75H70526Q00023.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

235CODE 16. ADMINISTERED BYCODE

X

X

621511

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR235

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

08/14/2026

WINONA KITTO

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIME

08/24/2026 1400 CT

b. TELEPHONE NUMBERa. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70526Q00023

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 7OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Bemidji MN 56601

2225 Cooperative Ct NW, Rm 200

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$41.5

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Indian Health Service WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

Bemidji MN 56601

2225 Cooperative Ct NW, Rm 200

Bemdiji Area Indian Health Service

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Service and Maintenance for Siemens CA-660 Coagulation Analyzer

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

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

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

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

75H70526Q00023 Siemens Coagulation Services

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SUPPLIES OR SERVICES AND PRICE/COSTS

B.1 CONTRACT ADMINISTRATION DATA

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

CONTRACTOR NAME AND ADDRESS:

EIN/TIN#_______________________________

UIE SAMS#_____________________________

CAGE#_________________________________

GSA#__________________________________

NAME:__________________________________

TELEPHONE:____________________________

EMAIL: _________________________________

DELIVERY ADDRESS:

Red Lake Hospital 24760 Hospital Dr Red Lake, MN 56671

CONTRACTOR REGISTRATION: All required information must be in the System for Award Management (SAM) at www.sam.gov.

GOVERNMENT:

Winona Kitto Jennifer Richardson Indian Health Service Indian Health Service 2225 Cooperative Ct NW, Rm 202 2225 Cooperative Ct NW, Rm 202 Bemidji, MN 56601 Bemidji, MN 56601 Winona.kitto@ihs.gov Jennifer.richardson@ihs.gov

The associated North American Industrial Classification System (NAICS) code: 621511- Medical Laboratories

PSC: J065 – Maint/Repair/Rebuild of Equipment-Medical, Dental and Veterinary Equipment and Supplies

CONTRACT TYPE: Firm-Fixed Price mailto:Winona.kitto@ihs.gov mailto:Jennifer.richardson@ihs.gov

INVOICES: In accordance with the Prompt Payment Act, payment will be due 15 days after receipt of services or receipt of a proper invoice, whichever is later.

INVOICE INSTRUCTIONS:

Electronic Invoicing and Payment Requirements - Invoice Processing Platform (IPP) Payment requests must be submitted electronically through the U. S. Department of the Treasury's Invoice Processing Platform System (IPP).

"Payment request" means any request for contract financing payment or invoice payment by the Contractor. To constitute a proper invoice, the payment request must comply with the requirements identified in the applicable Prompt Payment clause included in the contract, or the clause 52.212-4 Contract Terms and Conditions - Commercial Items included in commercial item contracts. The IPP website address is: https://www.ipp.gov.

Under this contract, the following documents are required to be submitted as an attachment to the IPP invoice:

- A copy of the Contractor's invoice shall be included with the IPP invoice. If no invoice is attached, the Invoice will be rejected;

- Contractor's Invoice shall contain:

* Contract number

* SAM's Registration - Unique Identity Number (UEI Number)

* EIN or Tax ID Number

* List of deliverables;

- Timesheets if applicable - Number of hours worked with corresponding labor category and rate

HHSAR 352.232-71 Electronic Submission of Invoice Payment Requests (Feb 2022)

(a) Definitions.

Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements identified in FAR 32.905(b), "Content of Invoices" and the applicable Payment clause included in this contract.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system. Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

(c) The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with HHS procedures.

(d) If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer's written authorization with each payment request.

Unless otherwise agreed to by the contracting officer per HHSAR 352.232-71(c), the use of IPP shall take precedence over previously established invoicing procedures.

Improperly prepared invoices or statements shall be returned to the contractor and may delay payment.

BID SCHEDULE – Base Plus 4 Option Years

DESCRIPTION QTY UNIT

OF

ISSUE

UNIT PRICE TOTAL

Base Year 10/01/2026 – 09/30/2027 12 MO $ $ Option Year 1 10/01/2027 – 09/30/2028 12 MO $ $ Option Year 2 10/01/2028 – 09/30/2029 12 MO $ $ Option Year 3 10/01/2029 – 09/30/2030 12 MO $ $ Option Year 4 10/01/2030 – 09/30/2031 12 MO $ $

Grand Total: $

Statement of Work

Siemens Coagulation Service and Maintenance Agreement

Background:

The Red Lake Service Unit (RLSU) provides healthcare services including Emergency Medical services, family practice, internal medicine, pediatrics, dental, optometry, physical/occupational therapy, lab/radiology with mammography and bone density, pharmacy, mental health services, nutrition/diabetic educator services, and contract health services. The laboratory at Red Lake services the entire facility. The purpose of this contract is to procure a service agreement to maintain operation of our current coagulation analyzer.

Scope:

The RLSU has identified a need for a service and maintenance agreement for the Siemens CA- 660 coagulation analyzer.

Objectives:

The vendors selected will allow the Red Lake Hospital Laboratory to accomplish a number of requirements including:

• Technical and application telephone assistance is available 24 hours, 7 days a week.

• On-site field service and support. Field service and support is provided by Siemens trained authorized service engineers.

• No charge for on-site service, inclusive of labor, travel or expenses incurred during normal business hours (Monday thru Friday 8:00 AM-5:00 PM local time excluding Holidays).

• No charge for replacement parts which become marginal or defective due to normal use during agreement period.

• No charge for Preventative Maintenance (PM) visits. PMs increase instrument reliability minimizes down time and assures performance to published specifications. The recommended PM is scheduled based on the instrument type. On an ongoing basis, PM needs are assessed and performed as needed with each service visit.

• Authorized product updates and modifications for improved product performance reliability.

• Extensive Field Service parts inventory. Field service engineers carry most commonly used parts for first time repair. A national distribution system provides prompt delivery of low usage parts.

• All-inclusive to include the printer and UPS

Brands or Equivalent:

Siemens

Delivery:

Red Lake Hospital 24760 Hospital Drive Red Lake, MN 56671

Government Furnished Property:

Sysmex CA-660 SD Serial #Q1168

Security Requirements:

Any visiting technicians will check in with the Security desk at the Red Lake Hospital

FEDERAL ACQUISITION REGULATIONS

52.204-7 System for Award Management 52.204-13 System for Award Management Maintenance.

52.204-19 Incorporation by Reference of Representations and Certifications.

52.209-10 Prohibition on Contracting with Inverted Domestic Corporations 52.212-4 Contract Terms and Conditions—Commercial Products and Commercial Services 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders—

Commercial Products and Commercial Services 52.217-8 Option to Extend Services.

52.217-9 (a) The Government may extend the term of this contract by written notice to the Contractor within 30 days; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 5 (years).

52.222-90 Addressing DEI Discrimination by Federal Contractors 52.223-18 Encouraging Contractor Policies to Ban Text Messaging While Driving 52.224-1 Privacy Act Notification 52.224-2 Privacy Act.

52.232-1 Payments.

C.2 HEALTH & HUMAN SERVICES ACQUISTION REGULATION (HHSAR)

CLAUSES:

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

http://www.hhs.gov/policies/hhsar/subpart301-1.html

HHSAR Provisions and Clauses:

352.224-70 Privacy Act.

352.226-1 Indian Preference.

352.237-70 Pro-Children Act.

352.237-74 Non-Discrimination in Service Delivery.

352.239-73 Electronic Information and Technology Accessibility Notice 352.239-74 Electronic and Information Technology Accessibility http://www.hhs.gov/policies/hhsar/subpart301-1.html