24BS0032_-_Exhibits_A-D.pdf

California Department of Veterans Affairs Agreement Number: 24BS0032 Exhibit A - Scope of Work TBD

BIOMEDICAL EQUIPMENT AND BED MAINTENANCE AND REPAIR SERVICES

1. INTRODUCTION/SERVICES

A. The Contractor shall provide services, as specified, to the California Department of Veterans Affairs

(CalVet). The Contractor shall provide services for the benefit and care of residents at the Veterans Home of California - Barstow (Home), located at 100 East Veterans Parkway, Barstow, CA 92311. The Contractor shall provide all labor, materials, staff, transportation, license, permits, and every other item of expense necessary, unless otherwise stated, to provide Biomedical Equipment Maintenance and Repair Services. Services shall be provided at the Home, upon request and in compliance with the terms of this Agreement.

B. All work shall be coordinated and approved by CalVet Contract Manager or designated representative.

Services shall be performed during standard business hours 8:00 a.m. to 4:30 p.m., Monday through Friday unless otherwise specified. No work is to be performed on State holidays or on an overtime basis unless prior approval is received in writing from the CalVet Contract Manager, prior to this work taking place. Any and all services performed outside the scope of this Agreement or not approved by the CalVet Contract Manager, or designated representative, will be at the sole risk and expense of the Contractor.

C. The Contractor/Provider must be able to perform the tasks associated with providing services under the scope of their license. The Contractor will provide services in accordance with federal and state laws and regulations and CalVet policies.

D. The Contractor is not authorized to deliver or commence the performance of services as described in the

Agreement until written approval has been obtained from the CalVet Contract Manager and the Contractor has received an executed contract from CalVet. Any delivery or performance of service commenced prior to the Contractor obtaining all written approvals shall be considered voluntary on the part of the Contractor.

2. EQUIPMENT

A. The equipment to be serviced is identified in Exhibit A-1, Equipment Inventory List.

B. CalVet reserves the right to add, delete, or exchange comparable equipment to Exhibit A-1. Equipment will be serviced as specified at the rates indicated in Exhibit B-1. The Contractor will be notified in writing by the Contract Manager of equipment that has been added and/or removed from the list.

C. Equipment Removal – The Contractor shall endeavor to perform all services required under this Agreement on Home premises. In the event that equipment must be removed from Home premises for repair, prior approval from the CalVet Contract Manager, or designee shall be obtained. The Contractor shall be responsible for pick-up and delivery to the Home. Upon completion of the repair, the Contractor shall notify the Contract Manager or designee and schedule a delivery date and time. Under no circumstances shall equipment be removed from Home premises and kept by the Contractor longer than fourteen (14) working days, unless prior written permission has been obtained from the CalVet Contract Manager.

3. MINIMUM QUALIFICATIONS

A. The Contractor must be licensed to conduct business in the State of California and possess the proper licenses and permits required to perform this service.

B. All service performed under this Agreement shall be performed by qualified service technicians in the employ or under the direction of the Contractor.

C. The Contractor shall provide CalVet with proof of the required training or experience for each technician providing services under this Agreement. Acceptable proof may be a resume showing experience, training, and/or factory course completion.

D. The Contractor Representatives must have a minimum of three (3) consecutive years of experience in maintaining and repairing the bio-medical equipment specified herein.

E. Apprentices or trainees are acceptable only under the direct supervision of a senior medical (or biomedical) equipment technician.

4. LICENSES, PERMITS, AND CERTIFICATION REQUIREMENTS

A. Prior to providing services as outlined in this Agreement, the Contractor shall ensure all service technicians have licenses, permits, and certification requirements are verified and remain current throughout the term of this Agreement.

B. The Contractor shall provide the Home with proof of the required training or experience for each service technician providing services under this Agreement prior to providing services. Acceptable proof may be a resume showing experience, training, and/or factory course completion. An example of sufficient evidence would be certification as a Biomedical Equipment Technician and/or Radiology Equipment Specialist.

5. CONTRACTOR’S RESPONSIBILITIES

The Contractor shall provide on an annual or semi-annual basis, all maintenance including but not limited to the safety inspections, adjustments, operational tests, and correction of equipment discrepancies in accordance with the manufacturer specification for each model of equipment as listed in Exhibit A-1, Equipment Inventory List. The Contractor shall provide an adequate number of qualified technicians on site to perform biomedical equipment maintenance and repair services as described herein, as scheduled with the CalVet Contract Manager or designee. The Contractor shall provide maintenance, repair, and documentation to meet required licensing, Title 22 of the California Code of Regulations, National Fire Protection Association (NFPA), Occupational Health and Safety Administration, United States Food and Drug Administration – Center for Devices and Radiological Health, Joint Commission on Accreditation of Healthcare Organizations, and CalVet/Home policy standards.

A. INSPECTIONS

1. Initial Safety Inspections

a. CalVet Contract Manager or designee shall notify the Contractor when any new instrument or piece of equipment is added to the contract and schedule an initial safety inspection to be completed by the Contractor.

b. When the equipment and/or instrument passes the Initial Safety Inspection, a sticker will be placed on the equipment/ instrument indicating the inspection date and that it is in safe operational condition.

2. Refer to Exhibit A-1, Equipment Inventory List for the maintenance frequency of the equipment listed under this Agreement.

a. Equipment shall be inspected to meet the following criteria: Annually, Semi-Annually, and when error function occurs (or before a piece of equipment is put back into service when removed from storage).

b. Equipment inspection and maintenance dates will be set up on a mutually agreed upon date between the Contractor and the CalVet Contract Manager or designee.

3. CalVet Contract Manager and Contractor will develop a mutually agreed upon Excel Spreadsheet log template to record inspections similar to Exhibit A-1, Equipment Inventory List.

4. All equipment calibrations or inspections shall be identified by placing inspection stickers on the equipment. These stickers shall specify the date of inspection or calibrations, the date of the next servicing, and the signature of the technician servicing the equipment.

B. PREVENTATIVE MAINTENANCE SERVICES

1. All Preventative Maintenance shall include the following but not be limited to, the original equipment manufacturer (OEM) recommendations:

a. The Contractor is responsible for providing all materials, equipment, tools, factory-authorized parts, transportation and repair time (including travel), and equipment to perform maintenance and repairs and provide documentation and testing that meet licensing, Title 22, and National Fire Protection Association (NFPA) standards. This may not be inclusive at the time of the scheduled work.

b. Prior to any major repairs, the Contractor will give an estimate of repair costs including parts to the CalVet Contract Manager to determine whether the piece of equipment is economically repairable.

C. REPAIR SERVICES

1. The Contractor shall provide unlimited visits for any repair services requested or necessary to keep the equipment fully operational at the flat rate for maintenance of equipment listed in Exhibit A-1.

2. Repair services that are outside of the regularly scheduled maintenance visits, shall be compensated by CalVet for actual hours worked on-site at the Contractor’s Repair Hourly Rate as specified in Exhibit B-1, Rate Sheet.

3. Any parts requiring replacement will be replaced in accordance with the Parts Replacement section.

Repair service will be provided upon written request from the CalVet Contract Manager.

