36C26325Q0733.pdf

31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) Joshua Imdacha Contracting Officer

30c. DATE SIGNED

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

1. REQUISITION NO.

None

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME Jennifer Watkins-Schoenig

36C26325Q0733

b. TELEPHONE NO. (No Collect Calls) 319-688-3631

05/09/2025

8. OFFER DUE DATE/LOCAL

TIME 05/22/2025

4:00 PM CDT

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR X SET ASIDE: 100 % FOR:

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

1303 5th St Suite 300

HUBZONE SMALL

BUSINESS

SMALL BUSINESS PROGRAM

EDWOSB

NAICS: 811210

Coralville IA 52241 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS 8(A)

SIZE STANDARD:

$34 Million

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

N/A

14. METHOD OF SOLICITATION

X RFQ IFB RFP

15. DELIVER TO CODE

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St Suite 300 Coralville IA 52241

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE

16. ADMINISTERED BY CODE

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St, Suite 300 Coralville IA 52241

18a. PAYMENT WILL BE MADE BY CODE

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

PHONE: FAX:

TELEPHONE NO. UEI: EFT:

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 x SEE ADDENDUM

19. 20. See CONTINUATION Page 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES

NCO23 plans to award a 5-year, single award IDIQ for Audiology Equipment Calibrations, Maintenance and Support across VISN23 locations.

Comparative Evaluation, see provision FAR 52.212-2 for items required to be submitted with offers.

See the Statement of Work in Section B.2 Total Small Business set aside.

FAR 13.5 Simplified Acquisition Procedures.

See the price schedule at section B.3 and Attachment D.1.

For consideration, all questions must be received 72 hours before date stipulated in block 8 of the SF1449 form.

Email all questions and responses to:

Jennifer.watkins-schoenig@va.gov and Joshua.imdacha@va.gov

Sign SF1449 and return all pages with offer submission.

QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

To be funded by task orders

See CONTINUATION Page 26. TOTAL AWARD AMOUNT (For Govt. Use Only) x 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

X ARE ARE NOT ATTACHED.

ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

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) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV. NOV 2021)

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

X

X mailto:Jennifer.watkins-schoenig@va.gov mailto:Joshua.imdacha@va.gov

36C26325Q0733

Table of Contents

SECTION A

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

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 Statement of Work B.3 Price Schedule

SECTION C - CONTRACT CLAUSES

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

AND COMMERCIAL SERVICES (NOV 2023)

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

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.8 52.229-3 FEDERAL, STATE, AND LOCAL TAXES (FEB 2013)

C.9 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.10 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.11 VAAR 852.212-71 GRAY MARKET AND COUNTERFEIT ITEMS (FEB 2023)

C.12 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.13 VAAR 852.222-71 COMPLIANCE WITH EXECUTIVE ORDER 13899

(DEVIATION) (APR 2025)

C.14 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.15 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) 38

C.16 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025) (DEVIATION FEB 2025)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 PRICE SCHEDULE

SECTION E - SOLICITATION PROVISIONS

E.1 52.201-1 ACQUISITION 360: VOLUNTARY SURVEY (SEP 2023)

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.3 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.4 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.5 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.8 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.9 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.10 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024) (DEVIATION

FEB 2025)

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:

b. GOVERNMENT: Contracting Officer 36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St

Suite 300

Coralville IA 52241

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

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.

http://www.tungsten-network.com/

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

AMENDMENT NO DATE

http://www.tungsten-network.com/

B.2 Statement of Work

VISN 23 Audiology Equipment Calibrations, Maintenance, and Support

Background

The VA Medical Centers in the VISN 23 VA Midwest Healthcare Network are seeking calibration and inspection services for the audiology equipment used in VISN 23. The equipment that needs calibration and inspection is listed by site on Appendix A.

Description of Services

The contractor must provide all management, labor, personnel, transportation, tools, supplies, reagents, equipment, and any peripheries necessary to provide and perform calibration of the audiology equipment at the VISN 23 VA Medical Centers and all associated outpatient clinics.

The equipment that needs calibration is listed by site on Appendix A. The contractor must coordinate and schedule the calibrations with the site leads Points of Contacts. The respective VA Medical Center point of contacts will determine the schedule for calibrations and/or repairs.

Contractor must provide the following:

• Preventative Maintenance (PM) including PM required parts, system verification, alignment, adjustments, and calibrations at no additional customer cost;

• Parts & Labor necessary for PM Inspection are provided by the Contractor at no additional customer cost; and

• Equipment Verification will be provided by the Contractor at no additional customer cost.

Place of Performance

Unless otherwise noted, the Contractor shall provide service and support at the following VA VISN 23 facilities and addresses outlined in the table below:

VISN 23 VA Medical Facilities Address

568-BHH-Black Hills, Fort Meade, SD 113 Comanche Rd, Fort Meade, SD 57741

636A6-CIH-Central Iowa, Des Moines, IA 3600 30th St, Des Moines, IA 50310

437-FAR, Fargo, ND 2101 Elm Street N, Fargo, ND 58102

6368-IOW, Iowa City, IA 601 Highway 6 West, Iowa City, IA 52246

636-NWI, Nebraska Western Iowa, Omaha, NE

4101 Woolworth Ave, Omaha, NE 68105

438-SUX, Sioux Falls, SD 2501 West 22nd St, Sioux Falls, SD 57117

Calibrations

Audiometers utilized in audiological procedures must be calibrated to the American National Standards Institute Specifications for Audiometers (ANSI S3.6-2018). An electroacoustic calibration of all audiometric equipment must be performed according to manufacturer specifications. Electroacoustic calibration must include accuracy of output levels, frequency, rise/decay times, attenuator linearity, shock hazard, and other measures as required by ANSI S3.6-2018, ANSI S3.39–1987 (R 2007) et seq, or other applicable standards.

The ANSI Specifications can be located and purchased at https://webstore.ansi.org/standards/asa/asaansis32018r2023

Listed equipment other than audiometers are required to be calibrated in accordance with manufacturer specifications.

Contractor shall provide current National Association of Special Equipment Distributors (NASED) certification or equivalent program transcripts for all service technicians assigned to complete calibration services at any VA locations prior to performing work.

