Bid Board Notice IFB Blood Collection Forms.03212023.pdf

BID BOARD NOTICE

PROCURMENT ID NUMBER: BPM032484

ISSUE DATE: 03/21/2023

TITLE: Blood Collection Forms 77 & 79

DUE DATE: 03/31/2023 at 2:00PM

THIS SOLICITATION SHALL BE MADE IN ACCORDANCE WITH THE SMALL PROCUREMENT

REGULATIONS DESCRIBED IN COMAR 21.05.07

Brief Description of Services:

The Maryland Department of Health – Laboratories Administration is seeking the services of a vendor to supply printed blood collection forms to the Laboratories Administration. The DHMH 77 and DHMH 79 forms are medical devices supplied to hospitals and pediatricians throughout the

State of Maryland. These forms are used to collect and send blood samples to State Labs as mandated by COMAR 10.10.13.00 Title 10 Department of Health and Mental Hygiene Subtitle 10

Laboratories Chapter 13 Medical Laboratories – Testing for Hereditary and Congenial Disorders in

Newborn Infants. The DHMH 77 form is for use when the baby is less than 7 days old and the

DHMH 79 is used to collect the second blood sample when the baby is 7 days of age or older.

I. PROCUREMENT OBJECTIVES

A. Issuing Office

Maryland Department of Health

1770 Ashland Avenue

Baltimore, Maryland 21205

The Contract Monitor for this solicitation:

Crystal Price crystal.price1@maryland.gov

443-681-3811

B. Submission Deadline

Bids must be submitted through eMMA on March 31, 2023 no later than 2:00PM.

mailto:crystal.price1@maryland.gov

II. GENERAL INFORMATION FOR VENDORS

A. Contract

1. The contract resulting from this solicitation shall be a fixed price contract

2. The Department reserves the right to reduce or withhold contract payment in the event the Contractor does not provide the Department with all required deliverables within the time frame specified in the contract or in the event that the Contractor otherwise materially breaches the terms and conditions of the contract.

B. Submission of Bids

Bidders MUST submit bid through eMMA. No emailed bids will be accepted. Please be sure to include your total price.

C. Vendor Experience and References

Vendor must be registered and in good standing with the Maryland Business

Express.

D. Transmittal Letter

A transmittal letter prepared on the Bidder’s business stationary MUST accompany the bid. The purpose of this letter is to transmit the bid; therefore, it should be brief. The letter shall be signed by an individual or corporate officer who is authorized to bind his firm to all statements, including services, material availability, timeliness and prices contained in the bid.

E. Selection Process

The contract resulting from this solicitation shall be awarded to the responsible and responsive bidder whose bid meets the requirements noted in this solicitation document, and is the most favorable bid price (lowest cost).

III. TECHNICAL SPECIFICATIONS

BLOOD COLLECTION FORMS 77 & 79

GENERAL

This procurement is to supply printed blood collection forms to Laboratories Administration. The

DHMH 77 and DHMH 79 forms are medical devices supplied to hospitals and pediatricians throughout the State of Maryland. These forms are used to collect and send blood samples to

State Labs as mandated by COMAR 10.10.13.00 Title 10 Department of Health and Mental Hygiene

Subtitle 10 Laboratories Chapter 13 Medical Laboratories – Testing for Hereditary and Congenial

Disorders in Newborn Infants. The DHMH 77 form is for use when the baby is less than 7 days old and the DHMH 79 is used to collect the second blood sample when the baby is 7 days of age or older.

CONTRACT PERIOD – 04/03/2023 – 04/02/2024

FINAL FORM APPROVAL

After contract has been awarded the vendor will be responsible for supplying sample forms for

“FINAL PROOF APPROVAL” to the agency’s end user. Agency Contact information will be provided at the time of award.

DELIVERY OF FORMS

Forms are to be delivered twice per year. Each shipment is to contain about 70,000 of DHMH Form

77 and 70,000 of DHMH Form 79. The first shipment is to be delivered within 6-8 weeks of the final proof approval. Subsequent shipments are to be coordinated with the end-user.

