36C26118R0306-010.pdf

AS = Activation Service Installed

CC = General Contractor Installed

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

BRMO310 23 Bracket, Television (40" Telehealth Monitor) Peerless-AV STL646 SmartMountLT STL646 (For 32'' to 50'') Consult Room 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090

AS wall mtd

BRMO310 44 Bracket, Television (40" Telehealth Monitor) Peerless-AV STL646 SmartMountLT STL646 (For 32'' to 50'') Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS wall mtd

BRMO310 7 Bracket, Television (40" Telehealth Monitor) Peerless-AV STL646 SmartMountLT STL646 (For 32'' to 50'') Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS wall mtd

BRMO312 8 Bracket, Television (55" and 85" Monitors) Peerless-AV SF670 SmartMount SF670 Univ Flat (Security, 46''- 90'') Group Room 2018, 2096, 3018, 3096 (2ea) AS wall mtd

CADI300 3 Cabinet, Defibrillator Storage Zoll AED Wall Cabinet 80000855 Corridor

Canteen

Staff Locker

Staff Locker

C105

2055A

3055B

AS wall mtd

CATH300 23 Cisco Camera w/ wall mount and mic kit (Telehealth) Cisco Systems, Inc. CTS-SX10N-K9 Cisco SX10 Quick Set with Precision HD 1080p 5x

Camera

Consult Room

Exam Room

Procedure

2017, 2014, 2098, 2061, 2080, 3017, 3058, 3079

2013, 2097, 2062, 2083, 2095, 3014, 3061, 3080

2034. 2068, 2078, 2091, 3024, 3068, 3078

X AS wall mtd

CAVT300 4 Cisco Camerca Quick Set with Precision HD

(V-Tel)

Cisco Systems, Inc. CTS-SX20-PHD4x-K9 Cisco SX20 Quick Set with Precision HD 1080p 12x

Camera

Group Room 2018, 2096, 3018, 3096 X AS wall mtd

CHVA300 44 Acuity Chart Tech-Optics RJ018 Eye Chart Snellen

10 Ft.

RJ018 Eye Chart Snellen 10 Ft. Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS dbl sided tape

CHVA300 7 Acuity Chart Tech-Optics RJ018 Eye Chart Snellen

10 Ft.

RJ018 Eye Chart Snellen 10 Ft. Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS dbl sided tape

COPE300 23 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Consult Room 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090

AS mount cpu to furniture wkstn track

COPE300 44 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Exam Rooms 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS mount cpu to furniture wkstn track

AMBULATORY CARE

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

COPE300 7 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS mount cpu to furniture wkstn track COPE300 201 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Teamlet Workrooms (large)

Teamlet Workrooms (small)

Multipurpose Rooms

Nurse Manager Office

Group Rooms

2020, 2042, 2065, 2087, 3020, 3042, 3065, 3087, 2019, 2041, 2044, 2086, 3019, 3041, 3044, 3066, 3086

2033B, 2021,3033C, 3021

2018, 2096, 3018, 3096

AS mount cpu to bracket. See

Item ID

COPE302

COPE301 23 Computer Monitors, 22" Dell P2217H Consult Room 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090

AS mount to monitor arms

COPE301 44 Computer Monitors, 22" Dell P2217H Exam Rooms 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS mount to monitor arms

COPE301 7 Computer Monitors, 22" Dell P2217H Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS mount to monitor arms

COPE301 402 Computer Monitors Dell P2217H Teamlet Workrooms (large)

Teamlet Workrooms (small)

Multipurpose Rooms

Nurse Manager Office

Group Rooms

2020, 2042, 2065, 2087, 3020, 3042, 3065, 3087, 2019, 2041, 2044, 2086, 3019, 3041, 3044, 3066, 3086

2033B, 2021,3033C, 3021

2018, 2096, 3018, 3096

AS mount to monitor arms

COPE302 201 Computer Brackets Hewlett-Packard G1K2288 Teamlet Workrooms (large)

Teamlet Workrooms (small)

Multipurpose Rooms

Nurse Manager Office

Group Rooms

2020, 2042, 2065, 2087, 3020, 3042, 3065, 3087, 2019, 2041, 2044, 2086, 3019, 3041, 3044, 3066, 3086

2033B, 2021,3033C, 3021

2018, 2096, 3018, 3096

AS mount to underside of desk

COPY310 8 Multifunction Copier Ricoh 416525 MP C5503 Teamlet Workrooms (large) 2020, 2042, 2065, 2087, 3020, 3042, 3065, 3087, X X VV

COSH321 44 Disposal, Sharps, Wall Mount Medtronic - Covidien Kendall Products 85161H SharpSafety In Room 85161H Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS wall mtd

COSH321 7 Disposal, Sharps, Wall Mount Medtronic - Covidien Kendall Products 85161H SharpSafety In Room 85161H Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS wall mtd

COSH321 8 Disposal, Sharps, Wall Mount Medtronic - Covidien Kendall Products 85161H SharpSafety In Room 85161H Medication Room 2027, 2049, 2060, 2082, 3027, 3049, 3060, 3082

AS wall mtd

COSH321 6 Disposal, Sharps, Wall Mount Medtronic - Covidien Kendall Products 85161H SharpSafety In Room 85161H Soiled Utility 2016, 2038, 2071, 3016, 3071, AS wall mtd

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

DEFI300 3 Defibrillator, Automatic Zoll AED Plus 21000010102011000 21000010102011000 Corridor

Canteen

Staff Locker

Staff Locker

C105

2055A

3055B DIGL300 8 Dispenser, Glove, Triple Box MarketLab, Inc ML3615 ML3615 Acrylic Side-Loading Medication Room 2027, 2049, 2060, 2082, 3027, 3049, 3060, 3082

AS wall mtd

DIGL300 6 Dispenser, Glove, Triple Box MarketLab, Inc ML3615 ML3615 Acrylic Side-Loading Soiled Utility Room 2016, 2038, 2071, 3016, 3071, AS wall mtd

DIOT300 44 Dispenser, Otoscope Tips Welch Allyn, Inc., A Hill-Rom Company 52400 524 Series Kleenspec [52400] Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS mtd to custom metal plate and clipped on rail

DIOT300 7 Dispenser, Otoscope Tips Welch Allyn, Inc., A Hill-Rom Company 52400 524 Series Kleenspec [52400] Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS mtd to custom metal plate and clipped on rail

ELIN300 3 Electrocardiograph (ECG), Interpretive

(existing/reuse)

