36C25921Q0434 Statement of Work.pdf

STATEMENT OF WORK

FOUR (4) FULLY EQUIPPED SOUTH CBOC EYE LANE

VETERANS AFFAIRS HEALTH CARE SYSTEM OKLAHOMA CITY, OKLAHOMA

1. General: Currently, the Oklahoma City Veterans Affairs Health Care System

(herein after referred to as OKC VAHCS) is adding Ophthalmology services at the South OKC CBOC. The new area requires four (4) fully equipped eye lane to perform comprehensive eye examinations and care for patients.

2. Delivery Location: 7919 Mid-America Boulevard, Third Floor, Oklahoma City, OK

73135-6610.

3. Delivery Times: Delivery times shall be Monday through Friday from 08:00 to

16:00 (8:00AM to 4:00PM). Delivery must be coordinated with the facility to ensure the space and building is ready for equipment delivery and installation. Delivery truck must be equipped with a lift gate.

4. Definitions/Acronyms

4.1. CBOC: Community Based Outpatient Clinic

4.2. OKC VAHCS: Oklahoma City Veterans Affairs Health Care System

5. Scope: The Contractor will provide the necessary equipment and accompanying software to the OKC VAHCS for the addition of four (4) new fully equipped eye lane at the South OKC CBOC. Brand name or equal is required for all equipment. The list of equipment salient characteristics is listed under section 7 entitled Specifications. The requirement is for a comprehensive and whole solution to the requirement. The Contractor is required to be an expert in the field of Ophthalmology equipment and requirements and as such the Contractor is required to include any items not specifically listed in section 7 but is necessary to enable the equipment or accompanying software to function. Examples include installation expenses, VA staff training, equipment mounts, display charts, and special equipment wiring requirements.

6. Training for VA Employees: Comprehensive training for VA staff is required.

Examples include; eye technicians, optometrists, ophthalmologist, and biomedical engineers.

7. Specifications

7.1. Below are the salient characteristics for the Brand Name or Equal requirement:

• NOTE: ALL ITEMS ARE QUANTITY OF FOUR (4) UNLESS OTHERWISE

SPECIFIED

o South Clinic Eye Lanes

- Right-Handed Refraction Desk with console (Lombart

RF0LO200SRFG) OR EQUAL

• Trial lens cabinet o Dimensions

▪ 49 inches high

▪ 19 ½ inches deep

▪ 27 ½ inches door opening

▪ 24 inches wide

• Hand instrument console o Three rechargeable Wells o Main switch o Rheostat o Auxiliary instrument switches

• Optional indirect hangar control which controls room lighting

• Optional slit lamps that powers the slit lamp

- Full Power Tilt Examination Chair (Reliance FX-920-L Chair #20 Pearl) OR EQUAL:

• Dual controls for base and top tilt

• Single lock adjustable concave headrest

• Auto return button to return chair to upright starting position

• Hydraulic base

• 600 pound capacity

• Safety switch to disable controls and footswitches

• Armrests that lock in place and allow the patient to sit or leave from either side of the chair

• Electrical - 110 Volt , 60 Hz, 8.0 amperes

• CSA, C/US Certificate of Compliance

- Instrument Stand (Reliance 7900-IC Floor Unit #20 Pearl) OR

EQUAL:

• 3 Rechargeable wells for handheld instruments

• Wheelchair option to bring refractor and slit lamp arms to patients in any model wheelchair

• Overhead lamp with arm that adjusts without use of tools

• Switches to control a chart projector and control the intensity of the overhead lamp

• Adjustable slit lamp arm with use of a single hand and a 12” range of travel

• Upper Refractor Arm with 50 lb. capacity

- Pneumatic Examination Stool (Reliance 5346 Pneumatic Stool, 301

Black) OR EQUAL:

• Adjustable and tilted backrest

• Height adjustment from 19.5” to 25 “

- Chair Mover:

• Low profile

• Unlock and roll mechanism

• Fits rectangular base up to 22.5” wide

- Applanation Tonometer (Tono-Pen XL Tonometer) OR EQUAL:

Qty of 8

• Weight: 2.1 oz (59.4 g)

• Length: 7.25 in. (18.4 cm)

• Width: 1 in. (2.5 cm)

• Thickness: 0.875 in. (2.2 cm)

• Transducer: Micro Strain Gauge

• Measurement Range: 5 - 80 mmHg

• Power Source: 2 Ocu-Cel XL batteries

- Phoroptor (Reichert 11635B Plus Cylinder Ultramatic RxMaster Phoroptor, Black) OR EQUAL:

• ± 0.25 Flip Cross Cylinder

• +1.50 Retinoscopic lenses

• Accessory Case

• Nylon Face Shields

• Rotochart

• Reading Rod with Card Holder

• Sphere: -19.00D to +16.75D with 0.25D steps

• Cylinder Power: 0.00D to 6.00D with 0.25D steps

• Cylinder Axis: 360 degrees with 5 degree graduations

• Cross Cylinder: ± 0.25

• Prism: 0 to 20 diopters with 1 prism diopter graduations

• P.D.: 48 to 75 mm with 1 mm graduations

• Vertex Distance: 13.75 mm, graduations extend range by 6 mm

• Reading Distance: 5 to 28 inches

• Auxiliary Dial: 10 lenses plus 2 open apertures

- Lensmeter (Topcon LM-8E)

• Target: American-Style Crosshair

• Scale Reading: External

• Vertex Power Scale: 0 to ± 25 diopters

• Vertex Power Scale Graduation: 0.125D up to ± 5 D / 0.25D above ± 5D

• Prism Diopter scale: 0 to 6 prism diopters 1 ∆ graduations

• Eyepiece Adjustment: +3 to –5 diopters

• Lens Diameter: 24mm to 90mm in diameter

• Tilt angle: 0 to 90 degree, freely adjustable

• Light source: LED 570 nm

• Dimensions: 160 (W) x 420 (D) x 310 (H)mm

• Weight: Approx. 4.0kg

• Power Source: Battery operated (1.5V x 2) Auto shut off 5 min.

