SOW Audiology- Vestibular Chair HCC1.pdf

VA Chesapeake Community Based Outpatient Clinic (CBOC) Chesapeake HCC1

Initial Outfitting, Transition & Activation Project Equipment Package #030 Audiology- Vestibular Chair

General Conditions and Statement of Work

INTRODUCTION

The Chesapeake, Virginia HCC1 has a requirement to purchase a vestibular chair 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 Chesapeake HCC1. Item(s) are to be delivered to the location specified in section 2.4.1.

Table 1 – Package Items Summary

Item# JSN Description QTY

0001 M4910 Product Number: 8526816ITA-8526816, Micromedical chair Reclining Rotational Vestibular Chair and VE5253rd Generation VNG System/VTQ Assessments &Diagnostics Pkg, Brand Name or Equal

0002 U3006 Product Number: 8525983ITA-8525983, EyeSeeCam vHIT 3rd Generation, Brand Name or Equal

U3006 &M4910

Product Number: 8517470,GSI-8013065, OtoAccess Database, Brand Name or Equal

0004 M4910 Product Number: 1000684 MISC, Misc. - TV/Monitor Wall Mount/ Occular Motor stimulus with all mounts and cables, min 55'' or larger, Brand Name or Equal

0005 U3006 Product Number: 8503836 ITA-8503836 MM AirFx, Brand Name or Equal 1

0006 U3006 Product Number: 8504102 ITA-8504102, MM AquaStim, Brand Name or Equal 1

0007 U3006 Product Number: 8503756 ITA-8503756, EOG Option, Brand Name or Equal 1

0008 U3006 Product Number: 1000686 MISC, Misc. - Computer Accessories 8526286 research module license, Brand Name or Equal

0009 U3006 &M4910

Product Number: 8122535 SERVICE, On Site Training, 1 day 1

U3006

Product Number: 8122326 SERVICE, Shipping 1

0011 U3006

Product Number: 8122535 SERVICE, Installation 1

GENERAL CONDITIONS

SITE ADDRESS

THE ADDRESS OF THE CHESAPEAKE VA HCC1 IS LISTED BELOW. ADDITIONAL INFORMATION ON

DELIVERY IS LOCATED IN SECTION 2.4.

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.

Table 2 – Anticipated Building Outfitting Schedule

Building Name Building # & Letter Order Items Est. Delivery Start Date

Est. Delivery End Date

Chesapeake VA

HCC1

HCC1 Audiology- Vestibular Chair Delivery and Installation

08/04/2024 09/15/2024

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 AND THE VENDOR. 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 VA LOGISTICS POC: CURTIS DAWSON_(OFFICE);

757-315-3924 (CELL) 757-633-2741_ 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.

☒ Chesapeake VA HCC1

70 Knells Ridge BLVD

Chesapeake VA 23320

☐ Chesapeake VA Off-Site Activation Warehouse

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 EASTERN 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 ☒ Manufacturer Certified Installation Required if Checked

☒ BMET Training Required if Checked ☒ End User Training Required if Checked

ASSEMBLY AND INSTALLATION [ ☒ IS ☐ IS NOT ] REQUIRED.

THE VENDOR IS REQUIRED TO MANAGE AND COORDINATE INSTALLATION AT THE HVAMC 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 EASTERN 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 HVAMC. ON-SITE REPRESENTATIVE CAN BE THE INSTALLER. ALL

INSTRUCTIONS PROVIDED FROM VA POC TO THE REPRESENTATIVE WILL BE BINDING AS IF GIVEN TO THE VENDOR’S MAIN CONTACT. THE VA POC MAY PROVIDE SPECIFIC INSTRUCTIONS, HOWEVER, ONLY

THE CONTRACTING OFFICER MAY CHANGE THE TERMS OR CONDITIONS OF THE CONTRACT.

TRAINING [ ☒ IS ☐ IS NOT ] REQUIRED

THE VENDOR SHALL COORDINATE THROUGH THE VA POC TO PROVIDE A HANDS-ON TRAINING SESSION TO STAFF SELECTED BY THE VA. TRAINING SHALL BE COMPLETED WITHIN 45 DAYS AFTER FINAL INSTALLATION OF EQUIPMENT. THE VENDOR WILL RECORD THE TRAINING AND PROVIDE AN ELECTRONIC COPY OF THE TRAINING TO THE VA POC FOR VA TO USE TO TRAIN ADDITIONAL PERSONAL AT A FUTURE DATE. IN ADDITION, THE VENDOR SHALL PROVIDE ADDITIONAL TRAINING DOCUMENTS TO THE VA POC

FOR TRAINING ADDITIONAL PERSONS AT A FUTURE DATE.

IF CHECKED IN SECTION 2.7.3 THE VENDOR IS TO PROVIDE TRAINING TO THE ONSITE AND/OR

REGIONAL BIOMED REPRESENTATIVE WORKING FOR THE VA. ALL DOCUMENTS RELATED TO THE

INSTALLATION, MAINTENANCE, AND WARRANTY INFORMATION IS TO BE TURNED OVER TO THE BIOMED

REPRESENTATIVE(S) ONCE TRAINING IS COMPLETED.

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 .

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 HVAMC PREMISES, THE VENDOR SHALL PERFORM ALL WORK IN SUCH A MANNER THAT WILL CAUSE A MINIMUM

INTERFERENCE WITH HVAMC 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).

2.11.4 The vendors shall abide by all rules and regulations set forth by the CDC & the HVAOPC due to the Coronavirus (COVID-19) and have their own personal protective equipment (PPE) in use for the time they are on the GLA campus grounds.

