36C26123Q1120 Amendment 0001.docx

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)

612-23-3-6214-0264

VA-23-00083579

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

00261 Department of Veterans Affairs Network Contracting Office 21 Southern Nevada Healthcare System 6900 N. Pecos Road, Building 6 North Las Vegas NV 89086 To all Offerors/Bidders

36C26123Q1120 08-18-2023

X

X

X

See CONTINUATION Page

A. The purpose of this Amendment is to correct the following items from the initial solicitation RFQ 36C26123Q1120:

1. Add delivery address and POC to DELIVERY section.

2. Add Attachments mentioned in Salient Characteristic documents.

3. Revise Attachment names on the Salient Characteristic documents.

4. Removed product item 6.

All other terms and conditions are in full force and effect.

-------------------------------------------------END OF SF 30----------------------------------------------------------

Mandy Thompson Contracting Officer

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

SERVICE/LABOR CAL COAST INSTALLATION & SETUP OF EQUIPMENT. FREIGHT IS ADDITIONAL.

Contract Period: Base POP Begin: 09-01-2023 POP End: 10-31-2023 LOCAL STOCK NUMBER: Labor

HAAG STREIT IMAGING MODULE IM910,RM-03,PC

POP Begin: 09-01-2023

LOCAL STOCK NUMBER: SLHS02-501

RELIANCE 980L CHAIR- COLOR: 634 PUMICE

POP Begin: 09-01-2023

LOCAL STOCK NUMBER: CSRE05-001SC

940 RELIANCE CHAIR GLIDE

POP Begin: 09-01-2023

LOCAL STOCK NUMBER: CSRE15-000

7900IC-WC RELIANCE STAND

POP Begin: 09-01-2023

LOCAL STOCK NUMBER: CSRE20-001

A.2 DELIVERY SCHEDULE

6505 S. Manthey Rd French Camp, CA 95231

USA

916-843-7550 jennifer.ledward@va.gov

6505 S. Manthey Rd French Camp, CA 95231

USA

6505 S. Manthey Rd French Camp, CA 95231

USA

6505 S. Manthey Rd French Camp, CA 95231

USA

6505 S. Manthey Rd French Camp, CA 95231

USA

Haag-Streit IM910 Digital Video Package for Haag-Streit BQ900 LED Slit Lamp or Equal

1. General The IM910 is a digital video package directly connected to the Haag-Streit BQ900 slit lamp. It encompasses a camera, a computer, and software which allows capturing optic images for storage.

3. Distinct Features

a. Can store eye images directly into the EyeSuite software.

b. By the turn of a knob, IM910 can share eye view within microscope directly onto a monitor screen instantly.

c. Capture eye images with the camera trigger button.

d. It has built-in sensor for the camera.

e. A performant auto-exposure mode in combination with the automatic aperture control.

4. Technical Specifications (minimum requirements)

a. Compatibility and fully integrated with: Haag-Streit BQ900 slit lamps.

See attached Attachment Chair Stand Locations plan showing the locations of Haag Streit IM910 Digital Video Package for Haag-Streit BQ900 LED slit lamps in the CBOC building.

Page 1 of

Reliance/ Haag-Streit 940 Chair Glide or Equal

1. General Chair Glide with Tapered Track is especially designed for Reliance/ Haag-Streit 980 Premium Full Power Exam / Procedure Chair. It is an equipment gear consisting of a base plate, a stainless steel track, and a carriage. The exam chair sits on this chair glide, allowing it to move back and forth thereby accommodating the movement of a wheelchair.

3. Distinct Features

f. Heavy-duty stops on base plate limit distance of travel.

g. Carriage to be heavy-duty, cast aluminum.

h. Tapered track improves access to patient.

i. Locking pedal secures chair in any position along its 27” path.

j. Case-hardened steel rollers allow to easily slide chair out of the way for wheelchair access.

4. Technical Specifications (minimum requirements)

b. Base plate length: 52” overall; wide section: 28”; narrow: 24” (max. dimensions).

See attached Attachment Chair Stand Locations plan showing the locations of Reliance/ Haag Streit 940 chair glides in the CBOC building.

