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STATEMENT OF WORK Contract Title: MTI 529W Exam Chair Requestor/Program Manager Name: Samantha Corbett Title: Supervisor, Radiation Therapy Section: Imaging Service Address: VA Pittsburgh Healthcare S... STATEMENT OF WORK Contract Title: MTI 529W Exam Chair Requestor/Program Manager Name: Samantha Corbett Title: Supervisor, Radiation Therapy Section: Imaging Service Address: VA Pittsburgh Healthcare System (VAPHS) University Drive C, Pittsburgh, PA 15240 Phone Number: (412) 360-6219 E-Mail Address: Samantha.Corbett2@va.gov Background: VA Pittsburgh is seeking to purchase a replacement exam chair for our consult room. The current chair is end of life. The chair is used to examine patients before, during, and after radiation. Scope: The contractor shall provide the following equipment: ITEM DESCRIPTION QTY MTI 529W Exam Chair Low Voltage Motors: power lift, back, tilt, foot extension Height: 18.75 -39 Width: 30 Backrest: integrated headrest, tapered Patient Load Capacity: 850 lbs. Control: foot control with optional foot section mounted hand control Program Buttons: 4 dynamic user-programmable positions Home Button: programmable & ADA compliant Headrest: integrated into backrest Removable Upholstery: seamless or designer Legrest: non knee-break with 11 power footrest extension Patient Arms: standard removable compensating (floating)** Leveling Glides: adjustable and built-in Safety Standards: Listed to the following standards IEC 60601-1:2005 Ed.3+A1;C1:2014, AAMI ES60601-1:2005+A1, CSA C22.2#60601-1:2014 Ed.3, IEC 60601-1-2:2014 Ed.4 ADA Base: standard Frame: all-steel G2 Accessories: plug-n-play accessories, optional seat, base, foot and back rail splines available (see details below) Podiatry and Wound chair is ADA complaint using the transfer support, providing easy patient ingress/egress, and equal access to patients and caregivers with disabilities. See quote for other specifics 1 Warranty: MTI offers a free 1 year warranty and will provide support for that year. Biomed will be responsible for the equipment thereafter. Performance Monitoring: The contractor shall keep the COR informed of work completed each day. The COR shall randomly inspect work performed. The contractor shall demonstrate to the COR, upon completion of work, the newly installed system is fully functional. Security Requirements: N/A Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI): There is no government furnished equipment or government furnished information in conjunction with this contract. Other Pertinent Information or Special Considerations Identification of Possible Follow-on Work: None anticipated. Identification of Potential Conflicts of Interest (COI): None anticipated. Identification of Non-Disclosure Requirements: None anticipated Packaging, Packing and Shipping Instructions: No special requirements. Inspection and Acceptance Criteria: See the following section, Performance Monitoring. Risk Control: Contractor is responsible for providing all applicable training and protective equipment to protect Contractor s employees from any hazards, including blood borne pathogens, which may be encountered in the performance of this contract. Place of Performance: Except for services provided remotely, work shall be performed at the VA Pittsburgh Healthcare System University Drive Division, University Drive C, Pittsburgh, PA 15240. Period of Performance: The contractor shall have 120 days from notice of award to ensure the equipment is installed and functioning.