Attachment 9 - Wheelchairs Pricing Schedule (Amend 0001).xlsx

XLSX spreadsheet 534 KB Posted May 4, 2022

Attached to: 6530--Standard Manual Wheelchair
Solicitation number: 36C10G22R0013
Issued by: Department of Veterans Affairs Headquarters

About this file

Written by GovTribe AI · Dec 30, 2023

This pricing schedule attachment provides unit pricing for standard manual wheelchairs and accessories under Solicitation 36C10G22R0013 issued by the Department of Veterans Affairs. The solicitation seeks to acquire various types of lightweight wheelchairs, brake extensions, elevating leg rests, crutch and cane holders, and cylinder tank carriers over four option years. Pricing is to be provided by region for delivery to VA medical centers. However, unit pricing is listed as TBD (to be determined) throughout the schedule, indicating this is a template. No other salient details such as response dates, awardees, or pricing terms are provided.

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Other files

File	Type	Posted
36C10G22R0013 0002_1.docx	DOCX document	May 10, 2022
36C10G22R0013 RFI (Amend 0001).docx	DOCX document	May 4, 2022
36C10G22R0013 0001_1.docx	DOCX document	May 4, 2022
Attachment 8 - Past Performance Questionnaire.pdf	PDF	Apr 18, 2022
Attachment 4 - Pay.gov Vendor Submittal Instructions.pdf	PDF	Apr 18, 2022
Attachment 3 QSR Reporting Tool.xlsx	XLSX spreadsheet	Apr 18, 2022
Attachment 5 - HIPAA-Business Associate Agreement.docx	DOCX document	Apr 18, 2022
Attachment 9 - Wheelchairs Pricing Schedule .xlsx	XLSX spreadsheet	Apr 18, 2022
Attachment 2 Contractor Discrepancy Report.pdf	PDF	Apr 18, 2022
Attachment 7 - RFP Questions.xlsx	XLSX spreadsheet	Apr 18, 2022
Attachment 1 - Invoice Inquiry Tracker 02.xlsx	XLSX spreadsheet	Apr 18, 2022
Attachment 6 - Cross Reference Index.xlsx	XLSX spreadsheet	Apr 18, 2022
36C10G22R0013_2.docx	DOCX document	Apr 15, 2022

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Action Line Item Information

Action Type Name	Primary ID	Secondary ID	Mod Number	Title	Order Discount Type Name	Order Discount Type	Order Discount
RFQ	36C10G21R0013			NX EQ Heat Sealers (VA-18-00024939)	Percent		0

KB Version: FY20.01C

Items

Item Number

SLIN

Description

Ref CLIN

Comment

Include Comments in Document

Contract Period

Pop Begin

Pop End

Quantity

Unit of Measure

Packaging Multiple

Receipt Type

Line Item Is

Unit Price

Unit Price to include SLA Fee

Total Costs with SLA (unit price with SLA X Est. quantity)

Item Discount Type Name

Item Discount

Date Updated

Address1

Address2

Address3

City

State

Zip

Zip4

Country

Mark For

Contact Name

Contact Phone

Contact Email

Delivery Date

FOB

Special Instructions

Include Instructions/Comments in Document

PRINCIPAL NAICS CODE

PRODUCT/SERVICE CODE

UNSPSC

SIC CODE

MANUFACTURER PART NUMBER (MPN)

NATIONAL STOCK NUMBER

LOCAL STOCK NUMBER

DM DOC ID

DELIVERY REF. COUNTER

UNIT TEXT/DESCRIPTION

DELIVERY REFERENCE

ITEM MASTER FILE NUMBER

EXPENDABLE/NON-EXPENDABLE

QUANTITY REQUESTED

0001

Standard Manual Wheelchairs & Accessories

Base

TBD

339113

6515

0001A

Lightweight Wheelchair (K0003) 16x16

Base

7561

$ - 0

339113

6515

0001B

Lightweight Wheelchair (K0003) 18x16

Base

17641

$ - 0

339113

6515

0001C

Lightweight Wheelchair (K0003) 20x18

Base

5419

$ - 0

339113

6515

0001D

Wheelchair Brake Extension (E0961)

