ATTACHMENT H_CERTIFICATION OF RECALL OR SAFETY ISSUES.docx
DOCX document 30 KB Posted
- Attached to
- NX EQ Lasers Ho-YAG
- Solicitation number
- 36C10G25R0032
About this file
This document is a Certification of Recall or Safety Issues form for the VA's NX EQ Lasers Ho-YAG solicitation (36C10G25R0032). The certification requires quoters to confirm that their medical equipment, specifically Holmium (Ho-YAG) Surgical Lasers, has no outstanding recalls or known safety issues, and complies with all relevant medical equipment regulations and standards.
The associated federal contract opportunity seeks a national single Requirements contract for Holmium Surgical Lasers, primarily for the Veterans Health Administration. The lasers will be used across VA medical centers in CONUS and OCONUS locations, with a focus on clinical applications such as urology, gynecology, gastroenterology, and general surgery. The contract includes a 12-month base period with four 12-month option periods, with the primary objective of providing Lumenis Pulse 120H Holmium Laser System or equivalent equipment. Contractors must demonstrate the ability to meet all solicitation requirements for these specialized medical lasers.
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Attachment J Certification of Recall or Safety Issues Instructions to Quoters:
1. Complete all fields in the certification form.
2. Ensure that the form is signed by an authorized representative of the company.
3. Submit the completed form along with your quote.
Certification of No Outstanding Recalls or Safety Issues Solicitation Number: 36C10G25R0032 Requirement for: NX EQ Lasers Ho-YAG
Company Unique Entity Identifier (UEI): __________________________________________
Certification:
By signing below, I, the undersigned, certify on behalf of the company identified by the UEI above, the medical equipment quoted in response to the above-referenced solicitation:
1. Does not have any outstanding recalls.
2. Does not have any known safety issues.
3. Complies with all relevant regulations and standards for medical equipment.
4. Has been thoroughly checked for compliance with safety and performance standards.
I understand that any false or misleading information provided in this certification may result in disqualification from the solicitation process and other penalties as permitted by law.
Authorized Representative:
Name: __________________________________________ Title: __________________________________________ Signature: __________________________________________ Date: __________________________________________
File details come from the government source that posted it. Updated .