STATEMENT OF WORK GENERAL INFORMATION Title of Project: Test Measurement and Diagnostic Equipment Calibrations Scope of Work: The contractor shall provide all resources necessary to accomplish the deliverables described in this statement of work (SOW), except as may otherwise be specified. This requirement includes the calibration of all specified test, measurement, and diagnostic equipment (TMDE) located in the James H. Quillen VA Medical Center s Biomedical Engineering department. Background: This is a regularly scheduled calibration, certification, and performance verification that occurs on an annual basis. The calibration certifications are required to be completed in the month of December. Performance Period: Performance shall begin upon award. Calibrations of all TMDE must be completed prior to close of business on December 30, 2016. Work shall be performed between the hours of 7:30 AM and 4:30 PM Monday through Friday, if possible, or unless otherwise permitted by the COR. Federal holidays are excluded. B. GENERAL REQUIREMENTS Contractor shall provide all parts, supplies, labor, shipping, and travel needed to complete the work. Contractor shall provide documentation or certification showing NIST traceability, where applicable, of all testing standards used in the performance of TMDE calibrations/certifications. Contractor shall place a calibration or certification sticker on each item that is certified or calibrated. Each sticker shall contain, at a minimum, the company name, technician name or code, contact phone number, date of service, and due date of the next calibration. Contractor shall provide a test equipment calibration certificate for each item that is calibrated or certified. The calibration certificates shall be in electronic PDF formation. The calibration certificate shall list, at a minimum, the following information: Vendor company name and address Serial Number Model name or number Manufacturer Calibration internal (annual, semi-annual, 12-month, etc.) Test date Due date As Found/Left Test results Procedure number or title of procedure used C. CONTRACTOR EXPERIENCE REQUIREMENTS The contractor shall be technically competent in performing the certification and calibration of listed equipment and may be required to show training or certification documentation of competency. The contractor shall be familiar with the equipment that can be calibrated or certified onsite and also be familiar with which equipment must be sent to a laboratory for testing. Shipping costs shall be included in the contract and not as an additional expense to the Government or Mountain Home VA Medical Center. D. SUPPORTING INFORMATION 1. Place of Performance: Calibrations and certifications are to be completed in the Biomedical Engineering department, A001 Building 200, of the James H. Quillen VA Medical Center, Mountain Home, TN 37684. Work space will be provided for the contractor. If equipment is unable to be calibrated and/or certified onsite, the Contractor shall provide shipping and any other associated costs to another location, as determined by the Contractor, to certify and/or calibrate the equipment. The Contractor shall track the shipping and receiving of any equipment that is sent off-station. 2. Shipping Information: Any Contractor-owned or VA-owned equipment may be shipped and received through the warehouse at the following address: James H. Quillen VAHCS Dogwood Avenue, Bldg. 205 Warehouse Attn: Biomedical Engineering Mountain Home, TN 37684 Contractor Furnished Materials: All labor, parts, supplies, and tools to complete the work as listed in the Statement of Work (SOW). Security Requirements: The Contractor shall identify which employees will be working under the awarded contract. Contractor personnel shall include employees, sub-contractors, sub-contractor employees, suppliers, and delivery personnel enter the Medical Center. This does not apply to suppliers and delivery personnel making deliveries to the VA Warehouse dock only. Those employees shall bring a photo ID to obtain a VA Contractor identification badge that shall be worn above the belt at all times while on Medical Center property. Contractor s employees shall return all ID badges to designated personnel at time designated in the task order. Inspections: The