36C24719Q0949-0001001.docx

36C24719Q0949 /10

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

544-19-4-126-0270 36C24719Q0949 09-03-2019

NOCHELLE ELLIOTT

803-695-3801 09-13-2019

09:00 AM

Department of Veterans Affairs WJB Dorn VA Medical Center 6439 Garners Ferry Road Columbia SC 29209 X X 333314 1000 Employees N/A X

WJB DORN VA MEDICAL CENTER

BLDG. 100 WAREHOUSE

MARK FOR: JAMES HARDIN

6439 GARNERS FERRY ROAD

COLUMBIA SC 29209

Department of Veterans Affairs WJB Dorn VA Medical Center 6439 Garners Ferry Road Columbia SC 29209

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971 See CONTINUATION Page

PLEASE SEE PRICE/COST SCHEDULE FOR LIST OF REQUIREMENTS.

THIS RFQ IS 100% SET-ASIDE SDVOSB.

VENDORS MUST BE VERIFIED IN https://www.vip.vetbiz.va.gov/ AND REGISTERED IN https://www.sam.gov/SAM/

PRIOR TO SUBMITTING A QUOTE.

THIS IS A BRAND NAME OR EQUAL PROCUREMENT.

See CONTINUATION Page 544-3690160-126-823200-3131-010044175 X

NOCHELLE ELLIOTT

NC07-16L2-69375

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C247

Department of Veterans Affairs WJB Dorn VA Medical Center 6439 Garners Ferry Road Columbia SC 29209

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

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 Requests.

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

5.00

EA

MANUFACTURER PRODUCT NO. NW400EZ212; TOPCON TRC-NW-400 DIGITAL NON MYDRIATIC RETINAL CAMERA TO INLCUDE THE FOLLOWING: 45 DEGREE FIELD OF CAPTURE,AUTO FOCUS, AUTO CAPTURE, EZ LITE 2 SOFTWARE; AUTO MOSAIC MODULE; QUICK DRAW MODULE; PATIENT CONSULTATION MODULE; ALL-IN-ONE PC; WINDOWS 7; CD/DVD ARCHIVING MODULE; QUICK 2-UP PRINT MODULE; STEREO ANALYSIS SOFTWARE MODULE; LEAD TOOLS DICOM PACS

LOCAL STOCK NUMBER: TRC-NW400

UPGRADE TO AIT-250W WHEELCHAIR ACCESSIBLE TABLE

LOCAL STOCK NUMBER: 25042-11-001

PATIENT STOOL AND OPERATOR STOOL SET (1) TOPCON OS-200 STOOL FOR OPERATOR TOPCON ITEM#26014-BL-000 (1) TOPCON OS-400 STOOL FOR PATIENT (W/LOCKING CASTERS) TOPCON ITEM #26014-BL-000

THREE YEAR WARRANTY W/CERTIFIED INTERNET ACCESS

JB

INSTALLATION AND TRAINING -ON SITE.

GRAND TOTAL

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SECTION C - CONTRACT CLAUSES

C.1 VAAR 852.219-10 VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS SET-ASIDE (JUL 2016)(DEVIATION)

(a) Definition. For the Department of Veterans Affairs, “Service-disabled veteran-owned small business concern or SDVSOB”:

(1) Means a small business concern:

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans or eligible surviving spouses (see VAAR 802.201 Surviving Spouse definition);

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans (or eligible surviving spouses) or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran;

(iii) The business meets Federal small business size standards for the applicable North American Industry Classification System (NAICS) code identified in the solicitation document;

(iv) The business has been verified for ownership and control pursuant to 38 CFR 74 and is so listed in the Vendor Information Pages database, (https://www.vip.vetbiz.gov); and

(v) The business will comply with subcontracting limitations in 13 CFR 125.6, as applicable

(2) “Service-disabled veteran” means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

(b) General.

(1) Offers are solicited only from verified service-disabled veteran-owned small business concerns. Offers received from concerns that are not verified service-disabled veteran-owned small business concerns shall not be considered.

(2) Any award resulting from this solicitation shall be made to a verified service-disabled veteran-owned small business concern.

(c) Agreement. A service-disabled veteran-owned small business concern agrees that in the performance of the contract, the concern will comply with the limitation on subcontracting requirements in 13 CFR §125.6.

(d) A joint venture may be considered a service-disabled veteran owned small business concern if the joint venture complies with the requirements in 13 CFR 125.15, provided that any reference therein to SDVO SBC is to be construed to apply to a VA verified SDVOSB as appropriate.

