Section A - Solicitation/Contract Form CLAUSES INCORPORATED BY FULL TEXT NAPS 5232.903 For prompt payment act purposes, order is subject to the seven (7) Calendar days constructive acceptance period. Vendor is to fill in blanks below. TIN: CAGE: DUNS: PHONE # POC: Section B - Supplies or Services and Prices ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 1 Each Duet Encompass-advanced, item# EUADV1FFPMILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0002 1 Each Encompass 4 channel pressure moduleFFPitem# 9032M0012MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0003 1 Each Duet urogynecology moduleFFPitem# 5132K0140MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0004 1 Each Duet anorectal manometry moduleFFP4 channel item # EMARM4MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0005 1 Each Duet advanced neurodiagnostics moduleFFP(encompass only) item# EMNEUROMILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0006 1 Each Washer microtip catheter starter kit-3FFPpressure, item# EWMCT3PMILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0007 1 Each STIM Hold, item# 9031B0212FFPMILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0008 1 Each Hinotes research patient managementFFPitem# 9032S0641MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0009 2 Each St Mark's pundendal electrodesFFPitem# 9013L4401MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0010 2 Each Disposable anal sponage electrodeFFPitem# 9013L4811MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0011 10 Each DPT Cables, 60in-disposable pressureFFPtransducer cables, item# 9022B1651MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0012 4 Each Disposable pressure transducer (DPT)FFPsets, item# 9022K0122MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0013 1 Each Office suite software-V8.60FFP item# 9032S0535MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0014 1 Each Microtip catheter, 6fr single sensor w/oFFPlumen washer item# 9022K0902MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0015 1 Each Microtip catheter, 8fr dual sensor withFFPlumen washer item# 9022K0922MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0016 3 Each MTC Enzymatic detergent (250g)FFP item# 9022B1671MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0017 2 Each Hush Yoke cable, straight, 1.5 MFFP item# 9013C0311MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0018 1 Each Sonesta 3 monitor chair, lockingFFPw/uroflowing swing arm item# 5128K0721MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0019 1 Each Puzzle piece table extension(6362)FFP item# 5028B0645MILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0020 1 Each Freight for sonesta chairFFP item# freightMILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0021 1 Lot Freight for encompass systemFFP item# freightMILSTRIP: N0018304RQGY006PURCHASE REQUEST NUMBER: N0018304RQGY006ADDITIONAL MARKINGS: 0BGYN CLINIC POC: HN FREEMAN 4309 NET AMT FOB: Destination Section C - Descriptions and Specifications CLAUSES INCORPORATED BY FULL TEXT ADDITIONAL SOLICIATIONS REQUIREMENTS ARE AS FOLLOWS: „h Selected vendor is to provide all items listed in Section B, Noted items are currently available from Medtronic Functional Catalog. Vendor shall supply products that are equal or better. Government retains the right to make finale determination equal or better. „h The Government reserves the right to award on an all or none bases. „h Vendors price should be inclusive of all cost including shipping. „h In the event that items are under Federal Supply Schedule, vendor to provide FSS pricing. In addition vendor is to supply details of FSS contract number and terms and conditions. „h Vendor is to provide one-year minimum warranty against manufacture defects. Section E - Inspection and Acceptance INSPECTION AND ACCEPTANCE TERMS Supplies/services will be inspected/accepted at: CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY 0001 Destination Government Destination Government 0002 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 Destination Government Destination Government 0006 Destination Government Destination Government 0007 Destination Government Destination Government 0008 Destination Government Destination Government 0009 Destination Government Destination Government 0010 Destination Government Destination Government 0011 Destination Government Destination Government 0012 Destination Government Destination Government 0013 Destination Government Destination Government 0014 Destination Government Destination Government 0015 Destination Government Destination Government 0016 Destination Government Destination Government 0017 Destination Government Destination Government 0018 Destination Government Destination Government 0019 Destination Government Destination Government 0020 Destination Government Destination Government 0021 Destination Government Destination Government CLAUSES INCORPORATED BY REFERENCE 252.246-7000 Material Inspection And Receiving Report MAR 2003

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