36C77018Q0800-003.pdf

VHAPM Part 806.3 Other Than Full and Open Competition (OFOC) SOP Attachment 2: Request for Sole Source Justification Format >SAT

OFOC SOP Revision 08 Page 1 of 8 Original Date: 03/22/11 Revision 08 Date: 04/18/2018

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID:____36C770-18-AP-0033_______________________________________

1. Contracting Activity: Chelmsford VA CMOP

IFCAP 2237# 761-18-3-014-0254

2. Nature and/or Description of the Action Being Processed:

BRAND NAME SPECIFIC MEDICATION AS REQUESTED BY THE VA MEDICAL CENTERS THE DALLAS VA

CMOP SERVES. AS REQUESTED ON 2237# 761-18-3-014-0254

3. Description of Supplies/Services Required to Meet the Agency’s Needs:

1. BRIEF DESCRIPTION OF SUPPLIES OR SERVICES REQUIRED AND THE INTENDED USE:

O0346 - ONE TOUCH VERIO (GLUCOSE) TEST STRIP

• NDC – 53885027210

• Quantity of request: 360

• Supplier: LIFESCAN The OneTouch Verio® test strips provide accuracy your patients can rely on.

Requiring only 0.4 µL of blood, our test strips have achieved 5 years of proven clinical accuracy even at extremely low and high blood glucose levels. For blood glucose testing with the OneTouch Verio® family of meters, including the OneTouch Verio Flex® meter, OneTouch Verio® meter, and OneTouch Verio IQ® meter.

The estimated Purchase Order value is for this request for this item is

XT104 - BAG,URINARY DRAINAGE MERIT #FZ624

• NDC/PART# 97909000624/FZ624

• Quantity of request: 120

• SUPPLIER: MERIT

Merit Medical Systems Drainage Depot Bag with Soft Cloth backing, 600mL, Large Bore Tubing, Twist Drain Valve Drainage Depot, 600 ml bag. Comes with easy to use twist valve empty port, Velcro strap, adjustable tubing and soft cloth back for extra patient comfort

The estimated Purchase Order value is for this request for this item is:

OFOC SOP Revision 08 Page 2 of 8

Revision 08 Date: 04/18/2018

XH709 - CATH SET,INTERM 12FR C#28422

• NDC -99050728422 (NO SUBSTITUTES)

• Quantity of request: 1080

• Supplier: COLOPLAST

Less than half the size of a standard male catheter, SpeediCath Compact Male can be stored, carried, used and disposed of more discreetly. It can be inserted without touching the coated section. It comes ready to use – for even greater convenience and discretion.

All-in-one catheter and bag set that is instantly ready to use

Small enough to keep in a pocket or handbag.

The only compact and discreet catheter with an integrated and sterile bag

The estimated Purchase Order value is for this request for this item is

XI429 - CATH,INTERMITTENT VAPRO PLUS 14F H#71144

• NDC/PART# HOLLISTER #71144

• Quantity of request: 120

• Supplier: HOLLISTER

• Easy-to-carry package fits easily into a pocket or backpack

• Protective tip helps shield the sterile catheter from bacteria located within the initial 15 mm of the distal urethra

• Protective sleeve allows the catheter to be gripped anywhere along the length of the catheter

• Ready-to-use hydrophilic catheter with pure catheter hydration technology. Designed to be evenly lubricated for easy insertion

• Large finger hole with tear strip helps facilitate easy opening

• Smooth eyelets help ease of insertion and withdrawal

• Ring cap helps keep protective tip clean and protected until use

• Available in both 16" (40 cm) and 8" (20 cm) lengths

• Not made with natural rubber latex, phthalates-free PVC material

• The estimated Purchase Order value is for this request for this item is

XV066 - CATH SET, INTERMIT 14FR H#96144

• NDC/PART# 5096144

• Quantity of Request: 480

• SUPPLIER – HOLLISTER

• Ready-to-use, pre-lubricated, single-use closed system intermittent catheter.

• Latex-Free.

• Unique protective tip.

• No-Touch insertion technique.

• User-regulated gel reservoir.

• 2 Smooth catheter eyelets.

OFOC SOP Revision 08 Page 3 of 8

Revision 08 Date: 04/18/2018

• Color-coded funnel.

• 1500mL collection pouch.

• The estimated Purchase Order value is for this request for this item is

XV077 – PLEURX DRAINAGE KIT D#50-7500

• NDC/PART# - 99950750010/50-7500B

• QUANTITY of REQUEST – 400

• SUPPLIER – CAREFUSION – POSSIBLY NOW BD?

