P09 NWI ASPS Sarpy CBOC Astera 2 Audiometer SOW.docx

NWI VAHCS Sarpy Community-Based Outpatient Clinic Audiology and Speech Pathology – Madsen Astera 2 audiometer Statement of Work

Background: Purchase and install 2 diagnostic full-range 2-channel audiometers for use by Audiology at the new Sarpy CBOC site located at 1330 Jersey St, Papillion, NE 68046.

Requirements: Audiometer must be PC-based, operate on Otosuite software, the same software as NWI audiometers used for Tele-Audiology.

· FREQUENCY RANGE:

· TDH39 earphones: Standard frequencies: 125 – 12500 Hz

· HDA 300 earphones: Standard frequencies: 125 – 20000 Hz

· Insert earphones: Standard frequencies: 125 – 8000 Hz

· Bone conduction: Standard frequencies: 250 – 8000 Hz

· Sound field: Standard frequencies: 125 – 20000 Hz

· FRESH noise stimulus*: 125 – 20000 Hz

· NBN masking: Available in entire frequency range

· Frequency resolution: 1/6, 1/12, 1/24 and 1/48 octave as well as 1 Hz (You can store up to 24 points for each audiometry curve)

· OPERATES IN OTOSUITE SOFTWARE

· INTEGRATES WITH OTOSUITE PRODUCTS AND NOAH

· ABILITY TO IMPORT DATA TO CPRS

· FRESH NOISE STIMULUS: AVAILABLE IN ENTIRE FREQUENCY RANGE WITHIN THE TRANSDUCER SPECIFIED RANGE. (FOR SF 125-12500 HZ, ACCURACY 0.3%)

· FULLY INTEGRATED TINNITUS QUESTIONNAIRES (THI, THS, TFI,) WITH ABILITY TO STORE, REVIEW AND SHARE DATA DURING ASSESSMENT

· INTEGRATED PEDIATRIC MODULE WITH VISUAL REINFORCEMENT AUDIOMETRY (VRA)

· PC BASED TWO CHANNEL AUDIOMETER-TWO SEPARATE AND IDENTICAL CHANNELS

· AIR, BONE AND SPEECH AUDIOMETER

· FULLY INTEGRATED QUICKSIN TEST

· INTEGRATED PSYCHOACOUSTICAL TESTS FOR PITCH AND LOUDNESS MATCHING, MINIMUM MASKING LEVEL (MML), AND RESIDUAL INHIBITION (RI)

· SPECIAL TESTS SUCH AS TEN TEST AND SAL TEST

Purpose of Project:

Sarpy County CBOC has dedicated two audiometric test suites for treatment of hearing disorders at a convenient location to Veterans. Two FTE Audiologists will be staffed at the Sarpy site and there may be a third audiologist completing Compensation and Pension evaluations at this site on a regular basis. The site is designed with two audiometric test suites and will need two diagnostic full-range audiometers.

Delivery Schedule Items shall be delivered no earlier than the estimated delivery start date and no later than the delivery end date listed in Table 2 below. The NWI Sarpy CBOC has a requirement to purchase 2 diagnostic full-range audiometers with an authorized vendor to supply and deliver the item(s) identified in Table 1 below. This requirement is in support of a brand name or equal requirement. See FAR Clause 52.211-6 – Brand Name or Equal (AUG 1999) for additional information. See attachments for salient characteristics. This requirement is in support of the activation of the NWI Sarpy Outpatient Clinic. Item(s) are to be delivered to the location specified in section 2.4.1.

Table 1 – Package Items Summary

General Conditions Site Address The address of the Sarpy Outpatient Clinic is listed below. Additional information on delivery is located in section 2.4.

Sarpy CBOC/1330 Jersey Street/Papillion, NE 68046

Delivery Schedule Items shall be delivered no later than 30 days after purchase contract is awarded.

Schedule and Order Management The above delivery schedule is based upon the current construction schedule, which is subject to change. The vendor shall not increase prices for a change in delivery date for up to 90 days due to construction delays.

The awardees actual delivery dates will be confirmed by VA upon award.

Post-award the vendor will coordinate delivery prior to beginning any work (see section 2.4). Once the dates have been confirmed, modifications to the schedule are subject to written approval by the VA POC. Schedule changes that are beyond the dates specified in the contract will require approval by the Contracting Officer and a contract modification.

Delivery and Receiving Delivery and receipt of the proposed items is anticipated to be directed to the location identified below. Confirmation of delivery location will be provided by the VA POC post-award. Delivery must be coordinated with NWI Biomed/Sarpy CBOC activation team prior to any attempts at delivery. Any item that has not been coordinated will be turned away and any additional charges will be the responsibility of the sender/transportation company. Vendor responsible for conducting a site visit to verify logistics and loading dock access/egress.

Sarpy CBOC 1330 Jersey Street, Papillion, NE 68046

TBD

Delivery shall be freight on board (FOB) – Destination.