4. The Contractor shall respond to requests for repair service within twenty-four (24) hours of initial notification. Every effort shall be made to perform repair services during normal business hours; State holidays and weekends excluded. CalVet may, at its discretion, allow access to the equipment during nonbusiness hours when necessary. Non-emergency repair services performed outside of normal business hours must be approved in advance in writing by the CalVet Contract Manager.

D. EMERGENCY REPAIR SERVICES

1. The Contractor shall provide any necessary emergency maintenance and/or repair services, upon request from the CalVet Contract Manager. The Contractor shall be compensated by CalVet for actual emergency hours worked on-site at the Contractor’s emergency hourly rate as specified in Exhibit B-1, Rate Sheet.

2. The Contractor will respond to requests for emergency services and perform required work within eight (8) hours of notification from the CalVet Contract Manager or designee. When possible, emergency services shall be provided during normal business hours as specified herein. CalVet may, at its discretion, allow access to the equipment during non-business hours when necessary.

3. Any emergency service provided shall be completed the same working day unless written notification of delay is submitted to the CalVet Contract Manager immediately upon diagnosis of equipment deficiency. Any parts that require replacement shall be replaced in accordance with the manufacturer’s instructions.

4. After completion of emergency service, the Contractor shall submit a complete report to the CalVet

Contract Manager for signature including the following:

a. Date of Service.

b. Hourly Rate (if applicable).

c. Time in and Time out.

d. Description of service provided, including replacement of any parts.

e. Name and signature of service technician.

f. Location of equipment.

g. Equipment make, model, and serial number.

h. Description of any noted deficiencies and suggest corrective action.

i. Total hours expended.

E. SPECIAL EQUIPMENT PROVISIONS

1. Special equipment is identified in green color and with an * accordingly in Exhibit A-1, Equipment

Inventory List.

2. Preventive maintenance, repair services, and performance assurance including testing and documentation to meet all current requirements of the Department of Health Services - Title 22.

3. Scheduled maintenance services and inspections including lubrication, cleaning, functional tests, leakage current tests, calibrations, and adjustments. One such inspection shall include calibrations to assure compliance with U.S. Bureau of Radiological Health Standards.

4. Services on the Planmeca Panoramic X-ray unit must be performed by qualified personnel, trained by Planmeca. The Contractor must provide a copy of the service technician’s training certificate by Planmeca prior to servicing the equipment.

5. Preventative maintenance and repairs of A-Dec dental equipment must be performed by qualified personnel, trained by A-Dec. The Contractor must provide a copy of the service technician’s training certificate by A-Dec prior to servicing the equipment.

6. Preventative maintenance and repairs of dental air compressor and vacuum pumps to be performed annually including the replacement of vacuum filters and compressor intake air filters.

7. If a piece of equipment requires a license, permit, certification, or credential to perform maintenance, the Contractor shall ensure the acquisition of the license, permit, or certification. The Contractor shall submit proof of the service technician’s certified training to calibrate and/or repair sensitive items such as the Planmeca Panoramic X-ray unit, Preva Progeny X-ray, A-Dec Dental Chairs, and A-Dec Delivery Systems as listed in Exhibit A-1, Equipment Inventory List prior to servicing the equipment.

a. If the Contractor is unable to service a piece of equipment due to proprietary status or service requires a certification that is unavailable to the Contractor, the CalVet Contract Manager may authorize the Contractor to schedule qualified technicians to come to the Home and service said equipment.

b. The Contractor shall always accompany the technician while on the grounds until work has been completed.

F. DOCUMENTATION REQUIREMENTS

1. Logs

a. The Contractor shall meet with the CalVet Contract Manager or designee within fourteen (14) days after the award of the contract. At the meeting, the Contractor shall present his/her proposed inspection and repair logs for review. The CalVet Contract Manager or designee shall review the Contractor’s inspection and repair logs for approval.

b. The Contractor shall develop and maintain a detailed and accurate Excel spreadsheet log of all instruments and equipment that have been serviced/repaired, in accordance with the latest standards given by the State Administrative Code, NFPA, OSHA, and manufacturer. A copy of the log will be turned over to the CalVet Contract Manager when the services/repairs have been completed and attached to the invoice. All instruments used to calibrate the equipment shall be certified and traceable to the National Bureau of Standards.

c. The maintenance performed by the Contractor shall include safety inspections, adjustments, operation tests, and correction of discrepancies in accordance with the manufacturer’s specification for each model of equipment. The Contractor will maintain an Excel spreadsheet log of all equipment owned and operated at the Home. The operational and technical information will be shared with the CalVet Contract Manager or designee.

G. Identification and Compliance with Home’s Policies and Procedures

1. The Contractor and Contractor’s representative shall wear an identification badge supplied by the Contractor that includes their name, current photo of the representative, name of the contractor, and title. The badge shall always be worn by the Contractor/Contractor’s representative while at the Home.

2. The Contractor and any Contractor Representative shall comply with the Home’s policies and procedures regarding the Home’s sign-in policy, dress code requirements, parking guidelines, and professional code of conduct at all times.

6. PARTS REPLACEMENT

This Agreement shall include replacement of any part that becomes worn or inoperable, or that otherwise affects the equipment's operability in any way. A written estimate of the required part(s) must be submitted to the CalVet Contract Manager and approved before replacement in all cases. Parts replaced under this Agreement shall be new, factory manufactured, or exceeding Original Equipment Manual (OEM) specifications. The Contractor should maintain an adequate supply and/or must be able to obtain within a reasonable amount of time any necessary replacement parts to perform repairs and maintenance in a timely manner. Consumables and other supply items are hereby excluded.

When parts are needed, the Contractor will be reimbursed for the actual cost of the parts plus 10%, plus actual shipping charges and taxes paid by the Contractor to obtain the parts. Proof of cost, such as a copy of the actual invoice for the parts from the business from which it was purchased must be attached to the Contractor's invoice for reimbursement.

Any parts replaced shall remain the property of the Home. The only exception is when the CalVet Contract Manager authorizes the Contractor to use the part(s) as a refund for “core” charges. If the Contractor is authorized to use the part for a “core” exchange, the invoice must reflect the reduced cost of the parts based on the “core” exchange value.

CalVet assumes no responsibility and shall not reimburse the Contractor for parts ordered by the Contractor and/or labor if the part was installed prior to authorization by the CalVet Contract Manager. The Contractor shall be responsible for the replacement of parts necessitated by the Contractor’s negligence at no expense to the CalVet.

7. WORK AREA

While working on equipment, the Contractor agrees to perform services with as little disruption to CalVet’s operations as possible. All tools, equipment, and other materials belonging to the Contractor will be removed from the Home at the end of each working day. CalVet shall not be responsible for the storage of any Contractor’s property.

8. WORKMANSHIP

All work provided by the Contractor shall conform to the latest requirements of federal, state, city, and county regulations. This includes but is not limited to Titles 17, 19, and 22 of the California Code of Regulations. The Contractor is responsible for compliance with all applicable laws, codes, rules, and regulations in connection with work performed under this Agreement. Any services performed by the Contractor will be inspected by CalVet after completion. The Home is solely responsible for determining the acceptability of the work performed and the operability of the equipment.