Newborn Screening Blood Collection Forms

Size: DHMH 77 5” x 9” (including filter paper and cover)

DHMH 79 4” x 9” (including filter paper and cover)

Four Part Form:

All four pages are glued together at the BOTTOM and perforated. Include serial number in numerals and as a barcode on the bottom of the form and as numerals on the filter paper. Include expiration date.

1) Top page is white lab copy (does not cover filter paper).

2) Second page is tinted submitter copy, carbonless, which extends over the filter paper.

3) Third page is carbonless copy with filter paper attached. Filter paper extends 1 ¼” beyond end of carbonless paper for total length of 9”.

4) Fourth page is the specimen cover. It is longer than 9” to provide a flap that will fold over the filter paper.

Specimen Cover:

1) Stiff paper; printed on both sides; top folds over filter paper.

2) Instructions and diagram on the inside to fold back at the dotted line to suspend the blood spots for drying.

3) On the back, print blood collection instructions, diagram of foot, examples of acceptable and unacceptable blood spots and the screening panel box.

4) The flap that folds over the blood specimen displays biohazard symbol.

Filter Paper:

1) Blood collection paper must meet CDC parameters for mean blood-absorption time, blood-spot diameter, serum-absorption volume and homogeneity of analyte spreading for newborn screening blood collection matrices and must have FDA approval for marketing the device.

2) Attach to top of form.

3) Include lot number of filter paper.

4) Print serial number in numerals.

5) Print “FILL ALL CIRCLES WITH BLOOD” centered below circles.

6) Print five circles; size of circle = ½ inch internal diameter.

7) Position the circles close to the lower (free) edge of the filter paper. Leave a space 3/16 inch or less between edge of circle and edge of filter paper.

Patient History:

1) DHMH 77 and DHMH 79 samples (attached) list the fields needed on each form in the order they should appear (to conform to the order of fields on our data entry screen).

NOTE: Contractor is alerted to take the following precautions:

1. The printing press must be absolutely clean to insure that no contaminants are absorbed into the filter paper.

2. When passing through the gluing press and/or the printing process, the filter paper must not be calendared as this will affect the absorbency of the paper. The contractor should maintain, and provide upon request, written documentation that the quality and performance characteristics of the filter paper have not been changed or affected in any way by the printing, gluing or collation processes.

3. The glue to be used must be insoluble and provide maximum adhesion. When dried, the glue must leave no residue other than the glue line, cause no effect on the absorbency of the filter paper, and emit no vapors when the finished product is wrapped and sealed. Size of glue line is to be 1/4" minimum, and is to be positioned no closer than 1/2 inch to printed circles on filter paper.

Type of glue is left to the discretion of printer.

4. The ink used on the filter paper and filter paper flap must be an FDA approved, bio-inactive ink.

THIS SPACE INTENTIONALLY LEFT BLANK

Layouts of 77 & 79 Blood Collection Forms:

BID PAGE

Price is based on Section III Technical Specifications for the period of one year 04/03/2023 –

04/02/2024. Please provide price per form for each. Total Price not to exceed $100,000.00.

BLOOD COLLECTION FORM 77 $_______________________ (price per form – 140,000 forms)

BLOOD COLLECTION FORM 79 $_______________________ (price per form – 140,000 forms)

TOTAL BASE PRICE $_______________________ (total price – NTE 100K)

Bid Price Authorized by:

Name/Title____________________________________________________

Signature________________________________Date_______________

Address____________________________________________________

City, State, Zip________________________________________________

Federal ID #:__________________________________________________

Phone Number/Fax Number______________________________________ eMM#_______________________________________________________

E-mail Address________________________________________________

THE STATE OF MARYLAND ENCOURAGES

MINORITY BUSINESS ENTERPRISES TO

PARTICIPATE IN THIS PROCUREMENT PROCESS.