36C24822R0033_Revised.pdf

PDF 1 MB Posted May 4, 2022

Attached to: 6515--VACHCS Home Oxygen Delivery Federal contract opportunity
Solicitation number: 36C24822R0033
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8

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File	Type	Posted
36C24822R0033 0003.docx	DOCX document	Jun 22, 2022
36C24822R0033 0002.docx	DOCX document	May 4, 2022
Attachment 1 - PAST PERFORMANCE QUESTIONNAIRE (Orlando).docx	DOCX document	May 4, 2022
36C24822R0033 0001.docx	DOCX document	May 4, 2022
36C24822R0033.pdf	PDF	Apr 7, 2022
Attachment 4 - Ventilator_Caregiver Checklist.docx	DOCX document	Apr 7, 2022
Attachment 1 - PAST PERFORMANCE QUESTIONNAIRE.docx	DOCX document	Apr 7, 2022
Attachment 3 - PATIENT SATISFACTION SURVEY.docx	DOCX document	Apr 7, 2022
Attachment 2 - PATIENT RIGHTS AND RESPONSIBILITIES.docx	DOCX document	Apr 7, 2022
Attachment 5 -Quality Assurance Surveillance Plan.docx	DOCX document	Apr 7, 2022

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PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C24822R0033 04-07-2022

Norbert Reed 407-646-4003 05-22-2022

14:00 EDT

36C248

Department of Veterans Affairs

Network Contracting Office 8 (NCO 8)

Orlando VA Healthcare System

13800 Veterans Way

Orlando FL 32827

X 100

532283

$35 Million

N/A

36C675

Department of Veterans Affairs

Orlando VA Healthcare System

Orlando Fl 32827

36C248

Department of Veterans Affairs

Network Contracting Office 8 (NCO 8)

Orlando VA Healthcare System

Department of Veterans Affairs

Financial Services Center

P.O. Box 149971

Austin TX 78714-9971

(877) 353-9791 (512) 460-5429

See CONTINUATION Page

This solicitation is in accordance with Federal Acquisition

Regulation (FAR) Part 15.

This solicitation is issued for the acquisition of home oxygen delivery for the Department of Veterans Affairs (VA)

Veterans Integrated Service Network (VISN 8) Orlando locations.

This will be a single award solicitation. Only one vendor will be awarded.

All request for clarification is due no later than

April 28, 2022 at 12:00 PM ET.

See CONTINUATION Page

X 1

36C24822R0033

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 STATEMENT OF WORK

SECTION C - CONTRACT CLAUSES

C.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

C.2 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

C.2a Addendum to 52.212-2 BASIS FOR CONTRACT AWARD

C.3 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2021)

C.4 52.216-18 ORDERING (AUG 2020)

C.5 52.222-19 CHILD LABOR—COOPERATION WITH AUTHORITIES AND

REMEDIES (JAN 2020) (JUL 2020) (DEVIATION)

C.6 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.7 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.8 VAAR 852.219-78 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SUPPLIES AND PRODUCTS (SEP 2021)

(DEVIATION)

C.9 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.10 52.232-18 AVAILABILITY OF FUNDS (APR 1984)

C.11 52.233-3 PROTEST AFTER AWARD (AUG 1996)

C.12 52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM (OCT 2004)

C.13 52.246-2 INSPECTION OF SUPPLIES—FIXED-PRICE (AUG 1996)

C.14 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2021) (JUL 2020)

(DEVIATION)

C.15 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.16 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)126

C.17 52.219-14 LIMITATIONS ON SUBCONTRACTING (SEP 2021)

C.18 52.222-3 CONVICT LABOR (JUNE 2003)

C.19 52.223-6 DRUG-FREE WORKPLACE (MAY 2001)

C.20 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

ATTACHMENT 1

ATTACHMENT 2

ATTACHMENT 3

ATTACHMENT 4

ATTACHMENT 5

SECTION E - SOLICITATION PROVISIONS

E.1 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.3 52.216-1 TYPE OF CONTRACT (APR 1984)