9. GUARANTEE

The Contractor will guarantee all services performed by the Contractor’s service technician(s), including any replaced parts, for a minimum of ninety (90) days from the date of service performance. If it is determined that failure has occurred to defective parts provided by Contractor or Contractor workmanship, the Contractor shall correct the failure at no additional expense to CalVet.

10. ORIENTATION/TRAINING

A. The Contractor agrees that prior to reporting for work at the Home, all Contractor Representatives shall complete any required orientation and training to become familiar with the operations of the Home, its medical facilities, Title 22 of the California Code of Regulations, Title 42 of the Code of Federal Regulations, and any other laws or bylaws that may apply to the Home.

B. To maintain continuity of services and ensure safety for all workers, the Contractor shall make available to the Home only those Providers who have completed the required orientation and training.

C. Each Provider must attend the Home’s orientation. The orientation will take approximately four (4) hours and the Contractor shall invoice at the scheduled repair service hourly rate.

11. HEALTH CLEARANCE

A. The Contractor shall comply with the Home’s infection control policies and procedures. Initial and annual health clearance, including tuberculosis (TB) screening, and Hepatitis B vaccine series offer (initial only) is required by the Home policy of all state employees, contract Providers, and volunteers in order to meet state facility licensure requirements.

B. Initial TB screening may include, but not be limited to, 2-step TST/PPD testing and/or X-ray, and TB questionnaire. Annual TB screening may include, but not be limited to, 1-step TST/PPD testing and/or X-ray, and TB questionnaire. The health clearance process must be completed prior to initiation of services or Provider assignment, and within the required timeframe stipulated by the Home for the annual requirement.

C. Pre-employment/pre-assignment and annual health screening performed for the Contractor or Contractor’s Provider will be at the Contractor’s expense.

D. All Providers must show proof of receiving an annual vaccination for influenza (flu). If the Provider cannot show proof of receiving the current vaccination, they must sign a declination form and wear a mask while in the Home during the entire duration of flu season.

E. The Contractor shall submit medical reports/documentation to the Home’s Ambulatory Care Clinic indicating the individual is cleared to perform their duties and is free of communicable disease. The medical documentation must be submitted prior to initiation of services or Provider assignment, and within the required timeframe stipulated by the Home for the annual requirement.

F. During times of endemic or pandemic (such as COVID-19) or other instances of widespread viral or bacterial infections, additional precautionary infection control steps may be implemented and required by the Home. These may include but are not limited to wearing CalVet-approved masks and/or face shields, extra or special cleanings, social distancing, partitions, adjusted hours, vaccinations, booster shots, and obtaining additional clearance certifications that may be required by local, state, or federal health authorities. Providers shall comply with the Home’s COVID-19 Mitigation or Infection Control Plan and follow all current COVID-19 guidelines for precautions.

G. Failure to comply with the Home’s infection control policies shall result in immediate Provider suspension, contract suspension, or termination. Any suspension will remain in effect until a medical clearance is provided to the Home’s Infection Control Specialist, CalVet Contract Manager, or designee.

12. BACKGROUND CLEARANCE

A. Background clearance involving fingerprinting is required by the Home policy of contract Providers and volunteers prior to assignment to the Home in order to meet state facility licensure requirements. Live- Scan is the only acceptable form of fingerprinting for the Home.

B. The Contractor shall coordinate with the Home’s Personnel Office to arrange Live-Scan services. At a minimum, DOJ results must show California state-level and Federal Bureau of Investigation (FBI) level criminal offender record information (CORI) clearances.

C. The Home’s Personnel Office must receive the Live-Scan results and DOJ clearances prior to approving the assignment to the Home.

13. INDEPENDENT CONTRACTOR STATUS

A. The Contractor/Contractor’s employee shall be considered “Independent Contractors” in relation to CalVet and the Home. Therefore, the Contractor/Contractor’s employee shall not be considered employee(s) of the Home and shall not be entitled to any employee benefits from CalVet or the State including, but not limited to, the following:

1. Premium Pay, Overtime Pay, or Holiday Pay;

2. Medical Insurance;

3. Vacation or Sick Leave;

4. Worker’s Compensation; and

5. Other employee benefits.

14. CONTACT INFORMATION

A. The project representatives during the term of this Agreement will be:

1. CalVet Home Representative:

Veterans Home of California - Barstow

TBD

Phone:

2. Contractor Representative:

TBD – Company Name Contract Manager Address City, State Zip code Phone:

Email

B. Contract Representatives, addresses, and phone/fax numbers may be changed by issuing a 20-day prior written notification and shall not require a formal amendment to this Agreement. The notifying party shall provide complete contact information for the replacement Contract Representative including, name, title, mailing address, phone/fax numbers, and email address. All other changes require a formal written amendment to this Agreement.

California Department of Veterans Affairs Exhibit A-1 Equipment Inventory List

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

TBD

Line # DESCRIPTION SERIAL# MODEL SCHEDULE 1 AMALGAMATOR Annual 2 AUTOCLAVE STEAM STERILIZER * 15050989 TUTTNAUER Annual 3 BLADDER SCANNER 07257573 BVI 3000 Annual 4 BRUSHLESS ELECTRIC LAB PIECE 14SCL002 BUFFALO X50 Annual 5 BRUSHLESS ELECTRIC LAB PIECE 1212DLD006 X50 Annual 6 BUFFALO ELECTRIC BRUSH Annual 7 CARENDO SHOWER CHAIR SEE0742376 BIB2003-01 Annual 8 CARENDO SHOWER CHAIR PO526512 BIB2003-01 Annual 9 COMPRESSOR MIDMARK * V1991845 P22 Annual

10 COTOLUX LED CURING LIGHT Annual 11 DELIVERY UNIT * 17C532-A1376 532 Annual 12 DELIVERY UNIT * 17C532-A1377 532 Annual 13 DENTAL CHAIR * 17C5711-A15371 ADEC 511 Annual 14 DENTAL CHAIR * 17C5711-A15372 ADEC 511 Annual 15 DENTAL VACUM * VPLG5-7060 VPLG55S Annual 16 DIAGNOSTIC SET 23810 Annual 17 DIAGNOSTIC SET Annual 18 EKG 122170000778 BURDICK Annual 19 EKG 122160001055 BURDICK Annual 20 EKG 122160001054 BURDICK Annual 21 EKG 4321025689 PHILLIPS Annual 22 EXAM TABLE 39246 HAUSMAN Annual 23 EXAM TABLE 39245 HAUSMAN Annual 24 EXAM TABLE 39244 HAUSMAN Annual 25 EXTERNAL AIR SUCTION VAC E20006965 Annual 26 EXTERNAL AIR SUCTION VAC E20006967 Annual 27 EXTERNAL FEEDING PUMP C0913056 KANGAROO Annual 28 EXTERNAL FEEDING PUMP C0913098 KANGAROO Annual 29 EXTERNAL FEEDING PUMP C0913089 KANGAROO Annual 30 FITNESS PRO 1 UPPER BODY 610-01873 SCIFIT Annual 31 HAND DYNAMOMETER 120103 BASELINE Annual 32 HYDROCOLLATOR T25394L 2402 Annual 33 INFUSION PUMP 753240 SPECTRUM Annual 34 INFUSION PUMP 986240 SPECTRUM Annual 35 INFUSION PUMP 752914 SPECTRUM Annual 36 INFUSION PUMP G0000857220 SPECTRUM Annual 37 INFUSION PUMP 753226 SPECTRUM Annual 38 INFUSION PUMP 747752 SPECTRUM Annual 39 INFUSION PUMP 986094 SPECTRUM Annual 40 INTELECT LEGEND XT COMBO T21911 2760 Annual 41 INTELECT LEGEND XT COMBO T21901 2760 Annual

