ATTACHMENT 2_Parts and Accessories List.xlsx

XLSX spreadsheet 55 KB Posted Apr 2, 2026

Attached to: 6515--Hearing Aid Parts and Accessories (HAPA) Commercial (VA-26-00029750)
Solicitation number: 36C79126R0003
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19

About this file

Written by GovTribe AI · Apr 2, 2026

This is a pricing instructions and parts list template for a hearing aid parts and accessories solicitation under contract 36C79126R0003. The document provides detailed formatting requirements for vendors submitting pricing proposals for commercial, non-proprietary hearing aid parts and accessories to support the Department of Veterans Affairs' National Audiology Program.

The pricing schedule requires vendors to populate 18 data columns including CLIN numbers, vendor and commercial product names, part numbers, accessory categories (such as adapters, batteries, domes, receivers, and wax guards), unit of issue (each, package, pair, or kit), estimated base year quantities, unit prices for the base year and four option years, total value calculations, MSRP discount percentages, MSRP values, HCPCS codes, manufacturer names and countries of origin, warranty information, and package dimensions and weight. All prices must be entered with two decimal places without rounding or formulas, and pricing for package/pair/kit items must represent the complete unit price. The document includes a separate "Tech Refresh Instructions" section for vendors to submit modifications, additions, and deletions to items using specific action codes (1 for discontinued items, 2 for deleted items with replacements, 3 for new items). The current pricing schedule lists 96 CLINs spanning approximately 655,080 estimated base year units across various hearing aid accessories and maintenance products, with all unit prices currently blank awaiting vendor submission. Field placement and format adherence are mandatory, as deviations will result in proposal rejection and return to the vendor for correction.

View the file

Other files

File	Type	Posted
36C79126R0003 0001.docx	DOCX document	Apr 13, 2026
ATTACHMENT 6 - Contractor Discrepancy Report.pdf	PDF	Apr 2, 2026
ATTACHMENT 4_ABBREVIATIONS AND DEFINITIONS.pdf	PDF	Apr 2, 2026
ATTACHMENT 1_DLC Hearing Aid Accessory Naming SOP.pdf	PDF	Apr 2, 2026
ATTACHMENT 7 _ Past Performance Questionnaire.pdf	PDF	Apr 2, 2026
ATTACHMENT 3 - HAPA QASP.pdf	PDF	Apr 2, 2026
S02-36C79126R0003.pdf	PDF	Apr 2, 2026
36C79126R0003_2.docx	DOCX document	Apr 2, 2026
ATTACHMENT 5 - Key Points of Contact.docx	DOCX document	Apr 2, 2026
0-List of Attachments.pdf	PDF	Apr 2, 2026

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PRICING INSTRUCTIONS

INSTRUCTIONS for PRICING SCHEDULE

Column Number

Data Element

CLIN

Vendor

Commercial Name

Part Number

Accessory Category

Unit of Issue

Quantity

Base Unit Price

Option 1 Unit Price

Option 2 Unit Price

Option 3 Unit Price

Option 4 Unit Price

Total Value

Discount % versus MSRP

MSRP

HCPCS

Manufacturer Name

Manufacturer Location

Warranty

Package/Box dimensions and weight

Size

1-4 characters

1-36 characters

0-60 characters

1-25 characters

1-30 characters

0 or 2 characters

1-3 characters

1-9 characters

Formula

1-9 characters

0-5 characters

0-60 characters

Description of Data Element

Contract Line Item Numbers

Name of the Vendor

Commercial name given by Vendor, 60 character limit includes all spaces

Item's current part number

Primary category item falls under (examples: Adapter, Battery Door, Dome, Receiver, Wax Guard, Tool) following the guidelines of DLC naming guidelines. If a category is not easily identified within DLC guidelines, the vendor shall use a logical, industry-standard term or abbreviation that is intuitive and as close to the commercially published name as possible.

Unit of issue for the item. EA (each), PG (package), PR (Pair), KT (Kit)

Quantity of items are only estimates for each unit for the base year. The contractor is not guaranteed any quantity amount as this is an IDIQ. An awarded contract has only a minimum guarantee of only $1,000.00.

Contract unit price for the base year. Enter numbers with two decimal only. Do not round the price or enter a formula. Example: If this is a package, pair or kit, the price should represent the whole price for the package, pair or kit. The package includes 10 items and the price of $1.00 includes all 10 items.

