Combined Synopsis and Solicitation - HT940626QE116.pdf

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Fit Check Solo
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0012462833
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RFQ Summary: Fit Check Solo Systems

This is a Combined Synopsis/Solicitation Request for Quotation (RFQ) issued by the Defense Health Agency Contracting Activity (DHACA), Southeastern Healthcare Operations Contracting Division for the procurement of Fit Check Solo hearing protector fit-testing systems. The requirement supports Navy and Marine Corps Force Health Protection Command (NMCFHPC) Portsmouth, Virginia, and is set aside for small businesses under full and open competition. The solicitation is for commercial products classified under NAICS 339112 (Surgical and Medical Instrument Manufacturing) and PSC 6515 (Medical and Surgical Instruments, Equipment, and Supplies). Quotes must be submitted electronically by 5:00 PM EST on September 22, 2026, with delivery required by October 30, 2026. Contractors must be registered in the System for Award Management (SAM) to be eligible. Payment will be made in arrears on a Net 30 basis through Wide Area WorkFlow (WAWF) electronic invoicing.

The procurement requires 12 complete FitCheck Solo systems including accessories, such as 2-subject turnkey systems with Panasonic Toughbook laptops, 6 additional systems with Android tablets, and 4 optional earmuff F-MIRE systems. All materials, labor, equipment, travel, and shipping must be included in the firm fixed price. The government will conduct a best value evaluation considering three factors: Business Summary (completeness), Technical Capability (subjective evaluation with acceptable or unacceptable ratings), and Price (completeness and fair and reasonable assessment). Technical capability is weighted more heavily than the other factors combined. Quotes must be submitted in four separate volumes: Business Summary (2-page limit), Technical Capability (15-page limit), and Completed RFQ with pricing (variable pages). All equipment must be brand new, and procurement must be exclusively from the Original Equipment Manufacturer or an OEM-authorized dealer to ensure warranty validity and software support.

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Combined Synopsis/Solicitation

Synopsis/Solicitation Requirement HT940626QE116 is issued as a Request for Quotation (RFQ). This solicitation for commercial products or commercial services is prepared and solicited in accordance with the Federal Acquisition Regulation (FAR) Overhaul Subpart 12.201-1 supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested, and a separate written solicitation will not be issued.

The Defense Health Agency Contracting Activity (DHACA), Southeastern Healthcare Operations Contracting Division intends to procure a firm-fixed price purchase order for Fit Check Solo in support of Navy and Marine Corps Force Health Protection Command (NMCFHPC) Portsmouth, Virginia. Provide all materials, labor and equipment to complete the required task. Additionally, the vendor is to provide any required travel and shipping.

This requirement is under North American Industry Classification System (NAICS) number 339112 – Surgical and Medical Instrument Manufacturing, Product Service Code (PSC) 6515 – Medical and Surgical Instruments, Equipment, and Supplies.

Deliver By: 30 October 2026

Competition Approach: Full and Open Competition – Set-aside for Small Businesses

Submission of Quote: Prospective contractors are required to follow the instructions and requirements of Addendum to 52.212-1 and Addendum 52.212-2 included in this document.

Questions or Clarifications: All questions are to be submitted via email to the Contract Specialist, Luis Zeno-Pimentel, luis.a.zeno-pimentel.civ@health.mil and Contracting Officer, Melissa Peregrino, melissa.peregrino-white.civ@health.mil with email subject: RFQ HT940626QE116 – Fit Check Solo. The Government may not respond to questions received less than 5 days prior to the due date and time for receipt of quotations.

Incumbent Contractor: This is a new contract.

Attachments:

Attachment I – Combined Synopsis / Solicitation – Request for Quote mailto:luis.a.zeno-pimentel.civ@health.mil mailto:melissa.peregrino-white.civ@health.mil

ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES.

a. Contract award. The Government intends to evaluate quotes and award a contract without discussions with Contractors. Therefore, the Contractor’s initial quote should contain the Contractor’s best terms. However, the Government reserves the right to conduct discussions, if necessary. The Government may reject any or all quotes if such action is in the public interest, accept other than the lowest quote, and waive informalities and minor irregularities in quotes received. This solicitation does not commit the Government to pay any costs incurred in the preparation and submission of a quote or for any other costs incurred by any contractor submitting a quote in response to this solicitation.

b. Submission of quotes. Submit signed and dated quotes to the office specified in this solicitation at or before the exact time specified in this solicitation. As a minimum, quotes shall include the following:

Proprietary information shall be clearly marked. Proprietary information submitted in response to this solicitation will be protected from unauthorized disclosure as required by Subsection 27 of the Office of Procurement Policy Act as amended (41 U.S.C. 423), hereinafter referred to as “the Act”, as implemented in the FAR.

Contractors must be registered in System for Award Management (SAM) in order to be eligible to be awarded a Department of Defense (DoD) contract.

Contractors must provide the information necessary to evaluate the factors contained in provision at Addendum 52.212-2. The Government will not make assumptions concerning intent, capabilities, or experiences. Clear identification of quote details is the sole responsibility of the offeror. Failure to clearly address all submittal requirements, evaluation criteria and information requirements of the RFQ may result in rejection of the offer.

