36C25019Q0525-001.pdf

PAGE 1 OF125 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. 2/2012)

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

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

See Task Order(s)

36C25019Q0525 02-01-2019

Brad Burhite 513-559-3704 02-09-2019

36C250

Department of Veterans Affairs Network Contracting Office (NCO) 10 260 E. University Avenue Cincinnati OH 45219

X 100

X

541690

$15 Million

X

N/A

X

See SCHEDULE OF SERVICE - PRICE SCHEDULE

36C250

Department of Veterans Affairs Network Contracting Office (NCO) 10 260 E. University Avenue Cincinnati OH 45219

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

The contractor shall provide all required labor, material, supplies, equipment and supervision of contractor personnel necessary to provide medical physics certification services for radiology at Columbus VAACC, Dayton VAMC, Cincinnati VAMC and Chillicothe VAMC in accordance with the terms and conditions established herein.

This solicitation shall be conducted in accordance with FAR Subpart 13.5 and is anticipated to result in the award of an Indefinite-Delivery type contract as defined in FAR Subpart 16.5. The performance of services under this contract shall only be authorized though the award of funded task order(s) by the cognizant government contracting.

The anticipated performance periods are as follows:

Base Year from 25 February 2019 to 24 February 2020;

Option Year One from 25 February 2020 to 24 February 2021;

Option Year Two from 25 February 2021 to 24 February 2022;

Option Year Three from 25 February 2022 to 24 February 2023;

Option Year Four from 25 February 2023 to 24 February 2024;

See CONTINUATION Page For accounting and appropriation data see each individually awarded task order. FAR 52.232-18 (Availability of Funds) applies to this contract.

X X

X 1

Bradley K. Burhite

VA-VHA-SAOC-2019-CD0069AC

Bradley K. Burhite 1461180 Digitally signed by Bradley K. Burhite 1461180 Date: 2019.02.01 13:21:43 -05'00'

36C25019Q0525

Table of Contents

SECTION A

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES – PRICE SCHEDULE (31 January 2019) B.3 PERFORMANCE WORK STATEMENT (PWS) dated 25 January 2019

B.4 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

C.2 52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE

(JUL 2016)

C.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

C.4 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

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

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (OCT 2018)

C.6 52.215-22 LIMITATIONS ON PASS-THROUGH CHARGES—IDENTIFICATION OF

SUBCONTRACT EFFORTS (OCT 2009)

C.7 52.215-23 LIMITATIONS ON PASS-THROUGH CHARGES (OCT 2009)

C.8 52.216-1 TYPE OF CONTRACT (APR 1984)

C.9 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.10 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.11 52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE (NOV 2011)

C.12 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.13 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984)

C.14 52.224-2 PRIVACY ACT (APR 1984)

C.15 52.224-3 PRIVACY TRAINING (JAN 2017)

C.16 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.17 INTERRUPTION OF SERVICE

C.18 52.242-15 STOP-WORK ORDER (AUG 1989)

C.19 52.244-6 SUBCONTRACTS FOR COMMERCIAL ITEMS (OCT 2018)

C.20 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.21 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.22 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.23 VAAR 852.236-76 CORRESPONDENCE (APR 1984)

C.24 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (MAR 2018)

C.25 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.26 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) 80

C.27 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES PROVIDED TO

BENEFICIARIES (JAN 2008)

SECTION D-1 - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF VETERANS

AFFAIRS VETERANS HEALTH ADMINISTRATION, Columbus VAACC, AND

SECTION D-2 - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF VETERANS

AFFAIRS VETERANS HEALTH ADMINISTRATION, Dayton VAMC, AND

SECTION D-3 - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF VETERANS

AFFAIRS VETERANS HEALTH ADMINISTRATION, Cincinnati VAMC, AND

SECTION D-4 - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF VETERANS

AFFAIRS VETERANS HEALTH ADMINISTRATION, Chillicothe VAMC, AND

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

E.2 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.3 52.212-2 (Addendum A) – Past Performance Questionnaire

E.4 52.212-4 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (OCT 2018)

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

1998)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C250

Department of Veterans Affairs

Network Contracting Office (NCO) 10

260 E. University Avenue

Cincinnati OH 45219

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

[] 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] Upon completion of work authorized by government representative(s) designated by the Contracting Officer in writing.

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.

