B.08._6.12.19_CLIN_Structure_19Q0138.docx

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 ea $ $ Functional Near-Infrared Spectroscopy

FFP

The Contractor shall provide Brand Name or Equal Artinis Medical Systems Dual Brite 54 Package Functional Near-Infrared Spectroscopy (fNIRS) in accordance with the Minimum Essential Characteristics (MECs) with preference given to amount of cortical surface coverage. System must include 20 or greater transmitting optodes and 16 or greater detectors, along with 8 or greater short channel detectors.

FOB: Destination

PSC CD: 6515

NET AMT $

************************************************************************************ ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0002 6 Each $ $ Headcap

FFP

The Contractor shall provide headcaps in accordance with the MECs. The Headcap must have the capability to be configured with fNIRS optodes and electroencephalography (EEG) electrodes. Require the following sizes:

1. Two (2) Small

2. Two (2) Medium

3. Two (2) Large

4. One (1) Extra-Large FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0003 216 Each $ $ TMSi Mobita 32 Channel EEG

FFP

The Contractor shall provide Brand Name or Equal TMSi Mobita 32 Channel Electroencephalography (EEG) Package in accordance with the MECs. The system must integrate with the fNIRS in a single headcap.

FOB: Destination

PSC CD: 6515

NET AMT $

************************************************************************************ ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0004 1 Each $ $ Oxymon Ring Electrode Holders

FFP

The Contractor shall provide Brand Name or Equal TMSi Oxymon Ring Electrode Holders in accordance with the MECs.

FOB: Destination

PSC CD: 6515

NET AMT $

*************************************************************************************ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0005 192 Each $ $ Portasync System

FFP

The Contractor shall provide a Portasync System or equivalent capability to synchronize the data from multiple sources and to add event markers in the data in accordance with the MECs.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0006 1 Each $ $ 3D Digitizer System and Stylus

FFP

The Contractor shall provide Brand Name or Equal Polhemus Patriot 3D Digitizer System and Stylus in accordance with the MECs.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0007 1 Each $ $ Software Tools

FFP

The Contractor shall a complete software package for analyzing fNRIS and EEG data loaded onto a laptop in accordance with the MECs.

FOB: Destination

PSC CD: 6515

NET AMT $

fNIRS/EEG Consumables Start Kit

FFP

The Contractor shall provide EEG Consumables Start Kit in accordance with the MECs. The EEG Consumables Start Kit must include electrode gel, surgical tape, electrodes, cleaning supplies, and 12cc irrigation syringes for 100 participants.

FOB: Destination

PSC CD: 6515

NET AMT $

Six (6) Inch Velcro Cable Strap

FFP

The Contractor shall provide six (6) inch Velcro Cable Strap, 12 pack FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0010 1 Each $ $ White Polyethylene Container

FFP

The Contractor shall provide four (4) quart White Polyethylene Container for cleaning of fNIRS/EEG system components.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0011 1 Each $ $ Hydrogen Peroxide Disinfectant Spray

FFP

The Contractor shall provide Hydrogen Peroxide Disinfect Spray, 32 ounce.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0012 1 Each $ $ Vinyl Measuring Tape

FFP

The Contractor shall provide five (5) foot Vinyl Measuring Tape to measure front of head to back of head and circumference of head from ear to ear.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0013 1 Each $ $ Plastic Head Cap Stand

FFP

The Contractor shall provide Plastic Head Cap Stand for the drying and storage of electrode caps.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0014 1 Each $ $

Double Sided Adhesive Rings

FFP

The Contractor shall provide Double Sided Adhesive Rings, 100 each, 4 mm id x 19 mm od.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0015 1 Each $ $ OEM Warranty Extension

FFP

The Contractor shall provide Five (5) Year Original Equipment Manufacturer (OEM) Warranty Extension for fNIRS and EEG systems.

FOB: Destination

PSC CD: 6515

NET AMT $

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0016 1 Each $ $ On-site Installation and training

FFP

The Contractor shall provide the following On-Site Installation and Training:

a. One (1) day, eight (8) hours of on-site installation and training of the fNIRS/EEG system. Complete installation of the systems is required and training on how the fNIRS/EEG system is applied to participants.

b. One (1) day, eight (8) hours of on-site training on the use of the fNIRS/EEG to collect data and analyze the data. The Contractor is required to provide step-by-step instructions on how to operate the fNIRS/EEG system with the end result of collecting and analyzing the data from the start of test to end of data analysis. *************************************************************************************

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0017 1 Each $ $

Shipping/Handling

FFP

Shipping/Handling FOB: Destination

PSC CD: 6515

NET AMT $