93--695H50002 695-15-1-155-0021 Research - Rehabilitation Study **SPECIAL** Arleen Reid/Mike Boettcher

This is a combined synopsis/solicitation for a SMALL BUSINESS SET-ASIDE, commercial items prepared in accordance with the format in FAR Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation. Quotes are being requested and a written solicitation will not be issued. The solicitation number, VA69D-15-Q-0203, is issued as a request for quotation (RFQ). This document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-77 effective Nov 15, 2014 and Veterans Affairs Acquisition Regulation Supplement (VAAR) current to January 2010. The North American Industry Classification System (NAICS) Code for this acquisition is 326199, Size Standard: 750 Employees. Offeror's quotes are hereby being requested and shall be submitted on offeror's letterhead or bid form and shall contain the name, title, and signature of the person authorized to submit quotes on behalf of the contractor. Offeror shall provide the following. In order to maintain the integrity of this combined/synopsis solicitation and subsequent award date, all offerors are advised that any questions must be submitted in written form via e-mail to Michael contact@example.gov via fax to +1 (555) 000-0000 to the Contracting Officer and shall be received no later than five (5) workdays before Offeors due date. Description: Design of Bathing Inserts and Shower for the Elderly or Veterans with Spinal Cord Injury/Dysfunction. Item # Description Quantity Unit Unit Cost Total Cost 001 SHORT INSERT SEAT W/IRGAGUARD B5000, SILVER ZEOITE BASED ANTIMICROBIAL ADDITIVE 4 EA 002 VENDOR TO SETUP A THREE PIECE CAST ALUMINUM W/26 INSERT BUSHINGS TO INCLUDE CAST ALUMINUM, SHOTE PEEN, CASTING FOR MULTIPIECE MOLD. LEAD TIME : PATTERN THREE WEEKS MOLD: FIVE WEEKS COOLING FIXTURES: TWO WEEKS 1 JB 003 OTTOMAN W/IRGAGUARD BS000 SILVER ZEOLITE BASED ANTIBACTERIAL ADDITIVE 4 EA 004 OTTOMAN CONSTRUCTION TWO PIECE CAST ALUMINUM MOLD W/12 INSERT BUSHINGS. PRIMARY MOLD FINISH SAND AND BEAD BLAST. PATTERN: TWO WEEKS MOLD: FIVE WEEKS 1 JB TOTAL PRICE for items (001 -004) $_____ ___ NOTE: This is a FOB destination contract. Total price shall include all delivery charges, fuel charges, driver fees etc. and be an all-inclusive price. This is a Firm Fixed Price Contract and NOT an economic price adjustment contract. Price will NOT be adjusted due to market fluctuations. Deliver all products to: Zablocki VA Medical Center 5000 W. National Ave. Milwaukee, WI 53295-1000 Attn: Spinal Cord Injury/Dysfunctional Center BLDG 28 Contracting Officer's Representative Renee Chartrand +1 (555) 000-0000 x42331 Ms. Mary Regozzi or Cherry Kunkel The provision at 52.212-3, Offeror Representations and Certification--Commercial Items, applies to this solicitation. The contractor shall return a completed copy of this provision with its quotation. A copy of the provision may be obtained from https://www.acquisition.gov/far/current/html/52_212_213.html#wp1179194 or the contractor may confirm that the representations and certifications were completed on SAM.gov. The resulting firm fixed price award will incorporate the requirements of the clause at FAR 52.212-4, Contract Terms and Conditions--Commercial Items. The clause at FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders--Commercial Items, is incorporated in this requirement, which will include: (1) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553); (2) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Pub L. 108-77, 108-78); (3) 52.203-6, Restrictions on Subcontractor Sales to the Government (SEPT 2006); (4) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns; (5) 52.219-6, Notice of total small business set-aside; (5) 52.219-28, Post Award Small Business Program Representation; (6) 52.222-3, Convict Labor ; (7) 52.222-19, Child Labor Cooperation with Authorities and Remedies; (8) 52.222-21, Prohibition of Segregated Facilities; (9) 52.222-26, Equal Opportunity; (; (11) 52.222-36, Affirmative Action for Workers with Disabilities; (13) 52.222-50, Combating trafficking in Persons; (14) 52.225-1, Buy American Act-Supplies; and (15) 52.232-34, Payment by Electronic Funds Transfer--Other than System for Award Management. The FAR clauses may be accessed in full text at this address https://www.acquisition.gov/far/ and VAAR clauses may be accessed at http://www1.va.gov/oamm/oa/ars/policyreg/vaar/. In addition, FAR 52.247-34 F.O.B. Destination, VAAR 852.246-70 Guarantee, 