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5. PROJECT NO.CODE7. ADMINISTERED BY2. AMENDMENT/MODIFICATION NO.CODE6. ISSUED BY8. NAME AND ADDRESS OF CONTRACTOR4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE9A. AMENDMENT OF SOLICITATION NO.9B. DATEDPAGEOF PAGES10A. MODIFICATION OF CONTRACT/ORDER NO.10B. DATEDBPA NO.1. CONTRACT ID CODEFACILITY CODECODE Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of OffersE. IMPORTANT:is extended, (a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR AC- KNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAYis not extended.12. ACCOUNTING AND APPROPRIATION DATA(REV. 10-83)is required to sign this document and return ___________ copies to the issuing office.is not,A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.15C. DATE SIGNEDB. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGESSET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b). RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:D. OTHERBYContractor16C. DATE SIGNED14. DESCRIPTION OF AMENDMENT/MODIFICATION16B. UNITED STATES OF AMERICAExcept as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.15A. NAME AND TITLE OF SIGNER16A. NAME AND TITLE OF CONTRACTING OFFICER15B. CONTRACTOR/OFFERORSTANDARD FORM 30NSN 7540-01-152-8070PREVIOUS EDITION NOT USABLEPrescribed by GSA - FAR (48 CFR) 53.243(Type or print)(Type or print)(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)(No., street, county, State and ZIP Code)(If other than Item 6)(Specify type of modification and authority)(such as changes in paying office, appropriation date, etc.)(If required)(If applicable)(SEE ITEM 11)(SEE ITEM 13)(X)(X)13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONSAMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT(Signature of person authorized to sign)(Signature of Contracting Officer) 1 26A0000212-18-2014NONEDepartment of Veterans AffairsNetwork Contracting Office 6201 Hay Street, Suite 304Fayetteville NC 28301Department of Veterans AffairsNetwork Contracting Office 6201 Hay Street, Suite 304Fayetteville NC 28301To all Offerors/BiddersVA246-14-Q-048308-07-2014XXX1** HOUR & DATE for Receipt of Offers is EXTENDED to:Receipt of Offers is 12/24/2014, 4:00PMSee CONTINUATION Pagex1The purpose of this Amendment is to:1. Changed the Set Aside in Block 10 of the RFQ from 100% Small Business Set Aside to Unrestricted.2. Remove clause 52.219-6, Notice of Total Small Business Set-Aside, by reference under FAR 52.212-5.3. Incorporate a revised SOW. The SOW is hereby replaced in its entirety by the revision included in this Amendment.4. Change the period of performance of the base period from 10/1/14 - 9/30/15 to 1/1/15 - 9/30/2015. The periods of performance for Option Year 1 and 2 remain unchanged.5. Extend the due date for receipt of offers from 12/18/2014 to 12/24/2014, 4:00pm.See SOW for changes and Period of Performance below. Nothing Follows----------------------------------------------------JAMES BROWNRADIOPHARMEUCEUTICALS STATEMENT OF WORKThe contractor will be required to provide Radiopharmaceutical supplies and services to the Department of Veterans Affairs Medical Center, Fayetteville, NC on a daily basis, and Monday through Friday, excluding national holidays. Service will include but not be limited to the following:1. Orders will be placed daily on an as needed basis by authorized employees. Individual radiopharmaceutical will be provided in unit dose form and will be delivered at the request of the VA. Payment will be made only for radiopharmaceutical used. Orders will be provided within two (2) hour of request.2. In accordance with the VA Memorandum dated January 3, 2014, and signed by Under Secretary for Health, the Department of Veterans (VA) will preferentially procure medical radioisotopes from non-High Enriched Uranium (HEU) sources. The contractor for the VA radiopharmaceuticals must be able to produce medical grade radioisotopes from preferentially procured non-Highly Enriched Uranium-235 (non-HEU) sources. A request has been made to VHA by the Interagency Policy Committee of the White House to preferentially procure Technetium-99m (Tc-99m), the primary radioisotope used in medical diagnosis, produced from non-HEU sources. The reason for this request is that transportation and storage of HEU by radioisotope