Attach 002A Price Cost Scehdule--Mandatory.xlsx
XLSX spreadsheet 55 KB Posted
- Attached to
- 6540--Unrestricted Low Vision Diagnostic Dispensing System and accessories for Lebanon VA Medical Center
- Solicitation number
- 36C24423Q1234
About this file
This document contains a price schedule with line item details for a low vision diagnostic dispensing system and accessories solicitation issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4. There are 66 line items listed with national stock numbers, descriptions, quantities, unit prices, manufacturers, and countries of origin for items such as frames, lighting systems, diagnostic equipment, and prism eyewear. Delivery is required within 30 days of order receipt to the Lebanon VA Medical Center. The total value of goods is not provided.
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Other files
| File | Type | Posted |
|---|---|---|
| Attach 003 52.225-2 BUY AMERICAN CERTIFICATE.docx | DOCX document | |
| Attach 004 52.225-18-Place of Manufacture.docx | DOCX document | |
| Attach 001 SON_Low Vision Diagnostic Dispensing System and accessories.docx | DOCX document | |
| 36C24423Q1234_1.docx | DOCX document |
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Text version
Low Vision Lebanon VAMC
| # | CLIN Description | UNIT | QTY | UNIT PRICE | Amount | Manufacturer Part Number | LI Item Part Number | OEM Country of Origin | LI SAM Unique Entity ID Number | LI OEM Name |
| 0001 | Item code-1615-325 Acunis Metal Frames, Small, 25 qty=1 Price=120.00 in accordance with the Statement of Need (SON). | EA | 1 | $ - 0 | $ - 0 | |||||
| 0002 | item code-1615-350 Acunis Metal Frame, Small, 50% qty=1 Price=120.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0003 | item code-1615-375 Acunis Metal Frame, Small, 75% qty=1 Price=120.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0004 | item code-1615-425 Acunis Metal Frame, Large, 25% qty=1 Price=120.00IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0005 | item code-1615-450 Acunis Metal Frame, Large 50% qty=1 Price=120.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0006 | item code-1615-475 Acunis Metal Frame, Large, 75% qty=1 Price=120.00e IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0007 | item code-1615-6325 Acunis, Plastic Frame, Panto qty=1 Price=98.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0008 | item code-1615-6350 Acunis Plastic Frame, Panto, 5 qty=1 Price=98.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0009 | item code-1615-6375 Acunis Plastic Frame, Panto, 7 qty=1 Price=98.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0010 | item code-1615-6425 Acunis Plastic Frame, Square qty=1 Price=98.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0011 | item code-1615-6450 Acunis Plastic Frame, Square qty=1 Price=98.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0012 | item code-1615-6475 Acunis Plastic Frame, Square qty=1 Price=98.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0013 | item code-1615-99 Acunis Test Kit qty=1 Price=195.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0014 | item code-1663-585 Ambelis/WP Large Black 85% qty=1 Price=118.49 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0015 | item code-CO-4100 Tini Kit Complete (36 tints) qty=1 Price=1,094.50 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0016 | item code-TAE-15AFK 15 Space Absortive Filter Case qty=4 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0017 | item code-TAE-3H3600S Haven Haven Black/Gray XL qty=1 Price=27.45 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0018 | item code-TAE-3H4600S Haven Summerwood Black/Gray LG qty=1 Price=27.45 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0019 | item code-TAE-3H4653ST Haven Summerwood Tort/Amber LG qty=1 Price=27.45 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0020 | item code-1895-C Optoform IV Cabinet only;five 1895-01 tray bottoms qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0021 | item code-1895-01 Optoform IV Individual Tray Qty=6 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0022 | item code-1438-30 MENAS LUX 3.0 qty=1 Price=153.29 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0023 | item code-1511-001 Mobase Stand for 3x, 3.5x, 4x qty=2 14.25/ea Price=28.50 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0024 | item code-1511-2 MOBILUX LED 3x (12D) 60mm qty=2 103.86/ea Price=207.72 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0025 | item code-1511-41 MOBILUX LED 4x (16D) 60mm qty=2 103.86/ea Price=207.72 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0026 | item code-1512-2 mobiluxLED 8D 3x 90x54 mm qty=1 Price=109.95 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0027 | item code-1520-94 Mobilent LED 4x qty=1 Price=54.95 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0028 | item code-1520-97 Mobilent LED 7x qty=1 Price=54.95 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0029 | item code-1520-910 Mobilent LED 10x qty=1 Price=54.95 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0030 | item code-1521-33 EasyPocket 6x qty=3 81.00/ea Price=243.