S01_36C25524R0020_VISN 15 Eyeglasses Optician Services_Amendment 0002_Final.pdf

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a) By completing items 8 and 15, and returning or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

E. IMPORTANT: Contractor is not is required to sign this document and return copies to the issuing office.

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended. is not extended.

12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER

NUMBER IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15C. DATE SIGNED

15A. NAME AND TITLE OF SIGNER (Type or print)

16C. DATE SIGNED

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

PAGE OF PAGES

6. ISSUED BY CODE

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, county, State and ZIP Code) (X)

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

Previous edition unusable

36C255

8CJP0

Philip A. Bouffard, Contracting Officer

The purpose of this Amendment is to:

1. Respond to questions presented by prospective offeror(s) and make revisions to the solicitation as a result of those questions.

2. Revisions to certain LINs Unit of Measure

3. Revisions to Statement of Work (SOW)

4. Revisions to solicitation 52.212-1 Instructions to Offerors (Q&A Date and Time)

36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth, KS 66048

Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth, KS 66048

36C25524R0020

36C25524R0020

1 147

12/01/2023

10/31/2023

36C25524R0020 0002

Table of Contents

SECTION A

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

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 DELIVERY SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.2 52.216-18 ORDERING (AUG 2020)

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

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.5 52.225-2 BUY AMERICAN CERTIFICATE (OCT 2022)

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.7 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.8 52.247-25 GOVERNMENT-FURNISHED EQUIPMENT WITH OR WITHOUT

OPERATORS (APR 1984)

C.9 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.10 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.11 VAAR 852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (MAY 2020)

C.12 VAAR 852.212-71 GRAY MARKET AND COUNTERFEIT ITEMS (FEB 2023) ... 37

C.13 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR VERIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (NOV 2022)

C.14 VAAR 852.219-76 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING--

CERTIFICATE OF COMPLIANCE FOR SUPPLIES AND PRODUCTS (NOV 2022)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.16 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.17 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.18 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) . 44

C.19 VAAR 852.246-71 REJECTED GOODS (OCT 2018)

C.20 VAAR 852.247-71 DELIVERY LOCATION (OCT 2018)

C.21 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

C.22 IT CONTRACT SECURITY

C.23 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 STATEMENT OF WORK

D.2 BUSINESS ASSOCIATE AGREEMENT

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 ADDENDUM to FAR 52.212-1 Instructions to Offerors – Commercial Products and Commercial Services

E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

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

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

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

E.7 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.8 VAAR 852.239-75 INFORMATION AND COMMUNICATION TECHNOLOGY

ACCESSIBILITY NOTICE (FEB 2023)

E.9 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.10 VAAR 852.212-72 GRAY MARKET AND COUNTERFEIT ITEMS—

INFORMATION TECHNOLOGY MAINTENANCE ALLOWING OTHER-THAN-NEW

PARTS (FEB 2023)

E.11 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.12 52.212-2 EVALUATION – COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES

E.13 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

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 36C255 Philip Bouffard, philip.bouffard@va.gov

Department of Veterans Affairs

Network Contracting Office (NCO) 15

3450 S 4th Street Trafficway

Leavenworth KS 66048

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

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Invoices submitted on a weekly basis in arrears.

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.

See box 18a on standard form 1449

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

AMENDMENT NO DATE

36C25524R0020 0001 11/29/23

B.2 PRICE/COST SCHEDULE

This is a five-year IDIQ contract with pricing periods:

Minimum Order: $25,000.00 Maximum Order: $5,000,000.00

ESTIMATED QUANTITIES CALCULATION: The estimated quantities were developed using the current contractor’s actual VISN wide line-item usage report for the period of January 1, 2023 – June 30, 2023. For LINs 0001-0037, the Agency multiplied the line-item usage data for January 1, 2023 - June 30, 2023, to develop the estimated quantities for the 1-year base pricing period. The estimated quantities developed for the 1-year base pricing period were then increased by 4% for the subsequent 1-year pricing period.

This 4% increase was incrementally applied for each 1-year pricing period. The four (4) percent annual estimated increase was determined by averaging the VISN 15 enrollment data, enrollment data with an assigned primary care physician and patients served by prosthetics department data percentages of increase or decrease from FY22 end of year though end of June FY 23. See formula explanation below:

Qty for January 1, 2023-June 30, 2023 (6 months) x 2 = Base Pricing Period Estimated Qty

Base Pricing Period Estimated Qty x 4% = Pricing Period 1 Estimated Qty

Pricing Period 1 Estimated Qty x 4% = Pricing Period 2 Estimated Qty

Pricing Period 2 Estimated Quantity x 4% = Pricing Period 3 Estimated Qty

Pricing Period 3 Estimated Qty x 4% = Pricing Period 4 Estimated Qty

The following LINs with an estimated quantity equal to one (1) are hereby identified as a new government need in the contract. Therefore, these LINs do not have historical usage data within VISN 15 network or previous contracts. The following LINs are the new government’s need and will used for price determination/evaluation purposes only.

