36C24219Q0631-0001000.docx

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Medical Gas Refills and Tank Rentals-528 and 528A4
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36C24219Q0631
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5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION

OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT

THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADM

INISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and d ate specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 3

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO

MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 05-13-2019 528-19-4-4855-0095 None Department of Veterans Affairs Network Contracting Office (NCO) 2 2875 Union Road Suite 3500 Cheektowaga NY 14227 Department of Veterans Affairs Network Contracting Office (NCO) 2 2875 Union Road Suite 3500 Cheektowaga NY 14227 To all Offerors/Bidders

36C24219Q0631 05-13-2019

X X X

See CONTINUATION Page 528-3690160-4855-820100 0100C00Q3 X One The purpose of this Amendment 0001 is to correct the B.3 Price Schedule and B.4 Price Worksheet to accurately reflect annual requirements for medical gas fills and tank rentals. These documents are required to be completed and submitted as Part 2 of the quote submission as specified in Section E under FAR 52.212-2 Evaluation instr uctions.

It is also noted the quantities reflected in the Statement of Work are estimated monthly requirements, not annual estimates as reflected in the B.4 Price Worksheet.

*All other terms and conditions remain unchanged.

Michelle A. Harsch Contracting Officer

CONTINUATION PAGE

B.3 PRICE SCHEDULE

Base Period: 8/1/2019-7/31/2020

CLIN -Base Year
SUPPLIES/ SERVICES
UOM
UNIT PRICE -Base Year
0001
Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI)
CY
0003
Customer owned cylinder: Oxygen Compressed, USP - Size H
CY
0004
Vendor owned cylinder: Oxygen Compressed, USP - Size H
CY
0005
Customer owned cylinder: Carbon Dioxide USP – Size E
CY
0006
Vendor owned cylinder: Carbon Dioxide USP – Size E
CY
0007
Customer owned cylinder: Carbon Dioxide USP - Size H
CY
0008
Vendor owned cylinder: Carbon Dioxide USP - Size H
CY
0009
Customer owned cylinder: Air Compressed – Size E
CY
0010
Vendor owned cylinder: Air Compressed – Size E
CY
0011
Customer owned cylinder: Air Compressed – Size H
CY
0012
Vendor owned cylinder: Air Compressed – Size H
CY
0013
Vendor owned cylinder: Nitrogen Compressed - Size E
CY
0014
Customer owned cylinder: Nitrogen Compressed - Size H
CY
0015
Vendor owned cylinder: Nitrogen Compressed - Size H
CY
0016
Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
0017
Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
0018
Vendor owned cylinder: Helium compressed USP – Size A
CY
0019
Customer owned cylinder: Helium compressed USP – Size H
CY
0020
Vendor owned cylinder: Helium compressed USP – Size H
CY
0021
Vendor owned cylinder: Biological Atmosphere - Size H
CY
0022
Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
0023
Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
0024
Customer owned cylinder: Nitrous Oxide, USP – Size H
CY
0025
Vendor owned cylinder: Nitrous Oxide, USP – Size H
CY
0026
Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2)
CY
0027
Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB
CY
0028
Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2
CY
0029
Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
0030
Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
0031
Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF
CY
0032
Customer owned cylinder: Argon Compressed, USP - Size B
CY
0033
Vendor owned cylinder: Argon Compressed, USP - Size B
CY

