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Information
| PERIODS OF PERFORMANCE | |
| BASE PERIOD APRIL 1, 2020 - MARCH 31, 2023 | Separately Priced |
| OPTION PERIOD 1 APRIL 1, 2023 - MARCH 31, 2026 | Separately Priced |
| OPTION PERIOD 2 APRIL 1, 2026 - MARCH 31, 2029 | Separately Priced |
| OPTION TO EXTEND SERVICES PERIOD April 1, 2029 - September 30, 2029 | Not Separately Priced |
VISN 1
| CLIN PRICING STRUCTURE SHEET |
| Medical/Surgical Prime Vendor (MSPV) 2.0 Solicitation 36C10G19R0050- Attachment A |
| VISN 1 |
Company Name:
| BASE PERIOD APRIL 1, 2020 - MARCH 31, 2023 | |
| CLIN 0001AW 120 Day Implementation Period | NOT SEPARATELY PRICED |
| Conventional/Bulk Distribution Fee | |
| CLIN 0001AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 0001AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0001AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0001AD- Saturday Deliveries | ______________% |
| CLIN 0001AE- Sunday Deliveries | ______________% |
| CLIN 0001AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 0001AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 0001AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0001AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0001AJ- Saturday Deliveries | ______________% |
| CLIN 0001AK- Sunday Deliveries | ______________% |
| CLIN 0001AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 0001AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 0001AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 0001AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 0001AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 0001AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 0001AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 0001AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 0001AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 0001AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 0001AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 0001AX Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 0001AY Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 0001AZ Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 0001BA Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 0001BB Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 1: APRIL 1, 2023 - MARCH 31, 2026 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 1001AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 1001AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1001AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1001AD- Saturday Deliveries | ______________% |
| CLIN 1001AE- Sunday Deliveries | ______________% |
| CLIN 1001AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 1001AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 1001AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1001AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1001AJ- Saturday Deliveries | ______________% |
| CLIN 1001AK- Sunday Deliveries | ______________% |
| CLIN 1001AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 1001AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 1001AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 1001AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 1001AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 1001AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 1001AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 1001AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 1001AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 1001AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 1001AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 1001AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 1001AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 1001AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 1001AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 1001BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 2: APRIL 1, 2026 - MARCH 31, 2029 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 2001AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 2001AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2001AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2001AD- Saturday Deliveries | ______________% |
| CLIN 2001AE- Sunday Deliveries | ______________% |
| CLIN 2001AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 2001AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 2001AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2001AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2001AJ- Saturday Deliveries | ______________% |
| CLIN 2001AK- Sunday Deliveries | ______________% |
| CLIN 2001AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 2001AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 2001AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 2001AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 2001AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 2001AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 2001AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 2001AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 2001AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 2001AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 2001AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 2001AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 2001AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 2001AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 2001AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 2001BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 52.217-8: APRIL 1, 2029 - SEPTEMBER 30, 2029 |
| Per FAR 52.217-8 Rates for this option period will be set at current rates at the end of Option Period 2 and may only be adjusted as a result of revisions to prevailing labor rates by the SEC of Labor. |
VISN 2
| CLIN PRICING STRUCTURE SHEET |
| Medical/Surgical Prime Vendor (MSPV) 2.0 Solicitation 36C10G19R0050- Attachment A |
| VISN 2 |
Company Name:
| BASE PERIOD APRIL 1, 2020 - MARCH 31, 2023 | |
| CLIN 0002AW 120 Day Implementation Period | NOT SEPARATELY PRICED |
| Conventional/Bulk Distribution Fee | |
| CLIN 0002AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 0002AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0002AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0002AD- Saturday Deliveries | ______________% |
| CLIN 0002AE- Sunday Deliveries | ______________% |
| CLIN 0002AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 0002AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 0002AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0002AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0002AJ- Saturday Deliveries | ______________% |
| CLIN 0002AK- Sunday Deliveries | ______________% |