36C25524R0020 0002 12/01/23

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES

ESTIMATED

QUANTITY UNIT UNIT PRICE

ESTIMATED

AMOUNT

Single Vision Lenses with Frame (Plastic, Metal, Safety) | Year 1 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

0001AA 40 PR ________________ ________________

Glass (estimated) | Year 1 Pricing Period

0001AB 9,442 PR ________________ ________________

Plastic CR-39 (estimated) | Year 1 Pricing Period

0001AC 7,032 PR ________________ ________________

Polycarbonate (estimated) | Year 1 Pricing Period

0001AD 160 PR ________________ ________________

Tri-vex (estimated) | Year 1 Pricing Period

Bifocal Lenses with Frame (Plastic, Metal, Safety) | Year 1 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

0002AA 114 PR ________________ ________________

Glass (estimated) | Year 1 Pricing Period

0002AB 7,566 PR ________________ ________________

Plastic CR-39 (estimated) | Year 1 Pricing Period

0002AC 7,606 PR ________________ ________________

Polycarbonate (estimated) | Year 1 Pricing Period

0002AD 210 PR ________________ ________________

Tri-vex (estimated) | Year 1 Pricing Period

Trifocal Lenses with Frame (Plastic, Metal, Safety) | Year 1 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

0003AA 28 PR ________________ ________________

Glass (estimated) | Year 1 Pricing Period

0003AB 1,354 PR ________________ ________________

Plastic CR-39 (estimated) | Year 1 Pricing Period

0003AC 1,111 PR ________________ ________________

Polycarbonate (estimated) | Year 1 Pricing Period

0003AD 44 PR ________________ ________________

Tri-vex (estimated) | Year 1 Pricing Period

No-Line (Progressive) Lenses with Frame (Plastic, Metal, Safety) | Year 1 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

0004AA 130 PR ________________ ________________

Glass (estimated) | Year 1 Pricing Period

0004AB 16,051 PR ________________ _______________

Plastic CR-39 (estimated) | Year 1 Pricing Period.

0004AC 14,062 PR ________________ ________________

Polycarbonate (estimated) | Year 1 Pricing Period.

0004AD 426 PR ________________ ________________

Tri-vex (estimated) | Year 1 Pricing Period

Single Vision Lens Only - Installed | Year 1 Pricing Period

0005AA 2 PR ________________ ________________

Glass (estimated) | Year 1 Pricing Period

0005AB 134 PR ________________ ________________

Plastic CR-39 - (estimated) | Year 1 Pricing Period

0005AC 124 PR ________________ ________________

Polycarbonate (estimated) | Year 1 Pricing Period

0005AD 4 PR ________________ ________________

Tri-vex (estimated) | Year 1 Pricing Period

Bifocal Lens Only - Installed | Year 1 Pricing Period

0006AA 4 PR __________________ __________________

Glass (estimated) | Year 1 Pricing Period

0006AB 120 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 1 Pricing Period

0006AC 158 PR __________________ __________________

Polycarbonate (estimated) | Year 1 Pricing Period

0006AD 4 PR __________________ __________________

Tri-vex (estimated) | Year 1 Pricing Period

Trifocal Lens Only - Installed | Year 1 Pricing Period

0007AA 2 PR __________________ __________________

Glass (estimated) | Year 1 Pricing Period

0007AB 30 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 1 Pricing Period

0007AC 44 PR __________________ __________________

Polycarbonate (estimated) | Year 1 Pricing Period

0007AD 1 PR __________________ __________________

Tri-vex (estimated) | Year 1 Pricing Period

No-Line (Progressive) Lens Only - Installed | Year 1 Pricing Period | Brand Name or Equal

0008AA 4 PR __________________ __________________

Glass (estimated) | Year 1 Pricing Period

0008AB 412 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 1 Pricing Period

0008AC 492 PR __________________ __________________

Polycarbonate (estimated) | Year 1 Pricing Period

0008AD 26 PR __________________ __________________

Tri-vex (estimated) | Year 1 Pricing Period

0009 1 EA __________________ __________________

Eyeglass Case Only (estimated) | Year 1 Pricing Period | Brand Name or Equal

0010 1 PR __________________ __________________

ADD-ON: Titanium Frame Upgrade | Brand Name or Equal

0011 464 PR __________________ __________________

ADD-ON: FT 35 Bifocal (estimated) | Year 1 Pricing Period

0012 28 PR __________________ __________________

ADD-ON: Slab Off (estimated) | Year 1 Pricing Period

0013 4,644 EA __________________ __________________

ADD-ON: Prism up to Diopter +or- 8 (estimated) | Year 1 Pricing Period

0014 372 EA __________________ __________________

ADD-ON: Prism Diopter +or- 9 and Above (estimated) | Year 1 Pricing Period

0015 2 PR __________________ __________________

ADD-ON: Aspheric Lenticular (estimated) | Year 1 Pricing Period.