Contracting Officer s Representative (COR) is responsible for the inspection of the Contractor s work. The COR will be identified by name, telephone number, and location. Inspections made by the COR are for the sole benefit of the Government and do not relieve the Contractor of any quality control responsibilities. Equipment List: DESCRIPTION MANUFACTURER MODEL NUMBER SERIAL NUMBER ISOLATED POWER TEST MODULE DYNATECH 202A 252 DIGITAL THERMOMETER DELTATRAK -58F TO 392F 06K1 DIGITAL THERMOMETER DELTATRAK -58F TO 392F 06K1 DIGITAL MULTIMETER PROTEK 506 10139-506 SCOPEMETER FLUKE 97 DM5580523 DIGITAL MULTIMETER PROSKIT MT-1232 12213522 ELECTRICAL SAFETY ANALYZER FLUKE BIOMEDICAL MEDTESTER 5000B 1745 ELECTRICAL SAFETY ANALYZER FLUKE BIOMEDICAL MEDTESTER 5000C 1765 ESU ANALYZER FLUKE BIOMEDICAL 454A 397 ELECTRICAL SAFETY ANALYZER DYNATECH NEVADA MEDTESTER 5000C 2820 CALIBRATION THERMOMETER SMITH MEDICAL HLTA-40 20060084 VENTILATOR ANALYZER PURITAN BENNETT PTS-2000 4150733009 PATIENT SIMULATOR FLUKE PS 420 50919 ULTRASOUND TRANSDUCER LEAKAGE CURRENT TESTER FLUKE ULT 800 1629012 SAFETY ANALYZER FLUKE ESA612 1670020 SAFETY ANALYZER FLUKE ESA612 1670065 SAFETY ANALYZER FLUKE ESA612 1670064 SAFETY ANALYZER FLUKE ESA612 1670058 SAFETY ANALYZER FLUKE ESA612 1670059 SAFETY ANALYZER FLUKE ESA612 1670060 SAFETY ANALYZER FLUKE ESA612 1670063 SAFETY ANALYZER FLUKE ESA612 1670062 SAFETY ANALYZER FLUKE BIOMEDICAL ESA620 1673033 SAFETY ANALYZER FLUKE BIOMEDICAL ESA620 1673036 TEMPERATURE TESTER WELCH ALLYN 9600 PLUS 11172054 ULTRASOUND WATTMETER BC BIOMEDICAL USP100A 8032341127 UVB TESTER NATIONAL BIOLOGICAL UVB-500C 502278 EXTERNAL PACEMAKER ANALYZER FLUKE BIOMEDICAL SIGMAPACE 1000 187001 LIGHT METER EXTECH EA30 110705897 UVB TESTER DAAVLIN X97 11442M DEFIBRILLATOR ANALYZER FLUKE IMPULSE 7000DP 1092020 DEFIBRILLATOR ANALYZER FLUKE IMPULSE 7000DP 1170060 VITAL SIGNS MONITOR FLUKE PROSIM 8 2182134 VITAL SIGNS MONITOR FLUKE PROSIM 8 2181023 SPO2 FINGER SIMULATOR FLUKE PROSIM SPOT 2182136 SPO2 FINGER SIMULATOR FLUKE PROSIM SPOT 2179071 INFUSION DEVICE ANALYZER FLUKE IDA4 PLUS 13594 CERTIFIER CONTROL MODULE TSI 4088D 408PAL81333008 HIGH FLOW MODULE TSI 4081G 40811332006 LOW FLOW MODULE TSI 4082C 40821333005 ECG PATIENT SIMULATOR BIO TEK INSTRUMENTS ECG PLUS 119037 DIGITAL PRESSURE METER BIO-TEK DPM I 390 DIGITAL PRESSURE METER BIOTEK DPM-2 PLUS 151439 TACHOMETER DALE TECHNOLOGIES 30 E80-378 TACHOMETER FISHER SCIENTIFIC 05-028-23 101971491 DIGITAL MULTIMETER FLUKE 179 13270835 DIGITAL MULTIMETER FLUKE 179 12650359 DIGITAL MULTIMETER FLUKE 115 20910014 DIGITAL MULTIMETER FLUKE 77 50431008 DIGITAL MULTIMETER FLUKE 77 II 68401389 DIGITAL MULTIMETER FLUKE 87V 98170442 DIGITAL THERMOMETER FLUKE 52 14050239 COMPONENT TESTER HUNTRON INC 2000 13877 CLASS 1 WEIGHT SET (21 PIECE) RICE LAKE 1 MG-100G 4NW9 DIGITAL MANOMETER SPER SCIENTIFIC 840080 9400392 POWER SUPPLY TENMA 72-2080 9400968 CLASS 1 WEIGHT SET (15 PIECE) TROEMNER 10 MG TO 50 G 5922 DIGITAL MULTIMETER MILWAUKEE 2217-20 B83A910340508 DIGITAL THERMOMETER FLUKE 51 II 26470512WS SPO2 ANALYZER PRONK TECHNOLOGIES OX-1 OX189 SPO2 ANALYZER PRONK TECHNOLOGIES OX-1 OX2370 SPO2 ANALYZER PRONK TECHNOLOGIES OX-1 OX2371 NIBP SIMULATOR PRONK TECHNOLOGIES SIMCUBE SC-1 1450 NIBP MONITOR TESTER PRONK TECHNOLOGIES SIMCUBE SC-5 3078 NIBP MONITOR TESTER PRONK TECHNOLOGIES SIMCUBE SC-5 3079 DIGITAL MULTIMETER FLUKE 233 27700024 SAFETY ANALYZER FLUKE ESA615 2884046 SAFETY ANALYZER FLUKE ESA615 2884041 VITAL SIGNS SIMULATOR FLUKE BIOMEDICAL PROSIM 3 2840026 VITAL SIGNS SIMULATOR FLUKE BIOMEDICAL PROSIM 3 2840025 ESU ANALYZER FLUKE QA-ES II 202050 SAFETY ANALYZER FLUKE BIOMEDICAL ESA609 2889040 CALIBRATOR TEMERATURE EXERGEN TAT5000 DIGITAL THERMOMETER FLUKE 52 II 28750159WS INFUSION DEVICE ANALYZER FLUKE BIOMEDICAL IDA-5 3123101 DIGITAL MULTIMETER FLUKE 37 4611067 PATIENT SIMULATOR BIOTEK LIONHEART S53484 ELECTRICAL SAFETY ANALYZER FLUKE BIOMEDICAL MEDTESTER 5000C 96615 PATIENT SIMULATOR FLUKE 217A 4030 TACHOMETER FISHER SCIENTIFIC 05-028-23 80533708 TEMPERATURE MODULE FLUKE 80T-150UA 97170717 CLASS F WEIGHT SET (4 PIECE) TROEMNER 100G CLASS 1 N/A CLASS F WEIGHT SET (25 PIECE) RICE LAKE WEIGHING SYSTEMS 38VT85 N/A ULTRASOUND TRANSESPHAGEAL TESTER FLUKE ELECTRONICS CORP. ULT 800 9858008

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