36C26120Q0256-0003003.docx

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6515--Prescription Eyeglasses and Optician Services for VA Pacific Islands Healthcare System
Solicitation number
36C26120Q0256
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36C26120Q0256 0003 Price Schedule.docx

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Base Ordering Period - Date of award expected to be May 1, 2020 – April 30, 2021 (The guaranteed minimum award amount for this contract is $1,000. The maximum aggregate value of orders that can be placed under this contract is $7,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.)

VA Pacific Islands Health Care System (459), Including Associated Clinics Estimated Unit Total

Line Item
Description
Unit
Quantity
Price
Price
0001
Single Vision
0001AA
Glass
PR
10
$
$
0001AB
Plastic-CR39
PR
3,628
$
$
0001AC
Polycarbonate
PR
100
$
$
0001AD
Hi-Index
PR
100
$
$
0002
Bifocal
0002AA
Glass
PR
10
$
$
0002AB
Plastic-CR39
PR
1750
$
$
0002AC
Polycarbonate
PR
100
$
$
0002AD
Hi-Index
PR
168
$
$
0003
Trifocal
0003AA
Glass
PR
10
$
$
0003AB
Plastic-CR39
PR
190
$
$
0003AC
Polycarbonate
PR
20
$
$
0003AD
Hi-Index
PR
20
$
$
0004
Progressive (No-Line)
0004AA
Glass
PR
2
$
$
0004AB
Plastic-CR39
PR
1,600
$
$
0004AC
Polycarbonate
PR
60
$
$
0004AD
Hi-Index
PR
60
$
$
0005
Special Lenses / Add-Ons
0005AA
Prism
PR
60
$
$
0005AB
Balanced
PR
60
$
$
0005AC
Roll & Polished Edge
PR
60
$
$
0005AD
Slab Off Prism
PR
60
$
$
0005AE
Solid/Gradient Tint
PR
200
$
$
0005AF
Anti Reflective
PR
200
$
$
0005AG
Lenses, Oversize Eye Greater Than 58
PR
200
$
$
0005AH
Photochromic
PR
100
$
$
0005AI
Polarized
PR
70
$
$
0005AJ
Aspheric
PR
200
$
$
0006
Lens Only

0006AA

SV-Glass, Plastic-CR39, Polycarbonate, Hi-Index

EA

$
$

0006AB

Bifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

0006AC

Trifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

0006AD

Progressive (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$
TOTAL
$
Line Item
Description
Unit
Quantity
Price
Price
0007
Optician, Full Time Employee (FTE)
0007AA
Optician, Full Time Employee (FTE)
HR
2080
$
$
0007AB
Optician, Full Time Employee (FTE)
HR
2080
$
$
0007AC
Optician, Full Time Employee (FTE)
HR
2080
$
$
TOTAL
$

Total Base Period: $

Ordering Period 1 - May 1, 2021 – April 30, 2022

Estimated Unit Total

Line Item
Description
Unit
Quantity
Price
Price
1001
Single Vision
1001AA
Glass
PR
10
$
$
1001AB
Plastic-CR39
PR
3,628
$
$
1001AC
Polycarbonate
PR
100
$
$
1001AD
Hi-Index
PR
100
$
$
1002
Bifocal
1002AA
Glass
PR
10
$
$
1002AB
Plastic-CR39
PR
1750
$
$
1002AC
Polycarbonate
PR
100
$
$
1002AD
Hi-Index
PR
168
$
$
1003
Trifocal
1003AA
Glass
PR
10
$
$
1003AB
Plastic-CR39
PR
190
$
$
1003AC
Polycarbonate
PR
20
$
$
1003AD
Hi-Index
PR
20
$
$
1004
Progressive (No-Line)
1004AA
Glass
PR
2
$
$
1004AB
Plastic-CR39
PR
1,600
$
$
1004AC
Polycarbonate
PR
60
$
$
1004AD
Hi-Index
PR
60
$
$
1005
Special Lenses / Add-Ons
1005AA
Prism
PR
60
$
$
1005AB
Balanced
PR
60
$
$
1005AC
Roll & Polished Edge
PR
60
$
$
1005AD
Slab Off Prism
PR
60
$
$
1005AE
Solid/Gradient Tint
PR
200
$
$
1005AF
Anti Reflective
PR
200
$
$
1005AG
Lenses, Oversize Eye Greater Than 58
PR
200
$
$
1005AH
Photochromic
PR
100
$
$
1005AI
Polarized
PR
70
$
$
1005AJ
Aspheric
PR
200
$
$
1006
Lens Only

