EAP SOW.pdf

Auditory Evoked Potential System for Audiology

Statement of Work (SOW)

1. Contract Title

Acquisition for one Auditory Evoked Potential System (ABR, OAE, ECochG, cVEMP, oVEMP, ML, LL, P300, and MNN with air and bone conduction. Type of contract is firm fixed price.

2. Scope

Acquisition of equipment requires shipment of the system by the manufacturer to the Atlanta VA Medical Center. The devices are standalone equipment and are not connected to the network. This is a module that will be added onto existing equipment

3. Background.

This is a replacement for an older device that has failed. The new purchase represents a significant improvement in the provision of services as well as an expansion of services. The Auditory Evoked Potential System can be used to assess the auditory system from the outer hair cells in the cochlea which is the beginning of hearing all the way through to the late auditory waves recorded from sites in the brain representing higher cognitive functions of information processing, working memory and stimulus categorization. Applications include hearing assessment, neuro diagnostic evaluation, auditory processing as well as assessment of vestibular function specifically otolith function and the inferior and superior branches of the VIII cranial nerve.

4. Task- Purchase and Delivery

This shall be as specified and meet the technical specifications listed below. All equipment shall be new.

The company shall deliver the equipment to the Atlanta VA Medical Center warehouse at 1670 Clairmont Road Decatur, GA 30033. The company shall provide all materials necessary for delivery. All parts shall be manufactured to meet state and local regulations.

5. Performance Monitoring

Receipt of device will be confirmed by reviewing the packing list that is enclosed with shipment.

Biomedical Engineering will inspect device upon arrival for electrical safety. Annual calibration of device function will be conducted by the trained biomedical engineering staff.

Item Description Qty Unit 1 Audio 1 2 RE-usable disc electrode cable 1 3 Installation Fee 1 4 Laptop Kit 1 5 OtoAccess Database 1 Total price

6. Security Requirements

The C&A requirements do not apply. A Security Accreditation Package is not required. The acquisition is a service that does not involve the storage, generating, transmitting, or exchanging of VA sensitive information. Patient information is never entered into the system and therefore is not retained.

8. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI).

No Government Furnished Equipment or Government Furnished Information will be provided.

9. Other Pertinent Information or Special Considerations.

a. Identification of Possible Follow-on Work Needed None. Upgrades to the system are not scheduled and will be on an available basis.

b. Identification of Non-Disclosure Requirements.

None. A Non-Disclosure Requirement is not indicated as there is no sensitive or proprietary information to which the contractor will have access.

c. Packaging, Packing and Shipping Instructions.

Device to be shipped to Atlanta VAHCS, Attn: Christi Wiltse, Audiology 126, 1670 Clairmont Rd, Decatur, GA 30033-4004.

d. Inspection and Acceptance Criteria.

Receipt of equipment will be confirmed, by Christi Wiltse, Audiology via packing list enclosed with shipment.

10. Risk Control

Patient interaction with the device is outside the scope of this contract; the contract only seeks to purchase replacement units and adequate training on the devices.

11. Place of Performance

The contractor is expected to deliver the goods, as specified in the contract, to the Atlanta VAHCS.

The device will be received by the warehouse at the Atlanta VA Health Care System and housed within the Audiology & Speech Pathology Clinic, Rm GA119. Hours of operation will be 7 a.m. to 5 p.m., Monday through Saturday. Contractor travel is covered by manufacturer representative.

12. Period of Performance

No additional services are to be expected from the contractor outside the delivery of the specified devices upon the execution of the contract, which is not expected to be longer than 45 days.

13. Delivery Schedule

The Auditory Evoked Potential System is expected to be delivered within 60 days of award.

14. Salient Characteristics

Auditory Evoked Potential System Integrate into existing visual eyes 525, additional computer or cart may be required.

• Tests:

o ECOG, ABR, MLR, LLR, MMN, P300, ASSR AC/BC;

cVEMP/oVEMP.

• Transducers:

o Insert phones, bone conduction oscillator.

• EP features:

o auto peak picking; Baysian weighting; objective waveform analysis (FMP, residual noise, waveform reproducibility); BB and NB CE Chirps.

• ASSR features:

o automatic waveform analysis; multi-freq binaural simultaneous testing; NB

CE Chirps; masking calculator.

• VEMP features:

o EMG VEMP monitoring; EMG scaling.

• Accessories:

o Starter supplies (electrodes; skin prep materials).