B.1 Price/Cost Schedule - Veterans Affairs



Amendment A00002: The purpose of this amendment is as follows:Extend solicitation close date from October 13, 2105 11:00AM (EST) to October 27, 2015 11:00AM (EST).Change Performance Period as follows: Base Year From: 11-13-2015 thru 11-12-2016 Base Year To: 11-20-2015 thru 11-19-2016 Option 1 From: 11-13-2016 thru 11-12-2017Option 1 To: 11-20-2016 thru 11-19-2017Change Delivery of Offers (Attachment A). Please see changes below.The Delivery of Offers information in Attachment A is changed from:Delivery of Offers: All Prospective Offerors are required to deliver by mail or hand carry their complete offer directly to Ms. Rosa I. Rivera or Daniel Pontoriero, Contracting Officer at the address listed below no later than the solicitation date posted in block 8 of the solicitation - 1449). In addition, all offerors shall electronically submit the same to rosa.rivera3@ prior to solicitation closing date and time.Delivery Address:Rosa I. Rivera, Contracting OfficerDepartment of Veterans Affairs Orlando Veterans Affairs Medical Center (OVAMC)Contracting Office 2500 Lake Mont Ave (Room 210)Orlando, FL 32814Contracting Supervisor: Daniel Pontoriero Department of Veterans Affairs Orlando Veterans Affairs Medical Center (OVAMC) Contracting Office 2500 Lake Mont Ave (Room 210) Orlando, FL 32814 Daniel.ponotriero@ Tel: (407) 646-4312Offerors are encouraged to use a delivery tracking method to ensure that their package is delivered to the contracting officer prior to solicitation closing. Offeror’s may e-mail rosa.rivera3@ to confirm receipt of offer/package. The Government will not provide any reimbursement for the cost of developing, presenting or delivering quotations in response to this RFQ. Submit all questions by: Thursday, September 17, 2015, 11:00 AM (EST) via e-mail to rosa.rivera3@.The Delivery of Offers information in Attachment A is changed to:Delivery of Offers: All Prospective Offerors are required to deliver by mail or hand carry their complete offer directly to Mr. J. Braden Smith, Contracting Officer at the address listed below no later than the solicitation date posted in block 8 of the solicitation - 1449). In addition, all offerors shall submit a CD containing their offer. The CD-ROM shall mirror the hard copy files. Acceptable format is either Adobe Acrobat XI or higher or MS Word 2010 or higher.Delivery Address:J. Braden Smith, Contracting OfficerDepartment of Veterans Affairs Contracting Office, Ste. 525 8875 Hidden River ParkwayTampa, FL 33637Braden.Smith@Tel: (813) 972-2000 Ext.7463Contracting Supervisor: Afanador, Adalberto Department of Veterans Affairs Contracting Office, Prosthetics 8900 Grand Oak Circle Suite 2A Tampa, FL 33637 Adalberto.Afanador@ Tel: (813) 903-4404Offerors are encouraged to use a delivery tracking method to ensure that their package is delivered to the contracting officer prior to solicitation closing. Offeror’s may e-mail rosa.rivera3@ to confirm receipt of offer/package. The Government will not provide any reimbursement for the cost of developing, presenting or delivering quotations in response to this RFQ. Submit all questions by: Thursday, September 17, 2015, 11:00 AM (EST) via e-mail to Braden.Smith@. Past Performance Surveys submissionSubmit past performance surveys to Braden.Smith@. Survey submitted to Rosa Rivera (rosa.rivera3@) prior to this amendment will be forwarded to Branden Smith. Line Item Add for portable liquid oxygen (see attached schedule)Respond to Vendor questions. The questions below are posted as written by vendor(s)Questions and Answers (PT2) Question #16: Attachment A – Instructions to Offers states: Delivery of Offers: All Prospective Offerors are required to deliver by mail or hand carry their complete offer directly to Ms. Rosa I. Rivera or Daniel Pontoriero, Contracting Officer at the address listed below no later than the solicitation date posted in block 8 of the solicitation - 1449). In addition, all offerors shall electronically submit the same to rosa.rivera3@ prior to solicitation closing date and time. The proposal documents will be very large considering all the items that are being requested. Therefore being able to electronically submit the same will be impossible. Please consider ernment Response #16: Electronic files are required. Offerors may submit electronic copies via multiple e-mails. Include the number of the submission to help track the submission. For example: VA248-15-Q-1560 Technical – Air Paradise Inc.- #1…#2….#3… Vendor Follow-up Question #38: Perhaps the question wasn’t asked properly. With the amount of data you are requesting contractors to provide in our proposals, submitting to you in an email, or multiple emails will be gigabytes of information. Most email servers allow 10 megabytes per email. I don’t think your office wants to receive hundreds of emails per contractor. Would you accept a thumb drive of our proposal documents in addition to the hard copy? That is considered an electronic ernment Response #38: In addition to the hard copies, submit CD-ROM with copies of all documents. The CD-ROM shall mirror the hard copy files. Acceptable format is either Adobe Acrobat XI or higher or MS Word 2010 or higher.