1006AA

SV-Glass, Plastic-CR39, Polycarbonate, Hi-Index

EA

$
$

1006AB

Bifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$
1006AC
Trifocal (Plastic-CR39, Hi-Index,

Polycarbonate)

EA
40
$
$
1006AD
Progressive (Plastic-CR39, Hi-Index,

Polycarbonate)

EA
60
$
$
Total:
$
Line Item
Description
Unit
Quantity
Price
Price
1007
Optician, Full Time Employee (FTE)
1007AA
Optician, Full Time Employee (FTE)
HR
2080
$
$
1007AB
Optician, Full Time Employee (FTE)
HR
2080
$
$
1007AC
Optician, Full Time Employee (FTE)
HR
2080
$
$
TOTAL
$

Total Period 1: $

Ordering Period 2 – May 1, 2022 – April 30, 2023

Estimated Unit Total

Line Item
Description
Unit
Quantity
Price
Price
2001
Single Vision
2001AA
Glass
PR
10
$
$
2001AB
Plastic-CR39
PR
3,628
$
$
2001AC
Polycarbonate
PR
100
$
$
2001AD
Hi-Index
PR
100
$
$
2002
Bifocal
2002AA
Glass
PR
10
$
$
2002AB
Plastic-CR39
PR
1750
$
$
2002AC
Polycarbonate
PR
100
$
$
2002AD
Hi-Index
PR
168
$
$
2003
Trifocal
2003AA
Glass
PR
10
$
$
2003AB
Plastic-CR39
PR
190
$
$
2003AC
Polycarbonate
PR
20
$
$
2003AD
Hi-Index
PR
20
$
$
2004
Progressive (No-Line)
2004AA
Glass
PR
2
$
$
2004AB
Plastic-CR39
PR
1,600
$
$
2004AC
Polycarbonate
PR
60
$
$
2004AD
Hi-Index
PR
60
$
$
2005
Special Lenses / Add-Ons
2005AA
Prism
PR
60
$
$
2005AB
Balanced
PR
60
$
$
2005AC
Roll & Polished Edge
PR
60
$
$
2005AD
Slab Off Prism
PR
60
$
$
2005AE
Solid/Gradient Tint
PR
200
$
$
2005AF
Anti Reflective
PR
200
$
$
2005AG
Lenses, Oversize Eye Greater Than 58
PR
200
$
$
2005AH
Photochromic
PR
100
$
$
2005AI
Polarized
PR
70
$
$
2005AJ
Aspheric
PR
200
$
$
2006
Lens Only

2006AA

SV-Glass, Plastic-CR39, Polycarbonate, Hi-Index

EA

$
$

2006AB

Bifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

2006AC

Trifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

2006AD

Progressive (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$
TOTAL
$
Line Item
Description
Unit
Quantity
Price
Price
2007
Optician, Full Time Employee (FTE)
2007AA
Optician, Full Time Employee (FTE)
HR
2080
$
$
2007AB
Optician, Full Time Employee (FTE)
HR
2080
$
$
2007AC
Optician, Full Time Employee (FTE)
HR
2080
$
$
TOTAL
$