Records of all calibration(s) shall be provided no later than the end of business day following the day the calibration work was conducted.

The calibration report shall accompany the Contractor’s invoice. The invoice must show details as to the charges being billed.

A calibration report of equipment serviced shall contain, at a minimum, date of service, location, hours on-site, technician’s name, description of work activity, serial number and equipment serviced.

Payment will not be authorized without appropriate detail of charges and a calibration report for each clinic. Any charges or expenses beyond these identified on the contract will be rejected unless prior authorization was provided by the VA Contracting Officer. The purchase order (PO) number must be included on all invoices.

Small Repairs and Maintenance

Small repairs and maintenance may be performed if the cost of such repairs and maintenance is included in the cost of the calibration for the specified piece of equipment. Repair and maintenance work that would not be considered included in a normal calibration service and would incur charges beyond the defined contract, may not be performed without written authorization of the VA Contract Officer.

Maintenance Support, Emergencies, and Re-Calibration The contractor shall join with the VA in keeping the audiology equipment in full functioning order and in good operating condition as originally designed by the manufacturer.

It is expected there will be times when a piece of equipment needs to be repaired or parts replaced, including emergency repairs and part replacements, the costs of which are not defined or included in the contract. When such repair or part replacement is indicated, the Contractor shall provide the VA written notice of the nature of the repair in the form of an inspection summary report accompanied by a budgetary cost estimate in the format of a detailed line-item https://webstore.ansi.org/standards/asa/asaansis32018r2023 quote for such repair or part replacement. The budgetary cost estimate may include the cost of recalibration services due to repair or part replacement of a piece of equipment.

The contractor shall also provide a comparison quote to the VA for what repairs or replacement parts would have cost for commercial pricing, so the Government has a basis for making a price fair and reasonableness determination. In the alternative, the Contractor shall provide a copy of an awarded contract with a federal agency for the same or similar repairs.

Once it has been determined and agreed upon both by the VA and the Contractor that the additional repairs and/or part replacements are needed, monetary funds will need to be requested and approval to proceed will occur by means of a Government Purchase Card (GPC) Purchase Order if total repair expenses are less than the VA Medical Center’s GPC limit or through means of a contract modification if total repair expenses are greater than the GPC limit for that VA Medical Center, The contractor may be required to work outside normal operational hours to meet contract requirements. The VA Point of Contacts (POC) must approve work outside the normal operational hours prior to the work being performed.

The contractor shall maintain emergency availability. The contractor will provide primary and alternate POC information for emergency repairs, response within 24 hours after notification from the VA POC’s and provide on-site services within 96 hours.

IMPORTANT: Repair work and replacement parts that are not priced in the contract must be approved by the contracting officer before work begins. Repair work, replacement parts, and any work or service that is not priced in the contract which is performed by the Contractor without prior written approval of the contracting officer will be performed by the contractor at no additional cost to the government.

Conformance Standards:

Contractor shall provide services and material to ensure that the equipment functions in conformance with the latest requirements of the Occupation Safety and Health Administration (OSHA), American National Standards institute (ANSI), The Joint Commission (TJC), and Federal and VA security specifications and requirements as applicable.

The equipment shall be maintained such that it meets or exceeds the performance specifications as established in the OEM technical specifications. Additional performance specifications that exceed the OEM specifications shall be specified in writing by the VA.

Contractor must be certified by the National Association of Special Equipment Distributors. The National Association of Special Equipment Distributors (NASED) is a trade association made up of audiometric distributors across the nation. NASED members make a commitment to the highest standards of technical training, professionalism, test equipment and quality. NASED certified audiometric technicians must pass a rigorous test demonstrating thorough knowledge of test equipment, ANSI standards and calibration procedures. The NASED gold seal on the calibration certificate provides assurance that the work was performed by a trained and qualified technician with the appropriate, calibrated test equipment.

Hours Of Coverage Normal hours of coverage are (Monday through Friday) from 8:00am to 5:00pm CT, excluding federal holidays. Work performed outside the normal hours of coverage at the request of the COR will be billed at the government rate. A separate purchase order will be issued to cover the cost(s) associated with any call back service as described herein.

Check In/Out and Removal Media Scanning The Contractor shall coordinate Check In/Out and Removable Media Scanning with the facility POC(s). For any services performed on-site the Contractor shall, upon arrival at the facility, report to the facility POC to check in before proceeding to the any department and before performing any services. Prior to leaving the medical center, the Contractor shall check out with the facility POC. This check in and check out is mandatory as well as wearing the Contractor badge issued upon checking in.

The Contractor personnel shall follow all VA policies, standard operating procedures, applicable laws and regulations while on VA property. Violations of VA regulations and policies may result in citation and disciplinary measures for persons violating the law.

1. The Contractor personnel shall comply with VA Privacy Training- TMS 20939 No Access

2. The Contractor personnel shall wear visible identification at all times while they are on the premises. Identification shall include, as a minimum, the employee’s name, position, and the Contractor’s trade name. In addition, if required the Contractor shall submit fingerprints through the VA police for issuance of a VA identification badge that shall be worn at all times while working at a VA facility.

3. VA does not provide parking space at the work site; the Contractor must obtain parking at the work site if needed. It is the responsibility of the Contractor to park in the appropriate designated parking areas. VA will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

4. Smoking is prohibited inside/outside any building other than the designated smoking areas.

5. Possession of weapons is prohibited.

6. The Contractor shall comply with any additional safety guidelines in place at a VA facility, which may include providing their own PPE.

Upon check in with the Facility POC and before performing any services, the Contractor shall ensure that any removable media is scanned by the Biomedical Engineering Section prior to connecting to any VA facility network, device, or system. The Contractor shall provide any removable media to Biomedical Engineering staff. Biomedical Engineering staff will perform a malware/virus scan of the Contractor’s removable media. If “nothing found” is displayed, the Contractor may proceed and use the removable media. If “nothing found” is not displayed and/or the number of detections is greater than zero, the removable media shall be presumed infected with malware and shall not be allowed to be used. The media shall be returned to the Contractor for virus removal. The Government will not perform any virus or malware removal on the Contractor’s removable media. Biomedical Engineering will report any detection to the Facility Information System Security Officer (ISSO). Failure by the Contractor to check in, check out, provide removable media for scanning, or use of any infected media is a breach of security and shall be acted upon in accordance with the terms and conditions of this agreement.

