Scope and Limitation of Business Proposal

Document Sample
Scope and Limitation of Business Proposal Powered By Docstoc


             RFP REFERENCE:



              SCOPE REPAIR

              TO BE OPENED:

          APRIL 1, 2010 AT 2:00 PM

            Mail sealed proposal to:
Erlanger Health System, Purchasing Department
        979 East Third Street, Suite 708
           Chattanooga, TN 37403
       RFP Ref. #___________________
RFP Opening Date & Time:___________________
                         ERLANGER HEALTH SYSTEM
                           975 EAST THIRD STREET
                       CHATTANOOGA, TENNESSEE 37403

                                   I. INVITATION

The purpose of this Request for Proposal is to solicit proposals from qualified Proposers
for Scope Repair. You are therefore invited to submit a proposal for Scope Repair as
outlined in the attached documents. The process is expected to be as follows:

       1. Publishing of RFP and advertising in the newspaper.
       2. Submittal of Proposals by the date and time at the location specified in these
       3. Evaluation of Proposals based on what is in the best interest of Erlanger
          Health System, considering price, terms, other matters set out hereinafter, and
          all other matter’s and things which Erlanger Health System deems appropriate
          in it’s sole discretion.
       4. Selection of one or more Proposals to be considered as final Proposals.
       5. Final evaluation with Erlanger Health System reserving the right to ask
          persons participating and providing Proposals to make a final and best offer on
          any particular Proposal or combination of several Proposals.
       6. Award and or rejection of all Proposals.

       Proposals must be in accordance with the attached instructions or they will not be
       considered. Erlanger Health System reserves the right to reject any or all
       Proposals received, to accept any proposal which in its opinion may be in the best
       interest of Erlanger Health System, and to combine Proposals into a final Proposal
       upon which it may solicit additional pricing or best or final offers. Erlanger Health
       System does not obligate itself to accept any particular Proposal.

       Proposals may be mailed, AT YOUR RISK, or delivered to the Procurement
       Manager, Erlanger Health System, 979 East Third Street, Suite 708
       Chattanooga, Tennessee 37403. We strongly suggest you hand deliver or use
       Fed Ex. Any other method of delivery puts the bid at risk of not making the

       Proposals must be received at the Purchasing Department NO LATER THAN
       2:00 P.M. ON APRIL 1, 2010, AT WHICH TIME THEY WILL BE
       PUBLICLY OPENED. Public Opening means that Proposals will be removed
       form their sealed envelopes, but prices and Proposals will not be reviewed in
       public until after they have been evaluated and an award has been made, if one is

                                          Page 2 of 20
                            II. INSTRUCTIONS

For the Proposal to be considered, it must be submitted in accordance with the
following instructions.


      REQUIRED. Facsimile or rubber stamp signatures will not be accepted.
      The Specification’s section must be signed and returned with the Proposal
      and all the exhibits properly completed and executed or otherwise the
      Proposal will not be accepted.

      changes to the Proposal will necessitate a re-submission of the entire
      Proposal on or before the opening.

      must consist of a properly completed and signed Specification section.


      THAN TIME AND DATE SET FOR OPENING. Proposal must be
      mailed or delivered to Purchasing Department as stated in the
      INVITATION. A date/time stamp will be affixed to the envelope
      immediately upon it’s arrival to the Purchasing Department. The date/time
      stamp must be on or before the date and time shown for the opening or the
      Proposal will not be considered. Proposals arriving late will be returned,
      unopened, to the Proposer.

7.    ANY ADDITONAL INFORMATION which Proposer desires to add to
      the Proposal shall be written, attached to and submitted with the formal
      sealed Proposal. If there are terms and conditions of the proposal and
      purchase a copy must be included in the sealed proposal.

      that all of the requirements of the Proposal are understood and accepted by
      the Proposer. The undersigned has reviewed the Proposal as submitted and
      understands Erlanger Health System will not be responsible for any errors
      or omissions on the part of the undersigned preparing this Proposal.

                                Page 3 of 20
9.    You may come to the RFP opening, however, pricing and term
      information will not be provided at that time. The RFP opening is a public
      event to demonstrate that Erlanger Health System follows all applicable
      laws in its process. Prices and terms will be available only after the
      Proposal is awarded and then only by appointment.