1 Year, and VAAR 852.203-70 Commercial Advertising, VAAR 852.215-71 Evaluation Factor Commitments, VAAR 852.237-70 Contractor Responsibilities apply to this acquisition. The Offeror shall also provide its DUNS number and Tax Identification number. All Contractors, are required to register in the System for Award Management (SAM) database before an award. Contractors are responsible for the accuracy of information added to SAM. To register, go to http://www.sam.gov/. STATEMENT OF WORK FOR THE MILWAUKEE VA Bathing and Shower Inserts. Background The goal of this project is to design and develop a new bathing seat and a foot & leg support device called an ottoman to be placed in existing bathtubs or in shower stalls. Objectives The design of new bathing prototypes to enable spinal cord injured veterans to bathe or shower safely and independently. Scope Contractor shall contact the Milwaukee VA Medical Center researchers to review the computer generated data files for design and manufacturability of patterns and cast aluminum molds for the bathtub seats and ottomans prior to commencing work. Contractor shall review VA provided bathing fixture prototypes as a visual reference prior to fabricating patterns and molds. Contractor shall procure patterns and cast aluminum molds for the bathtub seat and ottoman and fabricate 4 rotationally molded bathtub seats and 4 ottomans from the cast aluminum molds. Required Materials: Contractor's work and final product shall conform to the VA's salient characteristics and drawings provided in the attached documents: "Solicitation Salient Characteristics,"____ Contractor shall use the following thermoplastic polymer material to fabricate the seats and ottoman: .937" dry blend LLDPE (linear low density polyethylene) with Igraguard B5000 antimicrobial additive Reporting Contractor shall keep the Milwaukee VAMC contract representative and researchers informed of its progress in procuring patterns and cast aluminum molds and timing for deliverables of bathtub seats and ottomans. Selection criteria The Government intends to award a Firm Fixed Price contract to the Lowest Price Technically Acceptable quote. DISCUSSIONS will not be held with contractors. Deliverables or delivery schedule Delivery schedule in calendar days from the date of award: Bathtub seats: 70 to 80 days to procure pattern and cast aluminum mold and produce 4 bathtub seats Ottomans 50 to 60 days to procure pattern and cast aluminum mold and produce 4 ottomans Delivery of seats and ottomans to the Spinal Cord Injury/Dysfunction Center, Att: Ms Mary Regozzi, CRRN or Ms Cherry Kunkel, RN, Bldg 28, Zablocki VA Medical Center, 5000 W. National Ave, Milwaukee WI 53295-1000 The assigned Contract Specialist is Mike Boettcher. Offers must be submitted to FBO at https://www.fbo.gov/ or to contact@example.gov A. CONTRACTOR: __________________________________________ __________________________________________ POC/Title __________________________________________ PHONE #: __________________________________________ FAX #: __________________________________________ E-MAIL: __________________________________________ DUNS NO. __________________________________________ TIN NO. __________________________________________ SIGNATURE: __________________________________________ PAST PERFORMANCE POC: _________________________________ E-MAIL: _________________________________ B. GOVERNMENT: Mike Boettcher, Contract Specialist Great Lakes Acquisition Center - GLAC 115 S 84th Street, Suite 101 Milwaukee WI 53214 +1 (555) 000-0000 x43275 C. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the Contractor will be made in accordance with: [X] 52.232-34, Payment by Electronic Funds Transfer - Other than Central Contractor Registration, or D. INVOICES: Invoices shall be submitted in arrears: [X] Upon Delivery and Acceptance E. GOVERNMENT INVOICE ADDRESS: All invoices from the contractor shall be submitted electronically in accordance with 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2012) FACSIMILE, E-MAIL, AND SCANNED DOCUMENTS ARE NOT ACCEPTABLE FORMS OF SUBMISSION FOR PAYMENT REQUESTS. For assistance setting up e-Invoice, the below information is provided: * Tungsten e-Invoice Setup Information: +1 (555) 000-0000 * Tungsten e-Invoice email: contact@example.gov * FSC e-Invoice Contact Information: +1 (555) 000-0000 * FSC e-invoice email: contact@example.gov Vendor inquires: Toll Free Number +1 (555) 000-0000 E-mail Address: www.fsc.va.gov/fsc/vendors.htm