JA Approved -Signed - Redacted Copy_Redacted.pdf

VHAPM Part 808.405-6 Limiting Sources Attachment 2: Request for Limited Sources Justification Format >SAT

LIMITED SOURCES JUSTIFICATION

ORDER >SAT

FAR PART 8.405-6

Acquisition Plan Action ID:

(1) Contracting Activity: Department of Veterans Affairs, Network Contracting Office (NCO)

16, G. V. (Sonny) Montgomery VA Medical Center (GVSM VAMC), 1500 E. Woodrow Wilson Drive, Jackson, MS 39216.

(2) Description of Action: This acquisition is conducted under the authority of the

MultipleAward Schedule Program (41 U.S.C. 152{3) and 40 U.S.C. 501). The GVSM VAMC is requesting preventative maintenance and repair service for Philips medical imaging equipment to include radiology, CT and MR systems. This is a new requirement to consist of five (5) months of service from August 1, 2021 through December 31, 2021.

Order against: C8J FSS Contract Number: VA NAC# VA797H-17-D-0022

Name of Proposed Contractor: Philips Medical Systems of North America

Street Address: 22100 Bothell Everett Highway

City, State, Zip: Bothell, WA 98021-3003

Phone:

(3) Description of Supplies or Services:

The estimated value of the proposed action is $ 340.544.90

A contract is needed to provide maintenance and repair services to include preventive maintenance inspections of the following devices:

System Name DigitalDiagnost Release 3

DigitalDiagnost 4 High Performance DigitalDiagnost 4 High Performance

DigitalDiagnost 4 High Performance

DigitalDiagnost 4 Chest / Emergency CombiDiagnost R90

Allura XPER FD20

Allura XPER FDlO Ingenuity Core 128

Ingenuity Core 128

VHAPM Part 808.405-6 limiting Sources Original Date: 08/30/2017 Revision 03 Eff Date: 03/18/2021

Site# 60832530 65963187

73623138

73623479

65963206

76218512 41792527

541667 65589595

73634713

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