Submission Requirements: Quote shall be submitted in four (4) separate volumes as shown below:

Volume Factor Title Format Page Limitation

I 1 Business Summary PDF 2

II

Technical Capability PDF 15

IV 3 Completed Combined Synopsis and Solicitation / RFQ (include pricing)

PDF varies

Contractors shall not lock, encrypt, copy as an image, password protect or otherwise place barriers to opening files for their quote submissions. If the Government cannot access the electronic version to complete evaluation, the government will consider the quote invalid, and the quote will be deemed ineligible for award.

Incomplete offers may be considered non-responsive and removed from further consideration.

Additionally, to ensure a fair evaluation process, each contractor is permitted to submit only one quote. If a contractor submits more than one original quote, the government may invalidate all submissions from that contractor, who would then be considered ineligible for the contract award.

This policy does not apply to revised quotes requested by the government.

Format. All materials shall be in typeface Times New Roman 12 point (or Arial 12 point) and formatted to print on 8-1/2 x 11” white paper with one-inch margins all around. Tables and illustrations may use reduced font style but not less than 8-point. All material submitted may be single-spaced. Each page must provide identification of the submitting contractor in the header or footer.

The quote shall not contain any extraneous information such as advertisements or marketing information. Elaborated formats, or color presentations are not desired or required. Oral presentations will not be considered for this solicitation competition. The Government does not require any paper quotes and will not accept faxed quote copies.

Specific Instructions by Volume: Contractors shall provide each volume as explained below:

Volume I - Factor 1 Business Summary:

The contractor’s business summary must include the following details:

• Legal entity name and any "doing business as" alias.

• Full address and phone number.

• The address where the work will be performed (if different from your main address).

• CAGE Code and Unique Entity ID.

• GSA contract number(if applicable)

• Verification statement of their representations and certifications in SAM.gov affirming that these representations and certificates are current, complete, and accurate as of the date quotes are due.

• Period for acceptance of quotes. State whether the Contractor agrees to hold the prices in its quote firm for 90 calendar days from the date specified for receipt of quotes, unless another time period is specified in an addendum to the solicitation.

• Reference the RFQ number.

• Include a statement confirming your agreement with all terms, conditions, and provisions outlined in the solicitation.

• Acknowledgement of all amendments, if any.

• Affirm your company's ability to fulfill the stated requirement.

• Provide the total quoted price.

• The business summary document shall be signed by a company representative who is authorized to obligate the company. This person's contact information must also be included.

Volume II - Factor 2 Technical Capability – Do not include pricing information in this factor document.

Technical Capability Statement Requirements: To demonstrate the ability to meet the requirements of this RFQ, the capability statement must prove the contractor's expertise, qualifications, and authority to provide the required items and services. The submission must address the following areas:

• PWS Compliance and Execution Plan: The contractor must demonstrate a clear understanding of the requirements and detail how they will meet every part of the scope and each specific task in PWS. This section must include an implementation plan and an estimated transition timeframe.

• Proposed Solution Details: The statement must thoroughly describe all proposed items, resources, and methods, including specifications, performance capabilities, delivery schedules, and warranties.

• Equipment Condition: All parts and equipment must be brand new.

Volume III - Factor 3 Price

Use Attachment I- Request for Quote to prepare and submit the price offer. Contractors shall provide the shipping price included in their quoted firm fixed price to facilitated price evaluation. The contractor may add rows, columns, or spreadsheets to accommodate the required pricing information. Contractors shall provide the necessary details and supporting information to address the solicitation requirements and to allow a complete analysis of each line-item price. All quoted prices must not contain more than two (2) decimal places and shall be Free on Board (FOB) Destination.

c. Submissions, Late submissions, modifications, revisions, and withdrawals of quotes.

a. Contractors are responsible for submitting quotes and any modifications or revisions electronically to the Contract Specialist, Luis Zeno-Pimentel, luis.a.zeno-pimentel.civ@health.mil and Contracting Officer, Melissa Peregrino, melissa.peregrino-white.civ@health.mil before or at 5:00pm Eastern Standard Time (EST) 22 September 2026. All correspondence shall reference RFQ HT940626QE116 – Fit Check Solo in the email subject line and all enclosed documents.

b. Any quote, modification, or revision received after the time specified for receipt of quotes is “late” and will not be considered.

c. Contractors may withdraw their quotes by written notice to the Government received at any time before award.

d. Exceptions/Assumption to TOPR Requirements. Contractors are required to meet all solicitation requirements, such as terms and conditions; representations and certifications; and technical requirements. Failure to meet a requirement may result in an offer being ineligible for award. If necessary, contractors must clearly identify any exception to the solicitation terms and conditions and provide complete accompanying rationale. Each exception shall be specifically related to each paragraph and/or specific part of the solicitation to which the exception is taken. Provide rationale in support of the exception and fully explain its impact, if any, on the performance, schedule, price, and specific requirements of the solicitation. This information shall be provided in the format and content of table below.

Solicitation Document

Page/paragraph Requirement/Portion Rationale

PWS, Part X, Pricing Applicable Page and Identify the requirement or Describe Why the mailto:luis.a.zeno-pimentel.civ@health.mil mailto:luis.a.zeno-pimentel.civ@health.mil

Template, Past Performance

Paragraph Numbers portion to which exception is taken.

requirement can/will not be met.

