Sol_75H71026Q00208.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

17IHSCHINLE CODE 16. ADMINISTERED BYCODE

X

X

339112

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR17

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

08/29/2026 1700 MT

08/18/2026

TEOLA AUTAUBO

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H71026Q00208

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 47 IHS1524226OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Chinle AZ 86503

Highway 191 Hospital Drive

PO Drawer PH

Acquisition Department

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

1,000

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Chinle Comprehensive Hlth Care Fac WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

Chinle AZ 86503

HIGHWAY 191 HOSPITAL DRIVE

PO Drawer PH

CHINLE COMPREHENSIVE HEALTH CARE FA

Chinle AZ 86503

Highway 191 Hospital Drive

PO Drawer PH

Acquisition Department

Chinle Comprehensive Hlth Care Fac

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

This is a request for quote for a contractor to provide Transport Ventilation Machines and accessories, and One Year Service Contract that includes all parts, labor, travel, and annual preventive maintenance included, to the Respiratory Department and Patient Transport Department at Chinle Comprehensive Health Care Facility (CCHCF). Supplies shall be in strict accordance with attached specifications. Services shall be in strict accordance with the attached Statement of Work. Resultant contract type will

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

TANYA M. JOHNSON

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

be a firm fixed price contract. Per RFO

6.103-1(d) the Government has identified a specific brand name.

Delivery: 09/13/2027

Period of Performance: 09/14/2026 to 09/13/2027

1 HAMILTON-T1

Includes:

HAMILTON-T1 Li-Ion Battery- Initial Order

HAMILTON-T1 USA Customization

HAMILTON-T1 English (USA) Language Kit

HAMILTON-T1 O2 Cell- Initial Order

DISS CONNECTOR O2 - PLATFORM C

HAMILTON-C3/C2/C1/T1 POWER CORD

HAMILTON-T1 Universal Mount Handle

HAMILTON-T1 Reno Service Training Tuition

Clinical Training

HAMILTON-T1 Adult/Pediatric Configuration

HAMILTON-T1 Comm Board (CO2, Nurse Call, COM1)

Unit Price: $____________

QTY: 1/EA

Total: $____________

2 HAMILTON-H900 Humidifier

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

47 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 47

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H71026Q00208

Includes:

Clinical Training

Unit Price: $____________

QTY: 2/EA

Total: $____________

3 HAMILTON-C1 All-in-One Multiple Therapy Package

Includes:

HAMILTON-C1 NIV, NIV S/T Application

HAMILTON-C1 Adult/Pediatric Configuration

HAMILTON-C1 Li-Ion Battery- Initial Order

HAMILTON-C1 O2 Cell- Initial Order

HAMILTON-C1 USA Customization

HAMILTON-C1 English (USA) Language Kit

DISS CONNECTOR O2 - PLATFORM C

HAMILTON-C3/C2/C1/T1 POWER CORD

HAMILTON-C1 Trends / Loops Application

HAMILTON-C1 High Flow O2 Therapy Application

HAMILTON-C1 Reno Service Training Tuition

Clinical Training

HAMILTON-C1/T1 TROLLEY (Includes Humidifier

Support & O2 E-Cylinder Holder)

HAMILTON-T1/C1 Support Arm

HAMILTON-C1 Communication Board with CO2, Nurse

Call & COM 1

Unit Price: $____________

QTY: 2/EA

Total: $____________

Additional Items:

HAMILTON-C1/T1 Basket- Small

Unit Price: $____________

QTY: 1/EA

Total: $____________

HAMILTON-C3/C2/C1/T1/MR1 Battery Calibrator w/

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

4 47

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H71026Q00208

Cord

Unit Price: $____________

QTY: 1/EA

Total: $____________

HAMILTON-T1 Trends / Loops Application

Unit Price: $____________

QTY: 1/EA

Total: $____________

HAMILTON-C1 nCPAP Application

Unit Price: $____________

QTY: 1/EA

Total: $____________

HAMILTON-C1 Neonatal Application

Unit Price: $____________

QTY: 1/EA

Total: $____________

HAMILTON-C1 DuoPAP / APRV Application

Unit Price: $____________

QTY: 1/EA

Total: $____________

HAMILTON-T1 DuoPAP / APRV Application

Unit Price: $____________

QTY: 1/EA

Total: $____________

HAMILTON-T1 High Flow O2 Therapy Application

Unit Price: $____________

QTY: 1/EA

Total: $____________

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

5 47

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H71026Q00208

4 HAMILTON-C1 One Year Service Contract

(All parts, labor, travel and annual PM included)

Unit Price: $____________

QTY: 1/EA

Total: $____________

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Rev. 04/29/2026

SECTION B – CONTINUATION OF SF-1449

This page is intentionally blank.

SECTION C – CONTRACT CLAUSES

52.212-4 CONTRACT TERMS AND CONDITIONS –

COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES

NOV 2025

(DEVIATION)

The following Federal Acquisition Regulation clauses also apply:

☐ 52.203-3 GRATUITIES APR 1984

☐ 52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT Alt I

NOV 2021

☐ 52.203-12 LIMITATION OF PAYMENTS TO INFLUENCE CERTAIN FEDERAL

TRANSACTIONS

JUN 2020

☐ 52.203-13 CONTRACTOR CODE OF BUSINESS ETHICS AND CONDUCT NOV 2021

☐ 52.203-16 PREVENTING PERSONAL CONFLICTS OF INTEREST JUN 2020

☒ 52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS NOV 2023

☒ 52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS

JAN 2017

☐ 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL JAN 2011

☒ 52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE NOV 2025

(DEVIATION)

☐ 52.204-14 SERVICE CONTRACT REPORTING REQUIREMENTS NOV 2025

(DEVIATION)

☐ 52.204-15 SERVICE CONTRACT REPORTING REQUIREMENTS FOR INDEFINITE-

DELIVERY CONTRACTS

NOV 2025

(DEVIATION)

