Attachment C - FF_E List - Revised 08102020.pdf
PDF 1 MB Posted
- Attached to
- Q702--Rapid City Community Based Outpatient Clinic (CBOC) RFQ (VA-20-00011079) Amendment 0004
- Solicitation number
- 36A77620Q0302
About this file
This combined synopsis/solicitation from the Department of Veterans Affairs seeks quotes for initial outfitting, transition, and activation services at a new Rapid City Community-Based Outpatient Clinic in South Dakota. The anticipated contract period is August 2020 through September 2022.
The requirement is set aside exclusively for service-disabled veteran-owned small businesses. Quotes are due by the date and time specified in the solicitation. The work includes outfitting and transition services as described in the attached performance work statement. The government will award a firm-fixed price contract with options and anticipates making the award from this solicitation. Offerors must accept the terms or note any exceptions in their response. Questions may be submitted by the specified date and will be answered and posted to the Federal Business Opportunities website.
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Text version
PROGRAM FOR DESIGN
CFM RAPID CITY GSA JULY 31, 2018
RAPID CITY - STAND ALONE MSOC
RAPID CITY, SD
Projected Year: 2016 Midpoint Year: 2017
VISN: 23 State: SD Station ID: 568A4 Station: Black Hills, Hot Sprngs
Installation: VA Black Hills HCS, Hot Springs Campus
Project Created: 15 Oct 2014 10:22AM ET by Jason Moseley Space Plan Last Edited: 31 Jul 2018 11:45AM ET by Diane Lorengo-Volk
Contents List Created: 07 Aug 2018 11:44AM ET by Diane Lorengo-Volk Contents List Last Edited: 07 Aug 2018 11:44AM ET by Diane Lorengo-Volk
Report Generated: 07 Aug 2018 05:02PM
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 1 - LOBBY / RECEPTION AREA
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 NCWD4 Alcove, Volunteer 56 56 1 0
1 SRLW1 Alcove, Wheelchair 90 90 1 0
4 RECP4 Kiosk, Patient Check-In 40 160 1 0
1 XXYYC PIV office 80 80 1 0
4 RECP3 Reception 60 240 1 0
1 RECP5 Reception, Accessible 100 100 1 0
1 XXYYC Security Office 120 120 1 0
2 TLTU1 Toilet, Family 75 150 1 0
1 TLTF2 Toilet, Female 200 200 1 0
1 TLTM2 Toilet, Male 200 200 1 0
1 WRC05 Waiting, PACT 2 3,615 3,615 1 0
1 WRF01 Waiting, PACT Family 60 60 1 0
4 CLSC2 Workstation, Patient Education 30 120 1 0
FA Totals: Room Qty: 23 Net Area: 5,191 Gross Area: 7,890
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 2 - PACT SPACE - 2 MODULES, 8 TEAMLETS
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
2 PEHW2 Alcove, Height / Weight Accessible Station 40 80 1 0
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
RAPID CITY - STAND ALONE MSOC
RAPID CITY, SD
Functional Area: 2 - PACT SPACE - 2 MODULES, 8 TEAMLETS
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
2 RCA06 Alcove, Medication 20 40 1 0
1 CRA03 CONFERENCE ROOM, LARGE 400 400 1 0
10 OFDC2 Consult Room, Patient Aligned Care Team (PACT) 125 1,250 1 0
14 EXPA1 Exam Room, Patient Aligned Care Team (PACT) 125 1,750 1 0
4 EXW01 Exam Room, Women's Health 125 500 1 0
2 LR004 Locker, Staff Personal Property 60 120 1 0
2 SL001 Lounge, Staff 240 480 1 0
1 OFA02 OFFICE, Nurse Manager/AO 120 120 1 0
2 TRPR1 Procedure Room, General 180 360 1 0
2 CLSC4 Shared Medical Appointment Room 400 800 1 0
2 SRE01 Storage, Medical Equipment 120 240 1 0
2 SRE01 Storage, Shared Medical Appointments 100 200 1 0
8 WRTM1 Team Work Area 240 1,920 1 0
2 WRTM2 Tele-Health Room 125 250 1 0
1 WRTM3 Tele-Retinal / Tele-Derm Room 125 125 1 0
2 TLTB1 Toilet, General Procedure Room Patient 75 150 1 0
2 TLTU1 Toilet, PACT Patient 60 120 1 0
3 TLTU1 Toilet, Staff 60 180 1 0
4 TLTF1 Toilet, Women's Health Exam Room Patient 60 240 1 0
1 UCCL1 Utility Room, Clean 60 60 1 0
1 SPSU1 Utility, Soiled 60 60 1 0
1 WKTM3 Workroom, Patient Aligned Care Team (PACT), Touchdown 292 292 1 0
8 OFA03 Workstation, Extended Team 56 448 1 0
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
FA Totals: Room Qty: 79 Net Area: 10,185 Gross Area: 15,481
Functional Area: 3 - SPECIALTY CARE PATIENT AREA
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
5 EXRG3 Exam Rooms - Specialty Care 125 625 1 0
1 PEHW1 Height/Weight Screening 60 60 1 0
1 MEDP1 Medication Preparation Station 60 60 1 0
1 TLTU1 Patient Toilet 60 60 1 0
1 TROB2 Procedure Room 180 180 1 0
1 CLHS4 Storage/Equipment--Prosthetics DME 200 200 1 0
1 TLTU1 Toilet, Procedure Room 60 60 1 0
1 UCCL1 UTILITY, CLEAN 60 60 1 0
FA Totals: Room Qty: 12 Net Area: 1,305 Gross Area: 1,984
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 4 - OPC: ACQUISITION AND MATERIEL MANAGEMENT SERVICES (AMMS)
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 MMRP1 A&D: Receiving and Issue area 200 200 1 0
1 DOCK1 A&D: Receiving and Shipping Dock 110 110 1 0
1 SRSE1 Storage Room, Equipment/Shelving (warehousing) 200 200 1 0
FA Totals: Room Qty: 3 Net Area: 510 Gross Area: 775
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Functional Area: 5 - OPC: AUDIOLOGY AND SPEECH PATHOLOGY
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
2 EXOS1 AUD: Office, Therapy Room, Audiologist 130 260 1 0
2 PEHS4 AUD: Suite, Audiometric Exam 260 520 1 0
1 TREN2 AUD:HEARING AID FITTING AND MODIFICATION RM 160 160 1 0
1 SRSE1 Equipment Area 110 110 1 0
FA Totals: Room Qty: 6 Net Area: 1,050 Gross Area: 1,596
