Contract - HT941026PE240.pdf

WOMEN-OWNED SMALL

BUSINESS (WOSB)

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

1. REQUISITION NUMBER PAGE 1 OF

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME b. TELEPHONE NUMBER (No collect calls)

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NUMBER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

BELOW IS CHECKED

REQUEST

FOR QUOTE

(RFQ)

INVITATION

FOR BID

(IFB)

REQUEST

FOR

PROPOSAL

(RFP)

SEE ADDENDUM

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Government Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH

AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND

ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS

SPECIFIED

29. AWARD OF CONTRACT: REFERENCE OFFER

DATED . . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS UNRESTRICTED OR

NORTH AMERICAN

INDUSTRY CLASSIFICATION

STANDARD (NAICS):

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

THE DEFENSE PRIORITIES

AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

SET ASIDE: % FOR:

11. DELIVERY FOR FREE ON

BOARD (FOB) DESTINATION

UNLESS BLOCK IS MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

8(A)

ECONOMICALLY

DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30.

Solicitation/Contract Form Branch Clinic Makalapa 12-Lead Resting Electrocardiographs

HT941026PE240

Supplies or Services & Prices or Costs Additional Information/Notes

This award is made in reference to TrillaMed Quote #T307008 (Date: September 18, 2026) to provide two (2) GE MAC 7 12-Lead Resting Electrocardiographs for CLIN 0001. All associated accessories--including mobile carts/trolleys, lead wire acquisition arms, line hooks, resting tab electrodes, and thermal chart paper--are included for delivery to Branch Health Clinic Makalapa, Naval Health Clinic Hawaii.

Item Code Description Qt y

UO

M

Unit Price

Ext.

Price

2109091-001 MAC 7 2.

EA

CH

$0.00 $0.00

2109091-230 United States 2.

EA

CH

$0.00 $0.00

2109091-101 MAC 7 device - comes with one battery as standard 2.

EA

CH

$6,400 .00

$12,80 0.00

2109091-168 US AND CANADA POWER CORD 2.

EA

CH

$0.00 $0.00

2109091-801 STARTER KIT AHA TRUNK CABLE AND LEAD WIRES WITH ECG CLIPS 2.

EA

CH

$280.0

$560.0

2109091-103 MAC 7 Global Wireless 2.

EA

CH

$520.0

$1,040.

2109091-108 MAC 7 ADV CONNECT PACKAGE (Includes XML EXPORT and ADT/ORDERS) 2.

EA

CH

$2,080 .00

$4,160.

MAC7ACCESSBU

NDLE

MAC 7 Accessories Bundle 2.

EA

CH

$0.00 $0.00

2108408-001 MAC 7 Basic Compact Trolley 2.

EA

CH

$320.0

$640.0

2062313-010 OPT Simple Arm 2.

EA

CH

$48.00 $96.00

2110731-001 OPT Line Hook 2.

EA

CH

$24.00 $48.00

2104771-001 ECG Thermal Paper "8.5 x 11" White Patient Data Area, Red Grid 155MM wide, Z- Fold, 150 sheets, 16 packs

2.

EA

CH

$88.00 $176.0

ELT-RTABA-500 Resting ECG TAB Electrode, Solid Gel, Adult, 500/Box 2.

BX $20.00 $40.00

2091358-001 ECG WIFI - LAN GE INSTALL & CONFIGURATION PER CART CHARGE 2.