vendors may be a security and nuclear proliferation risk. Also, the enactment in January 2013 of the American Medical Isotopes Production Act of 2011 supports creation of domestic production with the goal of reducing U.S. dependence on foreign sources of medical radioisotopes.3. Contractor will provide a point and/or floor source daily. These are calibrated for 0800 each morning for the activity specified.4. Contractor will provide a quarterly linearity source at no charge. The activity requested can range from 40 to 250 mCi.5. Contractor will be responsible for pick up and disposal of all radioactive waste generated by the use of the Contractor’s radiopharmaceuticals. This will include needles and syringes.6. Contractor will not provide credit on any unused technetium-99m labeled radiopharmaceutical. No credit on I-123 doses and I-131 doses.7. Contractor will provide 24-hour on-call service for emergency procedures.8. Contractor will provide free deliveries on items ordered.9. If requested by the Medical Centers, the contractor will provide the provision of ad lib doses of preferential HEU Tc 99m MAA (5mCi calibrated at 1000 and 1600) each day.10. Radiopharmaceutical may be ordered up to 2:00 pm each day.11. Contractor will provide weekly invoices with complete itemized list of all procedures performed during the month, listed by prescription number, patient name, procedure, date and time and individual cost per item listed.12. Contractor will provide leukocyte and platelet labeling services, including weekends. If the volume warrants, leukocyte and platelet labeling will be available as same day service.13. If needed, the Contractor will provide unit-dose radiopharmaceuticals on Saturdays.14. Contractor will perform quality control on each agent dispensed.15. In order to comply with the Nuclear Regulatory Commission’s requirement that shippers and recipients of the radioactive material clearly delineate roles and responsibilities relating to shipper functions, the contractor will be responsible for the following while transporting radioactive materials to and from the medical center.a. Transporting radioactive material only in DOT and NC Department of Radiation Protection Section approved transport containers.b. Properly placarding the containers where appropriate with radioactive White I, Yellow II or Yellow III Radioactive Labels, following the standard DOT guidelines:RADIACTIVE MATERIAL PACKAGES LABEL CRITERIA49 CFR (172.403)Dose Rate LimitsAt Any Point onAt one Meter FromAppropriate DOTAccessible SurfaceExternal SurfaceLabelof Containerof ContainerRadioactive White I<0.5 mR/hrN/ARadioactive Yellow II0.5 to <50 mR/hr<1.0 mR/hr*Radioactive Yellow III>50 mR/hr-200>1 to 10 mR/hr**requires vehicle placarding – 49 CFR (172.504)c. Measuring and recording on the container the Transport Index (TI).d. Carrying a proper bill of lading and emergency response instruction with each shipment of radioactive material.Price / Cost ScheduleBase year – January 1, 2015 through September 30, 2015ITEM NUMBERDESCRIPTION OF SUPPLIES/SERVICESQUANTITYUNITUNIT PRICETOTAL AMOUNT 0001Tc99m Pertechnetate, price per dose100EA$ FORMTEXT ?????$ FORMTEXT ?????0002 Tc99m MAA, price per dose20EA$ FORMTEXT ?????$ FORMTEXT ?????0003 Tc99m MDP, price per dose150EA$ FORMTEXT ?????$ FORMTEXT ?????0004 Tc99m DTPA Renal, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0005 Tc99m Sources mCi, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ????? 0006Tc99m Sources uCi, price per dose 1EA$ FORMTEXT ????? $ FORMTEXT ????? 0007Tc99m Sulfur Colloid, price per dose40EA$ FORMTEXT ?????$ FORMTEXT ?????0008 Tc99m Sulfur Colloid Egg5EA$ FORMTEXT ?????$ FORMTEXT ?????0009 Tc99 Sulfur Colloid Filtered, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ????? 0010Tc99m Mebrofenin/Choletec, price per dose30EA$ FORMTEXT ?????$ FORMTEXT ?????0011Tc99m Choletec/Hepatolite MD, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0012Tc99m Disofenin/Hepatolite, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0013Tc99m DTPA Aerosal, price per dose20EA$ FORMTEXT ?????$ FORMTEXT ?????0014Tc99m Pyrophosphate, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0015Tc99m Mag3, price per dose25EA$ FORMTEXT ?????