36C26326Q0307 0002 RFQ MOD.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 7

0002 03-05-2026

568-26-1-5984-0006

36C263

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 23

1303 5TH STREET, SUITE 300

CORALVILLE IA 52241

Brian Whalen brian.whalen-crichton@va.gov

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 23

1303 5TH STREET, SUITE 300

CORALVILLE IA 52241

36C26326Q0307

02-13-2026

X

X X

** HOUR & DATE for Receipt of Offers is EXTENDED to: 03-11-2026 17:00 CDT

See CONTINUATION Page

See continuation page

Jeffrey Brown Contracting Officer

VA-VHA-RPOC-2024-0033

CONTINUATION PAGE

The purpose of this amendment is to respond to vendor questions, update the Statement of Work, add an installation line item to the Price/Cost Schedule and extend the offer deadline. Changes to the Statement of Work are highlighted.

Vendor Questions in bold/VHA Responses in red

1. The distributor would like to know if you would like the new bases on the chairs.

Yes, new bases for the chairs are required.

2. The Statement of Work references delivery coordination and site visit responsibility; however, it does not specify whether certified technician installation, assembly, or operational setup of the ESC2 chairs is required.

Please confirm whether the requirement is limited to delivery (dock or inside delivery) or if installation and functional setup by a qualified technician are required under this procurement.

Yes, this will require a qualified technician to ensure these are assembled correctly and ready for use.

These will be delivered to Bldg. 46 warehouse and will be checked in there and then moved when the certified technician arrives.

3. To ensure we are quoting the exact configuration intended, could you kindly confirm the specific Manufacturer Part Number(s) (MPN) associated with the referenced ESC2 Surgical Chair and listed accessories (power cord, O2 tank holder, and contoured head pads)?

The Manufacturer Part Numbers (MPNs) are listed on the Statement of Work.

STATEMENT OF WORK

The VA Black Hills has a requirement to purchase Ophthalmic Stretcher Procedure Chairs with the salient characteristics below. This requirement is in support of a brand name or equal requirement.

Brand Name or equal

If an item in this solicitation is identified as "brand name or equal," the purchase description reflects the characteristics and level of quality that will satisfy the Government’s needs. The salient physical, functional, or performance characteristics that "equal" products must meet are specified in the solicitation.

Clearly identify the item by-

(i) Brand name, if any; and

(ii) Make or model number;

(iii) Include descriptive literature such as illustrations, drawings, or a clear reference to previously furnished descriptive data or information available to the Contracting Officer;

and

(iv) Clearly describe any modifications the offeror plans to make in a product to make it conform to the requirements listed here. Mark any descriptive material to clearly show the modifications.

Salient Characteristics Reclining Ophthalmic Surgical Chair weight capacity of 500 lbs Chair height range of 20 inches to 40 inches Concave contoured head pads at sizes 4”, 4.5” and 5” 120V Power O2 Tank Holder Bases of the chairs are required to be provided.

Delivery and Receiving Delivery and receipt of the proposed items is anticipated to be directed to the location identified below. Confirmation of delivery location will be provided by the VA POC post-award. Delivery must be coordinated with VA Logistics POC Wesley Walker (Office);

605-720-7452 or Emily Apland (Office) 605-720-7427 prior to any attempts at delivery.

Any item that has not been coordinated will be turned away and any additional charges will be the responsibility of the sender/transportation company. Vendor responsible for conducting a site visit to verify logistics and loading dock access/egress.

Contractor shall include the PO# on the shipping label and packing slip to make sure it can be tracked when item is delivered to the Black Hills VA.

Contractor will ship or deliver the items to address below:

VA Black Hills Health Care System – Fort Meade Bldg 46 Warehouse 113 Comanche Rd Fort Meade, SD 57741

Working hours:

Deliveries are accepted Monday through Friday from 7:00 am – 3:00 pm. Deliveries are not accepted on weekends or federal holidays listed below:

Observed Federal Holidays:

New Year’s Day Martin Luther King Birthday Washington’s Birthday Memorial Day Juneteenteenth Independence Day Labor Day Columbus Day Veteran’s Day Thanksgiving Day Christmas Day

Installation

A qualified technician will be required to ensure the chairs are unboxed, inspected for damage, assembled correctly, thoroughly function tested and are ready to be used.

Installation must be coordinated with the Biomed staff on site.

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVI

CES

QUANTI

TY

UNI

T UNIT PRICE AMOUNT

4.00 EA _______________

ESC2 SURGICAL CHAIR

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, Equipment, Utensils, and Supplies

LOCAL STOCK NUMBER: ESC2EYEST

POWER CORD 120V USA

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: 999-0775-208120VB

PWR CORD 120V USA GRNDED HOSP GRD

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: 999-0775-208

ACCY. O2 TANK HOLDER ESC2

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: HSA080009

2.00 EA _______________

ESC2 CONTOURED HEAD PAD SET

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: H0103ESC2-049

ESC2 4" CONTOURED HEAD PAD

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and

Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: H080988-049

ESC2 4.5" CONTOURED HEAD PAD

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: H080989-049

ESC2 5" CONTOURED HEAD PAD

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: H080990-049

1.00 JB _______________

INSTALLATION

Contract Period: Base POP Begin: 04-01-2026 POP End: 06-30-2026 PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6530 - Hospital Furniture, LOCAL STOCK NUMBER: H080990-049

GRAND TOTAL _______________