Reliance/ Haag-Streit 980 Premium Full-Power Exam/ Procedure Chair or Equal

1. General Full-power articulating round-base examination chair.

3. Distinct Features

k. Memory programmable function automatically positions chair to preferred exam position.

l. Programmable safety function prevents children from operating chair.

m. Dual side controls.

n. Rotation locks allow you to swivel chair 330 degrees from both sides.

o. Armrests lock in place and release for easy patient access and security.

p. Auto return button returns chair to upright and lowered position.

q. Large hinged footrest supports patient’s full weight for safe ingress and egress.

r. Detached footswitch allows for hands-free patient positioning.

s. Headrest adjusts with a single hand and locks into place.

t. Finger switches and a corded footswitch that raises, lowers or reclines the chair and auto return.

u. Backlit membrane switches.

v. Long lasting hand-sewn upholstery with high-density foam.

w. Removable cushions for easy cleaning or replacement.

x. Cast iron bases and hinges.

4. Technical Specifications (minimum requirements)

c. Depth of chair (without headrest) table position: 60”, Seat: 18¾” wide, 18¼”deep (max. dimension).

See attached Attachment Chair Stand Locations plan showing the locations of Reliance/ Haag Streit 980 premium full-power exam/ procedure chairs in the CBOC building.

Reliance/ Haag-Streit 7900IC Ophthalmic Instrument Stand or Equal

1. General The Reliance 7900IC is an ophthalmic instrument stand with rechargeable wells for handheld instruments and multiple arms for mounting slit lamps and phoropters.

3. Distinct Features

y. The stand has exam chair controls to adjust chair’s heights located on the slit lamp arm.

z. The stand has (3) rechargeable wells for handheld instruments.

aa. The stand has following arms (at a minimum):

a. Counterbalanced slit-lamp arm: allow to lock and adjust the arm with a single hand. Arm can travel 12’’ in vertical direction, and can be counterbalanced for instruments weighing12 to 60 lbs.

b. Upper refractor arm: offers 10’’ range of vertical movement, and can support instruments up to 20 lbs. This arm must be able to support and compatible with Reichert Technologies Ophthalmic Instruments or equal’s phoropter that will be attached to this arm.

c. Third instrument arm available as an option: it has capacity to support 10- to 50 lb. instruments, and has the capability to travel 10’’ in vertical direction.

d. Monitor Arm: Instrument stand supports an additional monitor arm.

ab. Durability features:

a. Made from durable base materials, including polycarbonate, to be able to resist scrapes, scuffs and scratches.

b. The stand has backlit membrane switches. They control the chart projector, overhead lamp, and binding post for an indirect ophthalamoscope, and raise and lower the exam chair.

c. The stand has halogen lamp on the top of the stand that provides bright, direct light for minor procedures. The halogen lamp is supported on an arm that can easily be adjusted with hand without the use of any tools. The halogen lamp has low voltage for safety.

ac. Options:

a. An optional lower slit lamp arm to serve wheelchair patients.

b. Has an eclipse option to activate all room lighting from the stand. Lighting adjusts based on instrument moves or quick manual adjustments.

i. Verify with the end users if this feature needs to be included during technical evaluation period.

4. Technical Specifications (minimum requirements)

d. Height to top console: 36”.

See attached Attachment Chair Stand Locations plan showing the locations of Reliance/ Haag Streit 7900IC Ophthalmic Instrument Stands in the CBOC building.

ATTACHMENT LIST

See attached document: Attachment Chair Stand Locations.

See attached document: Attachment Eye Exam Chair Glide_Product Data.

See attached document: Attachment Eye Exam Chair_Product Data.

See attached document: Attachment Instrument Stands_Product Data.

The Amendment to the solicitation RFQ 36C26123Q1120 corrects the following items:

1. Add delivery address and POC to DELIVERY section.

2. Add Attachments mentioned in Salient Characteristic documents.

3. Revise Attachment names on the Salient Characteristic documents.

4. Removed product item 6.

All other terms and conditions are in full force and effect.