0016 1,140 PR __________________ __________________

ADD-ON: Roll & Polish (estimated) | Year 1 Pricing Period

0017 10 PR __________________ __________________

ADD-ON: Glass Tint (estimated) | Year 1 Pricing Period

0018 1,846 PR __________________ __________________

ADD-ON: Plastic Tint (estimated) | Year 1 Pricing Period

0019 200 PR __________________ __________________

ADD-ON: Photo-gray for Glass Lens - All (estimated) | Year 1 Pricing Period

0020 16,150 PR __________________ __________________

ADD-ON: Photochromatic Plastic - All (estimated) | Year 1 Pricing Period | Brand Name or Equal

0021 1,176 PR __________________ __________________

1.56 High Index Lenses - Single Vision (estimated) | Year 1 Pricing Period

0022 1 PR __________________ __________________

1.60 High Index Lenses - Single Vision (estimated) | Year 1 Pricing Period

0023 1,790 PR __________________ __________________

1.67 High Index Lenses - Single Vision (estimated) | Year 1 Pricing Period

0024 1 PR __________________ __________________

1.74 High Index Lenses - Single Vision (estimated) | Year 1 Pricing Period

0025 1 PR __________________ __________________

1.56 High Index Lenses - Bifocal D28 (estimated) | Year 1 Pricing Period

0026 1 PR __________________ __________________

1.60 High Index Lenses – Bifocal D28 (estimated) | Year 1 Pricing Period

0027 366 PR __________________ __________________

1.67 High Index Lenses - Bifocal D28 (estimated) | Year 1 Pricing Period

0028 1 PR __________________ __________________

1.74 High Index Lenses - Bifocal D28 (estimated) | Year 1 Pricing Period

0029 1 PR __________________ __________________

1.56 High Index Lenses - Progressive (estimated) | Year 1 Pricing Period

0030 1 PR __________________ __________________

1.60 High Index Lenses - Progressive (estimated) | Year 1 Pricing Period

0031 2,745 PR __________________ __________________

1.67 High Index Lenses - Progressive (estimated) | Year 1 Pricing Period

0032 1 PR __________________ __________________

1.74 High Index Lenses - Progressive (estimated) | Year 1 Pricing Period.

0033 8,279 PR __________________ __________________

ADD-ON: Varilux COMFORT / Short (estimated) | Year 1 Pricing Period | Brand Name or Equal

0034 48 PR __________________

ADD-ON: Varilux PHYSIO / Short (estimated) | Year 1 Pricing Period | Brand Name or Equal

0035 1 EA __________________ __________________

ADD-ON: Cable Temple (estimated) | Year 1 Pricing Period

0036 9,048 PR __________________ __________________

ADD-ON: Anti-Reflective Coating (estimated) | Year 1 Pricing Period

0037 1 EA __________________ __________________

Express Delivery (estimated) | Year 1 Pricing Period

Opticians | Year 1 Pricing Period

0038AA 4,160 HR __________________ __________________

Opticians - Columbia | Year 1 Pricing Period

0038AB 8,320 HR __________________ __________________

Opticians - Kansas City, Lenexa | Year 1 Pricing Period

0038AC 2,080 HR __________________ __________________

Opticians - Warrensburg | Year 1 Pricing Period

0038AD 6,240 HR __________________ __________________

Opticians - Poplar Bluff, Cape Girardeau, West Plains | Year 1 Pricing Period

0038AE 10,400 HR __________________ __________________

Opticians - St Louis | Year 1 Pricing Period

0038AF 2,080 HR __________________ __________________

Opticians - Farmington | Year 1 Pricing Period

0038AG 2,080 HR __________________ __________________

Opticians - Topeka | Year 1 Pricing Period

0038AH 4,160 HR __________________ __________________

Opticians - Wichita | Year 1 Pricing Period

0038AI 4,160 HR __________________ __________________

Opticians - Marion | Year 1 Pricing Period

0038AJ 2,080 HR __________________ __________________

Opticians - Mt Vernon | Year 1 Pricing Period

0038AK 2,080 HR __________________ __________________

Opticians - Evansville | Year 1 Pricing Period

0038AL 2,080 HR __________________ __________________

Opticians – Leavenworth | Year 1 Pricing Period

Single Vision Lenses with Frame (Plastic, Metal, Safety) | Year 2 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

1001AA 42 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period

1001AB 9,820 PR __________________ __________________

Plastic CR-39 (estimated) | Year 2 Pricing Period

1001AC 7,314 PR __________________ __________________

Polycarbonate (estimated) | Year 2 Pricing Period

1001AD 166 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period

Bifocal Lenses with Frame (Plastic, Metal, Safety) | Year 2 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

1002AA 119 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period

1002AB 7,869 PR __________________ __________________

Plastic CR-39 (estimated) | Year 2 Pricing Period

1002AC 7,910 PR __________________ __________________

Polycarbonate (estimated) | Year 2 Pricing Period

1002AD 218 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period

Trifocal Lenses with Frame (Plastic, Metal, Safety) | Year 2 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

1003AA 29 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period

1003AB 1,408 PR __________________ __________________

Plastic CR-39 (estimated) | Year 2 Pricing Period.

1003AC 1,155 PR __________________ __________________

Polycarbonate (estimated) | Year 2 Pricing Period.

1003AD 46 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period.

No-Line (Progressive) Lenses with Frame (Plastic, Metal, Safety) | Year 2 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

1004AA 135 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period.

1004AB 16,693 PR __________________ __________________

Plastic CR-39 (estimated) | Year 2 Pricing Period.

1004AC 14,624 PR __________________ __________________

Polycarbonate (estimated) | Year 2 Pricing Period.

1004AD 443 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period.

Single Vision Lens Only - Installed | Year 2 Pricing Period.

1005AA 2 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period.

