This is a cost breakdown template for equipment associated with a maintenance and service agreement solicitation. The file is designed to accompany the SF1449 form submission for the Orthoscan Mini C-Arm Fluoroscopy Maintenance and Service Agreement at Naval Medical Readiness Training Center (NMRTC) Sigonella. Vendors must complete this attachment to detail annual costs for equipment maintenance and service, presenting all pricing in Euros across the specified Contract Line Item Numbers (CLINs). The solicitation (HT940626QE107) issued by the Defense Health Agency requires vendors to provide documentation confirming authorized service provider status from the original equipment manufacturer (OEM) for the Orthoscan Mini C-Arm equipment to be considered for award.
The cost breakdown template must be submitted with the completed SF1449 form, vendor information, and OEM authorization documentation. An amendment to the solicitation corrected CLIN 5001's quantity and unit of issue (UOI), with corresponding updates reflected in this cost breakdown attachment. Vendors must ensure all pricing is provided in Euros and that submissions include digitally certified signatures on page one of the SF1449; cursive signatures without digital certification will not be accepted. This template is essential for establishing transparent annual maintenance and service costs for the medical equipment at the military medical facility in Italy.
Defense Health Agency