36C26320Q0215-000.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

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 82

636-20-2-3278-0014

36C26320Q0215 02-11-2020

John Becker (john.becker3@va.gov) 605-336-3230 x7960 02-21-2020

11:59PM EST

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105

John Becker, 605-336-3230 ext 7960 john.becker3@va.gov

X 100

X

811219

$22 Million

N/A

X

Department of Veterans Affairs

Des Moines VA Health Care System

3600 30th Street

Des Moines IA 5753

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105

Tungsten Electronic Invoicing System

VA Tungsten Number is: AAA544240062 va.registration@tungsten-network.com

Refer to VAAR Clause 852.232-72

See CONTINUATION Page

Patient Lift Preventive Maintenance Service to support the

Central Iowa, Des Moines IA VA Health Care System (VAHCS) located at 3600 30th Street, Des Moines IA 50310-5753.

See Statement of Work (SOW) and Cost Schedule for specific requirements and contractor qualifications.

Period of Performance: 4/1/2020 to 3/31/2021

Contract includes four (4) one-year option periods.

This procurement is set-aside for Veteran Owned Small

Business (VOSB) entities. VOSB firms shall be registered and verified in the Department of Veterans Affairs VIP database at the time of submission of offer and prior to award.

Offerors shall have an Active System for Award (SAM) registration at the time of offer and prior to award.

Subcontracting limitations apply; verified through payroll reporting.

DOL Wage Determination 2015-4979 Revision 9 applies to services performed under this requirement.

Evaluation of Offers: Lowest Price Technically Acceptable

See FAR Clause 52.212-2, Evaluation of Offers for specific details and offer submission requirements.

See CONTINUATION Page

636-3600160-3278-820100-2580-030055500

636-20-2-3278-0014

X X

X one 1

John Becker

VA-VHA-2019-95FFC7A6

36C26320Q0215

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 STATEMENT OF WORK

B.3 PRICE/COST SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

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

C.3 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.4 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ...31

C.5 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997)

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.7 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.8 VAAR 852.211-72 TECHNICAL INDUSTRY STANDARDS (NOV 2018)

C.9 VAAR 852.219-11 VA NOTICE OF TOTAL VETERAN-OWNED SMALL

BUSINESS SET-ASIDE (JUL 2019) (DEVIATION)

C.10 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.11 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.12 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN

2008)

C.13 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (OCT 2019)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 DEPARTMENT OF LABOR WAGE DETERMINATION

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

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

1998)

E.3 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.4 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.5 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.6 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.7 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (DEC 2019)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

Business Name:

DUNS Number:

Point of Contact:

Email Address:

Phone Number:

b. GOVERNMENT: Contracting Officer

Name: John Becker

Email Address: John.becker3@va.gov

Phone Number: 605-336-3230 ext 7960

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly, in arrears

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Tungsten Electronic Invoicing System VA Tungsten Number is: AAA544240062 va.registration@tungsten-network.com Refer to VAAR Clause 852.232-72

5. ADDITIONAL INVOICING INSTRUCTIONS. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

• Name and Address of Contractor

• Contractor’s Invoice Date and Invoice Number

• Contract Number, Task Order Number, and/or Purchase Order Number

• Date(s) of Service

• Cost of service, i.e., hourly rate, quantity, job cost, trip, etc.

• Total price mailto:John.becker3@va.gov

Electronic Invoice Submission Method. Invoice(s) shall be electronically submitted through the Tungsten Network: https://www.tungsten-network.com/customer-campaigns/veterans-affairs/. The VA-FSC pays all associated transaction fees for VA orders.

The Tungsten direct vendor support number is 877-489-6135 for VA contracts. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to five (5) business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. https://www.tungsten-network.com/us/support/’. The VA-FSC pays all associated transaction fees for VA orders.

For additional information, please contact:

• Tungsten Support, Phone: 1-877-752-0900, Email: va.registration@tungsten-network.com

• Department of Veterans Affairs Financial Service Center, Phone: 1-877-353-9791, Email: vafscched@va.gov

6. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

https://www.tungsten-network.com/us/support/

B.2 STATEMENT OF WORK

PATIENT LIFTS PREVENTIVE MAINTENANCE SERVICE

VA CENTRAL IOWA HEALTH CARE SYSTEM

Contractor shall provide all parts, equipment, material, labor and supervision, including travel costs, necessary to perform testing, preventive and corrective maintenance and all other necessary resources to accomplish all required preventive maintenance inspections and repairs for the equipment and patient lift(s) as listed in Attachment A, “Patient Lift Inventory Schedule”.

1. SCOPE

A. Contractor shall perform required weight and function tests, preventive and corrective maintenance of approx. 163 patient ceiling lift systems throughout the VA Central Iowa Healthcare Center in accordance with the following;

1) Each of the installed Patient Lift Manufacturers preventive maintenance manuals, schedules, requirements and patient lift service manual checklists.

2) ISO 10535: 2006, Hoist for the Transfer of Disabled Persons.

3) Patient Safety Alert AL 14-07 Addendum and associated checklists. Checklists are as follows.

a) Corrective and Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts (See

Attachment B).

b) Installation or Relocation Checklist for Ceiling Mounted Patient Lifts (See Attachment C).

c) Contractor shall be required to receive all necessary signatures for above checklists to be compliant with Line item 1 – A – 3) above.

4) If there are conflicts with all the above maintenance requirements, the most stringent maintenance requirement shall apply.

B. Contractor shall install new maintenance stickers on all equipment listed in Attachment A –

Patient Lift Inventory Schedule. The new patient lift stickers shall be installed on the underside of the patient lift and shall have lettering that is easily legible by the naked eye.

