6530--600-21-3-392-0314 Attn: Shavon Bogan, Project 405 CLC Activation; Patient Lifts (VA-21-00062918) VA Long Beach Activation; Patient Lifts

Page 6 of 6 Attachment A: SOW VA Long Beach Healthcare System Project 405 CLC Equipment Package-Basis of Design (BOD) Statement of Work/Salient Characteristics Introduction The VA Long Beach Healthcare System has a requirement to purchase 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 VAAR Clause 852.211-73 Brand Name or Equal (JAN 2008) for additional information. See attachments for salient characteristics. This requirement is in support of the activation of the VA Long Beach Healthcare System Project. Item(s) are to be delivered to the location specified in section 2.4.1. Table 1 Package Items Summary Item Number Item Description Quantity A1205 Ceiling lift, pt bedroom & bathroom 74 A1205A Ceiling lift, Bathing Suite 10 A1203 Overhead ceiling lift, bariatric, pt bedroom and bath 10 A1205B Patient lift materials 94 A1205 C Sling kit 94 Training 94 A1205D Approved Engineering & drawings 1 General Conditions Site Address The address of the VA Long Beach Healthcare System is listed below. Additional information on delivery is located in section 2.4. VA Long Beach Healthcare System 5901 E. 7th Street Building 149 Long Beach, CA 90822 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 Acronym Est. Delivery Start Date Est. Delivery End Date VA Long Beach Healthcare System Bldg 170 VALB CLC 10/1/2021 11/1/2021 Schedule and Order Management The above delivery schedule is based upon the current construction schedule. The vendor shall not increase prices for a change in delivery date for up to 30+ 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 COR 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 post-award. To coordinate delivery, contact Brian Fleenor contact@example.gov 563-7 43-9263 or Vickie Orloff at +1 (555) 000-0000, contact@example.gov VA Long Beach Healthcare System (VALBHCS) Direct Delivery to address detailed in paragraph 2.1.1) IOT&A Contractor-Provided Warehouse Local to the VALBHCS 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 Pacific 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 VA facilities contract number and VA purchase order number for identification and reference upon receipt of product. Use of Warehouse 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 perform a site walk provide CAD drawings (including shop drawings) and specifications for site prep for their product as required. 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. Assembly and Installation The vendor is required to manage and coordinate installation at the VALB with the COR.On-site assembly and installation of items, and performance of services 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 Pacific 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. 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 VALB. On-site representative can be the installer. All instructions provided from COR to the representative will be binding as if given to the vendor s main contact. The COR may provide specific instructions, however, only the Contracting Officer may change the terms or conditions of the contract. 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 a 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. 2.87 COVID-19: Vendors will wear face masks when on the VA Long Beach Campus and practice 6 feet social distancing. Contractors will be required to enter the hospital through the designated entry points and will be screened for CoVid 19 Use of Premises During the performance of this contract, work will be carried out on VALB premises. The vendor will perform all work in such a manner that will cause a minimum interference with VALB operations and the operations of other contractors on the premises. The vendor will communicate through the VA POC any required coordination requirements with the GC prior to and during delivery and installation activities. The project may be an active construction site during delivery and installation. The vendor will take all necessary precautions to protect the premises and all persons and property therein from damage or injury. The vendor will 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). VA Long Beach 405 A1205 5901 E. 7th Street Long Beach, CA 90822 _ Project: VA Long Beach 405 _ Total Quantity: 74 Finish Sample Required if Checked Manufacturer Certified Installation Required if Checked _ BMET Training Required if Checked End User Training Required if Checked _ _ Item Name: Ceiling lift with traverse rail H pattern, to connect to H -pattern ceiling lift in Patient bathrooms Include Scale Brand Name or Equal: Guldmann GH3+ w 550 lb. capacity Ceiling track System to be flush with ceiling in patient rooms: Salient Characteristics: The Ceiling Track shall be made from high strength extruded aluminum or VA approved equal Provide anchor supports at ceiling substrate. Installed rail shall be security tested for 1.5 times greater than the motor s weight capacity and maximum allowable deflection of a horizontal rail is no more than 1mm (1/16th inch) per 200mm (7.87 inch) of track length. (As per ISO 10535 standards.) Top of traverse rail shall be 2 5/8 below ceiling in rooms with Avasure Lift Battery: 24 V NiMH - Max charge time: 4 hours - Battery protection: At battery voltage