65-- MANOSCAN EQUIPMENT PARTS Brand Name SDVOSB

PAGE 1 OF 1. REQUISITION NO. 2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL TIME 9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR: SMALL BUSINESS HUBZONE SMALL BUSINESS SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM EDWOSB 8(A) NAICS: SIZE STANDARD: 11. DELIVERY FOR FOB DESTINA- TION UNLESS BLOCK IS MARKED SEE SCHEDULE 12. DISCOUNT TERMS 13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700) 13b. RATING 14. METHOD OF SOLICITATION RFQ IFB RFP 15. DELIVER TO CODE 16. ADMINISTERED BY CODE 17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE TELEPHONE NO. DUNS: DUNS+4: PHONE: FAX: 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED SEE ADDENDUM 19. 20. 21. 22. 23. 24. ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT (Use Reverse and/or Attach Additional Sheets as Necessary) 25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED. 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS: 30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012) PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212 7. FOR SOLICITATION INFORMATION CALL: STANDARD FORM 1449 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 9 644-18-1-260-0083 36C25818Q0066 Theresa Hamilton +1 (555) 000-0000 11-20-2017 11AM EST Department of Veterans Affairs VISN22 Phoenix 777 E. Missouri, Suite 300 Phoenix AZ 85014 X 100 X 334510 1250 Employees N/A X Department of Veterans Affairs Carl T Hagen Phoenix VA 650 E Indian School Rd. Phoenix AZ 85012 Department of Veterans Affairs VISN/18PHX 777 E. Missouri, Suite 300 Phoenix AZ 85014 This is accomplished through the Tungsten Network located at: http://www.fsc.va.gov/einvoice.asp This is mandatory and the sole method for submitting invoices. See CONTINUATION Page ALL PROPOSED PRODUCTS MUST BE BRAND NAME or equal MEDTRONIC and interface with Mano Scan by Medtronic SEE ATTACHED SOW for Details This procurement is for NEW Equipment ONLY no remanufactured or "gray market" items Vendor shall be an Original Equipment Manufacturer (OEM authorized dealer, authorized distributor or authorized reseller for the proposed equipment/system such that OEM warranty and service are provided and maintained by the OEM All software licensing, warranty and service associated wit the equipment shall be in accordance with the OEM terms and conditions Provide a copy of the authorized distributor letter from the Manufacturer to verify you are an authorized distributor Contracting POC contact@example.gov See CONTINUATION Page 644-18-1-260-0083 644-3680160-260-825500-2670 010055500 X X 36C25818Q0066 Page 1 of Page 2 of 9 Page 1 of Table of Contents SECTION A 1 A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1 SECTION B - CONTINUATION OF SF 1449 BLOCKS 3 B.1 CONTRACT ADMINISTRATION DATA 3 B.2 LIMITATIONS ON SUBCONTRACTING 4 Statement of Work 4 B.3 PRICE/COST SCHEDULE 5 ITEM INFORMATION 5 B.4 DELIVERY SCHEDULE 5 SECTION C - CONTRACT CLAUSES 6 C.1 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS COMMERCIAL ITEMS (JAN 2017) 6 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS 9 SECTION E - SOLICITATION PROVISIONS 9 E.1 52.212-2 EVALUATION COMMERCIAL ITEMS (OCT 2014) 9 36C25818Q0066 Page 1 of Page 4 of 9 Page 1 of SECTION B - CONTINUATION OF SF 1449 BLOCKS B.1 CONTRACT ADMINISTRATION DATA (continuation from Standard Form 1449, block 18A.) 1. Contract Administration: All contract administration matters will be handled by the following individuals: a. CONTRACTOR: b. GOVERNMENT: Contracting Officer 36C258 Department of Veterans Affairs VISN22 Phoenix 777 E. Missouri, Suite 300 Phoenix AZ 85014 2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with: [] 52.232-33, Payment by Electronic Funds Transfer System For Award Management, or [] 52.232-36, Payment by Third Party 3. INVOICES: Invoices shall be submitted in arrears: a. Quarterly [] b. Semi-Annually [] c. Other [X] Net 30 Days 4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests. This is accomplished through the Tungsten Network located at: http://www.fsc.va.gov/einvoice.asp This is mandatory and the sole method for submitting invoices. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows: AMENDMENT NO DATE B.2 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011) Any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement. Page 5 of 9 Page 5 of 9 Statement of Work ManoScanTM A120 Module Replacement General Objectives and Requirements Purpose: The Phoenix VA Health Care System (Agency) requires the replacement of the A120 module of its ManoScanTM EM Z manometry system. Scope: The Contractor shall deliver and install the items listed in the Item schedule: The equipment shall be compatible with the ManoScanTM EM Z Manometry System by Given Imaging, Currently owned by Medtonic. The equipment shall be new, not used, and not refurbished. The C&A requirements do not apply. A Security Accreditation Package is not required. Delivery: Requesting Delivery 14 Days ARO to Phoenix VAMC Phoenix VA Health Care System 650 E. Indian School Road Phoenix, AZ 85012 B.3 PRICE/COST SCHEDULE ITEM INFORMATION ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 A120 Upgrade Module STOCK NUMBER (STK#) MSE-6013 1.00 EA ____________ _____________ 0002 SET OF (2) A120 POWER CORDS. STK#2680 1.00 PG ____________ _____________ 0003 ManoScan V.3.0 software Kit STK#400100121 1.00 EA __________________ __________________ 0004 MANOVIEW ESO SOFTWARE V 3.3 STK#FGS-0628 1.00 EA ____________ _____________ 0005 MANOSCAN A120 MODULE STK#FGS-4374 1.00 EA __________________ __________________ 0006 CALIBRATION SET UP MODULAR CART STK#3282 1.00 EA ____________ _____________ 0007 ASSEMBLY MODULAR CART ACCESSORY KIT STK# 3283 1.00 EA ____________ _____________ GRAND TOTAL _____________ B.4 DELIVERY SCHEDULE ITEM NUMBER QUANTITY DELIVERY DATE 0001 SHIP TO: Carl T. Hayden VAMC 650 E. Indian School rd. Phoenix, AZ 