E.4 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.5 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.6 VAAR 852.219-10 VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS SET-ASIDE (JUL 2019) (DEVIATION)

E.7 52.215-14 INTEGRITY OF UNIT PRICES (NOV 2021)

E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (FEB 2021) (JUL 2020) (DEVIATION)

E.9 IT CONTRACT SECURITY

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1.1 AUTHORIZED REPRESENTATIVES

1.1.1 The primary Contracting Officer for this proposal is:

Norbert Reed, Contracting Officer Department of Veterans Affairs Orlando VA Healthcare System

1.2. POST AWARD PERFORMANCE CONFERENCE

A post award conference shall be scheduled with the contractor if deemed necessary for orientation purposes.

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment

Requests.

5. FSC MANDATORY ELECTRONIC INVOICE SUBMISSION: Contractors are required to submit payment requests in electronic form in accordance with the submission instructions below.

TUNGSTEN ELECTRONIC INVOICE SUBMISSION

FSC e-INVOICE PROGRAM THRU AUSTIN PORTAL

FSC MANDATORY ELECTRONIC INVOICE SUBMISSION FOR AUSTIN PAYMENTS

a. Vendor Electronic Invoice Submission Methods:

Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below.

1. VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission.

Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge.

2. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). The X12 EDI Web site (http://www.x12.org)

b. Vendor e-invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below.

1. Tungsten e-Invoice Setup Information: 1-877-489-6135

2. Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

3. FSC e-Invoice Contact Information: 1-877-353-9791

4. FSC e-invoice email: vafsccshd@va.gov

See https://www.fsc.va.gov/einvoice.asp for more information.

B.2 PRICE/COST SCHEDULE

The contractor agrees to provide Home Oxygen services in accordance with the terms, conditions, and provisions stated herein at the prices specified in the Schedule of

Supplies/Services. Proposed Contractor shall have a service office and warehouse within two

(2) hours of the Orlando VA Healthcare System (Lake Nona). The Parent Facility for this Home

Oxygen contact is the Orlando VA Medical Center, 13800 Veterans Way, Orlando, FL. Payment for home oxygen services shall be based monthly in arrears.

The guaranteed minimum contract amount, including the base year and any option years exercised, is $1,500,000.00 and the maximum contract amount, including the base year and any option years exercised, shall not exceed $14,000,000.00. A task order shall be issued at the start of each performance period and orders will be placed by Prosthetic Representatives.

ESTIMATED QUANTITIES: The quantities listed in the Price Schedule below are annual estimates only and are not to be considered a minimum or maximum. The Government is not obligated to purchase any specified amount of services under this contract, but will be obligated to make payment for all services requested and received in the quantities and of the quality requested. The Government does not guarantee or imply that any fixed number of orders/referrals for services will be placed under the resultant contract.

http://www.tungsten-network.com/US/en/veterans-affairs/ http://www.x12.org/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov https://www.fsc.va.gov/einvoice.asp

ORDERING PROCEDURES: Orders will be placed by Veteran’s Affairs Prosthetic or

Respiratory personnel via email, facsimile, or another electronic format. Each individual order will describe the deliverables required as well as the inclusive tasks and services.

The Contractor shall confirm receipt of VAHCS prescriptions for requests for services via email in password protected Excel report or via secure fax within two (2) working hours. The information shall include patient last, first name, last 4 SSN and type of request (new setup, renewal and/or cancellation).

AUTHORIZED USERS

Authorized Users refers to the clinical staff such as the Respiratory Care Practitioner or any other authorized medical professionals who are responsible for identifying the need of the patient and making the necessary recommendation in the form of a consult to the Prosthetics

Department. The respective Prosthetic or Respiratory personnel will then be responsible for creating the order which is then submitted to the vendor.

