36C24818Q9195-002.docx
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- Attached to
- Supply: Aquadex Aquapheresis system Federal contract opportunity
- Solicitation number
- 36C24818Q9195
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36C24818Q9195 Attachment 2-Price Schedule.docx
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|---|---|---|
| 36C24818Q9195-001.pdf | ||
| 36C24818Q9195-000.docx | DOCX document | |
| 36C24818Q9195-003.pdf |
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DESCRIPTION OF SUPPLIES/SERVICES
| ESTIMATED QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 0001 |
| Aquadex Blood Set with Hematocrit (HCT) |
P/N: 114156 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 0002 |
| Aquadex Blood Set without Hematocrit (HCT) |
P/N: 114157 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 0003 |
| Aquadex Flex Flow Console |
P/N: 114158 Brand Name or Equal CHF Solutions
| 25 |
| EA |
S__________________
| 0004 |
| Aquadex Flex Flow Cart with Stand |
P/N: 114172 Brand Name or Equal CHF Solutions
| 25 |
| EA |
S__________________
| GRAND TOTAL |
| $__________________ |
Attachment 2: Price and Cost Schedule Base Year: TBD – September 30, 2018
Note - Estimated (EST) Quantities- This is a Fixed Price Blanket Purchase Agreement contract for the supplies listed in the Statement of Need and Price/Cost Schedule, effective for the periods stated. The quantities of supplies are estimates only, and are not purchased by this contract. Quantities will be purchased via a separately issued Delivery Order. Except as this contract may otherwise provide, if the VA’s requirements does not result in orders in the quantities’ described the fact shall not constitute the basis for an equitable price adjustment.
Option Year One (1) October 1, 2018 – September 30,2019
| DESCRIPTION OF SUPPLIES/SERVICES |
| ESTIMATED QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 1001 |
| Aquadex Blood Set with Hematocrit (HCT) |
P/N: 114156 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 1002 |
| Aquadex Blood Set without Hematocrit (HCT) |
P/N: 114157 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 1003 |
| Aquadex Flex Flow Console |
P/N: 114158 Brand Name or Equal CHF Solutions
| 25 |
| EA |
S__________________
| 1004 |
| Aquadex Flex Flow Cart with Stand |
P/N: 114172 Brand Name or Equal CHF Solutions
| 25 |
| EA |
| GRAND TOTAL |
| $__________________ |
Note - Estimated (EST) Quantities- This is a Fixed Price Blanket Purchase Agreement contract for the supplies listed in the Statement of Need and Price/Cost Schedule, effective for the periods stated. The quantities of supplies are estimates only, and are not purchased by this contract. Quantities will be purchased via a separately issued Delivery Order. Except as this contract may otherwise provide, if the VA’s requirements does not result in orders in the quantities’ described the fact shall not constitute the basis for an equitable price adjustment.
Option Year Two (2)
| DESCRIPTION OF SUPPLIES/SERVICES |
| ESTIMATED QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 2001 |
| Aquadex Blood Set with Hematocrit (HCT) |
P/N: 114156 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 2002 |
| Aquadex Blood Set without Hematocrit (HCT) |
P/N: 114157 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 2003 |
| Aquadex Flex Flow Console |
P/N: 114158 Brand Name or Equal CHF Solutions
| 25 |
| EA |
S__________________
| 2004 |
| Aquadex Flex Flow Cart with Stand |
P/N: 114172 Brand Name or Equal CHF Solutions
| 25 |
| EA |
| GRAND TOTAL |
| $__________________ |
Note - Estimated (EST) Quantities- This is a Fixed Price Blanket Purchase Agreement contract for the supplies listed in the Statement of Need and Price/Cost Schedule, effective for the periods stated. The quantities of supplies are estimates only, and are not purchased by this contract. Quantities will be purchased via a separately issued Delivery Order. Except as this contract may otherwise provide, if the VA’s requirements does not result in orders in the quantities’ described the fact shall not constitute the basis for an equitable price adjustment.
Option Year Three (3)
| DESCRIPTION OF SUPPLIES/SERVICES |
| ESTIMATED QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 3001 |
| Aquadex Blood Set with Hematocrit (HCT) |
P/N: 114156 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 3002 |
| Aquadex Blood Set without Hematocrit (HCT) |
P/N: 114157 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 3003 |
| Aquadex Flex Flow Console |
P/N: 114158 Brand Name or Equal CHF Solutions
| 25 |
| EA |
S__________________
| 3004 |
| Aquadex Flex Flow Cart with Stand |
P/N: 114172 Brand Name or Equal CHF Solutions
| 25 |
| EA |
| GRAND TOTAL |
| $__________________ |
Note - Estimated (EST) Quantities- This is a Fixed Price Blanket Purchase Agreement contract for the supplies listed in the Statement of Need and Price/Cost Schedule, effective for the periods stated. The quantities of supplies are estimates only, and are not purchased by this contract. Quantities will be purchased via a separately issued Delivery Order. Except as this contract may otherwise provide, if the VA’s requirements does not result in orders in the quantities’ described the fact shall not constitute the basis for an equitable price adjustment.
Option Year Four (4)
| DESCRIPTION OF SUPPLIES/SERVICES |
| ESTIMATED QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 4001 |
| Aquadex Blood Set with Hematocrit (HCT) |
P/N: 114156 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 4002 |
| Aquadex Blood Set without Hematocrit (HCT) |
P/N: 114157 Brand Name or Equal CHF Solutions
| 52 |
| CS |
S__________________
| 4003 |
| Aquadex Flex Flow Console |
P/N: 114158 Brand Name or Equal CHF Solutions
| 25 |
| EA |
S__________________
| 4004 |
| Aquadex Flex Flow Cart with Stand |
P/N: 114172 Brand Name or Equal CHF Solutions
| 25 |
| EA |
| GRAND TOTAL |
| $__________________ |
Note - Estimated (EST) Quantities- This is a Fixed Price Blanket Purchase Agreement contract for the supplies listed in the Statement of Need and Price/Cost Schedule, effective for the periods stated. The quantities of supplies are estimates only, and are not purchased by this contract. Quantities will be purchased via a separately issued Delivery Order. Except as this contract may otherwise provide, if the VA’s requirements does not result in orders in the quantities’ described the fact shall not constitute the basis for an equitable price adjustment.
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