85012 1892 1.00 POC : Jennifer Wong +1 (555) 000-0000 x4221 contact@example.gov 0002 Same as above 1.00 0003 Same as above 1.00 0004 Same as above 1.00 0005 Same as above 1.00 0006 Same as above 1.00 0007 Same as above 1.00 36C25818Q0066 Page 1 of Page 8 of 9 Page 1 of SECTION C - CONTRACT CLAUSES C.1 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS COMMERCIAL ITEMS (JAN 2017) (a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items: (1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (JAN 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)). (2) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (NOV 2015). (3) 52.233-3, Protest After Award (Aug 1996) (31 U.S.C. 3553). (4) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004) (Public Laws 108-77 and 108-78 (19 U.S.C. 3805 note)). (b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: [X] (22) 52.219-28, Post Award Small Business Program Rerepresentation (Jul 2013) (15 U.S.C 632(a)(2)). [X] (25) 52.222-3, Convict Labor (June 2003) (E.O. 11755). [X] (26) 52.222 19, Child Labor Cooperation with Authorities and Remedies (OCT 2016) (E.O. 13126). [X] (27) 52.222-21, Prohibition of Segregated Facilities (APR 2015). [X] (28) 52.222 26, Equal Opportunity (SEP 2016) (E.O. 11246). [X] (30) 52.222-36, Equal Opportunity for Workers with Disabilities (JUL 2014) (29 U.S.C. 793). [X] (33)(i) 52.222-50, Combating Trafficking in Persons (MAR 2015) (22 U.S.C. chapter 78 and E.O. 13627). [X] (44) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (AUG 2011) [X] (48) 52.225-1, Buy American Supplies (MAY 2014) (41 U.S.C. chapter 83). [X] (51) 52.225-13, Restrictions on Certain Foreign Purchases (JUN 2008) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury). (d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records Negotiation. (1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract. (2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved. (3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law. (e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c), and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause (i) 52.203-13, Contractor Code of Business Ethics and Conduct (OCT 2015) (41 U.S.C. 3509). (ii) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (JAN 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)). (iii) 52.219-8, Utilization of Small Business Concerns (NOV 2016) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. (iv) 52.222-17, Nondisplacement of Qualified Workers (MAY 2014) (E.O. 13495). Flow down required in accordance with paragraph (l) of FAR clause 52.222-17. (v) 52.222-21, Prohibition of Segregated Facilities (APR 2015). (vi) 52.222 26, Equal Opportunity (SEP 2016) (E.O. 11246). (vii) 52.222-35, Equal Opportunity for Veterans (OCT 2015) (38 U.S.C. 4212). (viii) 52.222-36, Equal Opportunity for Workers with Disabilities (JUL 2014) (29 U.S.C. 793). (ix) 52.222-37, Employment Reports on Veterans (FEB 2016) (38 U.S.C. 4212). (x) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222-40. (xi) 52.222-41, Service Contract Labor Standards (MAY 2014) (41 U.S.C. chapter 67). (xii)(A) 52.222-50, Combating Trafficking in Persons (MAR 2015) (22 U.S.C. chapter 78 and E.O. 13627). (B) Alternate I (MAR 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O. 13627). (xiii) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Requirements (MAY 2014) (41 U.S.C. chapter 67). (xiv) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services Requirements (MAY 2014) (41 U.S.C. chapter 67). (xv) 52.222-54, Employment Eligibility Verification (OCT 2015) (E. O. 12989). (xvi) 52.222-55, Minimum Wages Under Executive Order 13658 (DEC 2015). (xvii) 52.222-59, Compliance with Labor Laws (Executive Order 13673) (OCT 2016) (Applies at $50 million for solicitations and resultant contracts issued from October 25, 2016 through April 24, 2017; applies at $500,000 for solicitations and resultant contracts issued after April 24, 2017). Note to paragraph (e)(1)(xvii): By a court order issued on October 24, 2016, 52.222-59 is enjoined indefinitely as of the date of the order. The enjoined paragraph will become effective immediately if the court terminates the injunction. At that time, DoD, GSA, and NASA will publish a document in the Federal Register advising the public of the termination of the injunction. (xviii) 52.222-60, Paycheck Transparency (Executive Order 13673) (OCT 2016)). (xix) 52.222-62 Paid Sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706). (xx)(A) 52.224-3, Privacy Training (JAN 2017) (5 U.S.C. 552a). (B) Alternate I (JAN 2017) of 52.224-3. (xxi) 52.225 26, Contractors Performing Private Security Functions Outside the United States (OCT 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note). (xxii) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (MAY 2014) (42 U.S.C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6. (xxiii) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64. (2) While not required, the Contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations. (End of Clause) 36C25818Q0066 Page 1 of Page 9 of 9 Page 1 of FAR Number Title Date 852.203-70 COMMERCIAL ADVERTISING JAN 2008 852.211-73 BRAND NAME OR EQUAL JAN 2008 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS NOV 2012 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS (None) SECTION E - SOLICITATION PROVISIONS E.1 52.212-2 EVALUATION COMMERCIAL ITEMS (OCT 2014) (a) 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 shall be used to evaluate offers: Lowest Price technically acceptable Technical and past performance, when combined, are less important than price. (b) Options. 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. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise 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) FAR Number Title Date 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS COMMERCIAL ITEMS JAN 2017