1) Information on sticker shall be as follows and, in the order, as follows;

a) The VA Central Iowa Healthcare Center assigned PMI number.

C. Contractor shall install and maintain an additional dynamic patient lift sticker system that shall contain the following information. This sticker shall be placed on the underside of each lift system;

1) Date of next service due. Date format shall be month of date dot punched out for the next year.

D. Equipment sticker in line item 1 – C above shall be removed at each maintenance cycle and replaced with a new sticker. New sticker shall duplicate the information stated in line 1 – C – 1) and 1 – C – 2) above.

E. The Contractor shall demonstrate the proper functioning and safety of all patient lift systems at the completion of each inspection/repair cycle.

F. Any changes to this SOW shall be authorized and approved only through written modification of this contract from the CO (Contracting Officer) in coordination with the COR (Contracting Officers Representative). Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

G. Notwithstanding, the Contractor shall perform no additional work without the prior written authorization of the Contracting Officer. Any additional work, which may be performed by the Contractor without this approval, will be performed by the Contractor at no additional cost to the Government.

H. Within fourteen (14) days of the award of this contract, the Contractor and the Government shall agree upon a date for work to take place, work shall be performed in the month scheduled by the Government to meet Preventive Management Program requirements.

2. SERVICE HOURS AND FEDERAL HOLIDAYS

A. Normal hours of coverage are Monday through Friday from 7:30 am to 4:30 pm, excluding Federal holidays. All work shall be performed during normal hours of coverage unless otherwise requested or approved by the COR or their designee.

B. All contract work shall be on a date and time mutually agreed upon between the Contractor and the COR.

C. Federal Holidays observed by the VAMC are:

New Year’s Day Labor Day Martin Luther King Day Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Any day by Presidential

Proclamation Independence Day Christmas Day

3. GENERAL INFORMATION

A. Compliance with General Safety Regulations:

1) All Contractors and Subcontractors performing services for the Government shall comply with all Occupational Safety and Health Administration (OSHA), State, County and Municipal Safety and Occupational Health Standards and any other applicable rules and regulations. All Contractors and Subcontractors shall be held responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site area under this contract.

2) All ladders, scaffolding, tools, equipment, personal protective equipment, etc. shall be OSHA approved for the work to be performed. Contractor shall use caution signs as/if required by OSHA Regulations. Caution signs shall be on-site on commencement of contract.

3) The contractor’s FST (Field Service Technician) shall contact the COR/POC prior to performing service at this location and shall communicate to the COR of their presence on the VA Central Iowa Healthcare Center campus.

4) Contractor is responsible to replace any items damaged by the contractor, sub-contractor, their employees or equipment at no extra charge to the Government.

5) Contractor personnel must conduct their work in a manner that does not interfere with the normal functions of the facility and will stop work if asked by the CO/COR as required if interruptions do occur.

6) The Contractor is responsible for supplying, completing, and submitting all reports required or requested by any additional Federal, State, or local codes as they pertain to any work performed under this contract.

4. CONRACTING OFFICER’S REPRESENTATIVE (COR) OR ASSIGNED TECHNICAL REPRESENTATIVE

Scheduling of work shall be arranged with at least one, or all the Point of Contacts below and in the following order; contract COR (Contracting Officers Representative) or contract ACOR (Alternate Contracting Officers Representative). See Table below for Point of Contact information.

NAME POSITION PHONE EMAIL

John Richardson

COR; Biomedical Equipment Support Specialist

515-699-5999 ext 2-6041

John.Richardson2@va.gov

Chadwick Heuton

ACOR; Biomedical Equipment Support Specialist

515-699-5999 ext 2-6047

Chadwick.Heuton@va.gov

5. COMPETENCIES AND QUALIFICATIONS OF PERSONNEL SERVICING EQUIPMENT

A. FSE shall have a minimum of two (2) years of experience performing this service. The FST(s) shall have completed a formalized training program for the equipment identified in the Statement of Work. For field experience, the FST(s) shall have a minimum of two years of experience, with respect to scheduled and unscheduled preventive and remedial maintenance, on the patient lifts as identified in this scope of work and related attachments.

B. The FST’s shall be authorized by the Contractor to perform the maintenance services. The Contractor shall provide written assurance of the competency of their personnel and a list of credentials of approved FST’s for each make and model the Contractor services at the VAMC. The CO may authenticate the training requirements, request training certificates or credentials from the Contractor at any time for any personnel who are servicing or installing any VAMC equipment. The CO and/or COR specifically reserves the right to reject any of the Contractor's personnel and refuse them permission to work on the VA Central Iowa Healthcare Center equipment.

6. DAILY IN-BRIEF AND OUT-BRIEF

Contractor shall allow adequate on-site time during service work site visits in order to brief the COR of proposed plan for mobilization and execution for all required service work required in contract, as well as necessary time to complete the preliminary review, with COR discussion and input, of all completed Attachment D - Daily Work Completion Checklists.

7. CONTRACT DELIVERABLES

Contractor shall provide, to the COR after completion of work, at the minimum, the following deliverables:

A. Documentation, which shall be referenced as the FSR (Field Service Report) for purposes of this

SOW, to include all the following;

1) The FSR shall be the record of all inspections, tests, all preventive maintenance performed, and any required corrective maintenance performed.

2) The FSR must include the date of inspection, testing and PM (Preventive Maintenance)/CM

(Corrective Maintenance), the serial number and Facility PMI (Preventive Maintenance Inspection) number of the lift and/or trolley system being tested and name of FST (Field Service Technician) who performed all work.

3) If Applicable, the completed Installation or Relocation Checklist for Ceiling Mounted Patient Lifts (Attachment C), with signatures, shall be provided as an attachment to the

FSR.

4) Additionally, any observations of importance for the safety of the hoist, the room number of the lift’s location, and any corrective actions taken shall be notated.

