STATEMENT OF WORK (SOW) Contract RFQ Number: 36C25021Q0788 1. Contracting Officer s Representative (COR). Name: TBD 2. Contract Title. HemoSphere 3. Background. The Anesthesia department would like to purchase a Edwards Lifesciences Hemosphere monitor. This is a addition to the 4 existing Edwards Lifesciences Hemosphere monitors located in the ORs at the Wade park campus of the VA Northeast Ohio Healthcare System. The additional Monitor is to expand the availability of use. This will provide the ability to process the monitors after use and still have one immediately available for additional cases or for more expedient turnovers.. 4. Scope. The contractor shall provide all resources necessary to accomplish the deliverables described in the statement of work (SOW), except as may otherwise be specified. Items shll be brand new. 5. Specific Tasks. 5.1 Task 1 Shipment of purchased items. Deliverables: Equal to or better Item # Description/Part Number* Qty HEMAQSR2 HEMOSPHERE ADVANCED MONITORING SYSTEM - SMART RECOVERY WITH CLEARSIGHT, PRESSURE CABLE FOR ACUMEN IQ / FLOTRAC, HPI, AND ACUMEN ANALYTICS Kit Contains: HEM1, HEMBAT10, HEMCSM10, PC2K, EVHRS, 2 X HEMPSC100, HEMTOM10, HEMDPT1000, 194371001, Acumen Analytics 1 HEMFSM10 HEMOSPHERE FORESIGHT TISSUE OXIMETRY CABLE 1 PCCVR PRESSURE CONTROLLER COVER - PCCVR Included with HEMAQSR2, HEMCSMUPG, EV1000CS, and EVNIUPG-US kits 1 HEMRLSTD1000 HEMOSPHERE ROLL STAND Accessory 1 HEM360Y2 HEMOSPHERE 360 PROGRAM 24MO PLAN Covers Model(s) listed under "Total Protection Program Highlights" 1 6. Performance Monitoring The deliverables will be monitored upon arrival by the Health System Specialist, Service Chief and Lead Anesthesia Technician. If they are not working properly, Anesthesiology will notify the vendor and logistics about the problem. 7. Security Requirements Vendor will not have access to any patient sensitive information. The C&A requirement do not apply and a Security Accreditation Package is not required. 8. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI). Vendor is delivering products and troubleshooting problems as they arise. Their will be no Government-Furnished Equipment or Government Furnished Information provided to the vendor. 9. Other Pertinent Information or Special Considerations. Identification of Possible Follow-on Work. Possible Follow-on work could be contact with the Vendor for troubleshooting problems. Vendor shall be notified if the product is not functioning properly. b. Identification of Potential Conflicts of Interest (COI). There are no known Conflicts of Interest at this time. Identification of Non-Disclosure Requirements. The vendor shall not have access to any VA patient sensitive information or proprietary information. d. Packaging, Packing and Shipping Instructions. Deliveralbles shall be shipped to the Anesthesiology Department 11A(W) at Louis Stokes Cleveland VAMC, 10701 East Blvd, OH 44106. Attention should be made to Raul Rios. e. Inspection and Acceptance Criteria. Products will be inspected upon arrival by the Health System Specialist, along with the Service Chief and Lead Anesthesia Technician. Vendor shall be contacted if items are received damaged or not working properly so that vendor shall rectify. 10. Risk Control Anesthesia will follow the cleaning instructions that were provided by the vendor. These have been uploaded to the Equipment Request Share Point. 11. Place of Performance. The equipment will be used in the Operating Rooms at the Wade Park Main Campus. Louis Stokes VAMC Cleveland, OH 44106 12. Period of Performance. Not Applicable. 13. Delivery Schedule. The following items shall be delivered to the Louis Stokes Cleveland VA Medical Center NLT 30 Days ARO. Item # Description/Part Number* Equal to or better Qty HEMAQSR2 HEMOSPHERE ADVANCED MONITORING SYSTEM - SMART RECOVERY WITH CLEARSIGHT, PRESSURE CABLE FOR ACUMEN IQ / FLOTRAC, HPI, AND ACUMEN ANALYTICS Kit Contains: HEM1, HEMBAT10, HEMCSM10, PC2K, EVHRS, 2 X HEMPSC100, HEMTOM10, HEMDPT1000, 194371001, Acumen Analytics 1 HEMFSM10 HEMOSPHERE FORESIGHT TISSUE OXIMETRY CABLE 1 PCCVR PRESSURE CONTROLLER COVER - PCCVR Included with HEMAQSR2, HEMCSMUPG, EV1000CS, and EVNIUPG-US kits 1 HEMRLSTD1000 HEMOSPHERE ROLL STAND Accessory 1 HEM360Y2 HEMOSPHERE 360 PROGRAM 24MO PLAN Covers Model(s) listed under "Total Protection Program Highlights" 1