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 6 - OPC: MENTAL HEALTH
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 OPMH3 Biofeedback Control Room / Tech Office 120 120 1 0
2 EXRG3 Exam / Treatment Room 120 240 1 0
2 OPMH1 Group Therapy Room 300 600 1 0
1 WKTM3 HUD/VASH 250 250 1 0
13 OFDC1 Office, Counseling Staff 120 1,560 1 0
1 WRTM2 Tele-Mental Health Room 120 120 1 0
1 TLTU1 Toilet, Unisex 60 60 1 0
FA Totals: Room Qty: 21 Net Area: 2,950 Gross Area: 4,484
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Functional Area: 7 - OPC: RADIOLOGY
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 DR001 ES: Dressing Room 35 35 1 0
1 XDR01 ES: General Purpose Radiology Room 300 300 1 0
1 OFA02 ES: Office, Professional, Non Physician, Reading Room 91 91 1 0
1 OFA03 ES: Office, Reception 56 56 1 0
1 TLTU1 ES: Toilet, Patient 60 60 1 0
1 UCCL1 ES: Utility Room, Clean 100 100 1 0
1 USCL1 ES: Utility Room, Soiled 80 80 1 0
1 DOCK1 Mobile MRI/CT Tech Pad access and waitng 200 200 1 0
1 LCCL1 STORAGE, CLEAN LINEN CART 100 100 1 0
FA Totals: Room Qty: 9 Net Area: 1,022 Gross Area: 1,553
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 8 - OPC: PATHOLOGY AND LABORATORY MEDICINE (PLM)
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 LBVP1 Blood Drawing Area 290 290 1 0
1 LMCH1 Chemistry 545 545 1 0
1 SRS01 LAB: Storage, Bulk 160 160 1 0
1 RECP3 RECEPTION, INFORMATION DESK 60 60 1 0
2 TLTU1 Toilet, Unisex 60 120 1 0
FA Totals: Room Qty: 6 Net Area: 1,175 Gross Area: 1,786
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Functional Area: 9 - OPC: PHARMACY SERVICE
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 CLCEX Anti-Coag 125 125 1 0
1 OFDC2 CONSULTATION ROOM - PharmD 125 125 1 0
2 PHOD2 Prescription Dispensing Area - OmniCell Station 60 120 1 0
1 SPSU1 Storage and Receiving, negative pressure 60 60 1 0
FA Totals: Room Qty: 5 Net Area: 430 Gross Area: 654
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 10 - OPC: CANTEEN
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 BX002 Vending Machine Area 100 100 1 0
FA Totals: Room Qty: 1 Net Area: 100 Gross Area: 152
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Functional Area: 11 - OPC: BUSINESS OFFICE
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 OFA02 Business Office Lead MSA FTEE 120 120 1 0
1 RPR01 Copy Room 100 100 1 0
1 OFA01 ID Badges - Veteran ID Card 100 100 1 0
1 OFA02 OFFICE, ROI/Billing Shared 100 100 1 0
FA Totals: Room Qty: 4 Net Area: 420 Gross Area: 638
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 12 - OPC: ENGINEERING
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 BMER1 Biomedical Engineering Repair Shop 200 200 1 0
FA Totals: Room Qty: 1 Net Area: 200 Gross Area: 304
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Functional Area: 13 - OPC: ENVIRONMENTAL MANAGEMENT (EMS)
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 UTC01 Dumpsters 150 150 1 0
3 JANC1 Housekeeping Aides Closet (HAC) 40 120 1 0
1 SRHM1 Infectious / Hazardous Waste 40 40 1 0
1 SRSE1 Storage, Large Equipment 150 150 1 0
1 SRSE1 STORAGE, Supplies 120 120 1 0
FA Totals: Room Qty: 7 Net Area: 580 Gross Area: 882
Department: 1 - OUTPATIENT CLINIC (265)
Functional Area: 14 - OPC: EMS: LOCKERS, LOUNGES, TOILETS AND SHOWERS (LLTS)
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 OFA02 Lactation 80 80 1 0
2 LR002 Locker Room 220 440 1 0
1 TLTS1 Shower, Female Staff 60 60 1 0
1 TLTS1 Shower, Male Staff 60 60 1 0
1 TLTU1 Toilet, Female Staff 60 60 1 0
1 TLTU1 Toilet, Male Staff 60 60 1 0
FA Totals: Room Qty: 7 Net Area: 760 Gross Area: 1,155
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Functional Area: 15 - OPC: OIT
Qty Room Code Room Name Unit Area
Net Area
Const Phase
Const Type
1 CMP03 Central Server Room 180 180 1 0
1 OFA02 Cubicle, Hardware Specialist w/ bench 100 100 1 0
2 CMP02 Tele Communications Room/Closet 80 160 1 0
FA Totals: Room Qty: 4 Net Area: 440 Gross Area: 669
Dept Totals: Room Qty: 188 Net Area: 26,318 Gross Area: 40,003
Bldg Totals: Room Qty: 188 Net Area: 26,318 Sum of Dept Gross Area: Gross Area: 54,00440,003
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Building Area Summary And Net to Gross Factor Breakdown
Current Building Factor applied to this Project: 1.35
Building GSF
Current 54,005
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Report Parameters
Sorted By: Compressed to Dept position, FA position, Room Name
(END OF REPORT)
Privacy Act - FOR OFFICIAL USE ONLY
Program For Design (07 Aug 2018 05:02PM)
CFM RAPID CITY GSA JULY 31, 2018
Project Room Contents
LOCAL CFM RAPID CITY GSA JULY 31, 2018
RAPID CITY - STAND ALONE MSOC
RAPID CITY, SD
Projected Year: 2016 Midpoint Year: 2017
VISN: 23 State: SD Station ID: 568A4 Station Name: Black Hills, Hot Springs
Installation: VA Black Hills HCS, Hot Springs Campus
Project Created: 15 Oct 2014 10:22AM ET by Jason Moseley Space Plan Last Edited: 07 Aug 2018 11:40AM ET by John Henderson
Contents List Created: 07 Aug 2018 11:44AM ET by John Henderson Contents List Last Edited: 07 Aug 2018 11:44AM ET by John Henderson
Report Generated: 07 Aug 2018 11:45AM ET
Project Room Contents (07 Aug 2018 11:45AM ET)
Privacy Act – FOR OFFICIAL USE ONLY (Page 2)
Department: OUTPATIENT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: SRLW1 Room Area: 90 Agency Room Name: Alcove, Wheelchair Staff: 0 Criteria Room Name: Alcove, Wheelchair Blueprint #:
JSN Content Name Qty Unit Of Issue Unit Price Total Price
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
M4705 Wheelchair, Patient Transport, Folding 1 EA 532 532 VV
M4710 Wheelchair, Patient, Bariatric, Transport, Folding 1 EA 1,703 1,703 VV
Room Code: WRC05 Room Area: 3615 Agency Room Name: Waiting, PACT 2 Staff: 0 Criteria Room Name: Waiting, PACT 2 Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 5 EA 222 1,110 VC
A5220 Bracket, Television, Wall Backing 5 EA 93 465 CC
F0206 Chair, Side, Bariatric, With Arms 23 EA 742 17,066 VV
F0305 Chair, Waiting Room, Single 87 EA 622 54,114 VV
F0740 Table, Occasional, Lamp 5 EA 343 1,715 VV F2000 Basket, Wastepaper, Fire Resistant 5 EA 51 255 VV
F2300 Rack, Magazine, Wall Mounted 5 EA 253 1,265 VC
F2310 Rack, Pamphlet, Wall Mounted 5 EA 174 870 VC
F3200 Clock, Battery, 12" Diameter 5 EA 50 250 VV
M0506 Television, Flat Screen 5 EA 537 2,685 VV . A
Total Content Costs for this Room: 2,235
Privacy Act – FOR OFFICIAL USE ONLY (Page 3)
Total Content Costs for this Room: 79,795
Room Code: WRF01 Room Area: 60 Agency Room Name: Waiting, PACT Family Staff: 0 Criteria Room Name: Waiting, PACT Family Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA 222 222 VC
A5220 Bracket, Television, Wall Backing 1 EA 93 93 CC
A6046 Artwork, Decorative, With Frame 1 EA 517 517 VC F0206 Chair, Side, Bariatric, With Arms 1 EA 742 742 VV
F0305 Chair, Waiting Room, Single 3 EA 622 1,866 VV
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
F2045 Furniture, Playroom, Assorted 1 LT 3,203 3,203 VV
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
M0515 Television, HD, 40" Class 1 EA 516 516 VV . A . . . M
Total Content Costs for this Room: 7,260
Room Code: RECP3 Room Area: 60 Agency Room Name: Reception Staff: 0 Criteria Room Name: Reception Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 2 EA 0 0 VV
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
A6105 Counter, Reception Control, Built-In 1 EA 7,736 7,736 CC . A
F0275 Chair, Swivel, High Back 1 EA 636 636 VV
Privacy Act – FOR OFFICIAL USE ONLY (Page 4)
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,512 1,512 VV . A
Total Content Costs for this Room: 9,985
Room Code: RECP5 Room Area: 100 Agency Room Name: Reception, Accessible Staff: 0 Criteria Room Name: Reception, Accessible Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
A6105 Counter, Reception Control, Built-In 1 EA 7,736 7,736 CC . A F0280 Chair, Swivel, Low Back 1 EA 490 490 VV
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
F3200 Clock, Battery, 12” Diameter 1 EA 50 50 VC - - - - - -
Total Content Costs for this Room: 9,789
Room Code: NCWD4 Room Area: 56 Agency Room Name: Alcove, Volunteer Staff: 0 Criteria Room Name: Alcove, Volunteer Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 1 EA 1,032 1,032 CC
Privacy Act – FOR OFFICIAL USE ONLY (Page 5)
C02Q0 Cabinet, Sink, U/C/B, 1 Door, 36x24x22 1 EA 704 704 CC
CB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 1 EA 723 723 CC CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT030 Countertop, High Pressure Laminate 1 LF 65 65 CC
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VC
K1552 Brewer, Coffee, Auto, Elect, 3 Burner, Front/Back 1 EA 1,241 1,241 VV J A
Total Content Costs for this Room: 4,966
Department: OUTPATIENT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: RECP4 Room Area: 40 Agency Room Name: Kiosk, Patient Check-In Staff: 2 Criteria Room Name: Kiosk, Patient Check-In Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 1 EA 0 0 CC
M1890 Kiosk, Educational, Stand-Up 1 EA 4,470 4,470 VC . A
Total Content Costs for this Room: 4,470
Room Code: CLSC2 Room Area: 30 Agency Room Name: Workstation, Patient Education Staff: 0 Criteria Room Name: Workstation, Patient Education Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 1 EA 0 0 CC A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
E0042 Workcenter, Computer, Free Standing, 48" W 1 EA 2,615 2,615 VV
F0280 Chair, Swivel, Low Back 1 EA 490 490 VV
Privacy Act – FOR OFFICIAL USE ONLY (Page 6)
Total Content Costs for this Room: 4,668
Room Code: TLTU1 Room Area: 75 Agency Room Name: Toilet, Family Staff: 0 Criteria Room Name: Toilet, Family Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1067 Mirror, Float Glass, ADA Accessible 1 EA 294 294 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
P3100 Lavatory, Vitreous China, Slab Type 1 EA 546 546 CC D
P9050 Toilet, Wall Hung, Siphon Jet 1 EA 824 824 CC B A4995 Table, Diaper Changning, Wall Mounted 1 EA CC
Total Content Costs for this Room: 2,145
Room Code: TLTF2 Room Area: 200 Agency Room Name: Toilet, Female Staff: 0 Criteria Room Name: Toilet, Female Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
Privacy Act – FOR OFFICIAL USE ONLY (Page 7)
A1067 Mirror, Float Glass, ADA Accessible 2 EA 294 588 CC
A4995 Table, Diaper Changing, Wall Mounted 1 EA 332 332 CC A5075 Dispenser, Soap, Disposable 2 EA 17 34 VC
A5082 Dispenser, Paper Towel, Sensor, Hands Free 2 EA 207 414 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 3 EA 51 153 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5110 Grab Bar, 1-1/4" Dia., SS, 2 Wall, Shower Use 1 EA 107 107 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 3 EA 87 261 CC C0041 Rail, Apron, 4X60X1 2 EA 82 164 CC
CT020 Countertop, Solid Surface 5 LF 179 895 CC
