A0002 - ATTACHMENT 4 - Room Contents List - updated.pdf

Project Room Contents

FREDERICKSBURG HCC FINAL (16 MAR 2018 VERSION)

MAJOR LEASE

FREDERICKSBURG, VA

Projected Year: 2018 Midpoint Year: 2021

VISN: 6 State: VA Station ID: 652 Station Name: Richmond

Installation: VA Medical Center

Project POC: John Pate john.pate2@va.gov

8380 Colesville Road Suite 420 Silver Spring, MD 20910

Project Created: 23 Mar 2017 04:31PM ET by Bailee Bannan Space Plan Last Edited: 16 Mar 2018 01:40PM ET by John Pate

Contents List Created: 16 Mar 2018 01:51PM ET by John Pate Contents List Last Edited: 16 Mar 2018 01:51PM ET by John Pate

Report Generated: 20 Apr 2018 03:01PM ET

NOTE: ROOM CONTENTS ARE PROVIDE AS TYPICAL BY ROOM TYPE. NOT EVERY ROOM LISTED

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

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Department: LOBBY Functional Area: LOBBY / RECEPTION Room Code: RCHK2 Room Area: 105 Agency Room Name: Kiosk, Patient Check-In (My Healthy Vet) Staff: 0 Criteria Room Name: Check-In Kiosk Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

M1890 Kiosk, Educational, Stand-Up 2 EA 4,696 9,392 VV . A

Total Content Costs for this Room: 9,392

Room Code: RCP01 Room Area: 100 Agency Room Name: Reception / Volunteer Information Desk Staff: 1 Criteria Room Name: Reception Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A6105 Counter, Reception Control, Built-In 1 EA 8,128 8,128 CC . A

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,588 1,588 VV . A

Total Content Costs for this Room: 10,490

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Room Code: TNPF4 Room Area: 270 Agency Room Name: Toilet, Female Public Staff: 0 Criteria Room Name: Toilet, Female Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 2 EA 309 618 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 2 EA 17 34 VV A5082 Dispenser, Paper Towel, Sensor, Hands Free 2 EA 217 434 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 2 EA 53 106 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 2 EA 91 182 CC

CT020 Countertop, Solid Surface 1 LF 188 188 CC

F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 2 EA 277 554 VV

P3070 Lavatory, Vitreous China, Under or Counter Top Mtd 2 EA 554 1,108 CC D

P9050 Toilet, Wall Hung, Siphon Jet 6 EA 865 5,190 CC B

Total Content Costs for this Room: 8,992

Total Content Costs for this Room: 8,992

Room Code: TNPM4 Room Area: 325 Agency Room Name: Toilet, Male Public Staff: 0 Criteria Room Name: Toilet, Male Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 2 EA 17 34 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 2 EA 217 434 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 2 EA 91 182 CC

CT020 Countertop, Solid Surface 1 LF 188 188 CC

F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 277 277 VV

P3070 Lavatory, Vitreous China, Under or Counter Top Mtd 2 EA 554 1,108 CC D

P8150 Urinal, Wall Hung 2 EA 469 938 CC B

P9050 Toilet, Wall Hung, Siphon Jet 5 EA 865 4,325 CC B

Total Content Costs for this Room: 8,373

Room Code: TNPFM Room Area: 80 Agency Room Name: Toilet, Family / Assist Staff: 0 Criteria Room Name: Toilet, Family Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 53 53 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 91 91 CC

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

P3000 Lavatory, Vitreous China, Straight Back 1 EA 400 400 CC D

P9050 Toilet, Wall Hung, Siphon Jet 1 EA 865 865 CC B

Total Content Costs for this Room: 2,749

Room Code: LOB02 Room Area: 250 Agency Room Name: Lobby, Vestibule Staff: 0 Criteria Room Name: LOBBY, VESTIBULE Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A6046 Artwork, Decorative, With Frame 1 EA 543 543 VV