Contract unit price for the option year one. Enter numbers with two decimal only. Do not round the price or enter a formula. ). Unit price for Option year 1, which is the second year of the contract. This a firm fixed unit price contract and the option years are your only chance to increase the unit price.

Contract unit price for the option year two. Enter numbers with two decimal only. Do not round the price or enter a formula. Unit price for Option year 2, which is the third year of the contract.

Contract unit price for the option year three. Enter numbers with two decimal only. Do not round the price or enter a formula. Unit price for Option year 3, which is the fourth year of the contract.

Contract unit price for the option year four. Enter numbers with two decimal only. Do not round the price or enter a formula. Unit price for Option year 4, which is the fifth and last year of the contract.

Quantity times unit price for base year and all option years.

Do not alter the formula in this section. The formula is base unit price divided by MSRP. No discount for bulk order based on MSRP shall be rejected.

Manufacturer's Suggested Retail Price (MSRP). The manufacturer’s suggested retail price (MSRP) is the price a manufacturer recommends a product be sold for, and is used as a reference for retailers to set their prices.

Healthcare Common Procedure Coding System alpha-numeric code associated with product

Name of the manufacturer that makes the product.

Name of the city and country where the product is made. If the Manufacturer is multiple locations, only provide the countries that apply to the product that will shipped to the DLS for this contract.

If commercial warranty is available, describe what covered under the warranty and the length of time offered by the manufacturer.

Individual package/box dimensions. Used for determining warehouse space allocation. Please use Length x Width x Height format. Weight in Lbs.

Required/Optional

Required

Preferred

Required

Formula

Required

Required if offered Commercially

Required

Notes

Shall be what is indicated on signed contract

Vendor discretion as long as it adheres to DLC naming Guidelines

Vendors updated part number

Vendor discretion as long as it adheres to DLC naming guidelines

Use DLC abbreviations listed above. If there is a question contact DLC

IF sold as EA unit quantity will be 1. If sold in a multiple greater than 1 in a single unit, indicate number of units in package.

Price proposed by vendor for each CLIN , which includes delivery and administrative costs.

Total Value proposed by Vendor for solicitation.

Discount offered to the Department of Veterans Affairs for a large bulk order.

Price a manufacturer recommends a product be sold for, and is used as a reference for retailers to set their prices.

Alpha-numeric code consisting of a single alphabetical letter followed by 4 numeric digits

Actual legal name and you may add the name they are also doing business by.

Actual location (city and Country) the product is made.

Example

XYZ Company

Hearing aid cleaning base 2.0

654-01-570-00

CLEANING

$ 1.20

$ 1.25

$ 1.30

$ 1.35

$ 1.40

-40%

$ 2.00

H8500

XYZ Company

Tokyo, Japan

1 year for limited coverage

2 x 2 x 3 inches

Additional Information All fields will remain in the exact place that they are listed here. If the fields are placed incorrectly in tab PRICING SCHEDULE your proposal SHALL be unacceptable.