F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 263 263 VV
P3070 Lavatory, Vitreous China, Under or Counter Top Mtd 2 EA 527 1,054 CC D
P9050 Toilet, Wall Hung, Siphon Jet 3 EA 824 2,472 CC B
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA CC A4995 Table, Diaper Changing, Wall Mounted 1 EA CC
Total Content Costs for this Room: 6,893
Room Code: TLTM2 Room Area: 200 Agency Room Name: Toilet, Male Staff: 0 Criteria Room Name: Toilet, Male Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1067 Mirror, Float Glass, ADA Accessible 2 EA 294 588 CC
A4995 Table, Diaper Changing, Wall Mounted 1 EA 332 332 CC
A5075 Dispenser, Soap, Disposable 2 EA 17 34 VC A5082 Dispenser, Paper Towel, Sensor, Hands Free 2 EA 207 414 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 2 EA 87 174 CC
C0041 Rail, Apron, 4x60x1 2 EA 82 164 CC
CT020 Countertop, Solid Surface 5 LF 179 895 CC
Privacy Act – FOR OFFICIAL USE ONLY (Page 8)
F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 263 263 VV
P3070 Lavatory, Vitreous China, Under or Counter Top Mtd 2 EA 527 1,054 CC D P8150 Urinal, Wall Hung 2 EA 446 892 CC B
P9050 Toilet, Wall Hung, Siphon Jet 2 EA 824 1,648 CC B
Total Content Costs for this Room: 6,614
Room Code: TLTU1 Room Area: 75 Agency Room Name: Toilet, Family Staff: 0 Criteria Room Name: Toilet, Family Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1067 Mirror, Float Glass, ADA Accessible 1 EA 294 294 CC A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
P3100 Lavatory, Vitreous China, Slab Type 1 EA 546 546 CC D
P9050 Toilet, Wall Hung, Siphon Jet 1 EA 824 824 CC B
Privacy Act – FOR OFFICIAL USE ONLY (Page 9)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
E0042 Workcenter, Computer, Free Standing, 48" W 1 EA 2,615 2,615 VV
F0280 Chair, Swivel, Low Back 1 EA 490 490 VV
Room Code: RECP4 Room Area: 40
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 1 EA 0 0 CC
M1890 Kiosk, Educational, Stand-Up 1 EA 4,470 4,470 VC . A
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 2 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
Privacy Act – FOR OFFICIAL USE ONLY (Page 10)
A6105 Counter, Reception Control, Built-In 1 EA 7,736 7,736 CC . A
F0275 Chair, Swivel, High Back 1 EA 636 636 VV F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 Comments
A1010 Telecommunication Outlet 2 EA 0 0 CC A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
A6105 Counter, Reception Control, Built-In 1 EA 7,736 7,736 CC . A
F0275 Chair, Swivel, High Back 1 EA 636 636 VV
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
Privacy Act – FOR OFFICIAL USE ONLY (Page 11)
M1890 Kiosk, Educational, Stand-Up 1 EA 4,470 4,470 VC . A
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
E0042 Workcenter, Computer, Free Standing, 48" W 1 EA 2,615 2,615 VV
F0280 Chair, Swivel, Low Back 1 EA 490 490 VV
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,512 1,512 VV . A
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
E0042 Workcenter, Computer, Free Standing, 48" W 1 EA 2,615 2,615 VV F0280 Chair, Swivel, Low Back 1 EA 490 490 VV
Privacy Act – FOR OFFICIAL USE ONLY (Page 12)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
M1890 Kiosk, Educational, Stand-Up 1 EA 4,470 4,470 VC . A
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 2 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
A6105 Counter, Reception Control, Built-In 1 EA 7,736 7,736 CC . A
F0275 Chair, Swivel, High Back 1 EA 636 636 VV
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
Total Content Costs for this Functional Area: 198,334
Privacy Act – FOR OFFICIAL USE ONLY (Page 13)
Department: OUTPATIENT CLINIC (265) Functional Area: PACT SPACE - 2 MODULES, 8 TEAMLETS Room Code: PEHW2 Room Area: 40 Agency Room Name: Alcove, Height / Weight Accessible Station Staff: 0 Criteria Room Name: Alcove, Height / Weight Accessible Station Blueprint #:
Log Cat/ Acq
Code
M4045 Scale, Wheelchair, Portable, 1000 lb Capacity 1 EA 3,185 3,185 VV
Total Content Costs for this Room: 3,185
Room Code: OFDC2 Room Area: 125 Agency Room Name: Consult Room, Patient Aligned Care Team (PACT) Staff: 1 Criteria Room Name: Consult Room, Patient Aligned Care Team (PACT) Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 2 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,024 1,024 CC
CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT030 Countertop, High Pressure Laminate 3 LF 65 195 CC F0205 Chair, Side With Arms 3 EA 552 1,656 VV
F0340 Stool, Self Adjusting 1 EA 373 373 VV
F0740 Table, Occasional, Lamp 1 EA 343 343 VV
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,050 1,050 VC . B . . . D 7110
Privacy Act – FOR OFFICIAL USE ONLY (Page 14)
Total Content Costs for this Room: 7,376
Room Code: EXPA1 Room Area: 125 Agency Room Name: Exam Room, Patient Aligned Care Team (PACT) Staff: 0 Criteria Room Name: Exam Room, Patient Aligned Care Team (PACT) Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV
A1066 Mirror, Float Glass, With SS Frame 1 EA 85 85 CC A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VC
A5108 Waste Disposal Unit, Sharps 1 CS 211 211 VC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VC
C01Q0 Cabinet, Sink, U/C/B, 1 Door, 36x18x22 1 EA 584 584 CC
CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,024 1,024 CC
CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT030 Countertop, High Pressure Laminate 3 LF 65 195 CC