(End of provision)

ADDENDUM TO 52.212-2 EVALUATION--COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES

a. The Government will award a contract resulting from this solicitation to the responsible contractor whose quote conforming to the solicitation will be most advantageous to the Government, price and other factors considered.

The Government intends to evaluate offers and issue a firm fixed price contract based on the initial offers received, utilizing the procedures found at Federal Acquisition Regulation (FAR) Overhaul Subpart 12.203 supplemented with additional information included in this document.

The Government intends to evaluate quotes and award a contract without discussions with Contractors. However, the Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary.

Contractors shall include all four (4) volumes listed in Addendum to 52.212-1. Incomplete quotes may be considered non-responsive and removed from further consideration.

BASIS FOR AWARD

This is a Best Value procurement. The Government may elect to award to other than the lowest priced quote where the perceived benefits merit the higher price, and the price is determined fair and reasonable. Conversely, the Government may select a lower-priced quote, and the technical capability is rated as acceptable.

The Government will review quotes to determine if they are complete and compliant with the solicitation requirements. A compliant quote is one that meets all the terms, conditions, and specifications in the solicitation. The contractor shall provide all documents listed and shall comply with all RFQ instructions for the quote to be considered “compliant and complete” with this solicitation. The Government may consider a contractor ineligible for award if any required document was not submitted by the required date and time; it is incomplete (missing items, signatures, etc.), or it does not comply with format requirements.

The following factors shall be used to evaluate quotes:

Factor 1: Business Summary;

Factor 2: Technical Capability;

Factor 3: Price

Factor 2 is more important than Factor 1 and Factor 3, Factor 3 is more important than Factor

1. Evaluation factors other than price when combined are significantly more important than price.

Factor 1 Business Summary: Evaluation of this factor will be for completeness.

Completeness: The business summary will be reviewed to determine the extent to which all the required elements listed in Addendum to 52.212-1 have been addressed. A business summary that fails to address all required elements may be excluded from further consideration.

Factor 2 Technical Capability/Medical Device and Equipment Risk Assessment Form:

Evaluation of this factor is a subjective evaluation of the contractor's understanding/capability/approach, demonstrated resources, and methods to meet all requirements.

The following adjectival ratings/definitions shall be used for the Technical Evaluation Factor. The combined technical/risk rating includes consideration of risk in conjunction with the strengths, weaknesses and deficiencies in determining technical ratings. Combined technical/risk evaluations shall utilize the combined technical/risk ratings listed below.

The contractor’s quote will be evaluated to determine whether the proposed capability approach demonstrates a clear and unambiguous understanding and a demonstrated ability to meet the requirements. Failure to demonstrate a clear and unambiguous capability approach to meeting the requirements will result in an “Unacceptable” rating for this factor.

Technical

Rating Description

Acceptable Quote meets requirements and indicates an adequate approach and understanding.

Unacceptable Quote does not meet requirements of the solicitation, and thus contains one or more deficiencies, and/or risk of unsuccessful performance is unacceptable.

Factor 3 Price: The Government will evaluate price for completeness and whether quoted prices are fair and reasonable. Prices must be entirely compatible with the capability portion of the quote.

Completeness: The Contractor’s pricing sheet will be reviewed to determine the extent to which the quote fulfills the solicitation requirements and whether all the price elements have been addressed.

The Contractor’s proposed price will be evaluated to ensure continuity and traceability of prices to the solicitation requirements. The Government may make a final rating determination based on the quote as submitted without requesting any further information.

Fair and Reasonable: The degree to which the proposed prices, base period and Option periods, compared to the prices, a reasonably prudent person would expect to incur for the same or similar services. The Factor 4 – Price/Attachment II – Pricing Template and any pricing information submitted will be evaluated to identify unusual high-price, inconsistent pricing patterns, and potential misunderstandings of the requirement. Comparison of quoted prices received in response to the solicitation and/or comparison of quoted prices with the Independent Government Estimate and historical prices may be used to determine whether a price is fair and reasonable. A contractor with pricing that reasonableness is determined to be questionable for any period of performance may not be considered for award.

(b) A written notice of award or acceptance of a quote, mailed or otherwise furnished to the successful contractor within the time for acceptance specified in the quote, shall result in a binding contract without further action by either party. Before the quote’s specified expiration time, the Government may accept a quote (or part of a quote), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

Solicitation/Contract Form Fit Check Solo

Product Service Code: 6515

HT940626QE116

Supplies or Services & Prices or Costs Additional Information/Notes

Essential Characteristics

Requirement Title: FitCheck Solo

Department: Navy and Marine Corps Force Health Protection Command (NMCFHPC)

1. Background/Acquisition History of the item(s) required. This is a new requirement.

2. Name/Nomenclature of item and quantity required: FitCheck Solo - 12 systems including accessories

a. Briefly describe the functionality of the equipment

The FitCheck Solo is a specialized quantitative hearing protector fit-testing system. Measures the real-world, individual protection a specific user receives from their hearing protection devices (HPDs) and uses Real-Ear Attenuation at Threshold.

b. List any requirements for this equipment to be compatible with any existing equipment.

It functions as an independent, non-invasive acoustic testing station utilizing a laptop, specialized headphones, and a patient response switch.

c. List specific delivery, transportation, and installation requirements.