*********************************************************************************Question #24: CLIN 0025: RCP Visits for delivery, initial set-up and evaluation of ventilator and/or Tracheostomy patients. The estimated quantities are listed as 4 per month, or 48 for the year. Is the unit price you are requesting our per visit price? Or are you looking for a per set-up price? RCP visits for the initial ventilator set up can be from 14-16 visits in the first month. If you are looking for a per set-up price I suggest you have a separate line item for ventilator set-up and a separate line item for Tracheostomy set-up. Ventilator set-ups are much more ernment Response #24: 0025- Includes ALL new setups. The contractor shall follow The Joint Commission standards applicable to Home ventilator equipment setup.Question #31: Reference SOW 2.11 much information is provided regarding ventilator set-ups. However hardly no information given regarding tracheostomy set-ups. Please provideGovernment Response #31: Contractor shall follow The Joint Commission standards of care.Vendor Follow-up Question #39: I posted these 2 questions and answers together since they are related. Joint Commission doesn’t state the number of RCP visits for a new patient set-up on a ventilator. Since CLIN 0025, as you state “Includes ALL new set-ups”, please provide the exact number of RCP visits we should include in a set-up. Is it based on 1 visit? 15 visits? This line item is not clear and contractors need to know exact quantities instead of guessing what the VA might or might not order. Or, if you can’t provide how many RCP visits are going to be included in a new patient ventilator set-up, consider revising the CLIN to read per RCP visit for new ventilator set-ernment Response #39: Reference 2.11.e; 2.11. Special Requirements/Special Services for Mechanical Ventilatorsrequired visitation schedule for home visitation after initial ventilator set-up is daily visits for a week then weekly visits X three then monthly visits.***********************************************************************************Question #27: What are the medical criteria established for accepting a home ventilator patient? The policy varies from company to company with these written criteria for safety reasons. An example of this is the patient’s FIO2 must be less than 40%, stable trach and patient. The patient will need caregiver support based on patient ernment Response #27: Medically stable patient with a secure artificial airway, be adequately oxygenated at less than an FIO2 40%, and able to maintain adequate ventilation on standard ventilator settings.Vendor Follow-up Question #40: Who makes this determination? The VA or the contractor?Government Response #40: The Contractor. Reference 2.11.a & b;2.11. Special Requirements/Special Services for Mechanical Ventilators. a. Once a veteran is identified as a candidate for home ventilation the contractor shall receive an order for the contractor’s Respiratory Care Practitioner (RCP) to perform a home inspection of the veteran's residence. This inspection will review; electrical capacity, physical space, cleaning and toilet facilities to determine ability to provide for veteran's needs upon discharge.b. OVAMC COR will provide information to contractor as requested so that contractor can make a recommendation and provide rational for accepting or declining the veteran into their home ventilator program. If the contractor declines the case, the government reserves the right to hire another provider to service the veteran.*************************************************************************************Question #28: OVAMC will provide a checklist for caregiver training which the contractor shall assist with completing. What does the checklist consist of? Government Response #28: CLIN 0010: Liquid Oxygen System (90-100 lbs.) Rental. Include delivery and set-up, stationary reservoir, portable container, humidifier, flow meter, refill adapter, contents gauge, cannulas and/or tubing and disposables. Vendor Follow-Up Question #41: The answer provided here does not answer the question. Very ernment Response #41: Checklist consists of pre-deliver checks, home evaluation, and other requirement. Checklist to be provided after contract award.Vendor Follow-up Question #42: On a related note, the list of questions goes from #28 to #30. Looks like Question #29 was skipped or left out or something, please clarify.Question #29: Some patients have more than 5 portables prescribed, how would we bill for more than 1? Government Government Response #42: See line item 0011 for portable liquid oxygen quantities.