$ FORMTEXT ?????0016Tc99m Neurolite, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????0017In111 Oncoscint, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0018Quadramet, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????0019In-111 DTPA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????0020Octreoscan, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0021CEA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????0022AcuTect, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0023DMSA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????0024Cardiolite, price per dose2500EA$ FORMTEXT ?????$ FORMTEXT ?????0025Tc99m Gluceptate, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0026C057 Cobalt-57 Capsule, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0027CO57 Cobalt-57 Reference, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????0028Ga67 Gallium Citrate, per Mci1EA$ FORMTEXT ?????$ FORMTEXT ?????0029I-123 Sodium Iodide Capsule, per 100 uCi 1EA$ FORMTEXT ?????$ FORMTEXT ?????0030I-123 Sodium Iodide Capsule, per 300 uCi40EA$ FORMTEXT ?????$ FORMTEXT ?????0031I-131 Sodium Iodide Diagnostic Capsule 7-100 uCi1EA$ FORMTEXT ?????$ FORMTEXT ?????0032I-131 Sodium Iodide Therapy Solution 1-6 mCi. Each additional mCi (and any portion thereof)1EA$ FORMTEXT ?????$ FORMTEXT ?????0033I-131 Sodium Iodide Theraphy Capsule, 1-5 mCi. Each additional mCi (any portion thereof), 150 each15EA$ FORMTEXT ?????$ FORMTEXT ?????0034Xe 133 Xenon Gas 20 mCi, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0035I-131 MIBG-500 uCi1EA$ FORMTEXT ?????$ FORMTEXT ?????0036Ti201 Thallous Chloride, mCi 1EA$ FORMTEXT ?????$ FORMTEXT ?????0037MAA (Drax), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0038Dobutamine, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0039Adenoscan 20 ml, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0040Adenoscan 30ml, price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????0041DTPA (Drax), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0042MDP (Bracco), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0043Disofenin (CIS), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????0044Pyrophophate (CIS), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????0045Choletec (Bracco), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????0046Ultra-tag, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0047Kinevac, price per vial20EA$ FORMTEXT ?????$ FORMTEXT ?????0048Gluceplate, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????0049Ultravent1EA$ FORMTEXT ?????$ FORMTEXT ?????0050In 111 WBC Handling1EA$ FORMTEXT ?????$ FORMTEXT ?????0051Ceretec WBC Labeling2EA$ FORMTEXT ?????$ FORMTEXT ?????0052In 111 Set up kit 1KT$ FORMTEXT ????? $ FORMTEXT ?????Total for Base Period 01/01/2015 to 09/30/2015 $ FORMTEXT ?????SUPPLES OR SERVICE AND PRICE/COST SCHEDULEOption year 1 – October 1, 2015 through September 30, 2016ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE TOTAL AMOUNT 1001Tc99m Pertechnetate, price per dose130EA$ FORMTEXT ?????$ FORMTEXT ?????1002Tc99m MAA, price per dose25EA$ FORMTEXT ?????$ FORMTEXT ?????1003Tc99m MDP, price per dose200EA$ FORMTEXT ?????$ FORMTEXT ?????1004Tc99m DTPA Renal, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1005Tc99m Sources mCi, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1006Tc99m Sources uCi, price per dose 1EA$ FORMTEXT ????? $ FORMTEXT ?????1007Tc99m Sulfur Colloid, price per dose40EA$ FORMTEXT ?????$ FORMTEXT ?????1008Tc99m Sulfur Colloid Egg8EA$ FORMTEXT ?????$ FORMTEXT ?????1009Tc99 Sulfur Colloid Filtered, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1010Tc99m Mebrofenin/Choletec, price per dose40EA$ FORMTEXT ?????$ FORMTEXT ?????1011Tc99m Choletec/Hepatolite MD, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1012Tc99m Disofenin/Hepatolite, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1013Tc99m DTPA Aerosal, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1014Tc99m Pyrophosphate, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1015Tc99m Mag3, price per dose30EA$ FORMTEXT ?????$ FORMTEXT ?????1016Tc99m Neurolite, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????1017In111 Oncoscint, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1018Quadramet, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????1019In-111 DTPA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????1020Octreoscan, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1021CEA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????1022AcuTect, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1023DMSA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????1024Cardiolite, price per dose3200EA$ FORMTEXT ?????