System consists of lightweight, portable components rather than heavy clinical machinery, the delivery and setup footprint is minimal.

There is no existing legacy equipment to be de-installed, decommissioned, or removed by the vendor.

d. List any unique facility specifications/accommodations required for the equipment to be operational within your facility.

It is desktop-based headphone system and does not require complex clinical utility hookups (like specialized plumbing, high-voltage power, or reinforced flooring).

The entire system (laptop, headphones, and response button) is portable, weighs less than 10 lbs., and sits on a standard office desk or examination table. Utility Requirements: Standard 110/120V AC electrical outlets are sufficient to power the system host computer. There are no specialized requirements for water supply, drainage, dedicated clinical ventilation, or high-capacity power lines.

e. For equipment that is required to be stationary or affixed, provide the dimensions of the available space.

The FitCheck Solo system is a portable, non-stationary desktop testing suite. It does not need to be permanently affixed, wall-mounted, or anchored to the facility's structure. The system operates entirely on a desk or mobile clinic cart. A minimum flat workspace of 36" Width x 24" Depth is sufficient to accommodate testing.

f. List any environmental factors regarding the equipment that should be taken into consideration?

Climate Controls: The FitCheck Solo system is designed for operation in a standard climate-controlled indoor medical environment. It should be operated within a temperature range of 50F to 104F (10C to 40C) and stored within -4F to 122F (-20C to 50C), with relative humidity kept between 30% and 75% (non-condensing).

Hygiene and Maintenance: The system headphones must be wiped down with approved, non-abrasive clinical sanitizing wipes between patients. Avoid exposing the headset, response button, etc. to moisture, liquids, or excessive dust.

g. Annotate the voltage and electrical requirements for the equipment.

Input Power: The system host computer utilizes a standard auto-ranging power adapter compatible with 100-240V AC, operating at 50/60 Hz, single phase. Current and Power Draw: The maximum electrical current draw is approximately 1.5A to 2.0A, with a nominal power consumption of 65W to 90W (standard laptop power range). Connection Type: The system connects to a standard grounded NEMA 5-15R wall outlet (15 Amp). No dedicated circuits or specialized hospital-grade high-voltage outlets are required. The acoustic hardware components (headphones and patient response button) are powered directly via the host computer's 5V DC USB ports.

h. Annotate whether the equipment has a need to be from an Original Equipment Manufacturer authorized dealer/distributor/seller for any service, software, warranty, or maintenance requirements.

Yes. The government requires that the FitCheck Solo systems, software licenses, and associated hardware components be procured exclusively from the Original Equipment Manufacturer (OEM) or an OEM-authorized dealer, distributor, or seller. Warranty Validation: The manufacturer's standard warranty remains fully valid and enforceable. Software Licensing and Support: The software licenses are legitimate, fully supported, and eligible for critical security patches and software updates. Hardware Integrity: Any future repair, component replacement (e.g., matching headphones/attenuators), or servicing is performed using genuine OEM parts that comply with clinical safety and acoustic testing standards. This work can be accomplished by NMCFHPC Calibration Laboratory.

i. List any training requirement for initial training on the use or maintenance of the equipment. Specify the desired format for training (online, on-site, in-person, etc.)

Desired Format: Virtual / Online. Due to the intuitive, plug-and-play nature of this commercial off-the-shelf (COTS) system, on-site training is not required.

Supplemental Materials: provide comprehensive written training materials, including the standard User Guide and Quick Start Guide, for ongoing self-paced familiarization by clinic staff.

3. List any Cybersecurity requirements for this equipment.

Standalone / No Interface. The system operates as an isolated software package on non-network computers and does not interface with network systems or have/ require network capability.

a. List any specifications for Authorization to Operate (ATO) approvals for this equipment.

N/A

Equipment List:

2 subject turnkey system, including Panasonic Toughbook laptop FitCheck host software, one client Android tablet, QR code scanner, headphones Panasonic Toughbook laptop Additional client Android tablets, pre-programmed, headphones Total, 6 systems

FitCheck Solo original single subject complete system Total, 12 systems

FitCheck Solo for Earmuffs F-MIRE system, option for FitCheck Solo original system Total, 4 systems

Item Supplies / Services Quantity Unit Unit Price Amount

Fit Check Solo

See Essential Characteristics and Equipment & Price List

Manufacturer's Part Number: Various Pricing Arrangement: Firm Fixed Price

1 Lot

Description/Specifications/Statement of Work

Requirements Fit Check Solo

Product Service Code: 6515

Packaging and Marking

Inspection and Acceptance Overall Contract Inspection/Acceptance Locations

Inspection and Acceptance Location

Both Destination Instructions: See Contract Terms and Conditions for Inspection and Acceptance criteria.

DoDAAC: HT0525 CountryCode: USA

NAVY MEDICINE EAST - MM

20 JOHN PAUL JONES CIRCLE, PORTSMOUTH VA 23708-2106

PORTSMOUTH, VA 23708-2106

UNITED STATES

Deliveries or Performance

Line Item Delivery Schedule Quantity Address and POC Special Handling/Notes

Delivery On Or Before Delivery Date 30 Oct 2026

1 Lot Ship To DoDAAC: HT0525 CountryCode: USA

NAVY MEDICINE EAST - MM

20 JOHN PAUL JONES CIRCLE, PORTSMOUTH VA 23708-2106

PORTSMOUTH, VA 23708-2106

UNITED STATES

FoB Details Contractor Destination

Contract Administration Data

VENDOR TO COMPLETE THE FOLLOWING:

Vendor Name:

Vendor Point of Contact:

Vendor Address:

Vendor Phone:

Vendor E-Mail:

UEI:

CAGE:

Vendor to reference Open Market Quote HT940626QE116 on all correspondence relating to this RFQ.