GE Healthcare - Cardiology 2053900-014/Cart MAC 5500 w/Cart Teamlet Workroom 2038, 2071, 3071 X VV

FRUC311 2 Freezer, Commercial, Undercounter Follett Corporation FZR5P-00-00 FZR5P Performance Plus Medical Grade Medication Room 2027, 3027 AS Install (1) stacking kit per freezer/ refrig. See

REUC315

LIEX305 5 Light, Exam/Procedure, Single, Ceiling Philips Burton ALEDSC AIM LED Procedure Room 2034, 2068, 2078, 3024, 3078 CC

LIPA305 7 Patient Lift, Ceiling Mounted ArjoHuntleigh-Getinge Group MS000-01-01R345 Maxi Sky 2 600LB (Room Covering) Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

CC

MEST330 8 Dispenser, Medication, Host CareFusion Pyxis MedStations Pyxis MedStations ES 5-Drawers Medication Room 2027, 2049, 2060, 2082, 3027, 3049, 3060, 3082

X X VV

MOBP305 44 Sphygmomanometer, Aneroid Welch Allyn, Inc., A Hill-Rom Company 7670-01 767 Wall w/ Adult Cuff Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS mtd to custom metal plate and clipped on rail

MOBP305 7 Sphygmomanometer, Aneroid Welch Allyn, Inc., A Hill-Rom Company 7670-01 767 Wall w/ Adult Cuff Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS mtd to custom metal plate and clipped on rail

MOPH300 44 Monitor, Vital Signs, w/Stand Welch Allyn, Inc., A Hill-Rom Company 67MXTX-B/ 4800-60 Connex 6700 w/Stand Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

VA Biomed

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

MOPH300 7 Monitor, Vital Signs, w/Stand Welch Allyn, Inc., A Hill-Rom Company 67MXTX-B/ 4800-60 Connex 6700 w/Stand Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

VA Biomed

OTOP301 44 Oto/Ophthalmoscope Set, Transformer Welch Allyn, Inc., A Hill-Rom Company 77710 Green Series 777 [77710] Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS mtd to custom metal plate and clipped on rail

OTOP301 7 Oto/Ophthalmoscope Set, Transformer Welch Allyn, Inc., A Hill-Rom Company 77710 Green Series 777 [77710] Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS mtd to custom metal plate and clipped on rail

OPTH300 44 Ophthalmoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 11820 11820 PanOptic Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS screws onto instrument handle

OPTH300 7 Ophthalmoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 11820 11820 PanOptic Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS screws onto instrument handle OTOP302 44 Otoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 23820 23820 MacroView Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS screws onto instrument handle

OTOP302 7 Otoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 23820 23820 MacroView Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS screws onto instrument handle REUC315 8 Refrigerator, Commercial, Undercounter Follett Corporation REF5P-00-00 REF5P Performance Plus Medical Grade Medication Room 2027, 2049, 2060, 2082, 3027, 3049, 3060, 3082

AS * see

FRUC311

stacking kit on (2) sets REUC320 2 Refrigerator, Undercounter w/ Freezer, ADA Summit Appliance CT66JADA CT66JADA Lactation 2099, 3033B

REWB301 7 Waste Can, Bio-Hazardous, Red (23 gal) Rubbermaid Commercial Products FG614600RED 6146 Red (23 gal) Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

REWB301 6 Waste Can, Bio-Hazardous, Red (23 gal) Rubbermaid Commercial Products FG614600RED 6146 Red (23 gal) Soiled Utility 2016, 2038, 2071, 3016, 3071, SCST300 44 Scale, Clinical, Adult, Digital, Platform Detecto Scale- Div.Cardinal Scale Mfg DR660 DR660 Bariatric Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS wall mtd.

digital reader

SCST300 7 Scale, Clinical, Adult, Digital, Platform Detecto Scale- Div.Cardinal Scale Mfg DR660 DR660 Bariatric Procedure Room 2024, 2034, 2068, 2078, 3024, 3068. 3078

AS wall mtd.

digital reader

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

SCWC300 2 Scale, Clinical, Adult, Wheelchair Scale-Tronix, Inc., A Hill-Rom Company 6202 6202 Stow-A-Weigh Alcove, Scale 2063, 3063 AS wall mtd.

STMA300 7 Stand, Mayo, Foot-Operated Pedigo Products, Inc P-1066-SS P-1066-SS Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

SYME300 7 Dispenser, Supply, Host (1-Cell Unit) Omnicell, Inc. SDA-FRM-001 One-Cell XT Supply Dispenser Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

X X AS install seismic anchors

SYME301 8 Dispenser, Supply, Host (2-Cell Unit) Omnicell, Inc. SDA-FRM-002 Two-Cell XT Supply Dispenser Alcove, Omni-Cell 2020A, 2042A, 2065A, 2087A, 3020A, 3042A, 3065A, 3087A

X X AS install seismic anchors

TAUT300 7 Table, Utility, General Purpose Blickman Inc. 0237857000 7857SS Saturn Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

TAEX302 44 Table, Exam/Treatment, Powered Midmark Corporation 625-004/002-0874 Midmark 625 Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

X VV X

TAPR302 7 Chair, Clinical, Exam, Power Adjust Midmark Corporation 641-005/002-0966 Midmark 641 Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

X VV X

TELE310 23 Television, 40 in, Flat Panel (Telehealth) Samsung Electronics UN40JU7100FXZA UN40JU7100 Consult Room 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090

X AS mtd to bracket

TELE310 44 Television, 40 in, Flat Panel (Telehealth) Samsung Electronics UN40JU7100FXZA UN40JU7100 Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

X AS mtd to bracket

TELE310 7 Television, 40 in, Flat Panel (Telehealth) Samsung Electronics UN40JU7100FXZA UN40JU7100 Procedure Room 2024, 2034, 2068, 2078, 3024, 3068. 3078

X AS mtd to bracket

TELE311 4 Television, 55 in, Flat Panel (V-Tel / Telehealth) Samsung Electronics UN55JU7100FXZA UN55JU7100 Group Room 2018, 2096, 3018,3096 X AS mtd to bracket

TELE313 4 Television, 85 in, Flat Panel Samsung Electronics UN85JU7100FXZA UN85JU7100 Group Room 2018, 2096, 3018,3096 X AS mtd to bracket

THDI300 44 Thermometer, Digital, Wall Mount Welch Allyn, Inc., A Hill-Rom Company 01690-300 SureTemp Plus 690 (Oral) Exam Room 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