PRICING SCHEDULE

Pricing Schedule for the Hearing Aid Parts and Accessory Solicitation 36C79126R0003
	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20
CLIN	VENDOR NAME	COMMERCIAL NAME of PRODUCT	PART NUMBER	ACCESSORY CATEGORY	UNIT OF ISSUE	Package Multiple	QUANTITY PER ITEM (Estimates Only)	BASE UNIT PRICE	OPTION 1 UNIT PRICE	OPTION 2 UNIT PRICE	OPTION 3 UNIT PRICE	OPTION 4 UNIT PRICE	Total Value (Formula)	Discount % versus MSRP (Formula)	MSRP	Manufacturer Name	Manufacturer Country of Origin	HCPC CODE	Warranty Information	PACKAGE/BOX DIMENSIONS AND WEIGHT
1		12 MEDIUM TUBING			EA	1	850						$ - 0	0%
2		13 MEDIUM TUBING			EA	1	2,500						$ - 0	0%
3		13 TUBE THCK LONG QUILL 25PK			PG	1	200						$ - 0	0%
4		13 TUBE THIN LONG QUILL 25PK			PG	1	20						$ - 0	0%
5		#12 STAND DOUBLE 25/PG			PG	1	280						$ - 0	0%
6		#13 MEDIUM DOUBLE 25/PKG			PG	1	350						$ - 0	0%
7		#13 THICK 25/PKG			PG	1	850						$ - 0	0%
8		BINAURAL BTE CLIP CLEAR			EA	1	600						$ - 0	0%
9		CASE WATERPROOF BLACK			EA	1	150						$ - 0	0%
10		CASE WATERPROOF BLUE			EA	1	80						$ - 0	0%
11		CLEANING SPRAY 30ML			EA	1	175						$ - 0	0%
12		CLEANING WIPES			PG	30	60,000						$ - 0	0%
13		CLEANING WIPES 160CT			PG	1	3,000						$ - 0	0%
14		CLEANING WIPES 30CT			PG	1	2,000						$ - 0	0%
15		CLEANING WIPES 90CT			PG	1	2,000						$ - 0	0%
16		DESSICANT FOR GLOBAL II			PG	3	750						$ - 0	0%
17		DRYING CAPSULE REPLACE			PG	2	7,000						$ - 0	0%
18		DRYING KIT WITH CUP & CAP			EA	1	3,250						$ - 0	0%
19		EAR GEL/LUBRICANT			EA	1	1,750						$ - 0	0%
20		OTOFLOSS FINE			PG	100	240,000						$ - 0	0%
21		#13 SUPER THICK 25/PKG			PG	1	225						$ - 0	0%
22		AUDIO WIPES LG CANISTER 160CT			EA	1	475						$ - 0	0%
23		BAND SWEAT LARGE GREY 2PCS			PG	2	100						$ - 0	0%
24		BAND SWEAT LARGE LT BRN 2PCS			PG	2	50						$ - 0	0%
25		BAND SWEAT LARGE NATURAL 2PCS			PG	2	125						$ - 0	0%
26		BAND SWEAT MEDIUM GREY 2PCS			PG	2	325						$ - 0	0%
27		BAND SWEAT MEDIUM LT BRN 2PCS			PG	2	200						$ - 0	0%
28		BAND SWEAT MEDIUM NATURAL 2PCS			PG	2	100						$ - 0	0%
29		BAND SWEAT SMALL GREY 2PCS			PG	2	300						$ - 0	0%
30		BAND SWEAT SMALL LT BRN 2PCS			PG	2	125						$ - 0	0%
31		BAND SWEAT SMALL NATURAL 2PCS			PG	2	125						$ - 0	0%
32		BAND SWEAT XLARGE GREY 2PCS			PG	2	75						$ - 0	0%
33		BAND SWEAT XS SLIM GREY 2PCS			PG	2	10						$ - 0	0%
34		BAND SWEAT XSMALL GREY 2PCS			PG	2	40						$ - 0	0%
35		BAND SWEAT XSMALL LT BRN 2PCS			PG	2	50						$ - 0	0%
36		BAND SWEAT XSMALL NATURAL 2PCS			PG	2	40						$ - 0	0%
37		COLOR OTOCLIP - BTE MON BLUE			EA	1	100						$ - 0	0%
38		COLOR OTOCLIP - BTE MON RED			EA	1	90						$ - 0	0%
39		COMPLETE HEARING AID CARE KIT			EA	1	950						$ - 0	0%
40		COMPLY SOFT WRAP			PG	10	325						$ - 0	0%
41		DRY CADDY			EA	1	275						$ - 0	0%
42		DRY STORE GLOBAL II			EA	1	325						$ - 0	0%
43		EARGEAR MICRO BI NO CORD BG			PG	2	100						$ - 0	0%
44		EARGEAR MICRO CORDED BINAUR BG			PG	2	50						$ - 0	0%
45		EARGEAR MINI CUR BI NO CORD BG			PG	2	150						$ - 0	0%