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center

PO Box 149971

Austin TX 78714-9971

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.2 SCHEDULE OF SERVICES – PRICE SCHEDULE (31 January 2019)

SCHEDULE OF SERVICES – PRICE SCHEDULE

Medical Physics Certification Services for Radiology at Columbus VAACC in Ohio

BASE YEAR | 25 February 2019 to 24 February 2020

NOTE 1: The IDIQ minimum shall be applied to the BASE YEAR only for each location which shall not exceed 15% of the total value established herein.

NOTE 2: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 3: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

0001A Nuclear Medicine (NM) | Recurring Audits BASE YEAR 4 Each $ $

0001B X-Ray Equipment (Annual Tube Certification) BASE YEAR 13 Each $ $ 0001C CT Equipment (Annual Tube Certification) BASE YEAR 1 Each $ $

0001D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) BASE YEAR 2 Each $ $

0001E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) BASE YEAR 0 Each $ $

0001F MRI Equipment (Annual Tube Certification) BASE YEAR 2 Each $ $ 0001G Mammography Equip (Annual Tube Certification) BASE YEAR 0 Each $ $ 0001H Lead Apron (Annual Equipment Certification) BASE YEAR 120 Each $ $ 0001I Ultra Sound Equip (Annual Tube Certification) BASE YEAR 6 Each $ $ 0001J Dental Pan/Ceph (Bi-annual Tube Certification) BASE YEAR 13 Each $ $ 0001K Dental CBCT (Bi-annual Tube Certification) BASE YEAR 1 Each $ $

0001A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0001K/U Room Survey for Shielding

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

BASE YEAR | Total Price for Columbus VAACC $

Medical Physics Certification Services for Radiology at Dayton VAMC in Ohio

NOTE 1: The IDIQ minimum shall be applied to the BASE YEAR only for each location which shall not exceed 15% of the total value established herein.

NOTE 2: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 3: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

0002A Nuclear Medicine (NM) | Recurring Audits BASE YEAR 4 Each $ $

0002B X-Ray Equipment (Annual Tube Certification) BASE YEAR 18 Each $ $

0002C CT Equipment (Annual Tube Certification) BASE YEAR 4 Each $ $

0002D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) BASE YEAR 5 Each $ $

0002E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) BASE YEAR 0 Each $ $

0002F MRI Equipment (Annual Tube Certification) BASE YEAR 2 Each $ $ 0002G Mammography Equip (Annual Tube Certification) BASE YEAR 0 Each $ $ 0002H Lead Apron (Annual Equipment Certification) BASE YEAR 0 Each $ $

0002I Ultra Sound Equip (Annual Tube Certification) BASE YEAR 0 Each $ $

0002J Dental Pan/Ceph (Bi-annual Tube Certification) BASE YEAR 2 Each $ $

0002K Dental CBCT (Bi-annual Tube Certification) BASE YEAR 16 Each $ $

0002A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0002K/U Room Survey for Shielding

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

BASE YEAR | Total Price for Dayton VAMC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

Medical Physics Certification Services for Radiology at Cincinnati VAMC in Ohio

NOTE 1: The IDIQ minimum shall be applied to the BASE YEAR only for each location which shall not exceed 15% of the total value established herein.

NOTE 2: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 3: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

0003A Nuclear Medicine (NM) | Recurring Audits BASE YEAR 4 Each $ $

0003B X-Ray Equipment (Annual Tube Certification) BASE YEAR 35 Each $ $

0003C CT Equipment (Annual Tube Certification) BASE YEAR 4 Each $ $

0003D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) BASE YEAR 4 Each $ $

0003E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) BASE YEAR 0 Each $ $

0003F MRI Equipment (Annual Tube Certification) BASE YEAR 2 Each $ $ 0003G Mammography Equip (Annual Tube Certification) BASE YEAR 0 Each $ $ 0003H Lead Apron (Annual Equipment Certification) BASE YEAR 0 Each $ $

0003I Ultra Sound Equip (Annual Tube Certification) BASE YEAR 0 Each $ $

0003J Dental Pan/Ceph (Bi-annual Tube Certification) BASE YEAR 1 Each $ $

0003K Dental CBCT (Bi-annual Tube Certification) BASE YEAR 0 Each $ $

0003A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0003K/U Room Survey for Shielding

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

BASE YEAR | Total Price for Cincinnati VAMC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

Medical Physics Certification Services for Radiology at Chillicothe VAMC in Ohio

NOTE 1: The IDIQ minimum shall be applied to the BASE YEAR only for each location which shall not exceed 15% of the total value established herein.

