Andhra Pradesh Medical Services & Infrastructure Development Corporation, plot no 9, survey no 49, IT Park, Mangalagiri, Guntur District

522503
Email: [email protected]
****
Cardiac and Neuroradiology Intervention and Therapeutic Services and Necessary Infrastructure in Government Hospitals Andhra Pradesh PPP Basis
Amendment No.3 dt:05.07.2018 to
Tender Notice No. 3.7/APMSIDC/Equipment /2018-19, Dated: 23.05.2018
Clarifications requested by the bidders during prebid meeting on 30.05.2018

Sl.no Page Clause Heading Tender requirements Bidder's request Bidder's request Bidder's request (M/s.Omini Health Care) Bidder's request Bidder's request Bidder's request Can be read as
No. no. (M/s.Siemens Healthcare Pvt Ltd.) (M/s. Philips India Ltd.,) (M/s.Sai Balaji Medimage) (M/s.Nagarjuna Hospitals) (M/s.Lakshmi Aarush Health
Care Pvt. Ltd.,)
1 45 1 Cathlab The CATH LAB machine should be FDA approved or Requested to amend to :The CATH LAB machine No Change
Machine & European CE marked. should be FDA approved AND European CE marked
Associated
Systems
Specificatio
ns
2 45 1 HF X- Cathlab Parameter Specification (Pulsed fluoroscopy should be Requested to amend to : Lower pulse will be better Pulsed fluroscopy & Cine -
Ray Machine & there with 3.75, 7.5,10,15,30 pulses) for lower dose to patient undergoing long time upto 30pps included.
Generat Associated procedures. Otherwise it will Lead to Radiation injury
or Systems to patient
Specificatio
ns
3 45 2 X-Ray Cathlab Parameter Specification ( Heat Capacity 1000KHU OR Requested to amend to :Heat Capacity 2.4MHU or Greater than or equal to 2
Tube Machine & 1500 KHU or 2MHU ) Greater (The Neuro coiling, gluing cases need very MHU.
Associated long fluoroscopy without break and Cases like
Systems additional Drug eluting stent requires complex lesion
Specificatio angioplasty. This need long fluoroscopy and high
ns capacity tube.)

4 45 3 Flat Cathlab Parameter Specification ( Pixel Active Area 19.8cm * 19.8 Requested to amend to : Pixel Active area should be No change
Panel Machine & cm) 25cmsX 25 cms or more (For better head coverage
Detector Associated and even 19.8X19.8 will not cover full head in lateral
Systems position of head)
Specificatio
ns
5 Also request to add the following No Change
features/specifications :
DSA for Neuro facility Without DSA bone shade
during Neuro procedure like coiling, will create very
bad image impression.
Also following tests are prescribed as tests that would
be requested from Government Hospitals to the
service provider Appendix -F needs DSA and Road
mapping.
a. Coaractation of Aorta Repair With Stent +
Aortoplasty
b. Coaractation of Aorta Repair Without Stent+
Aortoplasty
c. Renal Angioplasty
d. Peripheral Angioplasty - Additional Stent
6 Also request to add the following No Change
features/specifications :
Head to toe coverage Which helps to perform
Cardiac cases and Peripheral angiography procedure
which is specified in "The following tests are
prescribed as tests that would be requested from
Government Hospitals to the service provider
Appendix -F."_
7 Also request to add the following No Change
features/specifications :
Dose reduction package
Any Dose reduction software available with the
machine will help in less exposure to patient as
well to the doctor which is important during Long
range procedure like , Pacemaker implantation,
Neuro Coiling etc .

8 Also request to add the following Upto 30fps.

features/specifications :
Pulsed Cine with different frame rate 7.5 , 10, 15, 15
pulses per second (since it reduces the dose).