☐ 52.204-91 CONTRACTOR IDENTIFICATION NOV 2025

(DEVIATION)

☒ 52.209-6 PROTECTING THE GOVERNMENT’S INTEREST WHEN

SUBCONTRACTING WITH CONTRACTORS DEBARRED, SUSPENDED, OR

PROPOSED FOR DEBARMENT

NOV 2025

(DEVIATION)

☐ 52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS

NOV 2025

(DEVIATION)

☒ 52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC

CORPORATIONS

NOV 2025

(DEVIATION)

☐ 52.213-1 RESERVED

☐ 52.219-3 NOTICE OF HUBZONE SET-ASIDE OR SOLE-SOURCE AWARD NOV 2025

(DEVIATION)

☐ 52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE NOV 2025

(DEVIATION)

☐ 52.219-6 Alt I

NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE, WITH ALTERNATE I NOV 2025

(DEVIATION)

☐ 52.219-7 NOTICE OF PARTIAL SMALL BUSINESS SET-ASIDE NOV 2020

☐ 52.219-7 Alt I

NOTICE OF PARTIAL SMALL BUSINESS SET-ASIDE, WITH ALTERNATE I MAR 2020

☐ 52.219-8 UTILIZATION OF SMALL BUSINESS CONCERNS NOV 2025

(DEVIATION)

☐ 52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN NOV 2025

(DEVIATION)

☐ 52.219-9 Alt I

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE I NOV 2025

(DEVIATION)

☐ 52.219-9 Alt II

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE II NOV 2025

(DEVIATION)

☐ 52.219-9 Alt III

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE III NOV 2025

(DEVIATION)

☐ 52.219-9 Alt IV

SMALL BUSINESS SUBCONTRACTING PLAN, WITH ALTERNATE IV NOV 2025

(DEVIATION)

☐ 52.219-13 NOTICE OF SET-ASIDE OF ORDERS MAR 2020

☐ 52.219-13 Alt I

RESERVED

☐ 52.219-16 LIQUIDATED DAMAGES—SUBCONTRACTING PLAN NOV 2025

(DEVIATION)

☐ 52.219-27 NOTICE OF SET-ASIDE FOR, OR SOLE-SOURCE AWARD TO, SERVICE-

DISABLED VETERAN-OWNED SMALL BUSINESS (SDVOSB) CONCERNS

ELIGIBLE UNDER THE SDVOSB PROGRAM

NOV 2025

(DEVIATION)

☒ 52.219-28 POSTAWARD SMALL BUSINESS PROGRAM REREPRESENTATION NOV 2025

(DEVIATION)

☐ 52.219-28 Alt I

POSTAWARD SMALL BUSINESS PROGRAM REREPRESENTATION, WITH

ALTERNATE I

NOV 2025

(DEVIATION)

☐ 52.219-29 NOTICE OF SET-ASIDE FOR, OR SOLE-SOURCE AWARD TO,

ECONOMICALLY DISADVANTAGED WOMEN-OWNED SMALL BUSINESS

CONCERNS

NOV 2025

(DEVIATION)

☐ 52.219-30 NOTICE OF SET-ASIDE FOR, OR SOLE-SOURCE AWARD TO, WOMEN-

OWNED SMALL BUSINESS CONCERNS ELIGIBLE UNDER THE WOMEN-

OWNED SMALL BUSINESS PROGRAM

NOV 2025

(DEVIATION)

☐ 52.219-33 NONMANUFACTURER RULE NOV 2025

(DEVIATION)

☒ 52.222-3 CONVICT LABOR NOV 2025

(DEVIATION)

☒ 52.222-19 CHILD LABOR—COOPERATION WITH AUTHORITIES AND REMEDIES NOV 2025

(DEVIATION)

☐ 52.222-35 EQUAL OPPORTUNITY FOR VETERANS NOV 2025

(DEVIATION)

☒ 52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES NOV 2025

(DEVIATION)

☐ 52.222-36

ALT I

EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES, WITH

ALTERNATE I

JUL 2014

☐ 52.222-37 EMPLOYMENT REPORTS ON VETERANS NOV 2025

(DEVIATION)

☐ 52.222-40 NOTIFICATION OF EMPLOYEE RIGHTS UNDER THE NATIONAL LABOR

RELATIONS ACT

NOV 2025

☒ 52.222-41 SERVICE CONTRACT LABOR STANDARDS NOV 2025

(DEVIATION)

☐ 52.222-43 FAIR LABOR STANDARDS ACT AND SERVICE CONTRACT LABOR

STANDARDS-PRICE ADJUSTMENT (MULTIPLE YEAR AND OPTION

CONTRACTS)

NOV 2025

(DEVIATION)

☐ 52.222-44 FAIR LABOR STANDARDS ACT AND SERVICE CONTRACT LABOR

STANDARDS-PRICE ADJUSTMENT

NOV 2025

(DEVIATION)

☒ 52.222-50 COMBATING TRAFFICKING IN PERSONS NOV 2025

(DEVIATION)

☐ 52.222-50 Alt I

COMBATING TRAFFICKING IN PERSONS NOV 2025

(DEVIATION)

☐ 52.222-51 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS TO CONTRACTS FOR MAINTENANCE, CALIBRATION, OR

REPAIR OF CERTAIN EQUIPMENT—REQUIREMENTS

NOV 2025

(DEVIATION)

☐ 52.222-53 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS TO CONTRACTS FOR CERTAIN SERVICES—

REQUIREMENTS

NOV 2025

(DEVIATION)

☐ 52.222-54 EMPLOYMENT ELIGIBILITY VERIFICATION NOV 2025

(DEVIATION)

☒ 52.222-55 MINIMUM WAGES FOR CONTRACTOR WORKERS UNDER EXECUTIVE

ORDER 14026

NOV 2025

(DEVIATION)

☒ 52.222-62 PAID SICK LEAVE UNDER EXECUTIVE ORDER 13706 NOV 2025

(DEVIATION)