NOTE 2: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 3: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

0004A Nuclear Medicine (NM) | Recurring Audits BASE YEAR 4 Each $ $

0004B X-Ray Equipment (Annual Tube Certification) BASE YEAR 17 Each $ $

0004C CT Equipment (Annual Tube Certification) BASE YEAR 1 Each $ $

0004D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) BASE YEAR 0 Each $ $

0004E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) BASE YEAR 0 Each $ $

0004F MRI Equipment (Annual Tube Certification) BASE YEAR 1 Each $ $ 0004G Mammography Equip (Annual Tube Certification) BASE YEAR 0 Each $ $ 0004H Lead Apron (Annual Equipment Certification) BASE YEAR 58 Each $ $

0004I Ultra Sound Equip (Annual Tube Certification) BASE YEAR 0 Each $ $

0004J Dental Pan/Ceph (Bi-annual Tube Certification) BASE YEAR 0 Each $ $

0004K Dental CBCT (Bi-annual Tube Certification) BASE YEAR 1 Each $ $

0004A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

0004K/U Room Survey for Shielding

UNSCHEDULED

BASE YEAR

(As Needed) 0 Each

BASE YEAR | Total Price for Chillicothe VAMC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

OPTION YEAR ONE (1) | 25 February 2020 to 24 February 2021

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

1001A Nuclear Medicine (NM) | Recurring Audits OPTION YR 1 4 Each $ $

1001B X-Ray Equipment (Annual Tube Certification) OPTION YR 1 13 Each $ $

1001C CT Equipment (Annual Tube Certification) OPTION YR 1 1 Each $ $

1001D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 2 Each $ $

1001E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 0 Each $ $

1001F MRI Equipment (Annual Tube Certification) OPTION YR 1 2 Each $ $ 1001G Mammography Equip (Annual Tube Certification) OPTION YR 1 0 Each $ $ 1001H Lead Apron (Annual Equipment Certification) OPTION YR 1 120 Each $ $

1001I Ultra Sound Equip (Annual Tube Certification) OPTION YR 1 6 Each $ $

1001J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 1 13 Each $ $

1001K Dental CBCT (Bi-annual Tube Certification) OPTION YR 1 1 Each $ $

1001A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1001K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

OPTION YEAR ONE (1) | Total Price for Columbus VAACC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

1002A Nuclear Medicine (NM) | Recurring Audits OPTION YR 1 4 Each $ $

1002B X-Ray Equipment (Annual Tube Certification) OPTION YR 1 18 Each $ $

1002C CT Equipment (Annual Tube Certification) OPTION YR 1 4 Each $ $

1002D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 5 Each $ $

1002E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 0 Each $ $

1002F MRI Equipment (Annual Tube Certification) OPTION YR 1 2 Each $ $ 1002G Mammography Equip (Annual Tube Certification) OPTION YR 1 0 Each $ $ 1002H Lead Apron (Annual Equipment Certification) OPTION YR 1 0 Each $ $

1002I Ultra Sound Equip (Annual Tube Certification) OPTION YR 1 0 Each $ $

1002J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 1 2 Each $ $

1002K Dental CBCT (Bi-annual Tube Certification) OPTION YR 1 0 Each $ $

1002A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1002K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

OPTION YEAR ONE (1) | Total Price for Dayton VAMC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

1003A Nuclear Medicine (NM) | Recurring Audits OPTION YR 1 4 Each $ $

1003B X-Ray Equipment (Annual Tube Certification) OPTION YR 1 35 Each $ $

1003C CT Equipment (Annual Tube Certification) OPTION YR 1 4 Each $ $

1003D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 4 Each $ $

1003E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 0 Each $ $

1003F MRI Equipment (Annual Tube Certification) OPTION YR 1 2 Each $ $ 1003G Mammography Equip (Annual Tube Certification) OPTION YR 1 0 Each $ $ 1003H Lead Apron (Annual Equipment Certification) OPTION YR 1 0 Each $ $

1003I Ultra Sound Equip (Annual Tube Certification) OPTION YR 1 0 Each $ $

1003J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 1 1 Each $ $

1003K Dental CBCT (Bi-annual Tube Certification) OPTION YR 1 0 Each $ $

1003A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1003K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