Defense Health Agency Contracting Agency Point of Contact:

Melissa Peregrino E-Mail: melissa.peregrino-white.civ@health.mil (questions via e-mail only)

Payment in Arrears, Net 30

Note: Vendor will be required to provide billing electronically via the WAWF Electronic Invoicing Method. For additional information, a review of the following websites may be required:

https://wawf.eb.mil/

PROMPT PAYMENT: For Prompt Payment Act purposes, this contract is:

Subject to the 7-calendar day constructive acceptance period.

DFARS Clauses Incorporated by Reference

Number Title Effective Date

Alternate/ Deviation

Variation Effective Date

252.201-7000 Contracting Officer's Representative. Dec 1991 252.232-7003 Electronic Submission of Payment Requests and Receiving Reports. Dec 2018

DFARS Clauses Incorporated by Full Text

252.232-7006 Wide Area WorkFlow Payment Instructions. (Jan 2023)

WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JAN 2023)

(a) As used in this clause- Definitions.

"Department of Defense Activity Address Code (DoDAAC)" is a six position code that uniquely identifies a unit, activity, or organization.

"Document type" means the type of payment request or receiving report available for creation in Wide Area WorkFlow (WAWF).

"Local processing office (LPO)" is the office responsible for payment certification when payment certification is done external to the entitlement system.

"Payment request" and "receiving report" are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(b) The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Electronic invoicing.

Defense Federal Acquisition Regulation Supplement (DFARS) 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) To access WAWF, the Contractor shall- WAWF access.

(1) Have a designated electronic business point of contact in the System for Award Management at https://www.sam.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site.

(d) The Contractor should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site WAWF training.

before submitting payment requests through WAWF. Both can be accessed by selecting the "Web Based Training" link on the WAWF home page at https:// wawf.eb.mil/

(e) Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol. WAWF methods of document submission.

(f) The Contractor shall use the following information when submitting payment requests and receiving reports in WAWF for WAWF payment instructions.

this contract or task or delivery order:

(1) The Contractor shall submit payment requests using the following document type(s): Document type.

(i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher.

(ii) For fixed price line items-

(A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer.

(Contracting Officer: Insert applicable invoice and receiving report document type(s) for fixed price line items that require shipment of a deliverable.)

(B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer.

(Contracting Officer: Insert either "Invoice 2in1" or the applicable invoice and receiving report document type(s) for fixed price line items for services.)

(iii) For customary progress payments based on costs incurred, submit a progress payment request.

(iv) For performance based payments, submit a performance based payment request.

(v) For commercial financing, submit a commercial financing request.

(2) ) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract.

[Note: The Contractor may use a WAWF "combo" document type to create some combinations of invoice and receiving report in one step.]

(3) The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating Document routing.

payment requests and receiving reports in the system.

Routing Data Table*

Field Name in WAWF Data to be entered in WAWF

Pay Official DoDAAC HQ0490

Issue By DoDAAC HT9406

Admin DoDAAC HT9406

Inspect By DoDAAC N/A

Ship To Code HT0242

Ship From Code N/A

Mark For Code N/A

Service Approver (DoDAAC) HT0242

Service Acceptor (DoDAAC) HT0242

Accept at Other DoDAAC N/A

LPO DoDAAC N/A

DCAA Auditor DoDAAC N/A

Other DoDAAC(s) N/A

(*Contracting Officer: Insert applicable DoDAAC information. If multiple ship to/acceptance locations apply, insert "See Schedule" or "Not applicable.")

(**Contracting Officer: If the contract provides for progress payments or performance-based payments, insert the DoDAAC for the contract administration office assigned the functions under FAR 42.302(a)(13).)

(4) The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in Payment request.

accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable.

(5) The Contractor shall ensure a receiving report meets the requirements of DFARS Appendix F. Receiving report.

(g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact.

usn.ncr.bumedfchva.list.bumed-piee-support@health.mil

(Contracting Officer: Insert applicable information or "Not applicable.")

(2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed.

(End of clause)

Special Contract Requirements

Contract Clauses

FAR Clauses Incorporated by Reference

Number Title Effective Date

Alternate/ Deviation

Variation Effective Date

52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements. Jan 2017 52.204-13 System for Award Management-Maintenance. (Deviation 2026-O0038) Feb 2026

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded. (Deviation 2026-O0038)