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES

ESTIMATED

QUANTITY UNIT UNIT PRICE

ESTIMATED

AMOUNT

114,000.00 LB __________________ __________________

Liquid oxygen

Contract Period: Base POP Begin:

POP End:

150,000.00 EA __________________ __________________

Tank Rental

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Tank Rental (monthly) inclusive of consumable supplies for portable system, “E” “D” “C” or “B” size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch or backpack and all disposable supplies, continuous flow regulators and conserving devices. GFE conservers may be used if applicable. (12,500 ea. x 12 months = 150,000 ea.)

54,000.00 EA __________________ __________________

Refill cylinders, size B

Contract Period: Base

POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Refill cylinders, size “B”, for portable systems, aluminum (or metal of equivalent weight) tanks. (4,500 ea. x 12 months = 54,000 ea.)

4,500.00 EA __________________ __________________

Rental cylinder, size H

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental cylinder, size H, to include delivery and set-up, consisting of regulator, flow meter, safety stand, humidifier and disposable supplies (emergency backup system or as primary only per prescription) (375

ea. x 12 months = 4,500 ea.)

14,400.00 EA __________________ __________________

Refill cylinders, size E

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Refill cylinders, size “E” for portable systems, aluminum (or metal of equivalent weight) tanks. (1200 ea. x 12 months = 14,400 ea.)

2,400.00 EA __________________ __________________

Maintenance of Government-furnished equipment

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Maintenance of Government-furnished equipment (concentrators, conserver regulators, complete oxygen systems, and tanks) (200 ea. x 12 months = 2,400 ea.)

900.00 EA __________________ __________________

Delivery and set-up charge for Rental or Government-furnished equipment Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Delivery and set-up charge for Rental or Government-furnished equipment (Concentrator or Home Fill System). (75 ea. x 12 months = 900 ea.)

0008 48.00 EA __________________ __________________

Demand Nasal Cannula (e.g. Oximyzer), Reservoir or pendant/equivalent Contract Period: Base POP Begin:

POP End:

0009 120.00 EA __________________ __________________

Cylinder, size H Contract Period: Base POP Begin:

POP End:

0010 780.00 EA __________________ __________________

Liquid oxygen system (90-100 lbs.) Rental Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Liquid oxygen system (90-100 lbs.) Rental. Include initial delivery and set-up, stationary reservoir, portable container, humidifier, flow meter, refill adapter, contents gauge, cannulas and/or tubing and disposables.

(65 ea. x 12 months = 780 ea.)

0011 120.00 EA __________________ __________________

Portable Liquid Oxygen Container Contract Period: Base

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Portable Liquid Oxygen Container. (10ea x 12mo = 120)

24.00 EA __________________ __________________

Emergency set-up for Government-furnished or rental equipment

Contract Period: Base POP Begin:

POP End:

Delivery shall be made within 4 hours of request. This is a one-time charge in addition to item 0005. (2 ea. X 12 months = 24 ea.)

120.00 EA __________________ __________________

Patient Travel

Contract Period: Base POP Begin:

POP End:

(10 ea. X 12 months = 120 ea.)

2,880.00 EA __________________ __________________

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental Portable Oxygen Concentrator (Federal Airline Administration approved) to include battery(s) and/or charger(s), tubing and/or disposables. Rental cost will be a daily rate. (Estimate is 8 patients per month. Avg. up to 30 days travel = (240 ea. x 12 months = 2,880 ea.)

1,500.00 EA __________________ __________________

Battery for Portable Oxygen Concentrator (Federal Airline

Administration approved).

Contract Period: Base

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Battery for Portable Oxygen Concentrator (Federal Airline Administration approved). Rental cost will be a daily rate. (125 x 12 mo = 1500)

12.00 EA __________________ __________________

Rental concentrator with backup system

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified) and disposables

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified) and disposables. Concentrator flow rate up to 10 LPM. (1

ea. @ 12 mo = 12 ea.)

180.00 EA __________________ __________________

Rental of High Flow Aerosol Compressor

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental of High Flow Aerosol Compressor with all necessary cables and disposables and including annual preventive maintenance inspection. (15 ea. x 12 mo = 180 ea.)