| CLIN 0002AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 0002AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 0002AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 0002AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 0002AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 0002AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 0002AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 0002AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 0002AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 0002AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 0002AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 0002AX Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 0002AY Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 0002AZ Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 1002BA Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 1002BB Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 1: APRIL 1, 2023 - MARCH 31, 2026 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 1002AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 1002AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1002AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1002AD- Saturday Deliveries | ______________% |
| CLIN 1002AE- Sunday Deliveries | ______________% |
| CLIN 1002AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 1002AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 1002AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1002AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1002AJ- Saturday Deliveries | ______________% |
| CLIN 1002AK- Sunday Deliveries | ______________% |
| CLIN 1002AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 1002AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 1002AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 1002AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 1002AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 1002AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 1002AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 1002AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 1002AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 1002AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 1002AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 1002AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 1002AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 1002AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 1002AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 1002BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 2: APRIL 1, 2026 - MARCH 31, 2029 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 2002AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 2002AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2002AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2002AD- Saturday Deliveries | ______________% |
| CLIN 2002AE- Sunday Deliveries | ______________% |
| CLIN 2002AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 2002AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 2002AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2002AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2002AJ- Saturday Deliveries | ______________% |
| CLIN 2002AK- Sunday Deliveries | ______________% |
| CLIN 2002AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 2002AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 2002AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 2002AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 2002AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 2002AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 2002AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 2002AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 2001AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 2002AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 2002AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 2002AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 2002AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 2002AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 2002AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 2002BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 52.217-8: APRIL 1, 2029 - SEPTEMBER 30, 2029 |
| Per FAR 52.217-8 Rates for this option period will be set at current rates at the end of Option Period 2 and may only be adjusted as a result of revisions to prevailing labor rates by the SEC of Labor. |
VISN 4
| CLIN PRICING STRUCTURE SHEET |
| Medical/Surgical Prime Vendor (MSPV) 2.0 Solicitation 36C10G19R0050- Attachment A |
| VISN 4 |
Company Name:
| BASE PERIOD APRIL 1, 2020 - MARCH 31, 2023 | |
| CLIN 0004AW 120 Day Implementation Period | NOT SEPARATELY PRICED |
| Conventional/Bulk Distribution Fee | |
| CLIN 0004AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 0004AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0004AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0004AD- Saturday Deliveries | ______________% |
| CLIN 0004AE- Sunday Deliveries | ______________% |
| CLIN 0004AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 0004AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 0004AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0004AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0004AJ- Saturday Deliveries | ______________% |
| CLIN 0002AK- Sunday Deliveries | ______________% |
| CLIN 0002AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 0004AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 0004AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 0004AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 0004AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 0004AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 0004AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 0004AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 0004AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 0004AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 0004AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 0004AX Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 0004AY Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 0004AZ Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 1004BA Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 1004BB Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 1: APRIL 1, 2023 - MARCH 31, 2026 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 1004AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 1004AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1004AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1004AD- Saturday Deliveries | ______________% |
