Q999--CLEANING STERILIZER WASHERS -w/wd Base+4 POP 7/01/2026 - 6/30/2031

Form / Attachment / Pricing Sheet

This document is IRS Form W-9, Request for Taxpayer Identification Number and Certification. It is used by entities and individuals to provide their correct Taxpayer Identification Number (TIN) to a requester who is required to file an information return with the IRS. This form is not sent to the IRS; it is given directly to the requester.

• Part I: Taxpayer Identification Number (TIN): Requires the individual's or entity's name and TIN (Social Security Number, Individual Taxpayer Identification Number, or Employer Identification Number).
• Part II: Certification: Requires the individual or entity to certify that the TIN provided is correct, that they are not subject to backup withholding, that they are a U.S. citizen or other U.S. person, and that FATCA reporting exemptions are correct (if applicable).
• Lines 1-7: Collects identifying information such as name, business name, address, city, state, and ZIP code.
• Tax Classification: Requires specifying the federal tax classification (e.g., individual, C corporation, S corporation, partnership, LLC, trust/estate).
• Exemptions: Allows for reporting of exempt payee codes and FATCA reporting codes if applicable.

Bidders responding to a SAM.gov opportunity may be required to submit this form as part of their proposal or contract onboarding. It is crucial for vendors to accurately complete this form with their correct TIN and certifications to avoid potential issues such as backup withholding or delays in payment. The form ensures the government entity can correctly report payments made to the vendor to the IRS.

Form / Attachment / Pricing Sheet

This document, VA Form 10091, is a Vendor File Request Form used by the VA to gather essential payment data from vendors. It is used to establish or update vendor records for processing electronic payments in accordance with federal regulations.

• Request Type: New Vendor or Update Existing Vendor.
• VA Facility Information: For internal VA use (Station Number, Contact, Phone, Fax, Email).
• Payee/Vendor Information: Includes SAM.gov registration status, Unique Entity Identifier (UEI), EFT Indicator, SSN/TIN, NPI (for medical providers), Small Business status, Payee/Vendor Name, Doing Business As (DBA), Email, Phone, Current Address, and Previous Address (if changing).
• EFT/ACH Information: Requires Current Bank Name, 9-Digit Routing Number, Bank Account Number, and Account Type (Checking/Savings).
• Authorized Representative: Section for the name, title, and signature of the individual authorized to represent the vendor.

Vendors must complete and submit this form to register in the VA's financial system or to update their existing vendor information. Accurate completion is crucial for timely payment processing. If a vendor is new or not registered in SAM.gov, specific sections must be completed. For existing vendors registered in SAM.gov, banking changes must be made in SAM.gov, but other updates may require this form. Failure to provide accurate and matching information (especially with SAM.gov) can delay or prevent payment.

Form / Attachment / Pricing Sheet

This document is a "Vendor Information" form used to collect essential details about a vendor. It is required for vendors to be entered into the VA database and to do business with the Federal Government.

• Vendor Identification: Legal name, Doing Business As name, Tax Identification Number (TIN) or Social Security Number (SSN).
• Vendor Address: Physical and mailing addresses, including City, State, and Zip.
• Contact Information: Point of contact name, phone number, fax number, and email address.
• Contract Information: Details on existing contracts, including contract number, payment terms, beginning and expiration dates, FOB, and prompt payment discount.
• 1099 Indicator: Whether the vendor is eligible for a 1099 form.
• Business Type (FPDS): Classification as Small, Large, Outside VA, or Other Entities.
• Socioeconomic Group: Checkboxes for various categories including Small Disadvantaged Business, Veteran-Owned Small Business, Woman-Owned Small Business, Javits-Wagner-O'Day, Hubzone Small Business, Historically Black College & University/Minority Institute, and Veteran-Service Disabled.
• Purchase Card Acceptance: Whether the vendor accepts purchase cards.
• DUN and Bradstreet Number: Required for registration if the vendor does not have one.
• Central Contractor Registration (CCR): Confirmation of CCR registration status.
• Mandatory Registration Sites: Links to ePLS and Exclusions websites for final checks.

Vendors must complete this form accurately to be considered for opportunities and to be entered into the Federal Government's vendor database. Failure to complete the mandatory fields or meet registration requirements could result in administrative action and prevent doing business with the government.

Solicitation / RFP / RFQ

This solicitation is for the monthly cleaning of Sterilizer Washer #1 (S/N 1120185) and Washer #2 (S/N 1120200) located at the Phoenix VA Healthcare System. The service aims to prevent the buildup of debris that can compromise sterile medical procedures.

• Monthly cleaning of specified sterilizer washers.

• Contractor must provide all parts, travel, and labor.

• Services must be coordinated with the Contracting Officer’s Representative (COR).

• One-week advance notice is required before on-site services.

• Contractor must check in/out with Sterile Processing Service (SPS).

• Verify equipment functionality post-service.

• Deliver a Field Service Report (FSR) detailing service performed and results.

• The contract allows for the addition/removal of equipment and/or services.

• Contract Type: Firm Fixed Price

• Period of Performance: Base (07/01/2026 - 06/30/2027) with four Option Years extending to 06/30/2031.

• Place of Performance: Phoenix VA Healthcare System, Phoenix, AZ.

• NAICS Code: 811210 – Electronic and Precision Equipment Repair and Maintenance.

• Product/Service Code: J065 – Maintenance, Repair, and Rebuilding of Equipment – Medical, Dental, and Veterinary Equipment and Supplies.

• Offers are due by April 17, 2026, at 16:00 MST.

• Questions are due by March 30, 2026, at 14:00 MST.

• Offers must be submitted via email to jessica.brooks3@va.gov in PDF format.

• Evaluation will be based on Technical Approach, Experience, Price, Past Performance, and Required Documents.

• Award will be made to the most advantageous offer, considering both price and non-price factors (LPTA will not be used).

• This acquisition is set aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSB).

• Offerors must be certified and listed in the SBA certification database.

• Compliance with VAAR 852.219-73 and 852.219-75 is required.

• Offerors must submit VA Form 10091 and W-9 to the VA Financial Service Center.

• SAM registration is required.

• Specific certifications for personnel regarding chemical handling, infection control, and safety are required.

Solicitation / RFP / RFQ

This solicitation is for the cleaning of sterilizer washers. The Department of Veterans Affairs, Phoenix VA Healthcare System (PVAHCS), is seeking services for this requirement.

• The primary service required is the cleaning of sterilizer washers.

• Period of Performance: Base period begins July 1, 2026, with four option periods, extending through June 30, 2031.

• Response Date/Time/Zone: April 10, 2026, 16:00 Mountain Time, Denver, USA.

• The contracting office is located in zip code 85212.

• This opportunity is set aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSBC).

• Solicitation Number: 36C26226Q0498

• NAICS Code: 811310

• Product Service Code: Q999

• Place of Performance: Phoenix VA Healthcare System, 650 E. Indian School Road, Phoenix, AZ 85012.

• Contracting Office Address: NCO 22, Department of Veterans Affairs, 4135 S. Power Road, Mesa AZ 85212.

• Point of Contact: Jessica Brooks, Contract Specialist, jessica.brooks3@va.gov, 480-466-7940.