36C24624Q1294 0001.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

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) 565-24-3-090-0198 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 To all Offerors/Bidders

36C24624Q1294 09-06-2024

X

See CONTINUATION Page x The amendment is to add the Brand Justification to the solicitation.

All solicitation requirements will remain the same.

Daleta Coles Contracting Officer

CONTINUATION PAGE

DEPARTMENT OF VETERANS AFFAIRS

Justification for Single Source Awards IAW FAR 13.106-1 For Over Micro-Purchase Threshold but Not Exceeding the SAT ($250K)

Acquisition Plan Action ID: 36C246-24-AP-3607

1. Contracting Activity: Department of Veterans Affairs, VISN 06, Fayetteville VA Medical Center, 2300 Ramsey Street, Fayetteville, NC 28301. Purchase Rrequest Number: 565-24-3-090-0198

2. Brief Description of Supplies/ Services required and the intended use/Estimated Amount: Fayetteville VA Medical Center has a requirement to procure the Centurion Vision system for Ophthalmology department. The Vision System is a technology platform for cataract removal with phacoemulsification. The system is for emulsification, separation, irrigation, and aspiration of cataracts, residual cortical material and lens epithelial cells, vitreous aspiration and cutting associated with anterior vitrectomy, bipolar coagulation, and intraocular lens injection.

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used: The Centurian Phacoemulsification System is a mobile workstation that ia proprietary as it will be compatible with the components and supplies that are currently here at the facility used during cataract procedures. Any other brand would not be compatible and not work or work properly. The equipment and Phaco handpieces currently in use will be utilized with this Phaco system. This will be transported to the Operating room where it is needed for procedures. Procuring other manufacturer items would undermine current standardization efforts, and would result in an increased cost that are not anticipated to be recouped. Based on facility need and existing conditions, like or similar items will not suffice.

4. Description of market research conducted and results or statement why it was not conducted:

Previous Market Research dated 01/25/2024 for the exact product was used for this requirement. A Sources Sought 36C24624Q0284 was posted to contracting opportunities from 12/19/2023 to 12/27/2023, one response received. The CO researched all required sources and deemed that the items are available from the OEM and authorized distributor/reseller. The CO intends to pursue this requirement as Unrestricted, Full and Open.

5. Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106-1(b). I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

Centurion Vision System Standard 1-Year Factory Warranty, Delivery, Installation, and Training Included

LOCAL STOCK NUMBER: 900198090

A.2 DELIVERY SCHEDULE

2300 Ramsey St Fayetteville, NC 28301

USA

(910) 475-6565 Barbra.Bylicki@va.gov

The amendment is to add the Brand Justification to the solicitation.