Sole Source Justification Rauland R5 KO signed - 506-20-103.pdf

ATTACHMENT 4

Justification for Single (Sole) Source Awards to Other Than SDVOSB or VOSB Concerns Over Micro-Purchase Threshold of $2,000 but Not Exceeding $250,000

Acquisition Plan No.: 36C250-23-AP-3265 2237 No.: 506-23-4-586-0040

1. Contracting Activity: Department of Veterans Affairs, VISN 10, VA Ann Arbor Medical Center

2. Brief Description of Supplies/ Services required and the intended use/Estimated Amount:

Scope of Work Statement: Provide, configure, and install Rauland R5 Nurse call System IGCE (For Official Use Only): $50,000

3. Identity of Single Source Company:

Company Name: Rauland-Borg/Ametek Address: 1802 West Central Avenue City: Mount Prospect State: IL Zip: 60056 Phone: 800-752-7725 Point of Contact:

DUNS:

Socio-economic Classification (Small Business, Woman Owned, 8a, HUBZone, Small Disadvantaged Business): NA

4. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used (justify why the project needs to be limited to the single source): Facility Standard for integrated facility wide Nurse call & Code Blue system

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

The entire facility is under one common and fully integrated Nurse call System. Maintaining a single facility wide system improves patient and staff safety with one uniform training system one set of protocols and one set of planned responses.

Allowing more than 1 nurse call system in the facility can create risk if and when clinical staff are assigned to a different unit or area of the hospital and not knowing how the nurse call system in that new unit or area functions.

6. Contracting Officer's Certification: Single source request is approved. I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Name Date Title