Total Content Costs for this Room: 543

Room Code: SRLW1 Room Area: 100 Agency Room Name: Alcove, Wheelchair Storage Staff: 0 Criteria Room Name: STORAGE, WHEELCHAIR Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M4705 Wheelchair, Patient Transport, Folding 1 EA 559 559 VV

M4710 Wheelchair, Patient, Bariatric, Transport, Folding 1 EA 1,789 1,789 VV

Total Content Costs for this Room: 2,348

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Room Code: RCP01 Room Area: 100 Agency Room Name: Reception / Volunteer Information Desk Staff: 1

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A6105 Counter, Reception Control, Built-In 1 EA 8,128 8,128 CC . A

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Room Code: LAC01 Room Area: 75 Agency Room Name: Lactation Room Staff: 0 Criteria Room Name: LACTATION ROOM Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1080 Mirror, Posture, Wall Mounted 1 EA 403 403 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA 48 48 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

C0035 Rail, Apron, 4x24x1 2 EA 84 168 CC

C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 1 EA 1,085 1,085 CC

CS040 Sink, SS, Single Compartment, 7.5x14x14 ID 1 EA 965 965 CC D CT020 Countertop, Solid Surface 6 LF 188 1,128 CC

F0255 Chair, Easy 1 EA 1,824 1,824 VV

F0740 Table, Occasional, Lamp 1 EA 360 360 VV

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

M2605 Pump, Breast 1 EA 884 884 VV . A

R6200 Refrigerator, U/C or F/S, 5 Cu Ft 1 EA 2,057 2,057 VV . A

Total Content Costs for this Room: 9,789

Total Content Costs for this Functional Area: 165,158

Department: LOBBY Functional Area: WAITING Room Code: WTF03 Room Area: 400 Agency Room Name: Waiting, Family Staff: 0 Criteria Room Name: Waiting, Family Blueprint #:

Room Comments: Provide one PACT Family Waiting (Child Play Area) per floor of facility.

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA 48 48 VV

A6046 Artwork, Decorative, With Frame 1 EA 543 543 VV

F0206 Chair, Side, Bariatric, With Arms 1 EA 779 779 VV

F0215 Chair, Child's 4 EA 45 180 VV

F0305 Chair, Waiting Room, Single 2 EA 654 1,308 VV

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

F0760 Table, Child's 1 EA 237 237 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F2300 Rack, Magazine, Wall Mounted 1 EA 266 266 VV

Total Content Costs for this Room: 3,466 Total Content Costs for this Functional Area: 3,466 Total Content Costs for this Department: 168,624

Department: SERVICE ORGANIZATIONS (280) Functional Area: STAFF AND ADMINISTRATIVE AREA Room Code: OFA09 Room Area: 100 Agency Room Name: Office, Service Organization Representative (AM

Legion/DAV/VFW/VBA Staff: 1

Criteria Room Name: Office, Service Organization Representative Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

E0090 Workstation, L-Shaped, Free Standing, 72x72 1 EA 8,330 8,330 VV . A

F0205 Chair, Side With Arms 1 EA 580 580 VV

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Total Content Costs for this Room: 11,956

Department: SERVICE ORGANIZATIONS (280) Functional Area: STAFF AND ADMINISTRATIVE AREA

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Room Code: OFA09 Room Area: 150 Agency Room Name: Office, State Service Organization Representative Staff: 1 Criteria Room Name: Office, Service Organization Representative Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

E0090 Workstation, L-Shaped, Free Standing, 72x72 1 EA 8,330 8,330 VV . A F0205 Chair, Side With Arms 1 EA 580 580 VV

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Total Content Costs for this Functional Area: 71,736

Department: SERVICE ORGANIZATIONS (280) Functional Area: SUPPORT AREA Room Code: SRE01 Room Area: 150 Agency Room Name: Storage, Equipment Staff: 0 Criteria Room Name: STORAGE, EQUIPMENT Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M2055 Shelving, Storage, Wire, CRS, w/Adjustable Shelves 4 EA 889 3,556 VV

Total Content Costs for this Room: 3,556

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Total Content Costs for this Functional Area: 3,556 Total Content Costs for this Department: 75,292