E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,836 1,836 VV F0206 Chair, Side, Bariatric, With Arms 1 EA 742 742 VV
F0340 Stool, Self Adjusting 1 EA 373 373 VV
F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV
F2310 Rack, Pamphlet, Wall Mounted 1 EA 174 174 VC
F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VC F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
Privacy Act – FOR OFFICIAL USE ONLY (Page 15)
M1825 Printer, Computer 1 EA 809 809 VV . A
M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 189 189 VC M4116 Monitor, Vital Signs 1 EA 2,425 2,425 VV . A
M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,543 1,543 VC . A
M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,125 1,125 VV . A
M9025 Table, Examination/Treatment, With Cabinet 1 EA 1,859 1,859 VV . A
Total Content Costs for this Room: 26,088
Room Code: TLTU1 Room Area: 60 Agency Room Name: Toilet, PACT Patient Staff: 0 Criteria Room Name: Toilet, PACT Patient Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1067 Mirror, Float Glass, ADA Accessible 1 EA 294 294 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
P3100 Lavatory, Vitreous China, Slab Type 1 EA 546 546 CC D
P9050 Toilet, Wall Hung, Siphon Jet 1 EA 824 824 CC B
Room Code: TLTF1 Room Area: 60 Agency Room Name: Toilet, Women's Health Exam Room Patient Staff: 0 Criteria Room Name: Toilet, Women's Health Exam Room Patient Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 16)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1066 Mirror, Float Glass, With SS Frame 1 EA 85 85 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
P3000 Lavatory, Vitreous China, Straight Back 1 EA 380 380 CC D
Total Content Costs for this Room: 1,770
Room Code: EXW01 Room Area: 125 Agency Room Name: Exam Room, Women's Health Staff: 1 Criteria Room Name: Exam Room, Women's Health Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VC
A5108 Waste Disposal Unit, Sharps 1 CS 211 211 VC
A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC
A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VC
CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,024 1,024 CC CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
Privacy Act – FOR OFFICIAL USE ONLY (Page 17)
CT030 Countertop, High Pressure Laminate 3 LF 65 195 CC
E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,836 1,836 VV F0205 Chair, Side With Arms 1 EA 552 552 VV
F0340 Stool, Self Adjusting 1 EA 373 373 VV
F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV
F2310 Rack, Pamphlet, Wall Mounted 1 EA 174 174 VC
F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VC
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,512 1,512 VV . A
M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,050 1,050 VV . B . . . D 7110
M3072 Frame, Infectious Waste Bag w/Lid 1 EA 436 436 VV
M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 189 189 VC
M4116 Monitor, Vital Signs 1 EA 2,425 2,425 VV . A
M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,543 1,543 VC . A
Total Content Costs for this Room: 16,118
Room Code: TRPR1 Room Area: 180 Agency Room Name: Procedure Room, General Staff: 0 Criteria Room Name: Procedure Room, General Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 2 EA 0 0 CC
A1011 Telephone, Desk, 1 Line 1 EA 0 0 VV A1132 Rail, Accessory Mounting, Length As Required 1 LF 99 99 VC . . . . . J 6530
A1203 Lift System, Overhead, Bariatric 1 EA 14,499 14,499 CC . F . . . J
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VC
Privacy Act – FOR OFFICIAL USE ONLY (Page 18)
A5108 Waste Disposal Unit, Sharps 1 CS 211 211 VC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC A5180 Track, Cubicle, Surface Mounted, With Curtain 14 FT 7 98 VC
C02Q0 Cabinet, Sink, U/C/B, 1 Door, 36x24x22 1 EA 704 704 CC
CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,024 1,024 CC
CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT020 Countertop, Solid Surface 1 LF 179 179 CC
E0915 Locker, Supply, Medication, Wall Mtd, 23"W x 20"D 1 EA 3,840 3,840 VV E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,836 1,836 VV
F0205 Chair, Side With Arms 1 EA 552 552 VV
F0340 Stool, Self Adjusting 1 EA 373 373 VV
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
F3010 Board, Bulletin, 48 x 48 1 EA 143 143 VC
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,512 1,512 VV . A
M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,050 1,050 VC . B . . . D 7110
M3070 Hamper, Linen, Mobile, w/Lid 1 EA 535 535 VV
M3072 Frame, Infectious Waste Bag w/Lid 1 EA 436 436 VV
M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 189 189 VC M4116 Monitor, Vital Signs 1 EA 2,425 2,425 VV . A
M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,543 1,543 VC . A
M4255 Stand, IV, Adjustable 1 EA 425 425 VV
M4655 Stretcher, Mobile, CRS, 9 Position 1 EA 5,634 5,634 VV
M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,125 1,125 VV . A
M7405 Light, Exam, Ceiling Mounted 1 EA 2,989 2,989 CC . F M7710 Electrocardiograph, 12 Lead, Portable 1 EA 13,903 13,903 VV . A
M8810 Stand, Mayo 1 EA 739 739 VV
Total Content Costs for this Room: 59,960
Room Code: WRTM2 Room Area: 125
Privacy Act – FOR OFFICIAL USE ONLY (Page 19)
Agency Room Name: Tele-Health Room Staff: 0 Criteria Room Name: Tele-Health Room Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 2 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA 45 45 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VC
