36C24820Q0182-0001036.docx

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AMD 01 NEW DME CONTRACT SOUTHERN ZONE
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36C24820Q0182
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36C24820Q0182 0001 AMD 01 Revised ATTACHMENT 03-PRICE SCHEDULE SOUTHERN ZONE.docx

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Base Year - SOUTHERN ZONE

Item No.
Description of Supplies/Services
Estimated Quantity
Unit of Issue
Estimated Unit Price
Estimated Amount
0001
Delivery, Set-up, and Pick-up of Equipment (to include wheelchairs, patient lifts, shower chairs, home care beds, etc.) and Provision of

Patient Instructions (DME), in accordance with the Statement of Work (sections 15-19).

2553
JB
$
$
0002
Refurbish rate for VA-owned equipment
29
JB
$
$
0003
Emergency trip to and from beneficiaries’ home for delivery & set up/pickup, sanitizing, repair of DME.
227
JB
$
$
Base Year
$

Option Year #1

Item No.
Description of Supplies/Services
Estimated Quantity
Estimated Unit of Issue
Estimated Unit Price
Estimated Amount
1001
Delivery, Set-up, and Pick-up of Equipment (to include wheelchairs, patient lifts, shower chairs, home care beds, etc.) and Provision of

Patient Instructions (DME), in accordance with the Statement of Work (sections 15-19).

2553
JB
$
$
1002
Refurbish rate for VA-owned equipment
29
JB
$
$
1003
Emergency trip to and from beneficiaries’ home for delivery & set up/pickup, sanitizing, repair of DME.
227
JB
$
$
Option Year #1
$

Option Year #2

Item No.
Description of Supplies/Services
Estimated Quantity
Estimated Unit of Issue
Estimated Unit Price
Estimated Amount
2001
Delivery, Set-up, and Pick-up of Equipment (to include wheelchairs, patient lifts, shower chairs, home care beds, etc.) and Provision of

Patient Instructions (DME), in accordance with the Statement of Work (sections 15-19).

2553
JB
$
$
2002
Refurbish rate for VA-owned equipment
29
JB
$
$
2003
Emergency trip to and from beneficiary’s home for delivery & set up/pickup, sanitizing, repair of DME.
227
JB
$
$
Option Year #2
$

Option Year #3

Item No.
Description of Supplies/Services
Estimated Quantity
Estimated Unit of Issue
Estimated Unit Price
Estimated Amount
3001
Delivery, Set-up, and Pick-up of Equipment (to include wheelchairs, patient lifts, shower chairs, home care beds, etc.) and Provision of

Patient Instructions (DME), in accordance with the Statement of Work (sections 15-19).

2553
JB
$
$
3002
Refurbish rate for VA-owned equipment
29
JB
$
$
3003
Emergency trip to and from beneficiaries’ home for delivery & set up/pickup, sanitizing, repair of DME.
227
JB
$
$
Option Year #3
$

Option Year #4

Item No.
Description of Supplies/Services
Estimated Quantity
Estimated Unit of Issue
Estimated Unit Price
Estimate Amount
4001
Delivery, Set-up, and Pick-up of Equipment (to include wheelchairs, patient lifts, shower chairs, home care beds, etc.) and Provision of

Patient Instructions (DME), in accordance with the Statement of Work (sections 15-19).

2553
JB
$
$
4002
Refurbish rate for VA-owned equipment
29
JB
$
$
4003
Emergency trip to and from beneficiaries’ home for delivery & set up/pickup, sanitizing, repair of DME.
227
JB
$
$
Option Year #4
$

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