5) All the above documentation shall be provided to the COR in either physical copy or digital format on removable digital media.

B. Contractor must notify COR immediately, separately from certification forms, of any damage that jeopardizes the safety of the hoist system and any corrective action required to fix the patient lift so it can be put it back into service.

C. Contractor will provide all necessary parts, labor, shipping and travel to correct any deficiencies identified by all tests and maintenance checklists.

D. If the contractor requires a longer period to complete the field service report, a written justification shall be sent to the end user and the Contracting Officer for approval.

E. If provided in electronic format, deliverables shall be organized in a hierarchical folder/directory fashion, and as defined in the example in Table 2 below.

Table 2:

Flash drive

Building Number

Room Number

> Lift PMI Number V

Field Service Reports Completed Checklists Misc. Documents

F. As Contractor completes service performance on each lift, Contactor shall complete and fill in all data on Attachment D – Daily Work Completion Checklist.

1) At the end of the performance day, the recorded completion of work on Attachment D –

Daily Work Completion Checklist, shall be submitted to the contract COR/ACOR for review.

2) A new, unpopulated Attachment D – Daily Work Completion Checklist, shall be used, completed and submitted to the contract COR/ACOR, as indicated above, each day service is performed by the Contractor for the duration of the onsite inspection, testing and maintenance services.

DELIVERABLE TITLE FORMAT DISTRIBUTION DELIVERY

DATE

1 “Field Service Report” (FSR)

(1) Digital (Flash drive)

(1) Hardcopy at discretion of

COR

• Digital Copy (Flash drive) to COR

• Standard Distribution*

7 Days After Service Completion

* Standard Distribution: 1 copy of the transmittal letter without the deliverable to the Contracting Officer shall be Emailed.

8. PERFORMANCE MONITORING AND QUALITY ASSURANCE

A. The VA Central Iowa Healthcare Center Biomedical Engineering Dept. shall randomly inspect approximately 7% of patient lifts after each testing, maintenance and service cycle for this contract.

B. If said inspections yield results contrary to what was indicated on each corresponding FSR for that cycle, the COR shall do the following;

1) Contact the Contracting Officer and provide supporting documentation that indicates Contractor non-performance.

2) Consult and coordinate with Contracting Officer, Contractor and subject matter experts (Biomedical Engineering) to oversee the implementation of a Contractor provided plan that will indicate how non-performance will be corrected and what time frame corrections will be completed in.

3) Coordinate an additional follow-up inspection with the subject matter experts (Biomedical Engineering) to verify that corrections have been completed successfully.

4) Coordinate with the subject matter experts (Biomedical Engineering) for an additional (3%) random inspections for each testing, maintenance and service cycle, in addition to the standard 7% inspections, until performance measures are met for two consecutive testing, maintenance and service cycles by the Contractor per contract requirements.

C. All the measures indicated in Line Item 8 - B and its sub-items above will be addressed by the Contractor at no additional cost to the Government.

9. SECURITY REQUIREMENTS

A. All Contractor FST’s (Field Service Technician(s)) shall obtain contractor ID badges from the COR. Identification shall be worn visible always by the Contractor and all FST’s while on premises. Contractor shall coordinate with COR to acquire said identification badges.

B. During normal working hours of operation, Monday through Friday, the contractor shall check in with the COR/ Central Iowa VAMC (Veterans Affairs Medical Center) POC (Point of Contact) when arriving to perform work and check out with the COR/ John Richardson and/or Chadwick Heuton (ACOR) VAMC POC when work/work day is complete.

C. During other than normal hours of operation, the contractor shall sign-in and out with the Police Department.

D. It is the responsibility of the Contractor to park in the appropriate designated parking areas.

Information on parking is available from the VA Police Section. The VAMC will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

E. Effective October 1, 2019, smoking is prohibited both inside and outside (entire campus) at the

VAMC.

F. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court.

10. RISK CONTROL

A. The Contractor shall take all necessary precautions to protect government property and shall repair any damage caused by their efforts.

B. All work affecting patients shall be coordinated in advance by the Government and the

Contractor to have minimal impact on the patients.