(e) Any service-disabled veteran-owned small business concern (non-manufacturer) must meet the requirements in FAR 19.102(f) of the Federal Acquisition Regulation to receive a benefit under this program.

(End of Clause)

C.2 52.211-6 BRAND NAME OR EQUAL (AUG 1999)

(a) If an item in this solicitation is identified as "brand name or equal," the purchase description reflects the characteristics and level of quality that will satisfy the Government's needs. The salient physical, functional, or performance characteristics that "equal" products must meet are specified in the solicitation.

(b) To be considered for award, offers of "equal" products, including "equal" products of the brand name manufacturer, must—

(1) Meet the salient physical, functional, or performance characteristic specified in this solicitation;

(2) Clearly identify the item by—

(i) Brand name, if any; and

(ii) Make or model number;

(3) Include descriptive literature such as illustrations, drawings, or a clear reference to previously furnished descriptive data or information available to the Contracting Officer; and

(4) Clearly describe any modifications the offeror plans to make in a product to make it conform to the solicitation requirements. Mark any descriptive material to clearly show the modifications.

(c) The Contracting Officer will evaluate "equal" products on the basis of information furnished by the offeror or identified in the offer and reasonably available to the Contracting Officer. The Contracting Officer is not responsible for locating or obtaining any information not identified in the offer.

(d) Unless the offeror clearly indicates in its offer that the product being offered is an "equal" product, the offeror shall provide the brand name product referenced in the solicitation.

(End of Provision)

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SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

Attachment 1: Gray Market Prevention Language

(a) Gray market items are Original Equipment Manufacturer’s (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.

(b) 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.

(c) 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 to 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.

Attachment 2: Basis of Award

Project: TOPCON RETINAL CAMERA OR EQUAL

A. BASIS OF AWARD.

Award will be made to the lowest priced, technically acceptable responsible offeror, whose offer conforms to all stated terms, conditions, representations, certifications, and any other information required by this solicitation. Offers will be ranked by price first then evaluated for technically acceptable. If the low-priced offer is found to be technically acceptable, the evaluation process stops and no other offer will be evaluated.

If necessary this process will be performed until there is a low priced technically acceptable offer. If no offer is technically acceptable the government will make a determination to re-solicit. Technical tradeoff will not be made and no additional credit will be given for exceeding the minimum requirements.

In the event an offeror’s quote is determined to be unacceptable in any of these factors, the entire quote will be considered unacceptable and the offeror will be ineligible for award.

**ALL factors must be rated ACCEPTABLE to be considered for award.

B. EVALUATION METHODOLOGY. The award decision will be based on the following:

1. Registered in www.sam.gov to receive Government contracts.

2. Verified in www.vip.vetbiz.gov as a Service Disabled Veteran Owned Small Business (SDVOSB)

3. Authorized Dealer/Distributor: Offeror must provide information to document their business is an authorized dealer/distributor of the items being quoted.

4. Price. All line items in the Price Schedule must include a price. The total evaluated price will consist of the offeror’s total proposed price.

5. Compatibility: Product is fully functionable/compatible with any existing equipment.

Each factor will be scored as Acceptable or Unacceptable as defined below.

“Lowest Price, Technically Acceptable” Evaluation Standards

Acceptable All of the minimum acceptable criteria are clearly met by the offer. The offer meets the minimum performance and technical capability requirements defined in the solicitation.

Unacceptable Not all of the minimum acceptable criteria were met by the offer. An unacceptable offer contains one or more deficiencies that does not meet the performance and technical capability requirements defined in the solicitation.

The following table will be used for each proposal received to score each LPTA factor as to whether it is Acceptable or Unacceptable.

1. REGISTERED IN SAM

2. VERIFIED IN VIP AS SDVOSB

3. APPROVED DEALER/DISTRIBUTOR

4. COMPATIBILITY/FULLY FUNCTIONAL (if applicable)

Attachment 3: Salient Characteristics

BRAND NAME OR EQUAL – IMAGING SYSTEM

Digital Non Mydriatic Retinal Camera 45º Field of Capture, Auto Focus, Auto Capture EZ Lite 2 Software Windows 7 Auto Mosaic Module CD/DVD Archiving Module Quick Draw Module Quick 2-Up Print Module Patient Consultation Module Stereo Analysis Software Module All -In-One PC Certified Internet Access Lead Tools Dicom Pacs Installation and On-Site Training Included Minimum Three-Year Warranty for Parts and Labor

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