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0031 | item code-1521-33 EasyPocket 6x qty=1 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0032 | item code-1522-11 Easy Pocket XL 2.5x (6D)Silver qty=2 92.70/ea Price=185.40 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0033 | item code-1586-14 POWERLUX 3.5X (14D) Cool qty=2 161.46/ea Price=322.92 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0034 | item code-1586-28 POWERLUX 7X (28D) Cool qty=2 177.37/ea Price=354.74 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0035 | item code-1586-281 POWERLUX 7X (28D) Warm qty=1 Price=182.17 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0036 | item code-1632 GALILEAN & KEPLERIAN DIAGNOSTI qty=1 Price=3,336.30 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0037 | item code-1634 3x (12D) GALILEAN BINOCULAR f/ qty=1 Price=364.76 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0038 | item code-1636-2 2.5x (10D)GALILEAN BINOCULAR f qty=2 416.52/ea Price=833.04 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0039 | item code-1636-4 4x (16D) GALILEAN BINOCULAR f/ qty=1 Price=416.52 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0040 | item code-1673-3 4.2x (16.8D) KEPLERIAN MONOCUL qty=1 Price=414.42 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0041 | item code-1673-4 6x (24D) KEPLERIAN MONOCULAR qty=1 Price=414.42 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0042 | item code-1674-832 8x (32D) KEPLERIEN MONOCULAR w qty=2 429.96/ea Price=859.92 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0043 | item code-1680-1 KIT OF 5 1680 PRISMATIC EYEWEA qty=1 Price=1,003.75 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0044 | item code-1832-13 Grey Insert for 1832# qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0045 | item code-1837-63 Grey Insert #1511 9 Pcs qty=1 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0046 | item code-1881-03 1/2 Tray Insert f/ 1881-0# Rou qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0047 | item code-1881-13 1/2 Tray Insert f/ 1881-1# Rou qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0048 | item code-1881-53 1/2 Tray Mobilux Assortment qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0049 | item code-1882-03 1/2 Tray Insert f/ 1882-0# Lux qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0050 | item code-1883-33 1/2 Tray Insert f/ 1883-3# Eas qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0051 | item code-1882-43 1/2 Tray Insert System Vario P qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0052 | item code-1882-63 1/2 Tray Insert f/ 1882-6# Pow qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0053 | item code-1883-13 1/2 Tray Insert f/ 1883-1# Max qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0054 | item code-1883-33 1/2 Tray Insert f/ 1883-3# Eas qty=2 Price=0.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0055 | item code-4248-418 Vision 4x18 qty=1 Price=107.25 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0056 | item code-4248-618 Vision 6x18 qty=1 Price=124.25 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0057 | item code-4294-413 MICROLUX TELESCOPE 4X13 qty=2 123.82/ea Price=247.64 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0058 | item code-4294-618 KEPLERIAN COMPACT MONOCULAR 6x qty=2 167.65/ea Price=335.30 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0059 | item code-CO-5000-4 PREM PRISM EYEWEAR LG.+4W/+6 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0060 | item code-CO-5000-6 PREM PRISM EYEWEAR LG.+6w/+8 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0061 | item code-CO-5000-8 PREM PRISM EYEWEAR LG.+8w/+10 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0062 | item code-CO-5000-10 PREM PRISM EYEWEAR LG.+10W/+12 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0063 | item code-CO-5001-4 PREM PRISM EYEWEAR SM.+4W/+6 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0064 | item code-CO-5001-6 PREM PRISM EYEWEAR SM.+6W/+8 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0065 | item code-CO-5001-8 PREM PRISM EYEWEAR SM.+8W/+10 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| 0066 | item code-CO-5001-10 PREM PRISM EYEWEAR SM.10W/+12 qty=2 395.00/ea Price=790.00 IAW the SON. | EA | 1 | $ - 0 | $ - 0 | |||||
| Total: | $ - 0 |
ITEMs 0001-0066: Deliver to:
Department of Veterans Affairs Lebanon VA Medical Center 1700 South Lincoln Avenue Lebanon, PA 17042-7529
USA
DELIVERY DATE Items 0001 through 0066: 30 Days After Receipt of Order (ARO) Government Technical Point of Contact (GTPOC) Phone To Be Published (TBP) Email TBP Freight On Board: Destination
Data Dictionary
| eCMS Data Element Name | Line Item Template Name | Selection/Input | MSTR Attribute Name |
| LIN: | Item Number | This is the Line Item Number for this LIN and will be autogenerated | LIN |