9 a. OPD and IP details of Cardiology Dept need to be Enclosed in Annexure

shared.

b. In Case of any delay in the reimbursement by more No Change

than a month needs to be compensated along with
bank Interest of 8%.
Sl.no Page Clause Heading Tender requirements Bidder's request Bidder's request Bidder's request (M/s.Omini Health Care) Bidder's request Bidder's request Bidder's request Can be read as
No. no. (M/s.Siemens Healthcare Pvt Ltd.) (M/s. Philips India Ltd.,) (M/s.Sai Balaji Medimage) (M/s.Nagarjuna Hospitals) (M/s.Lakshmi Aarush Health
Care Pvt. Ltd.,)
c. Individual zone bidding should be allowed and Bank Individual Zone bidding is
Guarantee needs to be changed allowed with EMD of Rs.10
lakhs,(for one zone or all
zones) to be paid in online only
and Performance Security in
shape of Bank Guarantee of
Rs.3 Crs for each zone. The
bidder may bid for a single
Cathlab also and in that case
the selection shall be on per
location basis as per financial
bid format.

45 1 HF X- Cathlab 1. HF X-Ray Generator Output Power 100KW mA Output Output Power should be between 80 No Change
Ray Machine & 1000mA at 100KV to 100 KW (Here mA output is more
Generat Associated important. Our Cath lab can deliver
or Systems 1000 mA output with 80 KW at 80 KV
Specificatio only. 80 KW at 80 KV is standard in
ns India and is more than sufficient.)

45 2 X-Ray Cathlab 2. X-Ray Tube Focus 0.3/1.0mm OR 0.6/1.0 mm X-Ray Tube Focus should be 0.6 or No Change
Tube Machine & lower /1.2 mm or more (To cover a
Associated moving body (Heart/complex
Systems anatomy) you need a bigger focus.
Specificatio Even for peripheral cases you require
ns a bigger focus. This amendment shall
include bigger focus machines too.)

45 Image Cathlab Image Acquisition System While you are asking for all the tools No Change
Acquisiti Machine & in Image Acquisition, one most
on Associated important tool 'Live/online Stent
System Systems Enhancement' is missing. Kindly add
Specificatio 'Live stent enhancement' tool in the
ns list('Live Stent Enhancement' is one of
the most critical tools as it will help the
doctors position the stent better and
ensure that the same patient does not
have to come back due to stent
placement issues.)

4. Image Acquisition System Multi Frame display 4/9/16 You are asking for only 3 Frames. Changed to multi frame display
frame The system should have minimum 4 of 2,4,8,12.5 15,25,30 fps
or more magnification modes. (This
will enhance the view of fine
capillaries during coronary cases.)

5. Mechanical Specifications L=0° LAO 90° RAO 90°, Kindly delete this specification (For No change
CRA 45°, CAU 45° Range of L-Arm Movement -90° any fixed system, this L-Arm
/0°/+90° movement is not required.)

12 21 Point Section V 1. The Bidder shall be a sole provider Whether in consortium all consortium The Bidder may be a sole
No.1. Eligibility (Company/Society/Trust) or a group of companies members should have technical experience Bidder or a group of
Criteria (maximum3) coming together as Consortium to implement OR tech experience of one of the members is companies (maximum3)
the Project. The Lead Member in case of Consortium enough.. coming together as Consortium
should have at least 51% stake of the consortium and must Consortium is for financial stability and who to implement the Project,
also have all legal liabilities. The bidder cannot be an finances will generally be the lead member. however
individual or group of individuals. The Service provider the Bidder / the Lead member
should be registered as a legal entity such as company of the consortium shall have a
registered under Companies Act, Societies Registration minimum of three years of
Act, Trust Act or an equivalent law applicable in the experience in carrying out
region/state/ country. A bidder cannot bid as a sole similar type of assignment /
provider as well as a partner in a consortium. No bidder service in private or public
can place more than one bid in any form. In support of this, sector.
the bidder’s letter shall be submitted as per proforma in The financial criteria can be
Appendix ‘B’. collectively met by all members
of consortium together.
Sl.no Page Clause Heading Tender requirements Bidder's request Bidder's request Bidder's request (M/s.Omini Health Care) Bidder's request Bidder's request Bidder's request Can be read as
No. no. (M/s.Siemens Healthcare Pvt Ltd.) (M/s. Philips India Ltd.,) (M/s.Sai Balaji Medimage) (M/s.Nagarjuna Hospitals) (M/s.Lakshmi Aarush Health
Care Pvt. Ltd.,)
15 21 3 The Bidder shall have at least five Cathlab Service Centers 5000 procedures are from over all centers per Consortium shall have at least One Please request to make it 2 cath Please give Opportunity for The Bidder shall have at least
(with fully trained service personnel) and provides reports annum in INDIA or individual center’s working Cath Lab Service Centre with fully labs with fully trained personal people even with one Cath Lab five Cathlab Service Centers
for a minimum of 5000 procedures trained service personnel and provides and minimum 2000 procedures to with enough exposure and good (with fully trained service
per annum in one of more States of India. reports for a minimum of 1500 procedures be done: as 5 cath labs are not track record. Please encourage personnel) and provides
per annum - Five Cath Labs are not their owned by any hospital in the new start-ups as per the idea of reports for a minimum of 5000
for any hospital in New Andhra Pradesh. state of Andhra Pradesh. Hon'ble Chief Minister. procedures
Kindly encourage the local per annum in one of more
hospitals States of India.
However, in case of single
location bid, an eligibility of one
center with 1000 procedures
per annum is adequate.

