Section A - Solicitation/Contract Form CLAUSES INCORPORATED BY FULL TEXT Fill in Blanks: TIN: _________________ CAGE:_______________ DUNS:__________________ Vendor Point of Contact: __________________phone: ____________________ Vendor email: ________________________ Payment Monthly in Arrears 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 20 Package 0030-4305 VUE PACK CONTAINS THE FOLLOWINFFPCUSTOM VUE LICENSE FEE 10 eaCH CUSTOM VUE TREATMENT CARD 10 TX CUSTOM VUE ENHANCEMENT CARD 2 TX PREVUE CARD 2 TX PREVUE LENS 2 EA TOTAL OF ONE (1) 0030-4305 VUE PACKMILSTRIP: N0018304RQ68014PURCHASE REQUEST NUMBER: N0018304RQ68014 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0002 200 Each 00304016 CALIBRATION CARDFFPMILSTRIP: N0018304RQ68014PURCHASE REQUEST NUMBER: N0018304RQ68014 NET AMT FOB: Destination ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0003 1 Each SHIPPING 2ND DAYFFPMILSTRIP: N0018304RQ68014PURCHASE REQUEST NUMBER: N0018304RQ68014 NET AMT FOB: Destination Section C - Descriptions and Specifications CLAUSES INCORPORATED BY FULL TEXT THE MINIMUM REQUIREMENTS OF THIS ORDER ARE AS FOLLOWS: „h Vendor to provide a VUE pack item 30-4305 for Excimer Laser serial # 3631 upgraded to S4. o The VUE pack must contain the following: „X Custom VUE Licence fee 10 each „X Custom VUE Treatment card 10 TX „X Custom VUE Enhancement Card 2 TX „X Prevue Card 2 TX „X Prevue Lens 2 Each „h VUE pack must be programmed by the contractor for the Excimer Laser mentioned above. This description is from VISX manufacturer. o Vendors price to include all parts, labor and transportation including Shipping. „h Vendor to provide minimum 1 year warranty o Warranty shall be all inclusive against manufactures defects „h Equipment supplied must be certified for use in US adhering to UL requirements as required. 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 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 21-JUL-2004 20 NAVAL MEDICAL CENTERRECEIVING DEPARTMENTMMD54 LEWIS MINORS STREETPORTSMOUTH VA 23708-2297757-953-5770FOB: Destination N00183 0002 21-JUL-2004 200 (SAME AS PREVIOUS LOCATION)FOB: Destination N00183 0003 21-JUL-2004 1 (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 52.213-2 Invoices APR 1984 52.219-3 Notice of Total HUBZone Set-Aide JAN 1999 52.219-6 Notice Of Total Small Business Set-Aside JUN 2003 52.219-6 Alt I Notice of Total Small Business Set-Aside (Jun 2003) - Alternate I OCT 1995 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 52.223-3 Hazardous Material Identification And Material Safety Data JAN 1997 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 252.232-7003 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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