36C25619Q0133_0001.pdf

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)

1 11

0001 12-20-2018

564-19-1-150-0010

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

36C25619Q0133

12-20-2018

X

X X

See CONTINUATION Page

NOT APPLICABLE

X

THE PURPOSE OF THIS ADMENDMENT IS TO REPLACE THE "MRI PWS" WITH THE ATTACHED "MRI PWS (REVISED)". THE SOW IS REVISED TO

CORRECT THE PHYSICAL ADDRESS, CLARIFY THE TRAINING REQUIREMENT, INCLUDE AWNING COVER, ADRESS THE PREVENTATIVE

MAINTENANCE HOURS AND INCLUDE THE UTILITY INFRA-STRUCTURE REQUIREMENT. THE CHANGES ARE AS FOLLOW:

A. The MRI PWS is replaced with the attached "revised" MRI PWS.

B. All other terms and conditions remain unchanged.

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVIC

ES

QUANTIT

Y

UNI

T UNIT PRICE AMOUNT

0001 1.00 JB ________________

Contract to provide all equipment, tools, materials, labor, transportation, site construction to include utility hook-up (power, data, telephone, etc.), equipment training, on-site installation, and anything else necessary to provide for an equipment lease for a new fully functioning/fully operable 1.5 Tesla (T) Mobile Magnetic

Resonance Imaging (MRI) System trailer for the Gene Taylor

Community Based Outpatient Clinic, Springfield, MO.

0002 12.00 MO ________________

BASE PERIOD - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement

Contract Period: Base

POP Begin: 02-01-2019

POP End: 09-30-2019

0003 12.00 MO ________________

OPTION YEAR 1 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement

Contract Period: Option 1

POP Begin: 10-01-2019

POP End: 09-30-2020

0004 12.00 MO ________________

OPTION YEAR 2 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement

Contract Period: Option 2

POP Begin: 10-01-2020

POP End: 09-30-2021

0005 12.00 MO ________________

OPTION YEAR 3 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement

Contract Period: Option 3

POP Begin: 10-01-2021

POP End: 09-30-2022

0006 12.00 MO ________________

OPTION YEAR 4 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement

Contract Period: Option 4

POP Begin: 10-01-2022

POP End: 09-30-2023

0007 1.00 JB ________________

Contract to provide all equipment, tools, materials, labor, transportation, site construction to include disconnection of utility hook-up (power, data, telephone, etc.) on-site de-installation and anything else necessary to provide for the removal/deactivation of the

1.5 Tesla (T) Mobile Magnetic Resonance Imaging (MRI) System

trailer at the Gene Taylor Community Based Outpatient Clinic, Springfield, MO.

All work associated with removal/de-activation in accordance with the performance work statement.

GRAND TOTAL ________________

A.2 DELIVERY SCHEDULE

ITEM NUMBER QUANTITY

DELIVERY

DATE

0001 SHIP TO: VETERANS HEALTHCARE

SYSTEM OF THE OZARKS

GENE TAYLOR COMMUNITY

BASED OUTPATIENT CLINIC

1850 W Republic Street

Springfield, MO 65810

USA

1.00 1 February 2019

MARK

FOR:

Minh-Tri Dang, MD

573-239-8906

Minh-Tri.Dang@va.gov

0002 SHIP TO: VETERANS HEALTHCARE

SYSTEM OF THE OZARKS

GENE TAYLOR COMMUNITY

BASED OUTPATIENT CLINIC

1850 W Republic Street

12.00 1 Feb - 30 Sep

MARK

FOR:

Minh-Tri Dang, MD

0003 SHIP TO: VETERANS HEALTHCARE

GENE TAYLOR COMMUNITY

BASED OUTPATIENT CLINIC

1850 W Republic Street

12.00 1 Oct 2019 - 30

Sep 2020

MARK

FOR:

Minh-Tri Dang, MD

0004 SHIP TO: VETERANS HEALTHCARE

GENE TAYLOR COMMUNITY

BASED OUTPATIENT CLINIC

1850 W Republic Street

Springfield, MO 65810

12.00 1 OCT 2020 - 30

SEP 2021

FOR:

Minh-Tri Dang, MD

0005 SHIP TO: VETERANS HEALTHCARE

GENE TAYLOR COMMUNITY

BASED OUTPATIENT CLINIC

1850 W Republic Street

12.00 1 OCT 2021 - 30

SEP 2022

MARK

FOR:

Minh-Tri Dang, MD

0006 SHIP TO: VETERANS HEALTHCARE

GENE TAYLOR COMMUNITY

BASED OUTPATIENT CLINIC

1850 W Republic Street

12.00 1 OCT 2022 - 30

SEP 2023

MARK

FOR:

Minh-Tri Dang, MD

0007 SHIP TO: VETERANS HEALTHCARE

GENE TAYLOR COMMUNITY

BASED OUTPATIENT CLINIC

1850 W Republic Street

1.00 30 SEP 2023

FOR:

Minh-Tri Dang, MD

(REVISED)

Performance Work Statement

Gene Taylor CBOC Mobile MRI

Lease

Veterans Health Care System of the Ozarks

Springfield, MO

04/24/2018

1. PURPOSE

1.1 The overall purpose is to provide and install a Mobile MRI Trailer and Equipment at Veterans

Health Care System of the Ozarks (VHSO), Gene Taylor Community Based Outpatient Clinic, 1850 W. Republic St, Springfield, MO 65807.