Equipment Changes Equipment may be deleted from this agreement if replaced or "in excess" during the period of this contract at the discretion of the CO. New equipment may be added as needed at the discretion of the CO. Deleted equipment will be credited in the full amount if deleted before any scheduled maintenance has been performed on it. The Government reserves the right to purchase additional equipment not contained within this agreement as well as delete existing items upon the approval of the CO. The agreement shall be updated with the addition of new equipment and existing items that are taken out of service shall be deleted upon contract renewal and upon request.

Appendix A – Equipment Inventory

Omaha-Nebraska-Western Iowa VA Healthcare System

Manufacturer of Equipment

Description Model Serial Numbe r

Locatio ns

Sites

ETS-Lindgren BOOTH EXAM ACOUSTIC RE-242 AS02827 NW202-

001-GI

GRAND

ISLAND

Audioscan TESTERS: HEARING AID, VERIFIT VERIFIT 4646 NW202-

001-GI

GRAND

ISLAND

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

294111 NW202-

001-GI

GRAND

ISLAND

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

ZODIAC

ZODIAC 299644 N203-

001-GI

GRAND

ISLAND

PATH medical GmbH

AUDITORY FUNCTION SCREENING

DEVICES, SENTIERO

SENTIERO 200720 N203-

001-GI

GRAND

ISLAND

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C4640 NW201-

001-GI

GRAND

ISLAND

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C6045 NW201-

001-GI

GRAND

ISLAND

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

3026625 N203-

001-GI

GRAND

ISLAND

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS01039

NW202-

001-GI

GRAND

ISLAND

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

ZODIAC

ZODIAC 305116 2905-L4-

LN

LINCOL

N

PATH medical GmbH

AUDITORY FUNCTION SCREENING

DEVICES, SENTIERO

SENTIERO 200721 2904-L4-

LN

LINCOL

N

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

1922302 2907-L4-

LN

LINCOL

N

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

1922307 2905-L4-

LN

LINCOL

N

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

1922312 2904-L4-

LN

LINCOL

N

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, GSI 39

GSI 39 GS00924

2905-L4-

LN

LINCOL

N

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS00938

2907-L4-

LN

LINCOL

N

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS00929

2904-L4-

LN

LINCOL

N

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS00934

2906-L4-

LN

LINCOL

N

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

452638 2906-L4-

LN

LINCOL

N

IAC America Inc BOOTH AUDIOMETRIC CAE NO

SERIAL

2904-L4-

LN

LINCOL

N

IAC America Inc BOOTH AUDIOMETRIC CAE NO

SERIAL

2905-L4-

LN

LINCOL

N

IAC America Inc BOOTH AUDIOMETRIC CAE NO

SERIAL

2906-L4-

LN

LINCOL

N

IAC America Inc BOOTH AUDIOMETRIC CAE NO

SERIAL

2907-L4-

LN

LINCOL

N

IAC America Inc BOOTH AUDIOMETRIC IAC401A 176025 1132-1 OMAHA

Micro-Tech Hearing Instruments

AUDIOMETERS, WR-C WR-C AS11090

1129-1 OMAHA

ETS-Lindgren DOUBLE WALL EXAM BOOTH RE-242 NONE 1115B-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT VERIFIT 3407 1134-1 OMAHA

Eckel Industries Inc

BOOTH, AUDIOMETRIC CL-15LP 111197 1134-1 OMAHA

IAC America Inc IAC SOUND SUITE 1205ACT 105026 1141-1 OMAHA

IAC America Inc BOOTH, AUDIOMETRIC 1205ACT 10836 1140-1 OMAHA

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 AUDIOMETERS,

MADSEN

ASTERA2

289629 1142-1 OMAHA

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

294118 1132-1 OMAHA

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

294113 1143-1 OMAHA

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

294116 1115B-1 OMAHA

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

ZODIAC

ZODIAC 299643 1142-1 OMAHA

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

ZODIAC

ZODIAC 299636 1132-1 OMAHA

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

ZODIAC

ZODIAC 299641 1138-1 OMAHA

PATH medical GmbH

AUDITORY FUNCTION SCREENING

DEVICES, SENTIERO

SENTIERO 200722 1142-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT VERIFIT C4502 1101-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT VERIFIT C4503 1113-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT VERIFIT C4504 1137-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT VERIFIT C4505 1115-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C4641 1051-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C4968 1115B-1 OMAHA

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS01009

1143-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C6014 1200-1-

OM

OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C6028 1141-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C6044 1132-1 OMAHA