*************************************************************************************Vendor Follow-up Question #43: I’m sure we have all seen now that there has been a GAO protest to this solicitation. Will you be putting the proposal due date on indefinite hold until the protest is resolved?Government Response #43: No, offerors will be advised by procurement officer of changes in the procurement timeline. *************************************************************************************Question #33: The Past Performance Evaluation Ratings are very vague and confusing. It almost appears that someone with no past performance would be considered acceptable. Government Response#33: Past Performance Evaluation is in compliance with Federal Acquisition Regulation Part 42 and Agency Procurement Manual. More information on past performance can be found at .Question #34: This contract requires providing Home Oxygen Services for more than 1200 Veterans of the Orlando VAMC. For the reference information provided on the questionnaires, how many patients must we show for the government to have a reasonable expectation that the offeror will successfully perform the required effort? Government Response #34: Past performance shall be evaluated as stated in RFQ.Question #35: This contract requires providing Home Oxygen Services for more than 1200 Veterans of the Orlando VAMC. Please provide a list of the specific services you want to see in our reference information provided on the questionnaires we have provided for the government to have a reasonable expectation that the offeror will successfully perform the required effort?Government Response #35: Past performance shall be evaluated as stated in RFQ.Vendor Questions 33 through 35: (pertain to the questions below) Vendor Follow-up Question #44: Far Part 42 is provided below: which particular subsection of Far Part 42 are your referring to? And by stating this in your answer, is this now becoming a part of the solicitation?Government Response #44: FAR Part 42.15 offers information on Contractor Past Performance.Vendor Follow-up Question #45: Please provide a copy of Agency Procurement Manual since you reference this is your answer so all contractors are understanding your requirement. Government Response #45: NoVendor Follow-up Question #46: Upon visiting , it appears this system is set up for contracting officers to enter into ppirs the past performance information of contractors performing government contracts. I’m unclear why you sent contractors to this website. Please clarify what information contractors can gain from going to this website to further understand the past performance evaluation factors in your ernment Response #46: is for information purpose and offers valuable information for all. Peruse all areas to include “Guidance” where you will find pertinent information.Vendor Follow-up Question #47: Your answers to questions 34 and 35 were the same “Past Performance shall be evaluated as stated in the RFQ.” Perhaps the questions weren’t written properly; what contractors want to know is this: If we submit no past performance surveys, will we be found acceptable?Government Response #47: Past Performance will be evaluated in accordance with FAR 52.212-2, Evaluation. Offerors with no past performance are required to submit at least one completed past performance survey indicating that they have no past performance.Vendor Follow-up Question #48: There are multiple areas in the Statement of Work the contractors will be required to perform, are we required to have 4 years of experience in each area? For example, concentrators, ventilators, tracheostomy, etc…?Government Response #48: Yes, Offerors shall meet S.O.W. requirements.Part 42-Contract Administration and Audit Services42.000 Scope of part.42.001 [Reserved]42.002 Interagency agreements.42.003 Cognizant Federal agency.Subpart 42.1-Contract Audit Services42.101 Contract audit responsibilities.42.102 Assignment of contract audit services.42.103 Contract audit services directory.Subpart 42.2-Contract Administration Services42.201 Contract administration responsibilities.42.202 Assignment of contract administration.42.203 Contract administration services directory.Subpart 42.3-Contract Administration Office Functions42.301 General.42.302 Contract administration functions.Subpart 42.4-Correspondence and Visits42.401 Contract correspondence.42.402 Visits to contractors’ facilities.42.403 Evaluation of contract administration offices.Subpart 42.5-Postaward Orientation42.500 Scope of subpart.42.501 General.42.502 Selecting contracts for postaward orientation.42.503 Postaward conferences.42.503-1 Postaward conference arrangements.42.503-2 Postaward conference procedure.42.503-3 Postaward conference report.42.504 Postaward letters.42.505 Postaward subcontractor conferences.Subpart 42.6-Corporate Administrative Contracting Officer42.601 General.42.602 