2. SCOPE

2.1 The contractor to provide all equipment, tools, materials, labor, transportation, site construction (to include utility hook-ups (power, data, telephone), equipment training, on- site installation, and anything else necessary to provide for an equipment lease for fully functioning/fully operable 1.5 Tesla (T) Mobile Magnetic Resonance Imaging

(MRI) System trailer for the Gene Taylor Community Based Outpatient Clinic (VA) at

1850 W. Republic St, Springfield, MO 65807.

2.2 The mobile MR unit shall include awning cover long enough to cover all entries

2.3 The Vendor is responsible for transporting the unit to and from the location

2.4 The contractor shall be TJC (The Joint Commission) Accredited and/or shall follow established TJC guidelines, as they pertain to the Mobile MRI

Operations.

2.5 The Period of Performance will be for 8-Month Base Period and four (4) 12-Month Option

Periods.

2.6 The contractor must have the capability of providing a mobile MRI unit to be onsite 7 days per week for at least the Base Year with Four Option Years of service.

2.7 System/equipment shall be fully capable and able to transfer image and data to multiple modalities including VA PACS, VISTA Imaging, printers, and Hospital RIS System (full

DICOM Communication). Each location shall have different IP addresses, subnet masks, and VPNs. Communication between MRI and Radiology Services PACS: The Contractor shall ensure that a convenient and robust means of DICOM transfer of MRI studies to the

VA Radiology Service PACS is operational. The Contractor shall obtain and provide to the

VA any technology necessary to ensure that MRI studies can be conveniently read on the existing VA PACS display technology. Any peripherals that the VA does not have but that is needed to ensure convenient and timely display of MRI studies in the VA Radiology

Service shall be obtained by the Contractor, be installed, and be retained by the VA so that at future dates the archived studies can be reviewed. Each MRI study will be transferred to the VA PACS immediately following the acquisition of the study so that it can, if necessary, be reviewed before the patient leaves the MRI Trailer.

2.8 The Contractor shall have the MRI Trailer and Equipment in-place and fully operational no later than February 1, 2019.

2.9 The Mobile MRI Equipment shall be equal to or better than the description of a 1.5T

GE SIGNA Voyager Wide Bore MRI System.

2.10 The Vendor is responsible for the maintenance of the unit, including all Preventative

Maintenance, and all Parts and Labor. All Preventative Maintenance to be performed after normal duty hours. NOTE: The VAMC will consider Preventative Maintenance during normal duty hours with prior approval at least 7 working days prior to scheduled maintenance.

2.11 Vendor agrees to cooperate with VA for quality control purposes

2.12 Meeting all safety requirements such as posting MRI Hazardous ZONE Signs around the Mobile MRI Trailer

2.5 SALIENT CHARACTERISTICS

2.5.1 Minimum requirements for this system are a state of the art 1.5T magnet:

2.5.2 Must have 2D FSE-base magnetic resonance image compilation imaging.

2.5.3 The MRI must have a wide bore for patients that are claustrophobic and/or obese.

2.5.4 Gradient noise level of 99 db or below without reducing performance.

2.5.5 Magnetic Resonance Image Compilation (generate multiple image contrasts in a single MRI scan)

2.5.6 The MRI must have Total Digital Imaging (TDI). TDI helps deliver consistently sharper images than conventional MR systems with higher SNR, superior homogeneity and uniformity.

2.5.7 Equipment will be capable of sending images to a minimum of 3 destinations (printer, PAC’s, Hospital RIS System, etc)

2.5.8 Dedicated application packages:

2.5.8.1 MRI system will include these application packages as a minimum

• Synthetic MRI Capabilities

• Fat Suppression Technology

• MAGIC Suite

• 3d ASL, HEART, and Promo

• RF Coil Suite

• Silent Suite

• Silent Suite

• Neuro Suite

• Angio Suite

• Cardiac Suite

• Body Suite

• Breast Suite

• Viso Works

• Brease

• Ortho Suite

• Pediatric

• SPACE

• TWIST

• BLADE

• Diffusion

• SWI

• Argus Flow Quantification

2.5.8.2 These Coils must be included as a minimum:

• Head Coil

• Neck Coil

• Body Coil

• Spine Coil

• Angio Coil

• 4 channel shoulder array, small and large coils

• Large and Small CP Flex coils

• TMJ Coil

• 8 channel foot/ankle/knee coil

• 8 channel wrist coil

Additional MRI Trailer and System requirements

CD Burner

Full compatibility with hospital PACS system DICOM 3.0

Patient intercom system

Safety and Warning Systems Visual and Audible

Alarms Smoke Detectors, Fire Extinguishers

Emergency Lighting Battery

Phone and data ports

480v 50’ power cable

Hydraulic patient lift, Stairs and railings

HVAC system to maintain trailer environmental systems Operators and Technical support Manuals

