AUDIO BOOTH FOR BURLINGTON CBOC VA MEDICAL CENTER

Form / Attachment / Pricing Sheet

This document is a drawing, likely a floor plan, detailing the layout and dimensions of various rooms and spaces. It appears to be related to a construction or renovation project.

• Room labels such as "RADIOLOGY", "VIEWING", "DRESSING", "AUDIOLOGY BOOTH", "HEARING AID FITTING", and "CORRIDOR".
• Dimensions for rooms and corridors (e.g., 25'-10", 14'-0", 7'-6", 12'-10").
• Symbols and notations indicating structural elements, fixtures, or specific requirements (e.g., S6LT, S6L1, S6D1, S6S1, W3, SF3).
• A specific area labeled "L-9'-5" x 3' 3 1/8"" with a circled number 16.

This drawing provides critical spatial and dimensional information for any bidder involved in the physical construction, renovation, or outfitting of the described spaces. It will inform material estimates, labor planning, and adherence to the physical layout requirements of the opportunity.

Solicitation / RFP / RFQ

This is a Request for Quotation (RFQ) for one (1) Double Wall Exam Room audio booth to be custom fitted into new construction for the West Burlington CBOC (Community Based Outpatient Clinic) VA Medical Center. The booth is intended for use in veterans' hearing tests.

• Double Wall Construction: Premium 4" thick panels.

• Exterior Size: 12' 6" x 9' 0" x 8' 1" (height adjustable for 7' interior).

• Interior Size: 7' 0" x 10' 7" x 6' 6".

• Flooring: Flush with the floor, no ramp required.

• Doors: 36" clear opening, full vision tempered glass doors.

• Electrical: Vendor to provide and install all rough-in conduit, junction boxes, receptacles (110V/20A duplex hospital grade), and data ports (4-port, turn-key installed, CAT-6). All conduit to be at 90° angles, installed in EMT conduit or existing cable trays. Metal-Clad (MC) cable allowed within walls.

• Lighting: Recessed LED lighting.

• Sprinkler System: Vendor to provide factory or field-cut penetration for sprinkler system; VA to provide installation.

• Required Line Items: Double Wall Exam Booth, Shipping Charges, Factory Trained Installation, Extended Warranty (5 years), Upgrade to 36" Clear Opening Door, Window in Door, Quad Power Outlets, Quad Data Port Faceplate, Recessed Conduit Drop, Dimmer Switch, 2" pass-through pipe, 3"x3" Framed opening, User Manuals, Cleaning Instructions.

• Contract Type: Single Award, Firm Fixed Price.

• Period of Performance: Delivery orders with 120 days ARO (After Receipt of Order).

• Estimated Value: Not specified.

• Award Anticipated: 05/01/2026.

• Questions Due: April 20, 2026, 10:00 AM CST.

• Offers Due: April 23, 2026, 10:00 AM CST.

• Submission Method: Email to Becky.delossantos@va.gov. Subject line must include RFQ 36C26326Q0572.

• Evaluation: The Government intends to award without discussions and will evaluate all line items on a group basis. Evaluation factors are Technical, Past Performance, and Price.

• SF 1449: Offerors are recommended to fill in and sign the SF 1449. Alternatively, a quote can be submitted with a statement accepting the terms and conditions.

• Set-Aside: 100% Service-Disabled Veteran Owned Small Business (SDVOSB).

• NAICS Code: 334510 (Size Standard: 1250 Employees).

• SBA Waiver: An SBA Waiver for NAICS 334510 exists.

• Offerors must be registered in SAM.

• Late offers will be treated as described in FAR 52.212-4.

• The VA Notice of Limitations on Subcontracting (VAAR 852.219-76) and Buy American Certificate must be completed and submitted with the offer. Failure to do so may result in the quote being non-responsive.

Form / Attachment / Pricing Sheet

This document is the "52.225-2 Buy American Act Certificate (Tailored) Commercially available off-the-shelf (COTS)". It is a certification form required for offers related to solicitations involving commercially available off-the-shelf (COTS) items.

• Solicitation, Procurement Name, Location: Fields to be filled in with specific opportunity details.
• Completion Instructions: Guidance on how to complete the certificate, including:
  • Listing foreign end products and indicating if they exceed 55% domestic content.
  • Specifying that for non-American made COTS items, only Line Item No. and Country of Origin are required.
  • A checkbox for certifying that all items are domestically produced.
• Foreign End Products Table: A table to list Line Item No., Country of Origin, and whether the item exceeds 55% domestic content (Yes/No).
• Domestic Product Certification: A checkbox to certify all items are domestically produced.
• Signature Block: Fields for Signature, Printed Name, Company, and Title of the person completing the certificate.

Bidders must complete and submit this form as part of their offer to certify compliance with Buy American Act requirements for COTS items. The information provided will be used to evaluate the domestic content of the offered products.

Statement of Work (SOW) / Performance Work Statement (PWS)

To procure and install one (1) custom-fitted double-wall audio booth for the new construction of the Waterloo Community Based Outpatient Clinic (CBOC), designed for veteran hearing tests.

• Booth Construction: Double wall construction with premium 4” thick panels.

• Dimensions:

  • Exterior: 12' 6" L x 9' 0" W x 8' 1" H (or adjusted for 7' interior height).
  • Interior: 7' 0" H x 10' 7" L x 6' 6" W.
  • Door Clear Opening: 36 inches.

• Flooring: Booth base must be flush with the existing floor to avoid the need for a ramp.

• Doors: 36-inch clear opening with a full vision tempered glass door (20" x 60").

• Electrical: Vendor to provide and install all rough-in conduit, junction boxes, and fittings. All receptacles to be 110V/20A hospital grade. Data ports to be 4-port CAT-6, turn-key installed. Power and data ports to be located in cove molding at 36 inches above the floor. Vendor to make all connections from the VA-provided junction box for a turnkey installation.

• Lighting: Recessed LED lighting with dimmer switch, provided and installed by vendor.

• Sprinkler System: Vendor to provide factory or field-cut penetration for sprinkler system pass-through. VA/contractor to install the system itself.

• Specific Components: Includes AS-A504 panel construction, upgrade to 36" door, window in door, quad power outlets, quad data port faceplate, recessed conduit drops, dimmer switch, and pass-through pipes.

• Installation by a factory-trained team.

• Compliance with the latest edition of the National Electric Code (NFPA 70).

• Turnkey installation and booth operation.

• Place: Waterloo CBOC (new construction).

• Delivery: Products ordered to arrive on or about a specified date (to be confirmed).

• Warranty: Extended warranty for 5 years on wear items.

• Manuals: User manuals and cleaning instructions to be provided.

• Delivery Service: Must unload, remove packing material, and dispose of it.

• Optional Items: Trade-in, volume discounts, maintenance contracts, in-service training are listed as optional and require consultation with specific departments (Logistics, BioMed).