36C25026Q0115 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)

12-02-2025

553-26-1-063-0016

36C250 Department of Veterans Affairs Ann Arbor Healthcare System Network Contracting Office 10 2215 Fuller Road Ann Arbor MI 48105

36C250 Department of Veterans Affairs Ann Arbor Healthcare System Network Contracting Office 10 2215 Fuller Road Ann Arbor MI 48105 To all Offerors/Bidders

36C25026Q0115

X

X X

** HOUR & DATE for Receipt of Offers is EXTENDED to: 12-03-2025 11:00 am EST See CONTINUATION Page

553-3660160-063-820100-3131 010044175 x

RFQ amendment for (1) Xprezzon Monitor System 91393 update part numbers for lines 23, 24, 39, and 40 extend rfq due date FROM 12/2/2025 11 AM est TO 12/3/2025 11 AM est

Send completed 52.225-1 and quote that includes:

UEI#; LEAD TIME ARO and in THE EXACT order from the Cost/Price Section

Kellie Konopinski Contracting Officer

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

XPRESSION MONITOR 91393

PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

LOCAL STOCK NUMBER: 91393

XPRESSON MONITOR BASE UNIT 91393-A

LOCAL STOCK NUMBER: 91393-A

LANGUAGE ENGLISH

LOCAL STOCK NUMBER: 91393-1

EIGHT WAVEFORMS

LOCAL STOCK NUMBER: 91393-08

OPTION REMOTE DISPLAY CONTRO

LOCAL STOCK NUMBER: 91393-C

OPTION PERIOPERATIVE

LOCAL STOCK NUMBER: 91393-D

OPTION, CALCS

LOCAL STOCK NUMBER: 91393-N

OPTION, DATA SHUTTLE

LOCAL STOCK NUMBER: 91393-Q

OPTION, FULL VIEW 12-LEAD

LOCAL STOCK NUMBER: 91393-V

UVSL COMMAND MODULE

LOCAL STOCK NUMBER: 91496

OPTION LANGUAGE ENGLISH

LOCAL STOCK NUMBER: 91496-1

OPTION,ECG,NIBP,SPO2,2T,4P,CO

LOCAL STOCK NUMBER: 91496-C

OPTION,ADV MULTIVIEW ARRHYTHMIA

LOCAL STOCK NUMBER: 91496-H

OPTION,NELLCOR OXIMAX SPO2

LOCAL STOCK NUMBER: 91496-N

OPTION, DIAGNOSTIC 12-LEAD+INTERP

LOCAL STOCK NUMBER: 91496-D

OPTION,RESPIRATION

LOCAL STOCK NUMBER: 91496-R

OPTION, ST SEGMENT ANALYSIS

LOCAL STOCK NUMBER: 91496-S

6" DISPLAY ALARM CABLE

LOCAL STOCK NUMBER: 012-0887-03

6" DVI CABLE 012-1054-00

LOCAL STOCK NUMBER: 012-0895-01

6" TOUCHSCREEN CABLE

LOCAL STOCK NUMBER: 012-0896-01

ECG COMBINER CABLE, 5-LEAD SOACELABS MONITOR,AAMI

LOCAL STOCK NUMBER: 700-0008-57

ECG COMBINER LEAD WIRE SET,5L,MULTI-PINCH,AAMI,74CM/29IN

LOCAL STOCK NUMBER: 700-0006-37

SENSOR,SPO2,ADLT,NELLCOR DS-100A,FNGR,OXIMAX,REUS

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

MANUFACTURER PART NUMBER (MPN): 690-0003-01

LOCAL STOCK NUMBER: 690-0003-01

TRULINK CARDIAC OUTPUT ADAPTER CABLE

LOCAL STOCK NUMBER: 015-0739-00.

NELLCOR OXIMAX SENSOR ADAPTER CABLE

LOCAL STOCK NUMBER: 700-0792-11

KIT,FEET

LOCAL STOCK NUMBER: 016-0897-00

MOUNT,DESK TOP,94266 & 94267,PROMATE 19"

LOCAL STOCK NUMBER: 010-1835-00

BP CUFF,TL NYLON,1T,INFANT,8-14CM,HP

LOCAL STOCK NUMBER: 715-1111-10

DEPOT SUPPORT PLAN UNIT IS PER YEAR MONITORING PRODUCTS ONLY

LOCAL STOCK NUMBER: 999-9999-42

DISPLAY,19",XPRESSON

LOCAL STOCK NUMBER: 94267-19

CABLE,IBP,DUAL,EDWARDS

LOCAL STOCK NUMBER: 015-0728-00

CARDIAC OUTPUT ADAPTER CABLE,OHMEDA,3.0M

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

MANUFACTURER PART NUMBER (MPN): 015-0738-00

LOCAL STOCK NUMBER: 015-0738-00

BP HOSE,SINGLE TUBE,ADULT,9FT,QUICK RELEASE

LOCAL STOCK NUMBER: 714-0018-02

DUAL TEMPERATURE ADAPTER CABLE,30CM/12IN

LOCAL STOCK NUMBER: 700-0031-00

UNIVERSAL TEMPERATURE PROBE EXTENSION CABLE, YSI 400 SERIES COMPATIBLE

LOCAL STOCK NUMBER: 700-4000-00

ENHANCED SOFTWARE SUPPORT PLAN (ICS/XPREZZNET/XHIBIT) UNIT PRICE IS PER YEAR 999-1898-11

LOCAL STOCK NUMBER: 999-1898-00

CLINICAL ACCESS SOFTWARE BED LICENSE

LOCAL STOCK NUMBER: 910-3999-01

INTERFACE SOFTWARE SOFTWARE BED LICENSE

LOCAL STOCK NUMBER: 910-3998-01

PATIENT MONITORING SERVICE MANUAL Now available On Line (was 085-4-0700-03)

LOCAL STOCK NUMBER: ON LINE

PATIENT MONITORING OPERATIONS MANUAL, Now available on line (was 084-1101-06)

MANUFACTURER PART NUMBER (MPN): ONLINE

PWR CORD,DOM,120V,10A,18 AWG,10",HOSP GRADE

LOCAL STOCK NUMBER: 161-0032-00

INSTALLATION

LOCAL STOCK NUMBER: 999-9999-97

MOUNT,DUAL,POWER SUPPLY

LOCAL STOCK NUMBER: WM-0024-05

KIT,DOWNPOST MOUNT

LOCAL STOCK NUMBER: 016-0898-00

ADAPTER PLATE

LOCAL STOCK NUMBER: 016-0766-00

A.2 DELIVERY SCHEDULE

Warehouse Dock 4646 John R. Street Detroit, MI 48201

USA

(313) 576-1000, ex. 61675 antonio.avant@va.gov & phillip.lim@va.gov & matoka.johnson@va.gov

(End of Provision) This is a solicitation for commercial products and commercial services prepared in accordance with the format in Federal Acquisition Regulation (FAR) 12.

The associated North American Industrial Classification System (NAICS) code for this procurement is 339113. The FSC/PSC is 6515.

The Department of Veterans Affairs, Network Contracting Office (NCO) 10, 24 Frank Lloyd Wright Dr., Suite M2200, Ann Arbor MI, 48105 in support of John D, Dingell VA Medical Center, 4646 John R. St, Detroit, MI 48201is seeking to purchase Xprezzon Monitor for anesthesia care station.

The award will be made to the response most advantageous to the Government using Lowest Price Technically Acceptable.