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 1 Lot Synthes Implant InstrumentsFFPSee Section C for detailsMILSTRIP: N0018305RQWN022PURCHASE REQUEST NUMBER: N0018305RQWN022 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0002 5 Each ShippingFFPEach shipping cost must not exceed $100.MILSTRIP: N0018305RQWN022PURCHASE REQUEST NUMBER: N0018305RQWN022 NET AMT FOB: Destination Section C - Descriptions and Specifications CLAUSES INCORPORATED BY FULL TEXT 1. The Naval Medical Center, Portsmouth, VA Main Operating Room (MOR) will purchase items as needed for the month November-04 from the items listed below. These items are presently in use at the MOR in conjunction with the Synthes USA implant system, 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 Synthes USA Catalog. No substitutes will be accepted. · Vendor to provide prices for the below items and must have the capability to supply requested items within 72 hours of notification. · Vendor to warrant that all supplied items are free of manufacturers defect. · Vendor price to be inclusive of all costs including shipping. 2. There are no minimum guarantees. NAVAL MEDICAL CENTER, PORTSMOUTH MMD/RECEIVING DEPT 54 LEWIS MINORS ST./BLDG 250 PORTSMOUTH, VA. 23708 SYNTHES USA. AUGUST 2004 PURCHASE ORDER #: ITEMS PART NUMBER PART DESCRIPTION UNIT/ ISSUE QTY UNIT PRICE 1 310.19 DRILL BIT 2.0mm EA 2 310.31 DRILL BIT .3.2mm EA 3 310.431 DRILL BIT 4.3mm EA 4 310.44 DRILL BIT 4.5mm EA 5 224.541 PLATES 4.5mm NARROW LCP EA 6 224.551 PLATES 4.5mm NARROW LCP EA 7 224.561 PLATES 4.5mm NARROW LCP EA 8 224.571 PLATES 4.5mm NARROW LCP EA 9 224.581 PLATES 4.5mm NARROW LCP EA 10 224.591 PLATES 4.5mm NARROW LCP EA 11 224.601 PLATES 4.5mm NARROW LCP EA 12 224.611 PLATES 4.5mm NARROW LCP EA 13 224.621 PLATES 4.5mm NARROW LCP EA 14 224.641 PLATES 4.5mm NARROW LCP EA 15 224.661 PLATES 4.5mm NARROW LCP EA 16 226.561 PLATES 4.5mm BROAD LCP EA 17 226.571 PLATES 4.5mm BROAD LCP EA 18 226.581 PLATES 4.5mm BROAD LCP EA 19 226.591 PLATES 4.5mm BROAD LCP EA 20 226.601 PLATES 4.5mm BROAD LCP EA 21 226.611 PLATES 4.5mm BROAD LCP EA 22 226.621 PLATES 4.5mm BROAD LCP EA 23 226.641 PLATES 4.5mm BROAD LCP EA 24 226.661 PLATES 4.5mm BROAD LCP EA 25 240.141 PLATES 4.5mm “T” LCP EA 26 240.161 PLATES 4.5mm “T” LCP EA 27 240.181 PLATES 4.5mm “T” LCP EA 28 212.201-212.227 SCREW 5.0mm LOCKING, SELF TAPPING EA 29 214.228-214.240 SCREW 4.5mm SHAFT EA 30 214.242-214.250 SCREW 4.5mm SHAFT EA 31 214.814-214.870 SCREW 4.5mm CORTEX EA 32 215.025-215.070 SCREW 4.5mm MALLEOLAR EA 33 216.030-216.080 SCREW 6.5mm CANCELLOUS SCREW EA 34 216.085-216.110 SCREW 6.5 mm CANCELLOUS SCREW EA 35 217.025-217.080 SCREW 6.5mm CANCELLOUS SCREW EA 36 217.085-217.110 SCREW 6.5mm CANCELLOUS SCREW EA 37 218.025-218.060 SCREW 6.5mm CANCELLOUS SCREW EA 38 222.670-222.683 SCREW 4.0mm LOCKING SCREW SELF TAPPING EA 39 219.99 WASHER 13mm EA 40 310.19 DRILL BET 2.0MM EA 41 310.31 DRILL BIT 3.2mm EA 42 310.44 DRILL BIT 4.5MM EA 43 292.2 K- WIRE 2.0mm EA 44 214.014-214.068 SCREW 4.5mm CORTEX EA 45 222.04 PLATES 4.5mm SEMI TUBULAR EA 46 222.05 PLATES 4.5mm SEMI TUBULAR