36C25719Q1137-005.docx

Request for Ophthalmic Equipment

1. Contracting Officer’s Representative (COR).

Fax Number:

2. Contract Title Request for Ophthalmic Equipment

3. Background The eye Specialty Clinic under Surgical Service is in need of new ophthalmic equipment to perform ocular examinations for new and established patients.

4. Period of Performance – One Time

5. Place(s) of Delivery – Audie L. Murphy VA Medical Center/Warehouse

6. Scope Vendor will delivery the following ophthalmic equipment:

CS0RLFX920U. Includes Cushion Set #206 Charcoal (CS0RLFX920UCH)

CS0RL7900ICW220FG

Reliance 7900-IC Floor Unit with Wheelchair Modification, #20 Pearl

7. Security Requirements

Information System Officer, Information Protection: The contractor will not have access to VA Desktop computers they will not have access to online resources belonging to the government.

Privacy Officer: The Contractor will not have access to protected Patient Health Information (PHI)

Records Manager:

i. Citations to pertinent laws, codes and regulations such as 44 U.S.C chapters 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.

ii. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

iii. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government IT equipment and/or Government records.

iv. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

v. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract.

vi. The Government Agency owns the rights to all data/records produced as part of this contract.

vii. The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data.

viii. Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

ix. No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

x. Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information.

8. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI).

a. None provided or required.