P03 Brand Name Only Justification_Redactedv.pdf

VHAPM Part 813.106 Page 1 of 2 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

Acquisition Plan Action ID: 36C257-21-AP-3622

1. Contracting Activity:

The agency responsible for this acquisition is: Department of Veterans Affairs, VISN 17, VA North Texas Health Care System (VANTHCS),4500 South Lancaster Road, Dallas, Texas, 75216.

Transaction Number

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

The proposed VANTHCS action is for the Volk Pictor Prestige Retinal Imaging System (Brand name only). The Volk Pictor Prestige Retinal Imaging System is a compact hand-held ultra-widefield retinal imaging device that can provide greater imaging functionality & portability.

It is necessary for a collaboration pilot project with to deliver Retinal Imaging in clinics and at the bedside. VANTHCS will be sharing an imaging server with the who is already using this imaging system.

The estimated amount is

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

This is the equipment used at the who will be piloting a process with and allowing to share their imaging servers. This system will allow the Imaging Technicians to go into the clinics and inpatient units to take quality retinal images for patients in any situation, in under 90 seconds.

In accordance with the original equipment manufacturer (OEM) equipment terms and conditions, only Volk Optical Inc. trained and certified employees are authorized to distribute, repair and or service Polk Optical trademarked systems. Any service attempted or performed that is not authorized by Polk Optical will constitute a breach of the purchase agreement and will consequently void any warranty on the equipment in operation at

VANTHCS.

Salient Characteristics Display - 2.4” TFT-LCD with antireflective coating Image memory size - 2 GB SD card/1000+ images Integrated lens for general imaging (without module)

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 Page 2 of 2 Original Date: 08/30/17 Revision 02 Eff Date: 03/31/2020

Average usage time - 3 hours continuous use (two batteries included) Imaging Image Sensor – CMOS 5.0 megapixel • Image format - JPEG Video format - MPEG-4 and MPEG-1 Resolution in general mode – 2560 x 1920 pixels Automatic focusing Connectivity • Computer with USB port – no driver installation needed Interfaces to FDA and CE approved image analysis software User Interface Features Patient folders Image preview Maximum Portability Simple Integration

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

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

Matthew G. Clements Date Contracting Officer

Matthew G.

Clements 646011

Digitally signed by Matthew G.

Clements 646011 Date: 2021.07.19 14:58:53 -05'00'