10.   Following the RFP Opening, a proposer may not have any further
      contact with the Technical Contact or other ERLANGER HEALTH
      SYSTEM personnel or affiliated physicians about the RFP unless
      initiated or authorized by Erlanger Health System. Any unauthorized
      contact shall not be used as a basis for responding to this RFP and may
      result in the disqualification of the proposer's submittal. The responsibility
      for obtaining technical verification of any specification is prior to the RFP
      opening. Any questions about the RFP process at that point must be
      referred to the technical contact.

11.   Prices and terms are to be guaranteed for (90) days during the evaluation

12.   Erlanger Health System is exempt from all Federal, State and Local Taxes.
      An exemption certificate will be furnished to the successful proposer upon

13.   In the event Erlanger Management determines, in its sole discretion, that
      additional proposals are necessary for a competitive procurement process,
      Management may, with or without notice, extend the RFP opening date for
      a period of time as it deems necessary or appropriate. In the event the RFP
      opening date is extended pursuant to this paragraph, an updated copy of
      the RFP will be made available upon request, and any respondent that
      submitted a response prior to the RFP opening date extension may re-
      submit its proposal or rely upon its original proposal.

14.   Erlanger Health System will evaluate the proposals considering, without
      limitation, some or all of the following, if applicable: price, quality,
      delivery time and schedules, quantity, any exceptions taken to the RFP
      documents, including any agreements accompanying such documents, any
      warranties offered, and the proposer’s demonstration of its good faith
      commitment for equal opportunity of small business enterprises, minority
      businesses and individuals, and socially and economically-disadvantaged
      individuals (collectively, "Minority Businesses") and any other items or
      things, which the Authority considers important, applicable and in its best

                                 Page 4 of 20
               So that Erlanger Health System may evaluate each proposer’s
               demonstration of its good faith commitment for equal opportunity of
               Minority Businesses, each proposer is expected to submit information
               which will emphasize the extent of the proposer's efforts to offer equal
               opportunity to Minority Businesses to participate as contractors, sub-
               contractors, and suppliers of goods and services should the proposer be
               awarded the contract. Each proposer should be aware that in evaluating
               the proposer's response, Erlanger Health System will evaluate each
               proposer's good faith commitment and demonstrated effort to ensure equal
               opportunity for Minority Businesses.


       A.      The term "minority business" means a business:

               1.     In which at least fifty-one percent (51%) is owned by one or more
                      minority persons or socially and economically disadvantaged
                      individuals, or in the case of a corporation, in which at least fifty-
                      one percent (51 %) of the stock is owned by one or more minority
                      persons or socially and economically disadvantaged individuals;

               2.     Of which the management and daily business operations are
                      controlled by one or more of the minority persons or socially and
                      economically disadvantaged individuals who own it.

       B.      The term "minority individual" means a person who is a citizen or lawful
               permanent resident of the United States and who is from a background
               described in the instructions for completion of Form EEO-1 and its
               appendix all as required by Section 709(c) of Title VII, and the applicable
               regulations, Sections 1602.7 1602.14, Subpart B, Chapter XIV, Title 29 of
               the Code of Federal Regulations, which include as presently drafted:

               1.     African-American (Black) (Not of Hispanic origin) - All persons
                      having origins in any of the Black racial groups of Africa;
               2.     Female;
               3.     Hispanic - All persons of Mexican, Puerto Rican, Cuban, Central
                      or South American, or other Spanish culture or origin, regardless of
               4.     Asian or Pacific Islander - All persons having origins in any of the
                      original peoples of the Far East, Southeast Asia, the Indian
                      Subcontinent, or the Pacific Islands. This area includes, for
                      example, China, India, Japan, Korea, the Philippine Islands, and
               5.     American Indian or Alaskan Native - All persons having origins in
                      any of the original peoples of North America, and who maintain
                      cultural identification through tribal affiliation or community

       C.      The term "small business enterprise" includes a proprietorship,
               partnership, limited liability company, corporation, or other form of

                                         Page 5 of 20
               business, with annual gross revenues of less than the sum of Four Million
               Dollars ($4,000,000).

       D.      The term "socially and economically disadvantaged individual" means an
               individual who is within either or both of the following groups:

               1.      Socially disadvantaged individuals are those who have been
                       subjected to racial or ethnic prejudice or cultural bias because of
                       their identity as a member of a group without regard to their
                       individual qualities.