*Requires Special Equipment Provisions

GRAY AREA FOR BEDS

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

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Line # DESCRIPTION SERIAL# MODEL SCHEDULE 42 INTRA ORAL X-RAY * DM28078 30-A1025, PROGENY Annual 43 LANDICE REHABILITATION TREADMILL L8-24413 L8 Annual 44 LIFT CHAIR LAB 588B-100180 588 Annual 45 MAXIMOVE SEE0723069 KMBB4PLX2FUS Bi-Annual 46 MDSDIATHERMY SHORTWAVE DIATHE SZ19100007000081 THERA TOUCH Annual 47 METRON BARI MAT PLAT 6X8 BLACK BD2016100050 T9BMEXBBL Annual 48 MILAND HI-LOW MAT TABLE BD2014060182 9225951B Annual 49 NEBULIZER LTC8387432 3655LT Bi-Annual 50 NEBULIZER LTC8387430 3655LT Bi-Annual 51 NEBULIZER LTC8387107 3655LT Bi-Annual 52 NEBULIZER LTC8387108 3655LT Bi-Annual 53 NEBULIZER LTC8387105 3655LT Bi-Annual 54 NEBULIZER LTC8387106 3655LT Bi-Annual 55 NEBULIZER LTC8387109 3655LT Bi-Annual 56 NEBULIZER LTC8387110 3655LT Bi-Annual 57 NEBULIZER LTC8387119 3655LT Bi-Annual 58 NEBULIZER LTC8387117 3655LT Bi-Annual 59 NEBULIZER LTC8387120 3655LT Bi-Annual 60 NEBULIZER LTC8385256 3655LT Bi-Annual 61 NEBULIZER LTC8387118 3655LT Bi-Annual 62 NEBULIZER LTC8387122 3655LT Bi-Annual 63 NEBULIZER LTC8387121 3655LT Bi-Annual 64 NEBULIZER LTC8387083 3655LT Bi-Annual 65 NEBULIZER LTC8387082 3655LT Bi-Annual 66 NEBULIZER LTC8387085 3655LT Bi-Annual 67 NEBULIZER LTC8387086 3655LT Bi-Annual 68 NEBULIZER LTC8387081 3655LT Bi-Annual 69 NEBULIZER LTC8385254 3655LT Bi-Annual 70 NEBULIZER LTC8385252 3655LT Bi-Annual 71 NEBULIZER LTC8385878 3655LT Bi-Annual 72 NEBULIZER LTC8385865 3655LT Bi-Annual 73 NEBULIZER LTC8385879 3655LT Bi-Annual 74 NEBULIZER LTC8385880 3655LT Bi-Annual 75 NEBULIZER LTC8385875 3655LT Bi-Annual 76 NEBULIZER LTC8389548 3655LT Bi-Annual 77 NEBULIZER LTC8386190 3655LT Bi-Annual 78 NEBULIZER LTC8386188 3655LT Bi-Annual 79 NEBULIZER LTC8386189 3655LT Bi-Annual 80 NEBULIZER LTC8387084 3655LT Bi-Annual 81 NEBULIZER LTC8386191 3655LT Bi-Annual 82 NEBULIZER LTC8386187 3655LT Bi-Annual 83 NEBULIZER LTC8386192 3655LT Bi-Annual

*Requires Special Equipment Provisions

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Agreement Number: 24BS0032

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Line # DESCRIPTION SERIAL# MODEL SCHEDULE 84 NEBULIZER LTC8387434 3655LT Bi-Annual 85 NEBULIZER LTC8387120 3655LT Bi-Annual 86 NEBULIZER LTC8387349 3655LT Bi-Annual 87 NEBULIZER LTC8373050 3655LT Bi-Annual 88 NEBULIZER LTC8373049 3655LT Bi-Annual 89 NEBULIZER LTC8373051 3655LT Bi-Annual 90 NUPRO HANDPIECE Annual 91 OMNICYCLE A001-416-12-16455263 Annual 92 OMNICYCLE A002-520-04-18345279 Annual 93 OTHAMOSCOPE 227069 Welch Allyn Annual 94 OTHAMOSCOPE WELCH ALLYN 767 Annual 95 OTHAMOSCOPE WELCH ALLYN 767 Annual 96 OTO/OPHTHALMOSCOPE DIAGNOSTIC SET Annual 97 OTO/OPHTHALMOSCOPE DIAGNOSTIC SET Annual 98 OTO/OPHTHALMOSCOPE DIAGNOSTIC SET Annual 99 OTO/OPHTHALMOSCOPE Annual

100 OTO/OPHTHALMOSCOPE DIAGNOSTIC SET Annual 101 OTO/OPHTHALMOSCOPE DIAGNOSTIC SET Annual 102 OTO/OPHTHALMOSCOPE DIAGNOSTIC SET Annual 103 OTO/OPHTHALMOSCOPE DIAGNOSTIC SET Annual 104 OTO/OPHTHALMOSCOPE Annual 105 OTO/OPHTHALMOSCOPE Annual 106 OXYGEN CONCENTRATOR A223140059DS DEVILBISS Bi-Annual 107 OXYGEN CONCENTRATOR F669957DS DEVILBISS Bi-Annual 108 OXYGEN CONCENTRATOR F681733DS DEVILBISS 525DS Bi-Annual 109 OXYGEN CONCENTRATOR A223100394 DS DEVILIBISS Bi-Annual 110 OXYGEN CONCENTRATOR A223140008DS DEVILIBISS Bi-Annual 111 OXYGEN CONCENTRATOR A221260126DS DEVILIBISS Bi-Annual 112 OXYGEN CONCENTRATOR A223140010DS DEVILIBISS Bi-Annual 113 OXYGEN CONCENTRATOR A223140018DS DEVILIBISS Bi-Annual 114 OXYGEN CONCENTRATOR A223140073DS DEVILIBISS Bi-Annual 115 OXYGEN CONCENTRATOR A223140210DS DEVILIBISS Bi-Annual 116 OXYGEN CONCENTRATOR A223140009DS DEVILIBISS Bi-Annual 117 OXYGEN CONCENTRATOR A221260123DS DEVILIBISS Bi-Annual 118 OXYGEN CONCENTRATOR A223140058DS DEVILIBISS Bi-Annual 119 OXYGEN CONCENTRATOR A223140081DS DEVILIBISS Bi-Annual 120 OXYGEN CONCENTRATOR A223140005DS DEVILIBISS Bi-Annual 121 OXYGEN CONCENTRATOR A222110076DS DEVILIBISS Bi-Annual 122 OXYGEN CONCENTRATOR A223100328DS DEVILIBISS Bi-Annual 123 OXYGEN CONCENTRATOR A223140003DS DEVILIBISS Bi-Annual 124 OXYGEN CONCENTRATOR A223140206DS DEVILIBISS Bi-Annual 125 OXYGEN CONCENTRATOR A223140070DS DEVILIBISS Bi-Annual