Department: VOLUNTARY SERVICE (290) Functional Area: RECEPTION AREA Room Code: RCP01 Room Area: 85 Agency Room Name: Reception / Secretary Staff: 0 Criteria Room Name: Reception / Secretary Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A6105 Counter, Reception Control, Built-In 1 EA 8,128 8,128 CC . A

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Total Content Costs for this Functional Area: 10,490

Department: VOLUNTARY SERVICE (290) Functional Area: STAFF AND ADMINISTRATIVE AREA Room Code: OFA09 Room Area: 100 Agency Room Name: Office, Volunteer Service Coordinator Staff: 1 Criteria Room Name: Office, Volunteer Service Chief Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

E0090 Workstation, L-Shaped, Free Standing, 72x72 1 EA 8,330 8,330 VV . A

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

F0205 Chair, Side With Arms 1 EA 580 580 VV

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Total Content Costs for this Functional Area: 11,956

Department: VOLUNTARY SERVICE (290) Functional Area: VOLUNTEER AREA Room Code: SRS01 Room Area: 250 Agency Room Name: Storage Staff: 0 Criteria Room Name: STORAGE, SHELVING Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1014 Telephone, Wall Mounted, 1 Line, With Speaker 1 EA 0 0 VV

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: Functional Area:

Room Code: SACP1 Room Area: 80 Agency Room Name: Copy Room Staff: 0 Criteria Room Name: Copy Room Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

F0465 Cabinet, Storage, 2 Door, 5 Shelf 1 EA 683 683 VV

F0775 Table, Work, 2 Drawer 1 EA 989 989 VV F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F2550 Shredder, Paper Heavy Duty 1 EA 4,179 4,179 VV . A

M1810 Copier, Floor Standing, Digital 1 EA 11,796 11,796 VV . B

Total Content Costs for this Room: 19,288

Total Content Costs for this Functional Area:

3,556

Total Content Costs for this Department: 26,002

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: LOBBY / RECEPTION AREA Room Code: SRLW1 Room Area: 120 Agency Room Name: Alcove, Wheelchair Storage Staff: 0 Criteria Room Name: Alcove, Wheelchair Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M4705 Wheelchair, Patient Transport, Folding 1 EA 559 559 VV

M4710 Wheelchair, Patient, Bariatric, Transport, Folding 1 EA 1,789 1,789 VV

Total Content Costs for this Room: 2,348

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Room Code: RCP03 Room Area: 385 Agency Room Name: Reception Staff: 0

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 3 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 3 EA 0 0 VV

A6105 Counter, Reception Control, Built-In 1 EA 8,128 8,128 CC . A F0275 Chair, Swivel, High Back 3 EA 669 2,007 VV

F0420 Cabinet, Filing, Lateral, Half Height 3 EA 651 1,953 VV

F2000 Basket, Wastepaper, Fire Resistant 2 EA 53 106 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 3 EA 1,588 4,764 VV . A

Total Content Costs for this Room: 17,010

Room Code: RCHK2 Room Area: 105 Agency Room Name: Kiosk, Patient Check-In Staff: 0 Criteria Room Name: Kiosk, Patient Check-In Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M1890 Kiosk, Educational, Stand-Up 2 EA 4,696 9,392 VV . A

Room Code: WTPC3 Room Area: 4500 Agency Room Name: Waiting, PACT 3 Staff: 0

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Criteria Room Name: Waiting, PACT 3 Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA 48 48 VV

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 2 EA 118 236 VV

A5220 Bracket, Television, Wall Backing 2 EA 98 196 CC

A6046 Artwork, Decorative, With Frame 4 EA 543 2,172 VV

F0206 Chair, Side, Bariatric, With Arms 33 EA 779 25,707 VV

F0305 Chair, Waiting Room, Single 262 EA 654 171,348 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F2300 Rack, Magazine, Wall Mounted 1 EA 266 266 VV

