6540--36C249-21-AP-2621 - Visual Field Analyzer

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 14 626-21-3-313-0195 36C24921Q0389 06-21-2021 Elishia Lannom +1 (555) 000-0000 06-21-2021 08:00AM CST Department of Veterans Affairs Network Contracting Office 9 (90C) NCO 9 1639 Medical Center Parkway, Suite 400 Murfreesboro TN 37129 X 100 X 339115 1000 employees N/A X Department of Veterans Affairs NCO - 9 TVHS VA MEDICAL CENTER NASHVILLE CAMPUS 1310 24th Avenue South Nashville TN 37212 90C Network Contracting Office 9 Department of Veterans Affairs Network Contracting Office (90C) 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129 90C FSC e-Invoicing Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information +1 (555) 000-0000 Invoice must be submitted electronically Setup +1 (555) 000-0000 See CONTINUATION Page This is a competitive brand name only solicitation, which will result in a single award for Humphrey Visual Field Analyzer shipping to TVHS VA Medical Center Nashville This solicitation is an SDVOSB only set-aside opportunity. RFQ ISSUED 6/21/2021 Questions Due 6/27/2021 8:00AM CT Quote Due 6/28/2021 at 8:00AM CT Please email QUOTES to contact@example.gov No later than 6/28/2021 8:00AM CT See CONTINUATION Page 626-3610160-313-820200-3131 010044198 X X COREY A. MALIK CONTRACTING OFFICER 36C24921Q0163 Page 1 of Page 2 of 16 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 PRICE/COST SCHEDULE 4 ITEM INFORMATION 4 B.3 DELIVERY SCHEDULE 7 SECTION C - CONTRACT CLAUSES 8 C.1 COMMERCIAL LANGUAGE 8 C.2 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020) 8 C.3 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING MONITORING AND COMPLIANCE (JUL 2018) 10 C.4 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND COMPLIANCE (JUL 2018) 10 C.5 VAAR 852.247-71 DELIVERY LOCATION (OCT 2018) 11 C.6 VAAR 852.247-73 PACKING FOR DOMESTIC SHIPMENT (OCT 2018) 11 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS 12 SECTION E - SOLICITATION PROVISIONS 13 E.1 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020) 13 E.2 52.212-2 EVALUATION COMMERCIAL ITEMS (OCT 2014) 15 36C24921Q0389 Page 1 of Page 7 of 16 Page 1 of SECTION B - CONTINUATION OF SF 1449 BLOCKS INTENTIONALLY BLANK B.1 CONTRACT ADMINISTRATION DATA 1. Contract Administration: All contract administration matters will be handled by the following individuals: a. CONTRACTOR: b. GOVERNMENT: Contracting Officer 36C249 Department of Veterans Affairs Network Contracting Office 9 (90C) NCO 9 1639 Medical Center Parkway, Suite 400 Murfreesboro TN 37129 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] AFTER DELIVERY 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. FSC e-Invoicing Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information +1 (555) 000-0000 Invoice must be submitted electronically ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows: AMENDMENT NO DATE B.2 PRICE/COST SCHEDULE ITEM INFORMATION ITEM NUMBER DESCRIPTION OF SUPPLIES QTY UNIT UNIT PRICE AMOUNT 0001 1.00 EA __________________ __________________ Humphrey Visual Field Analyzer 266002-1170-747-PRO ZEISS OS | HFA3 MODEL 860 W/ LIQUID TRIAL LENS, RELEYE, KINETIC, | GPA, HEAD TRK, GAZE TRK, PRINTER & TABLE. Dimension: 46 L x 52 W x 58 H (cm) which is exactly equivalent to: 18.11 L x 20.47 W x 22.83 H (inch) Electrical Requirement: 100-120v- 50/60 Hz, 4.0A Internal Storage: 500 Gb Operating System: Windows 10 Fixation Control Video eye monitor Heijl-Krakau blind spot monitor Gaze Tracking Head Tracking Vertex Monitoring Visual Field IndexT: Summary measurement of the patient's visual field status, expressed as a percent of a normal age-adjusted visual field. Liquid Trial LensT: Using Liquid pressure, delivers each patient's refractive correction. Available correction range is -8 to +8 diopters. Spherical correction only. 0002 1.00 EA __________________ __________________ WARRANTY 0003 1.00 EA __________________ __________________ SHIPPING 0004 INSTALLATION 1.00 EA __________________ __________________ GRAND TOTAL __________________ B.3 DELIVERY SCHEDULE ITEM NUMBER QUANTITY DELIVERY DATE ALL SHIP TO: TVHS VAMC Nashville Campus 1310 24th Avenue South Nashville, TN 37212 USA ALL MARK FOR: Thelisia Miller +1 (555) 000-0000 contact@example.gov 36C24921Q0163 Page 1 of Page 12 of 16 Page 1 of SECTION C - CONTRACT CLAUSES C.1 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020) (a) The Contractor agrees to comply with any provision or clause that is incorporated herein by reference to implement agency policy applicable to acquisition of commercial items or components. The following provisions and clauses that have been checked by the Contracting Officer are incorporated by reference. [X] 852.203 70, Commercial Advertising. [] 852.209 70, Organizational Conflicts of Interest. [] 852.211 70, Equipment Operation and Maintenance Manuals. [] 852.214 71, Restrictions on Alternate Item(s). [] 852.214 72, Alternate Item(s). [Note: this is a fillable clause.] [] 852.214 73, Alternate Packaging and Packing. [] 852.214 74, Marking of Bid Samples. [X] 852.215 70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors. [X] 852.215 71, Evaluation Factor Commitments. [] 852.216 71, Economic Price Adjustment of Contract Price(s) Based on a Price Index. [] 852.216 72, Proportional Economic Price Adjustment of Contract Price(s) Based on a Price Index. [] 852.216 73, Economic Price Adjustment State Nursing Home Care for Veterans. [] 852.216 74, Economic Price Adjustment Medicaid Labor Rates. [] 852.216 75, Economic Price Adjustment Fuel Surcharge. [] 852.219 9, VA Small Business Subcontracting Plan Minimum Requirements. [] 852.219 10, VA Notice of Total Service-Disabled Veteran-Owned Small Business Set-Aside. [] 852.219 11, VA Notice of Total Veteran-Owned Small Business Set-Aside. [] 852.222 70, Contract Work Hours and Safety Standards Nursing Home Care for Veterans. [] 852.228 70, Bond Premium Adjustment. [] 852.228 71, Indemnification and Insurance. [] 852.228 72, Assisting Service-Disabled Veteran-Owned and Veteran-Owned Small Businesses in Obtaining Bonds. [X] 852.232 72, Electronic Submission of Payment Requests. [] 852.233 70, Protest Content/Alternative Dispute Resolution. [] 852.233 71, Alternate Protest Procedure. [] 852.237 70, Indemnification and Medical Liability Insurance. [X] 852.246 71, Rejected Goods. [] 852.246 72, Frozen Processed Foods. [] 