*Requires Special Equipment Provisions

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Agreement Number: 24BS0032

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Line # DESCRIPTION SERIAL# MODEL SCHEDULE 126 OXYGEN CONCENTRATOR A223100397DS DEVILIBISS Bi-Annual 127 OXYGEN CONCENTRATOR A223100396DS DEVILIBISS Bi-Annual 128 OXYGEN CONCENTRATOR 18136467 INOGEN ONE Bi-Annual 129 OXYGEN CONCENTRATOR 17079628 INOGEN ONE Bi-Annual 130 OXYGEN CONCENTRATOR 17075186 INOGEN ONE Bi-Annual 131 OXYGEN CONCENTRATOR 17079418 INOGEN ONE Bi-Annual 132 OXYGEN CONCENTRATOR 17075202 INOGEN ONE Bi-Annual 133 OXYGEN CONCENTRATOR 17075216 INOGEN ONE Bi-Annual 134 OXYGEN CONCENTRATOR 17075196 INOGEN ONE Bi-Annual 135 OXYGEN CONCENTRATOR 18137643 INOGEN ONE Bi-Annual 136 OXYGEN CONCENTRATOR 17075232 INOGEN ONE Bi-Annual 137 OXYGEN CONCENTRATOR 17079348 INOGEN ONE Bi-Annual 138 OXYGEN CONCENTRATOR 17079190 INOGEN ONE Bi-Annual 139 OXYGEN CONCENTRATOR 18137653 INOGEN ONE Bi-Annual 140 OXYGEN CONCENTRATOR 18137379 INOGEN ONE Bi-Annual 141 OXYGEN CONCENTRATOR 18137675 INOGEN ONE Bi-Annual 142 OXYGEN CONCENTRATOR 18137209 INOGEN ONE Bi-Annual 143 OXYGEN CONCENTRATOR 18137647 INOGEN ONE Bi-Annual 144 OXYGEN CONCENTRATOR 18129101 INOGEN ONE Bi-Annual 145 OXYGEN CONCENTRATOR 18137198 INOGEN ONE Bi-Annual 146 OXYGEN CONCENTRATOR 18137638 INOGEN ONE Bi-Annual 147 PARKER BATH VEP100003709 AL2XXXX-US Annual 148 PARKER BATH VEP100003972 AL2-XXXX-US Annual 149 PATIENT LIFT SEE0721415 KMBB4OLU2FUS Bi-Annual 150 PATIENT LIFT 300514467 KMCLUN Bi-Annual 151 PATIENT LIFT 300511917 KMCLUN Bi-Annual 152 PATIENT LIFT KMC05341 LOW CHASIS SC Bi-Annual 153 PATIENT LIFT PO533659 MAXI TWIN Bi-Annual 154 PATIENT LIFT PO703089 TENOR Bi-Annual 155 PHYSIO CONTROL AED 49713388 LIFE PAK Annual 156 PHYSIO CONTROL AED 46581024 LIFE PAK Annual 157 PHYSIO CONTROL AED 46666736 LIFE PAK Annual 158 PHYSIO CONTROL AED 46666737 LIFE PAK Annual 159 PHYSIO CONTROL AED 46670407 LIFE PAK Annual 160 PHYSIO CONTROL AED 46666740 LIFE PAK Annual 161 PHYSIO CONTROL AED 46666738 LIFE PAK Annual 162 PHYSIO CONTROL AED 46666741 LIFE PAK Annual 163 PHYSIO CONTROL AED 46666707 LIFE PAK Annual 164 PHYSIO CONTROL AED 46666742 LIFE PAK Annual 165 PINCH GAGE Annual 166 RUMBLEX PLUS 4D VIBRATION PLATE CVOF20123040623 LP-RMXPLS-BLK Annual 167 SARA 3000 LIFT STLA0908U263 ARJO Bi-Annual

*Requires Special Equipment Provisions

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

TBD

Line # DESCRIPTION SERIAL# MODEL SCHEDULE 168 SARA 3000 LIFT 2630908 ARJO Bi-Annual 169 SARA FLEX W/HANDLE 300344383 SARA FLEX Bi-Annual 170 SARA STEDY LIFT NTA-13627 ARJO Annual 171 SCI FIT 610-018793 PRO1 Annual 172 SCI FIT STATIONARY BIKE 572000396.00 ISO7000R Annual 173 SCIFIT 990-009777 REX7000 Annual 174 SECA DIGITAL MULTIFUNCTION BARIA 10000001024408 6841321107 Annual 175 SECA DIGITAL MULTIFUNCTION BARIA 10000001023650 6841321107 Annual 176 SECA DIGITAL MULTIFUNCTION BARIA 1E+13 6841321107 Annual 177 SKF ACTUATION SYSTEM LITE GAIT TLT10-AXXX0-027 Annual 178 STANDING FRAME MODERATE SUPPO 200015478104.00 EASY STAND Annual 179 SUCTION MACHINE 1115 GOMCO Annual 180 SUCTION MACHINE 1115 GOMCO Annual 181 SUCTION MACHINE 1115 GOMCO Annual 182 SUCTION MACHINE 1115 GOMCO Annual 183 SUCTION MACHINE 1209 GOMCO 130 Annual 184 SUCTION MACHINE 1209 GOMCO 180 Annual 185 SUCTION MACHINE 1209 GOMCO 180 Annual 186 SUCTION MACHINE 110 GOMCO 180 Annual 187 SUCTION MACHINE 110 GOMCO 180 Annual 188 TRI W-G ELECTRONIC PARALLEL BARS TWG141149 112-12.EC/TG1004.EC Annual 189 ULTRASONIC CLEANER 81681-94A UC125, BIOSONIC Annual 190 URINE ANALYZER 227069 CLINITEK STATUS + Annual 191 URINE ANALYZER 41415 CLINITEK STATUS Annual 192 VITAL SIGNS MONITOR SH615432279SA DINAMAP V100 Annual 193 VITAL SIGNS MONITOR SH617280025SA 2038172-001-29568 Annual 194 VITAL SIGNS MONITOR SH617280026SA 2038172-001-29568 Annual 195 VITAL SIGNS MONITOR SH617280017SA 2038172-001-29568 Annual 196 VITAL SIGNS MONITOR SH617280018SA 2038172-001-29568 Annual 197 VITAL SIGNS MONITOR SH617280024SA 2038172-001-29568 Annual 198 VITAL SIGNS MONITOR SH617280014SA 2038172-001-29568 Annual 199 VITAL SIGNS MONITOR SH617280015SA 2038172-001-29568 Annual 200 VITAL SIGNS MONITOR SH617280019SA 2038172-001-29568 Annual 201 VITAL SIGNS MONITOR SH617280016SA 2038172-001-29568 Annual 202 VITAL SIGNS MONITOR SH617280011SA 2038172-001-29568 Annual 203 VITAL SIGNS MONITOR SH617280021SA 2038172-001-29568 Annual 204 VITAL SIGNS MONITOR SH617280012SA CARESCAPE V100 Annual 205 VITAL SIGNS MONITOR SH619490083SA CARESCAPE V100 Annual 206 VITAL SIGNS MONITOR SH619490081SA CARESCAPE V100 Annual 207 VITAL SIGNS MONITOR SH619490085SA CARESCAPE V100 Annual 208 VITAL SIGNS MONITOR SH619490084SA CARESCAPE V100 Annual 209 VITAL SIGNS MONITOR SDT11070203SA GE DINAMAP Annual

