Section A - Solicitation/Contract Form CLAUSES INCORPORATED BY FULL TEXT Fill in Blanks: TIN: ________________ CAGE: ________________ DUNS: __________________ Vendor Point of Contact: ______________________Phone: ____________________ Vendor email: ______________________ Naval Medical Center POC: Payment in Arrears Vendor to reference contract number ________________ on all inquires including invoices and shipping documents. NAPS 5232.903 PROMPT PAYMENT For Prompt Payment Act Purposes, this contract is: Subject to the 7-calendar day constructive acceptance period. Section B - Supplies or Services and Prices ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 8 Box Part# LCSC5HA-5mm Harmonic ScalpelFFPHand Activated (6/BX)FOB: DestinationMILSTRIP: N0018305RQSU130PURCHASE REQUEST NUMBER: N0018305RQSU130 NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0002 20 Box Part# B5LT-5mm Xcel Trocar 100mm LengthFFP(6/BX)FOB: DestinationMILSTRIP: N0018305RQSU130PURCHASE REQUEST NUMBER: N0018305RQSU130 NET AMT ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0003 4 Box Part# TC003-ThermaChoice BalloonFFPCatheter (5/BX)FOB: DestinationMILSTRIP: N0018305RQSU130PURCHASE REQUEST NUMBER: N0018305RQSU130 NET AMT Section C - Descriptions and Specifications CLAUSES INCORPORATED BY FULL TEXT 1. The Naval Medical Center, Portsmouth, VA Main Operating Room (MOR) will purchase items and quantities as described on section B. These items are presently in use at the MOR. in conjunction with the Jonhson & Johnson Harmonic Scalpel Machine, therefore items must be from the Original Equipment Manufacturer (OEM) as stated on DFAR 217.7501 (Replenishment parts must be acquired so as to ensure the safe, dependable, and effective operation of the equipment. Where this assurance is not possible with new sources, competition may be limited to the original manufacturer of the equipment or other sources that have previously manufactured or furnished the parts as long as the action is justified). Part Number and description are from the J& J catalog. No substitutes will be accepted. „h Vendor to warrant that all supplied items are free of manufacturers defect. „h Vendor price to be inclusive of all costs including shipping. 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 Section F - Deliveries or Performance DELIVERY INFORMATION CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC 0001 05-APR-2005 8 NAVAL MEDICAL CENTERRECEIVING DEPARTMENTMMD54 LEWIS MINORS STREETPORTSMOUTH VA 23708-2297757-953-5770FOB: Destination N00183 0002 05-APR-2005 20 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0003 05-APR-2005 4 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 CLAUSES INCORPORATED BY REFERENCE 52.211-17 Delivery of Excess Quantities SEP 1989 52.247-34 F.O.B. Destination NOV 1991 Section G - Contract Administration Data CLAUSES INCORPORATED BY FULL TEXT Invoices for supplies rendered under this Task Order shall be submitted electronically through Wide Area Work Flow ¡V Receipt and Acceptance (WAWF): The vendor shall self-register at the web site https://wawf.eb.mil. Vendor training is available on the internet at http://wawftraining.com. One or more separate invoices will be prepared per order. Do not combine the payment claims for supplies provided under this contract ordered through multiple orders within one invoice. Select the Create Invoice And Receiving Report combo within WAWF as the invoice type (destination/destination). The Invoice and Receiving Report combo prepares the Material Inspection and Receiving Report, DD Form 250, and the Invoice at the same time. Back up documentation (such as delivery receipts, etc.) can be included and attached to the invoice in WAWF. Attachments created in any Microsoft Office product are attachable to the invoice in WAWF. The following information regarding Naval Medical Center Portsmouth is provided for completion of the invoice in WAWF: Issuing Office DODAAC: N00183 Admin DODAAC: N00183 Ship To DODAAC: N00183 LPO DODAAC: N00183 Pay DODAAC: N68688 The contractor shall submit invoices for payment per contract terms. The Government shall process invoices for payment per contract terms. For more information on Wide Area Workflow, please contact the Wide Area Workflow Implementation Team at [email protected] Section I - Contract Clauses CLAUSES INCORPORATED BY REFERENCE 52.203-3 Gratuities APR 1984 52.222-20 Walsh-Healey Public Contracts Act DEC 1996 52.222-35 Equal Opportunity For Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans DEC 2001 52.222-36 Affirmative Action For Workers With Disabilities JUN 1998 52.226-1 Utilization Of Indian Organizations And Indian-Owned Economic Enterprises JUN 2000 52.232-1 Payments APR 1984 52.232-8 Discounts For Prompt Payment FEB 2002 52.233-3 Protest After Award AUG 1996 52.246-1 Contractor Inspection Requirements APR 1984 252.204-7004 Alt A Central Contractor Registration (52.204-7) Alternate A NOV 2003 252.232-7003 Electronic Submission of Payment Requests JAN 2004 CLAUSES INCORPORATED BY FULL TEXT 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): www.arnet.gov/far (End of clause)

Bid Protests Not Available