Assignment and location.42.603 Responsibilities.Subpart 42.7-Indirect Cost Rates42.700 Scope of subpart.42.701 Definition.42.702 Purpose.42.703 General.42.703-1 Policy.42.703-2 Certificate of indirect costs.42.704 Billing rates.42.705 Final indirect cost rates.42.705-1 Contracting officer determination procedure.42.705-2 Auditor determination procedure.42.705-3 Educational institutions.42.705-4 State and local governments.42.705-5 Nonprofit organizations other than educational and state and local governments.42.706 Distribution of documents.42.707 Cost-sharing rates and limitations on indirect cost rates.42.708 Quick-closeout procedure.42.709 Scope.42.709-1 General.42.709-2 Responsibilities.42.709-3 Assessing the penalty.42.709-4 Computing interest.42.709-5 Waiver of the penalty.42.709-6 Contract clause.Subpart 42.8-Disallowance of Costs42.800 Scope of subpart.42.801 Notice of intent to disallow costs.42.802 Contract clause.42.803 Disallowing costs after incurrence.Subpart 42.9-Bankruptcy42.900 Scope of subpart.42.901 General.42.902 Procedures.42.903 Solicitation provision and contract clause.Subpart 42.10-[Reserved]Subpart 42.11-Production Surveillance and Reporting42.1101 General.42.1102 Applicability.42.1103 Policy.42.1104 Surveillance requirements.42.1105 Assignment of criticality designator.42.1106 Reporting requirements.42.1107 Contract clause.Subpart 42.12-Novation and Change-of-Name Agreements42.1200 Scope of subpart.42.1201 [Reserved]42.1202 Responsibility for executing agreements.42.1203 Processing agreements.42.1204 Applicability of novation agreements.42.1205 Agreement to recognize contractor’s change of name.Subpart 42.13-Suspension of Work, Stop-Work Orders, and Government Delay of Work42.1301 General.42.1302 Suspension of work.42.1303 Stop-work orders.42.1304 Government delay of work.42.1305 Contract clauses.Subpart 42.14-[Reserved]Subpart 42.15-Contractor Performance Information42.1500 Scope of subpart.42.1501 General.42.1502 Policy.42.1503 Procedures.Subpart 42.16-Small Business Contract Administration42.1601 General.Subpart 42.17-Forward Pricing Rate Agreements42.1701 Procedures.B.1 Price/Cost ScheduleItem InformationITEM NUMBERDESCRIPTION OF SUPPLIES/SERVICESQUANTITYUNITUNIT PRICEAMOUNT0001Liquid Oxygen (6,600 lbs X 12 months = 79,200 lbs.)VA No. HCPC code E00439Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201679,200.00LB____________________________________0002Tank Rental (monthly) inclusive of consumable supplies for portable system, “E” or “B” size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and all disposable supplies. (9300 ea X 12 months = 111,600 ea)VA No. HCPC code E0431Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016111,600.00EA____________________________________0003Refill cylinders, size “B” for portable systems, aluminum (or metal of equivalent weight) tanks. (2,250 ea X 12 months = 27,000 ea)VA No. HCPC code E0443Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201627,000.00EA____________________________________0004Rental cylinder, size H, to include delivery and set-up, consisting of regulator, flow meter, safety stand, humidifier and disposable supplies (used as emergency backup system). (375 ea X 12 months = 4500 ea)VA No. HCPC code E0424Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20164,500.00EA____________________________________0005Refill cylinders, size “E” for portable systems, aluminum (or metal of equivalent weight) tanks. (730 ea X 12 months = 8760 ea)VA No. HCPC code E0443Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20168,760.00EA____________________________________0006Maintenance of Government-furnished equipment (concentrators, conserver regulators, complete oxygen systems, and tanks) as per SOW paragraph 12.16. (200 ea x 12 months = 2400 ea)VA No. E1390Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20162,400.00EA____________________________________0007Delivery and set-up charge for Government-furnished equipment (Concentrator or Home Fill System). (60 ea X 12 months = 720 ea)VA No. HCPC code VA160Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016720.00EA____________________________________0008Demand Nasal Cannula (e.g, Oximyzer), Reservoir or pendant/equivalent (per prescription). (4 ea X 12 months = 48 ea)VA No. HCPC code VA111Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201648.00EA____________________________________0009Cylinder, size H, refill (backup/primary). (10 ea X 12 months = 120 ea)VA No. HCPC code E0441Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016120.00EA____________________________________0010Liquid Oxygen System (90-100 lbs.) Rental. Include delivery and set-up, stationary reservoir, portable container, humidifier, flow meter, refill adapter, contents gauge, cannulas and/or tubing and disposables. (65 ea X 12 months = 780 ea)VA No. HCPC code E0442Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016780.00EA____________________________________0011Portable Liquid Oxygen ContainersContract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201640.00EA____________________________________0012Emergency set-up for Government-furnished or rental equipment. Delivery within 4 hours of request. This is a one-time charge in addition to item 0005. (2 ea X 12 months = 24 ea)VA No. Code VA160Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201624.00EA____________________________________0013Patient Travel (SOW Para 16.0): Arrangement (to include delivery and pick-up) of oxygen services/equipment for beneficiary travel outside of catchment area. Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201640.00EA____________________________________0014Patient Travel: Rental Portable Oxygen Concentrator (Federal Airline Administration approved) to include battery(s) , charger(s), tubing and/or disposables. Rental cost will be a daily rate. (Estimate 8 patients per month. Avg up to 30 days travel = 240 ea x 12 months = 2880 ea.) VA No. HCPC Code: E1392Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20162,880.00EA____________________________________0015Battery for Portable Oxygen Concentrator (Federal Airline Administration approved)Rental cost will be a daily rateVA No. HCPC Code: E1356Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016500.00EA____________________________________0016Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified) and disposables. Concentrator flow rate up to 5LPM. (1 ea @ 1 months =1 ea)VA No. HCPC code: E1390Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20161.00EA____________________________________0017Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified) and disposables. Concentrator flow rate up to 10LPM. (1 ea @ 1 month = 1 ea)VA No. HCPC code: E1390Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20161.00EA____________________________________0018Rental of High Flow Aerosol Compressor with tubing and disposables. Includes annual preventive maintenance inspection. (15 ea X 12 months = 180 ea)VA No. HCPC code E0565Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016180.00EA____________________________________0019Liquid system set-up with patient education (completed plan of care and fall assessment documents). (2 ea X 12 months = 24 ea.)VA No. VA160Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201620.00EA____________________________________0020Equipment Relocation within Contract Svc Area. (3 ea X 12 months = 36 ea.)VA No. VA160Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201636.00EA____________________________________0021GFE pick-up for discontinuation of oxygen services per VA (45 ea X 12 months = 540 ea)VA No. VA 160Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016540.00EA____________________________________0022Equipment Exchange Fee (GFE)(20 ea X 12 months = 240 each)VA No. 160Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016240.00EA____________________________________0023Delivery and set-up charge of portable supplies (Non-VA Hospital Discharge)(10 ea X 12 months = 120 ea)VA No. HCPC code E0430Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016120.00EA____________________________________0024Emergency Respiratory Care Practitioner (RCP) visit after hours. (8PM – 8AM Mon-Sat and all day Sun) (1 ea X 12 months = 12 ea)VA No. HCPC VA120Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201612.00EA____________________________________0025Monthly RCP service for Ventilators and back-up supplies (SOW 2.11)(10 ea X 12 months = 120 ea)VA No. HCPC VA160Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-2016120.00EA____________________________________0026RCP Visits for delivery, initial set-up and evaluation of ventilator and/or Tracheostomy patients. (4 ea X 12 months = 48 ea)VA No. HCPC Code VA160 Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201648.00EA____________________________________0027Monthly rental of contractor owned ventilator to include back-up ventilator, tubing, trach mask, ventilator circuit, (HME/masks), and humidifier. VA No: HCPC E1390Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20161.00EA____________________________________0028Fisher & Paykel Airvo Humidifier w/Integrated Flow Generator (Monthly Rental) – Set up by an RCP to include water chambers (2), tubing (2), tracheostomy masks, and filters (2). VA No. HCPC E0565. (3 ea X 12 months = 36 ea)Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-201636.00EA____________________________________0029Phase-In: IAW Contractor's Proposed Plan not to exceed 120 days after award.Contract Period: BasePOP Begin: 11-20-2015POP End: 11-19-20161.00JB____________________________________0030Phase-Out: IAW Contractor's Proposed Plan not to exceed 120 days after base period completion.1.00JB____________________________________1001Liquid Oxygen (6,600 lbs X 12 months = 79,200 lbs.)VA No. HCPC code