36C24418Q0540-001.pdf

DEPARTMENT OF VETERANS AFFAIRS

FAR 8 – Justification for Limiting Sources (LSJ) For

Limiting Sources (<$150K)

Acquisition Plan Action ID: 595-18-3-455-0119 & 595-18-3-455-0120

1. Contracting Activity: Department of Veterans Affairs, VISN 04, Lebanon Medical Center

Network Contract Office 4

2. Description of Action: New Requirement.

Order against: FSS Contract Number: V797D-40279 and V797P4333B

Name of Proposed Contractor: Welch Allyn, Inc.

Street Address: 4341 State Street Road City, State, Zip: Skaneateles Falls, NY 13153 Phone: 800-535-6663

Name of Proposed Contractor: Claflin Service Co – DBA: Claflin Medical Equipment (CME) Street Address: 1206 Jefferson Blvd City, State, Zip: Warwick,RI 02886 Phone: 800-338-2372

3. Description of Supplies or Services:

The estimated value of the proposed action is $132,652.07

BRAND NAME ONLY

The Lebanon VA Medical Center (LVAMC) has a need for fifty-five (55) Welch Allyn Diagnostic units and accessories for activation to be used in the new Cumberland VA Clinic (40 units) and new Lancaster VA Clinic (15 units) exam rooms to be utilized for patient care.

• Mfg Part # 77794-MCSM Welch Allyn Green Series 777 Integrated Wall Diagnostic System including mounting bracket for Connex Spot Monitor Device (order CSM device separately), Coaxial Ophthalmoscope (#11720), MacroView Otoscope (# 23810), KleenSpec Disposable Specula Dispenser, Vital Signs Accessory Basket, Vital Signs Monitor Power Supply (7000-PS) Wall-Mount Panel, (30 x 12 in / 76.2 x 30.5 cm); 100-240 V, 50-60 Hz AC, IEC Plug Type-B Mfg: WELCH ALLYN, INC.

• Mfg Part #: 71WX-B Welch Allyn Connex Spot Monitor with SureBP Non-invasive Blood Pressure, Nonin SpO2 Mfg: WELCH ALLYN, INC.

• Mfg Part# Reuse-13, Thigh Cuff for Blood Pressure Unit Welch Allyn

• MFG Part #5243-U Bag of 850 4.25mm Adult Otoscope Tips, Welch Allyn

• Freight Free dock to dock freight

• Item quoted is a 30” board

4. Authority:

ORDER AGAINST FSS: Authority of the Multiple Award Schedule Program, Title III of the Federal Property and Administrative Services Act of 1949 (41 USC 251, et seq.); Title 40 USC 501, Services for Executive Agencies; and Section 803 of the National Defense Authorization Act of 2002 (PL 107-107) and implemented by FAR 8.405-6. Mark the applicable exception:

An urgent and compelling need exists, and following the procedures would result in unacceptable delays(FAR 8.405-6(a)(1)(i)(A);

Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized;

(FAR 8.405-6(a)(1)(i)(B));

In the interest of economy and efficiency, the new work is a logical follow-on to an original Federal Supply Schedule order and the original order was placed in accordance with the applicable Federal Supply Schedule ordering procedures. The original order was not previously issued under sole-source or limited-sources procedures (FAR 8.405- 6(a)(1)(i)(C)); or

Items peculiar to one manufacturer. An item peculiar to one manufacturer can be a particular brand name, product, or a feature of a product, peculiar to one manufacturer). A brand name item, whether available on one or more schedule contracts, is an item peculiar to one manufacturer (FAR 8.405-6(b)).

5. Rational/explanation to support cited authority:

This particular build is a Welch Allyn model, which is used throughout the Lebanon VAMC and is manufactured by Welch Allyn. The Welch Allyn unit we want to purchase is unique since we had the Thermometer and the tips taken off and added a pulse oximeter. This was added , since the hand held units are misplaced many times. We https://www.acquisition.gov/?q=/browse/far/8 https://www.acquisition.gov/?q=/browse/far/8 https://www.acquisition.gov/?q=/browse/far/8 https://www.acquisition.gov/?q=/browse/far/8 https://www.acquisition.gov/?q=/browse/far/8 https://www.acquisition.gov/?q=/browse/far/8 use Welch Allyn diagnostic units throughout the hospital and all the area VA clinics.

With all being standardized with the Welch Allyn units we do not have to purchase special ear tips and Blood pressure cuffs, but would be able to utilize the supply the hospital has in stock for the Welch Allyn units we use throughout the hospital and VA clinics. The units that are taken out of service are kept in Biomed to be used as spare parts if any part becomes faulty on another unit. We found that Welch Allyn diagnostic units are reliable and the majority of them only need light bulbs replaced.

6. BRAND NAME ONLY (Delete this section if it does not apply): This buy is estimated to exceed $25,000 and this documentation will be posted along with the RFQ on e-Buy, as required by FAR 8.405-1(e).

7. Note that this determination satisfies the requirements of FAR 8.405-6. The requirement to prepare a written justification IAW FAR 6.303 does not apply to Federal Supply Schedules.

Signature: _______________________ Signature: __________________________ Name: AMANDA SAUNDERS Name:

Title: Contracting Officer Title: Branch Chief, Hybrid 2 Facility: NCO4 Facility: NCO4 Date: Date:

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