ATTACHMENT 1 - Final SOW - Terre Haute Pkg 40 Brownsburg Pkg 90 - V3.0 6.30.21 (003).docx

Desk, Refraction

Veteran Health Indiana (VHI) Terre Haute AND Brownsburg VA Clinics Statement of Work Refraction Desk with Console/without Sink

INtroduction Veteran Health Indiana (VHI) has a requirement to purchase Refraction Desk with Console/without Sink with an authorized vendor to supply and deliver the item(s) identified in Table 1 below. See salient characteristics below. This requirement is in support of the activation of Terre Haute and Brownsburg VA Clinic Projects. The new outpatient clinics in Terre Haute and Brownsburg require refraction desks with refraction consoles (without sink) to provide a convenient storage space for supplies used during routine eye examinations and space to hold a trial frame set. The Lombart Refraction Desk with Console is the basis for design. This is a Brand Name or Equal Requirement.

Table 1 – Package Items Summary

Additional Item Requirements The vendor will provide service manuals that include theory of operation, maintenance requirements, repair information, schematics, part lists, and troubleshooting information in electronic format for use by the VA IT Operations Department.

Date of manufacture must not be greater than 2 years before the purchase order date. The equipment must not be used or refurbished and must have the latest manufacturer’s software/hardware updates installed. Any batteries provided with the unit will not be manufactured more than 12 months before the purchase order issue date.

general conditions Site Address The address of the Terre Haute and Brownsburg VA Clinics are provided below:

Delivery Schedule Items shall be delivered no earlier than the estimated delivery start date and no later than the delivery end date listed in Table 2 below.

Table 2 – Anticipated Building Outfitting Schedule

Schedule and Order Management The above delivery schedule is based upon the current construction schedule due to the nature of activation efforts and construction timelines and dates may vary and shift. Delivery dates need to be flexible. The delivery of items for installation are dependent upon the completion of applicable areas within the building. If there is a delay, the Contractor may be required to adjust the delivery date at no cost to the Government. The Contractor will coordinate with the on-site POC’s before delivery.

The awardees actual delivery dates will be confirmed by VA upon award.

Post-award, the vendor will coordinate delivery identified in this document with the VA prior to beginning any work (See Section 2.4). Once the dates have been confirmed, modifications to the schedule are subject to written approval by the CO, COR, and the vendor.

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 post-award. To coordinate delivery, contact VA Government POC Julie Webb at (317) 988-2747, Julie.Webb@va.gov, IOT&A POC Soren Nicholson at (719) 761-4387, Soren.Nicholson@sme-solutions.co, and Robert Stonerook at (706) 304-7194, Robert.stonerook@sme-solutions.co.

The vendor is required to define the need for a staging area to accommodate item delivery, if needed. Post-award, this information will be confirmed with the vendor.

The delivery of items identified in this document shall take place during normal loading dock business hours which are defined as: 8:15 AM to 3:00 PM Eastern Standard Time, Monday through Friday, and excluding Federal Holidays.

Delivery trucks will not be permitted to remain at the loading dock. Trucks shall be unloaded, moved from the dock, and then brought back to the dock if required to haul out any waste, tools, or excess materials.

Labeling of delivered items shall include the VA facilities contract number and VA purchase order number for identification and reference upon receipt of product.

NOTE: Due to the COVID19 situation, masks ARE required to be worn by all individuals when in common areas on VA property. Any individuals who need to enter the building for installation &/or training will be required to be screened by the site staff prior to entry. Please allow time for this in your schedule.

Clean Up and Disposal There are no dumpsters available for vendor use.

The removal of waste and/or excess material shall be conducted through the loading dock area.

Assembly, Installation, and Calibration Required (Yes ☒ No ☐) The vendor is required to manage and coordinate installation at the VHI Terre Haute and Brownsburg VA Clinics with the COR or her representative IOT&A POC.

On-site assembly and installation of items, and performance of services identified in this document shall take place during normal business hours which are defined as: 8:00 AM to 4:30 PM Eastern Standard Time, Monday through Friday, and excluding Federal Holidays.

Proposed installation date for Terre Haute will occur after delivery of equipment. Current timeframe of delivery is August 18, 2021 – September 18, 2021.

Proposed installation date for Brownsburg will occur after delivery of equipment. Current timeframe of delivery is ARO – August 7, 2021.

The vendor is required to define the need for a staging area to accommodate item assembly and installation, if needed. Post-award, this information will be confirmed with the vendor.

The vendor is required to provide tools, labor and materials to complete assembly and installation of the items detailed in this document.

The vendor shall protect all finished spaces and surfaces as required from delivery and installation damage. The vendor shall use covering and protection to the extent necessary to prevent damage to finished spaces. Any damage occurred during delivery and installation is the responsibility of the vendor. The vendor will be responsible for paying for and repairing any damage or noted deficiencies to finished spaces and surfaces that occur because of the vendor’s (or associated sub-contractors) installation.

During the entire duration of assembly and installation, the vendor will have a competent representative on-site as the vendor’s contact, and to serve as the interface between the vendor and the Terre Haute and Brownsburg VA Clinics. On-site representative can be the installer. All instructions provided from COR to the representative will be binding as if given to the vendor’s main contact. The COR may provide specific instructions, however, only the Contracting Officer may change the terms or conditions of the contract.

Training Required (Yes ☐ No ☒) Confidentiality and Non-Disclosure This equipment does not connect to a VA network. Therefore, in accordance with Appendix A, Handbook 6500.6 Checklist, block 6, the C&A requirements do not apply to this requirement, and a Security Accreditation Package is not required.

*See Section 3, Salient Characteristics on page 6

Salient Characteristics M5016, Desk, Refraction w/Console, w/o Sink Total Quantity: 12 [Three (3) for Terre Haute and nine (9) for Brownsburg] ☐ Network Required if Checked ☒ Manufacturer Certified Installation Required if Checked ☐ BMET Training Required if Checked ☐ End User Training Required if Checked

Basis of Design: Lombart Refraction Desk with Console (brand name or equal), Part No. RF0LO200SRFG Salient Characteristics:

• Right-Handed desk with console The desk must include:

· A writing surface with the minimum dimensions of 24” W x 24” D

· A minimum of 4 drawers underneath the writing surface; each drawer must meet the minimum dimensions of 20”W x 5” H

• Dimensions: 58-64”W X 24-30”D X 30-34”H (writing desk height)

• Hand instrument console with three (3) rechargeable wells

• Standard graystone laminate or comparable

• Main switch, rheostat, an auxiliary instrument switches

• Includes prewire kit for slit lamp with switch

• Includes prewire kit for indirect hanger Binocular Indirect Ophthalmoscope

• Reliable E.T.L. Listed approved electronics conforming to U.I. STD 544

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