PleurX drainage kit 50-7500B (500 mL) and 50-7510 (1,000 mL) The PleurX drainage kit includes a procedure pack that provides the components needed each time the patient drains fluid.

Each drainage kit (50-7500B and 50-7510) contains:

• Plastic vacuum bottle with attached drainage line Procedure pack components

• Blue wrapping

• Alcohol pads (qty. 3)

• Pair of gloves

• Valve cap

• Blue emergency slide clamp

• Gauze pads, 4" x 4" (10.2 cm x 10.2 cm, [qty. 4])

• Foam catheter pad

• Self-adhesive dressing

• The estimated Purchase Order value is for this request for this item is

S0473 - SODIUM CHLORIDE 0.9% IRRG SOLN 30ML

• NDC -64938000901

• Quantity of request: 240

• Supplier: WINCHESTER

Sal Jet Saline Solutions, manufactured by Winchester Laboratories, are Normal Saline solutions designed for wound irrigation. The unit dose packing makes these Sterile Saline Solutions more practical than using syringes and large bottles of saline. Sal Jet Normal Saline is perfect for moistening dressings, rinsing wounds, and devices. The small packaging allows you to use a new unit for each application. Discard unused solution after a unit is opened.

Sal Jet Sterile Saline Solution Features and Benefits

• Convenient Single Use Packaging

• Sterile

• Perfect for Rinsing Wounds, Devices, and Moistening Dressings

• Small Enough to Carry in a Pocket

Sal Jet Sterile Solution Specifications

• Odorless

OFOC SOP Revision 08 Page 4 of 8

Revision 08 Date: 04/18/2018

• Colorless

• Not Intended for Injection

The estimated Purchase Order value is for this request for this item is

XH019 - LANCET,ACCU-CHEK FASTCLIX DRUM

• NDC/PART# 65702028810

• Quantity of Request: 240

• SUPPLIER – ROCHE

These special strips are designed to work with all models of Accu-Chek FastClix, the only one-click lancing system available with a drum. Accu-Chek lancets draw blood quickly and effectively for neat and easy application onto test strips. Each package comes with 102 lancets. Accu-Chek FastClix devices and test strips are sold separately.

Accu-Chek FastClix Lancets:

• For all models of Accu-Chek FastClix

• Accu-Check FastClix devices are sold separately

• The only 1-click lancing system with a drum

• Designed to reduce the pain of blood glucose testing

• Proven least painful and overall easiest to use

• Package contains 102 Roche lancets

• The estimated Purchase Order value is for this request for this item is

XT868 - SET,INFUSION MINIMED #MMT-387

• NDC/PART# 70524406515/MMT-387

• Quantity of request: 120

• SUPPLIER : MEDTRONIC

The Medtronic Minimed Quick-set® infusion conveniently disconnects at the infusion site and offers a pre-attached adhesive for a discreet, low profile design. The Medtronic Minimed Quick-set® Infusion Set (MMT397) offers a 9mm soft cannula and 23 inch tubing for mostly everyone.

The Safe Needle Disposal System of the Medtronic Minimed Quick-set helps prevent accidental sticking when disposing of the introducer needle in your sharps container. This Medtronic Minimed set works with the Quick-serter to provide optimal insertion every time.

XV274 - SET,INFUSION ANIMAS #181-01

• NDC/PART# 181-01

• Quantity of Request: 50

• SUPPLIER – UNOMEDICAL

The Animas Inset Infusion System is an all in-one-infusion system. It features a built-in, disposable insertion Only the flexible cannula remains after the insertion needle is removed. Features self-adhesive, white cotto reversible connector and a quick disconnect at site. One-handed insertion for more site options. Luer lock t connection.

This set comes in 23" tubing, 9mm cannula and Blue in color - Box of 10.

OFOC SOP Revision 08 Page 5 of 8

Revision 08 Date: 04/18/2018

The estimated Purchase Order value is for this request for this item is

XV993 - SET,INFUSION ANIMAS #006-00

• NDC/PART# -99010000600 / 006-00

• Quantity of request: 100

• SUPPLIER: MEDTONIC

Animas Comfort Infusion Set - 17mm Cannula and 43" tubing - 10 Full sets/Bx The Animas Comfort Infusion Set has an angled insert that adjusts from 20 to 45 degrees. Includes a disconne site and clear window to view site. Discreet design for your comfort. Luer lock tube connection.

