4110--Countertop & Freestanding Ice and Water Dispenser

Form / Attachment / Pricing Sheet

This document is the "VAAR 852.219-76 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—CERTIFICATE OF COMPLIANCE FOR SUPPLIES AND PRODUCTS (JAN 2023) (DEVIATION)". It requires offerors to certify their compliance with subcontracting limitations as stipulated in the solicitation and resultant contract.

• Subcontracting Limitations: Offerors must select one of two options regarding compliance with subcontracting limitations:

  • For contracts for supplies/products (excluding nonmanufacturers), the offeror will not pay more than 50% of the contract amount to firms that are not certified SDVOSBs or VOSBs.
  • For contracts for supplies from a nonmanufacturer, the offeror will supply products from a domestic small business manufacturer or processor, unless a waiver is granted.

• Manufacturer or Nonmanufacturer Representation: Offerors must certify whether they are the manufacturer/producer of the end item or qualify as a nonmanufacturer.

  • Nonmanufacturer certification requires meeting specific criteria, including employee count (<=500, or <=150 for IT VAR exception), primary engagement in wholesale/retail trade, and taking ownership of items.

• Acknowledgement of Jurisdiction: Offerors acknowledge that this certification is within the jurisdiction of a U.S. Agency and subject to penalties under 18 U.S.C. 1001 for false certifications.

• Cooperation: Offerors agree to provide documents or records to the VA to determine compliance with subcontracting limitations.

• This form is mandatory and must be completed, signed, and returned with the offeror's bid, quotation, or proposal. Failure to provide this certification will result in the offer being deemed ineligible for evaluation and award.

• Bidders must carefully review and accurately complete the sections pertaining to subcontracting limitations and their status as a manufacturer or nonmanufacturer.

Solicitation / RFP / RFQ

This is a combined synopsis/solicitation for countertop and freestanding ice and water dispensers. The Department of Veterans Affairs (VA) is seeking to purchase these items for the VA Loma Linda Healthcare System and VA Phoenix Healthcare System. This announcement serves as the only solicitation, and quotes are being requested.

• CLIN 0001: Follett Symphony Plus Ice and Water Countertop Dispenser Model# 50CI414A-S or equal (Qty: 1)
• CLIN 0002: Follett Symphony Plus Ice and Water Countertop Dispenser Model# 25CI414A-S or equal (Qty: 2)
• CLIN 0003: Follett Base Stand Model# 25AND50BASE-00 or equal (Qty: 2) - for converting countertop dispensers to freestanding.
• CLIN 0004: Follett Symphony Plus Ice and Water Freestanding Dispenser Model# 25FB414A-S or equal (Qty: 2)
• CLIN 0005: Follett Carbonless High-Capacity Water Filter System Model# CARBONLESSHICAPSYS (Qty: 2) - compatible with CLIN 0004.

Specific salient characteristics for each CLIN are detailed in the document, including ice production capacity, dimensions, material (stainless steel), dispensing mechanisms (touchless preferred), energy efficiency, and warranty requirements for freestanding units.

• Contract Type: Firm-Fixed-Price.

• Delivery: To VA Loma Linda Healthcare System (CLINs 0001-0003) and VA Phoenix Healthcare System (CLINs 0004-0005). Shipping costs must be included in the total cost.

• Questions Due: Wednesday, June 3rd, 2026, 10:00 AM Pacific Time. Submit via email to Melissa.Ramirez8@va.gov.

• Quotes Due: Friday, June 5th, 2026, 10:00 AM Pacific Time.

• Offeror Requirements:

  • Complete quote/pricing with estimated lead time.
  • Brand name and model number of offering. If offering an "equal to," documentation proving compliance with all salient characteristics is required.
  • Fully completed and signed VAAR 852.219-76 VA Notice of Limitation on Subcontracting – Certificate of Compliance.
  • If applicable, complete E.4 52.225-2 BUY AMERICAN CERTIFICATE.

• Set-Aside: Total Service-Disabled Veteran-Owned Small Business (SDVOSBC).

• NAICS Code: 333415 (Size Standard: 1,250 Employees).

• Non-Manufacturer Rule (NMR): NMR is waived for this NAICS code, but verification is recommended.

• Limitations on Subcontracting (LOS): Offerors must complete and return the VAAR 852.219-76 Certificate of Compliance. Failure to submit a completed and signed certification will render the offer ineligible.

• SAM Registration: All offerors must be registered in www.SAM.gov.

• The solicitation will be in accordance with FAR Subpart 12.6, FAR Parts 12, 19, Simplified Acquisition Procedures, Small Business Programs, and VAAR.

• Offerors must review and monitor SAM.gov for amendments.

• Telephone inquiries will not be accepted.