36C25519Q0321 Page 1 of Page 4 of 30 Page 1 of Statement of Requirements. Submit a product brochure with offer. The purpose is to purchase Optometry Equipment. The item is for the Marion Optometry Clinic. Scope of Work: The machine requires an outlet with 100-120V~50/60Hz, 4.0A, 230V~, 50/60Hz, 1.8A as well as internet connectivity to VISTA Imaging Storage and HL7 capabilities. Location of work: The location for the device will be at 2401 W. Main St, Marion, IL 62959 Delivery Schedule: Equipment shall be delivered to 2401 W. Main St, Marion, IL 62959 Applicable Standards: Not applicable. Acceptance Criteria: A warehouseman shall determine if the products are acceptable at the time of delivery. Special Requirements: HVF: Test Specifications: Maximum temporal range (degrees) 90, Stimulus duration 200ms, Visual field testing distance 30cm, Background Illumination 31.5 ASB. Threshold test library: 24-2, 30-2, 10-2, Macula, 60-4, Nasal Step. Threshold test strategies: SITA Standard, SITA Fast, SITA Faster, Full Threshold, FastPac, SITA-SWAP. Suprathreshold library: 24-2, C40, C76, C80, C64, C-Armaly. Suprathreshold test modes: Threshold related, Single intensity. Specialty test Library: Esterman monocular, binocular, superior 36, 64, Kinetic testing, Custom Kinetic testing, Custom static testing, Social Security Disability, monocular, binocular. Fixation control: Heji-Krakau blind spot monitor, video eye monitor, Gaze tracking, Head tracking, Vertex monitoring. Operator interface: Display Touch-screen LCD, Keyboard. Stimulus: White-on-white, Red- or blue-on-white, Blue-on-Yelow (SWAP). General testing features: Stimulus Sizes: Goldman I-V, Automatic pupil measurement, Liquid Trial Lens, RelEYE review. Test Storage: User-defined. Software features: Single Field Analysis (SFA), Glaucoma Hemifield Test (GHT), Visual Field Index (VFI), Guided Progression Analysis (GPA), Mixed GPA, Serial field overview, Networking, FORUM Connectivity, DICOM Connectivity. Printer: Optional. Data Storage, retrieval and analysis: Hard Drive (500GB). Dimensions: Height 23 (58cm), Width 20 (51cm), Depth 18 (46cm), Weight 63 lbs. (28.7 kg). Standards: Meets UL, CSA and CE standards. B.2 PRICE/COST SCHEDULE ITEM INFORMATION ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 1.00 EA ____________ ______________ ZEISS OS I CIRRUS HD-OCT (Model 5000) with AngioPlex OCT Angiography Version 9.5. Includes GCGPA, Smart HD Scans, FastTrac, Adv RPE, GCA, Ant Seg Basic STOCK NUMBER: 266002-1161-980-PRO GRAND TOTAL __________________ B.3 DELIVERY SCHEDULE SHIP TO QUANTITY DELIVERY DATE Department of Veterans Affairs Marion VAMC 2401 West Main St Marion, IL 62959-1188 ALL Within 60 Days After Receipt of Order (ARO) 36C25519Q0321 Page 1 of Page 30 of 30 Page 1 of

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