11. PLACE OF PERFORMANCE

VA Central Iowa Health Care System 3600 30th Street Des Moines, IA 50310

ATTACHMENT A – PATIENT LIFT INVENTORY SCHEDULE

Asset Number Description EE Number Model Number Location

Serial Number

362381 LIFT CEILING 636 EE3009511 UNILIFT UDL 160 3204-01W-D 124153

362358 LIFT CEILING 636 EE3009514 UNILIFT UDL 160 3212-01W-D 124234

363019 LIFT CEILING 636 EE3012437 UNILIFT UDL 160 3220-01W-D 124785

363034 LIFT CEILING 636 EE3012440 UNILIFT UDL 160 3228-01W-D 122068

362345 LIFT CEILING 636 EE3009504 UNILIFT UDL 160 B416-001-D 119795

362363 LIFT CEILING 636 EE3009515 UNILIFT UDL 160 1728-001-D 124151

363038 LIFT CEILING 636 EE3012441 UNILIFT UDL 160 3230-01W-D 121729

362362 LIFT CEILING 636 EE3009507 UNILIFT UDL 160 3334-01W-D 121735

362369 LIFT CEILING 636 EE3009509 UNILIFT UDL 160 3330-01W-D 119063

362348 LIFT CEILING 636 EE3009512 UNILIFT UDL 160 3206-01W-D 124781

362353 LIFT CEILING 636 EE3009513 UNILIFT UDL 160 3210-01W-D 123482

363024 LIFT CEILING 636 EE3012438 UNILIFT UDL 160 3224-01W-D 124230

362337 LIFT CEILING 636 EE3009502 UNILIFT UDL 160 3347-01W-D 123497

363014 LIFT CEILING 636 EE3012436 UNILIFT UDL 160 1730-001-D 124237

363029 LIFT CEILING 636 EE3012439 UNILIFT UDL 160 3226-01W-D 121739

362340 LIFT CEILING 636 EE3009503 UNILIFT UDL 160 3212-01W-D 122063

362352 LIFT CEILING 636 EE3009505 UNILIFT UDL 160 3338-01W-D 122058

362357 LIFT CEILING 636 EE3009506 UNILIFT UDL 160 3338-01W-D 121725

362366 LIFT CEILING 636 EE3009508 UNILIFT UDL 160 3334-01W-D 119802

362376 LIFT CEILING 636 EE3009510 UNILIFT UDL 160 3340-01W-D 122066

365304 LIFT CEILING 636 EE3022886 UNILIFT UDL 160 B319-012-D 126317

365319 LIFT CEILING 636 EE3022889 UNILIFT UDL 160 B328-012-D 126324

365323 LIFT CEILING 636 EE3022918 UNILIFT UDL 160 B306-012-D 126320

365327 LIFT CEILING 636 EE3022912 UNILIFT UDL 160 B313-012-D 123486

365332 LIFT CEILING 636 EE3022893 UNILIFT UDL 160 C310-012-D 126496

365336 LIFT CEILING 636 EE3022894 UNILIFT UDL 160 C311-012-D 126322

365340 LIFT CEILING 636 EE3022938 UNILIFT UDL 160 A317-012-D 127021

365348 LIFT CEILING 636 EE3022940 UNILIFT UDL 160 A314-012-D 127062

365350 LIFT CEILING 636 EE3022931 UNILIFT UDL 160 C315-012-D 126741

365358 LIFT CEILING 636 EE3022925 UNILIFT UDL 160 B309-012-D 126574

365362 LIFT CEILING 636 EE3023002 UNILIFT UDL 160 B228-012-D 126146

365374 LIFT CEILING 636 EE3023019 UNILIFT UDL 160 B227-012-D 126888

365389 LIFT CEILING 636 EE3023007 UNILIFT UDL 160 C206-012-D 126492

365402 LIFT CEILING 636 EE3023033 UNILIFT UDL 160 B216-012-D 127126

365406 LIFT CEILING 636 EE3023017 UNILIFT UDL 160 B221-012-D 126830

368145 LIFT CEILING 636 EE3040845 UNILIFT UDL 160 3602-001-D 131582

368150 LIFT CEILING 636 EE3040856 UNILIFT UDL 160 3627-001-D 131933

368175 LIFT CEILING 636 EE3040861 UNILIFT UDL 160 3614-001-D 131925

368130 LIFT CEILING 636 EE3040842 UNILIFT UDL 160 3604-001-D 131915

368141 LIFT CEILING 636 EE3040836 UNILIFT UDL 160 3633-001-D 131914

Asset Number Description EE Number Model Number Location

Serial Number

368156 LIFT CEILING 636 EE3040847 UNILIFT UDL 160 3603-001-D 131928

365297 LIFT CEILING 636 EE3022895 UNILIFT UDL 160 C311-012-D 126208

365314 LIFT CEILING 636 EE3022888 UNILIFT UDL 160 B328-012-D 126323

365324 LIFT CEILING 636 EE3022890 UNILIFT UDL 160 C310-012-D 126315

365331 LIFT CEILING 636 EE3022928 UNILIFT UDL 160 C308-012-D 126738

365342 LIFT CEILING 636 EE3022915 UNILIFT UDL 160 B320-012-D 126209

365351 LIFT CEILING 636 EE3022991 UNILIFT UDL 160 C108-012-D 126696

365364 LIFT CEILING 636 EE3022934 UNILIFT UDL 160 A312-012-D 126991

365373 LIFT CEILING 636 EE3023004 UNILIFT UDL 160 A219-012-D 126218

365382 LIFT CEILING 636 EE3023013 UNILIFT UDL 160 C211-012-D 126701

365400 LIFT CEILING 636 EE3023016 UNILIFT UDL 160 A212-012-D 126742

368134 LIFT CEILING 636 EE3040852 UNILIFT UDL 160 3629-001-D 131577

368142 LIFT CEILING 636 EE3040864 UNILIFT UDL 160 3619-001-D 131580

368151 LIFT CEILING 636 EE3040846 UNILIFT UDL 160 3635-001-D 131926

365293 LIFT CEILING 636 EE3022884 UNILIFT UDL 160 B314-012-D 126312

365292 LIFT CEILING 636 EE3022877 UNILIFT UDL 160 A113-012-D 126213

365317 LIFT CEILING 636 EE3022917 UNILIFT UDL 160 C316-012-D 126316

365337 LIFT CEILING 636 EE3022914 UNILIFT UDL 160 A321-012-D 126150

365354 LIFT CEILING 636 EE3022941 UNILIFT UDL 160 A320-012-D 127063

365359 LIFT CEILING 636 EE3022933 UNILIFT UDL 160 A306-012-D 126892

365367 LIFT CEILING 636 EE3023010 UNILIFT UDL 160 B210-012-D 126499