*Requires Special Equipment Provisions

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

TBD

Line # DESCRIPTION SERIAL# MODEL SCHEDULE 210 VITAL SIGNS MONITOR SH613340084SA GE DINAMAP Annual 211 VITAL SIGNS MONITOR SH613320457SA GE DINAMAP Annual 212 VITAL SIGNS MONITOR SH615432270SA GE DINAMAP Annual 213 VITAL SIGNS MONITOR SH613320424SA GE DINAMAP Annual 214 WEIGHT SCALE E17207-0157 Detecto Annual 215 WEIGHT SCALE HealthOMeter Annual 216 WEIGHT SCALE HEALTHOMETER Annual 217 WEIGHT SCALE HEALTHOMETER Annual 218 WEIGHT SCALE 00343676EH TOLEDO Annual 219 X-RAY PANO * RPX238192 PROMAX Annual 220 CITADEL PLUS BED P085590 FX811B3B4AMABB Annual 221 GENDRON BARIATRIC BED 87113112.00 MC4054SD Annual 222 GENDRON BARIATRIC BED 87113111.00 MC4054SD Annual 223 GENDRON BARIATRIC BED 104021111.00 MC4054SD Annual 224 GENDRON BARIATRIC BED 104021112.00 MC4054SD Annual 225 HILL-ROM 100 LOW BED S067AR4137 P3930A000026 Annual 226 HILL-ROM 100 LOW BED S072AR4140 P3930A000026 Annual 227 HILL-ROM 100 LOW BED S072AP4141 P3930 Annual 228 HILL-ROM 100 LOW BED S076AR4170 P3930A000026 Annual 229 HILL-ROM 100 LOW BED S068AR4138 P3930A000026 Annual 230 HILL-ROM 100 LOW BED S067AR4136 P393A000026 Annual 231 HILL-ROM 100 LOW BED S068AR4139 P3930AA000026 Annual

232 HILL-ROM 100 LOW BED S072AR4141 P3930A000026

233 HILL-ROM BED U00AP2587 CARE ASSIST ES Annual 234 HILL-ROM BED Q070AP1982 CARE ASSIST ES Annual

235 HILL-ROM BED S151AP7168 CARE ASSIST ES

236 HILL-ROM BED Q075AP2261 CARE ASSIST ES

237 HILL-ROM BED U279AP9334 CARE ASSIST ES

238 HILL-ROM BED Q264AP8938 CARE ASSIST ES Annual 239 HILL-ROM BED S151AP7164 CARE ASSIST ES Annual 240 HILL-ROM BED P230AP3273 CARE ASSIST ES Annual 241 HILL-ROM BED P272AP5396 CARE ASSIST ES Annual 242 HILL-ROM BED Q070AP1974 CARE ASSIST ES Annual 243 HILL-ROM BED Q070AP1976 CARE ASSIST ES Annual 244 HILL-ROM BED Q070AP1980 CARE ASSIST ES Annual 245 HILL-ROM BED Q070AP1971 CARE ASSIST ES Annual 246 HILL-ROM BED P269AP5394 CARE ASSIST ES Annual 247 HILL-ROM BED P269AP5391 CARE ASSIST ES Annual 248 HILL-ROM BED Q070AP1965 CARE ASSIST ES Annual 249 HILL-ROM BED Q070AP1961 CARE ASSIST ES Annual 250 HILL-ROM BED Q070AP2005 CARE ASSIST ES Annual 251 HILL-ROM BED Q070AP1978 CARE ASSIST ES Annual

*Requires Special Equipment Provisions

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

TBD

Line # DESCRIPTION SERIAL# MODEL SCHEDULE 252 HILL-ROM BED P269AP5393 CARE ASSIST ES Annual 253 HILL-ROM BED P269AP5392 CARE ASSIST ES Annual 254 HILL-ROM BED Q070AP1975 CARE ASSIST ES Annual 255 HILL-ROM BED P272AP5439 CARE ASSIST ES Annual 256 HILL-ROM BED Q070AP2008 CARE ASSIST ES Annual 257 HILL-ROM BED Q070AP1991 CARE ASSIST ES Annual 258 HILL-ROM BED Q070AP1962 CARE ASSIST ES Annual 259 HILL-ROM BED Q070AP1986 CARE ASSIST ES Annual 260 HILL-ROM BED Q070AP1987 CARE ASSIST ES Annual 261 HILL-ROM BED Q070AP1967 CARE ASSIST ES Annual 262 HILL-ROM BED Q070AP1981 CARE ASSIST ES Annual 263 HILL-ROM BED Q070AP19666 CARE ASSIST ES Annual 264 HILL-ROM BED Q070AP1977 CARE ASSIST ES Annual 265 HILL-ROM BED Q070AP1970 CARE ASSIST ES Annual 266 HILL-ROM BED Q070AP1968 CARE ASSIST ES Annual 267 HILL-ROM BED Q070AP1985 CARE ASSIST ES Annual 268 HILL-ROM BED Q070AP1969 CARE ASSIST ES Annual 269 HILL-ROM BED Q070AP1989 CARE ASSIST ES Annual 270 HILL-ROM BED Q073AP2167 CARE ASSIST ES Annual 271 HILL-ROM BED Q070AP2007 CARE ASSIST ES Annual 272 HILL-ROM BED Q075AP2261 CARE ASSIST ES Annual 273 HILL-ROM BED Q070AP2012 CARE ASSIST ES Annual 274 HILL-ROM BED Q070AP1983 CARE ASSIST ES Annual 275 HILL-ROM BED Q070AP2006 CARE ASSIST ES Annual 276 HILL-ROM BED Q070AP2013 CARE ASSIST ES Annual 277 HILL-ROM BED Q070AP1984 CARE ASSIST ES Annual 278 HILL-ROM BED Q070AP2010 CARE ASSIST ES Annual 279 HILL-ROM BED Q070AP1964 CARE ASSIST ES Annual 280 HILL-ROM BED Q070AP2003 CARE ASSIST ES Annual 281 HILL-ROM BED Q075AP2263 CARE ASSIST ES Annual 282 HILL-ROM BED Q070AP1973 CARE ASSIST ES Annual 283 HILL-ROM BED Q070AP1993 CARE ASSIST ES Annual 284 HILL-ROM BED Q070AP2169 CARE ASSIST ES Annual 285 HILL-ROM BED P272AP5417 CARE ASSIST ES Annual 286 HILL-ROM BED Q070AP1992 CARE ASSIST ES Annual 287 HILL-ROM BED Q075AP1976 CARE ASSIST ES Annual 288 HILL-ROM BED Q264AP8944 CARE ASSIST ES Annual 289 HILL-ROM BED Q264AP8932 CARE ASSIST ES Annual