| Description: | Description | Enter a meaningful description of the item or service being procured. The description should directly relate to the PSC or NAICS code and also provide detailed characteristics. Start with the commodity or service being provided i.e., Mask and a more detailed description or Window Washing and a more detailed description, etc. | LI Description |
| Comment: | Comment | LI Comment | |
| Contract Period: | Contract Period | Select either 'Base' of the applicable 'Option Year' from the dropdown | LI Contract Period |
| POP Begin: | Pop Begin | Enter dd-mm-yyyy or dd/mm/yyyy date format for each LIN | LI POP Begin Date |
| POP End: | Pop End | Enter dd-mm-yyyy or dd/mm/yyyy date format for each LIN | LI POP End Date |
| Unit of Measure: | Unit of Measure | Select the applicable 'Unit of Measure' from the dropdown. The 'Unit of Measure' EA should always have a 'Packaging Multiple' of 1 | Item Unit Description |
| Packaging Multiple | Packaging Multiple | Enter the total quantity that comes in each 'Unit of Measure' i.e., How many come in each CS, CT, PG, etc. The 'Unit of Measure' EA should always have a 'Packaging Multiple' of 1 | Items Per UOI |
| LIN is: | Line Item Is | Select 'Priced', 'NSP' (Not Separately Priced), or 'N/C' (No Charge) from the dropdown | LI Price Type |
| Unit Price ($): | Unit Price | Enter the price for each 'Unit of Measure' i.e., What is the cost of each CS, CT, PG, etc. | Item Unit Price |
| PRINCIPAL NAICS CODE | PRINCIPAL NAICS CODE | Select the applicable North American Industry Classification System code | LI NAICS |
| PRODUCT/SERVICE CODE | PRODUCT/SERVICE CODE | Select the applicable Product Service Code | LI Prod Svc Code |
| MANUFACTURER PART NUMBER (MPN): | MANUFACTURER PART NUMBER (MPN) | The MPN identifies the manufacturer from which an item originated. Its purpose is to identify the company that made the part, as opposed to a SKU number that is used for inventory record keeping by the Vendor. Each MPN is unique and can be composed of letters, numbers, or both. | Manufacturer Part Number |
| ITEM PART NUMBER | ITEM PART NUMBER | Enter the distributor/vendor part number if different than the mfg. part number. | LI Item Part Number |
| ITEM TYPE: | ITEM TYPE | Select 'DENTAL', 'EMS', 'LAB', 'MEDICAL', 'OTHER', or 'SURGICAL' from the dropdown | LI Item Type |
| OEM COUNTRY OF ORIGIN: | OEM COUNTRY OF ORIGIN | Enter the original equipment manufacturers (OEM) physical location of origin | LI OEM Country of Origin |
| OEM DUNS NUMBER: | OEM DUNS NUMBER | Enter the OEM DUNS Number. Do not enter the Distributor/Vendor DUNS Number unless the Distributor/Vendor is the Manufacturer. | LI OEM DUNS Number |
| OEM NAME: | OEM NAME | Enter the Name of the OEM. Do not enter the Distributor/Vendor Name unless the Distributor/Vendor is the Manufacturer. | LI OEM Name |
| The SCMC will also pull the Contractor Name, Contract Number, NAICS, PSC, Contracor POC Name, Contractor POC Phone, Contractor POC Email, and Socio-economic data from the Base contract information | |||
| eCMS Data Element Name | Line Item Template Name | Selection/Input | MSTR Attribute Name |
| LIN: | Item Number | This is the Line Item Number for this LIN and will be autogenerated | LIN |
| Description: | Description | Enter a meaningful description of the item or service being procured. The description should directly relate to the PSC or NAICS code and also provide detailed characteristics. Start with the commodity or service being provided i.e., Mask and a more detailed description or Window Washing and a more detailed description, etc. | LI Description |
| Comment: | Comment | LI Comment | |
| PRINCIPAL NAICS CODE | PRINCIPAL NAICS CODE | Select the applicable North American Industry Classification System code | LI NAICS |
| PRODUCT/SERVICE CODE | PRODUCT/SERVICE CODE | Select the applicable Product Service Code | LI Prod Svc Code |
| MANUFACTURER PART NUMBER (MPN): | MANUFACTURER PART NUMBER (MPN) | The MPN identifies the manufacturer from which an item originated. Its purpose is to identify the company that made the part, as opposed to a SKU number that is used for inventory record keeping by the Vendor. Each MPN is unique and can be composed of letters, numbers, or both. | Manufacturer Part Number |
| ITEM PART NUMBER | ITEM PART NUMBER | Enter the distributor/vendor part number if different than the mfg. part number. | LI Item Part Number |
| OEM COUNTRY OF ORIGIN: | OEM COUNTRY OF ORIGIN | Enter the original equipment manufacturers (OEM) physical location of origin | LI OEM Country of Origin |
| OEM DUNS NUMBER: | OEM DUNS NUMBER | Enter the OEM DUNS Number. Do not enter the Distributor/Vendor DUNS Number unless the Distributor/Vendor is the Manufacturer. | LI OEM DUNS Number |
| OEM NAME: | OEM NAME | Enter the Name of the OEM. Do not enter the Distributor/Vendor Name unless the Distributor/Vendor is the Manufacturer. | LI OEM Name |
| The SCMC will also pull the Contractor Name, Contract Number, NAICS, PSC, Contracor POC Name, Contractor POC Phone, Contractor POC Email, and Socio-economic data from the Base contract information |
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