1005AB 139 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 2 Pricing Period.

1005AC 129 PR __________________ __________________

Polycarbonate (estimated) | Year 2 Pricing Period.

1005AD 4 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period.

Bifocal Lens Only - Installed | Year 2 Pricing Period.

1006AA 4 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period.

1006AB 125 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 2 Pricing Period.

1006AC 164 PR __________________ __________________

Polycarbonate (estimated) | Year 2 Pricing Period.

1006AD 4 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period.

Trifocal Lens Only - Installed | Year 2 Pricing Period.

1007AA 2 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period.

1007AB 31 PR __________________ __________________

Trifocal Lens Only - Installed (estimated) | Year 2 Pricing Period.

1007AC 46 PR __________________ __________________

Polycarbonate (estimated) | Year 2 pricing.

1007AD 1 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period.

No-Line (Progressive) Lens Only - Installed | Year 2 Pricing Period | Brand Name or Equal.

1008AA 4 PR __________________ __________________

Glass (estimated) | Year 2 Pricing Period.

1008AB 428 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 2 Pricing Period.

1008AC 512 PR __________________ __________________

Polycarbonate (estimated) | Year 2 Pricing Period.

1008AD 27 PR __________________ __________________

Tri-vex (estimated) | Year 2 Pricing Period.

1009 1 EA __________________ __________________

Eyeglass Case Only (estimated) | Year 2 Pricing Period.

1010 1 PR __________________ __________________

ADD-ON: Titanium Frame Upgrade | Brand Name or Equal

1011 483 PR __________________ __________________

ADD-ON: FT 35 Bifocal (estimated) | Year 2 Pricing Period.

1012 29 PR __________________ __________________

ADD-ON: Slab Off (estimated) | Year 2 Pricing Period.

1013 4,830 EA __________________ __________________

ADD-ON: Prism up to Diopter +or-8(estimated) | Year 2 Pricing Period.

1014 387 EA __________________ __________________

ADD-ON: Diopter +or- 9 and Above (estimated) | Year 2 Pricing Period.

1015 2 PR __________________ __________________

ADD-ON: Aspheric Lenticular (estimated) | Year 2 Pricing Period.

1016 1,186 PR __________________ __________________

ADD-ON: Roll & Polish (estimated) | Year 2 Pricing Period.

1017 10 PR __________________ __________________

ADD-ON: Glass Tint (estimated) | Year 2 Pricing Period.

1018 1,920 PR __________________ __________________

ADD-ON: Plastic Tint (estimated) | Year 2 Pricing Period.

1019 208 PR __________________ __________________

ADD-ON: Photo-gray for Glass Lens - All (estimated) | Year 2 Pricing Period.

1020 16,796 PR __________________ __________________

ADD-ON: Photochromatic Plastic (estimated) | Year 2 Pricing Period | Brand Name or Equal

1021 1,223 PR __________________ __________________

1.56 High Index Lenses - Single Vision (estimated) | Year 2 Pricing Period.

1022 1 PR __________________ __________________

1.60 High Index Lenses - Single Vision (estimated) | Year 2 Pricing Period

1023 1,862 PR __________________ __________________

1.67 High Index Lenses - Single Vision (estimated) | Year 2 Pricing Period.

1024 1 PR __________________ __________________

1.74 High Index Lenses - Single Vision (estimated) | Year 2 Pricing Period.

1025 1 PR __________________ __________________

1.56 High Index Lenses - Bifocal D28 (estimated) | Year 2 Pricing Period.

1026 1 PR __________________ __________________

1.60 High Index Lenses – Bifocal D28 (estimated) | Year 2 Pricing Period

1027 381 PR __________________ __________________

1.67 High Index Lenses - Bifocal D28 (estimated) | Year 2 Pricing Period.

1028 1 PR __________________ __________________

1.74 High Index Lenses - Bifocal D28 (estimated) | Year 2 Pricing Period.

1029 1 PR __________________ __________________

1.56 High Index Lenses - Progressive (estimated) | Year 2 Pricing Period.

1030 1 PR __________________ __________________

1.60 High Index Lenses – Progressive (estimated) | Year 2 Pricing Period

1031 2,855 PR __________________ __________________

1.67 High Index Lenses - Progressive (estimated) | Year 2 Pricing Period.

1032 1 PR __________________ __________________

1.74 High Index Lenses - Progressive (estimated) | Year 2 Pricing Period.

1033 8,610 PR __________________ __________________

ADD-ON: Varilux COMFORT/Short (estimated) | Year 2 Pricing Period | Brand Name or Equal

1034 50 PR __________________

ADD-ON: Varilux PHYSIO / Short (estimated) | Year 2 Pricing Period | Brand Name or Equal

1035 1 EA __________________ __________________

ADD-ON: Cable Temple (estimated) | Year 2 Pricing Period.

1036 9,410 PR __________________ __________________

ADD-ON: Anti-Reflective Coating (estimated) | Year 2 Pricing Period.