EA $250.0

$500.0

Total: $20,060.00

Item Supplies / Services Quantity Unit Unit Price Amount

Makalapa FP Electrocardiographs

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2109091-230 - United States Part Reference Number: 2109091-101 - MAC 7 device -comes with one battery as standard Part Reference Number: 2109091-168 - US AND CANADA POWER CORD Part Reference Number: 2109091-801 - STARTER KIT AHA TRUNK CABLE

AND LEAD WIRES WITH ECG CLIPS

Part Reference Number: 2109091-103 MAC 7 Global Wireless Part Reference Number: 2109091-108 MAC 7 ADV CONNECT PACKAGE (Includes XML EXPORT and ADT/ORDERS) Part Reference Number: 2109091-001 - MAC 7 Basic Contract Line Item Number: 0001 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 6,400.00

Firm Price

USD 12,800.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0001

Funded Amount

USD 12,800.00

STARTER KIT AHA TRUNK CABLE AND

LEAD WIRES with ECG CLIPS

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2109091-801 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 280.00

Firm Price

USD 560.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0002

Funded Amount

USD 560.00

MAC 7 Global Wireless

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2109091-103 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 520.00

Firm Price

USD 1,040.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0003

Funded Amount

USD 1,040.00

MAC 7 ADV CONNECT PACKAGE (Includes XML EXPORT and ADT/ORDERS)

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2109091-108 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 2,080.00

Firm Price

USD 4,160.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0004

Funded Amount

USD 4,160.00

MAC 7 Basic Compact Trolley MAC 7 Accessories Bundle

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2108408-001 Part Reference Number: MAC7ACCESSBUNDLE Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 320.00

Firm Price

USD 640.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0005

Funded Amount

USD 640.00

OPT Simple Arm

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2062313-010 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 48.00

Firm Price

USD 96.00

ACRN: AA

PR Number: HT06490012496771

Funded Amount

USD 96.00

PR Line Item Number: 0006

OPT Line Hook

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2110731-001 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 24.00

Firm Price

USD 48.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0007

Funded Amount

USD 48.00

ECG Thermal Paper "8.5 x 11" White Patient Data Area, Red Grid 155MM wide, Z-Fold, Hole Queue, 150 sheets, 16 packs

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: 2104771-001 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 88.00

Firm Price

USD 176.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0008

Funded Amount

USD 176.00

Resting ECG TAB Electrode, Solid Gel, Adult, 500/Box

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Part Reference Number: ELT-RTABA-500 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 20.00

Firm Price

USD 40.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0009

Funded Amount

USD 40.00

ECG WIFI - LAN GE INSTALL &

CONFIGURATION PER CART CHARGE

The contractor is required to furnish the items and related accessories in accordance with SOW and Attachment 1 - Quote # T307008 Confirmation Date: 09/18/2026 Quote Response to Supply Purchase Number

HT941026Q2091.

Firm Price

USD 500.00

Part Reference Number: 2091358-001 Basic Contract Line Item Number: 0002 Claimant Program Code: C9B Pricing Arrangement: Firm Fixed Price

2 Each USD 250.00

ACRN: AA

PR Number: HT06490012496771 PR Line Item Number: 0010

Funded Amount

USD 500.00

Description/Specifications/Statement of Work Statement of Work Makalapa ECG

I. Introduction

This Statement of Work (SOW) is issued in accordance with FAR Part 12 for the acquisition of commercial items. The purpose is to procure two (2) 12-Lead Resting Electrocardiographs to support the operations of Naval Health Clinic Hawaii Branch Health Clinic Makalapa. The contractor shall supply all items, services, and delivery functions necessary to meet the requirements described herein, in accordance with standard commercial practices.

II. Description of Supplies/Equipment

The contractor shall provide commercially available items meeting the following requirements:

1. Item Name: GE MAC 7 12-Lead Resting Electrocardiograph Manufacture: GE Healthcare / General Electric Part Number: Manufacture: GE Healthcare / General Electric

Part Number:

21090901-001 2109091-230 2109091-101 2109091-168 2109091-801 2109091-103 2109091-108

Quantity: 2

2. Item Name: MAC 7 Basic Compact Trolley Manufacture: GE Healthcare / General Electric Part Number: 2108408-001 Quantity: 2 Specifications: Locking/mechanical mounting mechanism to attach electrocardiograph

