36C24521R0047 0002.docx

DOCX document 105 KB Posted

Attached to
Baltimore, Home Oxygen
Solicitation number
36C24521R0047
Issued by

View the file

Other files

File Type Posted
Responses to Questions.docx DOCX document
Questions to solicitation 36C24521R0047.docx DOCX document
36C24521R0047 0001 Amendment.docx DOCX document
Attachment 5 PAST PERFORMANCE QUESTIONAIRE 36C24521R0047.docx DOCX document
36C24521R0047 .pdf PDF
P01 QASP Home Oxygen FY 21 - VAMHCS.pdf PDF
Attachment 5 PAST PERFORMANCE QUESTIONAIRE 36C24521R0047.docx DOCX document
CONTRACTOR CERTIFICATION Attachment 3.docx DOCX document
P07 Wage Determination.pdf PDF
CONTRACTOR RULES OF BEHAVIOR Attachment 4.docx DOCX document

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

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 ADMINISTRATIVE 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 date 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 30

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)

06-21-2021

NA

36C512 Department of Veterans Affairs VA Maryland Health Care System Crystal Hinton, Contracting Officer 209 West Fayette Street, Suite 611 Baltimore MD 21201

36C512 Department of Veterans Affairs VA Maryland Health Care System Crystal Hinton, Contracting Officer 209 West Fayette Street Baltimore MD 21201 To all Offerors/Bidders

36C24521R0047

X

See CONTINUATION Page

X The purpose of this amendment is to inform offerors of the revisions to solicitation sections B.3. pages 46-51 See the Continuation Pages for the revised sections.

The solicitation closing date is extended to 14:00 PM EST, 06/21/2021.

4001
Contract Months 51-60

(a) Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator will have flow rate capacity up to 5LPM.

625
$______
Month
12
$______
4002
Contract Months 51-60

(b) Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator must have flow rate capacity up to 10 LPM.

25
$______
Month
12
$______
4003
Contract Months 51-60

Cylinder, size M or H set-up consisting of regulator, flow meter, safety stand, humidifier, and disposable supplies as primary)

50
$______
Month
12
$______
4004
Contract Months 51-60

Cylinder, size M or H refill /Primary)

50
$______
EA
1
$______
4005
Contract Months 51-60

Portable system for new set ups consists of “E”, “D”, or “B” (M6) size aluminum (or equivalent eight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies.

250
$______
Month
12
$______
4006
Contract Months 51-60

Cylinder, size “E” refill for #00004 above. Aluminum (or metal of equivalent weight) tanks required.

1800
$______
EA
1
$______
4007
Contract Months 51-60

Cylinder, size “D” refill for #00004 above. Aluminum (or metal of equivalent weight) tanks required.

3600
$______
EA
1
$______
4008
Contract Months 51-60

Cylinder, size “B” (M6) refill for #00004 above. Aluminum (or metal of equivalent weight) tanks required.

43000
$______
EA
1
$______
4009
Contract Months 51-60

Demand Nasal Cannula (e.g. Oximyzer) Reservoir or pendant/equivalent/oxyplus mask. VA111

26
$______
EA
1
$______
4010
Contract Months 51-60

Rental demand Pulse Conserver Device; no less than a 5:1 ratio or 60 ML/pulse.

800
$______
Month
12
$______
4011
Contract Months 51-60

Rental “E” cylinders (aluminum, each) complete portable system (e.g. tank, regulator, etc.) for each Medical Center for availability to issue home oxygen beneficiaries who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient).

5
$______
Month
12
$______
4012
Contract Months 51-60

Rental liquid oxygen system (90 –100 lbs) with stationary reservoir per beneficiary.

40
$______
Month
12
$______
4013
Contract Months 51-60

Rental portable liquid oxygen system per beneficiary.

80
$______
Month
12
$______
4014
Contract Months 51-60

Liquid oxygen per pound for item #012

52,000
$______
EA
1
$______
4015
Contract Months 51-60

Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence.

10
$______
EA
1
$______
4016
Contract Months 51-60

Delivery, set-up and PT instruction for VA owned Electric Air Compressor

50
$______
EA
1
$______
4017
Contract Months 51-60

Pulse Oximetry (Not part of routine assessment)

76
$______
EA
1
$______
4018
Contract Months 51-60

Overnight Pulse Oximetry

200
$______
EA
1
$______
4019
Contract Months 51-60

Follow-up visit (after initial set-up). This is done by a RRT for patient evaluation and instruction. The # of pts is 700 so there could be 2800 quarterly visits a year

2800
$______
EA
1
$______
4020
Contract Months 51-60

Delivery, set-up and PT instruction for VA owned Suction machines.

76
$______
EA
1
$______
4021
Contract Months 51-60

Delivery, set-up and PT instruction for VA owned Nebulizers.

250
$______
EA
1
$______
4022
Contract Months 51-60

Administrative reimbursement for renewal, shipping to resupply of current PTS and PTS transferring to the Baltimore VA from an outside source.

1000
$______
EA
1
$______
4023
Contract Months 51-60

Phone call follow up performed by respiratory therapist for PAP therapy patients.

3000
$______
EA
1
$______
4024
Contract Months 51-60

Ventilators: includes a primary and a backup vent (if necessary), disposables, necessary battery backup, initial PT & family education and monthly assessments by a Credentialed Respiratory Therapist. Offeror shall Insert a monthly Rate.

