Brand Name or Equal Worksheet ( Salient Characteristics ) 1/21/2022 Brand Name Item: Essential/significant physical, functional, or performance characteristics. Tympanometer is a middle ear analyzer obtaining test results for Ipsilateral and contralateral acoustic reflexes in a screening and diagnostic mode as well as tympanograms and reflex decay. Three Eustachian tube function tests Ipsi and contra acoustic reflexes Reflex decay Reflex latency Optional high frequency probe tones (678, 800 and 1000Hz) Shoulder unit and probe indicator LED . Minimum requirements: Interacoustics Ver. 1 Diagnostic Impedance - Pricing Per VA Tympanometry Ipsi/ contra acoustic reflexes Reflex decay Intact TM ETF test Audiometric Insert Phone Probe extension cable 2 rechargeable lithium batteries 4 cavities (0.2, 0.5, 2 and 5cc) Ear tip kit USB cable Power supply & carrying case Charging stand and wall mount Suite software Report writing and Print Wizard report software Compatibility with NOAH Dimensions handheld unit Weight- Industry Standard Purpose used to analyze the status of the middle ear system Governing Body or Organization Complete generic identification Applicable model/make/catalog number 8016169 Interacoustics Ver. 1 Diagnostic Impedance Manufacturer name E3 Diagnostics - interacoustics Per VAAR 811.104 and 811.105, I certify the following regarding the above information: The salient characteristics listed above are essential to the Government s requirements. To my knowledge, the restrictions listed above will not limit the acquisition to an item peculiar to one manufacturer.