☒ 52.222-90 ADDRESSING DEI DISCIMINATION BY FEDERAL CONTRACTORS APR 2026

(DEVIATION)

☐ 52.223-2 REPORTING OF BIOBASED PRODUCTS UNDER SERVICE AND

CONSTRUCTION CONTRACTS

NOV 2025

(DEVIATION)

☒ 52.223-5 POLLUTION PREVENTION AND RIGHT-TO-KNOW INFORMATION MAY 2024

☐ 52.223-11 OZONE-DEPLETING SUBSTANCES NOV 2025

(DEVIATION)

☐ 52.223-12 MAINTENANCE, SERVICE, REPAIR, OR DISPOSAL OF REFRIGERATION

EQUIPMENT AND AIR CONDITIONERS

NOV 2025

(DEVIATION)

☒ 52.223-23 SUSTAINABLE PRODUCTS NOV 2025

(DEVIATION)

☐ 52.224-1 PRIVACY ACT NOTIFICATION APR 1984

☐ 52.224-2 PRIVACY ACT APR 1984

☐ 52.224-3 PRIVACY TRAINING JAN 2017

☐ 52.224-3

ALT I

PRIVACY TRAINING, WITH ALTERNATE I JAN 2017

☐ 52.225-1 BUY AMERICAN-SUPPLIES NOV 2025

(DEVIATION)

☐ 52.225-1 Alt I

BUY AMERICAN-SUPPLIES, WITH ALTERNATE I OCT 2022

☒ 52.225-3 BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT NOV 2025

52.225-3

ALT I

RESERVED

☐ 52.225-3 Alt II

BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT,

WITH ALTERNATE II

NOV 2025

(DEVIATION)

☐ 52.225-3 Alt III

BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT,

WITH ALTERNATE III

NOV 2025

(DEVIATION)

☐ 52.225-3 Alt IV

BUY AMERICAN-FREE TRADE AGREEMENTS-ISRAELI TRADE ACT,

WITH ALTERNATE IV

NOV 2025

(DEVIATION)

☐ 52.225-5 TRADE AGREEMENTS NOV 2023

☐ 52.225-14 INCONSISTENCY BETWEEN ENGLISH VERSION AND TRANSLATION OF

CONTRACT

FEB 2000

☐ 52.225-19 CONTRACTOR PERSONNEL IN A DESIGNATED OPERATIONAL AREA OR

SUPPORTING A DIPLOMATIC OR CONSULAR MISSION OUTSIDE THE

UNITED STATES

MAY 2020

☐ 52.225-26 CONTRACTORS PERFORMING PRIVATE SECURITY FUNCTIONS

OUTSIDE THE UNITED STATES

OCT 2016

☒ 52.226-1 UTILIZATION OF INDIAN ORGANIZATIONS AND INDIAN-OWNED

ECONOMIC ENTERPRISES

NOV 2025

(DEVIATION)

☐ 52.226-5 RESTRICTIONS ON SUBCONTRACTING OUTSIDE DISASTER OR

EMERGENCY AREA

NOV 2025

(DEVIATION)

☐ 52.226-6 PROMOTING EXCESS FOOD DONATION TO NONPROFIT

ORGANIZATIONS

NOV 2025

(DEVIATION)

☒ 52.226-8 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT MESSAGING

WHILE DRIVING

MAY 2024

☐ 52.229-12 TAX ON CERTAIN FOREIGN PROCUREMENTS AUG 2025

(DEVIATION)

☐ 52.232-18 AVAILABILITY OF FUNDS APR 1984

☐ 52.232-29 TERMS FOR FINANCING OF COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

NOV 2021

☐ 52.232-30 INSTALLMENT PAYMENTS OF COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

NOV 2021

☒ 52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER—SYSTEM FOR AWARD

MANAGEMENT

OCT 2018

☐ 52.232-34 PAYMENT BY ELECTRONIC FUNDS TRANSFER—OTHER THAN SYSTEM

FOR AWARD MANAGEMENT

JUL 2013

☐ 52.232-36 PAYMENT BY THIRD PARTY NOV 2025

(DEVIATION)

☒ 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS

MAR 2023

☐ 52.232-90 FAST PAYMENT PROCEDURE NOV 2025

(DEVIATION)

☒ 52.233-3 PROTEST AFTER AWARD NOV 2025

(DEVIATION)

☒ 52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM NOV 2025

(DEVIATION)

☒ 52.237-2 PROTECTION OF GOVERNMENT BUILDING, EQUIPMENT, AND

VEGETATION

APR 1984

☐ 52.237-3 CONTINUITY OF SERVICES JAN 1991

☒ 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS NOV 2025

(DEVIATION)

☐ 52.240-91 Alt I

SECURITY PROHIBITIONS AND EXCLUSIONS, WITH ALTERNATE I NOV 2025

(DEVIATION)

☐ 52.240-92 SECURITY REQUIREMENTS NOV 2025

(DEVIATION)

☐ 52.240-92 Alt II

SECURITY REQUIREMENTS WITH ALTERNATE II NOV 2025

(DEVIATION)

☐ 52.240-93 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS

NOV 2025

(DEVIATION)

☐ 52.242-5 PAYMENTS TO SMAL BUSINESS SUBCONTRACTORS JAN 2017

☐ 52.242-13 BANKRUPTCY JUL 1995

☐ 52.244-2 SUBCONTRACTS JUN 2020

☒ 52.244-6 SUBCONTRACTS FOR COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES

NOV 2025

(DEVIATION)

☐ 52.245-1 GOVERNMENT PROPERTY SEP 2021

☐ 52.245-2 GOVERNMENT PROPERTY INSTALLATION OPERATION SERVICES APR 2012

☐ 52.245-9 USE AND CHARGES APR 2012

☐ 52.247-64 PREFERENCE FOR PRIVATELY OWNED U.S.-FLAG COMMERCIAL

VESSELS

NOV 2025

(DEVIATION)

☐ 52.247-64 Alt I

PREFERENCE FOR PRIVATELY OWNED U.S.-FLAG COMMERCIAL

VESSELS, WITH ALTERNATE I

APR 2003

☐ 52.247-64 Alt II

PREFERENCE FOR PRIVATELY OWNED U.S.-FLAG COMMERCIAL

VESSELS, WITH ALTERNATE II

NOV 2021

52.222-42 STATEMENT OF EQUIVALENT RATES FOR

FEDERAL HIRES

MAY 2014

In compliance with the Service Contract Labor Standards statute and the regulations of the Secretary of Labor (29 CFR Part 4), this clause identifies the classes of service employees expected to be employed under the contract and states the wages and fringe benefits payable to each if they were employed by the contracting agency subject to the provisions of 5 U.S.C.5341 or 5 332.