EA 47 222.06 PLATES 4.5mm SEMI TUBULAR EA 48 222.07 PLATES 4.5mm SEMI TUBULAR EA 49 224.04 PLATES 4.5mm NARROW DCP EA 50 224.05 PLATES 4.5mm NARROW DCP EA 51 224.06 PLATES 4.5mmNARROW DCP EA 52 224.07 PLATES 4.5mm NARROW DCP EA 53 224.08 PLATES 4.5mm NARROW DCP EA 54 224.09 PLATES 4.5mm NARROW DCP EA 55 224.1 PLATES 4.5mm NARROW DCP EA 56 224.11 PLATES 4.5mm NARROW DCP EA 57 224.12 PLATES 4.5mm NARROW DCP EA 58 226.06-226.07 PLATES 4.5mm BROAD DCP EA 59 226.08-226.10 PLATES 4.5mm BROAD DCP EA 60 226.10-226.14 PLATES 4.5mm BROAD DCP EA 61 240.34 PLATES T-BUTTRESS EA 62 240.44-240.54 PLATES L-BUTTRERSS EA 63 310.243 DRILL GUIDE 2.5mm EA 64 310.632 DRILL BIT CANNULATED 5.0mm EA 65 222.535-222.549 SCREW 5.0mm LOCKING SCREW EA 66 222.554-222.565 SCREW 5.0mm CANNULATED CONICAL EA 67 222.567-222.576 SCREW 7.3mm CANNULATED LOCKING EA 68 222.656 PLATE 4.5mm LCP CONDYLAR EA 69 222.657 PLATE 4.5mm LCP CONDYLAR EA 70 222.658 PLATE 4.5mm LCP CONDYLAR EA 71 222.659 PLATE 4.5mm LCP CONDYLAR EA 72 222.66 PLATE 4.5mm LCP CONDYLAR EA 73 222.661 PLATE 4.5mm LCP CONDYLAR EA 74 222.662 PLATE 4.5mm LCP CONDYLAR EA 75 222.663 PLATE 4.5mm LCP CONDYLAR EA 76 222.664 PLATE 4.5mm LCP CONDYLAR EA 77 222.665 PLATE 4.5mm LCP CONDYLAR EA 78 222.666 PLATE 4.5mm LCP CONDYLAR EA 79 222.667 PLATE 4.5mm LCP CONDYLAR EA 80 222.668 PLATE 4.5mm LCP CONDYLAR EA 81 222.669 PLATE 4.5mm LCP CONDYLAR EA 82 214.828214.854 SCREW 4.5mm CORTEX SELF TAPPING EA 83 237.50-237.56 PLATES 95 DEGREE CONDYLAR EA 84 237.70-237.76 PLATES 95 DEGREE CONDYLAR EA 85 237.90-237.96 PLATES 95 DEGREE CONDYLAR EA 86 237.20-237.26 PLATES 95 DEGREE CONDYLAR EA 87 310.21 DRILL BIT 2.0mm EA 88 310.288 DRILL BIT 2.8mm EA 89 310.35 DRILL BIT 3.5mm EA 90 202.810-202.855 SCREW SELF TAPPING CORTEX 2.7mm EA 91 204.216-204.238 SCREW SHAFT 3.5mm EA 92 204.810-204.860 SCREW SELF TAPPING CORTEX 3.5mm EA 93 206.010-206.060 SCREW CANCELLOUS 4.0mm EA 94 207.010-207.050 SCREW CANCELLOUS 4.0mm EA 95 212.101-212.124 SCREW 3.5mm LOCKING EA 96 219.98 WAHSER 7.0mm EA 97 223.551 PLATES 3.5mm LCP EA 98 223.561 PLATES 3.5mm LCP EA 99 223.581 PLATES 3.5mm LCP EA 100 223.591 PLATES 3.5mm LCP EA 101 223.601 PLATES 3.5mm LCP EA 102 223.621 PLATES 3.5mm LCP EA 103 223.641 PLATES 3.5mm LCP EA 104 241.031-241.931 PLATES 3.5mm LCP T-PLATES EA 105 241.041-241.941 PLATES 3.5mm LCP T-PLATE EA 106 241.051-241.951 PLATES 3.5mm LCP T-PLATE EA 107 241.071-241.971 PLATES 3.5mm LCP T-PLATE EA 108 241.131 PLATES 3.5mm LCP T-PLATE EA 109 241.151 PLATES 3.5mm LCP T-PLATE EA 110 241.171 PLATES 3.5mm LCP T-PLATE EA 111 241.141 PLATES 3.5mm LCP T-PLATE EA 112 241.161 PLATES 3.5mm LCP T-PLATE EA 113 241.351 PLATES 3.5mm LCP 1/3 PLATE EA 114 241.361 PLATE 1/3 TUBULAR LCP EA 115 241.371 PLATE 1/3 TUBULAR LCP EA 116 241.381 PLATE 1/3 TUBULAR LCP EA 117 241.391 PLATE 1/3 TUBULAR LCP EA 118 241.401 PLATE 1/3 TUBULAR LCP EA 119 241.421 PLATE 1/3 TUBULAR LCP EA 120 241.901 PLATE PROXIMAL HUMEROUS EA 121 241.903 PLATE PROXIMAL HUMEROUS EA 122 245.051 PLATE LCP RECON PLATE EA 123 245.061 PLATE LCP RECON PLATE EA 124 245.071 PLATE LCP RECON PLATE EA 125 245.081 PLATE