Total Period 2: $

Ordering Period 3 - May 1, 2023 – April 30, 2024

Estimated Unit Total

Line Item
Description
Unit
Quantity
Price
Price
3001
Single Vision
3001AA
Glass
PR
10
$
$
3001AB
Plastic-CR39
PR
3,628
$
$
3001AC
Polycarbonate
PR
100
$
$
3001AD
Hi-Index
PR
100
$
$
3002
Bifocal
3002AA
Glass
PR
10
$
$
3002AB
Plastic-CR39
PR
1750
$
$
3002AC
Polycarbonate
PR
100
$
$
3002AD
Hi-Index
PR
168
$
$
3003
Trifocal
3003AA
Glass
PR
10
$
$
3003AB
Plastic-CR39
PR
190
$
$
3003AC
Polycarbonate
PR
20
$
$
3003AD
Hi-Index
PR
20
$
$
3004
Progressive (No-Line)
3004AA
Glass
PR
2
$
$
3004AB
Plastic-CR39
PR
1,600
$
$
3004AC
Polycarbonate
PR
60
$
$
3004AD
Hi-Index
PR
60
$
$
3005
Special Lenses / Add-Ons
3005AA
Prism
PR
60
$
$
3005AB
Balanced
PR
60
$
$
3005AC
Roll & Polished Edge
PR
60
$
$
3005AD
Slab Off Prism
PR
60
$
$
3005AE
Solid/Gradient Tint
PR
200
$
$
3005AF
Anti Reflective
PR
200
$
$
3005AG
Lenses, Oversize Eye Greater Than 58
PR
200
$
$
3005AH
Photochromic
PR
100
$
$
3005AI
Polarized
PR
70
$
$
3005AJ
Aspheric
PR
200
$
$
3006
Lens Only

3006AA

SV-Glass, Plastic-CR39, Polycarbonate, Hi-Index

EA

$
$

3006AB

Bifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

3006AC

Trifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

3006AD

Progressive (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$
TOTAL
$
Line Item
Description
Unit
Quantity
Price
Price
3007
Optician, Full Time Employee (FTE)
3007AA
Optician, Full Time Employee (FTE)
HR
2080
$
$
3007AB
Optician, Full Time Employee (FTE)
HR
2080
$
$
3007AC
Optician, Full Time Employee (FTE)
HR
2080
$
$
TOTAL
$

Total Period 3: $

Ordering Period 4 - May 1, 2024 – April 30, 2025

Estimated Unit Total

Line Item
Description
Unit
Quantity
Price
Price
4001
Single Vision
4001AA
Glass
PR
10
$
$
4001AB
Plastic-CR39
PR
3,628
$
$
4001AC
Polycarbonate
PR
100
$
$
4001AD
Hi-Index
PR
100
$
$
4002
Bifocal
4002AA
Glass
PR
10
$
$
4002AB
Plastic-CR39
PR
1750
$
$
4002AC
Polycarbonate
PR
100
$
$
4002AD
Hi-Index
PR
168
$
$
4003
Trifocal
4003AA
Glass
PR
10
$
$
4003AB
Plastic-CR39
PR
190
$
$
4003AC
Polycarbonate
PR
20
$
$
4003AD
Hi-Index
PR
20
$
$
4004
Progressive (No-Line)
4004AA
Glass
PR
2
$
$
4004AB
Plastic-CR39
PR
1,600
$
$
4004AC
Polycarbonate
PR
60
$
$
4004AD
Hi-Index
PR
60
$
$
4005
Special Lenses / Add-Ons
4005AA
Prism
PR
60
$
$
4005AB
Balanced
PR
60
$
$
4005AC
Roll & Polished Edge
PR
60
$
$
4005AD
Slab Off Prism
PR
60
$
$
4005AE
Solid/Gradient Tint
PR
200
$
$
4005AF
Anti Reflective
PR
200
$
$
4005AG
Lenses, Oversize Eye Greater Than 58
PR
200
$
$
4005AH
Photochromic
PR
100
$
$
4005AI
Polarized
PR
70
$
$
4005AJ
Aspheric
PR
200
$
$
4006
Lens Only

4006AA

SV-Glass, Plastic-CR39, Polycarbonate, Hi-Index

EA

$
$

4006AB

Bifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

4006AC

Trifocal (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$

4006AD

Progressive (Plastic-CR39, Hi-Index, Polycarbonate)

EA

$
$
TOTAL
$
Line Item
Description
Unit
Quantity
Price
Price
4007
Optician, Full Time Employee (FTE)
4007AA
Optician, Full Time Employee (FTE)
HR
2080
$
$
4007AB
Optician, Full Time Employee (FTE)
HR
2080
$
$
4007AC
Optician, Full Time Employee (FTE)
HR
2080
$
$
TOTAL
$

Total Period 4: $

Grand Total Base and 4 Ordering Periods: $

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