               2.      Economically disadvantaged individuals are those socially
                       disadvantaged individuals whose ability to compete in the free
                       enterprise system has been impaired due to diminished capital and
                       credit opportunities as compared to others in the same business
                       area that are not socially disadvantaged.


Erlanger Health System will award a contract to the Proposer who submits the lowest and
best proposal without regard to race, color, religion, creed, national origins, gender, age,
or handicap condition. Nothing herein shall be construed to require Erlanger Health
System or its contractors to award contracts or subcontracts to, or to make purchases of
goods or services, materials or equipment from Minority Businesses or anyone else who
does not submit the lowest and best proposal.

                                          Page 6 of 20
                                III. Grievance Process

The intention of the ERLANGER HEALTH SYSTEM is to conduct all its business
affairs in a fair and impartial manner. In order to assure fairness to all prospective
proposers we have developed this grievance process to provide an organized and effective
method of allowing each prospective proposer to present its side of an issue and to
resolve amicably any conflicts which may arise between ERLANGER HEALTH
SYSTEM and the prospective proposer.

If you initiate litigation prior to exhausting the grievance procedure, ERLANGER
HEALTH SYSTEM will plead your failure to exhaust as a defense.


1.     Challenges to the RFP specifications must be requested in writing and received in
       the Purchasing Department no later than seven (7) days after the RFP has been

2.     The request must contain the specific reasons for the challenge, contain the actual
       wording and give a specific reference found in the request for proposal.

3.     The request must be mailed or faxed to the Procurement Manager, 979 East Third
       Street, Suite 708, Chattanooga, Tennessee 37403, fax number (423) 778-3909 by
       4:00 P.M. any business day.

4.     The Procurement Manager will make a determination of merit for your request. If
       the determination is in your favor, an addendum to the RFP will be issued.

5.     If the decision of the Procurement Manager is negative, the RFP opening will
       continue as scheduled.

Following the RFP Award

1.     Should a Proposer have an objection to an RFP award, a formal request must be
       submitted in writing. The request itself must be received by the Purchasing
       Department within five business days after the RFP award has been announced.

2.     The request must specify the RFP involved and clearly identify the basis for what
       is in dispute. Specific examples and exact wording should be used where

3.     The request must be sent to the Procurement Manager at 979 East Third Street,
       Suite 708, Chattanooga, Tennessee 37403.

                                         Page 7 of 20
                       FORMAL GRIEVANCE PROCESS


1.   Within five (5) working days, the Procurement Manager will schedule a hearing
     date which is mutually acceptable and in a timely manner. At that time, the
     Vendor will be allowed to present all facts which led to the dispute.

2.   The Procurement Manager will evaluate all relevant facts which were in dispute
     and make a determination for the resolution of the dispute.

3.   The determination of the Procurement Manager will be made known to the
     Vendor in writing within three (3) working days.

4.   If the Procurement Manager determines that a cancellation of the original award
     and re-bid is warranted, the grievance process is deemed complete at that time for
     the vendor.


1.   If the Vendor is not satisfied with the response (other than a re-bid) in step 1, they
     may request a second review of the disputed facts by submitting a written, clearly
     defined statement of what is still in dispute for review to the Chief Financial
     Officer or designee, at 975 East Third Street, Chattanooga, Tennessee 37403. It
     must be limited to the same issues that were in dispute in the first step of the
     Grievance Procedure. No new or additional information will be considered.

2.   This request must be received at the Medical Center within five (5) calendar days
     after the response from the first hearing.

3.   Upon review of the written information, the Chief Financial Officer or designee
     can either request a meeting with the vendor or inform the vendor in writing of the
     final decision.