Liquid system set-up with patient education

Contract Period: Base

36.00 EA __________________ __________________

Equipment move

Contract Period: Base POP Begin:

POP End:

(3 ea. x 12 mo = 36 ea.)

540.00 EA __________________ __________________

Equipment pick-up for discontinuation of oxygen services

Contract Period: Base POP Begin:

POP End:

ea. x 12 mo = 540 ea.)

240.00 EA __________________ __________________

Equipment Exchange Fee

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Equipment Exchange Fee. (20 ea. x 12 mo = 240 ea.)

Delivery and set-up charge for portable supplies Non-VA Hospital

Discharge Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Discharge. (10 ea. x 12 mo = 120 ea.)

Emergency Respiratory Care Practitioner (RCP) visit after hours

Contract Period: Base POP Begin:

POP End:

(8PM – 8AM Mon-Sat and all day Sun). (1 ea. x 12 mo = 12 ea.)

Monthly RCP service of Ventilator

Contract Period: Base POP Begin:

POP End:

48.00 EA __________________ __________________

RCP Visits for delivery, initial set-up and evaluation

Contract Period: Base POP Begin:

POP End:

Monthly rental of contractor owned ventilator

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Monthly rental of contractor owned ventilator to include back-up ventilator, battery, charger and all necessary supplies (HME/masks).

(2 ea. x 12 mo = 24ea.)

Fisher & Paykel Airvo Humidifier w/Integrated Flow Generator

Contract Period: Base POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Fisher & Paykel Airvo Humidifier w/Integrated Flow Generator (Monthly Rental) – Set up by an RCP; to include water chambers (2), tubing (2), tracheostomy masks, and filters (2). (3 ea. x 12 mo = 36ea.)

1.00 JB __________________ __________________

Phase-In

Contract Period: Base POP Begin:

POP End:

1.00 JB __________________ __________________

Phase-Out

Contract Period: Base POP Begin:

POP End:

Fire Safe Valve (Thermal Fuses)

Contract Period: Base POP Begin:

POP End:

Contract Period: Option 1 POP Begin:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 1 POP Begin:

POP End:

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental cylinder, size H, to include delivery and set-up, consisting of regulator, flow meter, safety stand, humidifier and disposable supplies

Contract Period: Option 1 POP Begin:

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Delivery and set-up charge for Rental or Government-furnished equipment (Concentrator or Home Fill System). (75 ea. x 12 months = 900 ea.)

Demand Nasal Cannula (e.g. Oximyzer), Reservoir or pendant/equivalent Contract Period: Option 1 POP Begin:

POP End:

Cylinder, size H

Contract Period: Option 1 POP Begin:

POP End:

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical

Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Cylinder, size H, refill (backup/primary). (10 ea. x 12 months = 120 ea.)

1010 780.00 EA __________________ __________________

Liquid oxygen system (90-100 lbs.) Rental Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Liquid oxygen system (90-100 lbs.) Rental. Include initial delivery and set-up, stationary reservoir, portable container, humidifier, flow meter, refill adapter, contents gauge, cannulas and/or tubing and disposables.

(65 ea. x 12 months = 780 ea.)

1011 120.00 EA __________________ __________________

Portable Liquid Oxygen Container Contract Period: Option 1 POP Begin:

POP End:

1012 24.00 EA __________________ __________________

Emergency set-up for Government-furnished or rental equipment Contract Period: Option 1 POP Begin:

POP End:

Delivery shall be made within 4 hours of request. This is a one-time charge in addition to item 0005. (2 ea. X 12 months = 24 ea.)

1013 120.00 EA __________________ __________________

Patient Travel Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Arrangement (to include delivery and pick-up) of oxygen

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental Portable Oxygen Concentrator (Federal Airline Administration approved) to include battery(s) and/or charger(s), tubing and/or disposables. Rental cost will be a daily rate. (Estimate is 8 patients

Administration approved).