M0512 Television, HDTV, Large Screen, 60" 4 EA 4,082 16,328 VV . A

Total Content Costs for this Room: 216,406

Total Content Costs for this Room: 17,010

Room Code: TNPFM Room Area: 80 Agency Room Name: Toilet, Family Staff: 0 Criteria Room Name: Toilet, Family Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 53 53 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 91 91 CC

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

Total Content Costs for this Room: 2,749

Room Code: TNPM3 Room Area: 295 Agency Room Name: Toilet, Male Staff: 0 Criteria Room Name: Toilet, Male Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 2 EA 17 34 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 2 EA 217 434 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 2 EA 91 182 CC

CT020 Countertop, Solid Surface 1 LF 188 188 CC

F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 277 277 VV P3070 Lavatory, Vitreous China, Under or Counter Top Mtd 2 EA 554 1,108 CC D

P8150 Urinal, Wall Hung 1 EA 469 469 CC B

P9050 Toilet, Wall Hung, Siphon Jet 4 EA 865 3,460 CC B

Total Content Costs for this Room: 7,039

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Room Code: TNPF3 Room Area: 265 Agency Room Name: Toilet, Female Staff: 0 Criteria Room Name: Toilet, Female Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 2 EA 309 618 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 2 EA 17 34 VV A5082 Dispenser, Paper Towel, Sensor, Hands Free 2 EA 217 434 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 2 EA 53 106 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 2 EA 91 182 CC

CT020 Countertop, Solid Surface 1 LF 188 188 CC

F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 2 EA 277 554 VV

P3070 Lavatory, Vitreous China, Under or Counter Top Mtd 2 EA 554 1,108 CC D

P9050 Toilet, Wall Hung, Siphon Jet 3 EA 865 2,595 CC B

Total Content Costs for this Room: 6,397

Total Content Costs for this Functional Area: 297,709

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

TEAMS

Room Code: PEHW1 Room Area: 30 Agency Room Name: Alcove, Height / Weight Station Staff: 0 Criteria Room Name: Alcove, Height / Weight Station Blueprint #:

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1011 Telephone, Desk, 1 Line 1 EA 0 0 VV E0222 Worksurface, Computer, O/H Cab, Wall Mtd, 48" W 1 EA 2,464 2,464 VV . A

F0210 Chair, Side, Without Arms 1 EA 382 382 VV

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

M4040 Scale, Weighing, 300 Pound Capacity 1 EA 517 517 VV

Total Content Costs for this Room: 5,725

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: PEHW2 Room Area: 40 Agency Room Name: Alcove, Height / Weight Accessible Station Staff: 0 Criteria Room Name: Alcove, Height / Weight Accessible Station Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M4045 Scale, Wheelchair, Portable, 1000 lb Capacity 1 EA 3,346 3,346 VV

Total Content Costs for this Room: 3,346

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: OFDC2 Room Area: 125 Agency Room Name: Consult Room, Patient Aligned Care Team (PACT) Staff: 1 Criteria Room Name: Consult Room, Patient Aligned Care Team (PACT) Blueprint #:

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 92 92 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,076 1,076 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 1,036 1,036 CC D

CT030 Countertop, High Pressure Laminate 3 LF 68 204 CC

F0205 Chair, Side With Arms 3 EA 580 1,740 VV

F0340 Stool, Self Adjusting 1 EA 392 392 VV

F0740 Table, Occasional, Lamp 1 EA 360 360 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,103 1,103 VV . B . . . D 7110

Total Content Costs for this Room: 7,746

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: Room Area: 125 Agency Room Name: Triage Room, Patient Aligned Care Team (PACT) Staff: 0 Criteria Room Name: Triage Room, Patient Aligned Care Team (PACT) Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 92 92 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 29 29 VV

A5108 Waste Disposal Unit, Sharps 1 CS 221 221 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 8 96 VV

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,076 1,076 CC CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 1,036 1,036 CC D