Feb 2026

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations. (Deviation 2026-O0038) Feb 2026 52.212-4 Terms and Conditions-Commercial Products and Commercial Services. (Deviation 2026-O0038) Feb 2026 52.219-6 Notice of Total Small Business Set-Aside. (Deviation 2026-O0038) Feb 2026 52.222-3 Convict Labor. (Deviation 2026-O0038) Feb 2026 52.222-19 Child Labor-Cooperation with Authorities and Remedies. (Deviation 2026-O0038) Mar 2026 52.222-20 Contracts for Materials, Supplies, Articles, and Equipment. (Deviation 2026-O0038) Feb 2026 52.222-36 Equal Opportunity for Workers with Disabilities. (Deviation 2026-O0038) Feb 2026 52.222-50 Combating Trafficking in Persons. (Deviation 2026-O0038) Feb 2026 52.222-90 Addressing DEI Discrimination by Federal Contractors. (Deviation 2026-O0040, Revision 1) Apr 2026 52.223-23 Sustainable Products. (Deviation 2026-O0038) Feb 2026 52.225-3 Buy American-Free Trade Agreements-Israeli Trade Act. (Deviation 2026-O0038) Feb 2026 52.226-8 Encouraging Contractor Policies to Ban Text Messaging While Driving. May 2024 52.229-12 Tax on Certain Foreign Procurements. (Deviation 2026-O0038) Feb 2026 52.232-33 Payment by Electronic Funds Transfer-System for Award Management. Oct 2018 52.232-40 Providing Accelerated Payments to Small Business Subcontractors. Mar 2023 52.233-3 Protest after Award. (Deviation 2026-O0038) Feb 2026 52.233-4 Applicable Law for Breach of Contract Claim. (Deviation 2026-O0038) Feb 2026 52.240-91 Security Prohibitions and Exclusions. (Deviation 2026-O0038) Feb 2026 52.244-6 Subcontracts for Commercial Products and Commercial Services. (Deviation 2026-O0038) Apr 2026

DFARS Clauses Incorporated by Reference

Number Title Effective Date

Alternate/ Deviation

Variation Effective Date

252.203-7000 Requirements Relating to Compensation of Former DoD Officials. Sep 2011 252.203-7002 Requirement to Inform Employees of Whistleblower Rights. Dec 2022 252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting. May 2024 252.204-7018 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services. Jan 2023 252.223-7008 Prohibition of Hexavalent Chromium. Jan 2023 252.225-7056 Prohibition Regarding Business Operations with the Maduro Regime. Jan 2023 252.225-7060 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region. Jun 2023 252.232-7010 Levies on Contract Payments. Dec 2006 252.247-7023 Transportation of Supplies by Sea. Oct 2024

FAR Clauses Incorporated by Full Text

52.252-2 Clauses Incorporated by Reference. (Feb 1998)

CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far [Insert one or more Internet addresses]https://www.acquisition.gov/dfars ____

(End of clause)

DFARS Clauses Incorporated by Full Text

252.211-7003 Item Unique Identification and Valuation. (Jan 2023)

ITEM UNIQUE IDENTIFICATION AND VALUATION (JAN 2023)

(a) . As used in this clause- Definitions

"Automatic identification device" means a device, such as a reader or interrogator, used to retrieve data encoded on machine-readable media.

"Concatenated unique item identifier" means-

(1) For items that are serialized within the enterprise identifier, the linking together of the unique identifier data elements in order of the issuing agency code, enterprise identifier, and unique serial number within the enterprise identifier; or

(2) For items that are serialized within the original part, lot, or batch number, the linking together of the unique identifier data elements in order of the issuing agency code; enterprise identifier; original part, lot, or batch number; and serial number within the original part, lot, or batch number.

"Data matrix" means a two-dimensional matrix symbology, which is made up of square or, in some cases, round modules arranged within a perimeter finder pattern and uses the Error Checking and Correction 200 (ECC200) specification found within International Standards Organization (ISO)/International Electrotechnical Commission (IEC) 16022.

"Data qualifier" means a specified character (or string of characters) that immediately precedes a data field that defines the general category or intended use of the data that follows.

"DoD recognized unique identification equivalent" means a unique identification method that is in commercial use and has been recognized by DoD. All DoD recognized unique identification equivalents are listed at .https://www.acq.osd.mil/asda/dpc/ce/ds/unique-id.html

"DoD item unique identification" means a system of marking items delivered to DoD with unique item identifiers that have machine-readable data elements to distinguish an item from all other like and unlike items. For items that are serialized within the enterprise identifier, the unique item identifier shall include the data elements of the enterprise identifier and a unique serial number. For items that are serialized within the part, lot, or batch number within the enterprise identifier, the unique item identifier shall include the data elements of the enterprise identifier; the original part, lot, or batch number; and the serial number.

" Enterprise " means the entity (e.g., a manufacturer or vendor) responsible for assigning unique item identifiers to items.

" Enterprise identifier" means a code that is uniquely assigned to an enterprise by an issuing agency.

"Government's unit acquisition cost" means-

(1) For fixed-price type line, subline, or exhibit line items, the unit price identified in the contract at the time of delivery;

(2) For cost-type or undefinitized line, subline, or exhibit line items, the Contractor's estimated fully burdened unit cost to the Government at the time of delivery; and

(3) For items produced under a time-and-materials contract, the Contractor's estimated fully burdened unit cost to the Government at the time of delivery.

"Issuing agency" means an organization responsible for assigning a globally unique identifier to an enterprise, as indicated in the Register of Issuing Agency Codes for ISO/IEC 15459, located at http://www.aimglobal.org/?Reg_Authority15459.

"Issuing agency code" means a code that designates the registration (or controlling) authority for the enterprise identifier.

