Attach 1 SON.docx

STATEMENT OF WORK

Department of Veterans Affairs Butler VAMC Fire Emergency Services 353 N. Duffy Rd Butler, PA 16001 Zoll X Series Advanced Manual Monitor/Defibrillator

1. Introduction/Background

1.1. VA Butler Fire & Emergency Services operates a single basic life support (BLS) ambulance licensed by the Pennsylvania Department of Health (PA DOH). VAB FES utilizes Emergency Medical Technicians (EMT) licensed by PA DOH who operate under Pennsylvania Statewide BLS Protocols. VAB FES uses local ambulance service provider Butler Ambulance Service (BAS) for all advanced life support (ALS) functions. PA DOH recently broadened the Scope of Practice for EMTs to include the application and transmission of 12-lead EKGs to receiving facilities.

1.2. This will significantly reduce time to provide Veterans with a prehospital EKG and transmit findings to the receiving Emergency Department. Ensure compliance with PA DOH BLS protocols and improve the cardiac diagnostic care provided to our Veteran customers.

2. Scope of Work

2.1. The contractor shall provide all resources necessary to accomplish the deliverables described in this Statement of Work (SOW). Requirement is for the brand name only request for one (1) Part Number 601-2231112-01 Zoll X Series Advanced Manual Monitor/Defibrillator with a 4-trace tri-mode display monitor/defibrillator/printer.

3. Requirement

3.1. The contractor shall provide all equipment, labor, tools, materials, supervision, documentation, subscription services, and other items necessary to deliver, and install equipment for the Butler VA Medical Center (BVAMC).

3.2. Salient characteristics

3.2.1. Fully interoperable with both Zoll X Series and R Series Manual Monitor/Defibrillators

3.2.2. Tri-mode display monitor/defibrillator/printer

3.2.3. Real CPR help

3.2.4. Real BVM help

3.2.5. Advisory algorithm

3.2.6. Wi-Fi, Bluetooth, USB cellular modem capable

3.2.7. USB data transfer capable

3.2.8. 6.5" (16.5cm), or larger, diagonal screen

3.2.9. Full 12 ECG lead view with both dynamic and static 12-lead mode display

3.2.10. CPR Dashboard quantitative depth and rate in real time, release indicator, interruption timer, perfusion performance indicator (PPI)

3.2.11. See-thru CPR artifact filtering

3.2.12. End Tidal Carbon Dioxide monitoring (ETCO2) with Oridion Microstream Technology

3.2.13. MultiTech MTC Cat M1 Cell Modem, Verizon

3.2.14. Declaration of Conformity

3.2.15. 3 Year Extended Warranty

3.2.16. Accessories shall have the following features:

3.2.16.1. MFC cable

3.2.16.2. MFC CPR connector

3.2.16.3. A/C power adapter/battery charger

3.2.16.4. A/C power cord

3.2.16.5. One (1) roll printer paper

3.2.16.6. 6.6 Ah Li-ion battery

3.2.16.7. Carry case

3.2.16.8. Operator's Manual

3.2.16.9. Quick Reference Guide

3.2.16.10. NIBP Welch Allyn with Smartcuff 10-foot Dual Lumen hose and SureBP Reusable Adult Medium Cuff

3.2.16.11. Masimo Pulse Oximetry with Signal Extraction Technology (SET), Rainbow SET (for SpCO & SpMet), and SpO2/SpCO/SpMet Rainbow DCI Adult Reusable Sensor with connector (3 ft)

3.2.16.12. X Series Carry Case, Premium

3.2.16.13. Rainbow, RC-4, Reusable EMS Patient Cable (4 ft)

3.2.16.14. Interpretative 12- Lead ECG with 12-Lead one step ECG cable- includes 4- Lead limb lead cable and removable precordial 6-Lead set

3.2.16.15. SpO2/SpCO/SpMet Rainbow DCI Adult Reusable Sensor with connector (3FT)

3.2.16.16. Cuff Kit with Welch Allyn Small Adult, Large Adult and Thigh Cuffs

3.2.16.17. Cuff, Child, 2-Tube, Twist lock connector

3.2.16.18. Six-hour rechargeable Smart battery

3.2.16.19. SurePower 4 Bay Charging System including 4 battery charging adapters

3.2.16.20. AccuVent Sensors (10/box)

3.2.16.21. Paper, Thermal, w/ Grid, BPA Free

3.2.16.22. OneStep Cable, X Series

3.2.16.23. CPR-D Padz and CPR Stat Padz Connector for R Series

3.2.16.24. OneStep Pediatric CPR Electrode (1 pair)

3.2.16.25. Clear plastic display protector X Series

3.2.16.26. Cable sleeve, Propaq/X Series, ZOLL Blue

3.2.16.27. Worry-Free Service Plan, 3 Years, on-site includes annual preventative maintenance, accidental damage coverage, battery replacement upon failure

3.2.16.28. 12-lead ECG Simulator

4. Delivery

4.1. Hours of operation are 08:00-16:30 ET Monday – Friday excluding Holidays.

4.2. Butler VAMC

Fire & Emergency Services Department (VAB FES) 353 N. Duffy Rd.

Butler, PA 16001

5. Period of Performance

5.1. 60-90 Days ARO

6. VHA Supplemental Contract Requirements for Combatting COVID-19

6.1. Contractor employees who work in or travel to VHA locations must comply with the following:

6.1.1. Documentation requirements:

6.1.1.1. If fully vaccinated, contractors shall show proof of vaccination.

6.1.1.1.1. NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS- 319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

6.1.1.2. If unvaccinated contractors shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test that includes an affiliated telehealth service.

6.1.1.3. Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Contracting Officer Representatives (CORs) or other hospital personnel.

6.1.1.4. Documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

6.1.2. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

6.1.2.1. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

6.1.3. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

6.1.4. For indefinite delivery contracts: Contractor agrees to comply with VHA Supplemental Contract Requirements for any task or delivery orders issued prior to this modification when performance has already commenced.

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