17 24 Point Other New Installation & continuation: The service provider shall 120 days for commissioning Cath Lab facility is No Change
No. 11-C Terms & commission the Cathlab facility within 120 days of the too short a time. Minimum 6 to 9 months is
Conditions signing of the contract by both parties. In case of required as the entire set up has to be done.
continuation of the service provider for the subsequent (includes interiors, procurement of Machinery,
contract period, this time period shall not be valid. installation of the equipment etc.,)

19 Other Any assured no of cases by the Authority on The service is permitted to

Suggetions monthly basis. take open cases, Govt shall
reimburse for NTRVST and
Aarogya Raksha beneficiaries.

21 Page Point a) The Project will be awarded for a period of 10 years and Space provision facilities, at which locations Space shall be provided.
No-24 No.11-a. the Service Provider will be obliged to establish, manage will be provided by authorities.
and operate the Project in accordance with the provisions
of a Contract Agreement and terms and conditions therein.
24 Page Point Performanc a) The successful bidder shall furnish a performance Rs.3.0 Cr towards performance security is 1. EMD of Rs. 2 lakh per Cath
No-22 No.3-a. e Security security in the shape of a Demand Draft/Bank Guarantee mentioned. The set up cost is more than location and 2. Performance
issued by a Nationalised Bank in favour of Contracting Rs.10.0 Cr per each center. Hence EMD may bank guarantee of Rs. 25 lakhs
Authority for an amount of Rs. 3 Crores. The Bank kindly be converted to performance security. per Cath location.
guarantee shall be as per proforma at “Appendix G” and 3. Bidder shall have a
remain valid for a period, which is six months beyond the minimum tunover of 1 Cr/ cath
date of expiry of the contract. This shall be submitted within site and minimum turnover of
15 days (minimum) of receiving of Notice for Award of 10 Cr/all cath locations bidding
Contract, failing which the EMD may be forfeited and the would be evaluated on per
contract may be cancelled. financial year basis of previous
3 financial years.

26 Page Point b) The Authority may provide the required space, for Is lease amount included in monthly facility Lease amount is to be included
No-24 No.11-b. establishing the Project. A lease agreement shall be service charges OR is additional in monthly facility service
enforced for the full term of the contract at value and terms charges.
declared by the authority. A Possession Certificate in plain
paper shall be issued while handing over the above
mentioned space. In case the authority is unable to provide
the space; the service provider may carry these services at
its owned/rented/leased space or partner with an already
existing Cathlab facility near the hospital. In any of these
cases refurbished Cathlab machine is not allowed.
Sl.no Page Clause Heading Tender requirements Bidder's request Bidder's request Bidder's request (M/s.Omini Health Care) Bidder's request Bidder's request Bidder's request Can be read as
No. no. (M/s.Siemens Healthcare Pvt Ltd.) (M/s. Philips India Ltd.,) (M/s.Sai Balaji Medimage) (M/s.Nagarjuna Hospitals) (M/s.Lakshmi Aarush Health
Care Pvt. Ltd.,)
29 Page p) Annual review of performance and observance of terms Is provision of Cardiologist is necessary, when Service provider needs to
No-26 & conditions including quality of tests shall be carried out HOD of Cardiology is available in the particular provide all human resource
–p& by a committee which shall include Medical center. needed to operate Cathlab as
Page Superintendent, HOD of Cardiology ( Where available ) & per Regulations and
No-29 Head of department of Radio diagnosis of Government Standards.
Hospitals along with other members nominated by the
authority. The report of this annual review shall form the
basis for extension of the contract annually within the
contract period.