                                        Page 8 of 20


1. Bidder will submit a full service capitation / fixed agreement to EHS for annual
   maintenance of rigid endoscope to this RFP. If Bidder limits the inventory based
   on manufacture or model, then Bidder will provide within their response/bid the
   modified covered inventory.
2. Bidder will provide EHS with pre-paid FedEx or UPS labels at Bidder’s expense
   for equipment shipping to Bidder’s depot location for repair submittal. The
   contracted vendor must pay for all shipping of repairs to and from facilities
3. Bidder will provide EHS with at least a seven (7) business day turnaround for
   depot repairs including overhauls from date of receipt. All major repairs must be
   completed within 7 business days or the repair is free. All minor repairs must be
   completed within 1 to 2 business days or repairs are free.
4. Bidder will provide bi-monthly on-site education to include care and handling to
   each department covered by the agreement.
5. The contracted vendor must supply loaners on-site at facilities. Bidder will
   provide serial number upon award for each loaner delivered to EHS. The
   contracted vendor must pay for shipping of loners to and from the facilities.
6. Does your company provide loaners for rigid endoscopes if our facilities do not
   have a scope requiring repair---they only need to utilize a loaner to ease the
   burden of a heavy case load? If so, please indicate if there are any fees.
7. Do you perform all of your own repairs? If not, please list the type of equipment
   and repairs that are outsourced as well as the names of the companies performing
   those repairs.


1. Bidder will be required to sign EHS Corporate Integrity Agreement.
2. Bidder must clear both OIG and GAS sanction checks for debarment.
3. Bidder will agree by responding to this RFP to Employee Non-Solicitation during
   the RFP process, contract negotiation, and within any contract.
4. Bidder will agree to a mutual term of an agreement with EHS not to exceed three
   consecutive years to include cancellation terms with a written notice period of
   thirty (30) days without cause.
5. The fixed monthly cost must be firm and fixed for the entire term of the contract.
6. The firm fixed monthly price must have the flexibility at any point in the contract
   to be lowered if equipment is removed.
7. The contracted vendor must allow the flexibility to add equipment at any point
   within the contracted time frame.
8. If the contracted vendor is not able to repair any of the contracted equipment the
   contracted vendor must pay for the repair to be sent to the O.E.M. unlimited
   amount of times.

                                     Page 9 of 20
   9. Bidder agrees to delivery terms of Free on Board (FOB Customer) to EHS with
       title transferring upon Acceptance as mutually defined within awarded agreement.
       Freight will be included in the repair cost and not allowed as a separate charge.
       Bidder will provide round trip transit insurance at no charge to EHS.
   10. Bidder will indemnify and defend EHS within a contract.
   11. Bidder will maintain insurance coverage at their expense for Comprehensive
       General Liability, Professional Liability, Auto Liability and Worker’s
       Compensation. Bidder will provide upon EHS request, copies of such liability
   12. This contract does not allow for any additional cost other then the firm fixed
       monthly payment submitted by vendor.


   1. Bidder will provide a minimum of a 120-day warranty for replaced parts.
   2. Bidder will provide a guarantee of workmanship written in terms & conditions, to
      include equipment functioning within manufactures specifications.
   3. Attach company’s policies or statement to address provider’s safe handling
      procedures and International Organization for Standardization’s 9000 quality
      management standards certification award and 14000 environmental management
      standards if certified.
   4. Bidder will warrant that all hardware, software and licenses including those that
      are operated with a Third Party Software will perform in all material respects in
      accordance with its documentation during the applicable Warranty Period or
      Support Services Agreements.

Bidder must answer the following questions in full and provide any necessary back-
up information, drawings, certificates, etc.:


   1. Which GPOs are you currently contracted with? List the term and devices
      covered for each.
   2. How much of your company’s current capacity does our organization represent?
   3. How much of your company’s current revenue does our organization represent?
   4. How many sales representatives are actively servicing hospitals in the field?
      (Please provide a list by territory)
   5. List your repair facilities and what devices are repaired at each.
   6. Do you own your repair facilities?
   7. Would you be willing to let us tour your repair facilities?
   8. What % of repairs do you outsource?


   1. Are repair history reports available on-line?

                                        Page 10 of 20
  2. Are repair history reports real time and available on-line twenty-four hours per
      day, seven days per week?
  3. Is there a limit to the number of users who can access this information on-line?
  4. Is there software or special hardware required for access?
  5. Does this allow for real time equipment checks to see where equipment is in the
      service process, 24 hours per day, 7 days per week on-line?
  6. Can we view each touch-point that our equipment experiences in real time on-
  7. Can we see repair detail on-line including both the damage observed and the
      repairs performed?
  8. Can we review and approve repair estimates on-line?
  9. Is pricing available as part of the above process?
  10. List the different ways information can be segmented. (Date, manufacturer,
      model, etc.)
  11. Can these reports be printed?
  12. Can these reports be exported directly in Excel?
  13. Can these reports be e-mailed?