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C6047 1129-1 OMAHA

Audioscan SKULL SIMULATOR VA-300 S1386 1129-1 OMAHA

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

3026623 1134-1 OMAHA

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS01039

1115B-1 OMAHA

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS011212

1142-1 OMAHA

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS011143

B556-1 OMAHA

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS01113

B556-1 OMAHA

GN Otometrics North America

BOOTH, AUDIOMETRIC GA-12-A-MOD GAA1527

113-

NORFOL

K1-LN

NORFO

LK

GN Otometrics North America

AUDIO SOUND BOOTH GA-12-A-MOD GAA1527

113-

NORFOL

K1-LN

NORFO

LK

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

411584 113-

NORFOL

K1-LN

NORFO

LK

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

OTOFLEX 100

OTOFLEX 100 412334 113-

NORFOL

K1-LN

NORFO

LK

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

ZODIAC

ZODIAC 3023276 113-

NORFOL

K1-LN

NORFO

LK

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

3086189 1210-

636GM

SARPY

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

3086190 1214A-

636GM

SARPY

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO GS01155

1516-

636GM

SARPY

Eckel Industries Inc

AUDIO SOUND BOOTH CL-123 PRIME

MOD

2024028 2-1

1213-

636GM

SARPY

Eckel Industries Inc

AUDIO SOUND BOOTH CL-123 PRIME

MOD

2024028 2-2

1306-

636GM

SARPY

Natus Medical Inc RECORDERS: PHYSIO: EVOKED

POTENTIAL: AUDITORY, ICS CHARTR

EP 200

ICS CHARTR EP

25077136 1208-

636GM

SARPY

Grason-Stadler AUDIOMETERS, AUDIOSTAR PRO AUDIOSTAR PRO GS00947

1210-

636GM

SARPY

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C6035 1210-

636GM

SARPY

Audioscan TESTERS: HEARING AID, VERIFIT 2 VERIFIT 2 C6046 1207-

636GM

SARPY

Grason-Stadler ANALYZERS: PHYSIO: MIDDLE EAR, TYMPSTAR PRO

TYMPSTAR PRO GS011144

1214A-

636GM

SARPY

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

MADSEN ZODIAC

MADSEN ZODIAC 1908691 318-000-

GI

NORTH

PLATTE

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

411610 318-000-

GI

NORTH

PLATTE

GN Otometrics North America

TESTERS: HEARING AID, AURICAL

FREEFIT

MADSEN

FREEFIT

418185 318-000-

GI

NORTH

PLATTE

Grason-Stadler AUDIOMETERS, AUDIOSTAR PRO AUDIOSTAR PRO GS00963

TBD NORTH

PLATTE

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

2024314 128-L5-

OM

SHENA

NDOAH

Eckel Industries Inc

BOOTH AUDIOMETRIC C-15-LP MOD 2021006

128-L5-

OM

SHENA

NDOAH

GN Otometrics North America

AUDIOMETERS, MADSEN ASTERA2 MADSEN

ASTERA2

411608 145-

HOLDRE

GE

HOLDR

EGE

GN Otometrics North America

ANALYZERS: PHYSIO: MIDDLE EAR,

MADSEN ZODIAC

MADSEN ZODIAC 1834032 318-000-

GI

HOLDR

EGE

GN Otometrics North America

TESTERS: HEARING AID, AURICAL

FREEFIT

MADSEN

FREEFIT

429951 145-

HOLDRE

GE

HOLDR

EGE

Grason-Stadler AUDIOMETERS, AUDIOSTAR PRO AUDIOSTAR PRO GS00963

TBD HOLDR

EGE

Iowa City VA Healthcare System Equipment Type MODEL# Serial Locations Site AUDIOMETRIC BOOTHS Acoustic Rm 23294A 1 East29 Iowa City AUDIOMETERS ASTERA2 399764 1East29 Iowa City FREE FIT HARNESS 1053 411143 1East29 Iowa City PMM/SPEAKER MODULE 1081 407871 1East29 Iowa City ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 3029879 1East29 Iowa City AUDIOMETRIC BOOTHS (Sound suite) RSL None 1 East32 Iowa City AUDIOMETERS ASTERA2 399763 1East32 Iowa City ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 3029887 1 East32 Iowa City

AUDIOMETRIC BOOTHS (sound Suite) RSL None 1East33 Iowa City AUDIOMETERS ASTERA2 399762 1East33 Iowa City ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 3029885 1East33 Iowa City SLM/Calibrator CA250/800B 0316/0486B0412 1 East33 Iowa City Radio Shack #1 None 332080 1 East33 Iowa City

AUDITORY FUNCTION SCREENING

DEVICES CAPELLA 2 149611 1 East 34 Iowa City

TESTERS: HEARING AID AURICAL HIT 1902052 1East35A Iowa City AUDIOMETERS ASTERA2 192342 1East35A Iowa City AUDIOMETERS ASTERA2 192347 1East35A Iowa City ANALYZERS: PHYSIC: MIDDLE EAR OTOFLEX 100 190629 1East35A Iowa City

AUDITORY FUNCTION SCREENING

DEVICES SENTIERO 200784 1East35A Iowa City

ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 407757 1East35-A Iowa City ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 4MS86 1East35-A Iowa City ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 407754 1East35-A Iowa City ANALYZERS; PHYSIO: MIDDLE EAR OTOFLEX 100 407933 1East35-A Iowa City ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 367477 1East35-A Iowa City AUDIOMETRIC BOOTHS (Sound suite) RS143 None 1East36 Iowa City AUDIOMETERS ASTERA2 399753 1East36 Iowa City

ANALYZERS: PHYSIO: MIDDLE EAR Zodiac 3029880 1East36 Iowa City AUDIOMETRIC BOOTHS (sound suite) 000B None 1East37 Iowa City AUDIOMETERS ASTERA 398933 1East37 Iowa City PMM/SPEAKER MODULE 1081 180201 1East37 Iowa City FREE FIT HARNESS 1053 1802106 1East37 Iowa City ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 3070860 1East37 Iowa City TESTERS: HEARING AID VERIFIT 5089 1East31 Iowa City PMM/SPEAKER MODULE 1081 415102 1East31 Iowa City

PMM/SPEAKER MODULE Auricle Aud 411133/401458 1East47-Fitting rooms Iowa City

VIDEONYSTAGMOGRAPHS ICS CHARTR

200 397549 1East47-Fitting rooms Iowa City

FREE FIT HARNESS 1053 411133 1East47-Fitting rooms Iowa City

AUDIOMETERS MA 41 71535 1 East37 Iowa City Radio Shack #2 None None Speech 1E43 Iowa City Sound Meter 0B-145 DL6060004 Speech 1E43 Iowa City AUDIOMETRIC BOOTHS 140ACT Series 15035 ICFB-lC-120 IC Federal

Building AUDIOMETERS ASTERA2 1745017 ICFB-lC-120 IC Federal

Building ANALYZERS: PHYSIO: MIDDIE EAR ZODIAC 1749000 ICFB-lC-120 IC Federal

Building FREE FIT HARNESS 1053 410742 Dubuque Dubuque PMM/SPEAKER MODULE unknown unknown Dubuque Dubuque FREE FIT HARNESS 401456 Ottumwa Ottumwa PMM/SPEAKER MODULE 1081 407872 Ottumwa Ottumwa