31 Page NTRVST Package prices provided by the NTRVST package prices

No-28 Authority are an example OR service provider provided by authority are fixed
has to abide by NTRVST. Single price is asked prices should charge by
in the price bid. Is it for all the procedures put service provider to Authority
together or the package prices are separate and additional to that selection
and we only have to quote Lease amount. of service provider would
depends on monthly facility
service charges to the hospital.

33 Page Point No. What is the meaning of monthly facility Monthly facility charges should
No-26 q. charges? (Lease amount + any other be quoted by service provider
charges.??) as per financial bid.

36 Working units to be reduce to 1 instead of 5. Single location bidding is

permitted.

Instead of quoting zone wise can we quote for Yes

individual location
37 1. Kindly consider individual place Yes
tendering as it is easy to give round the
clock super specialty services
38 2. Kindly allocate a rate for Angiograms as As per NTRVST.
it includes expenditure.
39 4. The Principal Bidder shoulder be a No change
Share Holder or Director Multi Specialty
Hospital for a minimum of 15 years, with
minimum of 100 Beds.
40 27 Appendix - Annexure-1 Logistically it is difficult to have cathlabs at Re organization of Zones to make Please reorganise into smaller Single location bidding is
A District Hospitals as there is no functioning it logistically viable. zones or Allow individual permitted.
radiology departments to refer patients or ZONE I : bidders
for post cath care 1. GGH Kurnool
Request to remove RIMS & DH's and club 2. GGH Ananthapur
with GGH in head quarters for better 3. RIMS H Kadapa
management of patients & round the clock
care and Re Otganize the Zones as ZONE II:
follows: 1. DSR GGH Nellore
ZONE I : 2. SVVRRGGH Tirupathi
1. GGH Kurnool 3. RIMS H Ongole
2. GGH Ananthapur
3. RIMS H Kadapa ZONE III:
1. GGH Guntur
ZONE II: 2. GGH Vijayawada
1. DSR GGH Nellore 3. DH Eluru
2. SVVRRGGH Tirupathi
3. RIMS H Ongole ZONE IV:
1. GGH Kakinada
ZONE III: 2. KGH Visakhapatnam
1. GGH Guntur
2. GGH Vijayawada ZONE V:
1. DH Vizianagaram
ZONE IV: 2. RIMS H Srikakulam
1. GGH Kakinada
2. KGH Visakhapatnam
Sl.no Page Clause Heading Tender requirements Bidder's request Bidder's request Bidder's request (M/s.Omini Health Care) Bidder's request Bidder's request Bidder's request Can be read as
No. no. (M/s.Siemens Healthcare Pvt Ltd.) (M/s. Philips India Ltd.,) (M/s.Sai Balaji Medimage) (M/s.Nagarjuna Hospitals) (M/s.Lakshmi Aarush Health
Care Pvt. Ltd.,)
Bidders to have 5 cath labs with fully trained personnel and Interms of number of Cathlabs
minimum 5000 procedures to be done as eligibility the following is
required . 1.
One Cathlab bid - 1 existing
(as eligibility)
2. Two Cathlab bid - 2 existing
(as eligibility )
3. Three cathlab bid - 3
existing (as eligibility)
4. Four Cathlab bid - 4 existing
(as eligibility )
5. Five to thirteen (5-13)
Cathlab bid - 1 existing (as
eligibility ) .
Requirement of existing
Cathlab is equal to the No. of
locations, a bidder is bidding
with 1000 angios/annum/per
such location.
However, for bidder bidding for
Consortium shall have at least One
all 13 locations an existing 5
working Cath Lab Service Centre with
Cathlabs is adequate.
fully trained service personnel and
provides reports for a minimum of 1500
procedures per annum.
After Successful Installation, The Contracting Authority will
commissioning and satisfactory release the Performance
performance for a period of two years from Security without any interest to
the date of commissioning the the successful bidder on
performance guarantee can be released. successful completion of
contractual obligations.