The estimated Purchase Order value is for this request for this item is:

XZ835 - RESERVOIR,MINIMED #MMT-332A

• NDC/PART# 43169786554/ MMT-332A

• Quantity of request: 1080

• SUPPLIER: MEDRONIC

Medtronic MiniMed Paradigm Reservoir is intended for use with the MiniMed Paradigm™ 71x insulin pum infusion sets only. It is custom made for Medtronic MiniMed Paradigm™ 7 Series insulin pumps and can be u Medtronic MiniMed Paradigm™ infusion sets. User-filled reservoir holds up to 3ml of insulin Reservoir Size: 3 MMT332A About MiniMed Paradigm 71x insulin Pumps: Can be hidden and worn under clothing for daily use and water resistant. Ref #: MMT-332A

The estimated Purchase Order value is for this request for this item is

S0743 - SUNSCREEN 30-50/PHY BLOCK/PABA-F LOTION (240ml)

• NDC/PART#66080-0847-68/ISSC-8-30+FF

• Quantity of request: 720

• SUPPLIER: R & R LOTION

SUNSCREEN SPF30+ INDUSTRIAL, FULL BROAD SPECTRUM, 80 MIN WATER RESIST. A PHYSICAL ZINC OXIDE SU PROVIDES PROTECTION AGIANST UV RAYS. RUBS IN CLEAR. ASTM D120 CERT. MADE USA., 4oz BOTTLE SPF between 30 and 50 Physical block (contains zinc oxide as an active ingredient) PABA free (or free of the ingredient para-aminobenzoic acid) The estimated Purchase Order value is for this request for this item is

XI743 - INSULIN SYRINGE 0.5ML 31G 6MM (U-500)

• NDC/PART# BD 326730 (08290-3267-30)

• Quantity of request: 144

• Supplier: COLOPLAST

• Dose conversion is no longer needed when using this syringe with Humulin R U-500 vials

• The U-500 insulin syringe draws to and doses the insulin units prescribed

OFOC SOP Revision 08 Page 6 of 8

Revision 08 Date: 04/18/2018

• Only the U-500 insulin syringe should be used with the U-500 vial

Government Cost Estimate :

4. Statutory Authority Permitting Other than Full and Open Competition:

( x ) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per FAR 6.302-1;

( ) (2) Unusual and Compelling Urgency per FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per FAR 6.302-3;

( ) (4) International Agreement per FAR 6.302-4 ( ) (5) Authorized or Required by Statute FAR 6.302-5;

( ) (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per FAR 6.302-7;

5. FAR13.5 Simplified Procedures for Certain Commercial Items: The authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C. 1901 and is implemented by for restricting competition on this procurement via FAR 13.106-1(b)(2).

6. Demonstration that the Contractor’s Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

BRAND NAME JUSTIFICATION DOES ALLOW FOR FULL AND OPEN COMPETITION AS LONG AS THE

VENDOR MEET THE BRAND SPECIFIC REQUIREMENTS AS REQUESTED ON 2237# 761-18-3-014-0254

These types of brand name drugs are prescribed by the Veteran's attending Physician who has the authority to prescribe the method of treatment to best satisfy the medical condition of his/her patient. The physician has determined this item as the best drug to treat the patient's medical condition. Substituting another drug other than that specifically prescribed is beyond the role, OFOC SOP Revision 08 Page 7 of 8

Revision 08 Date: 04/18/2018 competency, and professional functions of the Contract Specialist and would be detrimental to the treatment of the Veteran patient

7. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable:

CHELMSFORD VA CMOP IS NOT REQUESTING PURCHASE FROM AND CERTAIN VENDOR. MULTIPLE

VENDORS OFFER THIS PARTICULAR NAME BRANDS

Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: Price were determined to be fair and reasonable based on past procurements purchased by The Government Purchase card.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted:

It is believed that two or more SDVOSB’s can provide the same product at a fair and reasonable price.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: NA

10. Requirements Certification: I certify that the requirement outlined in this justification is a Bona

Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Joseph Sousa Date Logsitics Chelmsford VA CMOP

11. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer or Designee’s Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Lori Nichols Fellows Date Contracting Officer

NCO 15

http://vaww.pclo.infoshare.va.gov/PMWeb/VHAPM_Part_806.3.aspx

OFOC SOP Revision 08 Page 8 of 8

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b. One Level Above the Contracting Officer (Required over SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

Ralph Crum Date

NCO 15

Supervisor, CMOP Acquisition