FREE FIT HARNESS 1053 410737 Galesburg Galesburg

PMM/SPEAKER MODULE 1081 401459 Galesburg Galesburg

AUDIOMETERS ASTERA2 3091745 Galesburg Galesburg

PMM/SPEAKER MODULE AURICAL 3089724 Galesburg Galesburg

ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 3091036 Galesburg Galesburg AUDIOMETRIC BOOTHS Acoustic Rm D-01-4222-

QCCBOC

Davenport Davenport

AUDIOMETERS ASTERA2 1831977 Davenport Davenport ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 1923741 Davenport Davenport ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 407956 Davenport Davenport

AUDITORY FUNCTION SCREENING

DEVICES CAPELLA 2 2830 Davenport Davenport

TESTERS: HEARING AID AURICAL HIT 2002593 Davenport Davenport FREE FIT HARNESS 1053 1828960 Davenport Davenport FREE Fir HARNESS 1053 2008285 Davenport Davenport PMM/SPEAKER MODULE 1081 1827933 Davenport Davenport AU DIOMETRIC B00THS GAA-15249 Decorah Decorah AUDIOMETERS ASTERA2 368198 Decorah Decorah ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 367476 Decorah Decorah FREE FIT HARNESS 1053 410473 Decorah Decorah PMM/SPEAKER MODULE 1081 401461 Decorah Decorah

Astera2 Clinical Audiometer ASTERA2 3089726 Decorah Decorah

PMM/SPEAKER MODULE AURICAL 3089726 Decorah Decorah ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 3091037 Decorah Decorah AUDIOMETERS ASTERA2 418717 Waterloo Waterloo ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 357477 Waterloo Waterloo TESTERS: HEARING AID AURICAL HIT 441469 Waterloo Waterloo FREE FIT HARNESS 1053 422669 Waterloo Waterloo PMM/SPEAXER MODULE 1081 3418717 Waterloo Waterloo AUDIOMETERS ASTERA2 418717 Waterloo Waterloo AUDIOMETRIC BOOTHS (Sound Suite) None Quincy Quincy

ANALYZERS PHYSIO: MIDDLE EAR ZODIAC 1907216 Quincy Quincy AUDIOMETERS Astera2 1919294 Quincy Quincy FREE FIT HARNESS 1053 411127 Quincy Quincy PMM/SPEAKER MODULE 1081 40157 Quincy Quincy PMM/SPEAKER MODULE 1081 408402 Sterling Sterling ANALYZERS: PHYSIC; MIDDLE EAR OTOFLEX 100 422669 Cedar Rapids Cedar Rapids AUDIOMETERS ASTERA 432316 Cedar Rapids Cedar Rapids

PMM/SPEAKER MODULE 1081 411127 Cedar Rapids Cedar Rapids AUDIOMETRIC BOOTHS Acoustic Rm AC7266 Mobile Audiology