365368 LIFT CEILING 636 EE3023003 UNILIFT UDL 160 A2140-012-D 126210

365377 LIFT CEILING 636 EE3023012 UNILIFT UDL 160 A206-012-D 126700

365385 LIFT CEILING 636 EE3022998 UNILIFT UDL 160 B228-012-D 125995

365386 LIFT CEILING 636 EE3023030 UNILIFT UDL 160 B213-012-D 127123

365395 LIFT CEILING 636 EE3023040 UNILIFT UDL 160 2202-01W-D 126383

365394 LIFT CEILING 636 EE3023015 UNILIFT UDL 160 C211-012-D 126737

365403 LIFT CEILING 636 EE3023025 UNILIFT UDL 160 2210-01W-D 127058

365412 LIFT CEILING 636 EE3023018 UNILIFT UDL 160 A2140-012-D 126831

365413 LIFT CEILING 636 EE3023035 UNILIFT UDL 160 C214-012-D 127128

365355 LIFT CEILING 636 EE3022932 UNILIFT UDL 160 B323-012-D 126891

365363 LIFT CEILING 636 EE3023009 UNILIFT UDL 160 B206-012-D 126495

365365 LIFT CEILING 636 EE3022943 UNILIFT UDL 160 C317-012-D 127061

365375 LIFT CEILING 636 EE3022996 UNILIFT UDL 160 B206-012-D 125990

365383 LIFT CEILING 636 EE3023006 UNILIFT UDL 160 C217-012-D 126491

365387 LIFT CEILING 636 EE3023022 UNILIFT UDL 160 C210-012-D 126994

365392 LIFT CEILING 636 EE3023008 UNILIFT UDL 160 B207-012-D 126494

365405 LIFT CEILING 636 EE3023042 UNILIFT UDL 160 1622-001-D 128039

365407 LIFT CEILING 636 EE3023034 UNILIFT UDL 160 B219-012-D 127127

368137 LIFT CEILING 636 EE3040863 UNILIFT UDL 160 3619-001-D 131918

368138 LIFT CEILING 636 EE3040853 UNILIFT UDL 160 3607-001-D 131929

368140 LIFT CEILING 636 EE3040844 UNILIFT UDL 160 3606-001-D 131593

Asset Number Description EE Number Model Number Location

Serial Number

368144 LIFT CEILING 636 EE3040855 UNILIFT UDL 160 3609-001-D 131931

365310 LIFT CEILING 636 EE3022880 UNILIFT UDL 160 A114-012-D 126382

365326 LIFT CEILING 636 EE3022927 UNILIFT UDL 160 A315-012-D 126736

365335 LIFT CEILING 636 EE3022937 UNILIFT UDL 160 C308-012-D 126995

365345 LIFT CEILING 636 EE3022939 UNILIFT UDL 160 B310-012-D 127022

365353 LIFT CEILING 636 EE3022924 UNILIFT UDL 160 B318-012-D 126498

365379 LIFT CEILING 636 EE3023005 UNILIFT UDL 160 C208-012-D 126319

365396 LIFT CEILING 636 EE3023032 UNILIFT UDL 160 B214-012-D 127125

365416 LIFT CEILING 636 EE3023028 UNILIFT UDL 160 C219-012-D 127121

368155 LIFT CEILING 636 EE3040857 UNILIFT UDL 160 3626-001-D 131917

368160 LIFT CEILING 636 EE3040858 UNILIFT UDL 160 3626-001-D 131913

368161 LIFT CEILING 636 EE3040848 UNILIFT UDL 160 3603-001-D 131590

368166 LIFT CEILING 636 EE3040849 UNILIFT UDL 160 3632-001-D 131575

368170 LIFT CEILING 636 EE3040860 UNILIFT UDL 160 3614-001-D 131583

368173 LIFT CEILING 636 EE3040850 UNILIFT UDL 160 3632-001-D 131581

365320 LIFT CEILING 636 EE3022882 UNILIFT UDL 160 A115-012-D 126220

365334 LIFT CEILING 636 EE3022920 UNILIFT UDL 160 B315-012-D 126384

365347 LIFT CEILING 636 EE3022999 UNILIFT UDL 160 C208-012-D 126141

365305 LIFT CEILING 636 EE3022879 UNILIFT UDL 160 A114-012-D 126311

365322 LIFT CEILING 636 EE3022926 UNILIFT UDL 160 C312-012-D 126697

365330 LIFT CEILING 636 EE3022936 UNILIFT UDL 160 A315-012-D 126993

365343 LIFT CEILING 636 EE3022930 UNILIFT UDL 160 C306-012-D 126740

365287 LIFT CEILING 636 EE3022876 UNILIFT UDL 160 A106-012-D 126215

365309 LIFT CEILING 636 EE3022887 UNILIFT UDL 160 B324-012-D 126325

365321 LIFT CEILING 636 EE3022910 UNILIFT UDL 160 2205-01W-D 123480

365339 LIFT CEILING 636 EE3022921 UNILIFT UDL 160 B322-012-D 126386

365360 LIFT CEILING 636 EE3022942 UNILIFT UDL 160 A312-012-D 126493

365372 LIFT CEILING 636 EE3023011 UNILIFT UDL 160 B220-012-D 126500

365381 LIFT CEILING 636 EE3023029 UNILIFT UDL 160 A215-012-D 127122

365390 LIFT CEILING 636 EE3023039 UNILIFT UDL 160 1804-001-D 126702

365411 LIFT CEILING 636 EE3023027 UNILIFT UDL 160 B223-012-D 127118

368178 LIFT CEILING 636 EE3040851 UNILIFT UDL 160 3630-001-D 131579

365356 LIFT CEILING 636 EE3022992 UNILIFT UDL 160 C108-012-D 126698

365370 LIFT CEILING 636 EE3022935 UNILIFT UDL 160 A314-012-D 126992

365378 LIFT CEILING 636 EE3023020 UNILIFT UDL 160 A220-012-D 126889

365388 LIFT CEILING 636 EE3023014 UNILIFT UDL 160 C210-012-D 126735

365352 LIFT CEILING 636 EE3023000 UNILIFT UDL 160 A221-012-D 126142

365361 LIFT CEILING 636 EE3022993 UNILIFT UDL 160 A120-012-D 126699

365369 LIFT CEILING 636 EE3022995 UNILIFT UDL 160 B215-012-D 125574

365384 LIFT CEILING 636 EE3023021 UNILIFT UDL 160 B222-012-D 126890

365391 LIFT CEILING 636 EE3023031 UNILIFT UDL 160 B224-012-D 127124

365399 LIFT CEILING 636 EE3023041 UNILIFT UDL 160 4308-001-D 127717

Asset Number Description EE Number Model Number Location

Serial Number

365408 LIFT CEILING 636 EE3023026 UNILIFT UDL 160 A206-012-D 127064