  1. Please describe your educational programs, both off-site at provided at our
     facility, as well as any associated CEUs and fees.
  2. Please describe the expertise of the individuals providing such educational



  1. What are the required processes to maintain autoclavable properties of the scope?
  2. Describe your outgoing Quality Control process for rigid endoscopes, including
     equipment you use to test each scope and the function each piece of equipment
  3. If you provide upgrades on models you no longer repair, attach upgrade pricing.
  4. If you have tested your replacement parts and adhesives with STERIS®, please
     provide a copy of the final report. Please indicate the number of cycles your
     products have successfully completed testing.
  5. If you have tested your replacement parts with any other independent laboratories,
     please provide copies of the final reports
  6. Does your company utilize a laser welder (used for the repair of autoclavable rigid
     endoscopes)? If yes, please provide the name and model number of the laser
  7. Please indicate where your replacement parts are purchased, for the equipment
     listed in this RFP.

                                       Page 11 of 20
  8. Does your company utilize any used replacement parts? If yes, please indicate
      which parts and for which type of equipment.
  9. Does your company manufacture any replacement parts? If so, please list the type
      of parts.
  10. Is your company registered with the F.D.A.? If yes, please provide a company of
      the registration certificate.


  1. What tools do you employ to open the scope?


  1. Do you own the designs for model-specific replacement parts? Please attach an
     engineering drawing of an optics part you own the design for and indicate the
     model the part would be used to repair. You may remove quantitative data or
     intellectual property data from the drawings.
  2. How do you attach the shaft to the body?
  3. Describe how you assure proper illumination of a rigid endoscope.
  4. Describe your process for replicating the original design of a rolled distal end?


  1. Please attach your engineering drawings for an objective lens assembly for a Storz
     26046 B/A and a Stryker 30 degree 502-555-030. You may remove quantitative
     data or intellectual property data from the drawings.
  2. Describe the process you follow to install an objective assembly on an
     autoclavable Storz endoscope? Describe the process you follow to install a
     negative lens in an autoclavable Stryker rigid scope.
  3. How do you assure proper illumination?


  1. Provide level pricing for the repair of rigid endoscopes. Identify any and all
     potential additional fees or “add-ons”.
  2. Clearly define how any proposed volume discounts work, including any penalties
     for noncompliance.
  3. Provide full service annual pricing or any other pricing scenarios designed to
     reduce costs.
  4. Please describe any fees, overages, exclusions, or other variables which may
     affect our agreed upon price.


  1. Does your company offer a “Flat Fee Pricing” for rigid endoscope repairs? If yes,
     please indicate the amount.

                                      Page 12 of 20
   The flat fee price must include all types of rigid endoscopes including needle rigid
   scopes (small diameter scopes) and video rigid scopes. The only exception will
   be operating/offset laparoscopes. The flat fee pricing must be honored regardless
   of the extent of damage or the cause of damage.


1. Does your company offer a “Capped Pricing” (the maximum your company would
   charge) for rigid Endoscope repairs? If yes, please indicate the amount.
   The capped pricing must include all types of rigid endoscopes including needle
   rigid endoscopes (small diameter scopes) and video rigid endoscopes. The only
   exception will be operating/offset laparoscopes. The capped pricing must be
   honored regardless of the extent of damage or the cause of damage.


Level repair pricing will be used in conjunction with the capped pricing amount.
Meaning no Level Repair price can exceed the capped pricing listed above.

1. Please indicate your company’s price for each level of repair:

   Level A                                                  Price:___________

                i.   Disassemble scope
               ii.   Interior cleaning of scope
              iii.   Cleaning of lens system
              iv.    Optical adjustments
               v.    Optical and light fiber polishing
              vi.    Complete functional and soaking test

   Level B

                i. Includes all Level A repairs and         Price:_____________
               ii. Repair or replace objective lens

   Level C
                i. Includes all Level B repairs and         Price:______________
               ii. New tubing
              iii. New light fiber optics

2. Please indicate your company’s price for each item:

                i. Rod Lens                                 Price:_____________
               ii. Optical Window                           Price:_____________
              iii. Eyepiece                                 Price:_____________

                                       Page 13 of 20
3. Is there a surcharge for rigid video scopes? If yes, please indicate the price.
4. Is there a surcharge for rigid needle scopes? If yes, please indicate the price.
5. Please indicate the price to perform a Level A repair to an offset/operating
6. Please indicate the maximum price to refurbish an offset/operating laparoscope.
7. Does your company repair semi-rigid ureteroscopes? If yes, what is the maximum
   repair price?