AS mtd to custom metal plate and clipped on rail

THDI300 7 Thermometer, Digital, Wall Mount Welch Allyn, Inc., A Hill-Rom Company 01690-300 SureTemp Plus 690 (Oral) Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS mtd to custom metal plate and clipped on rail

WAPH300 7 Disposal, Pharmacy (hazardous waste) Medtronic - Covidien Kendall Products 8608RC SharpSafety RCRA Haz. Waste 8608RC (8 gal) Medication Room 2027, 2049, 2060, 2082, 3027, 3049, 3060, 3082

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

WAPH301 7 Disposal, Pharmacy, Floor Cart Medtronic - Covidien Kendall Products 8981FP Sharpscart 8981FP (8 gallon/Slide-Top) Medication Room 2027, 2049, 2060, 2082, 3027, 3049, 3060, 3082

WHST400 10 Wheelchair, Adult, Transport STAXI Corporation Ltd. ST010-[X] Medical Chair [ST010] Storage, Wheelchair 1004B

VECNA 30 Queuing Monitors w/ brackets

(provided by others)

VECNA Teamlet Workrooms (large) 2020, 2042, 2065, 2087, 3020, 3042, 3065, 3087

X AS wall mtd

SODI300 23 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Consult Room 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090

X AS mtd to custom metal plate and clipped on rail

SODI300 44 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Exam Rooms 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

X AS mtd to custom metal plate and clipped on rail

SODI300 7 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

X AS mtd to custom metal plate and clipped on rail

SODI300 13 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Medication Rooms

Soiled Utility

2027, 2049, 2060, 2082, 3027, 3049, 3060, 3082

2016, 2038, 2071, 3016, 3071, SADI300 23 Hand Sanitizers Dispensers(provided by others) GOJO Industries 1928-04 Purell LTX-12 Dispenser Consult Room 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090

X AS mtd to custom metal plate and clipped on rail

SADI300 44 Hand Sanitizers Dispensers(provided by others) GOJO Industries 1928-04 Purell LTX-12 Dispenser Exam Rooms 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

X AS mtd to custom metal plate and clipped on rail

SADI300 7 Hand Sanitizers Dispensers(provided by others) GOJO Industries 1928-04 Purell LTX-12 Dispenser Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

X AS mtd to custom metal plate and clipped on rail

23 Telephones Cisco Systems, Inc. Consult Rooms 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090

X AS mtd directly on wkstn panel

44 Telephones Cisco Systems, Inc. Exam Rooms 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095

X AS mtd directly on wkstn panel

7 Telephones Cisco Systems, Inc. Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

AS mted directly on wkstn panel

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

SIPA300 23 Signature Pad, Electronic ePadLink VP9801 ePad Consult Rooms 2014, 2017, 2035, 2036, 2046, 2098, 2056, 2057, 2058, 2061, 2079, 2080, 2089, 2090, 3017, 3025, 3026, 3056, 3057, 3058, 3079, 3089, 3090 SIPA300 44 Signature Pad, Electronic ePadLink VP9801 ePad Exam Rooms 2011, 2012, 2013, 2025, 2026, 2039, 2097, 2047, 2048, 2051, 2052, 2053, 2062, 2064, 2069, 2070, 2073, 2074, 2075, 2083, 2084, 2085, 2091, 2092, 2095, 3011, 3012, 3013, 3014, 3029, 3030, 3031, 3061, 3062, 3064, 3074, 3075, 3080, 3083, 3084, 3085, 3091, 3092, 3095 SIPA300 7 Signature Pad, Electronic ePadLink VP9801 ePad Procedure Room 2024, 2034, 2068, 2078, 3024, 3068, 3078

ULBL300 2 Bladder Scanners w/ mobile cart Verathon 0270-0870 Prime Plus Storage Alcove

Large Omnicell Alcove

2094A

3087A

VA Biomed

MOGL300 3 Glucometer (existing /reuse) Roche Diagnostics 05060311001/05060290

Accuchek Inform II Teamlet 2042

X VA Biomed

ANBR300 6 Breath Analyzers Lifeloc Technologies FC10 FC10 Teamlet Workrooms 2020

2042 (2ea)

2065 (2ea)

ANHE304 2 Analyzer, Otolaryngologic, Hearing Aid Audioscan 3547 Verifit VF-2 Audiometric Exam 1051, 1053 VV

ANMI300 2 Analyzer, Otolaryngologic, Middle Ear Otometrics - Audiology Systems 8-02-220 Madsen Zodiac 901 Audiometric Control Room 1050, 1052 VV

ANOT300 1 Analyzer, Otolaryngologic, Visipitch KayPENTAX 3950B Visi-Pitch IV Model 3950 Speech Analysis Lab 1062 VV

AUDI300 2 Audiometer, Dual Channel Grason-Stadler, Inc. (GSI) 8503145 GSI AudioStar Pro Audiometric Control Room 1050, 1052 VV

BRMO312 2 Bracket, Television (55" and 85" Monitors) Peerless-AV SF670 SmartMount SF670 Univ Flat (Security, 46''- 90'') Group Therapy Room 1064 AS wall mtd

CAVT300 1 Cisco Camera, Quick Set with Precision HD Camera

(V-Tel)

Cisco Systems, Inc. CTS-SX20-PHD4x-K9 Cisco SX20 Quick Set with Precision HD 1080p 12x

Camera

Group Therapy Room 1064 X AS wall mtd

CLUL304 1 Bath, Water, Allowance Branson CPX952119R Hearing Aid Fabrication/Modification 1057

COPE300 12 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Administration

Audio Exam

Audio Control

Speech Pathologist Office

Audiologist Office

Speech Lab

Group Therapy

1054 (2ea)

1051, 1053

1050, 1052

1059, 1060, 1061

X AS mount cpu to bracket. See

Item ID

COPE302

COPE301 18 Computer Monitors, 22" Dell P2217H Administration

Audio Exam

Audio Control

Speech Pathologist Office

Audiologist Office

Speech Lab

Group Therapy

1054 (4ea)

1051, 1053

1050, 1052

1056 (2ea)

1059, 1060, 1061 (2ea)

AS mount to monitor arms

AUDIOLOGY

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

COPE302 12 Computer Brackets Hewlett-Packard Administration

Audio Exam

Audio Control

Speech Pathologist Office

Audiologist Office

Speech Lab

Group Therapy

1054 (2ea)