$ FORMTEXT ?????1025Tc99m Gluceptate, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1026C057 Cobalt-57 Capsule, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1027CO57 Cobalt-57 Reference, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????1028Ga67 Gallium Citrate, per Mci1EA$ FORMTEXT ?????$ FORMTEXT ?????1029I-123 Sodium Iodide Capsule, per 100 uCi 1EA$ FORMTEXT ?????$ FORMTEXT ?????1030I-123 Sodium Iodide Capsule, per 300 uCi60EA$ FORMTEXT ?????$ FORMTEXT ?????1031I-131 Sodium Iodide Diagnostic Capsule 7-100 uCi1EA$ FORMTEXT ?????$ FORMTEXT ?????1032I-131 Sodium Iodide Therapy Solution 1-6 mCi. Each additional mCi (and any portion thereof)1EA$ FORMTEXT ?????$ FORMTEXT ?????1033I-131 Sodium Iodide Theraphy Capsule, 1-5 mCi. Each additional mCi (any portion thereof), 150 each15EA$ FORMTEXT ?????$ FORMTEXT ?????1034Xe 133 Xenon Gas 20 mCi, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1035I-131 MIBG-500 uCi1EA$ FORMTEXT ?????$ FORMTEXT ?????1036Ti201 Thallous Chloride, mCi 1EA$ FORMTEXT ?????$ FORMTEXT ?????1037MAA (Drax), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1038Dobutamine, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1039Adenoscan 20 ml, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1040Adenoscan 30ml, price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????1041DTPA (Drax), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1042MDP (Bracco), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1043Disofenin (CIS), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????1044Pyrophophate (CIS), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????1045Choletec (Bracco), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????1046Ultra-tag, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1047Kinevac, price per vial25EA$ FORMTEXT ?????$ FORMTEXT ?????1048Gluceplate, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????1049Ultravent1EA$ FORMTEXT ?????$ FORMTEXT ?????1050In 111 WBC Handling1EA$ FORMTEXT ?????$ FORMTEXT ?????1051Ceretec WBC Labeling2EA$ FORMTEXT ?????$ FORMTEXT ?????1052In 111 Set up kit 1KT$ FORMTEXT ????? $ FORMTEXT ?????Total for Option Year 1 from 10/01/2015 to 09/30/2016 $ FORMTEXT ?????SUPPLES OR SERVICE AND PRICE/COST SCHEDULEOption year 2 – October 1, 2016 through September 30, 2017ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNITUNIT PRICE TOTAL AMOUNT 2001Tc99m Pertechnetate, price per dose130EA$ FORMTEXT ?????$ FORMTEXT ?????2002Tc99m MAA, price per dose25EA$ FORMTEXT ?????$ FORMTEXT ?????2003Tc99m MDP, price per dose200EA$ FORMTEXT ?????$ FORMTEXT ?????2004Tc99m DTPA Renal, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2005Tc99m Sources mCi, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2006Tc99m Sources uCi, price per dose 1EA$ FORMTEXT ????? $ FORMTEXT ?????2007Tc99m Sulfur Colloid, price per dose40EA$ FORMTEXT ?????$ FORMTEXT ?????2008Tc99m Sulfur Colloid Egg8EA$ FORMTEXT ?????$ FORMTEXT ?????2009Tc99 Sulfur Colloid Filtered, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2010Tc99m Mebrofenin/Choletec, price per dose40EA$ FORMTEXT ?????$ FORMTEXT ?????2011Tc99m Choletec/Hepatolite MD, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2012Tc99m Disofenin/Hepatolite, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2013Tc99m DTPA Aerosal, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2014Tc99m Pyrophosphate, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2015Tc99m Mag3, price per dose30EA$ FORMTEXT ?????$ FORMTEXT ?????2016Tc99m Neurolite, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????2017In111 Oncoscint, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2018Quadramet, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????2019In-111 DTPA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????2020Octreoscan, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2021CEA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????2022AcuTect, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2023DMSA, price per dose 1EA$ FORMTEXT ?????