Option Period 1: 8/1/2020-7/31/2021

CLIN - Option Year 1
SUPPLIES/ SERVICES
UOM
UNIT PRICE - Option Year 1
1001
Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI)
CY
1003
Customer owned cylinder: Oxygen Compressed, USP - Size H
CY
1004
Vendor owned cylinder: Oxygen Compressed, USP - Size H
CY
1005
Customer owned cylinder: Carbon Dioxide USP – Size E
CY
1006
Vendor owned cylinder: Carbon Dioxide USP – Size E
CY
1007
Customer owned cylinder: Carbon Dioxide USP - Size H
CY
1008
Vendor owned cylinder: Carbon Dioxide USP - Size H
CY
1009
Customer owned cylinder: Air Compressed – Size E
CY
1010
Vendor owned cylinder: Air Compressed – Size E
CY
1011
Customer owned cylinder: Air Compressed – Size H
CY
1012
Vendor owned cylinder: Air Compressed – Size H
CY
1013
Vendor owned cylinder: Nitrogen Compressed - Size E
CY
1014
Customer owned cylinder: Nitrogen Compressed - Size H
CY
1015
Vendor owned cylinder: Nitrogen Compressed - Size H
CY
1016
Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
1017
Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
1018
Vendor owned cylinder: Helium compressed USP – Size A
CY
1019
Customer owned cylinder: Helium compressed USP – Size H
CY
1020
Vendor owned cylinder: Helium compressed USP – Size H
CY
1021
Vendor owned cylinder: Biological Atmosphere - Size H
CY
1022
Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
1023
Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
1024
Customer owned cylinder: Nitrous Oxide, USP – Size H
CY
1025
Vendor owned cylinder: Nitrous Oxide, USP – Size H
CY
1026
Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2)
CY
1027
Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB
CY
1028
Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2
CY
1029
Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
1030
Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
1031
Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF
CY
1032
Customer owned cylinder: Argon Compressed, USP - Size B
CY
1033
Vendor owned cylinder: Argon Compressed, USP - Size B
CY

Option Period 2: 8/1/2021-7/31/2022

CLIN - Option Year 2
SUPPLIES/ SERVICES
UOM
UNIT PRICE - Option Year 2
2001
Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI)
CY
2003
Customer owned cylinder: Oxygen Compressed, USP - Size H
CY
2004
Vendor owned cylinder: Oxygen Compressed, USP - Size H
CY
2005
Customer owned cylinder: Carbon Dioxide USP – Size E
CY
2006
Vendor owned cylinder: Carbon Dioxide USP – Size E
CY
2007
Customer owned cylinder: Carbon Dioxide USP - Size H
CY
2008
Vendor owned cylinder: Carbon Dioxide USP - Size H
CY
2009
Customer owned cylinder: Air Compressed – Size E
CY
2010
Vendor owned cylinder: Air Compressed – Size E
CY
2011
Customer owned cylinder: Air Compressed – Size H
CY
2012
Vendor owned cylinder: Air Compressed – Size H
CY
2013
Vendor owned cylinder: Nitrogen Compressed - Size E
CY
1014
Customer owned cylinder: Nitrogen Compressed - Size H
CY
2015
Vendor owned cylinder: Nitrogen Compressed - Size H
CY
2016
Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
2017
Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
2018
Vendor owned cylinder: Helium compressed USP – Size A
CY
2019
Customer owned cylinder: Helium compressed USP – Size H
CY
2020
Vendor owned cylinder: Helium compressed USP – Size H
CY
2021
Vendor owned cylinder: Biological Atmosphere - Size H
CY
2022
Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
2023
Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
2024
Customer owned cylinder: Nitrous Oxide, USP – Size H
CY
2025
Vendor owned cylinder: Nitrous Oxide, USP – Size H
CY
2026
Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2)
CY
2027
Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB
CY
2028
Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2
CY
2029
Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
2030
Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
2031
Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF
CY
2032
Customer owned cylinder: Argon Compressed, USP - Size B
CY
2033
Vendor owned cylinder: Argon Compressed, USP - Size B
CY