852.246 73, Noncompliance with Packaging, Packing, and/or Marking Requirements. [] 852.270 1, Representatives of Contracting Officers. [] 852.271 72, Time Spent by Counselee in Counseling Process. [] 852.271 73, Use and Publication of Counseling Results. [] 852.271 74, Inspection. [] 852.271 75, Extension of Contract Period. [] 852.273 70, Late Offers. [] 852.273 71, Alternative Negotiation Techniques. [] 852.273 72, Alternative Evaluation. [] 852.273 73, Evaluation Health-Care Resources. [] 852.273 74, Award without Exchanges. (b) All requests for quotations, solicitations, and contracts for commercial item services to be provided to beneficiaries must include the following clause: [] 852.237 74, Nondiscrimination in Service Delivery. (End of Clause) C.3 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING MONITORING AND COMPLIANCE (JUL 2018) (a) This solicitation includes . (b) Accordingly, any contract resulting from this solicitation is subject to the limitation on subcontracting requirements in 13 CFR 125.6, or the limitations on subcontracting requirements in the FAR clause, as applicable. The Contractor is advised that in performing contract administration functions, the Contracting Officer 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. (c) 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 Contracting Officer in assessing the Contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. (d) 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 Contracting Officer to assess the Contractor's compliance with the limitations on subcontracting or percentage of work performance requirement. (End of Clause) C.4 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND COMPLIANCE (JUL 2018) (a) This solicitation includes the clause: 852.215-70 Service-disabled veteran-owned and veteran-owned small business evaluation factors. Accordingly, any contract resulting from this solicitation will include the clause 852.215-71 Evaluation factor commitments. (b) The Contractor is advised that in performing contract administration functions, the Contracting Officer may use the services of a support contractor(s) to assist in assessing Contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the Contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. (c) 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 Contracting Officer in assessing the Contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. (d) 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 Contracting Officer to assess the Contractor compliance with the subcontracting commitments. (End of Clause) C.5 VAAR 852.247-71 DELIVERY LOCATION (OCT 2018) Shipment of deliverable items, other than reports, shall be to: Department of Veterans Affairs NCO - 9 TVHS Nashville Campus 1310 24th Avenue South Nashville TN 37212 (End of Clause) C.6 VAAR 852.247-73 PACKING FOR DOMESTIC SHIPMENT (OCT 2018) Material shall be packed for shipment in such a manner that will insure acceptance by common carriers and safe delivery at destination. Containers and closures shall comply with regulations of carriers as applicable to the mode of transportation. (End of Clause) FAR Number Title Date 52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE OCT 2018 852.212-71 GRAY MARKET ITEMS APR 2020 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER OCT 2020 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS INTENTIONALLY BLANK 36C24921Q0163 Page 1 of Page 16 of 16 Page 1 of SECTION E - SOLICITATION PROVISIONS E.1 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020) The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument in paragraph (c)(1) in the provision at 52.204 26, Covered Telecommunications Equipment or Services Representation, or in paragraph (v)(2)(i) of the provision at 52.212 3, Offeror Representations and Certifications Commercial Items. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services in paragraph (c)(2) of the provision at 52.204 26, or in paragraph (v)(2)(ii) of the provision at 52.212 3. (a) Definitions. As used in this provision Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204 25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (b) Prohibition. (1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115 232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to (i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or (ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles. (2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115 232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to (i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or (ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles. (c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for covered telecommunications equipment or services. (d) Representations. The Offeror represents that (1) It [ ] will, [ ] will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds will in paragraph (d)(1) of this section; and (2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that It [ ] does, [ ] does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds does in paragraph (d)(2) of this section. (e) Disclosures. (1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded will in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer: (i) For covered equipment (A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known); (B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and (C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision. (ii) For covered services (A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or (B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision. (2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded does in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer: (i) For covered equipment (A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known); (B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and (C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision. (ii) For covered services (A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or (B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision. (End of Provision) FAR Number Title Date 52.204-7 SYSTEM FOR AWARD MANAGEMENT OCT 2018 E.2 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 evaluated price meeting the acceptability standards Best value includes Warranty and Lead-time (a) 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)