A5108 Waste Disposal Unit, Sharps 1 CS 211 211 VC
A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC
A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VC CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,024 1,024 CC
CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT030 Countertop, High Pressure Laminate 3 LF 65 195 CC
E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,836 1,836 VV
F0205 Chair, Side With Arms 1 EA 552 552 VV
F0340 Stool, Self Adjusting 1 EA 373 373 VV F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV
F2310 Rack, Pamphlet, Wall Mounted 1 EA 174 174 VC
F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VC
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,512 1,512 VV . A
M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,050 1,050 VC . B . . . D 7110 M3072 Frame, Infectious Waste Bag w/Lid 1 EA 436 436 VV
M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 189 189 VC
M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,543 1,543 VC . A
Privacy Act – FOR OFFICIAL USE ONLY (Page 20)
Total Content Costs for this Room: 13,738
Room Code: WRTM3 Room Area: 125 Agency Room Name: Tele-Retinal / Tele-Derm Room Staff: 0 Criteria Room Name: Tele-Retinal Room Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 2 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VC
A5108 Waste Disposal Unit, Sharps 1 CS 211 211 VC
A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC
A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VC
CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,024 1,024 CC CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT030 Countertop, High Pressure Laminate 3 LF 65 195 CC
E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,836 1,836 VV
F0205 Chair, Side With Arms 1 EA 552 552 VV
F0340 Stool, Self Adjusting 1 EA 373 373 VV
F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV F2310 Rack, Pamphlet, Wall Mounted 1 EA 174 174 VC
F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VC
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,512 1,512 VV . A
M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,050 1,050 VC . B . . . D 7110 M3072 Frame, Infectious Waste Bag w/Lid 1 EA 436 436 VV
M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 189 189 VC
M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,543 1,543 VC . A
Privacy Act – FOR OFFICIAL USE ONLY (Page 21)
M6050 Retinal Imaging System, Fluoroscein/Indocyanine 1 SY 41,326 41,326 VV . A
Total Content Costs for this Room: 55,019
Room Code: TLTB1 Room Area: 75 Agency Room Name: Toilet, General Procedure Room Patient Staff: 1 Criteria Room Name: Toilet, General Procedure Room Patient Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1067 Mirror, Float Glass, ADA Accessible 1 EA 294 294 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 207 207 CC A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV
P3005 Lavatory, Vitreous China, Bariatric 1 EA 5,018 5,018 CC D P9056 Toilet, Floor Mounted, Bariatric 1 EA 457 457 CC B
Total Content Costs for this Room: 6,558
Room Code: CLSC4 Room Area: 400 Agency Room Name: Shared Medical Appointment Room Staff: 0 Criteria Room Name: Shared Medical Appointment Room Blueprint #:
Log Cat/ Acq
Privacy Act – FOR OFFICIAL USE ONLY (Page 22)
A1010 Telecommunication Outlet 2 EA 0 0 CC
A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA 113 113 VV A5220 Bracket, Television, Wall Backing 1 EA 93 93 CC
E0945 Cart, Computer, Mobile 2 EA 1,923 3,846 VV
F0295 Chair, Stacking 16 EA 75 1,200 VV
F0435 Cabinet, Storage, Multi Media 1 EA 1,491 1,491 VV
F0860 Table, Mobile 4 EA 938 3,752 VV
F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV F3060 Whiteboard, Projection Screen Combination 1 EA 620 620 VV
M0506 Television, Flat Screen 1 EA 537 537 VV . A
M1801 Computer, Microprocessing, w/Flat Panel Monitor 2 EA 1,512 3,024 VV . A
Total Content Costs for this Room: 14,916
Room Code: SRE01 Room Area: 100 Agency Room Name: Storage, Shared Medical Appointments Staff: 0 Criteria Room Name: Storage, Shared Medical Appointments Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
M2055 Shelving, Storage, Wire, CRS, w/Adjustable Shelves 4 EA 846 3,384 VV
Total Content Costs for this Room: 3,384
Room Code: RCA06 Room Area: 20 Agency Room Name: Alcove, Medication Staff: 0 Criteria Room Name: Alcove, Medication Blueprint #:
Log Cat/ Acq
Privacy Act – FOR OFFICIAL USE ONLY (Page 23)
M3150 Distribution System, Medication, Automatic 1 EA 46,335 46,335 VV B A
Total Content Costs for this Room: 53,151
Room Code: WRTM1 Room Area: 240 Agency Room Name: Team Work Area Staff: 0 Criteria Room Name: Team Work Area Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 4 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 2 EA 0 0 VV
E0123 Workstation, Straight, Free Standing, 72" W 4 EA 7,609 30,436 VV . A
F0275 Chair, Swivel, High Back 4 EA 636 2,544 VV F0420 Cabinet, Filing, Lateral, Half Height 2 EA 620 1,240 VV
F2000 Basket, Wastepaper, Fire Resistant 4 EA 51 204 VV
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
M1801 Computer, Microprocessing, w/Flat Panel Monitor 4 EA 1,512 6,048 VV . A
A6046 Artwork, Decorative, With Frame 1 EA 517 517 VC F3050 Whiteboard, Dry Erase 1 EA VC
M1825 Printer, Computer 1 EA VV
