2026-02-02 MIL Instruments Serviced.pdf
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- Solicitation number
- 36C25226Q0075
About this file
This is a packing slip from STERIS Instrument Management Services, INC., documenting on-location instrument repair services provided to Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin. The document (Order Number 4372210, Service Request Number VEG761626) is dated February 2, 2026, and lists all instruments repaired and returned to the customer's Operating Room department.
The packing slip itemizes nine service line items covering multiple surgical instrument sets with varying repair levels. Services include basic cleaning and inspection (Level 1) through advanced restoration work (Level 4), encompassing procedures such as ultrasonic cleaning, rinsing, drying, lubrication, sharpening, alignment, and deburring. Specific instrument sets repaired include: Basic Plastic Instruments, Laparoscopic Hand Assist, Arthroscopy Instruments, Vascular Specials, Open Heart Pan, Tonsil Set, Vein Instruments, a Repair Bin, and Major Abdominal Instruments. Several instruments are listed as "Beyond Repair" due to conditions including pitting, exceeded useful life, and cracking in critical areas. All line items and the subtotal are priced at $0.00, indicating this represents completed warranty or included maintenance services. The document notes that an invoice will follow separately and advises the customer regarding any recalled items among those serviced.
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| S06-36C25226Q0075 0001.docx | DOCX document | |
| S05-VENDOR QUESTIONS-ANSWERS.docx | DOCX document | |
| 2026-02-09 MIL Instruments Serviced.pdf | ||
| 2026-02-17 MIL Instruments Serviced.pdf |
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Packing Slip Order Number: 4372210 Service Request Number: VEG761626
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/2/2026 Page 1 of 5
Customer
CLEMENT J ZABLOCKI - VA MEDICAL CENTER
5000 WEST NATIONAL AVENUE
MILWAUKEE, WI 53295
Deliver To
Purchase Order Department Operating Room
Last Ship Date
02-FEB-2026
Reference
Sales Person Fabitz, Eric E
Customer Contact Sandra Arntzen
Contact Phone Number 414-384-2000
Customer Number
Special Instructions
Notes :
Line Description Qty Unit Price Ext Price
1 SN:C10000255 ON-LOCATION INSTRUMENT SERVICE (Mil Basic Plastic Instruments
- 006)
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 18 $0.00 $0.00
ONL2122 - Clamps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align
3 $0.00 $0.00
ONL1204 - Delicate (Tenotomy/Iris) Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Deburr, Align, Proximate Tips, Thin Blade, Replace Screw
2 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 3 $0.00 $0.00 ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 1 $0.00 $0.00
ONL2383 - Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Straighten, Align Tips
2 $0.00 $0.00
ONL1103 - General Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Adjust Shank
1 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL3103 - Needleholder: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws, Align Ratchet, Align Shank
5 $0.00 $0.00
ONL2781 - Retractors-Self Retaining: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry
2 $0.00 $0.00
ONL2771 - Retractors-D/E: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 4 $0.00 $0.00
ONL2772 - Retractors-D/E: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
2 $0.00 $0.00
ONL2852 - Skin Hooks: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Deburr
2 $0.00 $0.00
ONL2853 - Skin Hooks: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Deburr, Align, Repair Tips
6 $0.00 $0.00
ONL2872 - Skin Rakes: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Deburr
2 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL1404 - Supersharp Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Serrate Edge, Thin Blade, Replace Screw
3 $0.00 $0.00
OBR1207 - Delicate (Tenotomy/Iris) Scissors: Beyond Repair - Exceeded Useful Life 3 $0.00 $0.00 ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
Item Total USD $0.00
2 SN:C10001686 ON-LOCATION INSTRUMENT SERVICE (MIL Laparoscopic Hand Assist - 4)
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 26 $0.00 $0.00
ONL2122 - Clamps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align
4 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 7 $0.00 $0.00
Service Request Number: VEG761626
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/2/2026 Page 2 of 5
ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 4 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