SALIENT CHARACTERISTICS

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Project Name: Hampton Roads Project Location: Chesapeake, Virginia

Cat Code: VV JSN: M4910 Date Prepared: July 13, 2023 Brand Name or Equal

Nomenclature: Chair, Exam, Vestibular

Manufacturer: Model Name:

Dealer: Model Number: Reclining

Email: 3rd Party Install: No Room Nbr(s): See Attached

Phone:

Dimensions: D 81.00 in W 32.00 in H 42.00 in D 2057.4 mm W 812.8 mm H 1066.8 mm

1: Plumbing: 7: Data: No 2: Electrical: 120 VOLT, CONVENTIONAL OUTLET 8: Drops:

DC: No EP: No Addl Outlets: Amps: Outlet Type: 9: Warranty:

3: Medical Gas: 10: Training: No 4: Misc Gas: 11: Weight: 712.00 5: NonMed Gas: 12: Wall Blocking: No 6: Misc:

Salient Characteristics

Rotary Chair with no booth enclosure. Rotary chair with reclining options, for caloric, dix hallpike. The chair can be reclined to varying positions, allowing the clinician to perform the entire VNG test battery from chair, to be used with VNG Visual Eyes 525 or similar system (not included).

Technical Specifications:

Standards: Applied Part Type: B according to IEC 60601-1” “Protection class: Class I accordint to IEC 60601-1 Operation Environment: Temperature:

Relative Humidity:

15 – 35°C 30 – 80% Transport & Storage Environment: Transport Temperature:

Storage Temperature:

Relative Humidity:

0 – 50°C 0 – 50°C 30 – 80%, Non-condensing Rotation Control: Software controlled

Available rotary tests (on top of standard VisualEyes Tests):

Step Rotation (up to 200°/s) Sinusoidal Harmonic Acceleration (0.01 – 0.64 Hz)

VOR Suppression (0.01-0.64 Hz) Interface: USB USB Cable Length: 9.8 Feed

Power Cable Length: 8 Feet Maximum Chair Speed: 200°/s

Maximum Chair Acceleration: 100°/s2 Maximum Patient Weight: 352lbs Reclined: 77.9 x 27 x 59.8 inches

Weight: 170 kg Patient Fixation: Safety belt for body, Ankle belt, Head strap Headrest:

Yes (Detachable for Dix Hallpike test) Footrest: Yes Emergency Stop: Yes Reclining range: 90° (upright) - 0° (flat) w/ 30° indication label for caloric irrigation

Power supply Options: 110VAC, 220VAC step down to 110VAC through included isolation Transformer

Department, Room, Quantity

AUDIOLOGY CLINIC

VEST/EMG-C1038(1)

Project Name: Hampton Roads Project Location: Chesapeake, Virginia

Cat Code: VV JSN: U3006 Date Prepared: July 13, 2023 Brand Name or Equal

Nomenclature: Videonsystagmography (VNG) System

Manufacturer: Model Name:

Dealer: Model Number:

Email: 3rd Party Install: No Room Nbr(s): See Attached

Phone:

Dimensions: D 15.00 in W 15.00 in H 15.00 in D 381 mm W 381 mm H 381 mm

1: Plumbing:

2: Electrical:

120 VOLT, CONVENTIONAL OUTLET

DC: No EP: No

Addl Outlets: Amps:

3: Medical Gas:

4: Misc Gas:

5: NonMed Gas:

7:Data:

8:Drops 1 9: Warranty:

10: Training: Yes 12: Wall Blocking:

Yes

1yr

Salient Characteristics

Videonystagmography System is a full range VNG system

Features:

-Touch-enabled user interface -Four button RF Remote to start and stop recording, turn on fixation light and center both eyes on computer screen -55” or larger TV screen to display large eye images (included with purchase) -Real time analysis of nystagmus measures patient's nystagmus response -Time line display -Color-coded nystagmus beats -Fixation light is automatically enabled -Patient Interview recording

VISUALEYES 525BT; VNG-EOG-VTQ ASMT & DIAG-SFF

-VNG goggle

- Top mounted cameras goggle w/start button - 6.5inL x 6.5inW x 3.5H

- Side mounted cameras goggle w/foam inserts - 12inL x 8.5inW x 5.2H

• VisualEyes™ software

• Remote control / foot switch

• Full HD room camera

• Cleaning cloth

• Introduction guides

• Certificates and reports: e.g. test result report, license certificate, certificate of conformity, and if applicable, safety test report.

*Continued next page*

VORTEQ Diagnostic

• Research Module

• EOG Accessory kit for VNG

• Orion Reclining

• Orion Comprehensive

• Orion Auto Traverse

• AquaStim

• AirFx

• Digital Lightbar

• Static SVV module

• External Sync

License overview:

Video Frenzel Spontaneous Nystagmus Gaze Dix Hallpike Positional Bithermal Caloric Optokinetic Smooth Pursuit Saccade Ocular Counter Roll Saccadometry

Minimum computer requirements Desktop PC: One PCI Express card available (FireWire® systems only). USB port required (expanded by USB hub).

Intel i5 processor 2.5 GHz or better, and not older than 5th generation. Minimum 4 cores (4 threads). Minimum 8 GB RAM or more.

Hard drive with min. 250 GB space.

Minimum display of 1366x768 (higher resolution recommended).

Touch monitor or laptop with touch screen is highly recommended though not require

Must include:

VORTEQTM Assessment bundle Dynamic Visual Acuity (DVA) BPPV bundle (Advanced Dix Hallpike and lateral head roll test) Gaze Stabilization Test (GST)

VORTEQTM Diagnostic bundle Active Head Rotation (AHR) vHIT with VNG goggle EyeSeeCam vHIT Research package EOG accessory kit for VNG"

Department, Room, Quantity

AUDIOLOGY CLINIC

VEST/EMG-C1038(1)

Salient characteristics