F0420 Cabinet, Filing, Lateral, Half Height 1 EA VV
Total Content Costs for this Room: 40,522
Room Code: OFA03 Room Area: 56 Agency Room Name: Workstation, Extended Team Staff: 1 Criteria Room Name: Workstation, Extended Team Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 24)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
E0075 Workstation, L-Shaped, Freestanding, 72x48 1 EA 9,010 9,010 VV . A
F0275 Chair, Swivel, High Back 1 EA 636 636 VV F0420 Cabinet, Filing, Lateral, Half Height 1 EA 620 620 VV
Total Content Costs for this Room: 11,829
Room Code: WKTM3 Room Area: 292 Agency Room Name: Workroom, Patient Aligned Care Team (PACT), Touchdown Staff: 2 Criteria Room Name: Workroom, Patient Aligned Care Team (PACT) Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 4 EA 0 0 CC A1011 Telephone, Desk, 1 Line 2 EA 0 0 VV
A6046 Artwork, Decorative, With Frame 1 EA 517 517 VV
E0120 Workstation, Straight, Free Standing, 60" W 2 EA 6,198 12,396 VV . A
F0275 Chair, Swivel, High Back 2 EA 636 1,272 VV
F0420 Cabinet, Filing, Lateral, Half Height 1 EA 620 620 VV
F2000 Basket, Wastepaper, Fire Resistant 2 EA 51 102 VV
M1801 Computer, Microprocessing, w/Flat Panel Monitor 4 EA 1,512 6,048 VV . A
Total Content Costs for this Room: 21,005
Privacy Act – FOR OFFICIAL USE ONLY (Page 25)
Room Code: UCCL1 Room Area: 60 Agency Room Name: Utility Room, Clean Staff: 0 Criteria Room Name: Utility Room, Clean Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
E0903 Locker, Supply, w/Shelves, Wall Mtd, 23"W x 20"D 2 EA 2,422 4,844 VV
E0906 Locker, Supply, General, Wall Mtd, 23"W x 20"D 2 EA 3,041 6,082 VV
E0912 Locker, Supply, Med Surg, Wall Mtd 2 EA 3,389 6,778 VV
E1500 Rail, MOD, W/MNTD, HX144XD 1 EA 726 726 VV
Total Content Costs for this Room: 18,576
Room Code: SRE01 Room Area: 120 Agency Room Name: Storage, Medical Equipment Staff: 0 Criteria Room Name: Storage, Medical Equipment Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
Room Code: SL001 Room Area: 240 Agency Room Name: Lounge, Staff Staff: 0 Criteria Room Name: Lounge, Staff Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 26)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV
A1080 Mirror, Posture, Wall Mounted 1 EA 383 383 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA 222 222 VV
A5220 Bracket, Television, Wall Backing 1 EA 93 93 CC
C02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 36x24x22 1 EA 859 859 CC
C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 1 EA 1,032 1,032 CC C04P0 Cabinet, Sink, U/C/B, 2 Door, 36x36x22 1 EA 737 737 CC
CB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 2 EA 723 1,446 CC
CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT020 Countertop, Solid Surface 7 LF 179 1,253 CC
F0225 Chair, Dining Room 4 EA 255 1,020 VV F0795 Table, Dining 1 EA 684 684 VV
F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 263 263 VV
F3065 Whiteboard/Bulletin Board, Combination 1 EA 349 349 VC
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
K1552 Brewer, Coffee, Auto, Elect, 3 Burner, Front/Back 1 EA 1,241 1,241 VV J A
K4665 Oven, Microwave, Consumer 1 EA 285 285 VV . A
R7250 Refrigerator/Freezer, 20 Cubic Feet 1 EA 1,336 1,336 VV . A
Total Content Costs for this Room: 12,891
Room Code: LR004 Room Area: 60 Agency Room Name: Locker, Staff Personal Property Staff: 0 Criteria Room Name: Locker, Staff Personal Property Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 27)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1040 Locker, 2 Person, Side by Side, 72x15x18 15 EA 467 7,005 VC
Total Content Costs for this Room: 7,056
Agency Room Name: Toilet, Staff Staff: 0 Criteria Room Name: Toilet, Staff Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1067 Mirror, Float Glass, ADA Accessible 1 EA 294 294 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
Agency Room Name: Toilet, Staff Staff: 0 Criteria Room Name: Toilet, Staff Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 28)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1067 Mirror, Float Glass, ADA Accessible 1 EA 294 294 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
Room Code: LR004 Room Area: 60 Agency Room Name: Locker, Staff Personal Property Staff: 0 Criteria Room Name: Locker, Staff Personal Property Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1040 Locker, 2 Person, Side by Side, 72x15x18 15 EA 467 7,005 VC
Total Content Costs for this Room: 7,056
Room Code: SL001 Room Area: 240 Agency Room Name: Lounge, Staff Staff: 0 Criteria Room Name: Lounge, Staff Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 29)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV
A1080 Mirror, Posture, Wall Mounted 1 EA 383 383 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA 222 222 VV
A5220 Bracket, Television, Wall Backing 1 EA 93 93 CC
C02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 36x24x22 1 EA 859 859 CC
C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 1 EA 1,032 1,032 CC C04P0 Cabinet, Sink, U/C/B, 2 Door, 36x36x22 1 EA 737 737 CC
CB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 2 EA 723 1,446 CC
CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D
CT020 Countertop, Solid Surface 7 LF 179 1,253 CC
F0225 Chair, Dining Room 4 EA 255 1,020 VV F0795 Table, Dining 1 EA 684 684 VV
F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 263 263 VV