CT030 Countertop, High Pressure Laminate 3 LF 68 204 CC

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,929 1,929 VV

F0206 Chair, Side, Bariatric, With Arms 1 EA 779 779 VV

F0340 Stool, Self Adjusting 1 EA 392 392 VV

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

F2310 Rack, Pamphlet, Wall Mounted 1 EA 182 182 VV

F3025 Board, Bulletin, Wood Framed 1 EA 62 62 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,588 1,588 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,103 1,103 VV . B . . . D 7110

M1825 Printer, Computer 1 EA 850 850 VV . A M4040 Scale, Weighing, 300 Pound Capacity 1 EA 517 517 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 199 199 VV

M4116 Monitor, Vital Signs 1 EA 2,548 2,548 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,621 1,621 VV . A

M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,182 1,182 VV . A

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: EXPA1 Room Area: 125 Agency Room Name: Exam Room, Patient Aligned Care Team (PACT) Staff: 0 Criteria Room Name: Exam Room, Patient Aligned Care Team (PACT) Blueprint #:

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV A1066 Mirror, Float Glass, With SS Frame 1 EA 89 89 CC

A1200 Lift System, Overhead, Patient Room 1 EA 8,453 8,453 VC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 92 92 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 29 29 VV

A5108 Waste Disposal Unit, Sharps 1 CS 221 221 VV

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 8 96 VV

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,076 1,076 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 1,036 1,036 CC D

CT030 Countertop, High Pressure Laminate 3 LF 68 204 CC E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,929 1,929 VV

F0206 Chair, Side, Bariatric, With Arms 1 EA 779 779 VV

F0340 Stool, Self Adjusting 1 EA 392 392 VV

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

F2310 Rack, Pamphlet, Wall Mounted 1 EA 182 182 VV

F3025 Board, Bulletin, Wood Framed 1 EA 62 62 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

M0506 Television, Flat Screen 1 EA 565 565 VV . A

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,588 1,588 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,103 1,103 VV . B . . . D 7110

M1825 Printer, Computer 1 EA 850 850 VV . A M4040 Scale, Weighing, 300 Pound Capacity 1 EA 517 517 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 199 199 VV

M4116 Monitor, Vital Signs 1 EA 2,548 2,548 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,621 1,621 VV . A

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

M9025 Table, Examination/Treatment, With Cabinet 1 EA 1,953 1,953 VV . A

Total Content Costs for this Room: 27,317

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: TPG01 Room Area: 60 Agency Room Name: Toilet, PACT Patient Staff: 0 Criteria Room Name: Toilet, PACT Patient Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 53 53 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 91 91 CC

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

Total Content Costs for this Room: 2,401

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: EXW01 Room Area: 125 Agency Room Name: Exam Room, Women's Health Staff: 1 Criteria Room Name: Exam Room, Women's Health Blueprint #:

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 92 92 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 29 29 VV

A5108 Waste Disposal Unit, Sharps 1 CS 221 221 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 8 96 VV

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,076 1,076 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 1,036 1,036 CC D

CT030 Countertop, High Pressure Laminate 3 LF 68 204 CC

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,929 1,929 VV

F0205 Chair, Side With Arms 1 EA 580 580 VV

F0340 Stool, Self Adjusting 1 EA 392 392 VV F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

F2310 Rack, Pamphlet, Wall Mounted 1 EA 182 182 VV

F3025 Board, Bulletin, Wood Framed 1 EA 62 62 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,588 1,588 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,103 1,103 VV . B . . . D 7110

M3072 Frame, Infectious Waste Bag w/Lid 1 EA 458 458 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 199 199 VV

M4116 Monitor, Vital Signs 1 EA 2,548 2,548 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,621 1,621 VV . A

Total Content Costs for this Room: 16,938

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: TPG01 Room Area: 60 Agency Room Name: Toilet, Women's Health Exam Room Patient Staff: 0 Criteria Room Name: Toilet, Women's Health Exam Room Patient Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 53 53 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 91 91 CC

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

Total Content Costs for this Room: 2,401

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: TRPR1 Room Area: 180 Agency Room Name: Procedure Room, General Staff: 0 Criteria Room Name: Procedure Room, General Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1011 Telephone, Desk, 1 Line 1 EA 0 0 VV