3. Item Name: OPT Simple Arm Manufacture: GE Healthcare / General Electric Part Number: 2062313-010 Quantity: 2 Specifications: Flexible metal arm to hold patient cables up and away from floor during exam that attached to the trolley/cart

4. Item Name: OPT Line Hook Manufacture: GE Healthcare / General Electric Part Number: 2110731-001 Quantity: 2 Specifications: Dedicated cable management hook that attaches to the trolley/cart

5. Item Name: Resting ECG TAB Electrode, Solid Gel, Adult, 500/Box Manufacture: GE Healthcare / General Electric Part Number: ELT-RTABA-500 Quantity: 2 Specifications: Medical standard Ag/AgCl sensors, solid gel tabs, 12-lead, latex-free/hypoallergenic

6. Item Name: ECG Thermal Paper 8.5 X 11, White Patient Data Area, Red Grid 155Mm Wide, ZFold, Hole Queue, 150 Sheets, 16 Packs Manufacture: GE Healthcare / General Electric Part Number: 2104771-001 Quantity: 2 4,800 pages Specifications: Z-Fold 8.5 inch x 11 inch, Red Grid standard grid layout (155mm-200mm wide grid lines), hole queue sensing marks along edge

The 12-Lead Resting Electrocardiograph must meet the following salient physical, functional, and/or performance characteristics:

Industry-validated, computerized ECG interpretation algorithm (equivalent to the GE Marquette 12SL) for adult and pediatric populations.

a. The algorithm must include gender- and pediatric-specific diagnostic criteria to improve accuracy in detecting cardiac events (such as acute myocardial infarction) based on physiological differences between men and women.

Must feature a color, high-resolution touchscreen interface (minimum 10 to 12 inches) for ease of use and wavelength review with an integrated digital keyboard.

Must be lightweight (less than 12 lbs), highly compact, and can function on a counter or mounted on a designated cart.

Must support bidirectional communication (DICOM, HL7, XML) for automated order downloading and result uploading to the Electronic Health Record without middleware Must be capable of cart-mounting with a small footprint, capable of operation on standard AC power and long-lasting backup battery (minimum 5.5 hours), and enclosed cable management.

The system must support secure, electronically deliverable software updates directly from the manufacturer, eliminating the operational need for manual field service visits or physical USB/media drives.

The items must conform to the specifications provided by the industry standard and include any manufacturer's literature or documentation that verifies conformance.

III. Delivery Requirements

Delivery Location:

480 Central Ave Bldg 1750 Joint Base Pearl Harbor-Hickam, HI 96860

Delivery Schedule:

Items shall be delivered on the following delivery date(s):

90 days after receipt of order

Partial shipments may be accepted if approved in writing by the Government.

Packaging & Marking:

Items should be packaged according to commercial standards to protect against damage during transit.

All shipments must be clearly marked with the contract number and item description.

IV. Quality Assurance & Inspection

Conformance:

All items shall be new, commercially acceptable, and conform to the performance specifications provided.

Inspection & Acceptance:

The Government reserves the right to inspect all deliveries at the point of receipt. Non-conforming items will be rejected and may be subject to replacement or repair at no additional cost.

Warranties:

All items must be covered by the manufacturer's warranty. The contractor shall provide warranties that the items will perform as described for a minimum period of 12 months.

V. Invoicing and Payment

Wide Area WorkFlow (WAWF) POC:

Name: Danica Hisatake Email: danica.e.hisatake.civ@health.mil Phone: (808) 474-4242 x9-1846

Invoices must reference the contract number and be submitted in accordance with the terms of the contract.

Payment:

Payments will be processed upon Government acceptance of the delivered items per the payment provisions of the contract.

