36C26119Q0793-002.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 7

612-19-3-146-0135

36C26119Q0793 7/1/2019

Shannon Archer 702-791-9000 x18932 07-9-2019

00261

Department of Veterans Affairs

Network Contracting Office 21

VA Southern Nevada Healthcare System

6900 N. Pecos Road, Building 6

North Las Vegas NV 89086

X 100

X

Y

339112

1000 Employees

Net 30 Days

N/A

X

See Delivery Schedule

00261

Department of Veterans Affairs

Network Contracting Office 21

Southern Nevada Healthcare System

6900 N. Pecos Road, Building 6

North Las Vegas NV 89086

Department of Veterans Affairs

Financial Services Center

See VAAR 852.232-72 Payment Instructions

1-877-489-6135

See CONTINUATION Page

SEE SCHEDULE CONTINUATION SHEET FOR DETAILS.

ALL INVOICES MUST REFERENCE OBLIGATION NUMBER TBD ,

PURCHASE ORDER NUMBER, AND BE SUBMITTED

THROUGH HTTP://WWW.TUNGSTEN-NETWORK.COM/US/EN.

See CONTINUATION Page x X

36C26119Q0793

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 PRICE/COST SCHEDULE

ITEM INFORMATION

B.2 DELIVERY SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1.00 EA __________________ __________________

OPTOS \F\ 200DTx California rg/af/fa/icg (Part No.\F\ A10650):

California has been specifically designed for general ophthalmologists and vitreo-retinal specialists with a need for multiple imaging modalities capturing 200? or 82% of the retina. California provides comprehensive visualization of the retina and choroid for enhanced detection, diagnosis and management of disease. California is available in three (3) models with varying imaging modalities. California rg/af/fa/icg- UWF image capture available with optomap, optomap af, optomap fa and optomap icg imaging modalities. Includes interweaved angiography enables parallel capture of fa and icg image. All California models provide non-mydriatic, high- resolution imaging, comprehensive retinal analysis through multiple wavelengths and image modalities, accurate geometrical presentation of the retina, adjustable chinrest to accommodate various facial geometries, and guided eye steering to extend image capture beyond 200?. Includes a

2-year warranty.

LOCAL STOCK NUMBER: A10650

OPTOS \F\ DICOM MODALITY WORKLIST AND LIVE\F\ STORE

TO THIRD PARTY PACS; ENABLES CAPTURE STATION TO

QUERY FOR AND RECEIVE MODALITY WORKLIST (MWL)

DATA FROM SUITABLE MWL SERVER. DICOM C-STORE IS

INCLUDED. THIS CAPABILITY DOES NOT INCLUDE THE

MODALITY WORKLIST AS A 'SERVICE CONTENT PROVIDER'

(SCP) BUT WHERE THE SCANHEADS ARE 'USERS OF THE

WORKLIST.' (SERVICE CONTENT USER)

LOCAL STOCK NUMBER: DICOM-OP

OPTOS \F\ INSTALLATION/TRAINING\F\

LOCAL STOCK NUMBER: INSTALL/TRAIN

GRAND TOTAL __________________

B.2 DELIVERY SCHEDULE

ITEM NUMBER QUANTITY

DELIVERY

DATE

PRODUCT/INSTALLATION ALL 9/30/2019

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/

(End of Clause)

FAR

Number Title Date

52.204-18

COMMERCIAL AND GOVERNMENT ENTITY CODE

MAINTENANCE

JUL 2016

52.212-4

CONTRACT TERMS AND CONDITIONS—COMMERCIAL

ITEMS

OCT 2018

52.212-5

CONTRACT TERMS AND CONDITIONS REQUIRED TO

IMPLEMENT STATUTES OR EXECUTIVE ORDERS—

COMMERCIAL ITEMS

(Insertion: 4, 8, 22, 25, 26, 27, 28, 30, 42, 46, 55, 59)

JAN 2019

52.228-5

INSURANCE—WORK ON A GOVERNMENT

INSTALLATION

JAN 1997

52.232-40

PROVIDING ACCELERATED PAYMENTS TO SMALL

BUSINESS SUBCONTRACTORS

DEC 2013

52.237-2

PROTECTION OF GOVERNMENT BUILDINGS,

EQUIPMENT, AND VEGETATION

APR 1984

852.203-70 COMMERCIAL ADVERTISING MAY 2018

852.219-10

VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS SET-ASIDE

JUL 2016

852.219-74

LIMITATIONS ON SUBCONTRACTING—MONITORING

AND COMPLIANCE

JUL 2018

852.228-71 INDEMNIFICATION AND INSURANCE MAR 2018

852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS NOV 2018

852.247-73 PACKING FOR DOMESTIC SHIPMENT OCT 2018

852.246-71 REJECTED GOODS OCT 2018

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR

ATTACHMENTS

STATEMENT OF WORK & SALIENT CHARACTERISTICS ARE ATTACHED

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers: Technical Merit and Price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the

Government to exercise the option(s).

(c) Fair & Reasonableness. Prior to award, the CO will determine if the successful vendor’s final price is more than five percent (5%) higher than known market-based prices. If the final price is more than 5%, prior to award, this action will be reviewed and approved at a level above the contracting officer, unless utilizing tiered evaluations. If the price is not 5% higher than known market-based prices, the award will be made if all other qualifications are met. Known market-based prices include but aren’t limited to:

prices of manufacturers, other distributors, large businesses, other small businesses and internet pricing.

(d) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of Provision)

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE (FEB 1998)

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/

(End of Provision)

FAR

Number Title Date

52.204-16

COMMERCIAL AND GOVERNMENT ENTITY CODE

REPORTING

JUL 2016

52.204-7 SYSTEM FOR AWARD MANAGEMENT OCT 2018

52.211-6 BRAND NAME OR EQUAL AUG 1999

52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS OCT 2018

52.212-3

OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS

OCT 2018