THIS STATEMENT IS FOR INFORMATION ONLY: IT IS NOT A WAGE DETERMINATION

OCCUPATION CODE TITLE RATE

23181 Electronics Technician Maintenance I 28.37

(End of Clause)

52.252-2 CLAUSES INCORPORATED BY REFERENCE FEB 1998

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

Revolutionary FAR Overhaul - FAR Overhaul - FAR Part Deviation Guidance | Acquisition.GOV

Federal Acquisition Regulation - https://www.acquisition.gov/browse/index/far

Department of Health and Human Services Acquisition Regulation – https://www.acquisition.gov/hhsar

(End of clause)

52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES NOV 2020

(a)The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause.

(b)The use in this solicitation or contract of any Department of Health and Human Services (48 CFR Chapter 3) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

(End of clause)

The following Department of Health and Human Services Acquisition Regulation clauses also apply:

☐ 352.203-70 ANTI-LOBBYING DEC 2015

☐ 352.208-70 PRINTING AND DUPLICATION DEC 2015

☐ 352.211-3 PAPERWORK REDUCTION ACT DEC 2015

☐ 352.219-71 MENTOR-PROTÉGÉ PROGRAM REPORTING REQUIREMENTS JAN 2010

☐ 352.223-70 SAFETY AND HEALTH DEC 2015

☐ 352.224-70 PRIVACY ACT DEC 2015

☒ 352.226-6 INDIAN ECONOMIC ENTERPRISE SUBCONTRACTING

LIMITATIONS

MAR 2022

☐ 352.227-70 PUBLICATIONS AND PUBLICITY DEC 2015

☐ 352.231-70 SALARY RATE LIMITATION DEC 2015

☐ 352.237-70 PRO-CHILDREN ACT DEC 2015

☐ 352.237-71 CRIME CONTROL ACT – REPORTING OF CHILD ABUSE DEC 2015

☐ 352.237-72 CRIME CONTROL ACT – REQUIREMENTS FOR BACKGROUND

CHECKS

DEC 2015

☐ 352.237-73 INDIAN CHILD PROTECTION AND FAMILY VIOLENCE ACT DEC 2015

352.232-71 ELECTRONIC SUBMISSION OF PAYMENT

REQUESTS

APR 2026

(a) Definitions. As used in this clause –

Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements in FAR 32.905(b) and the applicable payment clause included in this contract.

(b) Submission instructions. Except as provided in paragraph (c) of this clause, the Contractor must submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system. Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

(c) Alternate submission procedures. The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing.

(d) Submission of alternate payment procedures authorization. If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer’s written authorization with each payment request.

(End of clause)

NAIHS-ACQ-08 CONTRACTING OFFICER’S REPRESENTATIVE NOV 2025

(a) Definition. “Contracting Officer’s Representative (COR)” means an individual, including a contracting officer’s technical representative (COTR), designated and authorized in writing by the contracting officer to perform specific technical or administrative functions.

(b) Per FAR Subpart 1.404(a): The Contracting Officer (CO) determines that this contract requires a Contracting Officer Representative (COR).The Contracting Officer Representative (COR) is:

TBD at time of award.

(c) Upon award, the COR will receive a copy of the written designation, specifying the extent of the COR’s authority on behalf of the CO.

(d) Limitations.

(1) The COR has no authority to make any commitments or changes that affect price, quality, quantity, delivery, or other terms and conditions of the contract.

(2) The COR must not direct the contractor or its subcontractors to operate in conflict with the contract terms and conditions.

NAIHS-ACQ-09 UNAUTHORIZED COMMITMENTS NOV 2025

(a) Definitions.

Contracting Officer means a person with the authority to enter into, administer, and/or terminate contracts and make related determination and findings.

Ratification means the act of approving an unauthorized commitment by an official who has the authority to do so.

Unauthorized Commitment (UAC) means an agreement that is not binding solely because the Government representative who made it lacked the authority to enter into that agreement on behalf of the Government.

(b) Policy.

The Government is not bound by agreements with, or contractual commitments made to, prospective contractors by individuals who do not have delegated contracting authority. Unauthorized commitments do not follow the appropriate process for the expenditure of Government funds. Consequently, the Government may not be able to ratify certain actions, putting a contractor at risk for taking direction from a Federal official other than the contracting officer (see FAR 1.403-2). Government employees responsible for unauthorized commitments are subject to disciplinary action. Contractors perform at their own risk when accepting direction from unauthorized officials. Failure to follow statutory and regulatory processes for the expenditure of Government funds is a very serious matter.

(c) Procedure.

Any agreement, modification, or change to a contractual agreement made by a government personnel who lack authority will be deemed an unauthorized commitment. The Government is not liable to the Contractor or under the terms of the contract, financially or otherwise – unless the unauthorized commitment successfully passes the ratification process.

The ratification process does not have any lead time, nor does the Government make any promise that an unauthorized commitment will be ratified and, therefore, the Contractor would be paid. The Contractor proceeds at its own risk if any of the terms of the contract are altered, changed, or modified without the written concurrence by a Contracting Officer.