1037 1 EA __________________ __________________

Express Delivery (estimated) | Year 2 Pricing Period

Opticians | Year 2 Pricing Period

1038AA 4,160 HR __________________ __________________

Opticians - Columbia | Year 2 Pricing Period

1038AB 8,320 HR __________________ __________________

Opticians - Kansas City, Lenexa | Year 2 Pricing Period

1038AC 2,080 HR __________________ __________________

Opticians - Warrensburg | Year 2 Pricing Period

1038AD 6,240 HR __________________ __________________

Opticians - Poplar Bluff, Cape Girardeau, West Plains | Year 2 Pricing Period

1038AE 10,400 HR __________________ __________________

Opticians - St Louis | Year 2 Pricing Period

1038AF 2,080 HR __________________ __________________

Opticians - Farmington | Year 2 Pricing Period

1038AG 2,080 HR __________________ __________________

Opticians - Topeka | Year 2 Pricing Period

1038AH 4,160 HR __________________ __________________

Opticians - Wichita | Year 2 Pricing Period

1038AI 4,160 HR __________________ __________________

Opticians - Marion | Year 2 Pricing Period

1038AJ 2,080 HR __________________ __________________

Opticians - Mt Vernon | Year 2 Pricing Period

1038AK 2,080 HR __________________ __________________

Opticians - Evansville | Year 2 Pricing Period

1038AL 2,080 HR __________________ __________________

Opticians – Leavenworth | Year 2 Pricing Period

Single Vision Lenses with Frame (Plastic, Metal, Safety) | Year 3 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

2001AA 43 PR __________________ __________________

Glass | Year 3 Pricing Period.

2001AB 10,212 PR __________________ __________________

Plastic CR-39 (estimated) | Year 3 Pricing Period.

2001AC 7,607 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2001AD 173 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period.

Bifocal Lenses with Frame (Plastic, Metal, Safety) | Year 3 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

2002AA 123 PR __________________ __________________

Glass (estimated) | Year 3 Pricing Period.

2002AB 8,183 PR __________________ __________________

Plastic CR-39 (estimated) | Year 3 Pricing Period.

2002AC 8,227 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2002AD 227 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period.

Trifocal Lenses with Frame (Plastic, Metal, Safety) | Year 3 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

2003AA 30 PR __________________ __________________

Glass (estimated) | Year 3 Pricing Period.

2003AB 1,464 PR __________________ __________________

Plastic CR-39 (estimated) | Year 3 Pricing Period.

2003AC 1,202 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2003AD 48 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period

No-Line (Progressive) Lenses with Frame (Plastic, Metal, Safety) | Year 3 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

2004AA 141 PR __________________ __________________

Glass (estimated) | Year 3 Pricing Period.

2004AB 17,361 PR __________________ __________________

Plastic CR-39 (estimated) | Year 3 Pricing Period.

2004AC 15,209 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2004AD 461 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period.

Single Vision Lens Only - Installed | Year 3 Pricing Period.

2005AA 2 PR __________________ __________________

Glass (estimated) | Year 3 Pricing Period.

2005AB 145 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 3 Pricing Period.

2005AC 134 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2005AD 4 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period.

Bifocal Lens Only - Installed | Year 3 Pricing Period.

2006AA 4 PR __________________ __________________

Glass (estimated) | Year 3 Pricing Period.

2006AB 130 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 3 Pricing Period.

2006AC 171 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2006AD 4 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period.

Trifocal Lens Only - Installed | Year 3 Pricing Period.

2007AA 2 PR __________________ __________________

Glass (estimated) | Year 3 Pricing Period.

2007AB 32 PR __________________ __________________

Trifocal Lens Only - Installed (estimated) | Year 3 Pricing Period.

2007AC 48 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2007AD 1 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period.

No-Line (Progressive) Lens Only - Installed | Year 3 Pricing Period | Brand Name or Equal.

2008AA 4 PR __________________ __________________

Glass (estimated) | Year 3 Pricing Period.

2008AB 446 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 3 Pricing Period.

2008AC 532 PR __________________ __________________

Polycarbonate (estimated) | Year 3 Pricing Period.

2008AD 29 PR __________________ __________________

Tri-vex (estimated) | Year 3 Pricing Period.

2009 1 EA __________________ __________________

Eyeglass Case Only (estimated) | Year 3 Pricing Period.

2010 1 PR __________________ __________________

ADD-ON: Titanium Frame Upgrade | Brand Name or Equal

2011 502 PR __________________ __________________

ADD-ON: FT 35 Bifocal (estimated) | Year 3 Pricing Period.

2012 30 PR __________________ __________________

ADD-ON: Slab Off (estimated) | Year 3 Pricing Period.

2013 5,023 EA __________________ __________________

ADD-ON: Prism up to Diopter +or-8 (estimated) | Year 3 Pricing Period.

2014 402 EA __________________ __________________

ADD-ON: Diopter +or- 9 and Above (estimated) | Year 3 Pricing Period.

2015 2 PR __________________ __________________

ADD-ON: Aspheric Lenticular (estimated) | Year 3 Pricing Period.

2016 1,233 PR __________________ __________________

ADD-ON: Roll & Polish (estimated) | Year 3 Pricing Period.

2017 11 PR __________________ __________________

ADD-ON: Glass Tint (estimated) | Year 3 Pricing Period.

2018 1,997 PR __________________ __________________

ADD-ON: Plastic Tint (estimated) | Year 3 Pricing Period.

