ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0041 Lexington VA HCS - Robley Rex VAMC Rev 10-4-2023.xlsx

XLSX spreadsheet 423 KB Posted Oct 4, 2023

Attached to: Home Oxygen Services - Patients of the Lexington VA Healthcare System and the Robley Rex (Louisville) VA Medical Center
Solicitation number: 36C24923R0041_1
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 9

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Other files

File	Type	Posted
Amendment 36C24923R0041 0007.pdf	PDF	Oct 4, 2023
Amendment 36C24923R0041 0006.pdf	PDF	Sep 20, 2023
Q and As Home Ox Kentucky 36C24923R0041.pdf	PDF	Sep 20, 2023
ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0041 Lexington VA HCS - Robley Rex VAMC 9-19-2023.xlsx	XLSX spreadsheet	Sep 20, 2023
Amendment 36C24923R0041 0005.pdf	PDF	Sep 15, 2023
Amendement 36C24923R0041 0004.pdf	PDF	Sep 2, 2023
Amendment 36C24923R0041 0003.pdf	PDF	Aug 18, 2023
Amendment 36C24923R0041 0002 .pdf	PDF	Jul 31, 2023
S02 - Solicitation Amendment 36C24923R0041 0001 Home Oxygen Services - Lexington VA Healthcare System and Robley Rex (Louisville) VA .pdf	PDF	Jul 7, 2023
Attach D.2 - VHA 1605.05 BUSINESS ASSOCIATE AGREEMENT.docx	DOCX document	May 31, 2023
S02 - Solicitation Home O2 RFP Lexington Louisville VAs 5-31-2023.pdf	PDF	May 31, 2023
ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0041 Solicitation Home Oxygen Lexington HCS Robley Rex VAs.xlsx	XLSX spreadsheet	May 31, 2023
ATTACHMENT D.3 Reference Contract Worksheet Home O2.pdf	PDF	May 31, 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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

1200

Quantity

0.00

0002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

800

Quantity

0.00

0003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

800

Quantity

0.00

0004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

Quantity

0.00

0006

Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

Quantity

0.00

0009

H tank rental, each, rental per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

Quantity

0.00

0010

H tank refill, each, per refill, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

Quantity

0.00

0011

Compressors, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

Quantity

0.00

0012

Fire safety valves, purchase as needed, each, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

550

Quantity

0.00

0013

Rental of portable concentrator, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

185

Quantity

0.00

0014

Delivery of government owned property, each, per delivery, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

Quantity

0.00

0017

Equipment check of ultra-filled system (brand name or equal) each, per check of equipment, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

1500

Quantity

0.00

0019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Base

05/01/23

04/30/24

Quantity

0.00

0020

Emergency patient visits, each, per visit, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

1200

Quantity

0.00

1002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

800

Quantity

0.00

1003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

800

Quantity

0.00

1004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

Quantity

0.00

1006

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

Quantity

0.00

1010

H tank refill, each, per refill, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

Quantity

0.00

1011

Compressors, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

550

Quantity

0.00

1013

Rental of portable concentrator, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

185

Quantity

0.00

1014

Delivery of government owned property, each, per delivery, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

Quantity

0.00

1017

Equipment check of ultra-filled system (brand name or equal) each, per check of equipment, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

1500

Quantity

0.00

1019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 1

05/01/24

04/30/25

Quantity

0.00

1020

Emergency patient visits, each, per visit, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

1200

Quantity

0.00

2002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

800

Quantity

0.00

2003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

800

Quantity

0.00

2004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

Quantity

0.00

2006

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

Quantity

0.00

2010

H tank refill, each, per refill, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

Quantity

0.00

2011

Compressors, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

550

Quantity

0.00

2013

Rental of portable concentrator, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

185

Quantity

0.00

2014

Delivery of government owned property, each, per delivery, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

Quantity

0.00

2017

Equipment check of ultra-filled system (brand name or equal) each, per check of equipment, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

1500

Quantity

0.00

2019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 2

05/01/25

04/30/26

Quantity

0.00

2020

Emergency patient visits, each, per visit, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

1200

Quantity

0.00

3002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

800

Quantity

0.00

3003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

800

Quantity

0.00

3004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

Quantity

0.00

3006

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

Quantity

0.00

3010

H tank refill, each, per refill, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

Quantity

0.00

3011

Compressors, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

550

Quantity

0.00

3013

Rental of portable concentrator, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

185

Quantity

0.00

3014

Delivery of government owned property, each, per delivery, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

Quantity

0.00

3017

Equipment check of ultra-filled system (brand name or equal) each, per check of equipment, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

1500

Quantity

0.00

3019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 3

05/01/26

04/30/27

Quantity

0.00

3020

Emergency patient visits, each, per visit, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

1200

Quantity

0.00

4002

Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

800

Quantity

0.00

4003

Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

800

Quantity

0.00

4004

Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

Quantity

0.00

4006

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

Quantity

0.00

4010

H tank refill, each, per refill, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

Quantity

0.00

4011

Compressors, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

550

Quantity

0.00

4013

Rental of portable concentrator, portable, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

185

Quantity

0.00

4014

Delivery of government owned property, each, per delivery, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

Quantity

0.00

4017

Equipment check of ultra-filled system (brand name or equal) each, per check of equipment, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

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 Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

1500

Quantity

0.00

4019

Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

Quantity

0.00

4020

Emergency patient visits, each, per visit, per patient for patients of the Lexington VA Healthcare System and the Robley Rex VA Medical Center..

Option 4

05/01/27

04/30/28

Quantity

0.00

OPTION YEAR 4 TOTAL

GRAND TOTAL $0.00

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