36C26318Q0436-00002002.xlsx

XLSX spreadsheet 40 KB Posted

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BPA - Lab Analyzer CPT/CPRR Hgb A1C
Solicitation number
36C26318Q0436
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36C26318Q0436 00002 ATTACHMENT A.xlsx

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A- VA to complete

FacilityMinimum Test Thruput per hour (primary analzyer)Annual Volume Hemoglobin A1CAnnual Volume Other Testing (Identify)PRIMARY ANALYZER(S)BACK UP ANALYZERFrequency of QUALITY CONTROLDesired SERVICE OPTIONCurrent INTERFACE MANAGER in UseRequirement for PRIMARY INSTR. INTERFACINGRequirement for BACK UP INSTR. INTERFACING
VA XYZ30300000203 levels @ 3x/day24x7Data InnovationsRequiredN/A
636A83030000na102 levels 2x/day8x5Data InnovationsRequiredN/A
COLUMN E- INDICATE NUMBER OF ANALYZERS REQUIRED TO MEET WORKLOAD DEMAND
COLUMN F- INDICATE NUMBER OF ANALYZERS IF ANALYZER WILL BE USED AS A BACKUP AS DEFINED IN SOW
COLUMN G- NOTATE FREQUENCY OF QC AND HOW MANY LEVELS, I.E. 3 LEVELS @ 3X/DAY

Indicate Number of Additional Attachment As Included: No additional attachments

&"-,Bold"Estimated Annual Workload and Test Menu Attachment A

Page &P of &N

B- VA to complete

VISN
FACILITY NAMEDELIVERY LOCATIONHOURS OF OPERATIONPOINT OF CONTACTTEL #
VA XYZ123 Some St.
Anytown, STM-F 6am- 10pm
S-S 8am- 4:30pmJane.doe@va.govxxx-xxx-xxxx
636A8601 HWY 6 WEST IOWA CITY, IA 52246M-F 6am- 10pm
S-S 8am- 4:30pmKHALDEE.DAVENPORT-LANDRY@VA.GOV319-338-0581 EXT 5513
0
0
0
0
0
0
0
0
0
0
0
0
0
22
Indicate Number of Additional Attachment Bs Included:23
PCAC
PCOE
SAOW
SAOC
SAOE

&"-,Bold"Locations, Hours of Operation, Point of Contact Attachment B

Revision: 18 November 2013 Page &P of &N mailto:Jane.doe@va.gov C- Contractor to complete

ESTIMATED ANNUAL WORKLOAD AND TEST MENU
Contractor Name:FSS Number:
FACILITYPRIMARY ANALYZER(S)BACK UP ANALYZERAnnual Workload: Total of Primary + Back UpBPA PRICEExtended BPA PriceFSS PriceEXTENDED FSS Price: Product of Annual Workload * Modified FSS PriceSavings: EXTENDED FSS Price less Extended BPA Price
VA XYZModelModel2000$ 1.75$ 3,500$ 1.99$ 3,980.00$ 480.00
636A8$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
0$ - 0$ - 0$ - 0
COLUMN E- PRICE WILL BE THE SAME FOR ALL SITES INCLUDED IN THIS AGREEMENT

Indicate Number of Additional Attachment Cs Included:

&"-,Bold"BPA Estimated Savings from FSS Contract Attachment C

Revision: 18 November 2013 Page &P of &N

D- Contractor to complete Contractor Name: 0 FSS Number: 0

Base yearPricing Option Year 1Pricing Option Year 2
FACILITYAnnual Workload (total for Primary and Back Up)BPA Price Base yearTotalFACILITYAnnual Workload (total for Primary and Back Up)BPA Price Option year 1TotalFACILITYAnnual Workload (total for Primary and Back Up)BPA Price Option year 2Total
VA XYZ2000$ 1.75$ 3,500.00VA XYZ2000$ 1.75$ 3,500.00VA XYZ2000$ 1.75$ 3,500.00
636A80$ - 0636A80$ - 0636A80$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
00$ - 000$ - 000$ - 0
Annual Expense$ - 0Annual Expense$ - 0Annual Expense$ - 0

Indicate Number of Additional Attachment Ds Included:

Contractor Name: 0 FSS Number: 0

Pricing Option Year 3Pricing Option Year 4
FACILITYAnnual Workload (total for Primary and Back Up)BPA Price Option year 3TotalFACILITYAnnual Workload (total for Primary and Back Up)BPA Price Option year 4Total
VA XYZ2000$ 1.75$ 3,500.00VA XYZ2000$ 1.75$ 3,500.00
636A80$ - 0636A80$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
00$ - 000$ - 0
Annual Expense$ - 0Annual Expense$ - 0

&"-,Bold"Pricing Sheet Attachment D

Revision: 18 November 2013 Page &P of &N

Data Inputs

YesData InnovationsRequired8x510No additional attachments
NoDawningN/A8x721Yes, One Additional
24x732Yes, Two Additional
4Yes, Three Additional
5
6
7
8
9
10
11
12
15
16
17
18
19
20
21
22
23
PCOE
PCAC
SAOW
SAOE
SAOC

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