JA 760-21-1-050-0002_q0712_redacted_.pdf

VHAPM Part 813.106 Simplified Acquisition Procedures: Soliciting from a Single Source Attachment 1: Single Source Justification for SAP under the SAT

VHAPM Part 813.106 Original Date: 08/30/17 Revision 02 Eff Date: 03/31/2020

DEPARTMENT OF VETERANS AFFAIRS

Justification for Single Source Awards IAW FAR 13.106-1 For

Over Micro-Purchase Threshold but Not Exceeding the SAT ($250K)

Acquisition Plan Action ID: 36C770-20-AP-0798

1. Contracting Activity:

Department of Veterans Affairs Network 15 Contracting Office (NCO 15) 3450 South 13th Street Leavenworth, KS 66048

Department of Veterans Affairs, Leavenworth CMOP (760) Leavenworth, KS 66048-5581 Purchase request number: 760-21-1-050-0002

2. Brief Description of Supplies/ Services required and the intended use/Estimated Amount:

$222,100.00

Manufacturer # #MMT-326A Brand RESERVOIR,MINIMED #MMT-326A

NDC 76300-0326-10

• QTY : 2000/ 10 per BX

• Est Value:

• Delivery: 10 Days After Receipt of Order Total Cost =

VHAPM Part 813.106 Original Date: 08/30/17 Revision 02 Eff Date: 03/31/2020

Manufacturer # MMT381 Brand SET,MEDICATION

ADMINISTRATION,PARADIGM SILHOUETTE,13

MM CANNULA, ADHESIVE DRESSING,23 INCH

TUBING,DISPOSABLE,STERILE

NDC 76300-0381-10

• QTY : 800 BX

• Est Value:

• Delivery: 10 Days After Receipt of Order

Total Cost =

Manufacturer # #MMT-377 Brand SET,INFUSION MINIMED #MMT-377

NDC 76300-0377-10

• QTY: 300 BX

• Est Value:

• Delivery: 10 Days After Receipt of Order

Total Cost =

VHAPM Part 813.106 Original Date: 08/30/17 Revision 02 Eff Date: 03/31/2020

Manufacturer # #MMT-332A Brand RESRVOIR, MINIMED #MMT-332A

NDC 76300-0332-10

• QTY: 1,800 BX

• Est Value:

• Delivery: 10 Days After Receipt of Order

Total Cost =

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used:

a. This is not a J&A for a Sole Source procurement.

b. This a J&A for a Name Brand Only Item - available from multiple suppliers.

c. Name Brand Only is designated under Physician’s Orders.

d. The CMOP facility and CMOP contracting office do not have the authority to arbitrarily change or modify the Physician’s Prescription (i.e. substitute a generic brand for a name brand).

e. Within the Veterans Health Administration brand name drugs and medical surgical (MedSurg) products may be prescribed by physicians when in their clinical judgment the brand name drug/MedSurg will provide a better therapeutic outcome for patients.

f. Brand name drugs and MedSurg are requested when there is a clinical requirement for the drug/product or there is history of clinical requirements for the drug/product and inventory must be maintained to meet anticipated requirements.

VHAPM Part 813.106 Original Date: 08/30/17 Revision 02 Eff Date: 03/31/2020

4. Description of market research conducted and results or statement why it was not conducted:

a. J&A supporting an RFQ for a - NAME BRAND ONLY - MedSurg Supply item, used in Patient Care. - “Name Brand Only” meaning - no other like item will do.

b. No Generic MedSurg Item from another manufacturer will be accepted.

c. “Name Brand Only” originates with the VA Physician treating Veteran Patients

d. A VA Physician has prescribed a specific Name Brand MedSurg item for Veteran use/treatment.

e. Neither the CMOP nor Contracting Officer have the authority to change a Physician’s prescription.

f. This limits the Bids to one manufacturer but does not limit all bids from one source. –

g. One Manufacturer (Name Brand) – there are several different suppliers/sources.

ROBIN HALSTEAD

ROBIN.HALSTEAD@VA.GOV

VA CMOP Leavenworth – 760

Robin M.

Halstead 375606

Digitally signed by Robin M. Halstead 375606 Date: 2020.10.20 09:55:26 -05'00'

VHAPM Part 813.106 Original Date: 08/30/17 Revision 02 Eff Date: 03/31/2020

5. Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106-1(b). I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Prepared by:

Johnson, George A.

Contract Specialist

Approved by:

Crum, Ralph R.

Supervisory Contract Specialist

GEORGE A

JOHNSON 1048817

Digitally signed by GEORGE A

JOHNSON 1048817

Date 2020.10.20 10 17 16 -05'00'

Ralph R.

Crum 547284

Digitally signed by Ralph R. Crum 547284 Date: 2020.10.20 10:49:22 -05'00'