1051, 1053

1050, 1052

1059, 1060, 1061

AS mount to underside of desk

COPY310 1 Multifunction Copier Ricoh 416525 MP C5503 Corridor C104 X X VV

HEAI300 1 Hearing Aid Restoration Med Rx UltraVac Hearing Aid Fabrication/Modification 1057

LATH302 1 Lathe, Dental Polishing Handler Mfg Company, Inc. 26A 26A Red Wing Lathe Hearing Aid Fabrication/Modification 1057

OTOP307C 3 Oto/Ophthalmoscope Rechargeable Handle Welch Allyn, Inc., A Hill-Rom Company 71670 3.5v NiCad Rchg

Handle F / Desk Chgr

71670 3.5v NiCad Rchg Handle F / Desk Chgr Therapist Room/Audiologist 1059, 1060, 1061

OTOP307C 1 Oto/Ophthalmoscope Rechargeable Handle Welch Allyn, Inc., A Hill-Rom Company 71670 3.5v NiCad Rchg

Handle F / Desk Chgr

71670 3.5v NiCad Rchg Handle F / Desk Chgr Therapist Room/Speech Pathologist 1056

OTOP307B 3 Otoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 25020 25020 Halogen HPX Therapist Room/Audiologist 1059, 1060, 1061

OTOP307B 1 Otoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 25020 25020 Halogen HPX Therapist Room/Speech Pathologist 1056

REFR311 1 Refrigerator, Domestic with Freezer Frigidaire - Div. Electrolux FFTR1821QW FFTR1821QW (18 Cu. Ft./ White) Instrument Calibration & Storage 1058

REUC320 1 Refrigerator, Undercounter Summit Appliance AL750BI AL750BI (ADA Compliant, Built in) Hearing Aid Fabrication/Modification 1057

STDI300 1 Stroboscopy System, Digital Video, Laryngeal Jedmed Instrument Company 70-6500 StroboCAM II Speech Analysis Lab 1062 VV

STUN500 1 Stroboscopy System, Digital Video, Laryngeal KayPENTAX 9295 Digital Video Stroboscopy System Therapist Room/Speech Pathologist 1056 VV

TELE311 1 Television, 55 in, Flat Panel (V-Tel / Telehealth) Samsung Electronics UN55JU7100FXZA UN55JU7100 Group Therapy Room 1064 AS mtd to bracket

TELE313 1 Television, 85 in, Flat Panel Samsung Electronics UN85JU7100FXZA UN85JU7100 Group Therapy Room 1064 AS mtd to bracket

TYAU300 2 Tympanometer, Screening, Automatic Maico Diagnostics - A division of Diagnostics Group MI 24 Audiometric Exam 1051, 1053 VV

VECNA 1 Queuing Monitors w/ brackets VECNA Corridor C104 X X AS wall mtd

SODI300 5 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Hearing Aid Fabrication/Modification

Speech Pathologist

Therapist Room/Audiologist

1059, 1060, 1061

X AS wall mtd w/ dbl sided tape

SADI300 5 Hand Sanitizers Dispensers(provided by others) GOJO Industries 1928-04 Purell LTX-12 Dispenser Hearing Aid Fabrication/Modification

Speech Pathologist

Therapist Room/Audiologist

1059, 1060, 1061

X AS wall mtd w/ dbl sided tape

SHWI305 3 Shelving, Wire, Chrome, 24x48 InterMetro Industries Corp (5x)2448NC/(4x)74P Super Erecta 48x24x74 (5-Tier) BioMed Engineering Repair Shop 1040 AS assemble

WOBE800 1 Bench, Work, Steel w/ Power Lyon Workspace Products, Inc. Cat. No. 2402, 2625, 2642, and 2662

60" Work Bench w/ Shelf Riser and Outlet Strip BioMed Engineering Repair Shop 1040 AS assemble

CAST300 1 Cabinet, Storage, Non-Clinical, Drawers Stanley Vidmar SCU2070AL 245 Standard counter height (5 drawer) BioMed Engineering Repair Shop 1040

CAST301 1 Cabinet, Storage, Non-Clinical, Overhead Stanley Vidmar 0S110X1AL Overhead cabinet OS110X1A BioMed Engineering Repair Shop 1040

COPE300 1 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD BioMed Engineering Repair Shop 1040 AS mount cpu to bracket. See

Item ID

COPE302

COPE301 2 Computer Monitors, 22" Dell P2217H BioMed Engineering Repair Shop 1040 AS mount to monitor arms

COPE302 1 Computer Bracket Hewlett-Packard AS mount to underside of desk

BIO-MED ENGINEERING

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

VITE300 1 Blood Pressure Tester/Analyzer (existing/reuse) Welch-Allyn 407672 BP Test Volumn Repair Fixture BioMed Engineering Repair Shop 1040

ANBP300 1 Vital Sign Monitor Simulation Tester (existing/reuse) Pronk Technologies SimCube BioMed Engineering Repair Shop 1040

COPE300 3 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Eligibility Office

Travel Clerk Office

ROI Office sits on desktop

COPE300 2 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Supervisor Office

Service Org. Office

AS mount cpu to bracket. See

Item ID

COPE302

COPE301 3 Computer Monitors, 22" Dell P2217H Eligibility Office (1ea)

Travel Clerk Office (1ea)

ROI Office (1ea)

AS mtd on stand

COPE301 2 Computer Monitors, 22" Dell P2217H Supervisor Office (2ea)

Service Org. Office (2ea)

AS mount to monitor arms

COPE302 2 Computer Brackets Hewlett-Packard Supervisor Office

Service Org. Office

AS mount to underside of desk COPY310 1 Multifunction Copier Ricoh 416525 MP C5503 Document Control 1124 X X VV

VECNA 1 Queuing Monitors w/ brackets VECNA Waiting Area 1120 X AS wall mtd

SADI300 1 Hand Sanitizers Dispensers(provided by others) GOJO Industries 1928-04 Purell LTX-12 Dispenser Waiting Area 1120 X AS wall mtd w/ dbl sided tape

TAAF300 1 Hill Air-Flex Table Hill Laboratories Treatment/Exercise Area 1085

TAPT300 1 Hill PT Mobilization Table Hill Laboratories Exam Room 1084

CHCV300 1 Cervical Chair Gonstead Seminar, Inc. Exam Room 1084

BRMO312 2 Bracket, Television, Wall, Flat Panel 46-90in Peerless-AV SF670 SmartMount SF670 Univ Flat (Security, 46''- 90'') Conference/Multipurpose 3112 AS wall mtd

CAVT300 1 Cisco Camera Quick Set with Precision HD

(V-Tel)

