Statement of Work Procurement Of Angioseal 1. REQUIREMENT: Contractor shall provide supplies as listed in Attachment A and service for delivery/pickup and travel/transportation within 24 hours of notification of all requested consumable items and arrive within 5-7 business days. Contractor shall also provide a confirmation number for each order delivered to the Warehouse, Bldg. 100, located at the William Jennings Bryan Dorn, VA Medical Center (WJBDMC), 6439 Garners Ferry Road, Columbia, South Carolina 29209. 2. BACKGROUND: The WJBDMC is a 216-bed facility, encompassing acute medical, surgical, psychiatric, and long-term care. The hospital is located in Columbia, South Carolina and provides primary, secondary, and some tertiary care. Annually, the medical center serves approximately 56,116 patients. Satellite outpatient clinics are located in Anderson, Greenville, Florence, Orangeburg, Rockhill, Sumter, and Spartanburg, South Carolina. 3. REQUIREMENT OVERVIEW & PERIOD OF PERFORMANCE: The government has a requirement for an IDIQ contract for commercial off the shelf (COTS) consumable medical supplies as listed in Attachment A, the quantities listed is an estimate and may be more or less depending on patient volume. This requirement is being requested for one base year and four one year option periods. Base Year: 365 days after date of award OPTION YEAR 1 365 days after date of modification OPTION YEAR 2 365 days after date of modification OPTION YEAR 3 365 days after date of modification OPTION YEAR 4 365 days after date of modification 4. PLACE OF PERFORMANCE: WJB Dorn VA Medical Center, 6439 Garners Ferry Road, Columbia, SC 29209 5. DAYS AND HOURS OF DELIVERY: Monday - Friday, 8:00 a.m. to 4:00 p.m. excluding federal holidays. 6. DELIVERY REQUIREMENTS: Orders shall be shipped no later than 24 hours after receipt of request and arrive within 5-7 business days. 7. SPECIAL REQUIREMENTS: a. The Contractor is required to provide a confirmation number for each order. b. After the initial purchase order has been established, the following IMS personnel are authorized to place orders as needed via telephone: Priscilla Easley 803-776-4000 x6580 [email protected] Tammy Reese 803-776-4000 x6572 [email protected] Shirley Allen-Mattice 803-776-4000 x7241 [email protected] Tabbatha Jones 803-776-4000 x4840 [email protected] Sheila Harris 803-776-4000 x7883 [email protected] Larry Clark 803-776-4000 x4712 [email protected] Randy Dinkins 803-776-4000 x7896 [email protected] Jeffrey Gardner 803-776-4000 x4127 [email protected] c. POINT OF CONTACT: Contracting Officer's Representative (COR): Name: Tabbatha Jones Title: Supply Technician Department: Logistic Telephone: 803-776-4000 x 4840 FAX: 803-695-7939 Email: [email protected] d. Any changes referencing authorized staff as stated above will be communicated to the contracting specialist/officer and the contractor in writing throughout the life of the contract as an internal ordering guideline submitted by the COR. 8. INVOICES: a. Payment will be made upon receipt of a properly prepared detailed invoice, prepared by the Contractor and submitted through Tungsten Network (formerly known as OB10) http://www.tungsten-network.com/us/en/. A properly prepared invoice shall contain: " Invoice Number and Date " Contractor's Name and Address " Accurate Purchase Order Number " Supply or Service provided " Period Supply or Service Provided " Total Amount Due b. Please begin submitting your electronic invoices through the Tungsten Network for payment processing, free of charge. c. If you have questions about the e-invoicing program or Tungsten Network, contact information is as follows: " Tungsten e-Invoice Setup Information: 1-877-489-6135 " Tungsten e-Invoice email: [email protected] " FSC e-Invoice Contact Information: 1-877-353-9791 " FSC e-invoice email: [email protected] d. Web Address: HTTP://WWW.FSC.VA.GOV/EINVOICE.ASP 9. TERMINATION FOR CONVENIENCE: Subject to a 14 day advance notice, the Government reserves the right to terminate this contract for convenience if the need for this service changes or is no longer required. 10. Records Management Language for Contracts: The following standard items relate to records generated in executing the contract and should be included in a typical Electronic Information Systems (EIS) procurement contract: a. Citations to pertinent laws, codes and regulations such as 44 U.S.C chapters 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228. b. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. c. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government IT equipment and/or Government records. d. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act. e. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract. f. The Government Agency owns the rights to all data/records produced as part of this contract. g. The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data. h. Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.]. i. No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules. ATTACHMENT A Base Year Description Product No. Est. Qty. & Unit of Measure Est. Cost Actual Price AngioSeal 6FR VIP-610130 10 per BOX Option Year 1 Description Product No. Est. Qty. & Unit of Measure Est. Cost Actual Price Angioseal 6 Fr. VIP-610130 10 per Box Option Year 2 Description Product No. Est. Qty. & Unit of Measure Est. Cost Actual Price Angioseal 6 Fr. VIP-610130 10 per Box Option Year 3 Description Product No. Est. Qty. & Unit of Measure Est. Cost Actual Price Angioseal 6 Fr. VIP-610130 10 per Box Option Year 4 Description Product No. Est. Qty. & Unit of Measure Est. Cost Actual Price Angioseal 6 Fr. VIP-610130 10 per Box

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