Attachment 4: Tomah Mobile MRI Lease Statement of Work

SCOPE OF WORK

Mobile 1.5 Tesla Magnetic Resonance Imaging (MRI) Trailer LeaseTomah VA Health Care System

1. Scope

The Contractor shall provide all equipment, services, tools, transportation, delivery, setup, installation, initial labor, maintenance, training, accessories, and support necessary to provide and maintain one fully operational mobile Magnetic Resonance Imaging (MRI) system housed in a mobile coach for use by VA-referred beneficiaries of the Tomah VA Health Care System, 500 E. Veterans Street, Tomah, Wisconsin (Tomah VA). MRI studies shall be performed by Tomah VA employees as medically appropriate and requested by Tomah VA. The Contractor is responsible for all Contractor personnel, subcontractors, agents, and anyone acting for or on behalf of the Contractor. 2. Term of Contract and Period of Performance
The anticipated contract term consists of one (1) twelve-month base period and four (4) twelve-month option periods, for a potential total period of performance of sixty (60) months if all options are exercised. Exercise of any option is at the sole discretion of the Government. Specific period-of-performance dates will be established at award. The contract is subject to the availability of VA funds.

3. Operating Hours

The MRI trailer shall normally be used to perform studies Monday through Friday, 8:00 a.m. to 4:30 p.m. Extended hours and weekends may be utilized at the discretion of the facility. The facility will be closed on Federal holidays and any other day specifically declared by the President of the United States to be a Federal holiday.

4. Contractor Responsibilities

4.1 Transportation, Delivery, Setup, Site Interface, and Utilities The Contractor shall be responsible for transportation, delivery, positioning, setup, installation, commissioning, and connection of the mobile MRI system to Government-provided utilities and interfaces. All costs associated with these requirements shall be included in the monthly lease price. The mobile MRI trailer will be located at the northwest corner of Building 400 on an existing concrete pad approximately 11 feet by 60 feet. The Contractor shall verify that the proposed trailer configuration is compatible with the available site, patient-access interface, delivery route, and Government-provided utilities before delivery. Government-provided electrical service is 480 VAC, 3-phase, 150-amp service with a Russell-Stoll DS2504 FP female receptacle. Three telephone/communication connections are available at the exterior location. Three new cables have been installed at the exterior location for a future fire-protection connection. Final connection to the Building 400 fire-protection system will be accomplished through a separate Government project after the trailer model and accessory configuration are known. The Contractor shall provide technical information and reasonable coordination necessary to support that connection.