S02 - Attachment D.2 - DSI Form -AITC BPA.pdf
PDF 153 KB Posted
- Solicitation number
- 36C10B27Q0049
About this file
This is a Deliverable Support Information Form used by the Department of Veterans Affairs (VA) to document maintenance and support details for contracted products and services.
The form pertains to AITC Conference Systems Maintenance and Support for Fiscal Year 2026, involving multiple manufacturers and hardware purchases. The Contracting Officer Representative is L. Jani Shrout (512-981-4555, Lillian.Shrout@va.gov). Blocks 1-13 are completed by VA IO Software Team personnel and include manufacturer information, contract details, performance dates, and obligation numbers. Blocks 14-31 must be completed by the awardee and address vendor-specific support details, including coverage hours (e.g., 24x7, 8x5x2), type of support (telephone, online, updates, upgrades, email), end-of-life and end-of-service dates, level of service (Platinum, Premium, Gold), manufacturer contract numbers, and technical support contact information (name, phone, email, website). Additional required vendor-fillable fields include hardware and software serial numbers, licensing keys, and any comments needed for support access. The awardee must also provide completion contact information (name, phone, email) and may attach supplementary documentation if support details vary by contract line item (CLIN).
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10B27Q0049_1.docx | DOCX document | |
| S02 - Attachment D.3 - Price Evaluation.xlsx | XLSX spreadsheet | |
| S02 - Attachment D.1 - BPA Price List 10.14.26.xlsx | XLSX spreadsheet | |
| S02 - 36C10B27Q0049.pdf |
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Text version
IO Software Team Deliverable Support Information Form 03/09/2026 Page: 1 of 2
Deliverable Support Information Form
For VA Use Only:
1. Manufacturer
2. Awardee
3. Product Name Description
4. Purchase Type(s)
5. Fiscal Year
6. Contract/Task/Delivery Order #
7. VA Obligation #
8. Performance Start Date
9. Performance End Date
10. End Date (Including All Options)
11. Contracting Officer Rep
12. Requirements Portal ID
13. Change Order #
Vendor Fillable Fields (To Be Completed by Awardee):
14. Coverage
15. Type of Support
16. End of Life Date
17. End of Service Life Date
18. Level of Service
19. Manufacturer Contract #
20. Technical Support Name
21. Technical Support Phone
22. Technical Support Email
23. Technical Support Website
24. Hardware Serial Numbers
25. Software Serial Numbers
26. SW Licensing Key(s)
27. Comments/Add’l Info Required for Support
28. Completed By Name
29. Completed By Phone
30. Completed By Email
31. Attachment(s)
IO Software Team Deliverable Support Information Form 03/09/2026 Page: 2 of 2
Instructions – Deliverable Support Information Form
Block 1-13 to be Completed by VA IO SW Team Personnel Blocks 14-31 to be Completed by Awardee
14. Coverage List the Coverage being provided as part of this contract (in hours/day-days/week-response time in hours format). Example: 24x7, 8x5x2. If coverage varies by CLIN, please attach additional information outlining the coverage for each CLIN and note the attachment in Block 31.
15. Type of Support List the type of support provided as part of this contract. Example: Telephone, Online, Updates, Upgrades, Email. Choose the most complete response. If the Type of Support varies by CLIN, please attach additional information outlining the Type of Support for each CLIN and note the attachment in Block 31.
16. End of Life Date Provide the Date the asset will reach its end of life (if applicable).
17. End of Service Life Date Provide the Date the OEM will no longer provide updates & firmware or will no longer maintain the asset (if applicable).
18. Level of Service List the level of service being provided. Example: Platinum, Premium, Gold. IF the Level of Service varies by CLIN, please attach addition information outlining the Level of Service for each CLIN and note the attachment in Block 31. (If correct response is not available in pull-down menu, please type in the correct response).
19. Manufacturer Contract # Provide the Contract number between the Awardee and the OEM (if applicable).
20. Technical Support Name Provide the name of the technical support contact.
21. Technical Support Phone Provide the telephone number that VA personnel should use to contact the OEM for support. Include appropriate extensions (if applicable).
22. Technical Support Email Provide the email address that VA personnel can contact for support (if applicable).
23. Technical Support Website Provide the Web address that VA personnel can use to access support (if applicable).
24. Hardware Serial/Part #(s) List the Serial numbers by CLIN of the products being acquired or maintained. If the list exceeds the space allotted on this form, include an attachment with the relevant information and reference the attachment in this block (if applicable) and note the attachment in Block 31.
25. Software Serial/SKU#(s) List the Serial numbers by CLIN of the products being acquired or maintained. If the list exceeds the space allotted on this form, include an attachment with the relevant information and reference the attachment in this block (if applicable) and note the attachment in Block 31.
26. SW Licensing Key(s) List the Software Licensing Key(s) by CLIN of the products being acquired or maintained. If the list exceeds the space allotted on this form, include an attachment with the relevant information and reference the attachment in this block (if applicable) and note the attachment in Block 31.
27. Comments/Addl. info required to contact support
Add any additional information that will be required for VA personnel to obtain support.
28. Completed By (Name) List the Name of the person that provided the information contained on this form and who can be contacted in case additional information is needed.
29. Completed By (Phone) Provide the telephone number of the person completing this form.
30. Completed By (Email) Provide the email address of the person completing this form.
31. Attachment(s) Provide any additional attachments that may be needed to obtain support and/or any attachments referenced in in Blocks 15-31.
| Manufacturer: Multiple |
| Awardee: |
| Requirements Package Title: AITC Conference Systems Maintenance and Support |
| Contract/Task/Delivery Order #: |
| Obligation #: |
| COR: L. Jani Shrout 512-981-4555 Lillian.Shrout@va.gov |
| Portal ID: |
| Change Order: |
| Manufacturer Contract #: |
| Technical Support Name: |
| Technical Support Phone: |
| Technical Support Website: |
| Technical Support Email: |
| Hardware Serial #: |
| Software Serial #: |
| SW Licensing Key: |
| Comments: |
| Completed by Phone: |
| Completed by Name: |
| Completed by Email: |
| Attachments: |
| PoP Begin Date_af_date: |
| PoP End Date_af_date: |
| Contract End Date_af_date: |
| End of Life Date_af_date: |
| End of Life Service Date_af_date: |
| Purchase Type: [Hardware] |
| Fiscal Year: [2026] |
| Coverage: [Choose an Item] |
| Type of Support: [Choose an Item] |
| Level of Service: [Choose an Item] |
File details come from the government source that posted it. Updated .