Attachment 3 -Minimum Technical Requirements ( MTR)_Worksheet.docx

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6515--Transcutaneous Electrical Nerve Stimulation (TENS) Unit and Accessories
Solicitation number
36C79121R0015
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36C79121R0015 0001.docx DOCX document
36C79121R0015.docx DOCX document
Attachment 1 - Contractor Discrepancy Report.docx DOCX document
Attachment 5 - Past Performance Template.docx DOCX document
Attachment 2 - Schedule of Supplies Items Template.xlsx XLSX spreadsheet
Attachment 6 - Past Performance Questionnaire.docx DOCX document
Attachment 4 - Questions.xlsx XLSX spreadsheet

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ATTACHMENT 5

Minimum Technical Requirements (MTR)

Note: If response is “No”, then clarification must be provided in the justification section

?.## Minimum Technical Requirements (MTR)

Descriptions
HCPCs
Yes
No
Justification
MTR 1.
Digital Unit (NEW).
MTR 2.
Unit has Dual Independent Channel Output
MTR 3.
Unit shall use a Biphasic wave form.
MTR 4.
Unit shall include a timer.
MTR 5.
Unit shall have Adjustable Pulse Width and Frequency.
MTR 6.
Unit Shall include a Compliance Monitor
MTR 7.
Unit shall include 2 sets of 2 connecting Lead Wires Lead (e.g. 2 connecting Lead Wires Per Set – Total 4).
MTR 8.
Unit shall include a package of Four (4) “2x2” self-adhesive, reusable electrodes.
MTR 9.
Unit shall include Rechargeable Batteries.
MTR 10.
Unit shall include a Battery Charger.
MTR 11.
Unit shall include a belt clip.
MTR 12.
Unit shall include a Storage Pouch large enough to store TENS and the TENS Accessories
MTR 13.
Unit Shall include Product Instruction Manual in English.
MTR 14.
Unit shall be FDA 510(k) market approval.
MTR 15.
Serial number to be in battery compartment along with being in a visible location
MTR 16.
Warranty:
MTR 17.
Minimum of one (1) year
MTR 18.
Electrodes:
MTR 19.
2x2 Square - Self Adhesive, Reusable.
MTR 19.
2x4 Rectangle/Low Back - Self Adhesive, Reusable.
MTR 19.
2x2 Hypoallergenic/Sensitive Skin - Self Adhesive.

*The Healthcare Common Procedure Coding System (HCPCS).

_____________________________________________________
CONTRACTOR/OFFORER (Signature of person authorized to sign)

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