OR 2 LIGHTS CEILING-MOUNTED

5. PROJECT NUMBER (if applicable) CODE 7. ADMINISTERED BY 2. AMENDMENT/MODIFICATION NUMBER CODE 6. ISSUED BY 8. NAME AND ADDRESS OF CONTRACTOR 4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE 9A. AMENDMENT OF SOLICITATION NUMBER 9B. DATED PAGE OF PAGES 10A. MODIFICATION OF CONTRACT/ORDER NUMBER 10B.

DATED BPA NO. 1. CONTRACT ID CODE FACILITY CODE CODE Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers E. IMPORTANT: is extended, (a) By completing Items 8 and 15, and returning

copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended. 12. ACCOUNTING AND APPROPRIATION DATA (REV. 11/2016) is required to sign this document and return

copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:

(Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A. 15C. DATE SIGNED B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b). RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified. C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER Contractor 16C. DATE SIGNED 14. DESCRIPTION OF AMENDMENT/MODIFICATION 16B. UNITED STATES OF AMERICA Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect. 15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER 15B.

CONTRACTOR/OFFEROR STANDARD FORM 30 PREVIOUS EDITION NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.) (If required) (SEE ITEM 11) (SEE ITEM 13) (X) CHECK ONE 13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS, IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14. 11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT (Signature of person authorized to sign) (Signature of Contracting Officer) 0002 06/18/2026 NA Department of Veterans Affairs South Texas Veterans HCS 5441 Babcock Rd.

STE 302 San Antonio TX 79240 Same as Block 6 To all Offerors/Bidders 36C25726Q0476 X X X See CONTINUATION Page X 1 The purpose of this Amendment is to provide all answers to questions submitted by vendors related to Solicitation number 36C25726Q0476 Please see continuation page. Francisco Mendoza Contracting Officer CONTINUATION PAGE Please provide criteria in which responses to solicitation will be evaluated. I don't see any listed in this solicitation.

Responses to solicitation will be evaluated by whatever solution best meets the needs of the VA surgical team. Will the X-ray light box remain in the room or can it be removed? That may provide needed wall space for large monitor. Yes, that X-Ray light box will be removed Please confirm that the equipment boom will be removed and not replaced. Will all med gases to relocated to anesthesia boom? Yes, the equipment boom will be removed and not replaced.

It is correct that all med gases are to be relocated to anesthesia boom. The current Eq. & Anes Boom shows CO but marked as Not in Service . Will the CO service be needed on the anesthesia boom? No, it is not an anesthesia gas If so, there is concern that this may not adequately reach the insufflator mounted on the da Vinci tower. Would you prefer that we instead provide a dedicated CO wall outlet located near the planned da Vinci tower position?

Currently CO2 house gas is not available CLNs 9 is listed as PNEUMOCLEAR CO2 CONDITIONINGINSUFFLATOR KIT BOTTL LOCAL STOCK NUMBER: 0620-050-00. Do you want a connection kit or are you requesting an insufflation system? Please include an insufflation system Three monitors are listed, but the location of the third monitor is unclear. Where should it be mounted? It can go on the anesthesia boom down tube via a GCX arm or on the same mount as the other LT/FP monitors?

Two of the monitors are for arms and One is for a rolling MIS tower. The SOW lists a COR IP integration system as part of the new equipment install. Please confirm the requirement is for full integration and multiple image and source routing/capture capabilities. Yes, a full integration system is required, (40+ ports) Is the intent to include an in-light camera in this room, or is it no longer needed?

Yes, a 4K in-light camera is required The RFP requests rerouting existing med gas piping, demoing existing med gas risers, and installing new med gas risers. Confirmed Reuse of existing med gas risers is standard practice. Is the site requiring full replacement of the med gas risers? The standard practice is to install new medical gas risers and branch lines when installing new equipment or undergoing facility upgrades rather than reusing existing ones. Must comply with NFPA 99 Health care Facilities Code.

Verified by an ASSE 6030 certified verifier. What is the specific requirement or intent behind rerouting the existing med gas piping? Some med gas piping can be capped at the equipment boom, but additional services are needed at the new anesthesia boom. For example, two O2 are required for anesthesia, and an additional VAC is needed. However, that is accomplished is up to the vendor. Industry practice is to perform a deflection test prior to installation.

Additionally, per code, if the new boom/lights are within 5% of the existing boom s moment load, a structural evaluation is not required. If the new equipment exceeds the 5% threshold, a structural evaluation is required. Does the site have stamped structural drawings for the existing boom installations? No A post installation deflection test is required by the manufacturer as part of their inspection. Yes Will the manufacturer s inspection and deflection test satisfy the RFP requirement?

Yes If the new equipment exceeds the 5% moment load threshold, will the site require a full structural evaluation? Yes Will the site require a LIM (Line Isolation Monitor) certification upon project completion?