F3065 Whiteboard/Bulletin Board, Combination 1 EA 349 349 VC
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
K1552 Brewer, Coffee, Auto, Elect, 3 Burner, Front/Back 1 EA 1,241 1,241 VV J A
K4665 Oven, Microwave, Consumer 1 EA 285 285 VV . A
R7250 Refrigerator/Freezer, 20 Cubic Feet 1 EA 1,336 1,336 VV . A
Total Content Costs for this Room: 12,891
Room Code: SRE01 Room Area: 120 Agency Room Name: Storage, Medical Equipment Staff: 0 Criteria Room Name: Storage, Medical Equipment Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 30)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV
E0075 Workstation, L-Shaped, Freestanding, 72x48 1 EA 9,010 9,010 VV . A
F0275 Chair, Swivel, High Back 1 EA 636 636 VV
F0420 Cabinet, Filing, Lateral, Half Height 1 EA 620 620 VV
Log Cat/ Acq
Code
A1010 Telecommunication Outlet 4 EA 0 0 CC
Privacy Act – FOR OFFICIAL USE ONLY (Page 31)
A1015 Telephone, Desk, Multiple Line 2 EA 0 0 VV
E0123 Workstation, Straight, Free Standing, 72" W 4 EA 7,609 30,436 VV . A F0275 Chair, Swivel, High Back 4 EA 636 2,544 VV
F0420 Cabinet, Filing, Lateral, Half Height 2 EA 620 1,240 VV
F2000 Basket, Wastepaper, Fire Resistant 4 EA 51 204 VV
A6046 Artwork, Decorative, With Frame 1 EA 517 517 VC F3050 Whiteboard, Dry Erase 1 EA VC
Room Code: RCA06 Room Area: 20 Agency Room Name: Alcove, Medication Staff: 0 Criteria Room Name: Alcove, Medication Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
M3150 Distribution System, Medication, Automatic 1 EA 46,335 46,335 VV B A
Total Content Costs for this Room: 53,151
Room Code: SRE01 Room Area: 100 Agency Room Name: Storage, Shared Medical Appointments Staff: 0 Criteria Room Name: Storage, Shared Medical Appointments Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 32)
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
Room Code: CLSC4 Room Area: 400 Agency Room Name: Shared Medical Appointment Room Staff: 0 Criteria Room Name: Shared Medical Appointment Room Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 2 EA 0 0 CC
A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA 113 113 VV
A5220 Bracket, Television, Wall Backing 1 EA 93 93 CC
E0945 Cart, Computer, Mobile 2 EA 1,923 3,846 VV
F0295 Chair, Stacking 16 EA 75 1,200 VV
F0435 Cabinet, Storage, Multi Media 1 EA 1,491 1,491 VV F0860 Table, Mobile 4 EA 938 3,752 VV
F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV
F3060 Whiteboard, Projection Screen Combination 1 EA 620 620 VV
M0506 Television, Flat Screen 1 EA 537 537 VV . A
M1801 Computer, Microprocessing, w/Flat Panel Monitor 2 EA 1,512 3,024 VV . A
Total Content Costs for this Room: 14,916
Room Code: EXW01 Room Area: 125 Agency Room Name: Exam Room, Women's Health Staff: 1 Criteria Room Name: Exam Room, Women's Health Blueprint #:
Privacy Act – FOR OFFICIAL USE ONLY (Page 33)
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Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VC
A5108 Waste Disposal Unit, Sharps 1 CS 211 211 VC
A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC
A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VC
CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,024 1,024 CC
CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 986 986 CC D CT030 Countertop, High Pressure Laminate 3 LF 65 195 CC
E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,836 1,836 VV
F0205 Chair, Side With Arms 1 EA 552 552 VV
F0340 Stool, Self Adjusting 1 EA 373 373 VV
F2010 Basket, Wastepaper, Step-On 1 EA 240 240 VV F2310 Rack, Pamphlet, Wall Mounted 1 EA 174 174 VC
F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VC
F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VC
M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,512 1,512 VV . A
M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,050 1,050 VV . B . . . D 7110
M3072 Frame, Infectious Waste Bag w/Lid 1 EA 436 436 VV M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 189 189 VC
M4116 Monitor, Vital Signs 1 EA 2,425 2,425 VV . A
M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,543 1,543 VC . A
Total Content Costs for this Room: 16,118
Privacy Act – FOR OFFICIAL USE ONLY (Page 34)
Room Code: TLTF1 Room Area: 60 Agency Room Name: Toilet, Women's Health Exam Room Patient Staff: 0 Criteria Room Name: Toilet, Women's Health Exam Room Patient Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1066 Mirror, Float Glass, With SS Frame 1 EA 85 85 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV
P3000 Lavatory, Vitreous China, Straight Back 1 EA 380 380 CC D
Total Content Costs for this Room: 1,770
Agency Room Name: Toilet, PACT Patient Staff: 0 Criteria Room Name: Toilet, PACT Patient Blueprint #:
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1067 Mirror, Float Glass, ADA Accessible 1 EA 294 294 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 88 88 CC
A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC
A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 156 156 CC
Privacy Act – FOR OFFICIAL USE ONLY (Page 35)
A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC
Log Cat/ Acq
Code Util1 Util2 Util3 Util4 Util5 Util6 NSN
A1010 Telecommunication Outlet 1 EA 0 0 CC
A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV A1066 Mirror, Float Glass, With SS Frame 1 EA 85 85 CC
A5075 Dispenser, Soap, Disposable 1 EA 17 17 VC
A5080 Dispenser, Paper Towel, SS, Surface…
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