ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0026 Home Oxygen TVHS Mt Home Memphis Revised 7-28-2023.xlsx

XLSX spreadsheet 421 KB Posted Aug 3, 2023

Attached to: Q999--Home Oxygen Services - Tennessee Valley Healthcare System, James H. Quillen & Memphis VA Medical Centers
Solicitation number: 36C24923R0026
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 9

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Other files

File	Type	Posted
ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0026 Home Oxygen TVHS Mt Home Memphis Revised 8-9-2023.xlsx	XLSX spreadsheet	Aug 9, 2023
Amendment 36C24923R0026 0007.pdf	PDF	Aug 9, 2023
Amendment 36C24923R0026 0006.pdf	PDF	Aug 3, 2023
Amendment 36C24923R0026 0005.pdf	PDF	Jul 28, 2023
Amendment 36C24923R0026 0004.pdf	PDF	Jul 20, 2023
Amendment 36C24923R0026 0003 .pdf	PDF	Jul 20, 2023
ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0026 Home Oxygen TVHS Mt Home Memphis VAs Revised 7-20-2023.xlsx	XLSX spreadsheet	Jul 20, 2023
VISN 9 Tennessee Stations - Home Oxygen Questions _ Answers 6-30-2023.pdf	PDF	Jun 30, 2023
36C24923R0026 0002.docx	DOCX document	Jun 30, 2023
ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0026 Home Oxygen TVHS Mt Home Memphis VAs Revised 6-30-2023.xlsx	XLSX spreadsheet	Jun 30, 2023
NAICS APPEAL - Notice and Order VISN 9 Home Oxygen.pdf	PDF	Apr 12, 2023
36C24923R0026 0001.docx	DOCX document	Apr 12, 2023
ATTACHMENT D.2 VHA 1605.05 BUSINESS ASSOCIATE AGREEMENT.docx	DOCX document	Mar 30, 2023
ATTACHMENT D.3 Reference Contract Worksheet Home O2.pdf	PDF	Mar 30, 2023
S02 - Solicitation Home O2 RFP TVHS Mt Home Memphis VAs FINAL 02.pdf	PDF	Mar 30, 2023
36C24923R0026.docx	DOCX document	Mar 30, 2023
ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0026 Home Oxygen TVHS Mt Home Memphis VAs R1.xlsx	XLSX spreadsheet	Mar 30, 2023

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Action Line Item Information

Action Type Name	Primary ID	Secondary ID	Mod Number	Title	Order Discount Type Name	Order Discount Type	Order Discount
							0

KB Version:

Items

Item Number

SLIN

Description

Ref CLIN

Comment

Include Comments in Document

Contract Period

Pop Begin

Pop End

Quantity

Unit of Measure

Packaging Multiple

Receipt Type

Line Item Is

Unit Price

Item Discount Type Name

Item Discount

Date Updated

Address1

Address2

Address3

City

State

Zip

Zip4

Country

Mark For

Contact Name

Contact Phone

Contact Email

Delivery Date

FOB

Special Instructions

Include Instructions/Comments in Document

PRINCIPAL NAICS CODE

PRODUCT/SERVICE CODE

UNSPSC

SIC CODE

MANUFACTURER PART NUMBER (MPN)

NATIONAL STOCK NUMBER

LOCAL STOCK NUMBER

DM DOC ID

DELIVERY REF. COUNTER

UNIT TEXT/DESCRIPTION

DELIVERY REFERENCE

ITEM MASTER FILE NUMBER

EXPENDABLE/NON-EXPENDABLE

QUANTITY REQUESTED

UNIT OF PURCHASE CODE

UNIT OF PURCHASE TEXT/DESC.

0001

Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

3800

Quantity

0.00

0002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

3589

Quantity

0.00

0003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

2201

Quantity

0.00

0004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0005

Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

220

Quantity

0.00

0006

Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0007

Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0008

Government owned ventilator set-up and monthly assessment (vent patients), includes monthly purchase of supplies and respiratory therapist visit, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0009

H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0010

H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0011

Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0012

Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

2058

Quantity

0.00

0013

Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

151

Quantity

0.00

0014

Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0015

Rental of ultra-fill system (brand name or equal) stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0016

One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0017

Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

0018

Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

13017

Quantity

0.00

0019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

225

Quantity

0.00

0020

Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Base

05/01/23

04/30/24

Quantity

0.00

BASE YEAR TOTAL

1001

Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

3800

Quantity

0.00

1002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

3589

Quantity

0.00

1003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

2201

Quantity

0.00

1004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1005

Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

220

Quantity

0.00

1006

Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1007

Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1008

Option 1

05/01/24

04/30/25

Quantity

0.00

1009

H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1010

H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1011

Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1012

Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

2058

Quantity

0.00

1013

Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

151

Quantity

0.00

1014

Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1015

Rental of ultra-fill system (brand name or equal) stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1016

One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1017

Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

1018

Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

13017

Quantity

0.00

1019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

225

Quantity

0.00

1020

Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 1

05/01/24

04/30/25

Quantity

0.00

OPTION YEAR 1 TOTAL

2001

Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

3800

Quantity

0.00

2002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

3589

Quantity

0.00

2003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

2201

Quantity

0.00

2004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2005

Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

220

Quantity

0.00

2006

Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2007

Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2008

Option 2

05/01/25

04/30/26

Quantity

0.00

2009

H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2010

H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2011

Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2012

Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

2058

Quantity

0.00

2013

Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

151

Quantity

0.00

2014

Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2015

Rental of ultra-fill system (brand name or equal) stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2016

One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2017

Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

2018

Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

13017

Quantity

0.00

2019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

225

Quantity

0.00

2020

Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 2

05/01/25

04/30/26

Quantity

0.00

OPTION YEAR 2 TOTAL

3001

Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

3800

Quantity

0.00

3002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

3589

Quantity

0.00

3003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

2201

Quantity

0.00

3004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3005

Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

220

Quantity

0.00

3006

Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3007

Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3008

Option 3

05/01/26

04/30/27

Quantity

0.00

3009

H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3010

H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3011

Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3012

Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

2058

Quantity

0.00

3013

Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

151

Quantity

0.00

3014

Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3015

Rental of ultra-fill system (brand name or equal) stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3016

One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3017

Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

3018

Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

13017

Quantity

0.00

3019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

225

Quantity

0.00

3020

Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 3

05/01/26

04/30/27

Quantity

0.00

OPTION YEAR 3 TOTAL

4001

Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

3800

Quantity

0.00

4002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

3589

Quantity

0.00

4003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

2201

Quantity

0.00

4004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4005

Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

220

Quantity

0.00

4006

Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4007

Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4008

Option 4

05/01/27

04/30/28

Quantity

0.00

4009

H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4010

H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4011

Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4012

Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

2058

Quantity

0.00

4013

Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

151

Quantity

0.00

4014

Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4015

Rental of ultra-fill system (brand name or equal) stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4016

One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4017

Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

4018

Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

13017

Quantity

0.00

4019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

225

Quantity

0.00

4020

Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.

Option 4

05/01/27

04/30/28

Quantity

0.00

OPTION YEAR 4 TOTAL

GRAND TOTAL 0.00

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