Attachment 3CLINS_PricingSheet6-30-2026.xlsx
XLSX spreadsheet 51 KB Posted
- Attached to
- 6835--Med Gas Supply and Cylinder Rental
- Solicitation number
- 36C24E26Q0044
About this file
This is a pricing sheet template for a Request for Quote (RFQ) solicitation for medical gas supply and cylinder rental services. The solicitation number is 36C24E26Q0044, issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4 (VISN 4). The contract opportunity is set aside as a Total Service Disabled Veteran Owned Small Business (SDVOSB) with NAICS code 325120 (Industrial Gas Manufacturing) and PSC code 6835 (Medical Gases), with a business size standard of 1,200 employees. The period of performance is September 1, 2026 through August 31, 2031, with pricing valid through June 30, 2026.
Offerors must provide pricing for medical gas supply and delivery services using the specified pricing sheet format. All quotes must include line items (CLINs) with corresponding pricing details. Key submission requirements include registration in the System for Award Management (SAM) database prior to award. The solicitation incorporates Federal Acquisition Regulation (FAR) provisions and Veterans Affairs Acquisition Regulations (VAAR) with deviations in effect through FAC 2026-01. Awards will be issued on Standard Form 1449. Interested offerors should refer to Attachment 1 for the Statement of Work, Attachment 2 for clauses and submission instructions, and Amendment 0001 for additional information regarding this competitive solicitation.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24E26Q0044 0001.docx | DOCX document | |
| Questions and answers6-30-2026.docx | DOCX document | |
| Attachment 1 STATEMENT OF WORK 6-30-2026.docx | DOCX document | |
| 36C24E26Q0044 0001_1.docx | DOCX document | |
| Attachment 1 STATEMENT OF WORK 6-11-2026.docx | DOCX document | |
| Attachment 2_Terms_Conditions_Submit__Eval36C24E26Q0044.docx | DOCX document | |
| 36C24E26Q0044_1.docx | DOCX document | |
| Attachment 3CLINS_PricingSheet.xlsx | XLSX spreadsheet |
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Text version
Items
| ITEM NUMBER | DESCRIPTION | CONTRACT PERIOD | POP BEGIN | POP END | QUANTITY | UNIT OF MEASURE | LINE ITEM IS | UNIT PRICE | Total |
| 0001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/1/26 | 8/31/27 | 96 | EA | Priced | $0.00 | $0.00 |
| 0002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/1/26 | 8/31/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0003 | OX RX-E Medical Oxygen E tank | Base | 9/1/26 | 8/31/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/1/26 | 8/31/27 | 4380 | EA | Priced | $0.00 | $0.00 |
| 0005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/1/26 | 8/31/27 | 4380 | EA | Priced | $0.00 | $0.00 |
| 0006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/1/26 | 8/31/27 | 1460 | EA | Priced | $0.00 | $0.00 |
| 0007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/26 | 8/31/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/26 | 8/31/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0009 | Annual Audit | Base | 9/1/26 | 8/31/27 | 1 | EA | $0.00 | $0.00 | |
| 1001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/1/27 | 8/31/28 | 96 | EA | Priced | $0.00 | $0.00 |
| 1002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/1/27 | 8/31/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1003 | OX RX-E Medical Oxygen E tank | Base | 9/1/27 | 8/31/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/1/27 | 8/31/28 | 4380 | EA | Priced | $0.00 | $0.00 |
| 1005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/1/27 | 8/31/28 | 4380 | EA | Priced | $0.00 | $0.00 |
| 1006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/1/27 | 8/31/28 | 1460 | EA | Priced | $0.00 | $0.00 |
| 1007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/27 | 8/31/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/27 | 8/31/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1009 | Annual Audit | Base | 9/1/27 | 8/31/28 | 1 | EA | $0.00 | $0.00 | |
| 2001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/1/28 | 8/31/29 | 96 | EA | Priced | $0.00 | $0.00 |
| 2002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/1/28 | 8/31/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2003 | OX RX-E Medical Oxygen E tank | Base | 9/1/28 | 8/31/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/1/28 | 8/31/29 | 4380 | EA | Priced | $0.00 | $0.00 |