A1132 Rail, Accessory Mounting, Length As Required 1 LF 104 104 VC . . . . . J 6530

A1203 Lift System, Overhead, Bariatric 1 EA 15,233 15,233 CC . F . . . J

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 92 92 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 29 29 VV

A5108 Waste Disposal Unit, Sharps 1 CS 221 221 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 14 FT 8 112 VV C02Q0 Cabinet, Sink, U/C/B, 1 Door, 36x24x22 1 EA 739 739 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,076 1,076 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 1,036 1,036 CC D

CT020 Countertop, Solid Surface 1 LF 188 188 CC

E0915 Locker, Supply, Medication, Wall Mtd, 23"W x 20"D 1 EA 4,034 4,034 VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,929 1,929 VV

F0205 Chair, Side With Arms 1 EA 580 580 VV

F0340 Stool, Self Adjusting 1 EA 392 392 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F3010 Board, Bulletin, 48 x 48 1 EA 150 150 VV

M3070 Hamper, Linen, Mobile, w/Lid 1 EA 562 562 VV

M3072 Frame, Infectious Waste Bag w/Lid 1 EA 458 458 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 199 199 VV

M4116 Monitor, Vital Signs 1 EA 2,548 2,548 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,621 1,621 VV . A

M4255 Stand, IV, Adjustable 1 EA 446 446 VV

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA 5,920 5,920 VV M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,182 1,182 VV . A

M7405 Light, Exam, Ceiling Mounted 1 EA 3,141 3,141 CC . F

M7710 Electrocardiograph, 12 Lead, Portable 1 EA 14,607 14,607 VV . A

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

M8810 Stand, Mayo 1 EA 776 776 VV

Total Content Costs for this Room: 63,000

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: TPB01 Room Area: 75 Agency Room Name: Toilet, General Procedure Room Patient Staff: 0 Criteria Room Name: Toilet, General Procedure Room Patient Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 53 53 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 2 EA 164 328 CC A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 91 91 CC

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

P3005 Lavatory, Vitreous China, Bariatric 1 EA 5,272 5,272 CC D

P9056 Toilet, Floor Mounted, Bariatric 1 EA 480 480 CC B

Total Content Costs for this Room: 7,052

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: CLSC4 Room Area: 400 Agency Room Name: Shared Medical Appointment Room Staff: 0 Criteria Room Name: Shared Medical Appointment Room Blueprint #:

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

E0945 Cart, Computer, Mobile 2 EA 2,020 4,040 VV

F0295 Chair, Stacking 16 EA 79 1,264 VV F0435 Cabinet, Storage, Multi Media 1 EA 1,567 1,567 VV

F0860 Table, Mobile 4 EA 986 3,944 VV

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

F2250 Camcorder, Hand Held, HD, Zoom, w/Microphone 1 EA 3,005 3,005 VV

F3060 Whiteboard, Projection Screen Combination 1 EA 651 651 VV

M0506 Television, Flat Screen 1 EA 565 565 VV . A

M1801 Computer, Microprocessing, w/Flat Panel Monitor 2 EA 1,588 3,176 VV . A

Total Content Costs for this Room: 18,464

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: SRE01 Room Area: 100 Agency Room Name: Storage, Shared Medical Appointments Staff: 0 Criteria Room Name: Storage, Shared Medical Appointments Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

Total Content Costs for this Room: 48,682

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: OFA07 Room Area: 56 Agency Room Name: Workstation, Extended Team Staff: 28 Criteria Room Name: Workstation, Extended Team Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

E0123 Workstation, Straight, Free Standing, 72" W 1 EA 7,994 7,994 VV . A

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV

Total Content Costs for this Room: 10,955

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: CFR01 Room Area: 240 Agency Room Name: Conference Room Staff: 0 Criteria Room Name: Conference Room Blueprint #:

Room Comments: Conference Rooms are to be shared with Women's Health and Geri-PACT

