36C25819Q0096-009.doc

Attachment A

Southern Arizona VA Health Care System (SAVAHCS) Statement of Compliance from Vendor Representatives on SAVAHCS Property It is the SAVAHCS policy to afford vendor representatives the opportunity to furnish interested SAVAHCS staff with information regarding products and services, as long as it does not interfere with patient care, or the mission of the SAVAHCS, and appointments are made in advance of the business meeting.

Vendor representatives will report to the Vendor Liaison on the day of the visit, for the purpose of signing the "Visitor" registration log and obtaining a vendor ID badge. Vendor representatives, who visit without an appointment will be informed of the SAVAHCS policy and will be required to make an appointment in advance. Noncompliance may result in being escorted off the medical center grounds by the VA Police.

I understand that the vendor representatives are prohibited from offering or providing gifts, gratuities or food to any employee(s) of the SAVAHCS.

I understand that product samples for medical supplies must be submitted to the Logistics Officer, Resources Management Service Line, or Clinical Products Review Committee I understand that product samples for subsistence items must be submitted to the Chief, Nutrition and Food Service.

I understand that product samples for pharmaceutical items are prohibited I understand that VA employees (except authorized purchase card cardholders and Contracting Officers) are prohibited from agreeing to purchase, negotiate prices, barter, or divulge the intent of the VA in a procurement situation. Only authorized purchase card cardholders and contracting officers may obligate or financially commit the Government.

I have received a copy and consent to the policies and procedures of this SAVAHCS Policy and agree that failure to adhere to this policy may result in the forfeiture of my SAVAHCS meeting privileges.

Signature Date

Vendor/Sales Representative Name (printed) Company name, address, and telephone number