2019 216 PR __________________ __________________

ADD-ON: Photo-gray for Glass Lens - All (estimated) | Year 3 Pricing Period.

2020 17,468 PR __________________ __________________

ADD-ON: Photochromatic Plastic (estimated) | Year 3 Pricing Period | Brand Name or Equal

2021 1,272 PR __________________ __________________

1.56 High Index Lenses - Single Vision (estimated) | Year 3 Pricing Period.

2022 1 PR __________________ __________________

1.60 High Index Lenses - Single Vision (estimated) | Year 3 Pricing Period

2023 1,936 PR __________________ __________________

1.67 High Index Lenses - Single Vision (estimated) | Year 3 Pricing Period.

2024 1 PR __________________ __________________

1.74 High Index Lenses - Single Vision (estimated) | Year 3 Pricing Period.

2025 1 PR __________________ __________________

1.56 High Index Lenses - Bifocal D28 (estimated) | Year 3 Pricing Period.

2026 1 PR __________________ __________________

1.60 High Index Lenses – Bifocal D28 (estimated) | Year 3 Pricing Period

2027 396 PR __________________ __________________

1.67 High Index Lenses - Bifocal D28 (estimated) | Year 3 Pricing Period.

2028 1 PR __________________ __________________

1.74 High Index Lenses - Bifocal D28 (estimated) | Year 3 Pricing Period.

2029 1 PR __________________ __________________

1.56 High Index Lenses - Progressive (estimated) | Year 3 Pricing Period.

2030 1 PR __________________ __________________

1.60 High Index Lenses - Progressive (estimated) | Year 3 Pricing Period

2031 2,969 PR __________________ __________________

1.67 High Index Lenses - Progressive (estimated) | Year 3 Pricing Period.

2032 1 PR __________________ __________________

1.74 High Index Lenses - Progressive (estimated) | Year 3 Pricing Period.

2033 8,955 PR __________________ __________________

ADD-ON: Varilux COMFORT/Short (estimated) | Year 3 Pricing Period | Brand Name or Equal

2034 52 PR __________________

ADD-ON: Varilux PHYSIO / Short (estimated) | Year 3 Pricing Period | Brand Name or Equal

2035 1 EA __________________ __________________

ADD-ON: Cable Temple (estimated) | Year 3 Pricing Period.

2036 9,786 PR __________________ __________________

ADD-ON: Anti-Reflective Coating (estimated) | Year 3 Pricing Period.

2037 1 EA __________________ __________________

Express Delivery (estimated) | Year 3 Pricing Period

Opticians | Year 3 Pricing Period

2038AA 4,160 HR __________________ __________________

Opticians - Columbia | Year 3 Pricing Period

2038AB 8,320 HR __________________ __________________

Opticians - Kansas City, Lenexa | Year 3 Pricing Period

2038AC 2,080 HR __________________ __________________

Opticians - Warrensburg | Year 3 Pricing Period

2035AD 6,240 HR __________________ __________________

Opticians - Poplar Bluff, Cape Girardeau, West Plains | Year 3 Pricing Period

2038AE 10,400 HR __________________ __________________

Opticians - St Louis | Year 3 Pricing Period

2038AF 2,080 HR __________________ __________________

Opticians - Farmington | Year 3 Pricing Period

2038AG 2,080 HR __________________ __________________

Opticians - Topeka | Year 3 Pricing Period

2038AH 4,160 HR __________________ __________________

Opticians - Wichita | Year 3 Pricing Period

2038AI 4,160 HR __________________ __________________

Opticians - Marion | Year 3 Pricing Period

2038AJ 2,080 HR __________________ __________________

Opticians - Mt Vernon | Year 3 Pricing Period

2038AK 2,080 HR __________________ __________________

Opticians - Evansville | Year 3 Pricing Period

2038AL 2,080 HR __________________ __________________

Opticians – Leavenworth | Year 3 Pricing Period

Single Vision Lenses with Frame (Plastic, Metal, Safety) | Year 4 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

3001AA 45 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3001AB 10.621 PR __________________ __________________

Plastic CR-39 (estimated) | Year 4 Pricing Period.

3001AC 7,911 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3001AD 180 PR __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

Bifocal Lenses with Frame (Plastic, Metal, Safety) | Year 4 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

3002AA 128 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3002AB 8,511 PR __________________ __________________

Plastic CR-39 (estimated) | Year 4 Pricing Period.

3002AC 8,556 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3002AD 236 PR __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

Trifocal Lenses with Frame (Plastic, Metal, Safety) | Year 4 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

3003AA 31 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3003AB 1,523 PR __________________ __________________

Plastic CR-39 (estimated) | Year 4 Pricing Period.

3003AC 1,250 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3003AD 49 PR __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

No-Line (Progressive) Lenses with Frame (Plastic, Metal, Safety) | Year 4 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

3004AA 146 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3004AB 18,055 PR __________________ __________________

Plastic CR-39 (estimated) | Year 4 Pricing Period.

3004AC 15,818 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3004AD 479 __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

Single Vision Lens Only - Installed | Year 4 Pricing Period.

3005AA 2 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3005AB 151 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 4 Pricing Period.

3005AC 139 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3005AD 4 __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

Bifocal Lens Only - Installed | Year 4 Pricing Period.