LCP RECON PLATE EA 126 245.0101 PLATE LCP RECON PLATE EA 127 245.0121 PLATE LCP RECON PLATE EA 128 206.414-206.470 SCREW 4.0mm CORTEX EA 129 206.475-206.500 SCREW 4.0mm CORTEX EA 130 400.806-400.824 SCREW TITANIUM 1.5mm EA 131 401.806-401.824 SCREW 2.0mm TITANIUM CORTEX EA 132 402.806-402.824 SCREW 2.7mm TITANIUM CORTEX EA 133 446.19 PLATE TITANIUM STRAIGHT EA 134 446.23 PLATE TITANIUM T-PLATE EA 135 446.24 PLATE TITANIUM T-PLATE EA 136 446.63 PLATE TITANIUM CONDYLAR EA 137 446.64 PLATE TITANIUM CONDYLAR EA 138 443.19 PLATE TITANIUM 2.0mm STRAIGHT EA 139 443.23 PLATE TITANIUM 2.0mm T-PLATE EA 140 443.24 PLATE TITANIUM 2.0mm T-PLATE EA 141 443.61 PLATE TITANIUM 2.0mm CONDYLAR EA 142 443.64 PLATE TITANIUM 2.0mm CONDYLAR EA 143 442.33 PLATE TITANIUM 2.7mm L PLATE EA 144 442.34 PLATE TITANIUM 2.7mm L PLATE EA 145 442.41 PLATE TITANIUM 2.7mm T PLATE EA 146 442.61 PLATE TITANIUM 2.7mm CONDYLAR EA 147 442.62 PLATE TITANIUM 2.7MM CONDYLAR EA 148 208.401-208.482 SCREW CANNULATED 6.5mm EA 149 208.830-209.730 SCREW CANNULATED 7.3mm EA 150 208.030-208.130 SCREW CANNULATED 7.0mm EA 151 209.045-209.130 SCREW CANNULATED 7.0mm EA 152 219.99 WASHER 13.0mm EA 153 214.720-214.772 SCREW CANNULATED 4.5mm EA 154 207.610-207.650 SCREW CANNULATED 4.0mm EA 155 205.010-205.050 SCREW CANNULATED 3.5mm EA 156 310.69,65,67 DRILL BIT 4.5mm EA 157 202.714-202.740 SCREW CANNULATED 3.0mm EA 158 219.972 WASHER 6.5MM EA 159 105.100PI MODULAR FOOT IMPLANT SET EA 160 245.14 PLATE RECON 3.5mm EA 161 245.15 PLATE RECON 3.5mm EA 162 245.16 PLATE RECON 3.5mm EA 163 245.17 PLATE RECON 3.5mm EA 164 245.18 PLATE RECON 3.5mm EA 165 245.19 PLATE RECON 3.5mm EA 166 245.00 PLATE RECON 3.5mm EA 167 245.01 PLATE RECON 3.5mm EA 168 245.02 PLATE RECON 3.5mm EA 169 245.03 PLATE RECON 3.5mm EA 170 245.04 PLATE RECON 3.5mm EA 171 245.05 PLATE RECON 3.5mm EA 172 245.06 PLATE RECON 3.5mm EA 173 245.08 PLATE RECON 3.5mm EA 174 245.10 PLATE RECON 3.5mm EA 175 242.12 PLATE RECON 3.5mm EA 176 456.330S NAIL TITANIUM EA 177 458.18-458.80 LOCKING BOLT TITANIUM EA 178 458.818-458.999 LOCKING BOLT TITANIUM EA 179 310.25 DRILL BITS 2.5mm EA 180 241.23 PLATE 3.5mm "T" EA 181 241.24 PLATE 3.5mm "T" EA 182 241.25 PLATE 3.5mm "T" EA 184 458.10 END CAPS EA 185 458.120 END CAPS EA 186 SHIPPING EA NTE $100/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 CLAUSES INCORPORATED BY REFERENCE 252.246-7000 Material Inspection And Receiving Report MAR 2003 Section F - Deliveries or Performance DELIVERY INFORMATION CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC 0001 POP 04-NOV-2004 TO30-NOV-2004 N/A NAVAL MEDICAL CENTERRECEIVING DEPARTMENTMMD54 LEWIS MINORS STREETPORTSMOUTH VA 23708-2297757-953-5770FOB: Destination N00183 0002 POP 04-NOV-2004 TO30-NOV-2004 N/A (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 – 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 Required Central Contractor Registration Alternate A NOV 2003 252.225-7016 Restriction On Acquisition Of Ball and Roller Bearings MAY 2004 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)

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