36C25226Q0218 0001.docx

VHAPG Part 813.106 Simplified Acquisition Procedures: Soliciting from a Single Source Attachment 1: Single Source Justification for SAP under the SAT

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) 02-03-2026 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 3001 Green Bay Road North Chicago

IL

60064 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 3001 Green Bay Road North Chicago

IL

60064 To all Offerors/Bidders

36C25226Q0218 01-21-2026

X X X x This Amendment is to change the solicitation from Brand Name or Equal to Brand Name Only.

Brand Name Only:

Stryker arthroscopic crossflow consoles

Response Due Date remains unchanged- See Solicitation

Mack Taylor Contract Officer

DEPARTMENT OF VETERANS AFFAIRS

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

Acquisition Plan Action ID: 36C252-26-AP-0791 / 578-26-1-969-0010

1. Contracting Activity: Department of Veterans Affairs, VISN 12, Hines VA Veterans Hospital (578) has submitted 578-26-1-969-0010 for Arthroscopic Crossflow Consoles to the Great Lakes Acquisition Center (NCO12).

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

This justification and approval is for Brand Name arthroscopic crossflow consoles (arthroscopy pump). Which will be awarded as a firm-fixed-priced purchase order. The arthroscopic crossflow consoles are intended for use in the facility to enhance efficient fluid control. It prevents excess fluid use and injury to the patient's joint.

This order is estimated at $36,967.83.

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used:

Hines VA Veterans Hospital (Clinical Support Services) is requesting the purchase of Brand Name arthroscopic crossflow consoles that will be used in the operating rooms. “Our operating rooms currently have Stryker equipment that is used with the Stryker Crossflow pump, for arthroscopic surgeries. Stryker Arthroscopy pumps only communicate with the Stryker Crossfire and the Stryker Core 2 equipment that we currently have and use for all arthroscopic procedures. Therefore, we cannot choose to purchase this equipment from another company due to it being incompatible with our current Stryker equipment. Stryker pumps are also compatible with the disposable items that we use for Sports Medicine cases to include shavers, burrs and coagulators.

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

SBA Small Business Search (SBA DSBS) database to identify certified capable SDVOSBs and VOSBs. SBA DSBS Search of NAICs code 339112 resulted in 988 SDVOSB / VOSB. SBA DSBS Search of NAICs code 339112 with Key Words: arthroscopy pump resulted in 0 SDVOSB / 0 VOSB. NAICS code 339112 in SBA DSBS resulted in 5,178 SDVOSB/VOSB or small business. A GSA search using key words arthroscopy pump resulted in 0 vendors.

The CO reached out to the OEM requesting a listing of SB vendors and the OEM Stryker Sales, LLC (large business) responded that they do have two SDVOSB authorized vendors Trillamed LLC and Beacon Point Associates LLC. The OEM STRYKER stated the equipment is not listed on GSA.

An internet search conducted on November 20, 2025, using keywords “arthroscopy pump”, resulted in over 10 pages of search results. The top search result was Stryker's Crossflow Integrated Arthroscopy pump. Other manufactures found in the search included Dual Wave, Invamed, Conmed and Richard Wolf.

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.

Title

Revision: 01 Effective Date: 11/15/2024 Page 3 of 3 Acquisition ID# 36C252-26-AP-0791