P09 SOW Audiology FY24.doc

Statement of Work

Preventative Maintenance and Repair for Audiology Equipment

Montana VA Health Care System

PURPOSE: Contractor shall provide labor, repairs, preventive maintenance in Billings, Bozeman, Butte, Glasgow, Glendive, Great Falls, Hamilton, Havre, Helena, Kalispel, Lewistown, Miles City, Missoula, and Plentywood Montana.

This is a non-personal services contract. The Contractor, its employees, agents and subcontractors shall not be considered VA employees for any purpose of fulfilling the PWS and shall be considered employees of the Contractor. Contractor shall furnish all labor, materials, equipment, tools, shipping, transportation, insurances, licenses, certifications and supervision necessary to provide services in accordance with this Statement of Work (SOW). The Contractor is responsible for all charges and fees related to disposal. For a contract of this size, scope and complexity, the successful Contractor must perform in a professional manner as recognized by commercial industry standards as good to excellent.

Billings (436GH) 1766 Majestic Lane

Billings, MT 59102 9-99-10013 Cal, Fitting 1 1930658 - 1053 FreeFit

9-99-10013 Cal, Fitting 1 C3173 EE38123 -Audioscan Verifit 2

9-99-10007 Cal, Middle ear analyzer, 1918091 - 1096 Zodiac PC Diagnostic, Incl. Classic, Probe (US only)

9-99-10013 Cal, Fitting 1 3020452 - 1053 FreeFit, Module

9-99-10013 Cal, Fitting 1, 3021923 - 1081 AURICAL, (PMM, C&S) with HI-PRO, (US only)

9-99-10007 Cal, Middle ear analyzer, 3010097 - 1096 Zodiac PC, Diagnostic, Incl. Classic, Probe (US only)

9-99-10000 Cal, PC Audiometer, Type 1, 3017165 - 1066 MADSEN, Astera 2, US Only

9-99-10007 Cal, Middle ear analyzer, GS0102010 – Grason Stadler GSI Tympstar Pro

9-99-10013 Cal, Fitting 1 3015888 - 1053 FreeFit, Module

9-99-10013 Cal, Fitting 1, 3012540 - 1081 AURICAL, (PMM, C&S) with HI-PRO, (US only)

9-99-10001 Cal, PC Audiometer, Type 2, GS0049262 – Grason Stadler GSI-Audiostar

9-99-10001 Cal, PC Audiometer, Type 2, GS0094176 – Grason Stadler GSI-Audiostar

9-99-10020 Cal, Booth Certification AS7010 - Sound Booth, generic

9-99-10015 Cal, OAE, OAC-14058306 -Otodynamics Otoport DP, OAE

9-99-10015 Cal, OAE, ODS14020883 -Otodynamics Otoport DP OAE

9-99-10001 Cal, PC Audiometer, Type 2, 1911551 - 1081 AURICAL AUD w/o HI-PRO (US only) Incl. Bone conductor/Insert Phone and TDH Headset

9-99-10005 Cal, Standalone Audiometer, Type 3 25886 - Maico MA 27

9-99-10013 Cal, Fitting 1 T3173 - Audioscan Verifit 2

9-99-10022 Cal, Bioacoustic Simulator

Bozeman (436GD) 1101 E Main St, Ste 201

Bozeman, MT 59715

9-99-10013 Cal, Fitting 1 005119 - 1081 AURICAL (PMM, C&S) with HI-PRO

9-99-10000 Cal, PC Audiometer, Type 1 996086 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3020058 - 1053 FreeFit Module

9-99-10007 Cal, Middle ear analyzer 1 1921684 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 995775 - 1082, HIT BOX Butte (436GA) 40 Three Bears Ln

Butte, MT 59701 9-99-10007 Cal, Middle ear analyzer 1 3009964 - 1096 Zodiac PC, Diagnostic, Incl. Classic Probe (US only)

