ATCH 1 SCHEDULE_SON_DELIVERY_36C24823Q0179 HIP.pdf

PAGE 1 OF 7 1. REQUISITION NO.

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

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

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

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

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

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

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

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED 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) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

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

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

516-23-1-078-0030

36C24823Q0179 11-17-2022

Colleen Houser 1-727-201-6880 11-30-2022

1600 EST

36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) Room 315, Bldg. 2 10,000 Bay Pines Blvd Bay Pines FL 33744

X 100

X

622110

$41.5 Million

NET 30

N/A

MCC: 90D

Department Of Veteran Affairs C.W. Bill Young VA Medical Center Bldg 110 Warehouse 10,000 Bay Pines Blvd.

Bay Pines FL 33744

36C248

Department of Veterans Affairs Network Contracting Office 8 (NCO 8) C.W. Bill Young VA Medical Center 10000 Bay Pines Blvd. Room 315, Bldg. 2 Bay Pines FL 33744

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

This requirement is for two (2) Hip Arthroscope Sets System Instrument sets and two (2) Hip Arthroscopy Master Instrument Set.

**Brand Name or Equal** See Schedule Below

See CONTINUATION Page

Mark Cline

36C24823Q0179

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 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 DELIVERY SCHEDULE

36C24823Q0179

SECTION B - CONTINUATION OF SF 1449 BLOCKS

NO TEXT/INTENTIONALLY BLANK

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR: TBD

b. GOVERNMENT: Contracting Officer 36C248 – Mark Cline; mark.cline@va.gov

Department of Veterans Affairs

Network Contracting Office 8 (NCO 8)

Room 315, Bldg. 2

10,000 Bay Pines Blvd

Bay Pines FL 33744

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] Upon Receipt

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.

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

AMENDMENT NO DATE

RFQ: 36C24823Q0179

STATEMENT OF NEED

HIP ARTHOROSCOPE SET

**BRAND NAME OR EQUAL**

DESCRIPTION: Requesting two (2) Hip Arthroscope System Instrument sets and two (2) Hip Arthroscopy Master Instrument sets for hip arthroscope procedures to be completed at BPVAHCS.

Salient Characteristics – Hip Instruments

Units must have the following abilities/capabilities:

• Must be designed for arthroscopic procedures in the hip

• Must include instruments for joint access, tissue resection, grasping, microfracture and suture management

• Must include 30- and 70-degree arthroscopes

• Must include extended length arthroscopes

Hip Arthroscope System Instrument Set (P/N: AR-6576S-E)

24 Items in this set:

tear drop handle (P/N: AR-2001) inflow cannula adapter with stopcock (P/N: AR-3035L) hd hip arthroscope, 30 deg, 3.5x202mm (P/N: AR-3350-4030H) hd hip arthroscope, 70 deg, 3.5x204mm (P/N: AR-3350-4070H) shth,hip,tap/fen,2 stpck f/3.5mm hip scp (P/N: AR-3373-4002H) conical obturator for hi-f hip sheath (P/N: AR-3375-4001H) cann obt f/tap/fen 3.5mm hip scp sth w/h (P/N: AR-3375-4003H) bridge, xl,qc, 2 stpck f/3.5mm hip scope (P/N: AR-3380-4004H) metal cannula, xl, hip, 4.5mm (P/N: AR-3420H-4.5) metal cannula, xl, hip, 5.0mm (P/N: AR-3420H-5.0) metal cannula, xl, hip, 5.5mm (P/N: AR-3420H-5.5) metal cannula, xl, hip, 6.5mm (P/N: AR-3420H-6.5) cannulated obturator, xl, hip, 4.5mm (P/N: AR-3421H-4.5) cannulated obturator, xl, hip, 5.0mm (P/N: AR-3421H-5.0) cannulated obturator, xl, hip, 5.5mm (P/N: AR-3421H-5.5) cannulated obturator, xl, hip, 6.5mm (P/N: AR-3421H-6.5) Open Cannula, Tapered, Detachable, LP (P/N: AR-6507-03LP) Open Cannula, Blunt, Detachable, LP (P/N: AR-6507-04LP) switching stick, long, cannulated (P/N: AR-6520-15) swtchg stick,lng,cann,3.5mmx 15 (P/N: AR-6520-16) dilator handle (P/N: AR-6524) 4mm dilator (P/N: AR-6524-04) 6mm dilator (P/N: AR-6524-06) Hip Arthroscope System Instrument Case (P/N: AR-6576C)