290 HILL-ROM BED Q264AP8938 CARE ASSIST ES

291 HILL-ROM BED Q264AP8914 CARE ASSIST ES Annual 292 HILL-ROM BED Q264AP8934 CARE ASSIST ES Annual 293 HILL-ROM BED Q288AP9629 CARE ASSIST ES Annual

*Requires Special Equipment Provisions

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

TBD

Line # DESCRIPTION SERIAL# MODEL SCHEDULE 294 HILL-ROM BED Q264AP8937 CARE ASSIST ES Annual 295 HILL-ROM BED Q264AP8943 CARE ASSIST ES Annual 296 HILL-ROM BED Q264AP8942 CARE ASSIST ES Annual 297 HILL-ROM BED Q279AP9335 CARE ASSIST ES Annual 298 HILL-ROM BED Q272AP2943 CARE ASSIST ES Annual 299 HILL-ROM BED Q279AP9334 CARE ASSIST ES Annual 300 HILL-ROM BED Q279AP9336 CARE ASSIST ES Annual 301 HILL-ROM BED S076AR4169 CARE ASSIST ES Annual 302 HILL-ROM BED S151SP7170 CARE ASSIST ES Annual 303 HILL-ROM BED S151AP7160 CARE ASSIST ES Annual 304 HILL-ROM BED S151AP7162 CARE ASSIST ES Annual 305 HILL-ROM BED S151AP7167 CARE ASSIST ES Annual 306 HILL-ROM BED S15AP7157 CARE ASSIST ES Annual 307 HILL-ROM BED Q070AP1963 CARE ASSIST ES Annual 308 HILL-ROM BED U050AP2553 CARE ASSIST ES Annual 309 HILL-ROM BED U050AP2573 CARE ASSIST ES Annual 310 HILL-ROM BED U050AP2583 P1170G Annual 311 HILL-ROM BED U050AP2554 CARE ASSIST ES Annual 312 HILL-ROM BED U050AP2582 CARE ASSIST ES Annual 313 HILL-ROM BED U050AP250 CARE ASSIST ES Annual 314 HILL-ROM BED U050AP2585 P1170G Annual 315 HILL-ROM BED U050AP2557 CARE ASSIST ES Annual 316 HILL-ROM BED U050AP2575 CARE ASSIST ES Annual 317 HILL-ROM BED U050AP2555 CARE ASSIST ES Annual 318 HILL-ROM BED U050AP2576 CARE ASSIST ES Annual 319 HILL-ROM BED U050AP2551 CARE ASSIST ES Annual 320 HILL-ROM BED U050AP2558 CARE ASSIST ES Annual 321 HILL-ROM BED U050AP2586 CARE ASSIST ES Annual 322 HILL-ROM BED U050AP2549 CARE ASSIST ES Annual 323 HILL-ROM BED U050AP2571 CARE ASSIST ES Annual 324 HILL-ROM BED U050AP2556 CARE ASSIST ES Annual 325 HILL-ROM BED U050AP2588 CARE ASSIST ES Annual 326 HILL-ROM BED U050AP2570 CARE ASSIST ES Annual 327 HILL-ROM BED U050AP2574 CARE ASSIST ES Annual 328 HILL-ROM BED U050AP2552 P1170G Annual 329 HILL-ROM BED U050AP2584 CARE ASSIST ES Annual 330 HILL-ROM BED S151AP7172 CARE ASSIST ES Annual 331 HILL-ROM BED S151AP7173 CARE ASSIST ES Annual 332 HILL-ROM BED S116AP6218 CARE ASSIST ES Annual 333 HILL-ROM BED S151AP7159 CARE ASSIST ES Annual 334 HILL-ROM BED S151AP7164 CARE ASSIST ES Annual 335 HILL-ROM BED S15AP7163 CARE ASSIST ES Annual

*Requires Special Equipment Provisions

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

TBD

Line # DESCRIPTION SERIAL# MODEL SCHEDULE 336 HILL-ROM BED S116AP6217 CARE ASSIST ES Annual 337 HILL-ROM BED S116AP6216 CARE ASSIST ES Annual 338 HILL-ROM BED S151AP7166 CARE ASSIST ES Annual 339 HILL-ROM BED Q264AP8931 CARE ASSIST ES Annual 340 HILL-ROM BED S151AP7165 CARE ASSIST ES Annual 341 HILL-ROM BED S116AP6221 CARE ASSIST ES Annual 342 HILL-ROM BED Q264AP8936 CARE ASSIST ES Annual 343 HILL-ROM BED S151AP7158 CARE ASSIST ES Annual 344 HILL-ROM BED S117AP6226 CARE ASSIST ES Annual 345 HILL-ROM BED S151AP7168 CARE ASSIST ES Annual 346 HILL-ROM BED S151AP7169 CARE ASSIST ES Annual 347 HILL-ROM BED S116AP6219 CARE ASSIST ES Annual 348 HILL-ROM BED S116AP6222 CARE ASSIST ES Annual 349 HILL-ROM BED P269AP5389 CARE ASSIST ES Annual 350 HILL-ROM BED Q070AP2009 CARE ASSIST ES Annual 351 HILL-ROM BED S151AP7161 CARE ASSIST ES Annual 352 HILL-ROM BED Q070AP1972 CARE ASSIST ES Annual 353 HILL-ROM BED Q070AP2004 CARE ASSIST ES Annual 354 HILL-ROM BED S151AP7171 CARE ASSIST ES Annual 355 HILL-ROM BED U050AP2572 CARE ASSIST ES Annual 356 HILL-ROM BED CENTRELLA W113PF4336 CENTRELLA Annual 357 HILL-ROM BED CENTRELLA W113PF4323 CENTRELLA Annual 358 HILL-ROM BED CENTRELLA W224PF1656 CENTRELLA Annual 359 HILL-ROM BED CENTRELLA W224PF1662 CENTRELLA Annual 360 HILL-ROM BED CENTRELLA W231PF2090 CENTRELLA Annual 361 HILL-ROM BED CENTRELLA W231PF2102 CENTRELLA Annual 362 HILL-ROM BED CENTRELLA W231PF2093 CENTRELLA Annual 363 HILL-ROM BED CENTRELLA W231PF2099 CENTRELLA Annual 364 HILL-ROM BED CENTRELLA W231PF2099 CENTRELLA Annual 365 HILL-ROM BED CENTRELLA W231PF2095 CENTRELLA Annual 366 HILL-ROM BED CENTRELLA X104PF6796 P7900B200028 Annual 367 HILL-ROM BED CENTRELLA X104PF6808 P7900B200028 Annual 368 HILL-ROM BED CENTRELLA X104PF6811 P7900B200028 Annual 369 HILL-ROM BED CENTRELLA X104PF6807 P7900B200028 Annual 370 HILL-ROM BED CENTRELLA X104PF6812 P7900B200028 Annual 371 HILL-ROM BED CENTRELLA X104PF6810 P7900B200028 Annual 372 HILL-ROM BED CENTRELLA X104PF6809 P7900B200028 Annual 373 HILL-ROM BED CENTRELLA X137PF8877 P7900B200028 Annual 374 HILL-ROM CENTRELLA W084PF2339 CENTRELLA Annual 375 HILL-ROM CENTRELLA W084PF2334 CENTRELLA Annual 376 HILL-ROM CENTRELLA W084PF2355 CENTRELLA Annual 377 HILL-ROM CENTRELLA W084PF2350 CENTRELLA Annual