VI. Points of Contact

Government POC:

Branch Health Clinic Makalapa, Naval Health Clinic Hawaii Name: LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Phone: (808) 473-1880 x9-2293

Branch Health Clinic Makalapa, Naval Health Clinic Hawaii Name: HM2 Michael DeLeon Email: Michael.a.deleon46.mil@health.mil Phone: (808) 473-1880 x9-2277

Requirements 12-Lead Resting Electrocardiographs

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Product Service Code: 6515

North American Industry Classification System (NAICS): 339115

Packaging and Marking

Inspection and Acceptance Overall Contract Inspection/Acceptance Locations

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Acceptance Location

Acceptance Destination Instructions: See Statement of Work (SOW) for Acceptance/inspection criteria.

DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084744242

Deliveries or Performance

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

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

FoB Details Contractor Destination

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Delivery On Or Before Delivery Date 08 Jan 2027

2 Each Ship To DoDAAC: HT0649 CountryCode: USA

NAVAL HEALTH CLINIC HAWAII - MM

PEARL HARBOR HI, 480 CENTRAL AVENUE

PEARL HARBOR, HI 96860-4908

UNITED STATES

LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Telephone: 8084731880

FoB Details Contractor Destination

Contract Administration Data

POINTS OF CONTACT (POC) AND DELIVERY INFORMATION HT941026PE240

VENDOR

Contractor POC:

Name: Elizabeth Scalzo Email: escalzo@trillamed.com Phone: (248) 433-0597

CONTRACTS

Name: Jennifer E. Collins Title: Senior Contract Analyst, Contractor, Amyx, Inc.

Department: Defense Health Agency Contracting Activity, Western Healthcare Operations Contracting Division, Echo Branch Email: jennifer.e.collins23.ctr@health.mil

Name: Cha-on P. Gordon Title: Contracting Officer Department: Defense Health Agency Contracting Activity, Western Healthcare Operations Contracting Division, Echo Branch Phone: (726) 203-0120 Email: cha-on.p.gordon2.civ@health.mil

DELIVERY POC/LOCATION

Branch Health Clinic Makalapa, Naval Health Clinic Hawaii Name: LT Ellen Koseck Email: ellen.l.koseck.mil@health.mil Phone: (808) 473-1880 x9-2293

Branch Health Clinic Makalapa, Naval Health Clinic Hawaii Name: HM2 Michael DeLeon Email: Michael.a.deleon46.mil@health.mil Phone: (808) 473-1880 x9-2277

DELIVERY LOCATION:

Naval Health Clinic Hawaii ATTEN: Makalapa Family Practice 480 Central Ave Bldg 1750

JBPHH, HI 96860-4983

NOTE TO CONTRACTOR

Contractor: Include the contract number, located in block 2 of this 1449, on all packing slips and ensure a copy of the packing slips are provided to the acceptor upon delivery at the facility designated in this order. Once you have entered your invoice in Wide Area Work Flow (WAWF) please contact the below listed WAWF Acceptor.

WAWF ACCEPTOR/ PAYMENT QUESTIONS

Name: Danica Hisatake Email: danica.e.hisatake.civ@health.mil

DEFENSE BIOMETRIC IDENTIFICATION SYSTEM (DBIDS)

(a) DBIDS is the current system for access control verification and management for the Department of Defense (DoD).

(b) DBIDS guidance for Vendors/Contractors to obtain a pass is accessible through the following website: https://www.cnic.navy.mil/Operations-and-Management/ Base-Support/DBIDS/

(c) For more information or to enroll in the DBIDS Program, call: 1 (202) 433-4784.

For the local Pass and ID Office at the following location(s), call: Naval Health Clinic Hawaii, HI - Makalapa (808) 449-0865/0867 or (808) 471-2405

(d) Pre-enrolling will help expedite your processing time. To pre-enroll for a DBIDS card, visit the following website: https://dbids-global-enroll.dmdc.mil/preenrollui/

(e) Vendors, contractors, suppliers, and other service providers shall present their pass upon entry at the entry control point (ECP).

