Section A - Solicitation/Contract Form
CLAUSES INCORPORATED BY FULL TEXT
Fill in Blanks:
TIN: ________________
CAGE: ________________
DUNS: __________________
Vendor POC: ______________________Phone: ____________________
Vendor email: ______________________
User POC:
Payment in Arrears
Vendor to reference RFQ number N00183-07-T-0130 on all inquires including
PROMPT PAYMENT
For Prompt Payment Act Purposes, this contract is:
Subject to the 7-calender day constructive acceptance period.
Section B - Supplies or Services and Prices
ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0001 1 Each
Upgrade EquiTest system
FFP
includes Pentium computer, HP Deskjet printer, 17" LCD color monitor, mobile cart with LCD swing arm assembly. Includes SEnsory Organization Test, Motor Control Test, Adaptation Test, Weight Bearing Squat Limits of Stability, Rhythmic Weight Shift, Unilateral Stance assessments. Includes training for one person
FOB: Destination
MILSTRIP: N0018307RQXC010
PURCHASE REQUEST NUMBER: N0018307RQXC010
ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0002 1 Each
Pressure test
FFP
Pressure test to document inner-ear pressure changes
FOB: Destination
MILSTRIP: N0018307RQXC010
PURCHASE REQUEST NUMBER: N0018307RQXC010
ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0003 1 Each
Dynamic Visual Acuity Test
FFP
Gaze Stabilization test, Head Shake protocols
FOB: Destination
ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0004 1 Each
Static 18"X60" Long Forceplate
FFP
includes Walk Across, Tandem walk, Step up/Over, Step/Quick Turn, Forward Lunge, Sit to Stand assessment protocols
FOB: Destination
MILSTRIP: N0018307RQXC010
PURCHASE REQUEST NUMBER: N0018307RQXC010
ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0005 1 Each
Annual Product Support Agreement
FFP
Warranty extended for one year
FOB: Destination
MILSTRIP: N0018307RQXC010
PURCHASE REQUEST NUMBER: N0018307RQXC010
Bid Protests Not Available