Option Period 3: 8/1/2022-7/31/2023

CLIN - Option Year 3
SUPPLIES/ SERVICES
UOM
UNIT PRICE - Option Year 3
3001
Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI)
CY
3003
Customer owned cylinder: Oxygen Compressed, USP - Size H
CY
3004
Vendor owned cylinder: Oxygen Compressed, USP - Size H
CY
3005
Customer owned cylinder: Carbon Dioxide USP – Size E
CY
3006
Vendor owned cylinder: Carbon Dioxide USP – Size E
CY
3007
Customer owned cylinder: Carbon Dioxide USP - Size H
CY
3008
Vendor owned cylinder: Carbon Dioxide USP - Size H
CY
3009
Customer owned cylinder: Air Compressed – Size E
CY
3010
Vendor owned cylinder: Air Compressed – Size E
CY
3011
Customer owned cylinder: Air Compressed – Size H
CY
3012
Vendor owned cylinder: Air Compressed – Size H
CY
3013
Vendor owned cylinder: Nitrogen Compressed - Size E
CY
3014
Customer owned cylinder: Nitrogen Compressed - Size H
CY
3015
Vendor owned cylinder: Nitrogen Compressed - Size H
CY
3016
Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
3017
Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
3018
Vendor owned cylinder: Helium compressed USP – Size A
CY
3019
Customer owned cylinder: Helium compressed USP – Size H
CY
3020
Vendor owned cylinder: Helium compressed USP – Size H
CY
3021
Vendor owned cylinder: Biological Atmosphere - Size H
CY
3022
Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
3023
Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
3024
Customer owned cylinder: Nitrous Oxide, USP – Size H
CY
3025
Vendor owned cylinder: Nitrous Oxide, USP – Size H
CY
3026
Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2)
CY
3027
Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB
CY
3028
Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2
CY
3029
Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
3030
Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
3031
Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF
CY
3032
Customer owned cylinder: Argon Compressed, USP - Size B
CY
3033
Vendor owned cylinder: Argon Compressed, USP - Size B
CY

Option Period 4: 8/1/2023-7/31/2024

CLIN - Option Year 4
SUPPLIES/ SERVICES
UOM
UNIT PRICE - Option Year 4
4001
Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI)
CY
4003
Customer owned cylinder: Oxygen Compressed, USP - Size H
CY
4004
Vendor owned cylinder: Oxygen Compressed, USP - Size H
CY
4005
Customer owned cylinder: Carbon Dioxide USP – Size E
CY
4006
Vendor owned cylinder: Carbon Dioxide USP – Size E
CY
4007
Customer owned cylinder: Carbon Dioxide USP - Size H
CY
4008
Vendor owned cylinder: Carbon Dioxide USP - Size H
CY
4009
Customer owned cylinder: Air Compressed – Size E
CY
4010
Vendor owned cylinder: Air Compressed – Size E
CY
4011
Customer owned cylinder: Air Compressed – Size H
CY
4012
Vendor owned cylinder: Air Compressed – Size H
CY
4013
Vendor owned cylinder: Nitrogen Compressed - Size E
CY
4014
Customer owned cylinder: Nitrogen Compressed - Size H
CY
4015
Vendor owned cylinder: Nitrogen Compressed - Size H
CY
4016
Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
4017
Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D
CY
4018
Vendor owned cylinder: Helium compressed USP – Size A
CY
4019
Customer owned cylinder: Helium compressed USP – Size H
CY
4020
Vendor owned cylinder: Helium compressed USP – Size H
CY
4021
Vendor owned cylinder: Biological Atmosphere - Size H
CY
4022
Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
4023
Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI)
CY
4024
Customer owned cylinder: Nitrous Oxide, USP – Size H
CY
4025
Vendor owned cylinder: Nitrous Oxide, USP – Size H
CY
4026
Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2)
CY
4027
Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB
CY
4028
Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2
CY
4029
Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
4030
Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E*
CY
4031
Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF
CY
4032
Customer owned cylinder: Argon Compressed, USP - Size B
CY
4033
Vendor owned cylinder: Argon Compressed, USP - Size B
CY

See attached document: B.4 Price Worksheet-Medical Gas Fills and Tank Rentals-528 and 528A4.

File details come from the government source that posted it.