• Built-in Prism Compensator

• AC adapter

- Slit Lamp (Haag-Streit 900 BQ) OR EQUAL:

• Freeze technology to capture the moment you press the trigger

• History trigger to rewind and freeze the last few seconds

• Depth of field control to facilitate complete control of the depth of field

• Magnification with standard eyepieces: 6.3x, 10x, 16x, 25x, 40x

• Tungsten illumination

• Maximum intensity of 600,000

• Slit Width/Length: 0-8mm / 1-8mm

- Tonometer (Haag-Streit BP/BQ/BX Applanation Tonometer) OR

• Two resting positions

• Swing in front of the microscope to examine both left and right eye

- Wireless Digital Binocular (Keeler Vantage Plus LED Wireless

Indirect with slimline charging system) OR EQUAL:

• Software that allows use of any usb interface

• Provide still and dynamic images

• Wall mount that stores an extra lithium battery for back up

• Optics and mirrors automatically adjust when aperture changes

• 3 dimensional stereoscopic views of the retina through all pupil sizes

- 90D Aspheric Lens (Volk) OR EQUAL:

• Field of View: 74/89 degrees

• Image Mag: 0.76x

• Laser Spot: 1.32x

• Working Distance: 7mm

- 20D Aspheric Lens (Volk) OR EQUAL:

• Field of View: 46/60 degrees

• Image Mag: 3.13x

• Laser Spot: 0.32x

• Working Distance: 50mm

- Auto Projector and wall mount (Marco CP-770) OR EQUAL:

• LED illumination system

• Programmable up to 33 charts in any order

• Conduct exam by pressing one button on the remote control to advance to next chart

• Option to randomly select any chart

• Option to isolate and maneuver individual horizontal or vertical lines

• Brightness control to adjust brightness intensity of projected image

• Automatically compensate for any fluctuation in supply voltage or change in refraction distance

- Retinoscope (Welch Allyn 18245 Elite Streak) OR EQUAL:

• Dust-Free Sealed Optics

• Cross Linear Polarization Filter Switch

• Continuous Rotation External Focusing Sleeve

• Halogen lamp

• Detect corneal abrasions with cobalt blue filter

• Red-Free filter used with any aperture

• 28 focusing lenses with range of -25D to +40D

• Must be compatible 3.5v NiCad Well Handle (Welch Allyn 71670)

- 3.5v Halogen Coaxial Ophthalmoscope (Welch Allyn 11720) OR

• Coaxial optics to produce a shadow-free spot, easier entry into un-dilated pupils, and a larger field of view

• Detect corneal abrasions with cobalt blue filter

• Polarizing filter virtually eliminates corneal reflection

• Sealed optics keep out dust and dirt

• 18 unique aperture/filter combinations for greater versatility

• Red-free aperture may be used with any aperture

• 28 focusing lenses with a range of -25 to +40 diopters

• Must be compatible 3.5v NiCad Well Handle (Welch Allyn

71670)

- 3.5v NiCad Well Handle (Welch Allyn 71670) (Qty. of 12) OR

EQUAL

• Must be compatible with Welch Allyn products 11720, 41100, and 18245

• Must be compatible with the Refraction Desk (Lombart) and the

Instrument Stand (Reliance 7900-IC Floor Unit #20 Pearl):

- 3.5v Halogen Finnoff Transilluminator (Welch Allyn 41100) OR

EQUAL

• Must be compatible with 3.5v NiCad Well Handle (Welch Allyn 71670)

- Prism Set (S-22 Gulden Set) OR EQUAL

• Acrylic

• Soap and water cleanable

• Almost no clinical birefringent effects

• Sizes: ½, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 16, 18, 20, 25, 30, 35, 40, 45, 50, and a red lens.

- Horizontal and Vertical Prism Bar Set (Gulden Set) OR EQUAL

• Acrylic

• Soap and water cleanable

• Horizontal sizes: 1, 2,4, 6, 8, 10, 12, 14, 16, 18, 20, 25, 30, 35, 40, and 45 Diopters

• Vertical sizes: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, 18, 30, 25, and

• Almost no clinical birefringent effects

- Ishihara’s Tests for Color Deficiency Concise Edition 2018 OR

EQUAL

• 14 plate book test chart

- Stereo Fly Test OR EQUAL

• 1 pair of standard 3-D viewers

- Lombart metal trial frame OR EQUAL

- Lombart Full Diameter Trial Lens Set with Plus Cylinders in Case

OR EQUAL

- Pinhole Occluders (Lorgnette) OR EQUAL: Qty of 8

• Pinhole drop-in providing 17 pinholes

• Capable of testing visual acuity in mydriatic patients

• ABS plastic construction

- Snellen Reading Card OR EQUAL: Qty of 8

- Pachymeter (Packmate 2 Handheld) OR EQUAL:

• Measurement Range: Standard 200 microns to 1100 microns

• Accuracy: ± 5 microns

• Resolution: 1 micron

• Internal Clock Accuracy: ± 0.002%

• Dimensions: 7.1" (181 mm) L x 1.6" (41 mm) W x 0.9" (23 mm) D

• Weight: 3.6 oz (112 grams)

• Power Requirement: Two AAA batteries

8. Security Requirements: The contractor will have no access to patient records or areas of the hospital. The A&A requirements do not apply, and a Security

Accreditation Package is not required.