"Item" means a single hardware article or a single unit formed by a grouping of subassemblies, components, or constituent parts.

" Lot or batch number" means an identifying number assigned by the enterprise to a designated group of items, usually referred to as either a lot or a batch, all of which were manufactured under identical conditions.

"Machine-readable" means an automatic identification technology media, such as bar codes, contact memory buttons, radio frequency identification, or optical memory cards.

"Original part number" means a combination of numbers or letters assigned by the enterprise at item creation to a class of items with the same form, fit, function, and interface.

"Parent item" means the item assembly, intermediate component, or subassembly that has an embedded item with a unique item identifier or DoD recognized unique identification equivalent.

"Serial number within the enterprise identifier" means a combination of numbers, letters, or symbols assigned by the enterprise to an item that provides for the differentiation of that item from any other like and unlike item and is never used again within the enterprise.

"Serial number within the part, lot, or batch number" means a combination of numbers or letters assigned by the enterprise to an item that provides for the differentiation of that item from any other like item within a part, lot, or batch number assignment.

"Serialization within the enterprise identifier" means each item produced is assigned a serial number that is unique among all the tangible items produced by the enterprise and is never used again. The enterprise is responsible for ensuring unique serialization within the enterprise identifier.

"Serialization within the part, lot, or batch number" means each item of a particular part, lot, or batch number is assigned a unique serial number within that part, lot, or batch number assignment. The enterprise is responsible for ensuring unique serialization within the part, lot, or batch number within the enterprise identifier.

"Type designation" means a combination of letters and numerals assigned by the Government to a major end item, assembly or subassembly, as appropriate, to provide a convenient means of differentiating between items having the same basic name and to indicate modifications and changes thereto.

"Unique item identifier" means a set of data elements marked on items that is globally unique and unambiguous. The term includes a concatenated unique item identifier or a DoD recognized unique identification equivalent.

"Unique item identifier type" means a designator to indicate which method of uniquely identifying a part has been used. The current list of accepted unique item identifier types is maintained at .https://www.acq.osd.mil/asda/dpc/ce/ds/unique-id.html

(b) The Contractor shall deliver all items under a contract line, subline, or exhibit line item.

(c) Unique item identifier.

(1) The Contractor shall provide a unique item identifier for the following:

(i) Delivered items for which the Government's unit acquisition cost is $5,000 or more, except for the following line items:

Contract Line, Subline, or

Exhibit Line Item Number Item Description

(ii) Items for which the Government's unit acquisition cost is less than $5,000 that are identified in the Schedule or the following table:

Contract Line, Subline, or

Exhibit Line Item Number Item Description

(If items are identified in the Schedule, insert "See Schedule in this table.)

(iii) Subassemblies, components, and parts embedded within delivered items, items with warranty requirements, DoD serially managed reparables and DoD serially managed nonreparables as specified in Attachment Number .____

(iv) Any item of special tooling or special test equipment as defined in FAR 2.101 that have been designated for preservation and storage for a Major Defense Acquisition Program as specified in Attachment Number .____

(v) Any item not included in (i), (ii), (iii), or (iv) for which the contractor creates and marks a unique item identifier for traceability.

(2) The unique item identifier assignment and its component data element combination shall not be duplicated on any other item marked or registered in the DoD Item Unique Identification Registry by the contractor.

(3) The unique item identifier component data elements shall be marked on an item using two dimensional data matrix symbology that complies with ISO/IEC International Standard 16022, Information technology - International symbology specification - Data matrix; ECC200 data matrix specification.

(4) The Contractor shall ensure that- Data syntax and semantics of unique item identifiers.

(i) The data elements (except issuing agency code) of the unique item identifier are encoded within the data matrix symbol that is marked on the item using one of the following three types of data qualifiers, as determined by the Contractor:

(A) Application Identifiers (AIs) (Format Indicator 05 of ISO/IEC International Standard 15434), in accordance with ISO/IEC International Standard 15418, Information Technology - EAN/UCC Application Identifiers and Fact Data Identifiers and Maintenance and ANSI MH 10.8.2 Data Identifier and Application Identifier Standard.

(B) Data Identifiers (DIs) (Format Indicator 06 of ISO/IEC International Standard 15434), in accordance with ISO/IEC International Standard 15418, Information Technology - EAN/UCC Application Identifiers and Fact Data Identifiers and Maintenance and ANSI MH 10.8.2 Data Identifier and Application Identifier Standard.

(C) Text Element Identifiers (TEIs) (Format Indicator 12 of ISO/IEC International Standard 15434), in accordance with the Air Transport Association Common Support Data Dictionary; and

(ii) The encoded data elements of the unique item identifier conform to the transfer structure, syntax, and coding of messages and data formats specified for Format Indicators 05, 06, and 12 in ISO/IEC International Standard 15434, Information Technology - Transfer Syntax for High Capacity Automatic Data Capture Media.