Cisco Systems, Inc. CTS-SX20-PHD4x-K9 Cisco SX20 Quick Set with Precision HD 1080p 12x

Camera

Conference/Multipurpose 3112 X AS wall mtd

OVMI303 1 Oven, Domestic, Microwave, Countertop Frigidaire - Div. Electrolux FFCE1638LW FFCE1638LW (1.6 cu. ft., White) Kitchenette 3116

REFR311 1 Refrigerator, Domestic with Freezer Frigidaire - Div. Electrolux FFTR1821QW FFTR1821QW (18 Cu. Ft./ White) Kitchenette 3116

TELE311 1 Television, 55 in, Flat Panel (V-Tel / Telehealth) Samsung Electronics UN55JU7100FXZA UN55JU7100 Conference/Multipurpose 3112 AS mtd to bracket

TELE313 1 Television, 85 in, Flat Panel Samsung Electronics UN85JU7100FXZA UN85JU7100 Conference/Multipurpose 3112 AS mtd to bracket

COPE300 4 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Reception

AO Office

Health System Support

Director

X AS mount cpu to bracket. See

Item ID

COPE302

COPE301 8 Computer Monitors, 22" Dell P2217H Reception (2ea)

AO Office (2ea)

Health System Support (2ea)

Director (2ea)

AS mount to monitor arms

COPE302 4 Computer Bracket Hewlett-Packard Reception

AO Office

Health System Support

Directo

AS mount to underside of desk

BUSINESS OFFICE

CHIROPRACTIC SERVICES

CLINIC MANAGEMENT

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

COPY310 1 Multifunction Copier Ricoh 416525 MP C5503 Document Control 3115 X X VV

SODI300 1 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Kitchenette 3116 X AS wall mtd w/ dbl sided tape

BRMO310 3 Bracket, Television (40" Telehealth Monitor) Peerless-AV STL646 SmartMountLT STL646 (For 32'' to 50'') Exam Room, Dermatology 2029, 2030, 2031 AS wall mtd

CATH300 1 Cisco Camera w/ wall mount and mic kit (Telehealth) Cisco Systems, Inc. CTS-SX10N-K9 Cisco SX10 Quick Set with Precision HD 1080p 5x

Camera

Exam Room, Dermatology 2029 X AS wall mtd

COPE300 3 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Exam Room, Dermatology 2029, 2030, 2031 X AS mount cpu to furniture wkstn track COPE301 3 Computer Monitors, 22" Dell P2217H Exam Room, Dermatology 2029, 2030, 2031 AS mount to monitor arms

COSH321 3 Disposal, Sharps, Wall Mount Medtronic - Covidien Kendall Products 85161H SharpSafety In Room 85161H Exam Room, Dermatology 2029, 2030, 2031 AS wall mtd

DIOT300 3 Dispenser, Otoscope Tips Welch Allyn, Inc., A Hill-Rom Company 52400 524 Series Kleenspec [52400] Exam Room, Dermatology 2029, 2030, 2031 AS mtd to custom metal plate and clipped on rail

ELEC300 4 Electrosurgical Unit, Bipolar/Monopolar Conmed Corporation 7-900-115 Hyfrecator 2000 Exam Room, Dermatology

Procedure

2029, 2030, 2031

AS mtd to custom metal plate and clipped on rail

LIEX305 3 Light, Exam/Procedure, Single, Ceiling Philips Burton ALEDSC AIM LED Exam Room, Dermatology 2029, 2030, 3031 CC

OTOP301 3 Oto/Ophthalmoscope Set, Transformer Welch Allyn, Inc., A Hill-Rom Company 77710 Green Series 777 [77710] Exam Room, Dermatology 2029, 2030, 2031 AS mtd to custom metal plate and clipped on rail

OPTH300 3 Ophthalmoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 11720 11720 (3.5V Coaxial) Exam Room, Dermatology 2029, 2030, 2031 AS screws onto instrument handle OTOP302 3 Otoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 23820 23820 MacroView Exam Room, Dermatology 2029, 2030, 2031 AS screws onto instrument

REWB301 3 Waste Can, Bio-Hazardous, Red (23 gal) Rubbermaid Commercial Products FG614600RED 6146 Red (23 gal) Exam Room, Dermatology 2029, 2030, 3031

SIPA300 3 Signature Pad, Electronic ScriptPro ELECTRONICSIGNATURE Electronic Signature Device Exam Room, Dermatology 2029, 2030, 3031

STMA300 3 Stand, Mayo, Foot-Operated Pedigo Products, Inc P-1066-SS P-1066-SS Exam Room, Dermatology 2029, 2030, 3031

TAPR310 3 Table, Exam/Treatment, Powered Midmark Corporation 630-022/002-1644 Midmark 630 HumanForm Exam Room, Dermatology 2029, 2030, 2031 X VV

TELE310 3 Television, 40 in, Flat Panel (Telehealth) Samsung Electronics UN40JU7100FXZA UN40JU7100 Exam Room, Dermatology 2029, 2030, 2031 X AS mtd to bracket

SODI300 3 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Exam Room, Dermatology 2029, 2030, 2031 X AS mtd to custom metal plate and clipped on rail

SADI300 3 Hand Sanitizers Dispensers(provided by others) GOJO Industries 1928-04 Purell LTX-12 Dispenser Exam Room, Dermatology 2029, 2030, 2031 X AS mtd to custom metal plate and clipped on rail

3 Telephones Cisco Systems, Inc. Exam Room, Dermatology 2029, 2030, 2031 X AS mtd directly on wkstn panel

BRMO312 10 Bracket, Television (55" and 85" Monitors) Peerless-AV SF670 SmartMount SF670 Univ Flat (Security, 46''- 90'') Conference/Multipurpose (2ea)

Educational Conference (2ea)

2105, 2106, 3105, 3106

AS wall mtd

DEMATOLOGY

EDUCATION

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

CAVT300 5 Cisco Camera, Quick Set with Precision HD

(V-Tel)

Cisco Systems, Inc. CTS-SX20-PHD4x-K9 Cisco SX20 Quick Set with Precision HD 1080p 12x

Camera

Conference/Multipurpose

Educational Conference

2105, 2106, 3105, 3106

X AS wall mtd

5 Telephone, Conferencing Cisco Systems, Inc. CP-8831-K9= Unified IP Phone 8831 Conference/Multipurpose

Educational Conference

2105, 2106, 3105, 3106

TELE311 5 Television, 55 in, Flat Panel (V-Tel / Telehealth) Samsung Electronics UN55JU7100FXZA UN55JU7100 Conference/Multipurpose