below 22 V the indicator light turns orange. The hoist is stopped if the voltage falls below 20 V - Power supply: 33 V AC, 2.5 A - Supply voltage, transformer: 100-240V AC - Max. # of lift: 40/ 40 w/ 550 lb/ 40 - Intermittent: 10.90, 4 Hours - Include hand control - Include emergency brake, lowering device and stopping device - Include current limiter for circuit protection in case of overload - Charging time no more than 4 hours A1205C Straps & Sling: - One lifting strap to meet ISO 10535, Appendix A guidelines. - The straps shall ensure the patient s safety by preventing the patient from falling out of the sling. - The sling shall meet ISO 10535, Appendix A guidelines. - The sling shall cradle the body of the patient. Training: Included Main Image: VA Long Beach 405 A1025A 5901 E. 7th Street Long Beach, CA 90822 _ Project: VA Long Beach 405 _ Total Quantity:10 Finish Sample Required if Checked Manufacturer Certified Installation Required if Checked _ BMET Training Required if Checked End User Training Required if Checked _ _ Item Name: Ceiling lift with traverse rail H pattern, full room All Bathing Suites _ Brand Name or Equal: Guldmann GH3+ Ceiling track System to be flush with ceiling Salient Characteristics: The Ceiling Track shall be made from high strength extruded aluminum or VA approved equal Provide anchor supports at ceiling substrate. Installed rail shall be security tested for 1.5 times greater than the motor s weight capacity and maximum allowable deflection of a horizontal rail is no more than 1mm (1/16th inch) per 200mm (7.87 inch) of track length. (As per ISO 10535 standards.) Top of traverse rail shall be 2 5/8 below ceiling in rooms with Avasure Lift Battery: 24 V NiMH - Max charge time: 4 hours - Battery protection: At battery voltage below 22 V the indicator light turns orange. The hoist is stopped if the voltage falls below 20 V - Power supply: 33 V AC, 2.5 A - Supply voltage, transformer: 100-240V AC - Max. # of lift: 40/ 40 w/ 550 lb/ 40 - Intermittent: 10.90, 4 Hours - Include hand control - Include emergency brake, lowering device and stopping device - Include current limiter for circuit protection in case of overload - Charging time no more than 4 hours A1205C Straps & Sling: - One lifting strap to meet ISO 10535, Appendix A guidelines. - The straps shall ensure the patient s safety by preventing the patient from falling out of the sling. - The sling shall meet ISO 10535, Appendix A guidelines. - The sling shall cradle the body of the patient. Training: Included Main Image: VA Long Beach 405 A1203 35901 E. 7th Street Long Beach, CA 90822 _ Project: VA Long Beach 405 _ Total Quantity: 10 Finish Sample Required if Checked Manufacturer Certified Installation Required if Checked _ BMET Training Required if Checked End User Training Required if Checked _ _ Item Name: Ceiling lifts, Bariatric : Ceiling lift with traverse rail H pattern, to connect to H -pattern ceiling lift in Patient bariatric bathrooms _ Brand Name or Equal: Guldmann GH3 twin Ceiling track System with dual track and twin motors to be flush with ceiling in patient rooms: Salient Characteristics: _ The Ceiling Track shall be made from high strength extruded aluminum or VA approved equal. Provide anchor supports at ceiling substrate. Installed dual rail shall be security tested for 1.5 times greater than the motor s weight capacity and maximum allowable deflection of a horizontal rail is no more than 1mm (1/16th inch) per 200mm (7.87 inch) of track length. (As per ISO 10535 standards.) Lift Battery: 2X 24 V NiMH - Max charge time: 4 hours - Battery protection: At battery voltage below 22 V the indicator light turns orange. The hoist is stopped if the voltage falls below 20 V - Power supply: 33 V AC, 2.5 A - Supply voltage, transformer: 100-240V AC - Max. # of lift: 40/ 40 w/ 1100 lb/ 40 - Intermittent: 10.90, 4 Hours - Include hand control - Include emergency brake, lowering Device and stopping device - Include current limiter for circuit protection in case of overload - Charging time no more than 4 hours Top of traverse rail shall be 2 5/8 below ceiling in rooms with Avasure. A1205C Straps & Sling: - One lifting strap to meet ISO 10535, Appendix A guidelines. - The straps shall ensure the patient s safety by preventing the patient from falling out of the sling. - The sling shall meet ISO 10535, Appendix A guidelines. - The sling shall cradle the body of the patient. Main Image: Training: Included VA Long Beach 405 A1205B 5901 E. 7th Street Long Beach, CA 90822 _ Project: VA Long Beach 405 _ Total Quantity: 10 Finish Sample Required if Checked Manufacturer Certified Installation Required if Checked _ BMET Training Required if Checked End User Training Required if Checked _ _ Item Name: Ceiling lift additional materials:Miscellaneous flush ceiling profile, Spring plates, Rosettes Salient Characteristics: Parts and pieces necessary to install lifts as designed. VA Long Beach 405 A1025C 5901 E. 7th Street Long Beach, CA 90822 _ Project: VA Long Beach 405 _ Total Quantity: 94 Finish Sample Required if Checked Manufacturer Certified Installation Required if Checked _ BMET Training Required if Checked End User Training Required if Checked _ _ Item name: Sling kit Salent Characteristics: -Sling must have a lifting capacity of up to 560 lbs -Sling must be of a breathable material, like polyester/mesh or cotton