NAIHS-ACQ-20 PROTECTING FEDERAL EMPLOYEES AND

THE PUBLIC FROM EXPOSURE TO TOBACCO

SMOKE IN THE FEDERAL WORKPLACE

APR 2026

In accordance with Executive Order 13058 “Protecting Federal Employees and the Public from Exposure to Tobacco Smoke in the Federal Workplace,” and the Assistant Secretary for Health memorandum “Prohibition of Tobacco Use in HHS Occupied Facilities,” the use of tobacco products, in any form, is strictly prohibited at IHS-operated properties including, but not limited to:

1. All interior and exterior spaces of IHS-operated properties.

2. All HIS-operated spaces in multi-tenant buildings.

3. All Government vehicles regardless of their location.

4. Private vehicles while on IHS property.

The IHS continues to recognize the value and efficacy of patients’ traditional beliefs and ceremonial practices. The use of tobacco products for ceremonial purposes is allowed in the designated traditional healing room, including any space designated for a ceremony, or in a patient’s hospital room.

To the maximum extent practicable, Contractor must notify the Contracting Officer’s Representative in advance of using tobacco products in a ceremony.

SECTION D – DOCUMENTS, EXHIBITS, ATTACHMENTS, ETC.

Attachment A – Specifications

Attachment B – Statement of Work

Attachment C – Service Contract Wage Determination, Revision No.: 2015-5477

Attachment D – IHS IEE Representation Form

Attachment E – Justification to Restrict Competition

SECTION E – SOLICITATION PROVISIONS

52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

NOV 2025

(DEVIATION)

Addenda are included. 52.212-1 Instructions to Offerors – Commercial Products and Commercial Services

- Submission of Offers. All offers must include the following information and submitted at or before the date and time specified in this solicitation.

Sub-paragraph (a) is replaced in its entirety by the following:

(a) Submission of offers. All quotes must include the following information and emailed to the Contracting Officer (CO): Teola Autaubo, Purchasing Agent, (928) 674-7825, teola.autaubo@ihs.gov at or before the exact time specified in this solicitation. As a minimum, quotes shall include—

(1) The solicitation number;

(2) The name, address, telephone number of the Quoter;

(3) The Offeror’s Unique Entity Identifier (UEI) and, if applicable, Electronic Funds Transfer (EFT) indicator;

(4) Information necessary to evaluate the factors contained in the provision at 52.212-2 or as described in the solicitation;

a) Volume 1 – Label “Administrative Documents.” Provide signed and dated SF-1449 and all associated SF-30 amendments, if any. Provide a completed IHS IEE Representation Form attachment. Quotes that fail to provide required administrative documents or reject the Terms and Conditions of the solicitation may be excluded from consideration.

b) Volume 2 – Label “Technical Capability/Specifications.” Provide evidence that your item can meet or exceed the attached Specifications.

NO PRICING INFORMATION SHALL BE INCLUDED IN VOLUME 2.

c) Volume 3 – Label “Price.” Provide detailed pricing aligned with the technical approach on SF1449 Include a narrative that supports the pricing and indicate any discount terms.

All prices, base and option CLINs, must be quoted or the quote will not be considered.

Submission Format:

All Documentation must be in PDF format. Failure to follow instructions and/or to provide required information may render proposal nonresponsive or unacceptable and will be removed from award consideration.

Each volume must be submitted as a separate file with clear labeling (e.g., Volume I “Administrative Documents, etc.)

The email subject line should reference the solicitation number and quoter name.

Questions and Answers (Q&A) Period: The due date for all questions associated with this solicitation is (10) days before of offer due date. Questions requesting changes to solicitation/contract requirements will be considered only when supported by specific reasoning about how the change would increase competition/benefit the Government.

(5) Responses to provisions that require Offeror completion of information, representations, and certifications (other than those collected via the System for Award Management (SAM)); and

(6) A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation and any solicitation amendments.

(b) Period for acceptance of offers. The Offeror agrees to hold the prices in its offer firm for 60 calendar days from the date specified for receipt of offers, unless another time period is specified in an addendum to the solicitation.

(c) Late submissions, modifications, revisions, and withdrawals of offers.

(1) Offerors are responsible for submitting offers and any modifications or revisions to the Government office designated in the solicitation by the time specified in the solicitation.

(2) Any offer, modification, or revision received after the time specified for receipt of offers is “late” and will not be considered unless it is received before award is made and the Contracting Officer determines that accepting the late offer would not unduly delay the acquisition. However, a late modification of an otherwise successful offer that makes its terms more favorable to the Government will be considered at any time it is received and may be accepted.

(3) If an emergency or unanticipated event interrupts normal Government processes so that offers cannot be received at the Government office designated for receipt of offers by the exact time specified in the solicitation, and urgent Government requirements preclude amendment of the solicitation or other notice of an extension of the closing date, the time specified for receipt of offers will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume.

(4) Offerors may withdraw their offers by written notice to the Government received at any time before award.

(d) Contract award (not applicable to Invitation for Bids). The Government intends to evaluate offers and award a contract without discussions with Offerors. Therefore, the Offeror’s initial offer should contain the Offeror’s best terms. However, the Government reserves the right to conduct discussions, if necessary. The Government may reject any or all offers if such action is in the public interest, accept other than the lowest offer, and waive informalities and minor irregularities in offers received.

(e) Debriefings. If a postaward debriefing is given to requesting Offerors, the Government will disclose the following information, if applicable:

(1) The agency’s evaluation of the significant weak or deficient factors in the debriefed Offeror’s offer.

(2) The overall evaluated cost or price and technical rating of the successful Offeror and the debriefed Offeror and past performance information on the debriefed Offeror.

(3) The overall ranking of all Offerors when any ranking was developed by the agency during source selection.

(4) A summary of the rationale for award.

(5) For acquisitions of commercial products, the make and model of the product to be delivered by the successful Offeror.

