36C26321Q0508 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 NUMBERE

D 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 amendmen t, 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) Department of Veterans Affairs

NETWORK 23

CONTRACTING OFFICE

Contract Officer 4801 Veterans Drive St. Cloud MN 56303

To all Offerors/Bidders

36C26321Q0508 04-26-2021

X X X

See CONTINUATION Page 360/10160-8424-820100-2632-618 010020199 The purpose of this amendment is to make a change to the Statement of Work.

1. Salient Characteristic #6 is updated to increase the maximum number of gloves per box to 200.

See updated Statement of Work Below.

2. The closing date of the solicitation remains unchanged with quotes due Thrusday April 29th at 2pm ce ntral.

3. All other terms and conditions remain the same.

Eric Zintek Contracting Officer

B.2 STATEMENT OF WORK

Nitrile Examination Gloves VISN 23 requests 5 million Nitrile Examination Gloves rated for Chemotherapy drug use as per specifications listed below. This is not a request for manufacturing but a request for quantity on hand to be delivered within 30 calendar Days from order.

Quotes submitted with Free On Board (FOB) Origin terms, or that require any type of advanced contract financing or advanced payment shall render a quote not technically capable and not eligible for award. Similarly, a quote that offers an item(s) that cannot be returned to the vendor or that requires a restocking fee for returned items shall be determined as not technically capable and therefore not eligible for award. The Government has the right to refuse acceptance of nonconforming items.

The awarded vendor will have 30 calendar days to deliver the awarded quantities, or the contract will be terminated for cause and negative performance will be reflected within the Contractor Performance Assessment Reporting System (CPARS) and the Federal Awardee Performance and Integrity Information System (FAPIIS).

If the potential Authorized Supplier is not the OEM, the Authorized Supplier must provide an Authorized Distributor Letter from the OEM that is still in effect. The Authorized Distributor Letter from the OEM shall include for each product(s) proposed authorizing the quoter as a distributor for the proposed product(s). The letter must either state specific product(s) proposed or that the quoter is an authorized distributor for all the manufacturer’s products. This letter must be on the manufacturer’s letterhead and contain the signature of an authorized official for the manufacturer. The Authorized Supplier shall maintain its Authorized Distributor status of all manufacturers and distributors of supplies throughout the life of this agreement. Failure to do so will render the quote submitted as non-responsive and not eligible for award.

The section titled, “D.1 PPE Source Questionnaire Nitrile Exam Gloves” must be completed and submitted with the offer.

BRAND NAME OR EQUAL SALIENT CHARACTERISTICS:

Equal must meet all of these salient characteristics. Written explanation of how Equal meets each salient characteristic must be included with quote.

Nitrile Examination Gloves rated for chemotherapy drug use shall meet or exceed the following specifications and salient characteristics: (No FDA Emergency Use Authorization (EUA) applies to the solicitation in response to COVID-19.)

Nitrile Exam Gloves rated for Chemotherapy Drug use

Brand Name or Equal To: Kimberly-Clark Purple Nitrile Exam Gloves

· KC-500 Series 9.5” gloves for Chemo use.

· Part #55081 – Small

· Part #55082 – Medium

· Part #55083 – Large

· Part #55084 – X-Large

SALIENT CHARACTERISTICS:

1. Sizes: Small, Medium, Large, X-Large

2. Must be at least 9.5” in length

3. Must be Latex Free – Required by FDA to be identified on packaging label

4. Must be Powder Free – Meets ASTM D6124 – Residual Powder Test: The amount of powder allowed on powdered gloves is 120mg. Powder free gloves may only contain a maximum of 2mg per glove.

5. Gloves must be cleared for use in Chemotherapy ATSM D 6978 Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs

6. Maximum of 200 gloves count per box. This is required to fit the VISN’s glove dispensers.

7. Glove material must be nitrile

8. Gloves are Non-sterile

9. Gloves are single use

10. Gloves must be ambidextrous

11. Gloves must be puncture resistant – Meets ASTM D412 Tensile Test: at least 14 MPa and a minimum of 500% elongation

12. Meets ASTM D6319 standard for nitrile examination gloves for medical application

13. Meets ASTM D1671 – Blood-Borne Pathogen Test for barrier to the Phi-X174 virus

14. Meets ASTM D5151 – Water Test AQL of 2.5 or lower

The link below is the Standard Guide for Assessment of Medical Gloves: ASTM D7103-19 https://www.astm.org/Standards/D7103.htm