1
$______
Month
12
$______
4025
Contract Months 51-60

Delivery and set-up of VA owned CPAP machines

1500
$______
EA
1
$______
4026
Contract Months 51-60

Delivery and set-up of VA owned BiPAP machines

1000
$______
EA
1
$______
4027
Contract Months 51-60

Battery operated portable concentrator for traveling PTS. This requires the approval of the Home 02 Coordinator(s). Offeror shall insert a weekly Rate.

1
$______
Weekly
52
$______
4028
Contract Months 51-60

Battery operated portable concentrator for PTS with special needs as determined by the Home 02 Coordinator(s). Offeror shall insert a monthly rate.

1
$______
Month
12
$______
4029
Contract Months 51-60

Concentrator with Home Fill capabilities for PTS with special needs as determined by the Home 02 Coordinator(s). Offeror shall insert a monthly rate.

1
$______
Month
12
$______
5001
Contract Months 51-60

(a) Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator will have flow rate capacity up to 5LPM.

625
$______
Month
6
$______
5002
Contract Months 51-60

(b) Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator must have flow rate capacity up to 10 LPM.

25
$______
Month
6
$______
5003
Contract Months 51-60

Cylinder, size M or H set-up consisting of regulator, flow meter, safety stand, humidifier, and disposable supplies as primary)

50
$______
Month
6
$______
5004
Contract Months 51-60

Cylinder, size M or H refill /Primary)

50
$______
EA
1
$______
5005
Contract Months 51-60

Portable system for new set ups consists of “E”, “D”, or “B” (M6) size aluminum (or equivalent eight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies.

250
$______
Month
6
$______
5006
Contract Months 51-60

Cylinder, size “E” refill for #00004 above. Aluminum (or metal of equivalent weight) tanks required.

1800
$______
EA
1
$______
5007
Contract Months 51-60

Cylinder, size “D” refill for #00004 above. Aluminum (or metal of equivalent weight) tanks required.

3600
$______
EA
1
$______
5008
Contract Months 51-60

Cylinder, size “B” (M6) refill for #00004 above. Aluminum (or metal of equivalent weight) tanks required.

43000
$______
EA
1
$______
5009
Contract Months 51-60

Demand Nasal Cannula (e.g. Oximyzer) Reservoir or pendant/equivalent/oxyplus mask. VA111

26
$______
EA
1
$______
5010
Contract Months 51-60

Rental demand Pulse Conserver Device; no less than a 5:1 ratio or 60 ML/pulse.

800
$______
Month
6
$______
5011
Contract Months 51-60

Rental “E” cylinders (aluminum, each) complete portable system (e.g. tank, regulator, etc.) for each Medical Center for availability to issue home oxygen beneficiaries who deplete their portable units during appointments or to send home with new start-up (e.g. discharged from inpatient).

5
$______
Month
6
$______
5012
Contract Months 51-60

Rental liquid oxygen system (90 –100 lbs) with stationary reservoir per beneficiary.

40
$______
Month
6
$______
5013
Contract Months 51-60

Rental portable liquid oxygen system per beneficiary.

80
$______
Month
6
$______
5014
Contract Months 51-60

Liquid oxygen per pound for item #012

52,000
$______
EA
1
$______
5015
Contract Months 51-60

Delivery for re-supply and/or relocation of equipment due to change in beneficiary’s residence.

10
$______
EA
1
$______
5016
Contract Months 51-60

Delivery, set-up and PT instruction for VA owned Electric Air Compressor

50
$______
EA
1
$______
5017
Contract Months 51-60

Pulse Oximetry (Not part of routine assessment)

76
$______
EA
1
$______
5018
Contract Months 51-60

Overnight Pulse Oximetry

200
$______
EA
1
$______
5019
Contract Months 51-60

Follow-up visit (after initial set-up). This is done by a RRT for patient evaluation and instruction. The # of pts is 700 so there could be 2800 quarterly visits a year

2800
$______
EA
1
$______
5020
Contract Months 51-60

Delivery, set-up and PT instruction for VA owned Suction machines.

76
$______
EA
1
$______
5021
Contract Months 51-60

Delivery, set-up and PT instruction for VA owned Nebulizers.

250
$______
EA
1
$______
5022
Contract Months 51-60

Administrative reimbursement for renewal, shipping to resupply of current PTS and PTS transferring to the Baltimore VA from an outside source.

1000
$______
EA
1
$______
5023
Contract Months 51-60

Phone call follow up performed by respiratory therapist for PAP therapy patients.

3000
$______
EA
1
$______
5024
Contract Months 51-60

Ventilators: includes a primary and a backup vent (if necessary), disposables, necessary battery backup, initial PT & family education and monthly assessments by a Credentialed Respiratory Therapist. Offeror shall Insert a monthly Rate.

1
$______
Month
6
$______
5025
Contract Months 51-60

Delivery and set-up of VA owned CPAP machines

1500
$______
EA
1
$______
5026
Contract Months 51-60

Delivery and set-up of VA owned BiPAP machines

1000
$______
EA
1
$______
5027
Contract Months 51-60

Battery operated portable concentrator for traveling PTS. This requires the approval of the Home 02 Coordinator(s). Offeror shall insert a weekly Rate.

1
$______
Weekly
26
$______
5028
Contract Months 51-60

Battery operated portable concentrator for PTS with special needs as determined by the Home 02 Coordinator(s). Offeror shall insert a monthly rate.

1
$______
Month
6
$______
5029
Contract Months 51-60

Concentrator with Home Fill capabilities for PTS with special needs as determined by the Home 02 Coordinator(s). Offeror shall insert a monthly rate.

1
$______
Month
6
$______

File details come from the government source that posted it. Updated .