Van Coralville

AUDIOMETERS ASTERA2 432316 Mobile Audiology Van Coralville

ANALYZERS: PHYSIO: MIDDLE EAR OTOFLEX 100 441440 Mobile Audiology Van Coralville

FREE FIT HARNESS 1053 unknown Mobile Audiology Van Coralville

PMM/SPEAKER MODULE 1081 452517/457594 Mobile Audiology Van Coralville

ANALYZERS: PHYSIO: MIDDLE EAR ZODIAC 3004784

Mobile Audiology Van Coralville

Fargo VA Healthcare System

Manufacturer of Equipment

Description

Model

Serial Number

Location s

Sites

GN Otometrics North America

Otoflex Calibration OTOFLEX 100 367347

FAR -

4C32 Fargo

GN Otometrics North America

Otoflex Calibration

OTOFLEX 100

383593

FAR -

4C31

Fargo

America

369171

4C33

Audioscan

Verifit Calibration

Verifit 2

C7614

4C29

C7616

4C34

America

Astera Calibration

MADSEN

ASTERA2

388544/392

4C32

America

Astera Calibration

MADSEN

ASTERA2

388539/392

America

Astera Calibration

MADSEN

ASTERA2

388543/392

VerifitCalibration

C7615

4C26

ETS-Lindgren

SDRM

Certification

Sound Room

AC0607602

AC0607601

AC0607603

Natus Medical Inc

AuDX Pro Calibration

AUDX PRO

PLUS

12B18400

4C23

Interacoustics

AA222

AA222

663565

C4610

4C28

C4611

4C25

America

Astera Calibration

MADSEN

ASTERA2

351401

April

Bismar ck

GN Otometrics North America

353218 ck

IAC America Inc

140014

C7613

Black Hills VA Healthcare System

Number

Locatio ns

Delta Systems BOOTH ECKEL CL-14 LP CL-14 LP 202302 Fort Fort

Inc PRIME SOUNDPROOF ROOM Prime 58 Meade, SD

Meade

Interacoustics

USA

AUDITORY FUNCTION

SCREENING DEVICES, TITAN

TITAN

093693

Rapid City

CBOC

GN Otometrics North America

AUDIOMETERS, MADSEN

ASTERA2

MADSEN

ASTERA2

304713

Fort Meade

ZODIAC TYPANOMETER

ZODIAC

303557

Fort Meade

Natus Medical Inc

CAPELLA DPOAE

Fort Meade

C5397

Meade

Eckel Industries Inc

BOOTH, AUDIOMETRIC

EXAMINATION

CL-123 LP2

202405

Hot Springs, SD

Hot Springs

303558

Hot Springs

GN Otometrics North America

AUDIOMETERS, MADSEN

ASTERA2

MADSEN

ASTERA2

305803

Hot Springs

Hot Springs

C5398

Hot Springs

Grason-Stadler

AUDIOMETER CLINICAL

GRASON-STADLER

AUDIOSTAR

PRO

GS0084

Hot Springs

BOOTH AUDIOMETRIC EXAM

S-224

PRIME LP2

MOD

202203

21-1 Rapid City

Rapid City

Interacoustics

USA

AUDITORY FUNCTION

SCREENING DEVICES, TITAN

TITAN

093615

Rapid City

GN Otometrics North America

AUDIOMETERS, MADSEN

ASTERA2

MADSEN

ASTERA2

304712

Rapid City

303558

Rapid City

C5399

City

Audioscan Verifit Calibration Verifit 2 C6524 Rapid

City

City

GN Otometrics North America

AUDIOMETERS, MADSEN

ASTERA2

MADSEN

ASTERA2

305721

Central Iowa VA Healthcare System

Numbe r Locatio ns

Inc AURICAL HEARING TESTER

AURICAL

FREEFIT 200709

1600- 07M-D

Central Iowa

Actually Capella

1620- 07M-D

Central Iowa

AURICAL HEARING TESTER

AURICAL

FREEFIT

253333

1620- 07M-D

Central Iowa

ASTERA AUDIOMETER

Madsen Astera2

252596

1640- 07M-D

Central Iowa

AUDIO SOUND BOOTH

C26MR

107212

1640- 07M-D

Central Iowa

Natus Medical Inc

1096 ZODIAC SE CLINICAL

W/O Printer W/ CLASSIC Probe

8-04-16049

307022

1640- 07M-D

Central Iowa

252592

1660- 07M-D

Central Iowa

Eckel Industries Inc AUDIO SOUND BOOTH C26MR 107211

166A- 07M-D

Central Iowa

Natus Medical Inc CAPELLA DPOAE

VERIFIT-

Actually Capella 2318

166A- 07M-D

Central Iowa

Natus Medical Inc

166A- 07M-D

Central Iowa

200753

1670- 07M-D

Central Iowa

202742

1680- 07M-D

Central Iowa

AUDIO SOUND BOOTH

C26MR

107210

1680- 07M-D

Central Iowa

Natus Medical Inc

168A- 07M-D

Central Iowa

256228

1690- 07M-D

Central Iowa

200708

1700- 07M-D

Central Iowa

301717

07M-D

Iowa

Natus Medical Inc

301009

Iowa

FREEFIT

301491

Iowa

96875

Carroll

AURICAL FREEFIT COLLAR

200756

FREEFIT

302057

191271

96879

Dodge

Fort Dodge

AURICAL AUD

AURICAL AUD

018871

Dodge

Fort Dodge

AURICAL FREEFIT

256633

Dodge

Fort Dodge

191270

Fort Dodge

Fort Dodge

96882

Knoxvill e e

256232 e

Knoxvill e

191270

Knoxvill e

Knoxvill e

Aurical Hearing Tester/Free Fit

Aurical Hearing Tester/Free Fit

053417

L7-D e

037757

Marshall town

Marshall town

96885

Marshall town

Marshall town

GN Otometrics North America ZODIAC TYPANOMETER ZODIAC

191111

Marshall town

Marshall town

Natus Medical Inc AURICAL HEARING TESTER

AURICAL

FREEFIT 256231 L8-D

Marshall town

96873

Mason City

Mason City

015104

City

Mason City

200755

City

Mason City

190857

Mason City

Grason-Stadler

GSI AudioStarPro

AudioStarPro

GS009

Southsi de Clinic

Southsi de Clinic

Sioux Falls VA Healthcare System

Description Model Serial number location Sites

AUDIOMETER ABERDEEN AUDIOSTAR

PRO

GS00871

001-CBOC-

ABER

Aberde en

FITTING SYSTEM, BINAURAL, HEARING AID VERIFIT 2 C2408 001-CBOC-

ABER

Aberde en

MADSEN ZODIAC TYMPANOMETER ZODIAC 1804012 001-CBOC-

ABER

Aberde en

AUDIOMETER AUDIOSTAR

PRO

GS00960

001-CBOC-

SC

Sioux City

ANALYZER, MIDDLE EAR GSI 39 GS00959

001-CBOC-

SC

Sioux City

AUDIOMETER, CLINICAL, MADSEN ASTERA MADSEN

ASTERA2 1834038 001-CBOC-

SC

Sioux City

AUDIOMETRIC BOOTH, ACOUSTIC SYSEMS RE-243 HC-

55864

001-CBOC-

SC

Sioux City

ANALYZER, HEARING AID VERIFIT 2 C6568 001-CBOC-

SC

Sioux City

FITTING SYSTEM, BINAURAL, HEARING AID VERIFIT 2 C2411 001-CBOC-

SC

Sioux City

MADSEN ZODIAC TYMPANOMETER ZODIAC 1822369 001-CBOC-

SC

Sioux

GSI 39 AUTO TYMP V2 8514901 GS01148

56 439-5 Sioux

Falls

GSI PELLO AUDIOMETER 85404253 GS01151

40 439-5 Sioux

Falls

AUDIOMETER, CLINICAL, ACP ASTERA 2 ACP

ASTERA2 3097266 411-5 Sioux

Falls

AUDIOMETER, CLINICAL, ACP ASTERA 2 ACP

ASTERA2 3099821 411-5 Sioux

Falls

AUDIOMETER AUDIOSTAR

PRO

GS00964

74 2050-5 Sioux

Falls

AUDIOMETER CAPELLA 2 1497 407-5 Sioux Falls

ANALYZER, MIDDLE EAR GSI 39 GS01056

26 2050-5 Sioux

Falls

AUDIOMETER, GRASON STADLER GSI 39 GS00959

86 484-5 Sioux

Falls

GSI CORTI DPOAE DIAAGNOSTIC UNIT GSI CORTI

8103744

GI100989

7 439-5 Sioux

Falls

AUDIOMETER MADSEN

ASTERA2 3026868 407-5 Sioux

Falls

AUDIOMETER CONTROL PANEL MADSEN

ASTERA2 3008481 407-5 Sioux

Falls

AUDIOMETER MADSEN

ASTERA2 1498 411-5 Sioux

Falls