Full System Service (Monday – Friday after normal duty hours local time excluding Federal Holidays)

Regular scheduled maintenance to be performed after hours. NOTE: Maintenance will be considered during normal duty hours with advance prior approval by the VA.

24 Hour telephone technical support toll free line, response within 1 hour. 550 LBS maximum patient table weight

2.6 DELIVERY AND INSTALLATION

2.6.1 DELIVERY

2.6.1.1 Contractor shall deliver all equipment to the Veterans Health Care System of the Ozarks (VHSO), Gene Taylor Community Based Outpatient Clinic, 1850

W. Republic St, Springfield, MO 65807 no later than February 1, 2019. The

Vendor is responsible for transporting the unit to and from the location.

2.6.2 INSTALLATION

2.6.2.1 Install all equipment to manufacturer’s specifications maintaining Federal, and

Local safety standards

2.6.2.2 Installation must be completed by February 1, 2019. All work shall be completed between 8:00 a.m. and 4:30 p.m. Monday – Friday. All federal holidays, excluded.

2.6.2.4 If there is an operational conflict with installation, night or weekend installation may be required. Government will provide a 72 hours' notice of change of installation hours.

2.6.2.5 The Contractor shall remove all related shipping debris and cleanup any construction associated with delivery and installation of the specified items.

Contractor shall remove all packaging from the SLVHCS premises. The

Contractor shall be responsible for any damage to the building that occurs due to Contractor error or neglect.

2.7 SITE CONDITIONS

2.7.1--- There shall be no smoking, eating, or drinking inside the hospital at any time.

3. INSPECTION AND ACCEPTANCE:

3.1 Contractor shall provide dates of completion of punch list items and replacement parts and/or short ship items from the manufacturer(s). (IF APPLICABLE)

3.2 The COR shall ensure all work is completed satisfactorily prior to acceptance. Disputes shall be resolved by the Contracting Officer.

4. DELIVERY/STORAGE REQUIREMENTS

4.1 Delivery and Installation will be coordinated through the COR.

5. DELIVERABLES

5.1 Operation and Maintenance Manuals

5.1.1 Binders - Quantity (2) each

5.1.2 Digital Copies- Quantity (1) each

5.2 Deliver compilation of all manufacturer recommended maintenance schedule and operation materials packaged in binder(s) to COR upon completion of installation.

6. OPERATOR TRAINING:

6.1 Contractor shall provide On-site training of the equipment to the three (3) Government personnel users. Training shall be conducted one week onsite, one week offsite and as needed.

Scheduling of operator training shall be coordinated with the COR after installation is complete.

7. PROTECTION OF PROPERTY

7.1 Contractor shall protect all items from damage. The Contractor shall take precaution against damage to the building(s), grounds and furnishings. The Contractor shall repair or replace any items related to building(s) or grounds damaged accidentally or on purpose due to actions by the Contractor.

7.2 The Contractor shall perform an inspection of the building(s) and grounds with the COR prior to commencing work. To insure that the Contractor shall be able to repair or replace any items, components, building(s) or grounds damaged due to negligence and/or actions taken by the

Contractor. The source of all repairs beyond simple surface cleaning is the facility construction contractor (or appropriate subcontractor), so that building warranty is maintained. Concurrence from the VA Facilities Management POC and COR is required before the Contractor may perform any significant repair work. In all cases, repairs shall utilize materials of the same quality, size, texture, grade, and color to match adjacent existing work.

7.3 The Contractor shall be responsible for security of the areas in which the work is being performed prior to completion.

7.4 Contractor shall provide floor protection while working in all VA facilities. All material handling equipment shall have rubber wheels.

8. SECURITY REQUIREMENTS

8.1 The C&A requirements do not apply and a Security Accreditation Package is not required.

9. WARRANTY

9.1 The contractor shall provide a one year manufacturer’s warranty on all parts and labor.

9.2 The warranty shall include all travel and shipping costs associated with any warranty repair.

10. UTILITY INFRA-STRUCTRE

10.1 Power: 480V, 3-phase, 150 amp circuit in weather proof box

10.2 Water: Cold water supply, 3/4" female connector

10.3 Waste: 1 ½” female threaded connector for 1 1/2” male threaded hose connection.