ATTACHMENT A RFQ 36C24525Q0671 Eye Clinic Equipment for Hershel Woody Williams VAMC.pdf

ATTACHMENT A

Eye Clinic Equipment for Hershel "Woody" Williams VAMC

Statement of Work (SOW)

Background: The mission of the Hershel “Woody” Williams VAMC is to provide patient care. The mission of the Optometry Service is to provide assessment, diagnosis, and treatment of vision care. This acquisition will be multiple pieces of equipment that will be needed for day-to-day eye exams.

Objective: This acquisition will be multiple pieces of equipment that will be needed for day-to-day eye exams. Without these items, we will not be able to have a routine eye clinic at the new Prestonsburg location. These include but are not limited to the patient chair, the phoropter (used to check eyeglasses prescriptions), the acuity chart, the slit lamp, etc. All items are required for basic eye exams.

Place of Performance: The place of performance will be the eye clinic at the new Prestonsburg CBOC.

Prestonsburg CBOC 236 North Highland Avenue Prestonsburg, KY 41653

Deliverables:

• The contractor shall provide a price quote for the line items listed in the ITEM INFORMATION section.

• The contractor will coordinate with the Veterans Affairs Medical Center department of biomedical engineering, to service all on-site installation of hardware.

• The contractor shall provide a warranty for the products and provide any on-going support within the frame of the warranty-period. The warranty shall be pursued and maintained by the department of biomedical engineering.

• The products will be installed and used at the new Prestonsburg CBOC.

• Contractor must be an authorized distributor of products and show evidence from manufacturer.

• If proposing an “equal to” product, the price quote must show evidence that the “equal to” product meets or exceeds the brand name product’s capability, functional, compatibility and performance. The Contracting Officer will evaluate “equal” products on the basis of information furnished by the contractor. The Contracting Officer is not responsible for locating or obtaining any information not identified in the price quote. Unless the price quote clearly indicates that the product being offered is an “equal” product, the contractor shall provide the brand name product referenced in the solicitation.

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1.00 EA __________________ __________________

Reliance 942 Chair Glide

LOCAL STOCK NUMBER: CS1RL942

Reliance 7900-IC Floor Unit with Wheelchair Modification, #20 Pear

LOCAL STOCK NUMBER: CS0RL7900ICW20FG

Reliance 5348 Pneumatic Stool, #206 Charcoal with Back and D Shaped Cushion

LOCAL STOCK NUMBER: ST0RL5348CH

Reliance 7000-LFC Chair, #20 Pearl, Upholstery Color Required

LOCAL STOCK NUMBER: CS0RL7000L20

Reliance 7000 Designer Cushion Set, #206 Charcoal

LOCAL STOCK NUMBER: CS0RL7000UCH

Volk 90D Small Aspheric Lens, Clear (21.5mm), with Black Ring

LOCAL STOCK NUMBER: IL0VO90SMC

Volk 78D Small Aspheric Lens, Clear (31mm), with Black Ring

LOCAL STOCK NUMBER: IL0VO78SMC

Volk 20D Large Aspheric Lens, Clear (50mm), with Black Ring

LOCAL STOCK NUMBER: IL0VO20LGC

Volk VPRC Pan Retinal 2.2 Lens Clear (52mm), with Black Ring

LOCAL STOCK NUMBER: IL0VOPANC

Luneau Retinoscopy Rack

LOCAL STOCK NUMBER: RR0LU122084

Marco Brightness Acuity Tester Head Only

LOCAL STOCK NUMBER: BAT-2000

Welch Allyn 71670 3.5v NiCad Well Handle

LOCAL STOCK NUMBER: HI0WA71670NI

Reichert AVIA Tonopen

LOCAL STOCK NUMBER: TO0RE230650

Reliance 5399 Monitor Arm

LOCAL STOCK NUMBER: CS1RL0538992

Lombart Metal Trial Frame

LOCAL STOCK NUMBER: TF0LOMTFFG

Stereo Randot Test

LOCAL STOCK NUMBER: RA0SORANDOT

H.R.R. Pseudoisochromatic Color Test, 4th Edition

LOCAL STOCK NUMBER: CT0ZZHRR

Red Maddox Rod Long Handle - Occluder

LOCAL STOCK NUMBER: OC0ZZLHRM

Horizontal Prism Bar

LOCAL STOCK NUMBER: PR0ZZB15

Vertical Prism Bar

LOCAL STOCK NUMBER: PR0ZZB14

Stereo Distance Randot Stereo - Test

LOCAL STOCK NUMBER: RA0SODRANDOT

ARK-1A Automatic Objective Refractor/Keratometer

LOCAL STOCK NUMBER: ARK-1A

Reliance 7800/7900 Third/Auxiliary Arm, #20 Pearl

LOCAL STOCK NUMBER: CS1RL53801120

Small Top for TA0LOLET Electric Table, 23.5 x 16

LOCAL STOCK NUMBER: TA0LOTOPS

Lombart Table Plate (T Style)

LOCAL STOCK NUMBER: TA9LOTPLATE

Lensmeter, LM-101 Manual Operation

LOCAL STOCK NUMBER: LE0MA101

Exam Lane Installation

LOCAL STOCK NUMBER: SVRAEINSTALLLANE

Pre-Test Instrument Installation

LOCAL STOCK NUMBER: SVRAEINSTALLPT