3006AA 4 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3006AB 135 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 4 Pricing Period.

3006AC 178 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3006AD 4 PR __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

Trifocal Lens Only - Installed | Year 4 Pricing Period. | Year 4 Pricing Period.

3007AA 2 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3007AB 34 PR __________________ __________________

Trifocal Lens Only - Installed (estimated) | Year 4 Pricing Period.

3007AC 49 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3007AD 1 PR __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

3008 __________________ __________________ No-Line (Progressive) Lens Only - Installed | Year 4 Pricing Period | Brand Name or Equal.

3008AA 4 PR __________________ __________________

Glass (estimated) | Year 4 Pricing Period.

3008AB 463 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 4 Pricing Period.

3008AC 553 PR __________________ __________________

Polycarbonate (estimated) | Year 4 Pricing Period.

3008AD 29 PR __________________ __________________

Tri-vex (estimated) | Year 4 Pricing Period.

3009 1 EA __________________ __________________

Eyeglass Case Only (estimated) | Year 4 Pricing Period.

3010 1 PR __________________ __________________

ADD-ON: Titanium Frame Upgrade | Brand Name or Equal

3011 522 PR __________________ __________________

ADD-ON: FT 35 Bifocal (estimated) | Year 4 Pricing Period.

3012 31 PR __________________ __________________

ADD-ON: Slab Off (estimated) | Year 4 Pricing Period.

3013 5,224 EA __________________ __________________

ADD-ON: Prism up to Diopter +or-8 (estimated) | Year 4 Pricing Period.

3014 418 EA __________________ __________________

ADD-ON: Diopter +or- 9 and Above (estimated) | Year 4 Pricing Period.

3015 2 PR __________________ __________________

ADD-ON: Aspheric Lenticular (estimated) | Year 4 Pricing Period.

3016 1,282 PR __________________ __________________

ADD-ON: Roll & Polish (estimated) | Year 4 Pricing Period.

3017 11 PR __________________ __________________

ADD-ON: Glass Tint (estimated) | Year 4 Pricing Period.

3018 2,076 PR __________________ __________________

ADD-ON: Plastic Tint (estimated) | Year 4 Pricing Period.

3019 225 PR __________________ __________________

ADD-ON: Photo-gray for Glass Lens - All (estimated) | Year 4 Pricing Period.

3020 18,167 PR __________________ __________________

ADD-ON: Photochromatic Plastic (estimated) | Year 4 Pricing Period | Brand Name or Equal

3021 1,323 PR __________________ __________________

1.56 High Index Lenses - Single Vision (estimated) | Year 4 Pricing Period.

3022 1 PR __________________ __________________

1.60 High Index Lenses - Single Vision (estimated) | Year 4 Pricing Period

3023 2,014 PR __________________ __________________

1.67 High Index Lenses - Single Vision (estimated) | Year 4 Pricing Period.

3024 1 PR __________________ __________________

1.74 High Index Lenses - Single Vision (estimated) | Year 4 Pricing Period.

3025 1 PR __________________ __________________

1.56 High Index Lenses - Bifocal D28 (estimated) | Year 4 Pricing Period.

3026 1 PR __________________ __________________

1.60 High Index Lenses – Bifocal D28 (estimated) | Year 4 Pricing Period

3027 412 PR __________________ __________________

1.67 High Index Lenses - Bifocal D28 (estimated) | Year 4 Pricing Period.

3028 1 PR __________________ __________________

1.74 High Index Lenses - Bifocal D28 (estimated) | Year 4 Pricing Period.

3029 1 PR __________________ __________________

1.56 High Index Lenses - Progressive (estimated) | Year 4 Pricing Period.

3030 1 PR __________________ __________________

1.60 High Index Lenses - Progressive (estimated) | Year 2 Pricing Period

3031 3,088 PR __________________ __________________

1.67 High Index Lenses - Progressive (estimated) | Year 4 Pricing Period.

3032 1 PR __________________ __________________

1.74 High Index Lenses - Progressive (estimated) | Year 4 Pricing Period.

3033 9,313 PR __________________ __________________

ADD-ON: Varilux COMFORT/Short (estimated) | Year 4 Pricing Period | Brand Name or Equal

3034 54 PR __________________

ADD-ON: Varilux PHYSIO / Short (estimated) | Year 4 Pricing Period | Brand Name or Equal

3035 1 EA __________________ __________________

ADD-ON: Cable Temple (estimated) | Year 4 Pricing Period.

3036 10,178 PR __________________ __________________

ADD-ON: Anti-Reflective Coating (estimated) | Year 4 Pricing Period.

