A Price Schedule 1page.xlsx

XLSX spreadsheet 16 KB Posted Feb 13, 2025

Attached to: Brand Name or Equal Applied Medical Laparoscopic Cholecystectomy Supplies, IHS, Phoenix Indian Medical Center, 5-Year BPA
Solicitation number: RFQ-25-PHX-017
Issued by: Department of Health and Human Services Indian Health Service

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Written by GovTribe AI · Feb 13, 2025

This is a pricing schedule template for a 5-year Blanket Purchase Agreement (BPA) for Applied Medical Laparoscopic Cholecystectomy Supplies for the Phoenix Indian Medical Center. The schedule lists 18 specific line items including various trocars, clip appliers, retrieval bags, insufflation needles, LigaSure instruments, retractors, and other laparoscopic supplies, with quantities specified for each item across a base year and four option years.

The pricing schedule is part of RFQ-25-PHX-017, which is seeking brand name or equal supplies with proposals due March 7, 2025 at 4:00 PM MST. This is an unrestricted solicitation using Lowest Price Technically Acceptable (LPTA) evaluation criteria. Offerors must provide pricing for all line items across all five years, including estimated freight and hazard/drop ship charges. The contract will be awarded as a firm-fixed price BPA with FOB destination delivery terms to the Phoenix Indian Medical Center in Arizona.

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Other files

File	Type	Posted
B BPA Terms and Conditions 6pages.docx	DOCX document	Feb 13, 2025
RFQ-25-PHX-017 Solicitation 6pages.docx	DOCX document	Feb 13, 2025
C Clause Admin Data 8Pages.docx	DOCX document	Feb 13, 2025
D 2025 AZ Tax Exempt Letter Phoenix Area.pdf	PDF	Feb 13, 2025

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HARDY - NEW

					Base Year			Option Year 1			Option Year 2			Option Year 3			Option Year 4
NO.	PRODUCT NO.	M-SYSTEM NO.	DESCRIPTION	U/M	QTY	UNIT PRICE	AMOUNT	QTY	UNIT PRICE	AMOUNT	QTY	UNIT PRICE	AMOUNT	QTY	UNIT PRICE	AMOUNT	QTY	UNIT PRICE	AMOUNT
1	CFR03	575739	TROCAR, 5MM X 100MM, BALLOON OPTICAL PORT FIRST ENTRY, KII FIOS	BX/6	140	$ - 0	$ - 0	140	$ - 0	$ - 0	140	$ - 0	$ - 0	140	$ - 0	$ - 0	140	$ - 0	$ - 0
2	CFR01	577847	TROCAR, 5MM X150MM BALLOON, KII OPTICAL ACCESS SYSTEM	BX/6	27	$ - 0	$ - 0	27	$ - 0	$ - 0	27	$ - 0	$ - 0	27	$ - 0	$ - 0	27	$ - 0	$ - 0
3	CFR71	577855	TROCAR, 12MM X150MM BALLOON ,KII OPTICAL ACCESS SYSTEM	BX/6	48	$ - 0	$ - 0	48	$ - 0	$ - 0	48	$ - 0	$ - 0	48	$ - 0	$ - 0	48	$ - 0	$ - 0
4	CFR73	587882	TROCAR, 12MM X100MM KII OPTICAL BALLON ACCESS SYSTEM	BX/6	42	$ - 0	$ - 0	42	$ - 0	$ - 0	42	$ - 0	$ - 0	42	$ - 0	$ - 0	42	$ - 0	$ - 0
5	CA500	535818	CLIP APPLIERS - 20 MEDIUM/LARGE TiGOLD Clips	EA/1	62	$ - 0	$ - 0	62	$ - 0	$ - 0	62	$ - 0	$ - 0	62	$ - 0	$ - 0	62	$ - 0	$ - 0
6	CD001		RETRIEVAL BAG	BX/10	32	$ - 0	$ - 0	32	$ - 0	$ - 0	32	$ - 0	$ - 0	32	$ - 0	$ - 0	32	$ - 0	$ - 0
7	C2201		INSUFFLATION NEEDLE 13G X 120	BX/20	8	$ - 0	$ - 0	8	$ - 0	$ - 0	8	$ - 0	$ - 0	8	$ - 0	$ - 0	8	$ - 0	$ - 0
8	C2202		INSUFFLATION NEEDLE 13G X 150	EA/1	160	$ - 0	$ - 0	160	$ - 0	$ - 0	160	$ - 0	$ - 0	160	$ - 0	$ - 0	160	$ - 0	$ - 0
9	EB215	576743	LIGASURE, MARYLAND 5MM 37CM VOYANT	BX/6	7	$ - 0	$ - 0	7	$ - 0	$ - 0	7	$ - 0	$ - 0	7	$ - 0	$ - 0	7	$ - 0	$ - 0
10	EB230	576751	LIGASURE, FINE FUSION 13.5CM VOYANT#SPED1-20-D-0002	BX/6	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
11	C8403	577762	RETRACTOR, LARGE WOUND PROTECTOR	BX/5	2	$ - 0	$ - 0	2	$ - 0	$ - 0	2	$ - 0	$ - 0	2	$ - 0	$ - 0	2	$ - 0	$ - 0
12	C8404	577763	RETRACTOR, XLARGE	BX/5	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
13	C8402	587761	RETRACTOR, MEDIUM WOUND PROTECTOR	BX/5	4	$ - 0	$ - 0	4	$ - 0	$ - 0	4	$ - 0	$ - 0	4	$ - 0	$ - 0	4	$ - 0	$ - 0
14	EB240	638463	LIGASURE, OPEN FUSION 20CM, BX/6,(LIGASURE ALTERNT) #SPED1-20-D-0002	BX/6	3	$ - 0	$ - 0	3	$ - 0	$ - 0	3	$ - 0	$ - 0	3	$ - 0	$ - 0	3	$ - 0	$ - 0
15	C8XX2	890596	GELPORT, LAPAROSCOPIC SYSTEM	EA/1	12	$ - 0	$ - 0	12	$ - 0	$ - 0	12	$ - 0	$ - 0	12	$ - 0	$ - 0	12	$ - 0	$ - 0
16	CTR03		KII Optical 5x100mm Z-thread trocars	BX/6	140	$ - 0	$ - 0	140	$ - 0	$ - 0	140	$ - 0	$ - 0	140	$ - 0	$ - 0	140	$ - 0	$ - 0
17	CTR73		KII Optical 12x100mm Z-thread trocars	BX/6	48	$ - 0	$ - 0	48	$ - 0	$ - 0	48	$ - 0	$ - 0	48	$ - 0	$ - 0	48	$ - 0	$ - 0
18	C0R47		KII Balloon Blunt Tip 12 X 100MM (Hasson)	BX/6	42	$ - 0	$ - 0	42	$ - 0	$ - 0	42	$ - 0	$ - 0	42	$ - 0	$ - 0	42	$ - 0	$ - 0
						$ - 0			$ - 0			$ - 0			$ - 0			$ - 0
						$ - 0			$ - 0			$ - 0			$ - 0			$ - 0
			FREIGHT - ESTIMATE		1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
			Hazard/DropShip/Fees ESTIMATE		1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
							$ - 0			$ - 0			$ - 0			$ - 0			$ - 0

Base Year:	$ - 0
OPTION YEAR 1	$ - 0
OPTION YEAR 2	$ - 0
OPTION YEAR 3	$ - 0
OPTION YEAR 4	$ - 0
	$ - 0

Sheet1

File details come from the government source that posted it. Updated Feb 13, 2025.