E00439Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201779,200.00EA____________________________________1002Tank Rental (monthly) inclusive of consumable supplies for portable system, “E” or “B” size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and all disposable supplies. (9300 ea X 12 months = 111,600 ea)VA No. HCPC code E0431Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017111,600.00EA____________________________________1003Refill cylinders, size “B”, for portable systems, aluminum (or metal of equivalent weight) tanks. (2,250 ea X 12 months = 27,000 ea)VA No. HCPC code E0443Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201727,000.00EA____________________________________1004Rental cylinder, size H, to include delivery and set-up, consisting of regulator, flow meter, safety stand, humidifier and disposable supplies (used as emergency backup system). (375 ea X 12 months = 4500 ea)VA No. HCPC code E0424Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-20174,500.00EA____________________________________1005Refill cylinders, size “E” for portable systems, aluminum (or metal of equivalent weight) tanks. (730 ea X 12 months = 8760 ea)VA No. HCPC code E0443Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-20178,760.00EA____________________________________1006Maintenance of Government-furnished equipment (concentrators, conserver regulators, complete oxygen systems, and tanks) as per SOW paragraph 12.16. (200 ea x 12 months = 2400 ea)VA No. E1390Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-20172,400.00EA____________________________________1007Delivery and set-up charge for Government-furnished equipment (Concentrator or Home Fill System). (60 ea X 12 months = 720 ea)VA No. HCPC code VA160Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017720.00EA____________________________________1008Demand Nasal Cannula (e.g, Oximyzer), Reservoir or pendant/equivalent (per prescription). (4 ea X 12 months = 48 ea)VA No. HCPC code VA111Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201748.00EA____________________________________1009Cylinder, size H, refill (backup/primary). (10 ea X 12 months = 120 ea)VA No. HCPC code E0441Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017120.00EA____________________________________1010Liquid Oxygen System (90-100 lbs.) Rental. Include delivery and set-up, stationary reservoir, portable container, humidifier, flow meter, refill adapter, contents gauge, cannulas and/or tubing and disposables. (65 ea X 12 months = 780 ea)VA No. HCPC code E0442Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017780.00EA____________________________________1011Portable Liquid Oxygen ContainersContract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201740.00EA____________________________________1012Emergency set-up for Government-furnished or rental equipment. Delivery within 4 hours of request. This is a one-time charge in addition to item 0005. (2 ea X 12 months = 24 ea)VA No. Code VA160Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201724.00EA____________________________________1013Patient Travel (SOW Para 16.0): Arrangement (to include delivery and pick-up) of oxygen services/equipment for beneficiary travel outside of catchment area. Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201740.00EA____________________________________1014Patient Travel: Rental Portable Oxygen Concentrator (Federal Airline Administration approved) to include battery(s) , charger(s), tubing and/or disposables. Rental cost will be a daily rate. (Estimate 8 patients per month. Avg up to 30 days travel = 240 ea x 12 months = 2880 ea.) VA No. HCPC Code: E1392Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-20172,880.00EA____________________________________1015Battery for Portable Oxygen Concentrator (Federal Airline Administration approved)Rental cost will be a daily rateVA No. HCPC Code: E1356Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017500.00EA____________________________________1016Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified) and disposables. Concentrator flow rate up to 5LPM. (1 ea @ 1 months =1 ea)VA No. HCPC code: E1390Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-20171.00EA____________________________________1017Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified) and disposables. Concentrator flow rate up to 10LPM. (1 ea @ 1 month = 1 ea)VA No. HCPC code: E1390Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-20171.00EA____________________________________1018Rental of High Flow Aerosol Compressor with tubing and disposables. Includes annual preventive maintenance inspection. (15 ea X 12 months = 180 ea)VA No. HCPC code E0565Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017180.00EA____________________________________1019Liquid system set-up with patient education (completed plan of care and fall assessment documents). (2 ea X 12 months = 24 ea.)VA