AUDIOMETER CONTROL PANEL MADSEN

ASTERA2 2033968 411-5 Sioux

Falls

AUDIOMETER MADSEN

ASTERA2 3006755 411-5 Sioux

Falls

AUDIOMETER, CLINICAL, MADSEN ASTERA 2 MADSEN

ASTERA2 3091605 411-5 Sioux

Falls

AUDIOMETER CONTROL PANEL MADSEN

ASTERA2 2033967 439-5 Sioux

Falls

AUDIOMETER MADSEN

ASTERA2 3006902 439-5 Sioux

Falls

TYMPANOMETRY PROBE STAND ALONE MADSEN

ZODIAC 263665 407-5 Sioux

Falls

AUDIOMETRIC BOOTH, ACOUSTIC SYSEMS RE-243 AS05197

01 407-5 Sioux

Falls

AUDIOMETRIC BOOTH, ACOUSTIC SYSTEM RS-253 AS05197 411-5 Sioux Falls

AUDIOMETRIC BOOTH, ACOUSTIC SYSTEM RS-25-S AS05197

02 439-5 Sioux

Falls

HEARING MEASURING DEVICE, HEARING,

MIDDLE EAR, HANDHELD TITAN V4 1050104 411-5 Sioux Falls

ANALYZER, HEARING AID VERIFIT 2 C6566 407-5 Sioux Falls

ANALYZER, HEARING AID VERIFIT 2 C6662 411-5 Sioux Falls

FITTING SYSTEM, BINAURAL, HEARING AID VERIFIT 2 C4130 437-5 Sioux Falls

ANALYZER, HEARING AID VERIFIT 2 C6567 439-5 Sioux Falls

MADSEN ZODIAC TYMPANOMETER ZODIAC 1804015 439-5 Sioux Falls

AUDIOMETER AUDIOSTAR

PRO

GS00963

001-CBOC-

SPLK

Spirit Lake

ANALYZER, MIDDLE EAR GSI 39 GS00969

001-CBOC-

SPLK

Spirit Lake

AUDIOMETER SYSTEM MADSEN

ASTERA2 466797 001-CBOC-

SPLK

Spirit Lake

TESTER HEARING AID - 124 VERIFIT 2 C4639 001-CBOC-

SPLK

Spirit Lake

AUDIOMETER AUDIOSTAR

PRO

GS00958

001-CBOC-

WAT

Watert own

AUDIOMETER, W/KEYBOARD MADSEN

ASTERA2 341363 001-CBOC-

WAT

Watert own

OTOMETER, MIDDLE EAR ANALYZER OTOFLEX

100 344740 001-CBOC-

WAT

Watert own

AUDIOMETRIC BOOTH, ACOUSITIC SYSTEM RS-25-S AS05196 001-CBOC-

WAT

Watert own

FITTING SYSTEM, BINAURAL, HEARING AID VERIFIT 2 C2412 001-CBOC-

WAT

Watert own

MADSEN ZODIAC TYMPANOMETER ZODIAC 1804010 001-CBOC-

WAT

Watert own

VA INFORMATION AND INFORMATION SYSTEM SECURITY AND PRIVACY LANGUAGE

NOTE: Any sections (1-14) which DO NOT apply should not be included in the Statement of Work (SOW), Performance Work Statement (PWS), Product Description (PD) or contract.

1. GENERAL. This entire section applies to all acquisitions requiring any Information Security and Privacy language. Contractors, contractor personnel, subcontractors and subcontractor personnel will be subject to the same federal laws, regulations, standards, VA directives and handbooks, as VA personnel regarding information and information system security and privacy.

2. VA INFORMATION CUSTODIAL LANGUAGE. This entire section applies to all acquisitions requiring any Information Security and Privacy language.

a. The Government shall receive unlimited rights to data/intellectual property first produced and delivered in the performance of this contract or order (hereinafter “contract”) unless expressly stated otherwise in this contract.

This includes all rights to source code and all documentation created in support thereof. The primary clause used to define Government and Contractor data rights is FAR 52.227-14 Rights in Data – General. The primary clause used to define computer software license (not data/intellectual property first produced under this contractor or order) is FAR 52.227-19, Commercial Computer Software License.

b. Information made available to the contractor by VA for the performance or administration of this contract will be used only for the purposes specified in the service agreement, SOW, PWS, PD, and/or contract. The contractor shall not use VA information in any other manner without prior written approval from a VA Contracting Officer (CO). The primary clause used to define Government and Contractor data rights is FAR 52.227-14 Rights in Data – General.

c. VA information will not be co-mingled with any other data on the contractor’s information systems or media storage systems. The contractor shall ensure compliance with Federal and VA requirements related to data protection, data encryption, physical data segregation, logical data segregation, classification requirements and media sanitization.

d. VA reserves the right to conduct scheduled or unscheduled audits, assessments, or investigations of contractor Information Technology (IT) resources to ensure information security is compliant with Federal and VA requirements. The contractor shall provide all necessary access to records (including electronic and documentary materials related to the contracts and subcontracts) and support (including access to contractor and subcontractor staff associated with the contract) to VA, VA's Office Inspector General (OIG), and/or Government Accountability Office (GAO) staff during periodic control assessments, audits, or investigations.

e. The contractor may only use VA information within the terms of the contract and applicable Federal law, regulations, and VA policies. If new Federal information security laws, regulations or VA policies become applicable after execution of the contract, the parties agree to negotiate contract modification and adjustment necessary to implement the new laws, regulations, and/or policies.

f. The contractor shall not make copies of VA information except as specifically authorized and necessary to perform the terms of the contract.

If copies are made for restoration purposes, after the restoration is complete, the copies shall be destroyed in accordance with VA Directive 6500, VA Cybersecurity Program and VA Information Security Knowledge Service.

g. If a Veterans Health Administration (VHA) contract is terminated for default or cause with a business associate, the related local Business Associate Agreement (BAA) shall also be terminated and actions taken in accordance with VHA Directive 1605.05, Business Associate Agreements.

If there is an executed national BAA associated with the contract, VA will determine what actions are appropriate and notify the contactor.

h. The contractor shall store and transmit VA sensitive information in an encrypted form, using VA-approved encryption tools which are, at a minimum, Federal Information Processing Standards (FIPS) 140-2, Security Requirements for Cryptographic Modules (or its successor) validated and in conformance with VA Information Security Knowledge Service requirements.