OPTION YEAR ONE (1) | Total Price for Cincinnati VAMC $

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

1004A Nuclear Medicine (NM) | Recurring Audits OPTION YR 1 4 Each $ $

1004B X-Ray Equipment (Annual Tube Certification) OPTION YR 1 17 Each $ $

1004C CT Equipment (Annual Tube Certification) OPTION YR 1 1 Each $ $

1004D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 0 Each $ $

1004E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 1 0 Each $ $

1004F MRI Equipment (Annual Tube Certification) OPTION YR 1 1 Each $ $ 1004G Mammography Equip (Annual Tube Certification) OPTION YR 1 0 Each $ $ 1004H Lead Apron (Annual Equipment Certification) OPTION YR 1 58 Each $ $

1004I Ultra Sound Equip (Annual Tube Certification) OPTION YR 1 0 Each $ $

1004J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 1 0 Each $ $

1004K Dental CBCT (Bi-annual Tube Certification) OPTION YR 1 1 Each $ $

1004A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

1004K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 1

(As Needed) 0 Each

OPTION YEAR ONE (1) | Total Price for Chillicothe VAMC $

OPTION YEAR TWO (2) | 25 February 2021 to 24 February 2022

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

2001A Nuclear Medicine (NM) | Recurring Audits OPTION YR 2 4 Each $ $

2001B X-Ray Equipment (Annual Tube Certification) OPTION YR 2 13 Each $ $

2001C CT Equipment (Annual Tube Certification) OPTION YR 2 1 Each $ $

2001D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 2 Each $ $

2001E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 0 Each $ $

2001E MRI Equipment (Annual Tube Certification) OPTION YR 2 2 Each $ $ 2001F Mammography Equip (Annual Tube Certification) OPTION YR 2 0 Each $ $ 2001G Lead Apron (Annual Equipment Certification) OPTION YR 2 120 Each $ $

2001H Ultra Sound Equip (Annual Tube Certification) OPTION YR 2 6 Each $ $

2001I Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 2 13 Each $ $

2001J Dental CBCT (Bi-annual Tube Certification) OPTION YR 2 1 Each $ $

2001A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2001K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

OPTION YEAR TWO (2) | Total Price for Columbus VAACC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

2002A Nuclear Medicine (NM) | Recurring Audits OPTION YR 2 4 Each $ $

2002B X-Ray Equipment (Annual Tube Certification) OPTION YR 2 18 Each $ $

2002C CT Equipment (Annual Tube Certification) OPTION YR 2 4 Each $ $

2002D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 5 Each $ $

2002E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 0 Each $ $

2002F MRI Equipment (Annual Tube Certification) OPTION YR 2 2 Each $ $ 2002G Mammography Equip (Annual Tube Certification) OPTION YR 2 0 Each $ $ 2002H Lead Apron (Annual Equipment Certification) OPTION YR 2 0 Each $ $

2002I Ultra Sound Equip (Annual Tube Certification) OPTION YR 2 0 Each $ $

2002J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 2 2 Each $ $

2002K Dental CBCT (Bi-annual Tube Certification) OPTION YR 2 16 Each $ $

2002A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2002K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

OPTION YEAR TWO (2) | Total Price for Dayton VAMC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

2003A Nuclear Medicine (NM) | Recurring Audits OPTION YR 2 4 Each $ $

2003B X-Ray Equipment (Annual Tube Certification) OPTION YR 2 35 Each $ $

2003C CT Equipment (Annual Tube Certification) OPTION YR 2 4 Each $ $

2003D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 4 Each $ $

2003E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 0 Each $ $

2003F MRI Equipment (Annual Tube Certification) OPTION YR 2 2 Each $ $ 2003G Mammography Equip (Annual Tube Certification) OPTION YR 2 0 Each $ $ 2003H Lead Apron (Annual Equipment Certification) OPTION YR 2 0 Each $ $

2003I Ultra Sound Equip (Annual Tube Certification) OPTION YR 2 0 Each $ $

2003J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 2 1 Each $ $

2003K Dental CBCT (Bi-annual Tube Certification) OPTION YR 2 0 Each $ $

2003A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2003K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

OPTION YEAR TWO (2) | Total Price for Cincinnati VAMC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

2004A Nuclear Medicine (NM) | Recurring Audits OPTION YR 2 4 Each $ $

2004B X-Ray Equipment (Annual Tube Certification) OPTION YR 2 17 Each $ $

2004C CT Equipment (Annual Tube Certification) OPTION YR 2 1 Each $ $

2004D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 2 Each $ $

2004E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 2 0 Each $ $

2004F MRI Equipment (Annual Tube Certification) OPTION YR 2 1 Each $ $ 2004G Mammography Equip (Annual Tube Certification) OPTION YR 2 0 Each $ $ 2004H Lead Apron (Annual Equipment Certification) OPTION YR 2 58 Each $ $