What in Appendix B and Appendix C- You In Appendix - B you need to

mean to say manufactures of Cath Lab get a letter from the
need not have to fulfil other eligibility critiria manufacturer.
(or) we need to get a letter from suppliers In Appendix - C you need to
of equipment. fillup as per eligibility criteria
with documentary evidence
attached, in original.

Any minimum guarantee for no of cases Not Possible

at DH & RIMS as the investment is high.
Request removal of DH & RIMS cathlabs
and offer OP & Services and send to GGH Not Possible
for higher interventions for better
functioning and safety of the patient.

34 What is Ment by monthly facility service Service provider should quote

charges to the hospital. the monthly service charges as
per location basis.
Is it rent for space provided or What it
includes (if much space will be given).
Angiograms are done in large volumes Request a suitable rate for Angiograms are the Diagnostic
Please include a rate for Angiograms Angiograms to be included. procedure not the Surgical
intervention, however these
angigrams are the part of the
packages included in the
interventional procedures.
Refer to Financial Bid-
Appendix - F
The service provider has to fill the Both, machinery and staff.
remaining gaps Service provider shall pay for
Is it for machinery or for faculty also. If so, the same.
who has to pay for staff.
In Non teaching Hospitals without CTVS Service provider shall use the
how will we function. resources from the near by
hospitals
Sl.no Page Clause Heading Tender requirements Bidder's request Bidder's request Bidder's request (M/s.Omini Health Care) Bidder's request Bidder's request Bidder's request Can be read as
No. no. (M/s.Siemens Healthcare Pvt Ltd.) (M/s. Philips India Ltd.,) (M/s.Sai Balaji Medimage) (M/s.Nagarjuna Hospitals) (M/s.Lakshmi Aarush Health
Care Pvt. Ltd.,)
One Teaching Hospital GGH Referels are subject to patient
Guntur is given. What voulume and hospital choice. Could not
will work for remaining 3 Hospitals amend it.
Request amendment to :
Request to refer cases from
Ongole to Guntur and Eluru to
Vijayawada to make the project
more successful.

Bank guarantee period, is it for No Change

15 months:
Time to submission of Bank
Guarantee to be extended from
15 to 45 days as now banks are
taking more time for sanction of
submits.
Payment clarifications for NTRVS NTRVST packages are fixed
and remaining patients. even for direct walk in patients.

What is the role in Vijayawada for No Change

PPP model
Request you to separate these Not Possible
hospitals from this tenders and
call for a separate tenders for
those hospitals with different
packages including the OPD
Servces to establish the
departemnt.
We strongly feel the necessity of Medical and technical
Cardiac OT with required Medical manpower are the part of
and Technical Manpower in the service provider human
same setup. Hence, Please resources and staffing required
consider the same. to be provided.

In Zonal based Divisions non Patients having insurance are

Cardiology teaching Hospitals free to choose any hospital, for
where department is no which Govt shall reimburse
funcioning are added. In those NTRVST and Aarogya Raksha
Hospitals who is going to rates.
manage and refer patients for
Interventions and emergencies?

Remarks: Cath lab shall be started only in those hospitals where there is a Cardiac OT. The list of Cardiac OT's is attached.
Remarks: Preference for products locally manufuactured is valid as per DIPP, Govt. of India - Preferrential Market Access Notification
 Availability of Cardiac OT to be filled by APMSIDC
S. No. Location Qty Cardiac OT
1 GGH Kurnool 1 Available
2 GGH Anantpuramu 1 Not Available
3 RIMS H Kadapa 1 Not Available
4 DSR GGH Nellore 1 Not Available
5 SVVRRGGH Tirupathi 1 Not Available
6 RIMS H Ongole 1 Not Available
7 GGH Guntur 1 Available
8 GGH Vijayawada 1 Not Available
9 DH Eluru 1 Not Available
10 GGH Kakinada 1 Not Available
11 KGH Visakhapatnam 1 Available
12 DH Vizianagaram 1 Not Available
13 RIMS H Srikakulam 1 Not Available