365315 LIFT CEILING 636 EE3022881 UNILIFT UDL 160 A115-012-D 126385

365333 LIFT CEILING 636 EE3022913 UNILIFT UDL 160 B401A-001-D 124229

365349 LIFT CEILING 636 EE3022923 UNILIFT UDL 160 B321-012-D 126497

365357 LIFT CEILING 636 EE3023001 UNILIFT UDL 160 A212-012-D 126143

365366 LIFT CEILING 636 EE3022994 UNILIFT UDL 160 C216-012-D 125570

365397 LIFT CEILING 636 EE3023024 UNILIFT UDL 160 B217-012-D 127024

365283 LIFT CEILING 636 EE3022874 UNILIFT UDL 160 A106-012-D 126211

365300 LIFT CEILING 636 EE3022878 UNILIFT UDL 160 A113-012-D 126216

365467 LIFT CEILING 636 EE3023124 UNILIFT UDL 160 B416-001-D CL9271

365325 LIFT CEILING 636 EE3022883 UNILIFT UDL 160 B307-012-D 126212

365338 LIFT CEILING 636 EE3022929 UNILIFT UDL 160 A306-012-D 126739

365380 LIFT CEILING 636 EE3022997 UNILIFT UDL 160 B209-012-D 125993

365393 LIFT CEILING 636 EE3023023 UNILIFT UDL 160 A215-012-D 127023

365418 LIFT CEILING 636 EE3023036 UNILIFT UDL 160 A218-012-D 127295

368165 LIFT CEILING 636 EE3040859 UNILIFT UDL 160 3609-001-D 131587

368135 LIFT CEILING 636 EE3040843 UNILIFT UDL 160 3636-001-D 131586

368180 LIFT CEILING 636 EE3040862 UNILIFT UDL 160 3617-001-D 131578

365298 LIFT CEILING 636 EE3022885 UNILIFT UDL 160 B316-012-D 123481

365313 LIFT CEILING 636 EE3022916 UNILIFT UDL 160 A318-012-D 126313

365328 LIFT CEILING 636 EE3022919 UNILIFT UDL 160 B317-012-D 126381

365344 LIFT CEILING 636 EE3022922 UNILIFT UDL 160 B306-012-D 126387

437263 LIFT CEILING 636 MX437263 UNILIFT UDL 160 1540-001-D 135900

437264 LIFT CEILING 636 MX437264 UNILIFT UDL 160 1580-001-D 135897Y

437265 LIFT CEILING 636 MX437265 UNILIFT UDL 160 1541-001-D 135894V

437267 LIFT CEILING 636 MX437267 UNILIFT UDL 160 1545-001-D 135899

437269 LIFT CEILING 636 MX437269 UNILIFT UDL 160 1543-001-D 135895W

437271 LIFT CEILING 636 MX437271 UNILIFT UDL 160 1537-001-D 135902L

437272 LIFT CEILING 636 MX437272 UNILIFT UDL 160 1544-001-D 135896X

692716 LIFT CEILING 636 MX692716 UNILIFT UDL 160 B401A-001-D 132334

ATTACHMENT B – Corrective & Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts

Revision 2.1 1 of 2 Serial #: ____________________

Corrective and Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts

The commissioning for a patient ceiling lift system(s) shall include, but not be limited to, the following points as components of the commissioning procedures. NOTE: Ceiling mounted patient lifts are not to be installed in treatment units with actively suicidal patients.

Facility: Work Order: Manufacturer:

Lift Location: Model:

VAMC Contact: Serial Number: EE Number:

VAMC Contact's Phone Number:

Installer: MFG Contact:

Installer's Phone Number: MFG Contact's Phone Number:

Date:

Structure Complete

Perform a visual inspection to verify proper connections of the lift's structural system to the building’s structure (including seismic bracing if applicable).

Perform a visual inspection to verify proper interface at the ceiling (hard deck or soft tile) and proper installation of all protective features around the support rods and rails/tracks.

Perform a visual inspection to verify structural component sizing and physical installation to ensure that the correct structural system is in place and properly installed to support the lift.

NOTES:

Rails/Tracks and End Stops PASS FAIL

Verification that all fasteners and set screws are properly tightened on the trollies

Ensure that the rail/track is free of gaps (unless required by design). If included in installation, verify rail turntable function, exchanger function, gate alignment, and safety block installation.

Confirm track is clean and clear of all debris. (Use manufacturer’s recommended cleaning materials to avoid damage to the motor case and other components.)

Verification that all manufacturer specified end stops or docking gates are properly installed.

Lift Unit and Straps PASS FAIL

1 Inspection of lift unit casing for cracks and alignment.

2 Verification that the lift unit charges properly.

Inspection and activation of hand control for full operation (e.g., up, down, left, right) and “return to charge” function if applicable.

Confirm any and all lift unit indicator lights are functioning. (e.g., red service warning light, charging state light)

5 Inspection and verification of all emergency functions of the lift unit.

6 Full extension and inspection of lift strap for loose threads or frays.

Inspection of spreader bar and clips for cracks and for loose or missing rings or cotter pins.