(6) Reasonable responses to relevant questions posed by the debriefed Offeror as to whether the agency followed source-selection procedures set forth in the solicitation, applicable regulations, and other applicable authorities.

(End of provision)

52.212-2 EVALUATION – COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

(a) Evaluation factors. The Government will award a contract resulting from this solicitation to the responsible Offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors will be used to evaluate quotes:

The Government reserves the right to issue a single award or multiple awards to the contractor(s) whose offer represents the Lowest Price Technically Acceptable (LPTA); award will be made on the basis of the lowest evaluated price of proposals meeting or exceeding the acceptability standards for non-cost factors.

(b) Options (if applicable). The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. The evaluation of options does not obligate the Government to exercise the option(s).

(c) Notice of award. A written notice of award or acceptance of an offer furnished to the successful Offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

The following Federal Acquisition Regulations provisions incorporated by reference also apply:

☐ 52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO

INFLUENCE CERTAIN FEDERAL TRANSACTIONS

SEP 2024

52.203-18 PROHIBITION ON CONTRACTING WITH ENTITIES THAT REQUIRE

CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS OR

STATEMENTS-REPRESENTATION

JAN 2017

☒ 52.204-7

SYSTEM FOR AWARD MANAGEMENT - REGISTRATION

NOV 2025

(DEVIATION)

☐ 52.204-7 Alt I

SYSTEM FOR AWARD MANAGEMENT—REGISTRATION, WITH

ALTERNATE I

NOV 2025

(DEVIATION)

52.207-6 SOLICITATION OF OFFERS FROM SMALL BUSINESS CONCERNS AND

SMALL BUSINESS TEAMING ARRANGEMENTS OR JOINT VENTURES

(MULTIPLE-AWARD CONTRACTS)

AUG 2024

☐ 52.209-12 CERTIFICATION REGARDING TAX MATTERS OCT 2025

☐ 52.216-31 TIME-AND-MATERIALS/LABOR-HOUR PROPOSAL REQUIREMENTS –

COMMERCIAL ACQUISITION

NOV 2021

☐ 52.219-4 NOTICE OF PRICE EVALUATION PREFERENCE FOR HUBZONE SMALL

BUSINESS CONCERNS

NOV 2025

(DEVIATION)

☐ 52.219-31 NOTICE OF SMALL BUSINESS RESERVE MAR 2020

☐ 52.222-18 CERTIFICATION REGARDING KNOWLEDGE OF CHILD LABOR FOR

LISTED END PRODUCTS

FEB 2021

52.222-48 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS FOR MAINTENANCE, CALIBRATION, OR REPAIR OF

CERTAIN EQUIPMENT–CERTIFICATION

MAY 2014

☐ 52.222-52 EXEMPTION FROM APPLICATION OF THE SERVICE CONTRACT LABOR

STANDARDS FOR CERTAIN SERVICES-CERTIFICATION

MAY 2014

☐ 52.222-56 CERTIFICATION REGARDING TRAFFICKING IN PERSONS COMPLIANCE

PLAN

OCT 2020

☐ 52.223-1

BIOBASED PRODUCT CERTIFICATION

MAY 2024

☐ 52.223-4

RECOVERED MATERIAL CERTIFICATION

MAY 2008

☐ 52.229-11 TAX ON CERTAIN FOREIGN PROCUREMENTS—NOTICE AND

REPRESENTATION

AUG 2025

(DEVIATION)

☒ 52.237-1

SITE VISIT

APR 1984

☒ 52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS REPRESENTATIONS AND

CERTIFICATIONS

52.209-2 PROHIBITION ON CONTRACTING WITH

INVERTED DOMESTIC CORPORATIONS –

REPRESENTATION

(a) Definitions. As used in this clause—

Inverted domestic corporation means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Subsidiary means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

(b) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-3(b) applies or the requirement is waived in accordance with the procedures at 9.108-5.

(c) Representation. The Offeror represents that-

(1) It □ is, □ is not an inverted domestic corporation; and

(2) It □ is, □ is not a subsidiary of an inverted domestic corporation.

52.209-11 REPRESENTATION BY CORPORATIONS

REGARDING DELINQUENT TAX LIABILITY OR A

FELONY CONVICTION UNDER ANY FEDERAL

LAW

(a) The Government will not enter into a contract with any corporation that—

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that–

(1) It is □ is not □ a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is □ is not □ a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

52.225-4 BUY AMERICAN – FREE TRADE AGREEMENTS –

ISRAELI TRADE ACT CERTIFICATE

NOV 2025

(DEVIATION)

(a) (1) The Offeror certifies that each end product, except those listed in paragraph (b) or (c)(1) of this provision, is a domestic end product and that each domestic end product listed in paragraph (c)(2) of this provision contains a critical component.

(2) The terms "Bahraini, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "critical component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act."

(b) The Offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Free Trade Agreement Country End Products (Other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No. Country of Origin

[List as necessary]

(c) (1) The Offeror shall list those supplies that are foreign end products (other than those listed in paragraph (b) of this provision) as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements- Israeli Trade Act." The Offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products. For those foreign end products that do not consist wholly or predominantly of iron or steel or a combination of both, the Offeror shall also indicate whether these foreign end products exceed 55 percent domestic content, except for those that are COTS items. If the percentage of the domestic content is unknown, select “no”.

Other Foreign End Products:

(2) The Offeror shall list the line item numbers of domestic end products that contain a critical component (see FAR 25.105).

Line Item No. ___

[List as necessary]

(d) The Government will evaluate offers in accordance with the policies and procedures of part 25 of the Federal Acquisition Regulation.

(End of provision)

Alternate I [Reserved]

Alternate II (JAN 2025). As prescribed in 25.601(b)(2)(ii), substitute the following paragraph (b) for paragraph

(b) of the basic provision:

(b) The offeror certifies that the following supplies are Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”.

ISRAELI END PRODUCTS:

Alternate III (JAN 2025). As prescribed in 25.601(b)(2)(iii), substitute the following paragraph (b) for paragraph (b) of the basic provision:

(b) The Offeror certifies that the following supplies are Korean end products or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”.

