ENDOSCOPIC VEIN HARVESTING (EVH) SYSTEM STATEMENT OF NEED This request is being issued by the Department of Veterans Affairs, Medical Center (VAMC) at 510 Butler Avenue Bldg 500; Martinsburg West Virginia, 25405. The goal of this request is to determine the extent to which an endoscopic vein harvesting system, capable of extracting both the saphenous vein and radial artery, is commercially available. Absolutely NO ALTERNATIVE will be considered. Additionally, the objective is to identify the extent of small business presence. BACKGROUND The VAMC Martinsburg is seeking to reduce the number of multiple surgical procedures required for vein/ artery bypass. QUALIFICATIONS All potential products shall be comparable in both form and function to the VASOVIEW HEMOPRO 2 Endoscopic Vessel Harvesting System which for the purpose of this request will serve as the benchmark. All potential respondents shall be of a small business type at the time of response, as well as currently certified and/or verified in the governing system of registry (e.g. SBA, VET BIZ, SAM, Dun & Bradstreet etc.). INFORMATION REQUESTED Note: Provide your response in the table below and provide only the data specified. Proprietary data, trade secrets or any data of this nature SHALL BE appropriately marked by the respondent as such. The Department of Veterans Affairs does not maintain responsibility for safeguarding any data of the stated nature that is not properly marked, or is otherwise provided in contradiction to provisions of this request. 1. Legal Business Name: 2. DUNS Number: 3. Physical Address: 4. Point of Contact: (i.e. the individual responding to this request) Name Phone Number email 5. SOCIOECONOMIC STATUS: (select all that apply) 0 Small Business 0 Veteran-Owned Small Business 0 Service-Disabled Veteran-Owned Small Business 0 Small Disadvantaged Businesses (including section 8(a)) 0 Women-Owned Small Business 0 Historically Underutilized Business Zones (HUBZone) Small Business 6. Product Specifications: Product Name Product Number Brief Description EVALUATION OF RESPONSES Responses will be evaluated based on the data provided in sections 5 and 6, conforming explicitly to the qualifications and to the statement of need. Potential respondents not conforming explicitly in both of these areas need not respond. INSTRUCTIONS TO RESPONDENTS Responses shall be forwarded via email only, and in the format specified in the table provided. ALL responses shall be submitted by and up to Saturday September 22, 2012 at 11am EDT (eastern daylight time). The Department of Veterans Affairs WILL NOT enter into discussions, exchanges, negotiations, Q&A sessions or address clarifications of any kind in response to this request. SUBMISSION PROCEDURES Using the email address; [email protected], attach a completed copy of this RFI to your email with the subject line: VA245-12-I-0593 [Followed by Your Company Name]-EVH (End of Provision) DISCLAIMER This RFI is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this RFI that is marked as proprietary will be handled accordingly. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI.

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