36C25618Q0731-00001000.docx

REVISED

SOW-Statement of Work Wednesday, May 30, 2018

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

BY

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) 00001 05-30-2018 520-18-3-134-0023 None 00502

ALEXANDRIA VA HEALTH CARE SYSTEM

NETWORK CONTRACTING OFFICE 16

ALEXANDRIA VA HEALTH CARE SYSTEM

PO BOX 69004

ALEXANDRIA

LA

71306-9004 00502

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 16

ALEXANDRIA VA HEALTH CARE SYSTEM

2495 SHREVEPORT HIGHWAY

PINEVILLE

LA

71360-4004 To all Offerors/Bidders

36C25618Q0731 05-30-2018

X See CONTINUATION Page Not Applicable THE PURPOSE OF THIS AMENDMENT IS TO INCLUDE THE REQUIREMENT FOR DELIVERY, INSTALLATION, TRAINING, WARRANTY AND MANUALS.

ATTACHED IS THE REVISED STATEMENT OF WORK (S0W) WHICH REPLACES THE CURRENT SOW.

1. The attached revised statement of work includes the requirement for delivery, installation, training and manuals.

B. All other terms and conditions remain unchanged.

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

LOCAL STOCK NUMBER: 266002-1161-980-PRO

A.2 DELIVERY SCHEDULE

VA Gulf Coast Health Care System 400 Veterans Ave.

Biloxi, MS 39531

USA

Marqueshia.Lewis@va.gov

CONTINUATION PAGE

2. Contract Title: Cirrus 5000HD Optical coherence tomography (OCT) (X3)

3. Background: Cirrus 5000HD Optical coherence tomography (OCT) to replace old outdated Optical coherence tomography (OCT) machines. 2 machines in Biloxi and 1 machine at the JACC will be replaced.

4. Scope. Needing the purchase of 3 Cirrus 5000HD Optical coherence tomography (OCT) machine to include manufacturer warranty, delivery, installation, training, operators manual and service manuals.

5. Specifications/Characteristics:

Minimum technical specs must be provided

b. a. Brand Name or Equal – Zeiss Cirrus 5000HD OCT

OCT Imaging

Fundus Imaging

Iris Imaging

Electrical and Physical

Internal Computer

**TECHNICAL SPECIFICATIONS**

1. Has the capability to capture and provide OCT Angiography: This capability for OCT Angiography is provided by a 1 single OCT scan that allows for visualization of both micro vascular and structural information in a noninvasive dye free scan by the OCT.

2. Has the ability to import and integrate the Cirrus Model HD OCT 4000 raw data. The raw data must be interchangeable between the Cirrus 4000 and Cirrus 5000 unit (or new unit being procured).

3. The unit must have exact Macular Scan Pattern of 512x128 for retina scan with exact scanning speed at 27,000 A-scans a second within a 6mmx6mm.

4. Must be able to provide on Company Literature

5. The unit must have exact scan pattern of 200x200 in a 6mmx6mm cube for Glaucoma Scan with exact scanning speed at 27,000 A-scans a second.

6. The scan pattern must be able to capture and provide RNFL, ONH, Neuro Retinal Rim Tissue, and 3-D Cube capabilities all in one scan

7. Scanning speeds: Scan at exactly 27,000 A-scans/sec, as well as the ability to scan at 68,000 A-scans/sec

8. Unit must be able to provide a report for Ganglion Cell Analysis that is derived from a scan must be comprised of 6mmx6mm cube scan with a minimum by 200x200 line scan pattern with no more than 30 microns between each slice.

9. Minimum Pupil Requirements must be 2.0mm or less.

10. Unit must utilize an LSO Fundus Camera (Line Scanning Laser Ophthalmoscope).

11. The unit must Automatically Track to Prior Scan: The unit must be able to do this without technician needing to align to prior scan:

a. ACTIVITY QTY RATE AMOUNT

1. Anterior Segment scan that is at minimal 15.5 mm in length x 5.8 mm in depth. which is the full view of the Anterior Chamber. Must be able to provide on Company Literature.

2. Global Pachymetry report that is comprised of minimum of 24 radial scans and must be at a minimum 9mm in length.

3. The unit must be a 90 degree configuration, so that the tech (operator) must sit to the side (90 degrees) of the patient

6. Delivery.

Gulf Coast Veterans Health Care System Warehouse BLDG 26 400 Veterans Ave Biloxi MS 39531

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