9-99-10000 Cal, PC Audiometer, Type 1 3010120 - 1066 MADSEN Astera 2, US Only

9-99-10000 Cal, PC Audiometer, Type 1 GS0094175 – Grason Stadler GSI-Audiostar

9-99-10013 Cal, Fitting 1 3015891 - 1053 FreeFit Module

9-99-10007 Cal, Middle ear analyzer Glasgow (436GI) 630 Second Ave S, Ste A

Glasgow, MT 59230 9-99-40001 Travel, Zone 1

9-99-10000 Cal, PC Audiometer, Type 1 3010121 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3012901 - 1081 AURICAL (PMM, C&S) with HI-PRO (US only)

9-99-10013 Cal, Fitting 1 2029780 - 1081, LOUDSPEAKER

9-99-10007 Cal, Middle ear analyzer 1 3009956 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

Glendive (436GK) 2000 Montana Ave

Glendive, MT 59330 9-99-10007 Cal, Middle ear analyzer 1 3023279 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 3018205 - 1082 AURICAL HIT

9-99-40001 Travel, Zone 1 - 95.00 95.00

9-99-10013 Cal, Fitting 1 3008079 - 1081, LOUDSPEAKER

9-99-10000 Cal, PC Audiometer, Type 1 3026624 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1

Great Falls (436GB) 1400 29th St S, Ste 1

Great Falls, MT 59405 9-99-10001 Cal, PC Audiometer, Type 2, 432346 - 1066 MADSEN Astera 2, W/O HDA, US Only

9-99-10013 Cal, Fitting 1 440463 - 1081 AURICAL (PMM, C&S, AUD) w/o HIPRO

9-99-10013 Cal, Fitting 1 453402 - 1082, HIT BOX

9-99-10000 Cal, PC Audiometer, Type 1 3026871 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3011187 - 1081 AURICAL (PMM, C&S) with HI-PRO (US only)

9-99-10007 Cal, Middle ear analyzer 1 3023378 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 3018930 - 1082 AURICAL HIT

9-99-10013 Cal, Fitting 1 443798 - 1053 FreeFit Module

9-99-10007 Cal, Middle ear analyzer 1 1921682 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 3008098 - 1081, LOUDSPEAKER

Hamilton (436QA) 299 Fairgrounds Ste A

Hamilton, MT 59840 9-99-10000 Cal, PC Audiometer, Type 1 3010580 - 1066 MADSEN, Astera 2, US Only

9-99-10013 Cal, Fitting 1 3005190 - 1081, LOUDSPEAKER

9-99-10013 Cal, Fitting 1 3012539 - 1081 AURICAL (PMM, C&S) with HI-PRO (US only)

9-99-10007 Cal, Middle ear analyzer 1 3014891 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

Havre (436HC) 1753 US Highway 2 NW, Ste 3

Havre, MT 59501 9-99-10000 Cal, PC Audiometer, Type 1 3017370 - 1066 MADSEN Astera 2, US Only

9-99-10007 Cal, Middle ear analyzer 1 3009952 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 3012904 - 1081 AURICAL (PMM, C&S) with HI-PRO (US only)

Helena (Fort Harrison, 436) 3687 Veterans Dr

Ft. Harrison, MT 59636 9-99-10000 Cal, PC Audiometer, Type 1 996106 - 1066 MADSEN Astera 2, US Only 324.00 324.00

9-99-10013 Cal, Fitting 1 007009+005121 – 1081 URICAL (PMM, C&S) with HI-PRO

9-99-10013 Cal, Fitting 1 986204 - 1082, HIT BOX

9-99-10007 Cal, Middle ear analyzer 1 3023375 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10007 Cal, Middle ear analyzer 1 1921686 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10001 Cal, PC Audiometer, Type 2 GS0094177 – GSI AudiostarPro

9-99-10000 Cal, PC Audiometer, Type 1 3026627 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3008077 - 1081, LOUDSPEAKER

