Attachment A 36C24525Q0432 EXAM LANE.pdf

ATTACHMENT A - 36C24525Q0432

The Department of Veterans Affairs (VA), VISN 5 Network Contracting Office, is seeking sources that can provide a compact eye exam lane as part of the expansion of service involved with the

Technology-based Eye Care Services (TECS) Program for the Charlotte Hall VA Clinic.

STATEMENT OF WORK (SOW)

1. Contract Title. Compact Eye Exam Lane for Charlotte Hall VA Clinic

2. Background. The Charlotte Hall VA Clinic is requiring a compact eye exam lane as part of the expansion of service involved with the Technology-based Eye Care Services (TECS) Program. The room will be used to check patient’s vision, perform autorefraction and slit lamp examination.

3. Scope of Work. The procurement shall include all parts, materials, labor, software/licenses, resources, and training required to implement and utilize the equipment/system to their fullest capacity. All items must be covered by manufacturer’s warranty and procured through a manufacturer-approved distribution channel.

Distributers and resellers must be able to document ability to provide items through manufacturer-approved distribution channels upon request.

4. Specifications.

4.1 Equipment

Line Item Description Quantity Mini-Lane Refraction desk 1 CV-5000S Digital Phoropter 1 Deluxe Stool with Back 2 Dual Table-Top 1 Auto Kerato-Refractometer 1 Slit Lamp 1 Auto Lensmeter 1

4.2 Salient Characteristics

• Compact system combining exam lane equipment into one set-up: digital phoropter, autorefractor, lensmeter, visual acuity chart and chair & stand

• Customizable refraction programs, on-screen technician scripts and EMR connectivity

• Fit in a footprint of 6’ x 7’

• Digital Phoropter

• High-speed lens disc rotation

• Ability to connect to network for reduce potential transcription errors

• Small optical head requiring minimal space

• Dual table top - to allow for the use of two instruments, such as a slit lamp and an auto refractometer

• Auto Kerato-Refractometer o Ability to perform subjective VA Measurement for far & near distance, glare test, grid test & contrast test

• Slit Lamp

• Auto Lensmeter o Fully automate to measure glasses prescription.

• The system must have the ability to connect to the VA Network to a File Share and compatibility to this system.

• Enterprise Risk Analysis (ERA) approval.

5. Specific Tasks.

5.1 Delivery.

i. All equipment shall be delivered to:

Washington DC VA Medical Center 50 Irving St NW Washington, DC 20422 ATTN: VHAWAS Equipment Committee

ii. Contract VA Purchase Order (PO) number shall be included with delivery information (e.g., packing slip).

iii. Delivery Hours: The Warehouse is open to receive deliveries Monday through Friday, 8:00 a.m. to 4:00 p.m., excluding holidays.

iv. Contractor shall coordinate delivery with the on-site Point of Contact (POC) and provide shipment tracking information.

v. Contractor shall verify delivery date and time with the on-site POC at least 3 business days prior to scheduled delivery.

vi. Delivery is required within 90 days from award of the contract.

5.2 On Site Procedures.

i. COVID-19 Screening: All persons entering the facility shall be subject to screening for COVID-19 per the current CDC (Center for Disease Control) guidelines.

ii. Mask Requirement: All contractors shall wear masks while indoors.

iii. Contract personnel are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government Officials.

iv. Time spent on site shall be for a period sufficient to complete the work set forth in the statement of work.

v. On site visits shall be scheduled in advance with the designated on-site POC.

vi. Contractor shall check in and out with Biomedical Engineering prior to visiting the worksite for each day of work.

vii. The VA campus is non-smoking. Contractor personnel are required to comply with this policy.

viii. Parking: it is the responsibility of the Contractor to park in the appropriate designated parking areas.

ix. Contractor personnel’s tool bags are subject to inspection.

