HT941026Q2080 SOW NMCSD and NHCP.pdf

Statement of Work 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 a total of five (5) nitrous oxide & oxygen delivery systems with all accessories for a complete, usable system including regulators, vacuum connectors, hoses, disposable masks, and breathing circuits to support the operations of the following two (2) medical treatment facilities (MTFs): Naval Medical Center San Diego (NMCSD), Labor and Delivery Department and Naval Hospital Camp Pendleton (NHCP), Maternal Infant Services Department. Each nitrous oxide & oxygen delivery system shall consist of two (2) medical gas cylinders pre-mixed with 50% nitrous oxide and 50% oxygen, designed for use with the analgesia delivery machine. The systems shall include a compatible nitrous oxide regulator and medical gas hose to ensure secure, leak-free connection to the analgesia delivery machine. The system shall provide safe, on-demand inhalation analgesia for patient pain management during procedures such as labor, minor medical interventions, and bedside procedures. The 50/50 premixed formulation ensures consistent gas concentration, compliance with medical safety standards, and ease of use by trained clinical staff. The contractor shall supply all items, services, delivery functions, and training necessary to meet the requirements described herein, in accordance with standard commercial practices.

II. Description of Supplies/Equipment

The contractor shall provide the following commercially available contract line items (CLINs) meeting the requirements below:

0001 Item Name: Nitrous Oxide & Oxygen Delivery 50/50 System – NMCSD with Two (2) Cylinders (N2O and O2)

Quantity: 2 Unit of Measure: Each Specifications:

• Mixture Settings: Preset 50% N₂O / O₂ (50/50 model)

• Flow Rate: Up to 100 L/min total flow at 50% N₂O / O₂

• Gas Supply Pressure:

o O₂: 45 to 60 psi o N₂O: 45 to 60 psi

• Safety Features:

o Key lock mechanism for safety and security o Audible low gas pressure alarm o One-way directional flow (patient cannot breathe back into the system)

• Connection Fittings:

o Oxygen Inlet: DISS 1240 (Male) o Nitrous Oxide Inlet: DISS 1040A (Male)

• Tank Requirement: Uses standard "E" cylinders Accessories Required:

• 2 Oxygen Hoses

• 2 Vacuum Connectors

• 8 Replacement Yoke Washers

• 10 Small Disposable Masks

• 10 Medium Disposable Masks

• 10 Large Disposable Masks

• 1 Case (QTY: 20 each) Disposable Breathing Circuits

0002 Item Name: Onsite Training Session – NMCSD

Quantity: 1 Unit of Measure: Each

0003 Item Name: Virtual Training Session – NMCSD Quantity: 2

0004 Item Name: Nitrous Oxide & Oxygen Delivery 50/50 System – NHCP with Two (2) Cylinders (N2O and O2)

Quantity: 3 Unit of Measure: Each Specifications:

• Mixture Settings: Preset 50% N₂O / O₂ (50/50 model)

• Flow Rate: Up to 100 L/min total flow at 50% N₂O / O₂

• Gas Supply Pressure:

o O₂: 45 to 60 psi o N₂O: 45 to 60 psi

• Safety Features:

o Key lock mechanism for safety and security o Audible low gas pressure alarm o One-way directional flow (patient cannot breathe back into the system)

• Connection Fittings:

o Oxygen Inlet: DISS 1240 (Male) o Nitrous Oxide Inlet: DISS 1040A (Male)

• Tank Requirement: Uses standard "E" cylinders Accessories Required:

• 3 Oxygen Hoses

• 3 Vacuum Connectors

• 20 Replacement Yoke Washers

• 20 Small Disposable Masks

• 20 Medium Disposable Masks

• 10 Large Disposable Masks

• 4 Cases (QTY: 20 each) Disposable Breathing Circuits

0005 Item Name: Onsite Training Session – NHCP

Quantity: 1

0006 Item Name: Virtual Training Session – NHCP Quantity: 2

The Nitrous Oxide & Oxygen Delivery 50/50 System must meet the following salient physical, functional, and/or performance characteristics:

• The required system must provide a safe, reliable, and patient controlled method of delivering a consistent, premixed, inhaled analgesic gas for short-term pain and anxiety relief during medical procedures and suction to remove excess air.

• At a minimum, the system must be FDA-cleared and include safe gas delivery, patient-controlled use, compatibility with medical gas source, scavenging / gas removal capability, clinical workflow efficiency, infection control, and hygiene.

• The system shall include all components necessary for immediate clinical use.

• The system shall not require annual factory recalibration.

• Quoter SHALL confirm that the proposed system does not require annual factory recalibration. If system requires an annual factory recalibration is SHALL be deemed Technical Unacceptable.

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 Locations:

CLINs 0001 – 0003:

Naval Medical Center San Diego Labor and Delivery Department 34800 Bob Wilson Dr.

San Diego, CA 92134

CLINs 0004 – 0006:

Naval Hospital Camp Pendleton Maternal Infant Services Department 200 Mercy Circle Camp Pendleton, CA 92055

Delivery Schedule:

Items shall be delivered on the following delivery date(s): 90 Days After Receipt of Order

(ARO)

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 three (3) years.

V. Invoicing and Payment

Wide Area WorkFlow (WAWF) Points of Contact (POCs):

WAWF POC – NMCSD (CLINs 0001 – 0003):

Name: HA Isaac Delgadillo Title: Supply/Equipment Manager Email: isaac.delgadillo4.mil@health.mil Phone: (619) 532-8022

WAWF POC – NHCP (CLINs 0004 – 0006):

Name: Hector Flores Title: Management Analyst Email: hector.m.flores22.civ@health.mil Phone: (760) 421-9811

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 POCs:

NMCSD POCs:

mailto:isaac.delgadillo4.mil@health.mil mailto:hector.m.flores22.civ@health.mil

Name: HA Isaac Delgadillo Title: Supply/Equipment Manager Email: isaac.delgadillo4.mil@health.mil Phone: (619) 532-8022

Name: LCDR Gregory Yuen Title: Department Head, Labor and Delivery Department Email: gregory.yuen2.mil@health.mil Phone: (760) 805-3106

NHCP POCs:

Name: HM3 Alice Hicks Title: Supply Petty Officer Email: alice.g.hicks.mil@health.mil Phone: (760) 719-4551

Name: LT Mary Hinson Title: Department Head, Maternal Infant Services Department Email: Mary.b.hinson2.mil@health.mil Phone: (760) 719-3026 mailto:isaac.delgadillo4.mil@health.mil mailto:gregory.yuen2.mil@health.mil mailto:alice.g.hicks.mil@health.mil mailto:Mary.b.hinson2.mil@health.mil