Educational Conference

2105, 2106, 3105, 3106

X AS mtd to bracket

TELE313 5 Television, 85 in, Flat Panel Samsung Electronics UN85JU7100FXZA UN85JU7100 Conference/Multipurpose

Educational Conference

2105, 2106, 3105, 3106

AS mtd to bracket

COPE300 5 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Conference/Multipurpose

Educational Conference

2105, 2106, 3105, 3106

X AS mount cpu to bracket. See

Item ID

COPE302

COPE301 5 Computer Monitors, 22" Dell P2217H Conference/Multipurpose

Educational Conference

2105, 2106, 3105, 3106

AS mount to monitor arms

COPE302 5 Computer Brackets Hewlett-Packard Conference/Multipurpose

Educational Conference

2105, 2106, 3105, 3106

AS mount to underside of desk

COPE300 2 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Storage, EMS Supplies 1037 X AS mount cpu to bracket. See

Item ID

COPE302

COPE301 2 Computer Monitors, 22" Dell P2217H Storage, EMS Supplies 1037 AS mount to monitor arms

COPE302 2 Computer Brackets Hewlett-Packard Storage, EMS Supplies 1037 AS mount to underside of desk SHWI301 3 Shelving, Wire, Chrome, 18x48 InterMetro Industries Corp (4x)1848NC/(4x)74P Super Erecta 48x18x74 (4-Tier) HAC (1ea) 1018, 2076A, 3076A AS assemble

SHWI305 4 Shelving, Wire, Chrome, 24x48 InterMetro Industries Corp (5x)2448NC/(4x)74P Super Erecta 48x24x74 (5-Tier) Storage, EMS Supplies 1037 AS assemble

CASU300 1 Cart / Truck, Soiled Utility (existing/reuse) LogiQuip, LLC 39-16 39-16 (16 BU) Soiled Linen 1010

CACY300 1 Cart, Cylinder, H, Single Anthony Welded Products, Inc. 6114 6114 (Retractable Wheels) Oxygen - Full 1009-2

CAPL300 1 Platform Truck Grainger 26Y494 Dayton 2000lb Cap Warehouse 1013

CAUM300 1 Cart, Utility, Mail Charnstrom Company B233 Solid Mail Cart w/Lockingg Top Mail Room and Distribution Center 1014

GBMH300 1 Box, Glove, Mail Handling Terra Universal, Inc. 1716-50B Mail Handling Batch Process - Single Operator Mail Room and Distribution Center 1014

RACY300 1 Rack, Cylinder, Floor Anthony Welded Products, Inc. MCR-600 MCR-600 (H & T Cylinders) Oxygen - Empty 1009-1

RACY300 1 Rack, Cylinder, Floor Anthony Welded Products, Inc. MCR-600 MCR-600 (H & T Cylinders) Oxygen - Full 1009-2

REBA320 5 Scanner, Barcode Honeywell M005MX Maximo/Vista Kit Warehouse 1013

TRHL400 1 Cart / Truck, Pallet, Powered Big Joe Forklifts E30 Electric Pallet Truck E30 Warehouse 1013

COPE300 2 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Warehouse

Mail Room

X mount cpu to bracket. See

Item ID

COPE302

ENVIRONMENTAL MANAGEMENT (EMS)

LOGISTICS

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

COPE301 3 Computer Monitors Dell P2217H Warehouse (2ea)

Mail Room (1ea) mount to monitor arms

COPE302 2 Computer Brackets Hewlett-Packard Warehouse

Mail Room mount to underside of desk COPY310 1 Multifunction Copier Ricoh 416525 MP C5503 Warehouse 1013 X X VV

SHWI305 20 Shelving, Wire, Chrome, 24x48 InterMetro Industries Corp (5x)2448NC/(4x)74P Super Erecta 48x24x74 (5-Tier) Logistics Storage 1017 AS assemble

ANFI300 2 Analyzer, Ophthalmic, Visual Field Carl Zeiss Meditec 860 HFA3 Visual Fields 3046 X VV X

ANOP303 1 Analyzer, Ophthalmic, Corneal Topography Carl Zeiss Meditec Atlas 9000 Photography/ Imaging 3034 X X

ANOP302 1 Analyzer, Ophthalmic, OCT Carl Zeiss Meditec Cirrus HD OCT - Model 5000 w/ table Photography/ Imaging 3035 X VV X

DIOP320 1 Analyzer, Ophthalmic, OCT Heidelberg Spectralis HRA+OCT Spectralis HRA+OCT w/ table and all optional modules

Photography/ Imaging 3034 X X

AUKE300 2 Refractor / Keratometer, Automatic Carl Zeiss Meditec 266002-1149-110-NEW VISUREF 100 Photography/ Imaging 3034, 3035 VV

BESP300 4 Beam Splitter, 50/50 Haag-Streit USA, Inc. Eye Lane/Exam Room 3036, 3048, 3051, 3098 VV

CARE301 1 Camera, Retinal, Non-mydriatic Carl Zeiss Meditec Visucam 524 Visucam 524 w/ FA and ICGA software Photography/ Imaging 3035 X X

CARE302 1 Camera, Retinal, Wide Field Carl Zeiss Meditec Clarus 500 Clarus 500 HD Ultra-Widefield Photography/ Imaging 3034 X X

CHEX304 8 Chair, Clinical, Eye Exam Reliance Medical Products 070025LFC 7000-LFC (Low Base) Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

VV

COAC300 10 Chart, Visual Acuity, Wall, Digital Lombart Instrument CVSi21 CVSi21 Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035

VV

COSH321 11 Disposal, Sharps, Wall Mount Medtronic - Covidien Kendall Products 85161H SharpSafety In Room 85161H Eye Lane/Exam Room

Visual Fields

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035

AS wall mtd

EYEA112 10 Retinoscope, Streak, Pocket Welch Allyn, Inc., A Hill-Rom Company 18245 18245 Elite Streak Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA113 30 Ophthalmoscope, Recharable Power Handle Welch Allyn, Inc., A Hill-Rom Company 71670 3.5V Recharageble Power Handle for Universal

Desk Charger

Eye Lane/Exam Room (3ea)

Photography/ Imaging (3ea)

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA114 10 Ophthalmoscope, Head Only Welch Allyn, Inc., A Hill-Rom Company 11720 3.5V Halogen HPX Coaxial Ophthalmoscope Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035