*Requires Special Equipment Provisions

VHC-BARSTOW MEDICAL PROPERTY LIST

Agreement Number: 24BS0032

TBD

Line # DESCRIPTION SERIAL# MODEL SCHEDULE 378 HILL-ROM CENTRELLA W224PF1668 CENTRELLA Annual 379 HILL-ROM CENTRELLA W224PF1666 CENTRELLA Annual 380 HILL-ROM CENTRELLA W224PF1658 CENTRELLA Annual 381 HILL-ROM CENTRELLA W231PF2089 Annual 382 HILL-ROM CENTRELLA W224PF1662 CENTRELLA Annual 383 HILL-ROM CENTRELLA W224PF1670 CENTRELLA Annual 384 HILL-ROM CENTRELLA W231PF2096 CENTRELLA Annual 385 HILL-ROM CENTRELLA W231PF2101 CENTRELLA Annual 386 HILL-ROM CENTRELLA W231PF2092 CENTRELLA Annual 387 HILL-ROM CENTRELLA W231PF2098 CENTRELLA Annual 388 HILL-ROM CENTRELLA X088PF5582 P7900B200028 Annual 389 HILL-ROM CENTRELLA X104PF6797 P7900B200028 Annual 390 HILL-ROM CENTRELLA X104PF6806 P7900B200028 Annual 391 HILL-ROM CENTRELLA X104PF6813 P7900B200028 Annual 392 HILL-ROM CENTRELLA BED X137PF8857 P7900B200028 Annual 393 HILL-ROM CENTRELLA SMART BED/CO X137PF8868 P7900B200028 Annual 394 HILL-ROM CENTRELLA SMART BED/CO X137P8874 P7900B200028 Annual 395 HILL-ROM CENTRELLA SMART BED/CO X137PF8871 P7900B200028 Annual

*Requires Special Equipment Provisions

Exhibit B - Budget Detail and Payment Provisions TBD

1. STANDARD BUDGET DETAIL AND PAYMENT PROVISIONS

A. Invoicing and Payment

1. For services satisfactorily rendered, and upon receipt and approval of the invoices, the State agrees to compensate the Contractor for services rendered in accordance with the rates in Exhibit B-1.

2. Invoices shall include the Agreement Number and shall be submitted in not more frequently than monthly in arrears to:

Original Invoice Approval Copy Department of Veterans Affairs CalVet Accounting Office 1227 “O” Street Room 402 Sacramento, CA 95814 APInvoices@calvet.ca.gov

Veterans Home of California – Barstow Attn: TBD 100 East Veterans Parkway Barstow, CA 92311

B. Budget Contingency Clause

1. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further form and effect. In this event, the State shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement.

2. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either cancel this Agreement with no liability occurring to the State, or offer an Agreement amendment to Contractor to reflect the reduced amount.

C. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, Government Code, Chapter 4.5, commencing with Section 927.

2. SPECIAL BUDGET DETAIL AND PAYMENT PROVISIONS

Submissions of Invoices/Claims

A. All invoices/claims must be completed thoroughly and legibly, with all applicable fields completed.

Invoices/claims that are submitted to the appropriate location but have been altered, or are inaccurate, or do not provide all necessary information will not be accepted and will be returned to the Contractor for correction.

B. Any changes to this provision relating to the invoice/claim submittal process, including but not limited to an address, form, or process change, shall be an administrative change managed through the appropriate designated CalVet office and shall not require a contract amendment.

C. Contractor shall submit monthly invoices to the CalVet Contract Manager for approval and processing.

Invoices/claims submitted shall include the following information in order to be considered complete and acceptable for processing, or the invoice/claim will be returned:

1) Contractor’s Company name exactly as it appears on the Payee Data Record (STD.204)

2) Contractor’s Company address, phone number and e-mail

3) Date of invoice/claim

4) Invoice/claim number

Exhibit B - Budget Detail and Payment Provisions TBD

5) CalVet location where services were performed

6) Contract/Agreement Number

7) Date(s) of Service

8) Total dollar amount being billed

9) First and Last name of Contractor or Provider performing services, if applicable

10) Contractor’s or Provider’s Classification, whichever is applicable

11) Contractor’s final invoice must be clearly marked as “Final Invoice”

12) When applicable, Contractors shall include the following information on the invoice/claim submitted for hourly reimbursement:

a) Hourly Rate

b) Time in and time out

c) Total hours worked

d) Any other information or documentation reasonably required to verify and substantiate the provision of services and the charges for such services.

3. CONTRACTOR OVERPAYMENTS

A. If the State determines that an overpayment has been made to the Contractor, the State will seek recovery immediately upon discovery of the overpayment by: (a) calling the Contractor’s accounting office to request a refund of the overpayment amount, or (b) offsetting subsequent Contractor payments by the amount of the overpayment if Contractor repayment or credit is not received within thirty (30) days from the date of notice.

B. If Contractor discovers it has received an overpayment, Contractor must notify the State and refund the overpayment immediately.

4. DVBE Withhold

For contracts with DVBE subcontractors pursuant to Mil. & Vet. Code Section 999.7, ten thousand dollars ($10,000) will be withheld from the final payment, or the full final payment if less than ten thousand dollars ($10,000), until the prime contractor complies with the certification requirements of subdivision (d) of Mil.

& Vet. Code Section 999.5. Prime contractor shall be given 30 days’ notice to cure the defect. If, after 30 calendar days from the date of notice, the prime contractor refuses to comply with the certification requirements, CalVet shall permanently deduct ten thousand dollars ($10,000) from the final payment, or the full payment if less than ten thousand dollars ($10,000).

CalVet shall maintain all records of the information provided by the prime contractor pursuant to Section

999.5 and shall establish appropriate review procedures for those records to ensure the accuracy and completeness of the award amounts and paid amounts reported. The records shall be maintained in a manner that facilitates access and review by external auditors. Records collected pursuant to this section shall be retained for a minimum of six years after collection. (Mil. & Vet. Code Section 999.55)

Exhibit B-1, Rate Sheet TBD

RATE SHEET

The Contractor must be able to provide the services listed below. Subcontractors may be used to comply with this requirement. Subcontractor Agreements may be used to comply with this requirement. Subcontractor(s) information must be identified on Bidder Declaration (GSPD-05-105). If additional Subcontractors are added during the term of the Agreement, an updated GSPD-05-105 must be submitted.

The rates listed below are in effect for the term of the Agreement, including any…