Base

1091

339113

6515

0001E

Wheelchair Elevating Leg Rest(E0990)

Base

2530

$ - 0

339113

6515

0001F

Crutch and Cane Holder (E2207)

Base

$ - 0

339113

6515

0001G

Cylinder Tank Carrier (E2208)

Base

677

$ - 0

339113

6515

SUBTOTAL:

$ - 0

0002

Standard Delivery - Provide a fixed delivery cost for Medical Center delivery by region. The average cost of all regions will be multiplied by the total number of wheelchairs under CLINS 001A, 001B, and 001C

Base

30,621

$ - 0

002A

Regio+C11:C21n 1: New England (ME; MA; NH; VT; RI; CT)

Base

002B

Region 2: Northeast (NY; NJ; PA; DE)

Base

002C

Region 3: Mid-Atlantic (DC; MD; VA; WV)

Base

002D

Region 4: Southeast Sunbelt (KY; TN; NC; SC; GA; AL; MS)

Base

002E

Region 5: Sunshine and Caribbean (FL; Puerto Rico)

Base

002F

Region 6: Great Lakes (MN; WI; MI; IL; IN; OH)

Base

002G

Region 7: The Heartland (IA; NE; KS; MO)

Base

002H

Region 8: Greater Southwest (NM; TX; OK; AR; LA)

Base

002J

Region 9: Rocky Mountain (MT; ND; SD; WY; UT; CO)

Base

002K

Region 10: Pacific (CA; NV; AZ; HI)

Base

002L

Region 11: Northwest (AK; WA; OR; ID)

Base

0000

TOTAL BASE COST:

$ - 0

1001

Standard Manual Wheelchairs & Accessories

Option 1

TBD

339113

6515

1001A

Lightweight Wheelchair (K0003) 16x16

Option 1

7561

$ - 0

339113

6515

1001B

Lightweight Wheelchair (K0003) 18x16

Option 1

17641

$ - 0

339113

6515

1001C

Lightweight Wheelchair (K0003) 20x18

Option 1

5419

$ - 0

339113

6515

1001D

Wheelchair Brake Extension (E0961)

Option 1

1091

$ - 0

339113

6515

1001E

Wheelchair Elevating Leg Rest(E0990)

Option 1

2530

$ - 0

339113

6515

1001F

Crutch and Cane Holder (E2207)

Option 1

$ - 0

339113

6515

1001G

Cylinder Tank Carrier (E2208)

Option 1

677

$ - 0

339113

6515

SUBTOTAL:

$ - 0

1002

Option 1

30,621

$ - 0

339113

6515

1002A

Regio+C11:C21n 1: New England (ME; MA; NH; VT; RI; CT)

Option 1

339113

6515

1002B

Region 2: Northeast (NY; NJ; PA; DE)

Option 1

339113

6515

1002C

Region 3: Mid-Atlantic (DC; MD; VA; WV)

Option 1

339113

6515

1002D

Region 4: Southeast Sunbelt (KY; TN; NC; SC; GA; AL; MS)

Option 1

339113

6515

1002E

Region 5: Sunshine and Caribbean (FL; Puerto Rico)

Option 1

339113

6515

1002F

Region 6: Great Lakes (MN; WI; MI; IL; IN; OH)

Option 1

339113

6515

1002F

Region 7: The Heartland (IA; NE; KS; MO)

Option 1

339113

6515

1002H

Region 8: Greater Southwest (NM; TX; OK; AR; LA)

Option 1

339113

6515

1002J

Region 9: Rocky Mountain (MT; ND; SD; WY; UT; CO)