9-99-10013 Cal, Fitting 1 3020913 - 1082 AURICAL HIT

9-99-10000 Cal, PC Audiometer, Type 1 996060 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3018439 - 1053 FreeFit Module

9-99-10013 Cal, Fitting 1 3010947 - 1081 AURICAL (PMM, C&S) with HI-PRO (US only)

9-99-10007 Cal, Middle ear analyzer 1 1921685 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 986193 - 1082, HIT BOX

9-99-10007 Cal, Middle ear analyzer 1 GS0098062 – Grason Stadler GSI Tympstar Pro Kalispel (436GF) 31 3-Mile Dr, Ste 102

Kalispel, MT 59901 9-99-10000 Cal, PC Audiometer, Type 1 996074 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 005123 - 1081 AURICAL (PMM, C&S) with HI-PRO

9-99-10007 Cal, Middle ear analyzer 1 1902400 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 986192 - 1082, HIT BOX

Lewistown (436GM) 629 NE Main St.

Lewiston, MT 59457 9-99-10000 Cal, PC Audiometer, Type 1 3017161 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3013452 - 1081 AURICAL (PMM, C&S) with HI-PRO (US only)

9-99-10013 Cal, Fitting 1 3014948 - 1053 FreeFit Module

9-99-10007 Cal, Middle ear analyzer 1 3009063 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

Miles City (436A4) 316 South Haynes Ave

Miles City, MT 59301 9-99-10000 Cal, PC Audiometer, Type 1 3008857 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3005240 - 1081, LOUDSPEAKER

9-99-10007 Cal, Middle ear analyzer 1 3009067 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

Missoula (436GC) 3885 W Broadway

Missoula, MT 59808 9-99-10013 Cal, Fitting 1

9-99-10013 Cal, Fitting 1

9-99-10000 Cal, PC Audiometer, Type 1 3026628 - 1066 MADSEN Astera 2, US Only

9-99-10007 Cal, Middle ear analyzer 1 3023277 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 3018206 - 1082 AURICAL HIT

9-99-10007 Cal, Middle ear analyzer 1 GS0102011 – Grason Stadler GSI Tympstar Pro

9-99-10001 Cal, PC Audiometer, Type 2 GS0093843 – GSI AudiostarPro

9-99-10013 Cal, Fitting 1 3008078 - 1081, LOUDSPEAKER

9-99-10000 Cal, PC Audiometer, Type 1 3026626 - 1066 MADSEN Astera 2, US Only

9-99-10013 Cal, Fitting 1 3007965 - 1081, LOUDSPEAKER

9-99-10007 Cal, Middle ear analyzer 1 3023282 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 3018921 - 1082 AURICAL HIT

Plentywood (436QB) 440 West Laurel Ave

Plentywood, MT 59254 9-99-10013 Cal, Fitting 1

9-99-10000 Cal, PC Audiometer, Type 1 3025719 - 1066 MADSEN Astera 2, US Only

9-99-10007 Cal, Middle ear analyzer 1 3023376 - 1096 Zodiac PC Diagnostic, Incl. Classic Probe (US only)

9-99-10013 Cal, Fitting 1 3019417 - 1082 AURICAL HIT

9-99-10013 Cal, Fitting 1 3008089 - 1081, LOUDSPEAKER

TASKS and REQUIREMENTS:

1. Perform Annual preventive maintenance in accordance with manufactures specifications.

2. Perform repairs of audiology equipment

3. Maintain latest Software and firmware according to VA requirements and manufactures, with Veterans Affairs requiring approved versions that might be less than manufactures latest releases.

HOURS OF WORK: This contract include all necessary service calls, five (5) days per week (Monday-Friday excluding Federal Holidays), between the hours of 8:00 AM and 5:00 PM, mountain standard time.

SAFETY STANDARDS: Follow all VA safety standards with immunization requirements, masks, hygiene care, and ect. All equipment will be subject to inspection by Montana Veteran Affairs Health Care System Biomedical Equipment Support Specialist personnel to verify compliance with these standards.