$ FORMTEXT ?????2024Cardiolite, price per dose3200EA$ FORMTEXT ?????$ FORMTEXT ?????2025Tc99m Gluceptate, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2026C057 Cobalt-57 Capsule, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2027CO57 Cobalt-57 Reference, price per dose1EA$ FORMTEXT ?????$ FORMTEXT ?????2028Ga67 Gallium Citrate, per Mci1EA$ FORMTEXT ?????$ FORMTEXT ?????2029I-123 Sodium Iodide Capsule, per 100 uCi EA$ FORMTEXT ?????$ FORMTEXT ?????2030I-123 Sodium Iodide Capsule, per 300 uCi60EA$ FORMTEXT ?????$ FORMTEXT ?????2031I-131 Sodium Iodide Diagnostic Capsule 7-100 uCi1EA$ FORMTEXT ?????$ FORMTEXT ?????2032I-131 Sodium Iodide Therapy Solution 1-6 mCi. Each additional mCi (and any portion thereof)1EA$ FORMTEXT ?????$ FORMTEXT ?????2033I-131 Sodium Iodide Theraphy Capsule, 1-5 mCi. Each additional mCi (any portion thereof), 150 each15EA$ FORMTEXT ?????$ FORMTEXT ?????2034Xe 133 Xenon Gas 20 mCi, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2035I-131 MIBG-500 uCi1EA$ FORMTEXT ?????$ FORMTEXT ?????2036Ti201 Thallous Chloride, mCi 1EA$ FORMTEXT ?????$ FORMTEXT ?????2037MAA (Drax), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2038Dobutamine, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2039Adenoscan 20 ml, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2040Adenoscan 30ml, price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????2041DTPA (Drax), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2042MDP (Bracco), price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2043Disofenin (CIS), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????2044Pyrophophate (CIS), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????2045Choletec (Bracco), price per vial 1EA$ FORMTEXT ?????$ FORMTEXT ?????2046Ultra-tag, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2047Kinevac, price per vial25EA$ FORMTEXT ?????$ FORMTEXT ?????2048Gluceplate, price per vial1EA$ FORMTEXT ?????$ FORMTEXT ?????2049Ultravent1EA$ FORMTEXT ?????$ FORMTEXT ?????2050In 111 WBC Handling1EA$ FORMTEXT ?????$ FORMTEXT ?????2051Ceretec WBC Labeling2EA$ FORMTEXT ?????$ FORMTEXT ?????2052In 111 Set up kit 1KT$ FORMTEXT ????? $ FORMTEXT ?????Total for Option Year 2 from 10/01/2016 to 09/30/2017 $ FORMTEXT ?????The following table is to be completed by all offerors as part of the quote/offer. Failure to complete and submit the table with signature and include it with your quote/offer may deem your quote/offer unresponsive.Contractor Response to SOW Requirements SOW Sections/SubsectionsRequired Vendor ResponseContractor can supply all of the products as listed in Section B.4, Price/Cost Schedule of this solicitation to the Fayetteville VA Medical Center on a daily basis, Monday thru Friday, excluding national holidays.Check one:?Vendor can meet Requirement?Vendor cannot meet RequirementComments/Requested changes:Click here to enter text.Orders will be placed daily on an as needed basis by authorized employees. Individual radiopharmaceutical will be provided in unit dose form and will be delivered at the request of the VA. Payment will be made only for radiopharmaceutical used. Orders will be provided within two (2) hour of request.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.In accordance with the VA Memorandum dated January 3, 2014, and signed by Under Secretary for Health, the Department of Veterans (VA) will preferentially procure medical radioisotopes from non-High Enriched Uranium (HEU) sources. The contractor for the VA radiopharmaceuticals must be able to produce medical grade radioisotopes from preferentially procured non-Highly Enriched Uranium-235 (non-HEU) sources. A request has been made to VHA by the Interagency Policy Committee of the White House to preferentially procure Technetium-99m (Tc-99m), the primary radioisotope used in medical diagnosis, produced from non-HEU sources. The reason for this request is that transportation and storage of HEU by radioisotope vendors may be a security and nuclear proliferation risk. Also, the enactment in January 2013 of the American Medical Isotopes Production Act of 2011 supports creation of domestic production with the goal of reducing U.S. dependence on foreign sources of medical radioisotopes.