3037 1 EA __________________ __________________

Express Delivery (estimated) | Year 4 Pricing Period

Opticians | Year 4 Pricing Period

3038AA 4,160 HR __________________ __________________

Opticians - Columbia | Year 4 Pricing Period

3038AB 8,320 HR __________________ __________________

Opticians - Kansas City, Lenexa | Year 4 Pricing Period

3038AC 2,080 HR __________________ __________________

Opticians - Warrensburg | Year 4 Pricing Period

3038AD 6,240 HR __________________ __________________

Opticians - Poplar Bluff, Cape Girardeau, West Plains | Year 4 Pricing Period

3038AE 10,400 HR __________________ __________________

Opticians - St Louis | Year 4 Pricing Period

3038AF 2,080 HR __________________ __________________

Opticians - Farmington | Year 4 Pricing Period

3038AG 2,080 HR __________________ __________________

Opticians - Topeka | Year 4 Pricing Period

3038AH 4,160 HR __________________ __________________

Opticians - Wichita | Year 4 Pricing Period

3038AI 4,160 HR __________________ __________________

Opticians - Marion | Year 4 Pricing Period

3038AJ 2,080 HR __________________ __________________

Opticians - Mt Vernon | Year 4 Pricing Period

3038AK 2,080 HR __________________ __________________

Opticians - Evansville | Year 4 Pricing Period

3038AL 2,080 HR __________________ __________________

Opticians – Leavenworth | Year 4 Pricing Period

Single Vision Lenses with Frame (Plastic, Metal, Safety) | Year 5 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

4001AA 47 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4001AB 11,046 PR __________________ __________________

Plastic CR-39 (estimated) | Year 5 Pricing Period.

4001AC 8,228 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4001AD 187 PR __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

Bifocal Lenses with Frame (Plastic, Metal, Safety) | Year 5 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

4002AA 133 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4002AB 8,851 PR __________________ __________________

Plastic CR-39 (estimated) | Year 5 Pricing Period.

4002AC 8,898 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4002AD 246 PR __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

Trifocal Lenses with Frame (Plastic, Metal, Safety) | Year 5 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

4003AA 33 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4003AB 1,584 PR __________________ __________________

Plastic CR-39 (estimated) | Year 5 Pricing Period.

4003AC 1,300 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4003AD 51 PR __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

No-Line (Progressive) Lenses with Frame (Plastic, Metal, Safety) | Year 5 Pricing Period | Complete Eyeglasses (Lenses, Frame, and Case) | Brand Name or Equal

4004AA 152 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4004AB 18,777 PR __________________ __________________

Plastic CR-39 (estimated) | Year 5 Pricing Period.

4004AC 16,451 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4004AD 498 PR __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

Single Vision Lens Only - Installed | Year 5 Pricing Period.

4005AA 2 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4005AB 157 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 5 Pricing Period.

4005AC 145 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4005AD 5 __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

Bifocal Lens Only - Installed | Year 5 Pricing Period.

4006AA 5 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4006AB 140 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 5 Pricing Period.

4006AC 185 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4006AD 5 PR __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

Trifocal Lens Only - Installed | Year 5 Pricing Period | Year 5 Pricing Period.

4007AA 2 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4007AB 35 PR __________________ __________________

Trifocal Lens Only - Installed (estimated) | Year 5 Pricing Period.

4007AC 51 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4007AD 1 PR __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

No-Line (Progressive) Lens Only - Installed | Year 5 Pricing Period | Brand Name or Equal.

4008AA 5 PR __________________ __________________

Glass (estimated) | Year 5 Pricing Period.

4008AB 482 PR __________________ __________________

Plastic CR-39 - (estimated) | Year 5 Pricing Period.

4008AC 576 PR __________________ __________________

Polycarbonate (estimated) | Year 5 Pricing Period.

4008AD 30 PR __________________ __________________

Tri-vex (estimated) | Year 5 Pricing Period.

4009 1 EA __________________ __________________

Eyeglass Case Only (estimated) | Year 5 Pricing Period | Brand Name or Equal

4010 1 PR __________________ __________________

ADD-ON: Titanium Frame Upgrade | Brand Name or Equal

4011 543 PR __________________ __________________

ADD-ON: FT 35 Bifocal (estimated) | Year 5 Pricing Period.

4012 33 PR __________________ __________________

ADD-ON: Slab Off (estimated) | Year 5 Pricing Period.

4013 5,433 EA __________________ __________________

ADD-ON: Prism up to Diopter +or-8 (estimated) | Year 5 Pricing Period.

4014 435 EA __________________ __________________

ADD-ON: Diopter +or- 9 and Above (estimated) | Year 5 Pricing Period.

4015 2 PR __________________ __________________

ADD-ON: Aspheric Lenticular (estimated) | Year 5 Pricing Period.

4016 1,334 PR __________________ __________________

ADD-ON: Roll & Polish (estimated) | Year 5 Pricing Period.

4017 12 PR __________________ __________________

ADD-ON: Glass Tint (estimated) | Year 5 Pricing Period.

4018 2,160 PR __________________ __________________

ADD-ON: Plastic Tint (estimated) | Year 5 Pricing Period.

4019 234 PR __________________ __________________

ADD-ON: Photo-gray for Glass Lens - All (estimated) | Year 5 Pricing Period.

4020 18,893 PR __________________ __________________

ADD-ON: Photochromatic Plastic (estimated) | Year 5 Pricing Period | Brand Name or Equal

4021 1,376 PR __________________ __________________

1.56 High Index Lenses - Single Vision (estimated) | Year 5 Pricing Period.

4022 1 PR __________________ __________________

1.60 High Index Lenses - Single Vision (estimated) | Year 5 Pricing Period

4023 2,094 PR __________________ __________________

1.67 High Index Lenses - Single Vision (estimated) | Year 5 Pricing Period.

4024 1 PR __________________ __________________

1.74 High Index…