Page 1 of 3 DEPARTMENT OF VETERANS AFFAIRS Justification for Single Source Awards IAW FAR 13.106-1 For Over Micro-Purchase Threshold but Not Exceeding the SAT ($250K) Acquisition Plan Action ID: 36C244-20-AP-3507 Contracting Activity: Department of Veterans Affairs, VISN 04, James E. Van Zandt Medical Center, 2907 Pleasant Valley Blvd., Altoona, PA 16602. Purchase Request (2237) Number: 503-20-3-225-0172 Brief Description of Supplies required, the intended use and estimated amount: The James E. Van Zandt VA Medical Center has a new brand name requirement for one (1) Small Joint Arthroscope system to expand the Altoona Medical Center s scope of care and to complete endoscopic surgical procedures. The arthroscope system is used for endoscopic small joint outpatient surgeries such as ankles, elbows, and wrists. The endoscope is equipped with a camera which is guided through a small incision (single-portal technique) or at the wrist and palm (two-portal technique). All instruments and accessories must be Smith and Nephew which connects with the VA patient management software already in place. Total estimated amount CLIN DESCRIPTION OF SUPPLIES QTY UNIT UNIT PRICE AMOUNT 0001 SPIDER 2 ENDOSCOPE 1 EA $18,799.72 $18,799.72 0002 PIGGY BACK (2) ENDOSCOPE 1 EA $1,025.26 $1,025.26 0003 ACCESSORY, TRACTION 1 EA $2,221.11 $2,221.11 0004 WRIST ARTHROSCOPY ACCESSORY TENET 1 EA $700.40 $700.40 0005 WRIST COUNTER TRACTION POST TENET 1 EA $355.48 $355.48 0006 ANKLE ARTHROSCOPY ACCESSORY 1 EA $562.26 $562.26 0007 DYONICS POWERMINI WITH HAND CONTROLS 2 EA $2,080.00 $4,160.00 0008 UNIVERSAL LIGHT GUIDE ORANGE 5MM X 10 FT 2 EA $205.00 $410.00 0009 DYONICS WOLF SOURCE VERSITIP 4 EA $97.38 $389.52 0010 DYONICS WOLF INSTRUMENT VERSITIP 2 EA $97.85 $195.70 0011 LIGHT CABLE, 2MM X 8FT 2 EA $387.03 $774.06 0012 VAS ASSEMBLY ROD LENS 1.9MM 2 EA $6,446.14 $12,892.28 0013 ROD LENS VAS 2.7 X 30DEG X 67MM W.L.X25 2 EA $6,321.20 $12,642.40 0014 SPIDER 2 BATTERY 1 EA $371.520 $371.52 0015 CART, TRANSPORT, SPIDER 1 EA $852.020 $852.02 0016 THIGH SUPPORT FIERCELY 1 EA $1,614.62 $1,614.62 0017 MICROGRASPER, STRAIGHT 2 EA $1,554.50 $3,109.00 0018 MICROPUNCH, STRAIGHT 2 EA $1,554.50 $3,109.00 0019 MICROPUNCH, TEARDROP, RIGHT 2 EA $1,583.25 $3,166.50 0020 MICROPUNCH TEARDROP, LEFT 2 EA $1,554.50 $3,109.00 0021 HOOK, PROBE, 2.2MM 2 EA $168.17 $336.34 0022 TRAY, STERILIZATION MICRO-INSTRUMENT SET 2 EA $894.89 $1,789.78 0023 HOOK PROBE, 2.2MM 1 EA $168.17 $168.17 0024 CANNULA, 2.2 FOR 1.9 SCOPES 1 EA $199.01 $199.01 0025 TROCAR, 2.2MM FOR 1.9 SCOPES 1 EA $188.35 $188.35 0026 OBTURATOR 2.2MM FOR 1.9 SCOPES 1 EA $182.81 $182.81 0027 HOOK PROBE 2.2MM 1 EA $168.17 $168.17 0028 CANNULA 2.9 GRADUATED LUER 1 EA $199.01 $199.01 0029 OBTURATOR 2.9 PASSIVE BLUNT 1 EA $182.81 $182.81 0030 OBTURATOR 2.9 CONICAL,SHORT 1 EA $193.07 $193.07 0031 BLUNT NOSE JR PUNCH 1 EA $1,415.95 $1,415.95 0032 GRASPERS JOINT SMALL 1 EA $1,443.84 $1,443.84 0033 CANNULA 2.9 OPERATIVE 2 EA $196.34 $392.68 0034 TRAY, STERILIZATION, LARGE GENERIC 3 EA $552.71 $1,658.13 0035 STERI-TRAY 3' X 9', 4.0MM SCOPE 4 EA $386.15 $1,544.60 0036 SMITH&NEPHEW ENDO CANNULA FOR 3.6 OPERATIVE SET LOCAL STOCK NUMBER: 4308 1 EA $473.54 $473.54 0037 SMITH&NEPHEW ENDO TROCAR FOR 3.6 OPERATIVE SET LOCAL STOCK NUMBER: 4309 1 EA $190.12 $190.12 0038 SMITH&NEPHEW ENDO OBTURATOR FOR 3.6MM OPER SET LOCAL STOCK NUMBER: 4310 2 EA $182.81 $365.62 GRAND TOTAL Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used: The Small Joint Arthroscope system is an extension of the Arthroscope system ordered by The James E. Van Zandt VA Medical Center from the mandatory NX-SAC contract. The purchase of that system included a Smith & Nephew DII controller (a wireless foot pedal), a Motor drive, hand control, and other accessories. It is imperative to have the same instrumentation to complement the existing system purchased. Description of market research conducted and results or statement why it was not conducted: The Contract Specialist used the Veteran Information Pages, Strategic Acquisition Center, National Acquisition Center, Federal Procurement Data System, and General Service Administration (GSA) search engines. Request for Information number 36C24420Q0791 was posted to GSA on July, 8 2020 and closed July 10, 2020 no vendors are able to provide the brand name request from an existing schedule. One (1) Women Owned Small Business, Metro Medical Equipment and Supply and one (1) Service Disabled Veteran Owned Small Business, SpecOps Medical Supply, LLC. However, both companies do not provide these items through their Federal Supply Schedule contracts. A mandatory NX-SAC Contract had been found to contain 3 Smith & Nephew items to be ordered off of the mandatory schedule. A Request for Quote will be posted to obtain quotes in order to fulfill the requirement for the remaining 38 items. The resulting solicitation will be competed as a small business set-aside utilizing FAR Part 13 Simplified Acquisition Procedures and is expected to result in a firm-fixed-price contract award for the brand name Smith & Nephew requirement. Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106- 1(b). I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief. NCO 4 Contracting Specialist NCO 4 Contracting Officer NCO 4 Acting Branch Chief, Commodities 2