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will provide a point and/or floor source daily. These are calibrated for 0800 each morning for the activity specified.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will provide a quarterly linearity source at no charge. The activity requested can range from 40 to 250 mCi.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will be responsible for pick up and disposal of all radioactive waste generated by the use of the Contractor’s radiopharmaceuticals. This will include needles and syringes.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will not provide credit on any unused technetium-99m labeled radiopharmaceutical. No credit on I-123 doses and I-131 doses.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will provide 24-hour on-call service for emergency procedures and radiopharmaceuticals.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will provide free deliveries on items ordered.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.If requested by the Medical Centers, the contractor will provide the provision of ad lib doses of preferential Non-HEU Tc 99m MAA (5mCi calibrated at 1000 and 1600) each day.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Radiopharmaceutical may be ordered up to 2:00 pm each day.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will provide weekly invoices with complete itemized list of all procedures performed during the month, listed by prescription number, patient name, procedure, date and time and individual cost per item listed.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor will provide leukocyte and platelet labeling services, including weekends. If the volume warrants, leukocyte and platelet labeling will be available as same day service.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.If needed, the Contractor will provide unit-dose radiopharmaceuticals on Saturdays.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text. Contractor will perform quality control on each agent dispensed.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.In order to comply with the Nuclear Regulatory Commission’s requirement that shippers and recipients of the radioactive material clearly delineate roles and responsibilities relating to shipper functions, the contractor will be responsible for the following while transporting radioactive materials to and from the medical center.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text. Transporting radioactive material only in DOT and NC Department of Radiation Protection Section approved transport containers.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Properly placarding the containers where appropriate with radioactive White I, Yellow II or Yellow III Radioactive Labels, following the standard DOT guidelines:Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.RADIACTIVE MATERIAL PACKAGES LABEL CRITERIA49 CFR (172.403)Dose Rate LimitsCheck one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text. At Any Point onAt one Meter FromAppropriate DOTAccessible SurfaceExternal SurfaceLabelof Containerof ContainerRadioactive White I<0.5 mR/hrN/ARadioactive Yellow II0.5 to <50 mR/hr<1.0 mR/hr*Radioactive Yellow III>50 mR/hr-200>1 to 10 mR/hr**requires vehicle placarding – 49 CFR (172.504)Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor shall measure and record on the container the Transport Index (TI).Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.Contractor is responsible for carrying a proper bill of lading and emergency response instruction with each shipment of radioactive material.Check one:?Vendor Accepts Requirement?Vendor Rejects RequirementComments/Requested changes:Click here to enter text.All radiopharmaceuticals will be ordered by the Nuclear Medicine service at the Fayetteville VA Medical Center on an as needed basis. Radiology Service at 910-488-2120 will be the POC for ordering of radiopharmaceuticalsNo response neededI certify that the responses and information provided by me in Table 1 are accurate and complete to the best of my knowledge and belief._______________________________ _______________________________ Signature Date___________________________________ Printed Name___________________________________ Company Name ................
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