The vendor is required to define the need for a staging area to accommodate item delivery, if needed. Post-award, this information will be confirmed with the vendor.

The delivery of items identified in this document shall take place during normal business hours which are defined as: 0800 to 1630 (i.e.: 8:00am to 4:30pm Pacific Standard Time), Monday through Friday, and excluding Federal Holidays.

Delivery trucks will not be permitted to remain at the loading dock. Trucks shall be unloaded, moved from the dock, and then brought back to the dock if required to haul out any waste, tools, or excess materials.

Labeling of delivered items shall include the awarded contract number and VA purchase order number for identification and reference upon receipt of product.

2.4.7 Delivery and Installation includes:

Offloading the equipment from the truck, moving the equipment to the correct delivery location in the space, uncrating or unboxing the equipment and removing all trash, setting up the equipment according to the manufacturers specification and testing the equipment to verify that it is operational. Equipment installation paperwork & warranty information must be handed to the approved government contact onsite. See Sections 2.8, 2.9, & 2.10 below Use of Warehouse-Not applicable direct delivery to the new facility If the vendor requires the use of the Government’s activation contractor’s warehouse to meet the requirements of this contract the vendor must provide a certificate of insurance prior to the delivery and offloading of the item(s). This insurance certificate must be completed and presented to the activation contractor prior to delivery.

The vendor shall communicate through the VA POC any required coordination requirements.

Clean Up and Disposal There are no dumpsters available for vendor use.

The removal of waste and/or excess material shall be conducted through the loading dock area. Delivery trucks and/or other vendor vehicles will not be permitted to remain at the loading dock. Vehicles will need to be brought back to the dock if required to remove any waste, tools, or excess materials.

Deliverables The vendor shall provide CAD drawings (including shop drawings) and specifications for site prep for their product as required. AutoCad or Revit drawings are not a requirement of this SOW.

The vendor shall provide a completed VA Form 6550 with submittal documents for any and all item(s) that may connect to the VA network and medical devices that store sensitive patient information.

2.7.3 ☐ Network Required if Checked X-Manufacturer Certified Installation Required if Checked X-BMET Training Required if Checked X-End User Training Required if Checked Assembly and Installation [ ☒ is ☐ is not ] required.

The vendor is required to manage and coordinate installation at the Sarpy CBOC with the VA POC.

Installation and assembly shall take place during normal business hours which are defined as: 0800 to 1630 (i.e.: 8:00am to 4:30pm Pacific Standard Time), Monday through Friday, and excluding Federal Holidays.

The vendor is required to define the need for a staging area to accommodate item assembly and installation, if needed. Post-award, this information will be confirmed with the vendor.

The vendor is required to provide tools, labor and materials to complete assembly and installation of the items detailed in this document.

The vendor shall protect all finished spaces and surfaces as required from delivery and installation damage. The vendor shall use covering and protection to the extent necessary to prevent damage to finished spaces. Any damage occurred during delivery and installation is the responsibility of the vendor. The vendor will be responsible for paying for and repairing any damage or noted deficiencies to finished spaces and surfaces that occur as a result of the vendor’s (or associated sub-contractors) installation.

During the entire duration of assembly and installation, the vendor will have a competent representative on-site as the vendor’s contact, and to serve as the interface between the vendor and RCVAHC. On-site representative can be the installer. All instructions provided from COR to the representative will be binding as if given to the vendor’s main contact. The COR may provide specific instructions, however, only the Contracting Officer may change the terms or conditions of the contract.

Training [ ☐ is ☒ is not required] Standard Warranty The products shall be covered by vendor’s standard warranty terms and provisions. Vendors to provide their standard warranty information in their proposals. It should be noted however that the warranty coverage shall be no less than 1 YEAR per VA policy.

The warranty period set forth therein shall be for one year following the first patient day at the new NWI Sarpy CBOC.

The vendor shall extend such warranty directly to the customer as if such customer had purchased the Products directly from the vendor.

The vendor shall warrant the products against defects in material and workmanship under normal use and service, repair or replace at vendor’s cost any defective Product (or issue a credit or refund, as the case may be, based on the purchase price paid therefor); and The vendor shall pay (or refund the amount of) all freight and shipping charges for any defective Products returned under this paragraph.

Use of Premises If during the performance of this contract, work will be carried out on Sarpy CBOC premises, the vendor shall perform all work in such a manner that will cause a minimum interference with NWI Sarpy CBOC HCS operations and the operations of other contractors on the premises.

The vendor shall communicate through the VA POC any required coordination requirements with the General Construction contractor (GC) prior to and during delivery and installation activities.

The project may be an active construction site during delivery and installation. The vendor shall take all necessary precautions to protect the premises and all persons and property therein from damage or injury. The vendor shall assume responsibility for taking precautions for the vendor's (and associated subcontractors’) employees, agents, licensees, and permittees. The vendor shall abide by any safety requirements imposed by the GC (e.g. hard hats, safety vests).