(5) . Unique item identifier

(i) The Contractor shall-

(A) Determine whether to-

Serialize within the enterprise identifier; (1)

Serialize within the part, lot, or batch number; or (2)

Use a DoD recognized unique identification equivalent (e.g. Vehicle Identification Number); and (3)

(B) Place the data elements of the unique item identifier (enterprise identifier; serial number; DoD recognized unique identification equivalent;

and for serialization within the part, lot, or batch number only: original part, lot, or batch number) on items requiring marking by paragraph (c)(1) of this clause, based on the criteria provided in MIL-STD-130, Identification Marking of U.S. Military Property, latest version;

(C) Label shipments, storage containers and packages that contain uniquely identified items in accordance with the requirements of MIL- STD-129, Military Marking for Shipment and Storage, latest version; and

(D) Verify that the marks on items and labels on shipments, storage containers, and packages are machine readable and conform to the applicable standards. The contractor shall use an automatic identification technology device for this verification that has been programmed to the requirements of Appendix A, MIL-STD-130, latest version.

(ii) The issuing agency code-

(A) Shall not be placed on the item; and

(B) Shall be derived from the data qualifier for the enterprise identifier.

(d) For each item that requires item unique identification under paragraph (c)(1)(i), (ii), or (iv) of this clause or when item unique identification is provided under paragraph (c)(1)(v), in addition to the information provided as part of the Material Inspection and Receiving Report specified elsewhere in this contract, the Contractor shall report at the time of delivery, as part of the Material Inspection and Receiving Report, the following information:

(1) Unique item identifier.

(2) Unique item identifier type.

(3) Issuing agency code (if concatenated unique item identifier is used).

(4) Enterprise identifier (if concatenated unique item identifier is used).

(5) Original part number (if there is serialization within the original part number).

(6) Lot or batch number (if there is serialization within the lot or batch number).

(7) Current part number (optional and only if not the same as the original part number).

(8) Current part number effective date (optional and only if current part number is used).

(9) Serial number (if concatenated unique item identifier is used).

(10) Government's unit acquisition cost.

(11) Unit of measure.

(12) Type designation of the item as specified in the contract schedule, if any.

(13) Whether the item is an item of Special Tooling or Special Test Equipment.

(14) Whether the item is covered by a warranty.

(e) For embedded subassemblies, components, and parts that require DoD item unique identification under paragraph (c)(1)(iii) of this clause or when item unique identification is provided under paragraph (c)(1)(v), the Contractor shall report as part of the Material Inspection and Receiving Report specified elsewhere in this contract, the following information:

(1) Unique item identifier of the parent item under paragraph (c)(1) of this clause that contains the embedded subassembly, component, or part.

(2) Unique item identifier of the embedded subassembly, component, or part.

(3) Unique item identifier type.**

(4) Issuing agency code (if concatenated unique item identifier is used).**

(5) Enterprise identifier (if concatenated unique item identifier is used).**

(6) Original part number (if there is serialization within the original part number).**

(7) Lot or batch number (if there is serialization within the lot or batch number).**

(8) Current part number (optional and only if not the same as the original part number).**

(9) Current part number effective date (optional and only if current part number is used).**

(10) Serial number (if concatenated unique item identifier is used).**

(11) Description.

** Once per item.

(f) The Contractor shall submit the information required by paragraphs (d) and (e) of this clause as follows:

(1) End items shall be reported using the receiving report capability in Wide Area WorkFlow (WAWF) in accordance with the clause at 252.232-7003. If WAWF is not required by this contract, and the contractor is not using WAWF, follow the procedures at http://dodprocurementtoolbox.com/site/uidregistry/.

(2) Embedded items shall be reported by one of the following methods-

(i) Use of the embedded items capability in WAWF;

(ii) Direct data submission to the IUID Registry following the procedures and formats at http://dodprocurementtoolbox.com/site/uidregistry/; or

(iii) Via WAWF as a deliverable attachment for exhibit line item number (fill in) , Unique Item Identifier Report for Embedded Items, Contract ____ Data Requirements List, DD Form 1423.

(g) . If the Contractor acquires by subcontract, any item(s) for which item unique identification is required in accordance with paragraph (c)(1) of Subcontracts this clause, the Contractor shall include this clause, including this paragraph (g), in the applicable subcontract(s), including subcontracts for commercial products or commercial services.

(End of clause)

List of Attachments

Representations, Certification, & Other Statements

FAR Clauses Incorporated by Reference

Number Title Effective Date

Alternate/ Deviation

Variation Effective Date

52.240-90 Security Prohibitions and Exclusions Representations and Certifications. (Deviation 2026-O0038) Feb 2026

DFARS Clauses Incorporated by Reference

Number Title Effective Date

Alternate/ Deviation

Variation Effective Date

252.203-7005 Representation Relating to Compensation of Former DoD Officials. Sep 2022 252.204-7008 Compliance with Safeguarding Covered Defense Information Controls. Oct 2016 252.225-7055 Representation Regarding Business Operations with the Maduro Regime. May 2022 252.225-7059 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region-Representation. Jun 2023

FAR Clauses Incorporated by Full Text

52.225-4 Buy American-Free Trade Agreements-Israeli Trade Act Certificate. (Deviation 2026-O0038) (Feb 2026)

BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT CERTIFICATE (FEB 2026) (DEVIATION 2026-O0038)

(a) The Offeror certifies that each end product, except those listed in paragraph (b) or (c)(1) of this provision, is a domestic end product and that each domestic (1) end product listed in paragraph (c)(2) of this provision contains a critical component.

(2) The terms "Bahraini, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "critical component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act."

(b) The Offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Free Trade Agreement Country End Products (Other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line item No.

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