5.3 Installation/Implementation.

i. Installation/Implementation will be completed by personnel certified and knowledgeable with the designated equipment/system.

ii. Installation shall be completed within the period of performance.

iii. Contractor shall be responsible for any Personal Protection Equipment (PPE) required when performing work on site.

iv. Contractor shall submit all removable media to be used on a VA system to

Biomedical Engineering for scanning with anti-virus software prior to use.

v. In the case turn-in, exchange, repair, or replacement of equipment containing hard drives used by the VA, the hard drives shall be removed from the equipment and remain in possession of the VA (this includes loaned or rented equipment).

vi. The contractor shall take all necessary precautions to prevent damage to any government property. The contractor shall report any damages immediately and shall be assessed current replacement costs for property damaged by the contractor, unless corrective action is taken. Any damaged material (i.e., trees, shrubs, lawn/turf, curbs, gutters, sidewalks, etc.) will be replaced in a timely manner or corrected by the contractor with like materials, at no extra cost to the government, upon approval of the Contracting Officer.

5.4 Training.

i. Contractor shall be responsible for providing on-site training to clinical staff/users.

ii. Training is to be scheduled in advance with the designated on-site POC.

iii. Education shall be provided prior to and/or at time of installation.

iv. Education professional shall be certified to provide instruction on the designated equipment/system.

v. Education curriculum must include: operations and set-up, user maintenance, safety, and user troubleshooting tips.

5.5 Inspection and Acceptance.

i. Contractor shall conduct a joint inspection with the on-site POC upon completion of installation.

ii. In the event deficiencies are identified, the contractor shall provide the date when the identified deficiencies will be addressed if not addressed on the date of installation.

The Contractor shall conduct a joint inspection with the on-site POC after addressing all deficiencies. All deficiencies identified in the joint inspections shall be corrected by the Contractor prior to Government acceptance of the item. Any disputes shall be resolved by the Contracting Officer.

5.6 Deliverables.

The Contractor shall provide the below documentation for the proposed equipment to TBA within 10 business days of work completion:

i. Service report.

ii. Warranty information.

iii. Electronic copy of the Operators Manual.

iv. Electronic copies of the complete technical service manuals, including troubleshooting guides, necessary diagnostic software and equipment information, schematic diagrams, and parts lists.

6. Hours of Operation.

DC VAMC’s normal business hours are Monday-Friday, 8:00 am to 4:30 pm, excluding observed Federal holidays:

New Year’s Day Labor Day Martin Luther King’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Juneteenth Christmas Day Independence Day Any other national holiday as declared by the President of the United States

7. Period of Performance. Delivery within 90 days from contract award.

PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1.00 UN __________________ __________________

Topcon IDS-300 Mini-Lane with CV-5000s Refraction desk

PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

MANUFACTURER PART NUMBER (MPN): 24445K1-OM

2.00 UN __________________ __________________

Topcon OS-300 Deluxe Stool with Back

PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, MANUFACTURER PART NUMBER (MPN): 13081K53-OM

Topcon CV-5000S KIT W/POLARIZED MC-5S PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, MANUFACTURER PART NUMBER (MPN): 26011-BL-000-FSS

Topcon IDS-300 Dual Table-Top

PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, MANUFACTURER PART NUMBER (MPN): 23000DUAL-FSS

Topcon KR-800S Auto Kerato-Refractometer

PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, MANUFACTURER PART NUMBER (MPN): 15097-FSS

Topcon SL-D701 Slit Lamp

PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, MANUFACTURER PART NUMBER (MPN): 28070UK-FSS

Topcon SOLOS Auto Lensmeter

PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, MANUFACTURER PART NUMBER (MPN): 42-0001417-OM

Installation, Calibration & On-Site Training

PRINCIPAL NAICS CODE: 339112 - Surgical and Medical Instrument Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, MANUFACTURER PART NUMBER (MPN): TRAINING

GRAND TOTAL __________________

Manufacturer: Topcon