AS screws onto instrument handle EYEA115 10 Transilluminator Welch Allyn, Inc., A Hill-Rom Company 41100 3.5V Halogen Fiber Optic Transilluminator Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA120 8 Trial Lens Set Marco Ophthalmic Custom Deluxe Set Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

EYEA122 10 Volk 20D Large Aspheric Lens, Clear (50mm) Volk Optical, Inc. V20LC V20LC Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA123 10 Volk 60D Small Aspheric Lens, Clear (31mm) Volk Optical, Inc. V60C V60C Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA124 10 Volk 78D Small Aspheric Lens, Clear (31mm) Volk Optical, Inc. V78C V78C Eye Lane/Exam Room (3ea)

Photography/ Imaging (3ea)

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA125 10 Volk 90D Small Aspheric Lens, Clear Volk Optical, Inc. V90C V90C Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA126 10 Volk Digital Wide Field Lens Volk Optical, Inc. VDGTLWF VDGTLWF Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035

EYEA127

HOLD

24 Volk Gonio Fundus Laser Lens, 3-Mirror Glass, w/

Flange

Volk Optical, Inc. VG3 VG3 Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

EYEA128

HOLD

24 Volk Hand Held Gonio Lens, 4 Mirror Glass, Large

Ring, No Flange

Volk Optical, Inc. VG4LNF VG4LNF Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

OPTOMETRY/OPHTHALMOLOGY

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

EYEA129 10 Luneau Retinoscopy Rack Luneau RALU01-000 Retinoscopy Rack Convex/Convex Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA130 10 Prism Bar Set, Horizontal & Vertical Lombart BR0ZZB14

BR0ZZB15

Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA135 10 Stereo Rando Test Lombart RA0ORANDOT Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 EYEA136 10 Front Surface Mirror Lombart CP1ZZMIRLFG Front Surface Mirror, Limestone (12 x 12) Eye Lane/Exam Room

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035

VV

GLCH301 8 Chair, Clinical, Eye Exam Chair Glide Reliance Medical Products 940 Chair Glide for ADA

Compliance

940 Chair Glide for ADA Compliance Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

VV

LASL302 4 Slit Lamp Haag-Streit USA, Inc. 0900.011 LED BQ 900 LED Eye Lane/Exam Room 3036, 3048, 3051, 3098 X VV

LASL303 4 Slit Lamp w/ IM 900 Digital Video Pkg Haag-Streit USA, Inc. EC706 LED BQ 900 LED w/ IM 900 Digital Video Pkg Eye Lane/Exam Room 3039, 3053, 3052, 3047

LMAU300 9 Lensometer, Automatic Carl Zeiss Meditec VISULENS 500 Eye Lane/Exam Room

Visual Fields

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

VV

OPHT350 8 Ophthalmoscope, Binocular, Indirect Heine OMEGA 500 LED Heine Omega 500 Binocular Indirect

Ophthalmoscope, LED

Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

VV

PACO300

HOLD

2 Pachymeter, Cornea, Ultrasonic DGH Technology, Inc. DGH 550 Pachette 2 - DGH 550 Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

PHRE300 8 Phoropter, Refractor Reichert Technologies Ophthalmic Instruments 11637 Illuminated Phoroptor - Plus Cylinder 11637 Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

VV

REWB300 8 Waste Can, Bio-Hazardous, Red (8 gal) Rubbermaid Commercial Products 1883564 Slim Jim Front Step 8-gal. (Red) Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

SHOB300 4 Short Observer Tube Haag-Streit USA, Inc. Eye Lane/Exam Room 3036, 3098, 3048, 3051 VV

STIN304 8 Stand, Ophthalmic, Instrument Reliance Medical Products 780002 7800-IC Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

VV

TAIN301 2 Stand, Equipment, Ophthalmic Topcon Medical Systems, Inc. 25016-11-000 AIT-16 Photography/ Imaging 3034, 3046

TAEQ301 2 Table, Equipment, Instrument, Eye Topcon Medical Systems, Inc. 25042-11-001 AIT-250W Photography/ Imaging 3034, 3046

TOPR300

HOLD

120 Prism, Tonometer Haag-Streit USA, Inc. Haag-Streit Tonometer Prism Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

TOAU300 8 Tonometer, Automatic Haag-Streit USA, Inc. 0900.2101 AT 900 Goldmann Applanation Model R Eye Lane/Exam Room 3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

TOHH300 2 Tonometer, Hand-Held

(include tip 2 boxes tip covers)

Reichert Technologies Ophthalmic Instruments Tono-Pen Avia Tono-Pen Avia Eye Lane/Exam 3039, 3052

LASL304 1 Slit Lamp, Hand-Held Kowa SL-17 Hand-held portable slit lamp Eye Lane/Exam Room 3039, 3052

TBD 2 Manual Lensometer Marco Ophthalmic Marco 101 Manual Lensometer Photography/ Imaging 3034, 3035

STOL300 14 Pneumatic Stools - 14" x 16" with back Reliance Medical Products 5348 Pneumatic Stools Eye Lane/Exam Room

Visual Fields

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3046 (2ea)

3034, 3035 (2ea) MOPH301 2 Automated Blood Pressure Monitor Omron Omron HEM-907XL Blood Pressure Monitor w/ mobile base mounting kit

Photography/ Imaging 3034, 3035

SIPA300 11 Signature Pad, Electronic ePadLink VP9801 ePad Eye Lane/Exam Room

Visual Fields

Photography/ Imaging

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3035 COPE300 11 Computer Workstation (CPU, Mouse, Keyboard) TBD TBD TBD Eye Lane/Exam Room

Imaging Rooms

Visual Fields

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3046

X AS mount cpu to furniture wkstn track

COPE301 22 Computer Monitors Dell P2217H Eye Lane/Exam Room

Imaging Rooms

Visual Fields

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3046

AS mount to monitor arms

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

SODI300 11 Soap Dispenser (provided by others) GOJO Industries 1972-04 Provon LTX-12 Dispenser Eye Lane/Exam Room

Imaging Rooms

Visual Fields

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3046

X AS mtd to custom metal plate and clipped on rail

SADI300 11 Hand Sanitizers Dispensers(provided by others) GOJO Industries 1928-04 Purell LTX-12 Dispenser Eye Lane/Exam Room