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1020 Telephone, Conferencing System 1 EA 617 617 VV . A . . . T

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA 118 118 VV

A5220 Bracket, Television, Wall Backing 1 EA 98 98 CC A6046 Artwork, Decorative, With Frame 1 EA 543 543 VV

F0220 Chair, Conference 6 EA 573 3,438 VV

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

F0765 Table, Folding / Nesting 2 EA 1,759 3,518 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

M0507 Video Teleconferencing System 1 EA 13,335 13,335 VV . A

M0512 Television, HDTV, Large Screen, 60" 1 EA 4,082 4,082 VV . A

Total Content Costs for this Room: 25,854

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: UCCL1 Room Area: 60 Agency Room Name: Utility Room, Clean Staff: 0 Criteria Room Name: Utility Room, Clean Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

E0903 Locker, Supply, w/Shelves, Wall Mtd, 23"W x 20"D 2 EA 2,545 5,090 VV E0906 Locker, Supply, General, Wall Mtd, 23"W x 20"D 2 EA 3,195 6,390 VV

E0912 Locker, Supply, Med Surg, Wall Mtd 2 EA 3,561 7,122 VV

E1500 Rail, MOD, W/MNTD, HX144XD 1 EA 763 763 VV

P8710 Utility Center, Plumbing Connection 1 EA 100 100 CC D

Total Content Costs for this Room: 19,518

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: SRE01 Room Area: 120 Agency Room Name: Storage, Medical Equipment Staff: 0 Criteria Room Name: Storage, Medical Equipment Blueprint #:

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: TNPG1 Room Area: 60 Agency Room Name: Toilet, Staff Staff: 0 Criteria Room Name: Toilet, Staff Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC A4995 Table, Diaper Changing, Wall Mounted 1 EA 348 348 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 53 53 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 164 164 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 91 91 CC

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

P3200 Lavatory, Vitreous China, Slab Type w/Sens Op Fauc 1 EA 751 751 CC D

Total Content Costs for this Room: 3,100

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: LR004 Room Area: 60

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Agency Room Name: Locker, Staff Personal Property Staff: 0 Criteria Room Name: Locker, Staff Personal Property Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1040 Locker, 2 Person, Side by Side, 72x15x18 15 EA 491 7,365 VV

Total Content Costs for this Room: 7,418

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: OFDC2 Room Area: 125 Agency Room Name: Consult Room, Patient Aligned Care Team (PACT) Staff: 1 Criteria Room Name: Consult Room, Patient Aligned Care Team (PACT) Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 92 92 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,076 1,076 CC CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 1,036 1,036 CC D

CT030 Countertop, High Pressure Laminate 3 LF 68 204 CC

F0205 Chair, Side With Arms 3 EA 580 1,740 VV

F0340 Stool, Self Adjusting 1 EA 392 392 VV

F0740 Table, Occasional, Lamp 1 EA 360 360 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: TPB01 Room Area: 75 Agency Room Name: Toilet, General Procedure Room Patient Staff: 0 Criteria Room Name: Toilet, General Procedure Room Patient Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 309 309 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 217 217 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 53 53 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 2 EA 164 328 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 91 91 CC

F2010 Basket, Wastepaper, Step-On 1 EA 252 252 VV

P3005 Lavatory, Vitreous China, Bariatric 1 EA 5,272 5,272 CC D

P9056 Toilet, Floor Mounted, Bariatric 1 EA 480 480 CC B

Total Content Costs for this Room: 7,052

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: LR004 Room Area: 60 Agency Room Name: Locker, Staff Personal Property Staff: 0 Criteria Room Name: Locker, Staff Personal Property Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1040 Locker, 2 Person, Side by Side, 72x15x18 15 EA 491 7,365 VV

Total Content Costs for this Room: 7,418

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE. 6 PACT MODULES Functional Area: PATIENT ALIGNED CARE TEAM (PACT) 6.5 MODULES, 24