Korean End Products or Israeli End Products:

52.252-1 SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE

FEB 1998

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):

Revolutionary FAR Overhaul - FAR Overhaul - FAR Part Deviation Guidance | Acquisition.GOV

Federal Acquisition Regulation - https://www.acquisition.gov/browse/index/far

Department of Health and Human Services Acquisition Regulation – https://www.acquisition.gov/hhsar

(End of Provision)

52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS NOV 2020

(a)The use in this solicitation of any Federal Acquisition Regulation (48 CFR Chapter 1) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause.

(b)The use in this solicitation of any Department of Health and Human Services (48 CFR Chapter 3) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

(End of Provision)

The following Department of Health and Human Services Acquisition Regulation provisions also apply:

☐ 352.219-70 MENTOR-PROTÉGÉ PROGRAM DEC 2015

☐ 352.223-71 INSTRUCTIONS TO OFFERORS – SUSTAINABLE ACQUISITION DEC 2015

☒ 352.226-5 NOTICE OF INDIAN ECONOMIC ENTERPRISE SET ASIDE MAR 2022

☒ 352.226-4 NOTICE OF INDIAN SMALL BUSINESS ECONOMIC ENTERPRISE SET

ASIDE

MAR 2022

☒ 352.226-7 INDIAN ECONOMIC ENTERPRISE REPRESENTATION MAR 2022

☐ 352.239-73 ELECTRONIC AND INFORMATION TECHNOLOGY ACCESSIBILITY

NOTICE

DEC 2015

Specifications

Transport Ventilation Machine

1. Ventilator or producing parts must be used from a 8kg patient to an adult. Must be for peds and adult.

2. Must be able to lift easily and transport with the patient, mobility is a must.

3. Can be used interior and exterior of a building. Ground, in the air and water.

4. Shock-resistant and able to withstand movement while in use with patient in transport.

Reinforced housing with impact protection and vibration proof

5. Able to use the same mode and settings as one at the bedside.

6. Baterry powered when needed.

7. Dimensions (WxDxH) 320x220x270mm, with out a handle 630x630x1380mm, with handle

630x630x1433mm

8. Weight: 6.5kg

9. Monitor size and resolution: 8.4 in diagonal, 640x480 pixels

10. Battery operating time: 4-8 hours

Attachment A – Specifications

1. Ventilator or producing parts must be used from a 8kg patient to an adult. Must be for peds and adult.

2. Has oxygen cylinder holder

3. Dimensions: (WxDxH) 310x210x245mm (unit), 630x630x1380mm (with trolley)

4. Weight: 4.9 kg/10.8 lb, 16.9kg/37.3 lb with trolley

5. Monitor size and resolution: 8.4 in diagonal, 640x480 pixels

6. Battery opeating time: 4-6 hours

7. Connectivity: CO2/Nurse Call/COM1, CO2/Sp02/COM1, CO2/Humidifer & COM1, USB Port, RJ-

45 Ethernet Port

8. CPR Ventilation

9. Suctioning tool

10. On-screen help

11. High Flow O2/NIV, NIV S/T, nCPAP, Neonatal

Statement of Work

VENTILATOR

Author: Ferlinda Jishie

BACKGROUND

The Respiratory department and Patient transport department are in need of Infant/Peds/Adult ventilator within their department. Current ventilators are obsolete and no parts are available to fix them at this time. This is an urgent request.

OBJECTIVES

Ventilators will be used in the ER/In-patient areas/and on patient transports when needed. Ventilators will be used for patients who are in distress and need the additional assistance.

PERIOD OF PERFORMANCE

Contractor shall deliver items within 30 days of purchase order date.

SCOPE

CSU would like the contractor to furnish the equipment that meet the needs and specifications listed. The contractor shall deliver promptly and in a timely manner.

TASK

Transport Ventilator shall have the specifications listed on specs sheet.

Training should be conducted for the reno service training.

DELIVERY

The contractor shall provided one year of services which include parts, labor, travel and annual preventative maintenance.

GOVERNMENT-FURNISHED PROPERTY

This section should identify any government-furnished property provided to the contractor. This includes all government-furnished property, such as government furnished material, equipment, or information. If the list of property is extensive, this section should identify where that list can be found. Before offering to provide any property, make sure that it will be available when required, where required, and in the condition required by the contract. Failure to meet government furnished property requirements often lead to a contractor claim for an equitable adjustment to contract price, delivery, or other requirements. Specific requirements about providing government furnished property can be found in FAR 45, government property, and related agency policy.

Attachment B – Statement of Work

Statement of Work

VENTILATOR

Author: Ferlinda Jishie

CONTRACTOR-FURNISHED PROPERTY

Contractor shall provided ventilators and training as requested.

SECURITY REQUIREMENTS

None required

PLACE OF PERFORMANCE

Chinle Comprehensive Health Care Facility

REGISTER OF WAGE DETERMINATIONS UNDER | U.S. DEPARTMENT OF LABOR

THE SERVICE CONTRACT ACT | EMPLOYMENT STANDARDS ADMINISTRATION

By direction of the Secretary of Labor | WAGE AND HOUR DIVISION

| WASHINGTON D.C. 20210

| Wage Determination No.: 2015-5477

Daniel W. Simms Division of | Revision No.: 30 Director Wage Determinations| Date Of Last Revision: 5/13/2026

State: Arizona

Area: Arizona Counties of Apache, Gila and Navajo

**Fringe Benefits Required Follow the Occupational Listing**

OCCUPATION CODE - TITLE FOOTNOTE RATE

01000 - Administrative Support And Clerical Occupations 01011 - Accounting Clerk I 17.10 01012 - Accounting Clerk II 19.19 01013 - Accounting Clerk III 21.47 01020 - Administrative Assistant 27.90 01035 - Court Reporter 20.65 01041 - Customer Service Representative I 15.56 01042 - Customer Service Representative II 16.98 01043 - Customer Service Representative III 19.05 01051 - Data Entry Operator I 15.95