                                   Page 14 of 20

                                         BEH SURGERY
  30        2.9mm     HYSTESCOPE (GYN)                            STORZ        2
  30                  CYSTOSCOPE (UROL)                           STORZ       13
  70                  CYSTOSCOPE (UROL)                           STORZ        9
   0         5mm      LAPAROSCOPE                                 STORZ       13
  30         5mm      LAPAROSCOPE                                 STORZ        6
  45         5mm      LAPAROSCOPE                                 STORZ        2
  45        10mm      LAPAROSCOPE                                 STORZ        2
  30        10mm      LAPAROSCOPE                                 STORZ        5
   0        10mm      LAPAROSCOPE                                 STORZ        6
  12                  SCOPES: SEE BELOW                           STORZ
                        HYSTEROSCOPE (GYN)                        STORZ        3
                        EXTRAS (GYN)                              STORZ        2
            10mm      LAPAROSCOPE                                 STORZ        3
  0                   CYSTOSCOPE (UROL) includes:                 STORZ        4
                        Resectoscope x 2
                        Visual Urethrotome x1
                        Extra x1
                      HD CAMERA                                   STORZ       14
                      RIGID URETEROSCOPE (UROL)                   WOLFE        3
                      FLEXIBLE URETEROSCOPE
                                                                ACMI CIRCON    4
   0                  DaVINCI (ROBOICS)                          INTUITIVE     2
  30                  DaVINCI (ROBOICS)                          INTUITIVE     2
  12                  NEPHOSCOPE (UROL)                            WOLFE       1
  25                  NEPHOSCOPE (UROL)                            WOLFE       1
                      FLEXIBLE CYSTOSCOPE (UROL)                ACMI CIRCON    2
                      FLEXIBLE CYSTOSCOPE (UROL)                   STORZ       1
                                          ENT SCOPES
   0                  SINUSCOPE                                                5
  30                  SINUSCOPE                                   STORZ        7
  70                  SINUSCOPE                                                7
  45                  SINUSCOPE                                                1
                                   ORTHO ARTHROSCOPES
  30                  ARTHROSCOPES                             SMITH NEPHEW    3
  70                  ARTHROSCOPES                             SMITH NEPHEW    1
                      CAMERAS                                  SMITH NEPHEW    3
                      GASTROSCOPE (GEN. SURG)                    OLYMPUS       2
                      BRONCHOSCOPE (GEN. SURG)                   OLYMPUS       2
                      COLONOSCOPE (GEN. SURG)                    OLYMPUS       1
                      CHOLEDOCHOSCOPE (GEN.
                      RIGID EVH (C - V SURG.)
  0         7mm                                                  GUIDANT       4
                       (Endovascular Vein Harvesting)