Load Testing PASS FAIL

Verification of any “soft start” or “soft stop” features and that lifting speed does not exceed 2.5 inches per second with “zero” load.

Verification of load testing and deflection testing at the manufacturer's specified maximum rated lift capacity.

Verification of any “soft start” and “soft stop” features and that lifting speed does not exceed 1.5 inches per second under maximum rated lift capacity.

4 Verification of function of emergency stop at maximum rated lift capacity.

5 Verification of emergency lowering feature at maximum rated lift capacity.

Inspector COMPLETE

After the activities listed in the above checklist and in the manufacturer's installation/operations/owner’s manual(s) have been completed, the inspector shall release the ceiling mounted lift installation to VA representative.

SIGNATURE:

DATE:

TITLE:

VA Representative COMPLETE installation/operations/owner’s manual(s) have been completed, the VA representative shall review those items with the inspector prior to releasing the ceiling mounted lift back into service to ensure completion of all requirements.

SIGNATURE:

DATE:

Manager of the Service Using the Ceiling Mounted Lifts COMPLETE installation/operations/owner’s manual(s) have been completed, the manager of the service using the ceiling mounted lifts confirms that the current staff have received initial training on ceiling mounted lifts and that there is a process in place to provide ongoing training on the proper use of ceiling mounted lifts.

SIGNATURE: DATE:

ATTACHMENT C – INSTALLATION/RELOCATION CHECKLIST FOR CEILING MOUNTED PATIENT LIFTS

Revision 2.1 1 of 4 Serial #: ____________________

Installation or Relocation Checklist for Ceiling Mounted Patient Lifts

The commissioning for a patient ceiling lift system(s) shall include, but not be limited to, the following points as components of the commissioning procedures. NOTE: Ceiling mounted patient lifts are not to be installed in treatment units with actively suicidal patients.

Facility: Work Order: Manufacturer:

Lift Location: Model:

VAMC Contact: Serial Number: EE Number:

VAMC Contact's Phone Number:

Installer: MFG Contact:

Installer's Phone Number: MFG Contact's Phone Number:

Date:

Pre-Installation COMPLETE

Perform site survey of the pre-existing conditions and as-built drawings above and below finish ceiling at the installation location to confirm existing structural and ceiling conditions.

Obtain structural and related engineering design drawings and calculations for the new lift installation. Design drawings shall be developed for specific lift installation under specific pre-existing conditions of the facility.

If the facility is located in a seismic area, as identified in VA Handbook H-18-8 Seismic Design Requirements, verify that the ceiling mounted patient lift system installation is in compliance with the requirements of VA Directive 7512 Seismic Safety of VA Buildings and VA Master Design Specification 13.05.041 Seismic Restraint Requirements for Non-Structural Components.

Verify that the lift is listed by the manufacturer to be installed and operated in the environment that the lift is operating under. (For example, water tight lifts shall be installed and operated in wet, damp or humid locations such as pools or bathrooms.)

Verify NFPA 13 compliance for fire sprinkler system (including but not limited to fire sprinkler heads and piping).

6 Verify NFPA 99 and NFPA 70 compliance for proper grounding and bonding.

Verify NFPA 99 and NFPA 70 compliance for access to electrical and safety systems.

Verify required access to mechanical, HVAC, and fire systems components within the lift installation area.

Verify minimum clearances for operation are compliant with manufacturer recommendations. (Ensure room clearance and that the ceiling height is adequate for lift usage.)

Perform pre-installation walkthrough to confirm full understanding and consensus of design drawing(s) and installation conditions.

Installation COMPLETE

Verify proper connections of the lift's structural system to the building’s structure (including seismic bracing if applicable).

Verify proper interface at the ceiling (hard deck or soft tile) and proper installation of all protective features around the support rods and rails/tracks.

Verify structural component sizing and physical installation to ensure that the correct structural system is in place and properly installed to support the lift.

Verify proper installation of electric motor per manufacturer's instructions to ensure operational rigidity of motor mounting.

Verify proper electrical connections per design drawings and manufacturer's instructions.

Post-Installation COMPLETE

Perform walkthrough to ensure compliance of the installation per the design drawing(s) and manufacturer's instructions.

2 Perform operational test to verify lift functionality.

Rails/Tracks and End Stops PASS FAIL

Verification that all fasteners and set screws are properly tightened on the trollies

Ensure that the rail/track is free of gaps (unless required by design). If included in installation, verify rail turntable function, exchanger function, gate alignment, and safety block installation.

Confirm track is clean and clear of all debris. (Use manufacturer’s recommended cleaning materials to avoid damage to the motor case and other components.)

Verification that all manufacturer specified end stops or docking gates are properly installed.

Lift Unit and Straps PASS FAIL

1 Inspection of lift unit casing for cracks and alignment.

2 Verification that the lift unit charges properly.

Inspection and activation of hand control for full operation (e.g., up, down, left, right) and “return to charge” function if applicable.

Confirm any and all lift unit indicator lights are functioning. (e.g., red service warning light, charging state light)

5 Inspection and verification of all emergency functions of the lift unit.

6 Full extension and inspection of lift strap for loose threads or frays.

Inspection of spreader bar and clips for cracks and for loose or missing rings or cotter pins.

Load Testing PASS FAIL

Verification of any “soft start” or “soft stop” features and that lifting speed does not exceed 2.5 inches per second with “zero” load.

Verification of load testing and deflection testing at the manufacturer's specified maximum rated lift capacity.

Verification of any “soft start” and “soft stop” features and that lifting speed does not exceed 1.5 inches per second under maximum rated lift capacity.

4 Verification of function of emergency stop at maximum rated lift capacity.

5 Verification of emergency lowering feature at maximum rated lift capacity.

Manuals COMPLETE

Confirm that the manufacturer's operating and maintenance manuals for this lift have been received.