Option 1

339113

6515

1002K

Region 10: Pacific (CA; NV; AZ; HI)

Option 1

339113

6515

1002L

Region 11: Northwest (AK; WA; OR; ID)

Option 1

339113

6515

Total Option 1

$ - 0

2001		Standard Manual Wheelchairs & Accessories	Option 2	TBD	TBD		EA			339113	6515
	2001A	Lightweight Wheelchair (K0003) 16x16	Option 2			8022	EA		$ - 0	339113	6515
	2001B	Lightweight Wheelchair (K0003) 18x16	Option 2			18715	EA		$ - 0	339113	6515
	2001C	Lightweight Wheelchair (K0003) 20x18	Option 2			5749	EA		$ - 0	339113	6515
	2001D	Wheelchair Brake Extension (E0961)	Option 2			1158	EA		$ - 0	339113	6515
	2001E	Wheelchair Elevating Leg Rest(E0990)	Option 2			2684	EA		$ - 0	339113	6515
	2001F	Crutch and Cane Holder (E2207)	Option 2			19	EA		$ - 0	339113	6515
	2001G	Cylinder Tank Carrier (E2208)	Option 2			44	EA		$ - 0	339113	6515
								SUBTOTAL:	$ - 0
2002		Standard Delivery - Provide a fixed delivery cost for Medical Center delivery by region. The average cost of all regions will be multiplied by the total number of wheelchairs under CLINS 2001A, 2001B, 2001C	Option 2			32,486	EA	$ - 0	$ - 0
2002A		Regio+C11:C21n 1: New England (ME; MA; NH; VT; RI; CT)	Option 2			1	EA
2002B		Region 2: Northeast (NY; NJ; PA; DE)	Option 2			1	EA
2002C		Region 3: Mid-Atlantic (DC; MD; VA; WV)	Option 2			1	EA
2002D		Region 4: Southeast Sunbelt (KY; TN; NC; SC; GA; AL; MS)	Option 2			1	EA
2002E		Region 5: Sunshine and Caribbean (FL; Puerto Rico)	Option 2			1	EA
2002F		Region 6: Great Lakes (MN; WI; MI; IL; IN; OH)	Option 2			1	EA
2002G		Region 7: The Heartland (IA; NE; KS; MO)	Option 2			1	EA
2002H		Region 8: Greater Southwest (NM; TX; OK; AR; LA)	Option 2			1	EA
2002J		Region 9: Rocky Mountain (MT; ND; SD; WY; UT; CO)	Option 2			1	EA
2002K		Region 10: Pacific (CA; NV; AZ; HI)	Option 2			1	EA
2002L		Region 11: Northwest (AK; WA; OR; ID)	Option 2			1	EA
								Total Option 2	$ - 0