                                       Page 15 of 20
                                CHILDREN’S SURGERY
   0        4mm       SINUSCOPE                                  STORZ         6
  30        4mm       SINUSCOPE                                  STORZ         4
  70        4mm       SINUSCOPE                                  STORZ         5
   0        2mm       SINUSCOPE                                  STORZ         4
  30        2mm       SINUSCOPE                                  STORZ         3
  30                  BRONCHOSCOPE                                             3
   0                  BRONCHOSCOPE                                             1
   0                  BRONCHOSCOPE LONG                                        2
  30       2.9mm      LAPAROSCOPE                               STRYKER        2
   0        5mm       LAPAROSCOPE                            STORZ/STRYKER     4
  30        5mm       LAPAROSCOPE                            STORZ/STRYKER     2
   0       10mm       LAPAROSCOPE                            STORZ/STRYKER     3
  30       10mm       LAPAROSCOPE                            STORZ/STRYKER     4
           10mm       OPERATING SCOPE                        STORZ/STRYKER     5
  30        1mm       LAPAROSCOPE                                STORZ         2
  30       3.3mm      LAPAROSCOPE                                STORZ         2
                                   EAST SURGERY
  12                  HYSTERSCOPE                  2620FA        STORZ         2
  30                  HYSTERSCOPE                 26120BA        STORZ         9
  30                  CYSTOSCOPE                  27005BA        STORZ        10
  70                  CYSTOSCOPE                  27005CA        STORZ         9
   0        10mm      LAPAROSCOPE                 26003AA        STORZ         7
  30        10mm      LAPAROSCOPE                 26003BA        STORZ         2
            10mm      OPERATING SCOPE             26034AA        STORZ         6
   0         5mm      LAPAROSCOPE                 26046AA        STORZ        14
  30         5mm      LAPAROSCOPE                 26046BA        STORZ         2
                      CAMERAS                                    STORZ        12
   0         5mm      LAPAROSCOPE                  7207947   SMITH & NEPHEW    9
   0        10mm      LAPAROSCOPE                   8000     SMITH & NEPHEW    8
  30        10mm      LAPAROSCOPE                   8107     SMITH & NEPHEW    2
            10mm      OPERATING SCOPE             8912.431       WOLFE         2
  12                  HYSTERSCOPE                  M3-12A         ACMI         3
  30                  HYSTERSCOPE/CYSTO            M3-30A         ACMI         8
  70                  HYSTERSCOPE                  M3-70A         ACMI         4
  30        4mm       VIDEOARTHROSCOPE             7205922   SMITH & NEPHEW   11
  30        4mm       VIDEOARTHROSCOPE              3626     SMITH & NEPHEW    5
  70        4mm       VIDEOARTHROSCOPE              3628     SMITH & NEPHEW    7
  30       2.7mm      VIDEOARTHROSCOPE              4131     SMITH & NEPHEW    1
  30       2.7mm      VIDEOARTHROSCOPE              3632     SMITH & NEPHEW    2
  30       2.7mm      VIDEOARTHROSCOPE              3768     SMITH & NEPHEW    2
   0       10mm       LAPAROSCOPE                  7207944   SMITH & NEPHEW    6
   0        5mm       LAPAROSCOPE                  7207951   SMITH & NEPHEW    6
                      CAMERAHEAD                             SMITH & NEPHEW   22
                      SHAVER HANDPIECE            72200616   SMITH & NEPHEW   12

                                      Page 16 of 20
Purchasing Contact: Jeffrey A. Loy, Procurement Manager
                    (423) 778-4684 or email –

             Signature                                 Print


      Address                            City          State          Zip Code

                                     Page 17 of 20
                       Intent to Quote
                     RFP REF #0028-0910

            Please fax this document to the Attention of:

                          Katherine Davis
                         Bid Coordinator
                      Erlanger Health System
                        (423) 778-3726 Fax

Contact Person                                   Company

Address                                   City   State      Zip Code

Telephone                                 Email Address

                              Page 18 of 20
                          ERLANGER HEALTH SYSTEM
                       979 EAST THIRD STREET, SUITE 708
                            CHATTANOOGA, TN 37403


The following information is gathered for statistical use only:

1.     Type of Business:                (Check Appropriate)

       _______MANUFACTURING                _______DISTRIBUTION _______SERVICE

2.     List Specific Product Line(s):


3.     Type of Ownership:               (Check Appropriate)

        ______Male                                            ______Female

        _____White                                            ______African American

        ______Asian or Pacific Islander                       ______Hispanic

        ______American Indian or Alaskan Native               ______Small Business
        ______Socially & Economically Disadvantaged

        _____Minority Business                                _____Other: (Please Specify)


4.     Explain how you demonstrate your good faith commitment for equal opportunity
       for Minority Businesses (attach a detailed explanation).

                                           Page 19 of 20
        I, the undersigned, hereby certify that the foregoing statistical information and any
attachments hereto are true, accurate, and in accordance with the definitions set forth in
this request for proposal to the best of my knowledge, information and belief, and those
made on information and belief are believed to be true, accurate, and in accordance with
the definitions set forth in this request for proposal.

                                      Print Name:

CITY:                                                 STATE:
ZIP:                                                  PHONE:

For EHS use only:

                                          Page 20 of 20

Shared By:
Description: Scope and Limitation of Business Proposal document sample