Attachment 2 - Contractor Discrepancy Report - EIS.pdf

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7030--**DRAFT PRE SOLICITATION** NX EQ GI Endoscopy Information System - EndoSoft BNOE (VA-18-00024348) **DRAFT PRE SOLICITATION**
Solicitation number
36C10G20Q0050
Issued by

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This combined synopsis/solicitation document seeks quotes for an Endoscopy Information System (EIS) to be used by various VA Medical Centers. The VA requires the Utech Products (EndoSoft) brand or equal EIS and related equipment to deliver patient care. Interested vendors must provide pricing for all Contract Line Item Numbers listed in Attachment A by June 12, 2020. The VA intends to award a one-year firm-fixed price requirements contract with four one-year option periods to the responsible vendor that offers the best value based on technical capability, past performance, and price. The contract will have a NAICS code of 511210 and be unrestricted with full and open competition.

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Other files

File Type Posted
Attachment 6 - Pay.gov Vendor Submittal Instructions - EIS.pdf PDF
S02 - DRAFT Solicitation - NX EQ GI EIS - 36C10G20Q0050.pdf PDF
Attachment 7 - Monthly_Quarterly Sales Report - EIS.xlsx XLSX spreadsheet
Attachment 4 - Business Associates Agreement Template - EIS.doc DOC document
Attachment 3 - Cost_Price Schedule - EIS.xlsx XLSX spreadsheet
Attachment 1 - Minimum Technical Requirements - EIS.docx DOCX document
Attachment 5 - Past Performance Questionnaire - EIS.docx DOCX document
36C10G20Q0050_3.docx DOCX document

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CONTRACT DISCREPANCY REPORT

1. CONTRACT NUMBER 2. REPORT NUMBER FOR THIS DISCREPANCY

3. TO (Contractor and Manager's Name) 4. FROM (Name of QAE)

5. DATES (YYYYMMDD)

a. PREPARED b. RETURNED BY CONTRACTOR c. ACTION COMPLETE

6. DISCREPANCY OR PROBLEM (Describe in detail. Include reference to PWS Directive; attach continuation sheet if necessary.)

7. SIGNATURE OF CONTRACTING OFFICER

8a. TO (Contracting Officer) b. FROM (Contractor)

9. CONTRACTOR RESPONSE AS TO CAUSE, CORRECTIVE ACTION AND ACTIONS TO PREVENT RECURRENCE. (Cite applicable Q.C.

program procedures or new Q.C. procedures. Attach continuation sheet(s) if necessary.)

10. SIGNATURE OF CONTRACTOR REPRESENTATIVE b. DATE (YYYYMMDD)

11. GOVERNMENT EVALUATION (Acceptance, partial acceptance, reflection. Attach continuation sheet(s) if necessary)

12. GOVERNMENT ACTIONS (Reduced payment, cure notice, show cause, other)

13. CLOSE OUT

NAME

(1)

TITLE

(2)

SIGNATURE

(3)

DATE (YYYYMMDD)

(4)

a. CONTRACTOR

NOTIFIED

b. QAE

c. ACO

DD FORM 2772, SEP 1998 REPLACES MT FORM 352-R, WHICH IS OBSOLETE. Adobe Professional 8.0

ctr_no:
rpt_no:
to:
from:
prep_date:
ret_date:
comp_date:
discrep:
to_ctr:
from_ctr:
ctr_resp:
rep_date:
govt_eval:
govt_act:
notif_name:
notif_title:
notif_date:
qae_name:
qae_title:
qae_date:
aco_name:
aco_title:
aco_date:
Reset:

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