**Memorandum of Agreement Between**

**\[Participating Activity Name\]**

**And**

**Department of Veterans Affairs Service and Distribution Center**

**For the Repair of Biomedical Equipment and Devices**

1.  **Purpose:** This agreement is established to identify those
    services and responsibilities of VA SDC and \[Participating Activity
    Name\] in the repair, shipping and billing of biomedical equipment
    and devices. This agreement allows \[Participating Activity Name\]
    to participate in VA SDC's repair programs, which provide fast
    turn-around times at the lowest costs possible with attention to
    customer needs.

2.  **Responsibilities:**

> A. \[Participating Activity Name\] will:

1)  Utilize VA SDC's repair services for endoscopic devices, surgical
    handpieces and accessories and dental handpieces as needed and
    providing the services delivered are of high quality and more cost
    effective than other agencies.

2)  Originate repair request documents that include:

    -   Any reference or work order numbers;

    -   Equipment model and serial numbers;

    -   Customer's complaint; item fault or failure;

    -   Estimated cost of repair; and

    -   include above documents with items shipped to VA SDC.

3)  Designate a contact person who has knowledge of the equipment and
    who will approve the repairs and payment.

4)  Return any loaner instruments provided in good working condition
    upon receipt of repaired items.

> B. VA SDC will:

1)  Upon receipt and evaluation of items, either repair to original
    Manufacturer's specifications or comparable condition based on
    customer complaint and estimated cost, or contact to discuss repair
    options and costs involved.

2)  Obtain verbal approval for minor repair charges to be billed on
    credit card and obtain verbal approval for any repairs over
    estimated cost or for major repairs by manufacturers.

3)  Provide payment to manufacturers for major repairs and bill
    \[Participating Activity Name and Specific Billing Information
    including Address/Phone/Fax Numbers, etc.\] for those repairs.

4)  Return repaired items to the designated location at \[Ship To
    Address that SDC will use to return items to Participating
    Activity\] via next business day Federal Express delivery with no
    premium transportation fees added.

5)  Provide \[Participating Activity Name and Specific Billing
    Information including Address/Phone/Fax Numbers, etc.\] upon request
    with any reports on repair status, repair costs, work performed,
    instrument repair history and shipment tracking.

6)  Provide loaner instruments upon availability at no additional cost
    and work as liaison between \[Participating Activity Name\] and
    manufacturers concerning major repairs.

7)  Provide ninety (90) days warranty on repairs performed in-house due
    to defects in parts or workmanship.

**3. Understanding:**

A.  It is understood that VA SDC will bill \[Participating Activity Name
    and Specific Billing Information including Address/Phone/Fax
    Numbers, etc.\] cardholder's Government credit card for all charges
    within their credit card limit, and that \[Participating Activity
    Name\] will provide purchase orders at the end of each fiscal
    quarter for the total of all charges in excess of the cardholder's
    limit during that fiscal quarter.

B.  It is understood that \[Participating Activity Name\] will report
    any on-going performance problems to VA SDC's Service and
    Reclamation Division Chief or Lead Biomedical Technician.

C.  It is expressly agreed that this written statement embodies the
    entire agreement of the parties regarding this relationship, and no
    other agreements exist between the parties except as herein set
    forth. Any changes or modifications to this agreement must be in
    writing and be signed by both parties.

**4. Effective Date:**

This agreement becomes effective upon completion of signatures of both
parties.

**5. Termination:**

> This agreement may be terminated without cause by either party with
> ninety (90) days written notice by registered mail.

**6. Approval:**

\[Name of Authorizing Official\] Date Michael A. Tyllas, Ph.D. Date

> \[Title of Authorizing Official\] Department of Veterans Affairs
>
> \[Participating Activity Name\] Office of Acquisition & Materiel
> Management
>
> Executive Director, Service and Distribution Center