AUTHORIZED SERVICES: Only those services specified within the contract are authorized. Before performing any service or repair of a non-contract nature, the Contracting Officer or his/her designee must be advised of the reason for this additional work. If appropriate, the Contracting Officer or his/her designee may authorize the additional services or repairs under a separate purchase authorization. Contractor is cautioned that only the Contracting Officer or his/her designee may authorize additional services or repairs and reimbursement will not be made unless this prior authorization is obtained, and task order cut/ PO provided.

DISCONT INUANCE OF SERVICE: The Government reserves the right to terminate service if unable to meet criteria upon thirty (30) days written notice to the Contractor with payment to be prorated.

TEST EQUIPMENT: The Montana Veteran Affairs Health Care System will not furnish test equipment for the performance of this contract. It is the responsibility of the Contractor to bring the appropriate equipment and/or supplies necessary to complete the work as required within.

PERFORMANCE CONFERENCE: If appropriate the Contracting Officer will schedule a performance conference for contract orientation purposes with the Contractor receiving award.

HAZARD COMMUNICATONS STATEMENT:

1. As a vendor, supplier, and/or contractor under to the VA Montana Health Care System for the purpose delineated in the subject contract, you should be aware of this facility's hazard communication program. By the provisions of your contract, you may be required to work in certain areas where there are hazardous chemicals or radiation/ gamma rays are in use. Examples include, but are not limited to areas in, Dental Service, Radiology Service, surgery, and any area needed radiology testing.

2. It is the responsibility of each Contractor to familiarize himself with the specific area(s) in which contractor requires room to work. This shall include the Contractor introducing himself to the expose zone supervisor. The Contractor will work with zone supervisor, getting understanding of hazards within work areas at Montana Veteran Affairs Health Care System, to include types of chemicals used. In addition, the Contractor shall learn the procedures for obtaining MSDS in case of an emergency pertaining to hazardous chemicals in the exposure zone.

3. It is also the responsibility of each Contractor to meet criteria.

These include:

a. Prior to the beginning of any contract. shall provide the Contracting Officer's Representative (COR) with a complete list of all chemicals to be used by the Contractor on the facility premises. Appropriate MSDS shall accompany the list of chemicals. The COR will forward a copy of this list and the MSDS to the VA Montana Healthcare System Industrial Hygienist (138).

b. The Contractor shall ensure that all chemical containers are properly labeled, and MSDS for each chemical shall be available on the Montana Veteran Affairs Health Care System premises. MSDS shall be maintained by the senior representative of the Contractor at this facility.

c. Protective equipment for Contractor perisomal shall be the responsibility of the Contractor. Lead vest, goggles, thyroid shielding maybe onsite but cannot guarantee, be proactive and provide your own please.

d. All other Department Veteran Affairs and Occupational Safety and Health Administration regulations shall apply as appropriate.

4. In compliance with paragraphs 2 and 3 above, it shall be the responsibility of the Contractor to convey to his subordinate personnel and sub-contractors the appropriate information regarding hazard communication.

CONTRACTOR SUBMITTALS: Within fifteen calendar days after award date, but not later than performance of the first servicing of equipment, the Contractor shall furnish two (2) copies of its preventive maintenance procedures manual which will be used during the preventive maintenance services of this contract to the Contracting Officer. These manuals are required by the Government as a condition of the facility's JCAHO accreditation and must be received before any invoice can be certified for payment.

OBSOLETE MACHINES: Services under a resulting contract will not cover obsolete decommissioned machines where parts for such obsolete machines are not available under the original manufacturer's commercial price list, unless mutually agreed to by the Contracting Officer and the Contractor. Audiology and COR will work to replace obsolete machines, however old machine must meet manufactures specifications until replaced.

ORDERS: The Contractor’s repairmen shall reply to the office of the Contracting Officer's Representative (COR) prior to start of work and after completing the services required during that call. Services to be rendered will be directed by the COR and any changes must receive concurrence of the Contracting Officer and/or the COR.