEG, WORKING LENGTH 67MM, J-LOCK CANNULA CONNECTION, 4MM LIGH CABLE CONNECTION Qty 2 Part No. 7205682

STERILIZATION TRAY, MULTI-USE Qty 2 Part No.7205683

SMALL JOINT HANDPIECE WITH BLADE POSITTIONING HAND CONTROLS, SUCTION LEVER AND 10FT CORD – To be used with the electric driver control system Qty 2 Part No. 72201500

UNIVERSAL LIGHT GUIDE ORANGE 4MM X8 FT Qty 2 Part No. 72204858

VA Nebraska-Western Iowa Healthcare System U0025

Total Quantity: 1

JSN Nomenclature: JSN U0025 – Small Joint Set Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred)

2MM HOOK PROBE Qty 2 Part No. 3312

2.5MM STRAIGHT SUCTION PUNCH Qty 2 Part No. 3499

RAPTOR JR., PUNCH Qty 2 Part No. 014843

BLUNT NOSE JR. PUNCH Qty 2 Part No. 014844

PITBULL, JR. Qty 2 Part No. 014845

MICROGRASPER, STRAIGHT Qty 2 Part No. 7207598

MICROPUNCH, STRAIGHT Qty 2 Part No. 7207600

MICROPUNCH, TEARDROP, RIGHT Qty 2 Part No. 7207601

MICROPUNCH, TEARDROP, LEFT Qty 2 Part No. 7207602

CURETTE, 2.5MM, SMALL JOINT, 30 DEG Qty 2 Part No. 72201377

CURETTE, 2.5MM, SMALL JOINT, ANTERIOR LESION Qty 2 Part No. 72201379

PICK, CURVED 65 DEGREE Qty 2 Part No. 72203662

ELEVATOR, CURVED, TEARDROP Qty 2 Part No. 72203665

PICK, STRAIGHT 40 DEGREE Qty 2 Part No. 72203680

ELEVATOR, CURVED Qty 2 Part No. 72203703

TRAY, INSTRUMENT, FOOT & ANKLE Qty 2 Part No. 72203782

VA Nebraska-Western Iowa Healthcare System U0026

Total Quantity: 1

JSN Nomenclature: JSN U0026 – Leg Positioner

PIGGY BACK (2) | 2/BX Qty 2 Part No. 7210570

SPIDER LEG ACCESSORY (LEFT), TENET 7645 QTY 2

Part No. 7220325

SPIDER LEG ACCESSORY (RIGHT),TENET 7626 Qty 2 Part No. 7220326

3D SPIDER CONNECTOR, TENET 7625 Qty 4 Part No. 72203239

VA Nebraska-Western Iowa Healthcare System U0027

Total Quantity: 1

JSN Nomenclature: JSN U0027 – Shoulder Positioner

STERILIZATION TRAY,MULTI-USE Qty 2 Part No. 7205683

TRAY, STERILIZATION, LARGE GENERIC Qty 4 Part No. 7207357

BEACH CHAIR, SHOULDER EXPOSURE POSITIONER Qty 2 Part No. 7210551

ARM BOARD & GEL PAD, ADJUSTABLE Qty 2 Part No. 7210552

CART, BEACH CHAIR Qty 2 Part No. 7210553

CLAMPS, SQUARE RAIL (2) Qty 2 Part No. 7210554

PIGGY BACK (2) | 2/BX Qty 3 Part No. 7210570

BAR, CONNECTOR, SHOULDER (2) | 2/BX Qty 2 Part No. 7210571

BAR, CONN, SHOULDER, LATERAL(2) | 2/BX Qty 1 Part No. 7210576

ACCESSORY, TRACTION Qty 2 Part No. 7210577

CART, TRANSPORT, SPIDER Qty 2 Part No. 72200918

REPLACEMENT BEACH CHAIR BODY STRAP Qty 2 Part No. 72201184

LIMB POSITIONER Qty 2 Part No. 72203299

LIMB POSITIONER BATTERY Qty 2 Part No. 72203301

VA Nebraska-Western Iowa Healthcare System U0028

Total Quantity: 1

JSN Nomenclature: JSN U0028 – Western Arm Positioner

POSITIONER, ELBOW, WESTERN – Fits onto clark clamp for lateral and prone elbow procedures Qty 3 Part No. 7210575