| CLIN 1004AE- Sunday Deliveries | ______________% |
| CLIN 1004AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 1004AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 1004AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1004AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1004AJ- Saturday Deliveries | ______________% |
| CLIN 1004AK- Sunday Deliveries | ______________% |
| CLIN 1004AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 1004AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 1004AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 1004AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 1004AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 1004AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 1004AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 1004AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 1004AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 1004AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 1004AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 1004AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 1004AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 1004AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 1004AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 1004BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 2: APRIL 1, 2026 - MARCH 31, 2029 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 2004AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 2004AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2004AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2004AD- Saturday Deliveries | ______________% |
| CLIN 2004AE- Sunday Deliveries | ______________% |
| CLIN 2004AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 2004AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 2004AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2004AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2004AJ- Saturday Deliveries | ______________% |
| CLIN 2004AK- Sunday Deliveries | ______________% |
| CLIN 2004AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 2004AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 2004AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 2004AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 2004AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 2004AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 2004AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 2004AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 2004AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 2004AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 2004AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 2004AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 2004AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 2004AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 2004AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 2004BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 52.217-8: APRIL 1, 2029 - SEPTEMBER 30, 2029 |
| Per FAR 52.217-8 Rates for this option period will be set at current rates at the end of Option Period 2 and may only be adjusted as a result of revisions to prevailing labor rates by the SEC of Labor. |
VISN 5
| CLIN PRICING STRUCTURE SHEET |
| Medical/Surgical Prime Vendor (MSPV) 2.0 Solicitation 36C10G19R0050- Attachment A |
| VISN 5 |
Company Name:
| BASE PERIOD APRIL 1, 2020 - MARCH 31, 2023 | |
| CLIN 0005AW 120 Day Implementation Period | NOT SEPARATELY PRICED |
| Conventional/Bulk Distribution Fee | |
| CLIN 0005AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 0005AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0005AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0005AD- Saturday Deliveries | ______________% |
| CLIN 0005AE- Sunday Deliveries | ______________% |
| CLIN 0005AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 0005AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 0005AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0005AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0005AJ- Saturday Deliveries | ______________% |
| CLIN 0005AK- Sunday Deliveries | ______________% |
| CLIN 0005AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 0005AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 0005AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 0005AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 0005AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 0005AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 0005AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 0005AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 0005AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 0005AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 0005AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 0005AX Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 0005AY Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 0005AZ Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 0005BA Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 0005BB Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 1: APRIL 1, 2023 - MARCH 31, 2026 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 1001AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 1005AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1005AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1005AD- Saturday Deliveries | ______________% |
| CLIN 1005AE- Sunday Deliveries | ______________% |
| CLIN 1005AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 1005AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 1005AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1005AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1005AJ- Saturday Deliveries | ______________% |
| CLIN 1005AK- Sunday Deliveries | ______________% |
| CLIN 1005AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 1005AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 1005AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 1005AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 1005AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 1005AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 1005AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 1005AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 1005AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 1005AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 1005AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 1005AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 1005AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 1005AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 1005AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 1005BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 2: APRIL 1, 2026 - MARCH 31, 2029 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 2005AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 2005AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2005AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2005AD- Saturday Deliveries | ______________% |