Hip Arthroscopy Master Instrument Set (P/N: AR-6517S) 35 Items in this set:

probe, hook 4.8 mm tip, 220 mm long (P/N: AR-10030) probe,crvd sft,220 mm w/5 mm mrks (P/N: AR-10030C) knot pusher (P/N: AR-1305H) hip rasp, long (P/N: AR-1309H) tissue elevator, 15 degrees (P/N: AR-1342H-15) tissue elevator, 30 degrees (P/N: AR-1342H-30) birdbeak,45°up tip 220mmw/wb (P/N: AR-14800W) birdbeak,22°up tip 220mmw/wb (P/N: AR-14890W) punch,med 3.4 mm15°up crvd,220mm w/wb (P/N: AR-15310W) punch, med. 3.4mm, rev, str, 220mm, w/wb (P/N: AR-15530W) sutr retrievr 10°up crvd,220mm w/wb (P/N: AR-15551W) punch,med. 3.4mm45°r,str,220mm w/wb (P/N: AR-15800W) punch,med. 3.4mm45°l,str,220mm w/wb (P/N: AR-15810W) sutr cutr 4.2mm str,220mm w/wb (P/N: AR-16250W) grasper, loose body, 4.2mm, str w/wb (P/N: AR-16400W) grasper, hook tip 4.2mm, straight w/wb (P/N: AR-16600W) fw grspr 220mm w/wb hndl (P/N: AR-16975W) Curette,BS Cut,Ø 5.4mm Ring,220 mm (P/N: AR-20030) pentrtr 15°up crvd 220mm w/wb hndl (P/N: AR-2267W-2) Long crochet push pull hook (P/N: AR-5010H) Open Cannula, Tapered Tip, Low Profile (P/N: AR-6506LP) Open Cannula, Blunt Tip, Low Profile (P/N: AR-6507LP) access guide, hip portal (P/N: AR-6513-01) needle sleeve, hip portal (P/N: AR-6513-02) hip arthroscopy master instrument case (P/N: AR-6517C) dilator, 4 mm replacement for ar-6520s (P/N: AR-6520-4) dilator handle (P/N: AR-6524) 4mm dilator (P/N: AR-6524-04) 6mm dilator (P/N: AR-6524-06) reusable obturator for ar-6575-11 (P/N: AR-6576-11) reusable obtr for 7mmx 11cm cnula (P/N: AR-6578-11) curette, curved (P/N: AR-8660H) chondro pick, long (P/N: AR-8670H) chondro pick, long 90 deg (P/N: AR-8671H) chondro pick, long 60 deg (P/N: AR-8672H)

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVIC

ES

QUANTIT

Y

UNI

T UNIT PRICE AMOUNT

2.00 SE ________________

Hip Arthroscopy Master Instrument Set **Brand Name or Equal** Contract Period: Base POP Begin: 12-07-2022 POP End: 01-31-2023 PRINCIPAL NAICS CODE: 622110 - General Medical and Surgical Hospitals PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

LOCAL STOCK NUMBER: AR-6517S

2.00 SE ________________

HIP ARTHROSCOPE SYSTEM

**BRAND NAME OR EQUAL**

Contract Period: Base POP Begin: 12-07-2022 POP End: 01-31-2023 PRINCIPAL NAICS CODE: 622110 - General Medical and Surgical Hospitals PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

LOCAL STOCK NUMBER: AR-6576S-E

GRAND TOTAL ________________

B.3 DELIVERY SCHEDULE

ITEM NUMBER QUANTITY

DELIVERY

DATE

0001 SHIP TO: US DEPARTMENT OF VETERANS

AFFAIRS

10000 BAY PINES BLVD

Bldg 110 Warehouse

BAY PINES, FL 33744

USA

2.00 01/31/2023

MARK

FOR:

LOGISTICS

1-727-398-6661

0002 SHIP TO: US DEPARTMENT OF VETERANS

AFFAIRS

10000 BAY PINES BLVD

Bldg 110 Warehouse

BAY PINES, FL 33744

USA

2.00 01/31/2023

MARK

FOR:

LOGISTICS

1-727-398-6661

B.3 DELIVERY SCHEDULE