36C24822R0087.pdf

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6515--San Juan Home Oxygen Delivery
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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

36C24822R0087 04-07-2022

Norbert Reed 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

X

532283

$35 Million

N/A

Department of Veterans Affairs

VA Caribbean Healthcare System

#10 Casia St

San Juan PR 00921

36C248

Department of Veterans Affairs

Network Contracting Office 8 (NCO 8)

Orlando VA Healthcare System

13800 Veterans Way

Orlando FL 32827

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) San Juan 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

$0.00

See CONTINUATION Page

36C24822R0087

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 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2021)

C.2 52.216-18 ORDERING (AUG 2020)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) . 115

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.7 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.8 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.9 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.10 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.11 VAAR 852.219-78 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SUPPLIES AND PRODUCTS (SEP 2021)

(DEVIATION)

C.12 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.13 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

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

(DEVIATION)

C.14 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 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

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

SERVICES (NOV 2021)

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

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

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 13800 Veterans Way Orlando FL 32827

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.

http://www.tungsten-network.com/US/en/veterans-affairs/

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.

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 http://www.x12.org/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov https://www.fsc.va.gov/einvoice.asp 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

300.00 EA __________________ __________________

Refill Oxygen 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 Refill Oxygen Cylinder/Size H including Wrench, Base and Regulator

39,050.00 EA __________________ __________________

Refill Oxygen Cylinder/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

Refill Oxygen Cylinder/Size E including Wrench, Cart and Regulator

30,060.00 EA __________________ __________________

Refill Oxygen Cylinder/ 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 Oxygen Cylinder/ Size B (M6) including Wrench, Carrying Bag and Regulator

13,345.00 EA __________________ __________________

Humidifier (Bubble Jet)

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

1,050.00 EA __________________ __________________

Oxygen Mask

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

2,500.00 EA __________________ __________________

Oxygen Tubing 7’

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

750.00 EA __________________ __________________

Oxygen Tubing 14’

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

525.00 EA __________________ __________________

Oxygen Trach Mask

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

13,295.00 EA __________________ __________________

Cannulas 7’ Tubing

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

90.00 EA __________________ __________________

Cannulas 14’ Tubing

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

45.00 EA __________________ __________________

Cannulas 25’ Tubing

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

25.00 EA __________________ __________________

Cannulas 50’ Tubing

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

Suction Canister (Disposable)

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

Suction Tubing (Small)

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

Suction Tubing (Long)

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

Ventilator Circuits

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

Pall Filters for 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

Bacterial Filters

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

550.00 EA __________________ __________________

Preventive Maintenance Svc for O2 Concentrator Machines

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 Preventive Maintenance Svc for O2 Concentrator Machines – Puerto Rico

50.00 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 Preventive Maintenance Svc for O2 Concentrator Machines – Municipal Islands – Vieques/Culebra

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 Preventive Maintenance Svc for O2 Concentrator Machines – Virgin Islands

20.00 EA __________________ __________________

Preventive Maintenance Svc for Ventilator Machines

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

Preventive Maintenance Svc for Ventilator Machines – Puerto Rico

4.00 EA __________________ __________________

Contract Period: Base POP Begin:

POP End:

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

Preventive Maintenance Svc for Ventilator Machines - Municipal Islands – Vieques/Culebra

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

Preventive Maintenance Svc for Ventilator Machines – Virgin Islands

8.00 EA __________________ __________________

Preventive Maintenance Svc for Compressor PSI 50

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 Preventive Maintenance Svc for Compressor PSI 50 Machines – Puerto Rico

Preventive Maintenance Svc for Compressor PSI 51

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

Preventive Maintenance Svc for Compressor PSI 52

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 Preventive Maintenance Svs for Compressor PSI 50 Machines – Virgin

Equipment Delivery Cost for Relocation of Equipment/Supplies

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 Equipment Delivery Cost for Relocation of Equipment/Supplies due to change in patient’s residence/nursing home – Puerto Rico

10.00 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 Equipment Delivery Cost for Relocation of Equipment/Supplies due to change in patient’s residence/nursing home – Municipal Islands – Vieques/Culebra

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 change in patient’s residence/nursing home – Virgin Islands

Equipment Pick-up Cost from patient’s residence/nursing home to

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive Maintenance” to be performed by Manufacturer and/or authorized dealer – Puerto Rico

30.00 EA __________________ __________________

Contractor’s warehouse

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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive Maintenance” to be performed by Manufacturer and/or authorized dealer – Municipal

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive Maintenance” to be performed by Manufacturer and/or authorized dealer – Virgin

150.00 EA __________________ __________________

Equipment Calibration

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 Equipment Calibration due to VACHS Prosthetics Service/Home O2 Program issuing a new and/or replacing an existing – Puerto Rico

15.00 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

Program issuing a new and/or replacing an existing – Municipal

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

Program issuing a new and/or replacing an existing – Virgin Islands

250.00 EA __________________ __________________

Thermal Fuses

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

200.00 EA __________________ __________________

Respiratory Therapist visit

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

Respiratory Therapist visit (Every 15 calendar Day) Ventilator Patients

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 Respiratory Therapist Visit (Every 60 calendar Days) Visits for Oxygen Concentrator patients

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 Respiratory Therapist Visit (Every 60 calendar Days) Non-Invasive Ventilation/ASV/BIPAP With Respiratory Rate Back up Patients

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 Respiratory Therapist Visit (Every 180 calendar Days) Visits for Patients on Oxygen only or During the night or on Compressor PSI 50

1.00 JB __________________ __________________

Phase-In

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 Phase-In: IAW Contract’s Proposed Plan not to exceed 90 Days after award.

1.00 JB __________________ __________________

Phase-Out

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 Phase-Out: IAW Contract’s Proposed Plan not to exceed 90 days after base period completion.

Contract Period: Option 1 POP Begin:

POP End:

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

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 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

Contract Period: Option 1 POP Begin:

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

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

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 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

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

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

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

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 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 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

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:

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 MANUFACTURER PART NUMBER (MPN): None

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive Maintenance” to

Contractor’s warehouse

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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive Maintenance” to

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 Equipment Calibration due to VACHS Prosthetics Service/Home O2

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

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

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 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

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:

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

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

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

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

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

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

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

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

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 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:

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:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Equipment Delivery Cost for Relocation of Equipment/Supplies due to

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

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of

Contractor’s warehouse 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

Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive Maintenance” to

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive Maintenance” to

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 Equipment Calibration due to VACHS Prosthetics Service/Home O2

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

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

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

Respiratory Therapist visit 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:

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

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

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

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

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:

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

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

Contract Period: Option 3

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

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

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

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

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 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:

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies MANUFACTURER PART NUMBER (MPN): None Equipment Delivery Cost for Relocation of Equipment/Supplies due to

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

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of

Contractor’s warehouse 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 Equipment Pick-up Cost from patient’s residence/nursing home to Contractor’s warehouse to set up as “Equipment Patient Ready” due to patient discharge from the Home O2 Program or patient refusal of receiving equipment/supplies and/or for “Preventive…

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