2004I Ultra Sound Equip (Annual Tube Certification) OPTION YR 2 0 Each $ $

2004J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 2 0 Each $ $

2004K Dental CBCT (Bi-annual Tube Certification) OPTION YR 2 1 Each $ $

2004A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

2004K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 2

(As Needed) 0 Each

OPTION YEAR TWO (2) | Total Price for Chillicothe VAMC $

OPTION YEAR THREE (3) | 25 February 2022 to 24 February 2023

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

3001A Nuclear Medicine (NM) | Recurring Audits OPTION YR 3 4 Each $ $

3001B X-Ray Equipment (Annual Tube Certification) OPTION YR 3 13 Each $ $

3001C CT Equipment (Annual Tube Certification) OPTION YR 3 1 Each $ $

3001D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 3 2 Each $ $

3001E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 3 0 Each $ $

3001E MRI Equipment (Annual Tube Certification) OPTION YR 3 2 Each $ $ 3001F Mammography Equip (Annual Tube Certification) OPTION YR 3 0 Each $ $ 3001G Lead Apron (Annual Equipment Certification) OPTION YR 3 120 Each $ $

3001H Ultra Sound Equip (Annual Tube Certification) OPTION YR 3 6 Each $ $

3001I Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 3 13 Each $ $

3001J Dental CBCT (Bi-annual Tube Certification) OPTION YR 3 1 Each $ $

3001A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3001K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

OPTION YEAR THREE (3) | Total Price for Columbus VAACC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

3002A Nuclear Medicine (NM) | Recurring Audits OPTION YR 3 4 Each $ $

3002B X-Ray Equipment (Annual Tube Certification) OPTION YR 3 18 Each $ $

3002C CT Equipment (Annual Tube Certification) OPTION YR 3 4 Each $ $

3002D SPEC-CT/PET Equipment WITH Diagnostic Continuation (Annual Tube Certification) OPTION YR 3 5 Each $ $

3002E SPEC-CT/PET Equipment WITHOUT Diagnostic Continuation (Annual Tube Certification) OPTION YR 3 0 Each $ $

3002F MRI Equipment (Annual Tube Certification) OPTION YR 3 2 Each $ $ 3002G Mammography Equip (Annual Tube Certification) OPTION YR 3 0 Each $ $ 3002H Lead Apron (Annual Equipment Certification) OPTION YR 3 0 Each $ $

3002I Ultra Sound Equip (Annual Tube Certification) OPTION YR 3 0 Each $ $

3002J Dental Pan/Ceph (Bi-annual Tube Certification) OPTION YR 3 2 Each $ $

3002K Dental CBCT (Bi-annual Tube Certification) OPTION YR 3 0 Each $ $

3002A/U Nuclear Medicine (NM) | Recurring Audits

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002B/U X-Ray Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002C/U CT Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002D/U SPEC-CT/PET Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002E/U MRI Equipment (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002F/U Mammography Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002G/U Lead Apron (Annual Equipment Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002H/U Ultra Sound Equip (Annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002I/U Dental Pan/Ceph (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002J/U Dental CBCT (Bi-annual Tube Certification)

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

3002K/U Room Survey for Shielding

UNSCHEDULED

OPTION YR 3

(As Needed) 0 Each

OPTION YEAR THREE (3) | Total Price for Dayton VAMC $

SCHEDULE OF SERVICES – PRICE SCHEDULE

NOTE 1: The contractor shall invoice only upon completion of authorized work for each TUBE certification and/or DEPARTMENT audit completed in accordance with the terms and conditions established in this contract not-to-exceed (NTE) the maximum quantity and total price established herein.

NOTE 2: All offerors must provide full and complete pricing with their offer for all data elements contained within this SCHEDULE OF SERVICE – PRICE SCHEDULE (SHADED IN YELOW) to be considered acceptable for consideration for award. This includes unit pricing for contract line item numbers (CLINs) for UNSCHEDULED SERVICES (A/U, B/U, C/U, D/U, E/U, F/U, H/U and J/U) at a quantity of zero (0) which shall only be funded and exercised on an “as needed” basis upon bi-lateral modification.

Line Item Description of Services Performance

Period

QTY

Max NTE Unit of Issue

Unit Price

Total Price Max NTE

3003A Nuclear Medicine (NM) | Recurring Audits OPTION YR 3 4 Each $ $

3003…