Room Code: WRTM1 Room Area: 240 Agency Room Name: Team Work Area Staff: 104 Criteria Room Name: Team Work Area Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 4 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 2 EA 0 0 VV

E0123 Workstation, Straight, Free Standing, 72" W 4 EA 7,994 31,976 VV . A F0275 Chair, Swivel, High Back 4 EA 669 2,676 VV

F0420 Cabinet, Filing, Lateral, Half Height 2 EA 651 1,302 VV

F2000 Basket, Wastepaper, Fire Resistant 4 EA 53 212 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 4 EA 1,588 6,352 VV . A

Total Content Costs for this Room: 42,570

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE Functional Area: PATIENT ALIGNED CARE TEAM Room Code: OFA04 Room Area:

Agency Room Name: Office, SOCIAL WORKER Staff: 1 Criteria Room Name: OFFICE, SOCIAL WORKER Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 33 66 CC

E0078 Workstation, L-Shaped w/Peninsula, Free Std, 78x72 1 EA 7,884 7,884 VV . A

F0110 Bookcase, 3 Shelf 1 EA 455 455 VV

F0205 Chair, Side With Arms 2 EA 580 1,160 VV

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Total Content Costs for this Room: 12,578

Department: PRIMARY CARE Functional Area: PATIENT ALIGNED CARE TEAM (PACT) Room Code: OFA09 Room Area:

Agency Room Name: Office, Staff: 1 Criteria Room Name: Office, Nurse Manager Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

E0090 Workstation, L-Shaped, Free Standing, 72x72 1 EA 8,330 8,330 VV . A

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Room Code: OFDC2 Room Area: 120 Agency Room Name: Social Work Staff: 1 Criteria Room Name: Social Work Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 92 92 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,076 1,076 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 1,036 1,036 CC D

CT030 Countertop, High Pressure Laminate 3 LF 68 204 CC

F0205 Chair, Side With Arms 3 EA 580 1,740 VV

F0340 Stool, Self Adjusting 1 EA 392 392 VV F0740 Table, Occasional, Lamp 1 EA 360 360 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

F3200 Clock, Battery, 12" Diameter 1 EA 52 52 VV

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

Department: PRIMARY CARE Functional Area: PATIENT ALIGNED CARE TEAM (PACT)

Agency Room Name: Office, Staff: 1 Criteria Room Name: Office, MSA Supervisor Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

E0090 Workstation, L-Shaped, Free Standing, 72x72 1 EA 8,330 8,330 VV . A

F0205 Chair, Side With Arms 1 EA 580 580 VV

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Agency Room Name: Office, Section Chief Staff: 1 Criteria Room Name: Office,Section Chief Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 33 33 CC

E0090 Workstation, L-Shaped, Free Standing, 72x72 1 EA 8,330 8,330 VV . A

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the restrictions on the Title Page of this Revised Proposal.

F0275 Chair, Swivel, High Back 1 EA 669 669 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 651 651 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 53 53 VV

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: PRIMARY CARE Room Code: SSLG2 Room Area:

Agency Room Name: Employee Lounge Staff: 0 Criteria Room Name: Staff Lounge Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A1080 Mirror, Posture, Wall Mounted 1 EA 394 394 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 90 90 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 32 32 CC

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA 116 116 VV

A5220 Bracket, Television, Wall Backing 1 EA 96 96 CC

C02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 36x24x22 2 EA 884 1,768 CC

C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 2 EA 1,062 2,124 CC

C02Q0 Cabinet, Sink, U/C/B, 1 Door, 36x24x22 2 EA 724 1,448 CC CB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 4 EA 744 2,976 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 2 EA 1,014 2,028 CC D

CT020 Countertop, Solid Surface 14 LF 184 2,576 CC

F0225 Chair, Dining Room 12 EA 263 3,156 VV

F0795 Table, Dining 3 EA 704 2,112 VV

F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 2 EA 271 542 VV

SUBMITTED MAY 20, 2020 • 36C10F18R0529 FREDERICKSBURG, VA OPC

Use or disclosure of the data, drawings and all information contained on this sheet is subject to the…