| CLIN 2005AE- Sunday Deliveries | ______________% |
| CLIN 2005AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 2005AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 2005AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 2005AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 2005AJ- Saturday Deliveries | ______________% |
| CLIN 2005AK- Sunday Deliveries | ______________% |
| CLIN 2005AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 2005AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 2005AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 2005AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 2005AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 2005AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 2005AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 2005AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 2005AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 2005AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee (In Addition To CBD Fee) |
| CLIN 2005AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 2005AW Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 2005AX Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 2005AY Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 2005AZ Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 2005BA Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 52.217-8: APRIL 1, 2029 - SEPTEMBER 30, 2029 |
| Per FAR 52.217-8 Rates for this option period will be set at current rates at the end of Option Period 2 and may only be adjusted as a result of revisions to prevailing labor rates by the SEC of Labor. |
VISN 6
| CLIN PRICING STRUCTURE SHEET |
| Medical/Surgical Prime Vendor (MSPV) 2.0 Solicitation 36C10G19R0050- Attachment A |
| VISN 6 |
Company Name:
| BASE PERIOD APRIL 1, 2020 - MARCH 31, 2023 | |
| CLIN 0006AW 120 Day Implementation Period | NOT SEPARATELY PRICED |
| Conventional/Bulk Distribution Fee | |
| CLIN 0006AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 0006AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0006AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0006AD- Saturday Deliveries | ______________% |
| CLIN 0006AE- Sunday Deliveries | ______________% |
| CLIN 0006AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 0006AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 0006AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 0006AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 0006AJ- Saturday Deliveries | ______________% |
| CLIN 0006AK- Sunday Deliveries | ______________% |
| CLIN 0006AL- Deliveries on Federal Government Holidays | ______________% |
| EMERGENCY DELIVERIES | |
| CLIN 0006AM- Number of Emergency deliveries offered at no additional charge beyond the three allowed per month per account: | Flat rate fee in addition to delivery fee (includes transportation charges) for emergency deliveries in excess of the three deliveries required and the additional deliveries being offered at no cost. Flat fee charges shall be based per delivery trip. |
| ____________ Additional free deliveries per month. | $_________________ |
| DROP SHIPMENT | |
| CLIN 0006AN- Drop Shipment Fee (Flat Fee Per Order / Per Supplier) | $_________________ |
| Restock Fee | |
| CLIN 0006AO- Restock Fee (Flat Fee Per Item, regardless of quantity of item) | $_________________ |
| WILL/CALL | |
| CLIN 0006AP- Will/Call (Flat Fee Per Order) | $_________________ |
| SERVICE REPRESENTIVE FEE | |
| Add-on MSPV Service Rep Distribution Fee (monthly rate) |
| CLIN 0006AQ Full Time, on-site rep (monthly flat fee) | $_________________ |
| CLIN 0006AR Part Time, on-site rep (monthly flat fee) | $_________________ |
| OFF-SITE DELIVERY FEE | |
| CLIN 0006AS Off-Site Delivery: (<25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| CLIN 0006AT Off-Site Delivery: (>25 miles from ordering facility) (flat fee per delivery) | $_________________ |
| INSIDE DELIVERY FEE | |
| CLIN 0006AU- Delivery to locations within the primary ordering facility (surgical suites, etc) | ____________________% |
| STOCKLESS SERVICE FEE | |
| Add-On Stockless Service Distribution Fee |
| CLIN 0006AV Stockless Service Fee: | ____________________% |
| ADDITIONAL VALUE ADDED SERVICES PROPOSED BY OFFEROR | |
| CLIN 0006AX Value Added Service 1 (Insert Title and Description Below) | ____________________% |
CLIN 0006AY Value Added Service 2 (Insert Title and Description Below) ____________________%
CLIN 0006AZ Value Added Service 3 (Insert Title and Description Below) ____________________%
CLIN 1006BA Value Added Service 4 (Insert Title and Description Below) ____________________%
CLIN 1006BB Value Added Service 5 (Insert Title and Description Below) ____________________%
| OPTION PERIOD 1: APRIL 1, 2023 - MARCH 31, 2026 | |
| Conventional/Bulk Distribution Fee | |
| CLIN 1006AA Conventional/Bulk Distribution Fee (Deliveries Five Days a Week): | _______________________________% |
| VALUE-ADDED SERVICES- Conventional/Bulk Distribution Fee | Adjustment To Conventional/Bulk Distribution Fee. (Please indicate proposed adjustment as either an increase(+) or decrease (-) to the conventional/bulk distribution fee. Please indicate “No Change” for no adjustment to conventional/bulk distribution fee.) |
| CLIN 1006AB- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1006AC- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1006AD- Saturday Deliveries | ______________% |
| CLIN 1006AE- Sunday Deliveries | ______________% |
| CLIN 1006AF- Deliveries on Federal Government Holidays | ______________% |
| LUM | |
| CLIN 1006AG- Low Unit of Measure Method (LUM) Fee (Deliveries Five Days a Week) | _______________________________% |
| VALUE-ADDED SERVICES to Low Unit of Measure Method (LUM) | Adjustment To Low Unit of Measure Base Distribution Fee. (Please indicate proposed adjustment as either an increase or decrease to the Low Unit of Measure Base Distribution Fee. Please indicate “No Change” for no adjustment to the Low Unit of Measure Base Distribution Fee.) |
| CLIN 1006AH- Deliveries One or Two Days Per Week | ______________% |
| CLIN 1006AI- Deliveries Three or Four Days Per Week | ______________% |
| CLIN 1006AJ- Saturday Deliveries | ______________% |
| CLIN 1006AK- Sunday Deliveries | ______________% |
| CLIN 1006AL- Deliveries on Federal Government Holidays | ______________% |
This is the start of the file's text. The full file is on GovTribe.