| 2005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/1/28 | 8/31/29 | 4380 | EA | Priced | $0.00 | $0.00 |
| 2006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/1/28 | 8/31/29 | 1460 | EA | Priced | $0.00 | $0.00 |
| 2007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/28 | 8/31/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/28 | 8/31/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2009 | Annual Audit | Base | 9/1/28 | 8/31/29 | 1 | EA | $0.00 | $0.00 | |
| 3001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/1/29 | 8/31/30 | 96 | EA | Priced | $0.00 | $0.00 |
| 3002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/1/29 | 8/31/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3003 | OX RX-E Medical Oxygen E tank | Base | 9/1/29 | 8/31/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/1/29 | 8/31/30 | 4380 | EA | Priced | $0.00 | $0.00 |
| 3005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/1/29 | 8/31/30 | 4380 | EA | Priced | $0.00 | $0.00 |
| 3006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/1/29 | 8/31/30 | 1460 | EA | Priced | $0.00 | $0.00 |
| 3007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/29 | 8/31/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/29 | 8/31/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3009 | Annual Audit | Base | 9/1/29 | 8/31/30 | 1 | EA | $0.00 | $0.00 | |
| 4001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/1/30 | 8/31/31 | 96 | EA | Priced | $0.00 | $0.00 |
| 4002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/1/30 | 8/31/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4003 | OX RX-E Medical Oxygen E tank | Base | 9/1/30 | 8/31/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/1/30 | 8/31/31 | 4380 | EA | Priced | $0.00 | $0.00 |
| 4005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/1/30 | 8/31/31 | 4380 | EA | Priced | $0.00 | $0.00 |
| 4006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/1/30 | 8/31/31 | 1460 | EA | Priced | $0.00 | $0.00 |
| 4007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/30 | 8/31/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/1/30 | 8/31/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4009 | Annual Audit | Base | 9/1/30 | 8/31/31 | 1 | EA | $0.00 | $0.00 | |
| $0.00 |
Unit of Measure of Cylinder is not available in the system and therefore was not used.
FOB Destination for all
Alternative CLIN set-up will not be considered. This includes grouping and a daily versus a monthly rate.
RefData
| Discount Type | YN | Options | Receipt Type | Line Item is | FOB | State Code | State Description |
| Percent | Yes | Base | Quantity | Priced | (none) | AK | Alaska |
| Amount | No | Option 1 | Amount | NSP | Origin | AL | Alabama |
| Option 2 | N/C | Destination | AR | Arkansas | |||
| Option 3 | AS | American Samoa | |||||
| Option 4 | AZ | Arizona | |||||
| Option 5 | CA | California | |||||
| Option 6 | CO | Colorado | |||||
| Option 7 | CT | Connecticut | |||||
| Option 8 | DC | District of Columbia | |||||
| Option 9 | DE | Delaware | |||||
| Option 10 | FL | Florida | |||||
| FM | Federal States of Micronesia | ||||||
| GA | Georgia | ||||||
| GU | Guam | ||||||
| HI | Hawaii | ||||||
| IA | Iowa | ||||||
| ID | Idaho | ||||||
| IL | Illinois | ||||||
| IN | Indiana | ||||||
| KS | Kansas | ||||||
| KY | Kentucky | ||||||
| LA | Louisiana | ||||||
| MA | Massachusetts | ||||||
| MD | Maryland | ||||||
| ME | Maine | ||||||
| MH | Marshall Islands | ||||||
| MI | Michigan | ||||||
| MN | Minnesota | ||||||
| MO | Missouri | ||||||
| MP | Northern Mariana Islands | ||||||
| MS | Mississippi | ||||||
| MT | Montana | ||||||
| NC | North Carolina | ||||||
| ND | North Dakota | ||||||
| NE | Nebraska | ||||||
| NH | New Hampshire | ||||||
| NJ | New Jersy | ||||||
| NM | New Mexico | ||||||
| NV | Nevada | ||||||
| NY | New York | ||||||
| OH | Ohio | ||||||
| OK | Oklahoma | ||||||
| OR | Oregon | ||||||
| PA | Pennsylvania | ||||||
| PR | Puerto Rico | ||||||
| PW | Palau | ||||||
| RI | Rhode Island | ||||||
| SC | South Carolina | ||||||
| SD | South Dakota | ||||||
| TN | Tennessee | ||||||
| TX | Texas | ||||||
| UT | Utah | ||||||
| VA | Virginia | ||||||
| VI | Virgin Islands | ||||||
| VT | Vermont | ||||||
| WA | Washington | ||||||
| WI | Wisconsin | ||||||
| WV | West Virginia | ||||||
| WY | Wyoming |
File details come from the government source that posted it. Updated .