VA Nebraska-Western Iowa Healthcare System U0036

Total Quantity: 1

JSN Nomenclature: JSN U0036 – SMALL JOINT Ortho Set Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred) CANNULA FOR 3.8MM Double Valve rotatable Qty 3 Part No. 72201792

OBTURATOR FOR 3.8MM OPERATIVE SET Qty 3 Part No. 7205993

ARTHROSCOPE, AUTOCLAVABLE 2.7MM X30DEG Qty 3 Part No. 7205681

SMALL JOINT HANDPIECE WITH BLADE POSITTIONING HAND CONTROLS, SUCTION LEVER AND 10FT CORD – To be used with the electric driver control system Qty 3 Part No. 72201500

Holder For SMITH & NEPHEW® FERKEL™ Thigh System Qty 1 Part No. 72201812

SMALL JOINT GRASPER W/ NEW LOCKING RATCHET Qty 2 Part No. 7220612

STERI-TRAY 3’9’, 4.0MM SCOPE Qty 3 Part No. 7204737 PICK ASSIST Qty 2 Part No. 72203781

VA Nebraska-Western Iowa Healthcare System U0041

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

JSN Nomenclature: JSN U0041 – Integration Broker, DICOM

Integration Broker, Dicom – Software application that converts images and videos from the surgical imaging system to a DICOM compatible format for export to the hospital PACS system(wifi enabled) Qty 1 Part No. 72201081

INTEGRATION BROKER, ANNUAL SUPPORT, DICOM Qty 1 Part No. 72201082

VA Nebraska-Western Iowa Healthcare System U0042

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

JSN Nomenclature: JSN U0042 – Ortho Imaging Tower Salient Characteristics: Surgical Grade Stainless Steel unless otherwise specified and Etched for Censitrac (preferred) INSTRUMENT VERSITIP ADAPTOR - Intended to interface Universal Fiber Optic Light Cables with endoscopes Qty 14 Part No. 2147

SOURCE VERSITIP - Intended to interface Universal Fiber Optic Light Cable with light sources Qty 14 Part No. 2146

LIGHT POST ADAPTOR SLEEVE TO FIT ALL ARTHROSCOPES, HYSTEROSCOPES/CYSTOURETHEROSCOPES, AND LAPAROSCOPES WITH 4MM LIGHT POST Qty 14 Part No. 4347

STERI-TRAY, 3' X 9',4.0MM SCOPE Qty 12 Part No. 7204737

AUTOCLAVABLE SCOPE 4MM, 30DEG-DIRECTION OF VIEW, 115DEG FIELD OF VIEW, 160MM WORKING LENGTH, J-LOCK CANNULA CONNECTION QTY 9 Part No. 72202087

AUTOCLAVABLE SCOPE 4MM, 70DEG-DIRECTION OF VIEW, 115DEG FIELD OF VIEW, 160MM WORKING LENGTH, J-LOCK CANNULA CONNECTION QTY 3 Part No. 72202088

CROSS SPECIALTY CART W/ BOOM AND TRANSFORMER QTY 3

Part No. 72205120

PRINTER, COLOR PHOTO, MEDICAL GRADE QTY 3

Part No. 72203944

LENS 4K A/C CAMERA HEAD QTY 9

Part No. 72205058

LENS 4K CCU WIFI VERSION Qty 3 Part No. 72205059

IMAGE MANAGEMENT SYSTEM Qty 3

-HIGH DEFINITION

-FUNCTION TO CAPTURE, EDIT, PRINT, AND STORE INTRAOPERATIVE SURGICAL IMAGES AND VIDEOS TO PACS AND EMR(VISTA) Part No. 72204668

KIT US, IMAGE MANAGEMENT SYSTEM Qty 3 Part No. 72204700

COUPLER HD 19.5MM AUTOCLAVABLE Qty 9 Part No. 72200315

UNIVERSAL LIGHT GUIDE ORANGE 4MMX10 FT Qty 14 Part No. 72204922

KIT US LENS 4K A/C CAMERA HEAD QTY 9

Part No. 72205345 KIT US LENS 4K CCU WIFI VERSION Qty 3 Part No. 72205225

UHD 4K FLAT PANEL DISPLAY LCD SONY31"(SURGICAL GRADE) Qty 3 Part No. 72205011 image2.png