3 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00
ONL3102 - Needleholder: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws
4 $0.00 $0.00
ONL2732 - Retractors-Handheld: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
2 $0.00 $0.00
ONL2772 - Retractors-D/E: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
5 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL1304 - TC Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
OBR2383 - Forceps: Beyond Repair - Pitting 1 $0.00 $0.00
Item Total USD $0.00
3 SN:C10000269 ON-LOCATION INSTRUMENT SERVICE (MIL ARTHROSCOPY
INSTRUMENTS - 3)
1 $0.00 $0.00
ONL2061 - Cannulas/Sheaths: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 13 $0.00 $0.00 ONL2221 - Curettes: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2353 - Elevators-D/E: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen, Reshape Edge
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 4 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
2 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2562 - Mallet: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Deburr 1 $0.00 $0.00
ONL3102 - Needleholder: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws
2 $0.00 $0.00
ONL2801 - Rongeurs-D/A: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2872 - Skin Rakes: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Deburr
2 $0.00 $0.00
OBR1103 - General Scissors: Beyond Repair - Pitting 1 $0.00 $0.00
ONL2641 - Punches-ENT: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
12 $0.00 $0.00
ONL8551 - Graspers-Alligator: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL1151 - Scissor-ENT: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL2602 - Nerve Hook: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00 ONL2691 - Suture Grasper: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2961 - Probe: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
Item Total USD $0.00
4 SN:C10002246 ON-LOCATION INSTRUMENT SERVICE (Vascular Specials (OR) - 2) 1 $0.00 $0.00 ONS755 - Diamond Dusting (Needle Holder) 5 $0.00 $0.00
ONL4113 - Corneal Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips
2 $0.00 $0.00
ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
ONL4103 - Micro Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips
1 $0.00 $0.00
ONL3152 - Needle Holder-Castro: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align
3 $0.00 $0.00
Service Request Number: VEG761626
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/2/2026 Page 3 of 5
Item Total USD $0.00
5 SN:C10002036 ON-LOCATION INSTRUMENT SERVICE (MIL OPEN HEART PAN #1 -
001)
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 41 $0.00 $0.00
ONL2122 - Clamps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align
4 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 11 $0.00 $0.00 ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 7 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
3 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 6 $0.00 $0.00
ONL3103 - Needleholder: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws, Align Ratchet, Align Shank
17 $0.00 $0.00
ONL2781 - Retractors-Self Retaining: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry
1 $0.00 $0.00
ONL2772 - Retractors-D/E: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
2 $0.00 $0.00
ONL1404 - Supersharp Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Serrate Edge, Thin Blade, Replace Screw
2 $0.00 $0.00
OBR2123 - Clamps: Beyond Repair - Pitting 1 $0.00 $0.00 OBR1107 - General Scissors: Beyond Repair - Exceeded Useful Life 1 $0.00 $0.00 ONL2601 - Nerve Hook: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
Item Total USD $0.00
6 SN:C10001687 ON-LOCATION INSTRUMENT SERVICE (MIL Tonsil Set - 1) 1 $0.00 $0.00 ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 10 $0.00 $0.00
ONL2122 - Clamps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align
7 $0.00 $0.00
ONL2232 - Curettes-Adenoid: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen
5 $0.00 $0.00
ONL1204 - Delicate (Tenotomy/Iris) Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Deburr, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
ONL2352 - Elevators-D/E: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Sharpen
1 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 5 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
2 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 2 $0.00 $0.00 ONL2551 - Knives: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL3101 - Needleholder: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
3 $0.00 $0.00
ONL2732 - Retractors-Handheld: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Straighten, Deburr
