36C10G18R0195-0003000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 10-24-2018 N/A 36C10G U.S. Department of Veterans Affairs OPAL | Strategic Acquisition Center 10300 Spotsylvania Ave | STE 400 Fredericksburg

VA

22408-2697 36C10G U.S. Department of Veterans Affairs OPAL | Strategic Acquisition Center 10300 Spotsylvania Ave | STE 400 Fredericksburg

VA

22408-2697 To all Offerors/Bidders

36C10G18R0195 10-24-2018

X X X ** HOUR & DATE for Receipt of Offers is EXTENDED to:

NOV 7, 2018 @ 2PM EST

X

The purpose of this amendment is to revise and replace Attachment A - Price Cost Schedule - Auditory Function Screening Devices and Section B - Contract Administration Section of the solicitation.

Attachment A and Section B are hereby replaced in their entirety with the below sections.

The closing date is extended to November 7, 2018 at 2PM EST.

Beth A. Davis Contracting Officer

B.1 CONTRACT ADMINISTRATION

All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: TBD

b. GOVERNMENT: Contracting Officer 36C10G Beth Davis U.S. Department of Veterans Affairs

Fredericksburg, VA 22408 Beth.davis2@va.gov

Fredericksburg, VA 22408 Ninatile.bacote@va.gov

Program Office POC

TBD

2. CONTRACTOR REMITTANCE ADDRESS:

All payments by the Government to the Contractor will be made in accordance with 52.232-33, Payment by Electronic Funds Transfer—System for Award Management.

3. INVOICES:

Invoices shall be submitted monthly in arrears based upon delivery and acceptance:

4. GOVERNMENT INVOICE ADDRESS:

All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Request.

5. FSC MANDATORY ELECTRONIC INVOICE SUBMISSION:

Contractors are required to submit payment requests in electronic form in accordance with the submission instructions below.

TUNGSTEN ELECTRONIC INVOICE SUBMISSION

FSC e-INVOICE PROGRAM THRU AUSTIN PORTAL

FSC MANDATORY ELECTRONIC INVOICE SUBMISSION FOR AUSTIN PAYMENTS

Contracting POC:

COR (Contracting Officers Representative):

Contract/Task Order Number:

a. Vendor Electronic Invoice Submission Methods:

Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below.

1. VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge.

2. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). The X12 EDI Web site (http://www.x12.org)

b. Vendor e-invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below.

1. Tungsten e-Invoice Setup Information: 1-877-489-6135

2. Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

3. FSC e-Invoice Contact Information: 1-877-353-9791

4. FSC e-invoice email: vafsccshd@va.gov See https://www.fsc.va.gov/einvoice.asp for more information.

B.2 TERMS AND CONDITIONS

1. The Government is obligated only to the extent of authorized purchases actually made under the resultant contract. The terms and conditions included in this contract apply to all purchases made pursuant to it. In the event of an inconsistency between the provisions of this contract and the Contractors invoice, the provisions of this contract will take precedence.

1. Purchase/Ordering Limitation:

Orders placed against this contract are limited to FAR Clause 52.216-19 Order Limitations, as noted in the contract. The estimated total quantities are listed on ATTACHMENT A – AUDITORY FUNCTION SCREENING DEVICES – PRICE COST SCHEDULE. The quantities provided are estimates only, and VA makes no guarantee regarding the actual quantities that may be purchased.

1. Individuals Authorized to Purchase Under the Contract:

This is a Strategic Acquisition Center decentralized contract. Orders may be placed only by designated VA Ordering Officers for each facility with prior approval from the program manager and/or the project manager/COR. Ordering officers are responsible for issuing and administering orders placed under this contract. Ordering officers may negotiate revisions/modifications to their orders, but only within the scope of this contract. Ordering officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. Orders placed by Ordering Officers will be accompanied by a funded purchase request and will be approved by the program manager and/or project manager/COR prior to submission to the Contractor. The Contractor shall accept orders against this contract only from the Contracting Officer or from Ordering Officers when the order form is accompanied by the review and approval of the project manager/COR for this contract. Fulfilling orders from persons other than the Contracting Officer or an Ordering Officer may result in loss or delay in payment for supplies/services provided under such orders.

1. Delivery Tickets:

The following provisions apply to all shipments:

Inspection: Destination Acceptance: Destination Shipping: Free on Board (FOB) – Destination Ship To and Mark For: Deliveries shall be marked and shipped to various VHA locations identified in each order placed against the contract.

All shipments, either single or multiple container deliveries, shall bear and contain on the delivery tickets or sales slips (external shipping labels and associated manifests or packing lists) the following at a minimum:

(i) Name of supplier

(ii) Contract/Delivery Order/Task Order number

(iii) Date of purchase

(iv) Contract number

(v) Itemized list of supplies or services furnished

(vi) Quantity, unit price, and extension of each item, less applicable discounts (unit prices and extensions need not be shown when incompatible with the use of automated systems, provided the invoice is itemized to show this information).