No. VA160Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201720.00EA____________________________________1020Equipment Relocation within Contract Svc Area. (3 ea X 12 months = 36 ea.)VA No. VA160Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201736.00EA____________________________________1021GFE pick-up for discontinuation of oxygen services per VA (45 ea X 12 months = 540 ea)VA No. VA 160Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201736.00EA____________________________________1022Equipment Exchange Fee (GFE)(20 ea X 12 months = 240 each)VA No. 160Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017240.00EA____________________________________1023Delivery and set-up charge of portable supplies (Non-VA Hospital Discharge)(10 ea X 12 months = 120 ea)VA No. HCPC code E0430Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017120.00EA____________________________________1024Emergency Respiratory Care Practitioner (RCP) visit after hours. (8PM – 8AM Mon-Sat and all day Sun) (1 ea X 12 months = 12 ea)VA No. HCPC VA120Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201712.00EA____________________________________1025Monthly RCP service for Ventilators and back-up supplies (SOW 2.11)(10 ea X 12 months = 120 ea)VA No. HCPC VA160Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-2017120.00EA____________________________________1026RCP Visits for delivery, initial set-up and evaluation of ventilator and/or Tracheostomy patients. (4 ea X 12 months = 48 ea)VA No. HCPC Code VA160 Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201748.00EA____________________________________1027Monthly rental of contractor owned ventilator to include back-up ventilator, tubing, trach mask, ventilator circuit, (HME/masks), and humidifier. VA No: HCPC E1390Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-20171.00EA____________________________________1028Fisher & Paykel Airvo Humidifier w/Integrated Flow Generator (Monthly Rental) – Set up by an RCP to include water chambers (2), tubing (2), tracheostomy masks, and filters (2). VA No. HCPC E0565. (3 ea X 12 months = 36 ea)Contract Period: Option 1POP Begin: 11-20-2016POP End: 11-19-201736.00EA____________________________________1029Phase-Out: IAW Contractor's Proposed Plan not to exceed 120 days after option 1 completion.1.00JB____________________________________GRAND TOTAL__________________Base Year11-20-2015 thru 11-19-2016Option 111-20-2016 thru 11-19-2017 Aggregate Total (Base + 1)B.2 Delivery ScheduleITEM NUMBERQUANTITYDELIVERY DATE0001SHIP TO:Department of Veterans AffairsOVAMC-Prosthetics5201 Raymond St.Orlando, FL 32803 820879,200.00MARK FOR:Noris Falcon or Brenda Brown (321) 397-6429 or (407) 599-1438noris.falcon@ or Brenda.M.Brown@0002SHIP TO:Same as item 0001111,600.000003SHIP TO:Same as item 000127,000.000004SHIP TO:Same as item 00014,500.000005SHIP TO:Same as item 00018,760.000006SHIP TO:Same as item 00012,400.000007SHIP TO:Same as item 0001720.000008SHIP TO:Same as item 000148.000009SHIP TO:Same as item 0001120.000010SHIP TO:Same as item 0001780.000011SHIP TOSame as item 000140.000012SHIP TO:Same as item 000124.000013SHIP TO:Same as item 000140.000014SHIP TO:Same as item 00012,880.000015SHIP TO:Same as item 0001500.000016SHIP TO:Same as item 00011.000017SHIP TO:Same as item 00011.000018SHIP TO:Same as item 0001180.000019SHIP TO:Same as item 000120.000020SHIP TO:Same as item 000136.000021SHIP TO:Same as item 0001540.000022SHIP TO:Same as item 0001240.000023SHIP TO:Same as item 0001120.000024SHIP TO:Same as item 000112.000025SHIP TO:Same as item 0001120.000026SHIP TO:Same as item 000148.000027SHIP TO:Same as item 00011.000028SHIP TO:Same as item 000136.000029SHIP TO:Same as item 00011.000030SHIP TO:Same as item 00011.001001SHIP TO:Department of Veterans AffairsOVAMC - Prosthetics5201 Raymond St.Orlando, FL 32803 820879,200.00MARK FOR:Noris Falcon or Brenda Brown(407) 599-1438noris.falcon brenda.m.brown@1002SHIP TO:Same as item 1001111,600.001003SHIP TO:Same as item 100127,000.001004SHIP TO:Same as item 10014,500.001005SHIP TO:Same as item 10018,760.001006SHIP TO:Same as item 10012,400.001007SHIP TO:Same as item 1001720.001008SHIP TO:Same as item 100148.001009SHIP TO:Same as item 1001120.001010SHIP TO:Same as item 1001780.001011SHIP TOSame as item 100140.001012SHIP TO:Same as item 100124.001013SHIP TO:Same as item 100140.001014SHIP TO:Same as item 10012,880.001015SHIP TO:Same as item 1001500.001016SHIP TO:Same as item 10011.001017SHIP TO:Same as item 10011.001018SHIP TO:Same as item 1001180.001019SHIP TO:Same as item 100120.001020SHIP TO:Same as item 100136.001021SHIP TO:Same as item 100136.001022SHIP TO:Same as item 1001240.001023SHIP TO:Same as item 1001120.001024SHIP TO:Same as item 100112.001025SHIP TO:Same as item 1001120.001026SHIP TO:Same as item 100148.001027SHIP TO:Same as item 10011.001028SHIP TO:Same as item 100136.001029SHIP TO:Same as item 10011.00 ................
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