1 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
OBR2123 - Clamps: Beyond Repair - Pitting 1 $0.00 $0.00 OBR2383 - Forceps: Beyond Repair - Pitting 1 $0.00 $0.00
ONL2641 - Punches-ENT: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
Item Total USD $0.00
7 SN:C10000570 ON-LOCATION INSTRUMENT SERVICE (Vein Instruments -002) 1 $0.00 $0.00 ONS755 - Diamond Dusting (Needle Holder) 1 $0.00 $0.00 ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 1 $0.00 $0.00 ONL2122 - Clamps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, 1 $0.00 $0.00
Service Request Number: VEG761626
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/2/2026 Page 4 of 5
Align
ONL2124 - Clamps: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align, Adjust, Set Ratchet, Adjust Shank, Reset Box Lock, Reshape Severely Damaged Jaw
2 $0.00 $0.00
ONL2161 - Clip Appliers: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
2 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00 ONL2382 - Forceps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust 2 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL3103 - Needleholder: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws, Align Ratchet, Align Shank
1 $0.00 $0.00
ONL2781 - Retractors-Self Retaining: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry
1 $0.00 $0.00
ONL2771 - Retractors-D/E: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 1 $0.00 $0.00
ONL2873 - Skin Rakes: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Deburr, Align, Repair Tips
2 $0.00 $0.00
OBR2123 - Clamps: Beyond Repair - Pitting 1 $0.00 $0.00 OBR2523 - Knife-Handles: Beyond Repair - Pitting 1 $0.00 $0.00 OBR1107 - General Scissors: Beyond Repair - Exceeded Useful Life 1 $0.00 $0.00
ONL3152 - Needle Holder-Castro: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align
1 $0.00 $0.00
Item Total USD $0.00
8 SN:9999 (Repair Bin) 1 $0.00 $0.00
ONL4303 - Micro Forceps: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust, Straighten, Align Tips
1 $0.00 $0.00
ONL4304 - Micro Forceps: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Adjust, Straighten, Align Tips, Badly Damaged
1 $0.00 $0.00
ONL4103 - Micro Scissors: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips
1 $0.00 $0.00
ONL1304 - TC Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
ONL2373 - Manipulator-Ophthalmic: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Adjust, Align, Deburr
1 $0.00 $0.00
Item Total USD $0.00
9 SN:C10000780 ON-LOCATION INSTRUMENT SERVICE (MIL MAJOR ABDOMINAL
INSTRUMENTS - 006)
1 $0.00 $0.00
ONL2121 - Clamps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate 42 $0.00 $0.00
ONL2122 - Clamps: Level 2: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align
7 $0.00 $0.00
ONL2161 - Clip Appliers: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
3 $0.00 $0.00
ONL2381 - Forceps: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 11 $0.00 $0.00
ONL1104 - General Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
2 $0.00 $0.00
ONL2521 - Knife-Handles: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry 4 $0.00 $0.00
ONL3103 - Needleholder: Level 3: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Align Jaws, Align Ratchet, Align Shank
8 $0.00 $0.00
ONL2911 - Suction Tubes/Tips: Level 1: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate
1 $0.00 $0.00
ONL1304 - TC Scissors: Level 4: Inspection, Ultrasonic Clean, Rinsing, Dry, Lubricate, Sharpen, Align, Proximate Tips, Thin Blade, Replace Screw
1 $0.00 $0.00
OBR2123 - Clamps: Beyond Repair - Pitting 1 $0.00 $0.00 OBR2162 - Clip Appliers: Beyond Repair - Cracked in a Critical Area 1 $0.00 $0.00
Service Request Number: VEG761626
STERIS Instrument Management Services, INC.
3316 2nd Ave North Birmingham, AL 35222 800-783-9251 www.steris-ims.com
Date Printed: 2/2/2026 Page 5 of 5
OBR1103 - General Scissors: Beyond Repair - Pitting 2 $0.00 $0.00 OBR1107 - General Scissors: Beyond Repair - Exceeded Useful Life 1 $0.00 $0.00
Item Total USD $0.00
Customers: Do not pay from this document, invoice will follow.
Where applicable, tax and shipping/handling will be added.
******************************************************************** Subtotal USD $0.00
Customer Signature
We appreciate your business!
In the event any item(s) identified on this Packing Slip is currently subject to a recall, please be aware that in the process of completing the repairs indicated, IMS did not take actions related to any such recall. We encourage you to strictly follow any guidance provided by the Recalling Firm with respect to any recall in effect.
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