Imaging Rooms

Visual Fields

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3046

X AS mtd to custom metal plate and clipped on rail

11 Telephones Cisco Systems, Inc. Eye Lane/Exam Room

Imaging Rooms

Visual Fields

3036, 3039 , 3047, 3048, 3051, 3052, 3053, 3098

3034, 3046

X AS mtd directly to wkstn panel

SYME300 1 Dispenser, Supply, Host (1-Cell Unit) Omnicell, Inc. SDA-FRM-001 One-Cell XT Supply Dispenser Teamlet Area 3042 X X VV

ANBL310 1 Analyzer, Lab, Hematology (leased equip) Sysmex XN-1000 Laboratory 1102 VA Biomed

ANCH310 1 Analyzer, Lab, Blood Gas, Point-of-Care

(existing/reuse)

Abbott Point of Care Inc 04J60-20 I-STAT 1 w/Distribution Kit (Waived) Laboratory 1102 X

ANSR300 1 Analyzer, Lab, Sedimentation Rate Diesse Inc. 240401 Mini-Cube w/ Printer & Scanner Laboratory 1102

BACS205 4 Scanner, Barcode Honeywell Sensing and Productivity Solutions MK7180-31A138 OrbitCG 7180 Omnidirectional Laser Scanner Private Drawing/Specimen Collection (1ea)

Reception (1ea)

Blood Specimen Collection (2ea)

BACS205 2 Scanner, Barcode (existing/reuse) Honeywell Sensing and Productivity Solutions MK7180-31A138 OrbitCG 7180 Omnidirectional Laser Scanner Laboratory (2ea) 1102

CAPR300 1 Cart, Procedure, Phlebotomy MarketLab, Inc ML0379 ML0379 Go-Cart Deluxe Pkg Private Drawing/Specimen Collection 1111 AS assemble

CENT302 2 Centrifuge, General Purpose, Countertop Beckman Coulter, Inc. B05802 Allegra X-30R Laboratory 1102 VA Biomed

CENT310 2 Centrifuge, General Purpose, Countertop Thermo Fisher Scientific 75007200 Sorvall ST 8 Laboratory 1102 VA Biomed

CHPH300 3 Chair, Clinical, Blood Draw, Reclining Beecher Group KP9020 KP9020 Phlebotomy Chair Blood Specimen Collection 1114

COPY310 1 Multifunction Copier Ricoh 416525 MP C5503 Reception 1112 X X VV

COSH320 3 Disposal, Sharps, Floor Bin Medtronic - Covidien Kendall Products 8980 SharpSafety 8980 (8 gal Red) Private Drawing/Specimen Collection (1ea)

Laboratory (2ea)

AS wall mtd

DIGL300 4 Dispenser, Glove, Triple Box MarketLab, Inc ML3615 ML3615 Acrylic Side-Loading Private Drawing/Speciment Collection (1ea)

Blood Specimen Collection (1ea)

Laboratory (2ea)

AS wall mtd

FREE310 1 Freezer, Laboratory, 1 door Helmer Scientific iLF120 iLF120 Laboratory 1102

FRUC312 1 Freezer, Commercial, Undercounter (ADA) Follett Corporation FRZ2 FRZ2 Laboratory 1102

HEBL310 2 Heater, Dri-Bath w/ (2) inserts for heat blocks Thermo Fisher Scientific 88871001 Compact Dry Bath S Blood Specimen Collection

Laboratory

MAFL302 12 Mat, Floor, Anti-Fatigue Allen Medical Systems, A Hill-Rom Company O-CM Comfort Mat Blood Specimen Collection (4ea)

Laboratory (8ea)

MICR402 1 Microscope, Binocular (existing/reuse) Olympus America Inc - Scientific BX43F BX43 Laboratory 1102

MIVO310 1 Mixer, Vortex (existing/reuse) Fisher Scientific Company 02-215-375 Pulsing Vortex Mixer Laboratory 1102

PRLA301 4 Printer, Label, Barcode Zebra Technologies Corp 105SL Plus 105SL Plus Reception (1ea)

Blood Specimen Collection

Laboratory (1ea)

Courier Receiving (1ea)

X VA OI&T

PRWB300 4 Printer, Label, Barcode Zebra Technologies Corp ZD410 ZD410 Reception (1ea)

Blood Specimen Collection

Laboratory (1ea)

Courier Receiving (1ea)

X VA OI&T

REDO310 1 Refrigerator, Laboratory, 2 door Helmer Scientific 5102245-1 i.Series iLR245 (115V) Laboratory 1102

REFR300 1 Refrigerator, Commercial, Compact Follett Corporation REF2 REF2 Medical Grade Blood Specimen Collection 1114

REFR310 1 Refrigerator, Domestic with Freezer Helmer Scientific iLR120 iLR120 Laboratory 1102

REUC325 1 Refrigerator, Commercial, Undercounter (ADA) Follett Corporation REF4P-00-00 REF4P ADA Performance Plus Medical Grade Urinalysis & Microscope 1117

REWB301 3 Waste Can, Bio-Hazardous, Red (23 gal) Rubbermaid Commercial Products FG614600RED 6146 Red (23 gal) Laboratory 1102

STRE305 1 Stretcher, Procedure / Recovery, Chair TransMotion Medical, Inc. TMM4-WB TMM4-WB Multi-Purpose Stretcher-Chair Private Drawing/Specimen Collection Room 1111

SYME300 1 Dispenser, Supply, Host (1-Cell Unit) Omnicell, Inc. SDA-FRM-001 One-Cell XT Supply Dispenser Blood Specimen Collection 1114 X AS install seismic anchors

SYME301 1 Dispenser, Supply, Host (2-Cell Unit) Omnicell, Inc. SDA-FRM-002 Two-Cell XT Supply Dispenser Laboratory 1102

PATHOLOGY & LAB MEDICINE

VV = VA's Vendor Installed

San Jose Outpatient Clinic

Equipment List 03/05/2018

Item ID Qty Description Manufacturer Mfr # Model Room Room # Network Ship to Site Installation SOW Training

TAPH301 5 Table, Phlebotomy, Adjustable Blood Draw Stand Chapparal UN-ADS-DT Adjustable

Draw Stand with Double

Taper Top

UN-ADS-DT Adjustable Draw Stand with Double

Taper Top

Private Drawing/Specimen Collection(1ea)

Blood Specimen Collection Room (4ea)

URTE310 1 Analyzer, Lab, Urinalysis (existing/reuse) Siemens Healthcare Diagnostics 1420 Clinitek Advantus Laboratory 1102 X

WOTE310 1 Analyzer, Lab, Microbiology (existing/reuse) BD Diagnostics 250100 BD…