Contract Period: Option 1 POP Begin:

POP End:

Contract Period: Option 1 POP Begin:

POP End:

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental

Instruments, Equipment, and Supplies

MANUFACTURER PART NUMBER (MPN): None Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when

Contract Period: Option 1 POP Begin:

POP End:

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Discharge Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1

POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 1 POP Begin:

POP End:

Contract Period: Option 1 POP Begin:

POP End:

Contract Period: Option 1 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 2 POP Begin:

POP End:

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental cylinder, size H, to include delivery and set-up, consisting of regulator, flow meter, safety stand, humidifier and disposable supplies

Contract Period: Option 2 POP Begin:

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Cylinder, size H, refill (backup/primary). (10 ea. x 12 months = 120 ea.)

2010 780.00 EA __________________ __________________

Liquid oxygen system (90-100 lbs.) Rental Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Liquid oxygen system (90-100 lbs.) Rental. Include initial delivery and set-up, stationary reservoir, portable container, humidifier, flow meter, refill adapter, contents gauge, cannulas and/or tubing and disposables.

(65 ea. x 12 months = 780 ea.)

2011 120.00 EA __________________ __________________

Portable Liquid Oxygen Container Contract Period: Option 2 POP Begin:

POP End:

2012 24.00 EA __________________ __________________

Emergency set-up for Government-furnished or rental equipment Contract Period: Option 2 POP Begin:

POP End:

Delivery shall be made within 4 hours of request. This is a one-time charge in addition to item 0005. (2 ea. X 12 months = 24 ea.)

2013 120.00 EA __________________ __________________

Patient Travel Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental Portable Oxygen Concentrator (Federal Airline Administration approved) to include battery(s) and/or charger(s), tubing and/or disposables. Rental cost will be a daily rate. (Estimate is 8 patients

Administration approved).

Contract Period: Option 2 POP Begin:

POP End:

Contract Period: Option 2 POP Begin:

POP End:

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental

MANUFACTURER PART NUMBER (MPN): None Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when

Contract Period: Option 2 POP Begin:

POP End:

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Discharge Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2

POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 2 POP Begin:

POP End:

Contract Period: Option 2 POP Begin:

POP End:

Contract Period: Option 2 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 3 POP Begin:

POP End:

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental cylinder, size H, to include delivery and set-up, consisting of regulator, flow meter, safety stand, humidifier and disposable supplies

Contract Period: Option 3 POP Begin:

PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Cylinder, size H, refill (backup/primary). (10 ea. x 12 months = 120 ea.)

3010 780.00 EA __________________ __________________

Liquid oxygen system (90-100 lbs.) Rental Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Liquid oxygen system (90-100 lbs.) Rental. Include initial delivery and set-up, stationary reservoir, portable container, humidifier, flow meter, refill adapter, contents gauge, cannulas and/or tubing and disposables.

(65 ea. x 12 months = 780 ea.)

3011 120.00 EA __________________ __________________

Portable Liquid Oxygen Container Contract Period: Option 3 POP Begin:

POP End:

3012 24.00 EA __________________ __________________

Emergency set-up for Government-furnished or rental equipment Contract Period: Option 3 POP Begin:

POP End:

Delivery shall be made within 4 hours of request. This is a one-time charge in addition to item 0005. (2 ea. X 12 months = 24 ea.)

3013 120.00 EA __________________ __________________

Patient Travel Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Rental Portable Oxygen Concentrator (Federal Airline Administration approved) to include battery(s) and/or charger(s), tubing and/or disposables. Rental cost will be a daily rate. (Estimate is 8 patients

Administration approved).

Contract Period: Option 3 POP Begin:

POP End:

Contract Period: Option 3 POP Begin:

POP End:

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental

MANUFACTURER PART NUMBER (MPN): None Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when

Contract Period: Option 3 POP Begin:

POP End:

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

Discharge Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3

POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None

Contract Period: Option 3 POP Begin:

POP End:

Contract Period: Option 3 POP Begin:

POP End:

Contract Period: Option 3 POP Begin:

POP End:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER…

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File details come from the government source that posted it. Updated May 4, 2022.