(vii) Date of delivery or shipment In the case of multiple container deliveries, a statement readable near the VA Order number will indicate total number of containers for the complete shipment (ex. “Package 1 of 2”), clearly readable on manifests and external shipping labels.

Packing Slips/Labels and Lists shall include the following:

IFCAP PO # ____________ (i.e., 166-E11234) Total number of Containers: Package ___ of ___. (i.e., Package 1 of 3)

1. Reports:

Monthly Report: In order for the contracting office to submit the required financial reporting on FPDS-NG the contractor needs to submit ATTACHMENT C– SALES REPORT on a monthly basis to the Contract Specialist and Contracting Officer Representative. The report is due by the 5th of each month.

Quarterly Report: In addition to the monthly submission, the same ATTACHMENT C– SALES REPORT needs to be submitted quarterly as outlined below.

In order to track compliance, VA requires the contractor to submit the quarterly report of sales in the approved format listed in ATTACHMENT C– SALES REPORT based on the Governments fiscal calendar year. See below.

The contractor agrees that they shall adhere to this requirement. The contractor shall provide a quarterly report, no later than 60 calendar days after the end of each fiscal quarter ending December, March, June, and September. Reports shall be sent electronically to the SAC Government points of contact until the contractor is notified, in writing, of a different point of contact.

a. Project Manager: TBD

b. VA PAS: TBD

c. Contracting Officer: TBD

d. Contract Specialist: TBD

B.3 ACKNOWLEDGMENT OF AMENDMENTS

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.4 PRODUCT DESCRIPTION / SALIENT CHARACTERISTICS

1. SCOPE OF WORK:

The Veterans Health Administration (VHA) Non-Expendable Equipment National Program identified Auditory Function Screening Devices as a candidate for VHA-wide (otherwise referred to as “national”) single award Requirements contract.

Auditory Function Screening Devices are used for evaluating hearing acuity. Auditory Function Screening Devices usually consist of an embedded hardware unit connected to a pair of headphones and a test subject feedback button, sometimes controlled by a standard PC. There are five different Auditory Function Screening Devices and these devices are targeted at specific evaluations. A Mid-level Audiometer, a Middle Ear Analyzer, a Two Channel Clinical Audiometer, a Otoacoustic Emissions, an Evoked Potential Screener and a Pure Tone & Tympanometry Screener. The period of performance is for one 12-month base period with two 12-month option periods.

2. REQUIREMENT:

This requirement will be IAW FAR clause 52.211-6, “Brand Name or Equal” which requires that the offeror indicate each product that is being offered as an “equal” product. For each equal product, the offeror must include a description reflecting the characteristics and level of quality that will satisfy the salient physical, functional, or performance characteristics of the equal product(s) specified in the solicitation. The offeror also must clearly identify the item by brand name (if any) and make/model number. Finally, the offeror must include descriptive literature, such as illustrations, drawings, or a clear reference to previously furnished descriptive data or information available to the contracting officer, and clearly describe any modifications it plans to make to a product to make it conform to the solicitation requirements.

Auditory Function Screening Devices

GSI AudioStar Pro is a versatile two-channel clinical audiometer designed to perform efficient audiometric evaluations on every patient population. It may be used independently or with a computer for HIPAA compliant data storage and EMR/EHR compatibility. From the extra-large display that reduces eye strain, the ergonomic housing that maximizes hand and wrist comfort, to the light pipes around selected test buttons

GSI AudioStar Pro Options

GSI AudioStar Pro Supplies

GSI AudioStar Pro Transducers

GSI AudioStar Pro CD’s and Accessories

GSI TympStar Pro offers comprehensive middle-ear testing capabilities that support the needs of hearing healthcare professionals. Change parameters on the fly or interpret results with the touch screen display. Protocols may be configured to optimize efficiency and workflow; the flexibility of pre-defined protocols saves time and creates consistency in testing procedures.

GSI TympStar Pro Clinical Tympanometer - Comprehensive Middle Ear Analyzer

GSI TympStar Pro Options

GSI TympStar Pro Supplies

GSI TympStar Pro CD’s and Accessories

Salient Characteristics (SC) VENDORS ARE REQUIRED TO SITE IN THE CHART BELOW WHERE IN THEIR TECHNICAL LITERATURE THESE SC’s ARE REFLECTED AND INCLUDE THE CHART AS PART OF THEIR PROPOSAL.

SC #

(PAGE/PARAGRAPH)

Emissions Measurements (TEOAE) Literature Review

Definitions

GSI 39

GSI AUDIOSTAR PRO

measurement of SNR loss (signal-to-noise ratio loss) is important because speech understanding in noise cannot be reliably predicted from the pure tone audiogram. The QuickSIN test was developed to provide a quick way for clinicians to quantify a patient’s ability to hear in noise. SPEECH-IN-NOISE

AUDERA

See attached document: ATTACHMENT A PRICE COST SCHEDULE AUDITORY FUNCTION SCREENING DEVICES.