The contractor shall transmit VA sensitive information using VA approved Transport Layer Security (TLS) configured with FIPS based cipher suites in conformance with National Institute of Standards and Technology (NIST) 800-52, Guidelines for the Selection, Configuration and Use of Transport Layer Security (TLS) Implementations.

i. The contractor’s firewall and web services security controls, as applicable, shall meet or exceed VA’s minimum requirements.

j. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor may use and disclose VA information only in two situations: (i) in response to a qualifying order of a court of competent jurisdiction after notification to VA CO (ii) with written approval from the VA CO. The contractor shall refer all requests for, demands for production of or inquiries about, VA information and information systems to the VA CO for response.

k. Notwithstanding the provision above, the contractor shall not release VA records protected by Title 38 U.S.C. § 5705, Confidentiality of medical quality- assurance records and/or Title 38 U.S.C. § 7332, Confidentiality of certain medical records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse or infection with Human Immunodeficiency Virus (HIV). If the contractor is in receipt of a court order or other requests for the above- mentioned information, the contractor shall immediately refer such court order or other requests to the VA CO for response.

l. Information made available to the contractor by VA for the performance or administration of this contract or information developed by the contractor in performance or administration of the contract will be protected and secured in accordance with VA Directive 6500 and Identity and Access Management (IAM) Security processes specified in the VA Information Security Knowledge Service.

m. Any data destruction done on behalf of VA by a contractor shall be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management, VA Handbook 6300.1, Records Management Procedures, and applicable VA Records Control Schedules.

n. The contractor shall provide its plan for destruction of all VA data in its possession according to VA Directive 6500 and NIST 800-88, Guidelines for Media Sanitization prior to termination or completion of this contract. If directed by the COR/CO, the contractor shall return all Federal Records to VA for disposition.

o. Any media, such as paper, magnetic tape, magnetic disks, solid state devices or optical discs that is used to store, process, or access VA information that cannot be destroyed shall be returned to VA.The contractor shall hold the appropriate material until otherwise directed by the Contracting

Officer’s Representative (COR) or CO. Items shall be returned securely via VA-approved methods. VA sensitive information must be transmitted utilizing VA-approved encryption tools which are validated under FIPS 140-2 (or its successor) and NIST 800-52. If mailed, the contractor shall send via a trackable method (USPS, UPS, FedEx, etc.) and immediately provide the COR/CO with the tracking information. Self-certification by the contractor that the data destruction requirements above have been met shall be sent to the COR/CO within 30 business days of termination of the contract.

p. All electronic storage media (hard drives, optical disks, CDs, back-up tapes, etc.) used to store, process or access VA information will not be returned to the contractor at the end of lease, loan, or trade-in. Exceptions to this paragraph will only be granted with the written approval of the VA CO.

3. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS. Not

Required

4. TRAINING. Not Required

5. SECURITY INCIDENT INVESTIGATION. Not Required

6. INFORMATION SYSTEM DESIGN AND DEVELOPMENT. Not

Required

7. INFORMATION SYSTEM HOSTING, OPERATION,

MAINTENANCE OR USE. Not Required

8. SECURITY AND PRIVACY CONTROLS COMPLIANCE TESTING,

ASSESSMENT AND AUDITING. Not required

9. PRODUCT INTEGRITY, AUTHENTICITY, PROVENANCE, ANTI-

COUNTERFEIT AND ANTI-TAMPERING.

This entire section applies when the acquisition involves any product (application, hardware, or software) or when section 6 or 7 is included.

a. The contractor shall comply with Code of Federal Regulations (CFR) Title 15 Part 7, “Securing the Information and Communications Technology and Services (ICTS) Supply Chain”, which prohibits ICTS Transactions from foreign adversaries. ICTS Transactions are defined as any acquisition, importation, transfer, installation, dealing in or use of any information and communications technology or service, including ongoing activities, such as managed services, data transmission, software updates, repairs or the platforming or data hosting of applications for consumer download.

b. When contracting terms require the contractor to procure equipment, the contractor shall purchase or acquire the equipment from an Original Equipment Manufacturer (OEM) or an authorized reseller of the OEM. The contractor shall attest that equipment procured from an OEM or authorized reseller or distributor are authentic. If procurement is unavailable from an OEM or authorized reseller, the contractor shall submit in writing, details of the circumstances prohibiting this from happening and procure a product waiver from the VA COR/CO.

c. All contractors shall establish, implement, and provide documentation for risk management practices for supply chain delivery of hardware, software (to include patches) and firmware provided under this agreement.

Documentation will include chain of custody practices, inventory management program, information protection practices, integrity management program for sub-supplier provided components, and replacement parts requests. The contractor shall make spare parts available.

All contractor(s) shall specify how digital delivery for procured products, including patches, will be validated and monitored to ensure consistent delivery. The contractor shall apply encryption technology to protect procured products throughout the delivery process.

d. If a contractor provides software or patches to VA, the contractor shall publish or provide a hash conforming to the FIPS Security Requirements for Cryptographic Modules (FIPS 140-2 or successor).

e. The contractor shall provide a software bill of materials (SBOM) for procured (to include licensed products) and consist of a list of components and associated metadata which make up the product. SBOMs must be generated in one of the data formats defined in the National Telecommunications and Information Administration (NTIA) report “The Minimum Elements for a Software Bill of Materials (SBOM).”

f. Contractors shall use or arrange for the use of trusted channels to ship procured products, such as U.S. registered mail and/or tamper-evident packaging for physical deliveries.

g. Throughout the delivery process, the contractor shall demonstrate a capability for detecting unauthorized access (tampering).

h. The contractor shall demonstrate chain-of-custody documentation for procured products and require tamper-evident packaging for the delivery of this hardware.

10. VIRUSES, FIRMWARE AND MALWARE. Not Required

11. CRYPTOGRAPHIC REQUIREMENT. Not Required

12. PATCHING GOVERNANCE. Not Required

13. SPECIALIZED DEVICES/SYSTEMS (MEDICAL DEVICES, SPECIAL PURPOSE

SYSTEMS, RESEARCH SCIENTIFIC COMPUTING). Not Required

14. DATA CENTER PROVISIONS. Not required

B.3 Price Schedule The Department of Veterans Affairs has set the maximum cost…