Yes Set of Questions 3: What mount specifically needs to be removed? Equipment boom Can you please clarify information on gases for the anesthesia boom? Some med gas piping can be capped at the equipment boom, but additional services are needed at the new anesthesia boom. For example, two O2 are required for anesthesia, and an additional VAC is needed. However, that is accomplished is up to the vendor. Can you please confirm ceiling height? 10 ft How many monitors are needed?

Two of the monitors are for arms and One is for a rolling MIS tower. Specific needs for integration - Does it need to control lights and video? Yes, a full integration system is required, (40+ ports) Yes integration needs to control surgical lights, camera box, insufflator, light source and in-light camera. Can you please share information on Connectivity to your EHR - Epic? N/A for this project 7) Can the VA please provide detailed technical specifications for:

Surgical lighting systems -Surgical Lights are required to have 60,000 lux in all spot sizes - Color Temperature changes are required - 4K In Light Camrea is required - 60,000 LED hours of life - Frequency range of 80MHz to 6,000MHz, 100-240V, 65-80w, 50/60hz - Wt: 60kg. -Max Torque: 495Nm -Light Diameter: 75cm -Max Swivel Radius: 231cm -Temp:

10-40C, Humidity:

30-75%, Barometric Pressure: 700-1060hPa - Transformer primary voltage 100/120/127/220/230/240 V (AC) Power consumption for mains operation 80 W AC frequency 50/60 Hz

OR integration requirements 4K integration is required 40+ port system Device control for surgical lights, camera box, insufflator, light source and in-light camera Universal Wall Plate 4K Recording Package

Mechanical/electrical interface standards Standard mechanical and electrical interface standards. Quality should be that of a typical commercial or hospital environment. Are drawings, room layouts, and interface control documents available for OR #2? Please see attached Q1 Consistent User Interface "This Operating Room is adjacent to other ORs that may already have integrated surgical equipment in place.

Does the VA prefer that the new boom controls, surgical lights, and video integration system match the look and feel of equipment in neighboring rooms to reduce staff retraining and support day-to-day workflow?" Yes the VA surgical team would like a consistent user interface Q2 Single Point of Contact for Service "This project involves multiple equipment types booms, lights, video integration, and camera systems.

Does the VA prefer that all of these systems be serviceable through a single vendor rather than managing separate service contracts or calls for each system?" Yes a single point of contact for the service of booms/lights/integration/and video is the preference of the VA team. As well as the equipment will be from the same vendor, preferably OEM to honor warranties.

Q3 Pre-Wired Boom Cabling "Some boom systems come with cabling already routed through the boom arm from the factory, while others require cabling to be run on-site during installation. Does the VA prefer a boom solution with factory pre-wired cabling to reduce installation time and minimize disruption to the OR?"

Yes pre-wired boom cabling is the preference of the VA team Q4 Scope Confirmation: Boom Removal & Service Consolidation "Please confirm that the scope of work includes removing the existing equipment boom and relocating all electrical and medical gas connections to the new anesthesia boom, including any ceiling work needed to support the installation." Confirmed removing equipment boom. Some med gas piping can be capped at the equipment boom, but additional services are needed at the new anesthesia boom.

For example, two O2 are required for anesthesia, and an additional VAC is needed. However, that is accomplished is up to the vendor. Q5 DaVinci Robotic Infrastructure "Please confirm the following items related to future DaVinci Robotic System preparation: Is the selected vendor responsible for installing conduit and fiber pathways for the future DaVinci interface plates ('blue cable' connections)? Yes Should the vendor also supply and install the physical fiber cable, terminated and tested to be DV5 plate capable?

Yes Should the vendor provide dedicated electrical circuits for the DaVinci system one circuit per surgeon console, one for the Patient Cart, and two for the Vision Tower at the foot wall." Yes Q6 Integration Cabinet Replacement "Please confirm that the scope includes removing the existing AV/integration cabinet and replacing it with a new cabinet holding components of the new integration system."

Yes Q7 Flooring Replacement "Please confirm that the scope of work includes replacing the existing OR floor with sheet vinyl, with the flooring to be turned up and finished at the base of the integration cabinet." Yes, flooring shall be Manning-Paradigm II intersect or similar. the relative humidity should be at least 30%. Quality should be that of a typical commercial or hospital operating room environment. Q8 ICRA Containment "Please confirm the infection control requirements for this project.

Is the contractor responsible for setting up and maintaining Class V ICRA containment barriers for the full duration of the work?" Yes Q9 De-Installation of Existing Equipment "Please confirm that the selected vendor will be responsible for de-installation and removal of all existing equipment included in the scope of this project." Confirmed, work with VA staff to dispose of equipment according to VA policy. POC will be designated.

Q10 Wall Video Plates for DaVinci and MIS Workflow "Please confirm whether the scope of work includes installation of additional wall-mounted video interface plates at strategic locations within the OR to support optimal workflow for both the DaVinci Robotic System and minimally invasive surgery (MIS) video carts." Confirmed new video plates around the room for MIS video connection and Robot connections are required (6+) new plates See attached document: OR 2.