3001		Standard Manual Wheelchairs & Accessories	Option 2	TBD	TBD		EA			339113	6515
	3001A	Lightweight Wheelchair (K0003) 16x16	Option 3			8022	EA		$ - 0	339113	6515
	3001B	Lightweight Wheelchair (K0003) 18x16	Option 3			18715	EA		$ - 0	339113	6515
	3001C	Lightweight Wheelchair (K0003) 20x18	Option 3			5749	EA		$ - 0	339113	6515
	3001D	Wheelchair Brake Extension (E0961)	Option 3			1158	EA		$ - 0	339113	6515
	3001E	Wheelchair Elevating Leg Rest(E0990)	Option 3			2684	EA		$ - 0	339113	6515
	3001F	Crutch and Cane Holder (E2207)	Option 3			19	EA		$ - 0	339113	6515
	3001G	Cylinder Tank Carrier (E2208)	Option 3			44	EA		$ - 0	339113	6515
								SUBTOTAL:	$ - 0
3002		Standard Delivery - Provide a fixed delivery cost for Medical Center delivery by region. The average cost of all regions will be multiplied by the total number of wheelchairs under CLINS 3001A, 3001B, 3001C	Option 2			30,621	EA	$ - 0	$ - 0
3002A		Regio+C11:C21n 1: New England (ME; MA; NH; VT; RI; CT)	Option 2			1	EA
3002B		Region 2: Northeast (NY; NJ; PA; DE)	Option 3			1	EA
3002C		Region 3: Mid-Atlantic (DC; MD; VA; WV)	Option 3			1	EA
3002D		Region 4: Southeast Sunbelt (KY; TN; NC; SC; GA; AL; MS)	Option 3			1	EA
3002E		Region 5: Sunshine and Caribbean (FL; Puerto Rico)	Option 3			1	EA
3002F		Region 6: Great Lakes (MN; WI; MI; IL; IN; OH)	Option 3			1	EA
3002G		Region 7: The Heartland (IA; NE; KS; MO)	Option 3			1	EA
3002H		Region 8: Greater Southwest (NM; TX; OK; AR; LA)	Option 3			1	EA
3002J		Region 9: Rocky Mountain (MT; ND; SD; WY; UT; CO)	Option 3			1	EA
3002K		Region 10: Pacific (CA; NV; AZ; HI)	Option 3			1	EA
3002L		Region 11: Northwest (AK; WA; OR; ID)	Option 3			1	EA
								Total Option 3	$ - 0
4001		Standard Manual Wheelchairs & Accessories	Option 4	TBD	TBD		EA			339113	6515
	4001A	Lightweight Wheelchair (K0003) 16x16	Option 4			8511	EA		$ - 0	339113	6515
	4001B	Lightweight Wheelchair (K0003) 18x16	Option 4			19854	EA		$ - 0	339113	6515
	4001C	Lightweight Wheelchair (K0003) 20x18	Option 4			6099	EA		$ - 0	339113	6515
	4001D	Wheelchair Brake Extension (E0961)	Option 4			1229	EA		$ - 0	339113	6515
	4001E	Wheelchair Elevating Leg Rest(E0990)	Option 4			2848	EA		$ - 0	339113	6515
	4001F	Crutch and Cane Holder (E2207)	Option 4			21	EA		$ - 0	339113	6515
	4001G	Cylinder Tank Carrier (E2208)	Option 4			46	EA		$ - 0	339113	6515
								SUBTOTAL:	$ - 0
4002		Standard Delivery - Provide a fixed delivery cost for Medical Center delivery by region. The average cost of all regions will be multiplied by the total number of wheelchairs under CLINS 4001A, 4001B, 4001C	Option 4			34,464	EA	$ - 0	$ - 0
4002A		Regio+C11:C21n 1: New England (ME; MA; NH; VT; RI; CT)	Option 4			1	EA
4002B		Region 2: Northeast (NY; NJ; PA; DE)	Option 4			1	EA
4002C		Region 3: Mid-Atlantic (DC; MD; VA; WV)	Option 4			1	EA
4002D		Region 4: Southeast Sunbelt (KY; TN; NC; SC; GA; AL; MS)	Option 4			1	EA
4002E		Region 5: Sunshine and Caribbean (FL; Puerto Rico)	Option 4			1	EA
4002F		Region 6: Great Lakes (MN; WI; MI; IL; IN; OH)	Option 4			1	EA
4002G		Region 7: The Heartland (IA; NE; KS; MO)	Option 4			1	EA
4002H		Region 8: Greater Southwest (NM; TX; OK; AR; LA)	Option 4			1	EA
4002J		Region 9: Rocky Mountain (MT; ND; SD; WY; UT; CO)	Option 4			1	EA
4002K		Region 10: Pacific (CA; NV; AZ; HI)	Option 4			1	EA
4002L		Region 11: Northwest (AK; WA; OR; ID)	Option 4			1	EA
								Total Option 4	$ - 0

GRAND TOTAL $ - 0

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File details come from the government source that posted it. Updated May 8, 2026.