Attachment C – Service Contract Wage Determination, Revision No.: 2015-5477

01052 - Data Entry Operator II 17.40 01060 - Dispatcher, Motor Vehicle 22.58 01070 - Document Preparation Clerk 16.45 01090 - Duplicating Machine Operator 16.45 01111 - General Clerk I 17.01 01112 - General Clerk II 18.56 01113 - General Clerk III 20.82 01120 - Housing Referral Assistant 23.03 01141 - Messenger Courier 13.56 01191 - Order Clerk I 15.08 01192 - Order Clerk II 16.45 01261 - Personnel Assistant (Employment) I 19.77 01262 - Personnel Assistant (Employment) II 22.11 01263 - Personnel Assistant (Employment) III 24.64 01270 - Production Control Clerk 32.41 01290 - Rental Clerk 17.57 01300 - Scheduler, Maintenance 18.46 01311 - Secretary I 18.46 01312 - Secretary II 20.65 01313 - Secretary III 23.03 01320 - Service Order Dispatcher 20.19 01410 - Supply Technician 27.90 01420 - Survey Worker 18.06 01460 - Switchboard Operator/Receptionist 17.24 01531 - Travel Clerk I 16.45 01532 - Travel Clerk II 18.28 01533 - Travel Clerk III 20.32 01611 - Word Processor I 16.45 01612 - Word Processor II 18.46 01613 - Word Processor III 20.65

05000 - Automotive Service Occupations 05005 - Automobile Body Repairer, Fiberglass 26.38 05010 - Automotive Electrician 21.25 05040 - Automotive Glass Installer 19.91 05070 - Automotive Worker 19.91 05110 - Mobile Equipment Servicer 17.26 05130 - Motor Equipment Metal Mechanic 22.69 05160 - Motor Equipment Metal Worker 19.91 05190 - Motor Vehicle Mechanic 22.60 05220 - Motor Vehicle Mechanic Helper 15.93 05250 - Motor Vehicle Upholstery Worker 18.59 05280 - Motor Vehicle Wrecker 19.91 05310 - Painter, Automotive 22.12 05340 - Radiator Repair Specialist 19.91 05370 - Tire Repairer 17.22 05400 - Transmission Repair Specialist 22.60

07000 - Food Preparation And Service Occupations 07010 - Baker 17.50

07041 - Cook I 18.00 07042 - Cook II 20.76 07070 - Dishwasher 14.86 07130 - Food Service Worker 16.50 07210 - Meat Cutter 18.24 07260 - Waiter/Waitress 16.66

09000 - Furniture Maintenance And Repair Occupations 09010 - Electrostatic Spray Painter 26.36 09040 - Furniture Handler 16.69 09080 - Furniture Refinisher 26.36 09090 - Furniture Refinisher Helper 19.76 09110 - Furniture Repairer, Minor 23.06 09130 - Upholsterer 26.36

11000 - General Services And Support Occupations 11030 - Cleaner, Vehicles 15.24 11060 - Elevator Operator 17.12 11090 - Gardener 22.08 11122 - Housekeeping Aide 17.12 11150 - Janitor 17.12 11210 - Laborer, Grounds Maintenance 17.71 11240 - Maid or Houseman 14.68 11260 - Pruner 16.64 11270 - Tractor Operator 20.38 11330 - Trail Maintenance Worker 17.71 11360 - Window Cleaner 18.22

12000 - Health Occupations 12010 - Ambulance Driver 17.23 12011 - Breath Alcohol Technician 30.92 12012 - Certified Occupational Therapist Assistant 42.42 12015 - Certified Physical Therapist Assistant 30.40 12020 - Dental Assistant 23.31 12025 - Dental Hygienist 46.96 12030 - EKG Technician 46.84 12035 - Electroneurodiagnostic Technologist 46.84 12040 - Emergency Medical Technician 17.23 12071 - Licensed Practical Nurse I 27.64 12072 - Licensed Practical Nurse II 30.92 12073 - Licensed Practical Nurse III 34.46 12100 - Medical Assistant 21.04 12130 - Medical Laboratory Technician 28.30 12160 - Medical Record Clerk 21.77 12190 - Medical Record Technician 24.35 12195 - Medical Transcriptionist 23.51 12210 - Nuclear Medicine Technologist 67.95 12221 - Nursing Assistant I 14.37 12222 - Nursing Assistant II 16.17 12223 - Nursing Assistant III 17.65

12224 - Nursing Assistant IV 19.81 12235 - Optical Dispenser 21.34 12236 - Optical Technician 27.64 12250 - Pharmacy Technician 22.27 12280 - Phlebotomist 21.02 12305 - Radiologic Technologist 39.94 12311 - Registered Nurse I 28.31 12312 - Registered Nurse II 34.64 12313 - Registered Nurse II, Specialist 34.64 12314 - Registered Nurse III 41.90 12315 - Registered Nurse III, Anesthetist 41.90 12316 - Registered Nurse IV 50.22 12317 - Scheduler (Drug and Alcohol Testing) 38.30 12320 - Substance Abuse Treatment Counselor 30.49

13000 - Information And Arts Occupations 13011 - Exhibits Specialist I 17.08 13012 - Exhibits Specialist II 21.08 13013 - Exhibits Specialist III 25.71 13041 - Illustrator I 18.79 13042 - Illustrator II 23.18 13043 - Illustrator III 28.27 13047 - Librarian 23.06 13050 - Library Aide/Clerk 17.15 13054 - Library Information Technology Systems Administrator 20.92 13058 - Library Technician 17.34 13061 - Media Specialist I 15.03 13062 - Media Specialist II 16.81 13063 - Media Specialist III 18.75 13071 - Photographer I 14.99 13072 - Photographer II 17.27 13073 - Photographer III 21.32 13074 -…