Training COMPLETE

Verify that manufacturer or manufacturer’s representative has provided training on the use of patient handling equipment to clinicians and other staff who move and handle patients.

Verify that training and competency are documented prior to release for use with patients.

Revision 2.1 4 of 4 Serial #: ____________________ Installing Contractor COMPLETE installation/operations/owner’s manual(s) have been completed, the installing contractor shall release the ceiling mounted lift installation to VA representative.

VA Representative COMPLETE installation/operations/owner’s manual(s) have been completed, the VA representative shall review those items with the installing contractor prior to releasing the ceiling mounted lift into service to ensure completion of all requirements.

Manager of the Service Using the Ceiling Mounted Lifts COMPLETE

After the activities listed in the above checklist and in the manufacturer's installation/operations/owner’s manual(s) have been completed, the manager of the service using the ceiling mounted lifts confirms that the current staff have received initial training on ceiling mounted lifts and that there is a process in place to provide ongoing training on the proper use of ceiling mounted lifts.

ADDITIONAL NOTES:

ATTACHMENT D – DAILY WORK COMPLETION CHECKLIST

Patient Ceiling Lift Daily Work Completion Checklist

Field Service Technician (FST) Name:

Today’s Date:

EE Number of Completed Ceiling Lift Location of Completed Ceiling Lift

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVICE

S

QUANTIT

Y UNIT UNIT PRICE AMOUNT

163.00 EA ___________

Annual Preventive Maintenance for Horcher Patient Ceiling Lifts installed at the Des Moines IA VA Health Care System (VAHCS).

Annually, the lifts are inspected and repaired per Horcher guidelines and following the new “Corrective and Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts” per the newly released “Safety Patient Alert.” Services to include:

- 4 hour or next day response time.

- Hours are from 8:30AM to 5:00PM Monday through Friday with all Federal Holidays observed.

- Travel to and from facility included.

- All parts, labor, repair and reports are included in price.

- Yearly safety inspection.

- Annual weight load testing for all lift systems.

- Call service provided for technical information.

- Lift systems may be added or taken off at the VA’s discretion.

Contract Period: Base POP Begin: 04-01-2020 POP End: 03-31-2021

Annual Preventive Maintenance for Horcher Patient Ceiling Lifts installed at the Des Moines IA VA Health Care System (VAHCS).

Annually, the lifts are inspected and repaired per Horcher guidelines and following the new “Corrective and Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts” per the newly released “Safety Patient Alert.” Services to include:

- 4 hour or next day response time.

- Hours are from 8:30AM to 5:00PM Monday through Friday with all Federal Holidays observed.

- Travel to and from facility included.

- All parts, labor, repair and reports are included in price.

- Yearly safety inspection.

- Annual weight load testing for all lift systems.

- Call service provided for technical information.

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVICE

S

QUANTIT

Y UNIT UNIT PRICE AMOUNT

- Lift systems may be added or taken off at the VA’s discretion.

Contract Period: Option 1 POP Begin: 04-01-2021 POP End: 03-31-2022

Annual Preventive Maintenance for Horcher Patient Ceiling Lifts installed at the Des Moines IA VA Health Care System (VAHCS).

Annually, the lifts are inspected and repaired per Horcher guidelines and following the new “Corrective and Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts” per the newly released “Safety Patient Alert.” Services to include:

- 4 hour or next day response time.

- Hours are from 8:30AM to 5:00PM Monday through Friday with all Federal Holidays observed.

- Travel to and from facility included.

- All parts, labor, repair and reports are included in price.

- Yearly safety inspection.

- Annual weight load testing for all lift systems.

- Call service provided for technical information.

- Lift systems may be added or taken off at the VA’s discretion.

Contract Period: Option 2 POP Begin: 04-01-2022 POP End: 03-31-2023

Annual Preventive Maintenance for Horcher Patient Ceiling Lifts installed at the Des Moines IA VA Health Care System (VAHCS).

Annually, the lifts are inspected and repaired per Horcher guidelines and following the new “Corrective and Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts” per the newly released “Safety Patient Alert.” Services to include:

- 4 hour or next day response time.

- Hours are from 8:30AM to 5:00PM Monday through Friday with all Federal Holidays observed.

- Travel to and from facility included.

- All parts, labor, repair and reports are included in price.

- Yearly safety inspection.

- Annual weight load testing for all lift systems.

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVICE

S

QUANTIT

Y UNIT UNIT PRICE AMOUNT

- Call service provided for technical information.

- Lift systems may be added or taken off at the VA’s discretion.

Contract Period: Option 3 POP Begin: 04-01-2023 POP End: 03-31-2024

Annual Preventive Maintenance for Horcher Patient Ceiling Lifts installed at the Des Moines IA VA Health Care System (VAHCS).

Annually, the lifts are inspected and repaired per Horcher guidelines and following the new “Corrective and Preventive Maintenance Checklist for Ceiling Mounted Patient Lifts” per the newly released “Safety Patient Alert.” Services to include:

- 4 hour or next day response time.

- Hours are from 8:30AM to 5:00PM Monday through Friday with all Federal Holidays observed.

- Travel to and from facility included.

- All parts, labor, repair and reports are included in price.

- Yearly safety inspection.

- Annual weight load testing for all lift systems.

- Call service provided for technical information.

- Lift systems may be added or taken off at the VA’s discretion.

Contract Period: Option 4 POP Begin: 04-01-2024 POP End: 03-31-2025

GRAND

TOTAL

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

ITEMS (OCT 2018)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The

Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered;

and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims

Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the

Governmentwide commercial purchase card), the Contractor may not assign its rights to…