ACRN LOA Total Amount

^^^097^2026^2026^^0130^000^^260^D^1^^^^^1800^^021001^AHOQ5^0010016563^^^6100.260R^^101000807900^

Line Item PR/MIPR - PR Line Item# CIN Amount

CLIN 0001 HT06490012496771 - 0001 USD 12,800.00

CLIN 0002 HT06490012496771 - 0002 USD 560.00

CLIN 0003 HT06490012496771 - 0003 USD 1,040.00

CLIN 0004 HT06490012496771 - 0004 USD 4,160.00

AA USD 20,060.00

CLIN 0005 HT06490012496771 - 0005 USD 640.00

CLIN 0006 HT06490012496771 - 0006 USD 96.00

CLIN 0007 HT06490012496771 - 0007 USD 48.00

CLIN 0008 HT06490012496771 - 0008 USD 176.00

CLIN 0009 HT06490012496771 - 0009 USD 40.00

CLIN 0010 HT06490012496771 - 0010 USD 500.00

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 before WAWF training.

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 this WAWF payment instructions.

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.

INVOICE AND RECEIVING REPORT COMBO

(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.

N/A

(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 HT9410

Admin DoDAAC HT9410

Inspect By DoDAAC HT0649

Ship To Code HT0649

Ship From Code N/A

Mark For Code N/A

Service Approver (DoDAAC) N/A

Service Acceptor (DoDAAC) N/A

Accept at Other DoDAAC N/A

LPO DoDAAC N/A

DCAA Auditor DoDAAC N/A

Other DoDAAC(s) N/A

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

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.

Danica Hisatake Email: Danica.e.hisatake.civ@health.mil

(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 52.204-9 Personal Identity Verification of Contractor Personnel. Jan 2011 52.204-13 System for Award Management-Maintenance. (Deviation 2026-O0038) Feb 2026 52.204-19 Incorporation by Reference of Representations and Certifications. Dec 2014 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 52.222-3 Convict Labor. (Deviation 2026-O0038) Feb 2026 52.222-19 Child Labor-Cooperation with Authorities and Remedies. (Deviation 2026-O0038) Mar 2026 52.222-36 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 52.226-8 Encouraging Contractor Policies to Ban Text Messaging While Driving. May 2024 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 52.233-1 Disputes. (Deviation 2026-O0038) Feb 2026 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 52.240-93 Basic Safeguarding of Covered Contractor Information Systems. (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 252.204-7003 Control of Government Personnel Work Product. Apr 1992 252.204-7004 Antiterrorism Awareness Training for Contractors. Jan 2023 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 252.211-7008 Use of Government-Assigned Serial Numbers. Sep 2010 252.223-7008 Prohibition of Hexavalent Chromium. Jan 2023 252.225-7001 Buy American and Balance of Payments Program. Feb 2024 252.225-7002 Qualifying Country Sources as Subcontractors. Mar 2022 252.225-7036 Buy American-Free Trade Agreements--Balance of Payments Program. Feb 2024 252.225-7048 Export-Controlled Items. Jun 2013 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 252.243-7001 Pricing of Contract Modifications. Dec 1991 252.244-7000 Subcontracts for Commercial Products or Commercial Services. Nov 2023 252.246-7008 Sources of Electronic Parts. Jan 2023 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 https://www.acquisition.gov/sites/default/files/page_file_uploads/RFO.pdf https://www.acquisition.gov/browse/index/far https://www.acquisition.gov/dfars

(End of clause)

52.252-6 Authorized Deviations in Clauses. (Nov 2020)

Authorized Deviations in Clauses (Nov 2020)

The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition (a) of "(DEVIATION)" after the date of the clause.

The use in this solicitation or contract of any (48 CFR ) clause with an authorized deviation is (b) Defense Federal Acquisition Regulation Supplement Chapter 2 indicated by the addition of "(DEVIATION)" after the name of the regulation.

(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

See Schedule See Schedule

(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

See Schedule See Schedule

(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 .N/A

(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 .N/A

(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…