46		EARGEAR MINI CUR CORD BINAU BG			PG	2	30						$ - 0	0%
47		EARGEAR ORIG BI NO CORD BEIGE			PG	2	100						$ - 0	0%
48		EARGEAR ORIG CORD BINAURAL BG			PG	2	10						$ - 0	0%
49		EARWAX DROPS ONLY-STN ONLY			EA	1	1,750						$ - 0	0%
50		EARWAX MD KIT W RINSE BULB-STN			EA	1	8,000						$ - 0	0%
51		EARWAX REMOVAL DROPS-STN ONLY			EA	1	6,000						$ - 0	0%
52		EARWAX REMOVAL KIT-STN ONLY			EA	1	600						$ - 0	0%
53		EARWAX REMOVAL SYSTEM-STN ONLY			EA	1	6,250						$ - 0	0%
54		EARWAX RINSEBALL KIT-STN ONLY			EA	1	250						$ - 0	0%
55		FLOW-MED UV2 ELECTRONIC DRYER			EA	1	40						$ - 0	0%
56		GOLD TUBE LOCK #13 THICK10/PK			PG	1	125						$ - 0	0%
57		OTO-EASE LUBRICANT			EA	1	575						$ - 0	0%
58		OTOCLIP - BTE BINAURAL			EA	1	1,000						$ - 0	0%
59		OTOCLIP - BTE MON. BLUE CLIP			EA	1	200						$ - 0	0%
60		OTOCLIP - BTE MON. RED CLIP			EA	1	225						$ - 0	0%
61		OTOCLIP - ITE MONAURAL BLUE			EA	1	300						$ - 0	0%
62		OTOCLIP - ITE MONAURAL RED			EA	1	300						$ - 0	0%
63		OTOCLIP FOR GLASSES (BTE)			EA	1	200						$ - 0	0%
64		OTOCLIP FOR GLASSES (ITE)			EA	1	60						$ - 0	0%
65		OTOCLIP ITE BINAURAL (PAIR)			EA	1	450						$ - 0	0%
66		PERFECTCLEAN			EA	1	100						$ - 0	0%
67		PERFECTCLEAN REFILL CARTRIDGE			EA	1	225						$ - 0	0%
68		PERFECTDRY LUX			EA	1	3,000						$ - 0	0%
69		SWEAT BAND XS SLIM LT BRN 2PCS			EA	1	10						$ - 0	0%
70		SWEAT BAND XS SLIM NATRL 2PCS			PG	2	40						$ - 0	0%
71		TOOL NANO CLEAN			PG	20	250,000						$ - 0	0%
72		UV HEARING AID DRYER RECHARGE			EA	1	250						$ - 0	0%
73		AIR BLOWER			EA	1	1,000						$ - 0	0%
74		TOOL CLEANER MULTI TOOL			EA	1	7,000						$ - 0	0%
75		CORD POWER - GLOBAL / ZEPHYR			EA	1	10						$ - 0	0%
76		EARGEAR MINI CUR BI NO CORD BK			EA	1	75						$ - 0	0%
77		EARGEAR MINI CUR BI NO CORD GY			EA	1	75						$ - 0	0%
78		EARGEAR MINI CUR BI W/CORD BG			EA	1	30						$ - 0	0%
79		EARGEAR MINI CUR BI W/CORD BK			EA	1	25						$ - 0	0%
80		EARGEAR MINI CUR BI W/CORD GY			EA	1	10						$ - 0	0%
81		EARGEAR ORIG BI W/CORD BEIGE			EA	1	10						$ - 0	0%
82		EARGEAR ORIG BI W/CORD GREY			EA	1	10						$ - 0	0%
83		OTOCLIP BTE MONAURAL LEFT			EA	1	800						$ - 0	0%
84		TUBE 12 DISAPPEAR STD A/B			PG	10	10						$ - 0	0%
85		TUBE 12 STD			PG	25	6,000						$ - 0	0%
86		TUBE 13 DISAPPEAR CFA MED A/B			PG	10	300						$ - 0	0%
87		TUBE 13 DISAPPEAR MED A/B			PG	10	1,600						$ - 0	0%
88		TUBE 13 DISAPPEAR THK A/B			PG	10	3,250						$ - 0	0%
89		TUBE 13 DISAPPEAR TRS THK A/B			PG	10	1,750						$ - 0	0%
90		TUBE 13 MED CFA			PG	10	1,750						$ - 0	0%
91		TUBE 13 SUPER THICK A/B			PG	10	1,000						$ - 0	0%
92		TUBE 13 SUPER THK			PG	25	14,500						$ - 0	0%
93		TUBE 13 SUPER THK TRS			PG	25	1,000						$ - 0	0%
94		TUBE 13 THK CFA			PG	10	3,250						$ - 0	0%
95		TUBE 15 PREFORMED			PG	25	500						$ - 0	0%
96		TUBE 16 PREFORMED			PG	25	500						$ - 0	0%
							655,080	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	0%

TECH REFRESH INSTRUCTIONS

INSTRUCTIONS for Attachment 2

Column Number

Data Element

1 - Vendor

2 - DLC Name

3 - Part Number

4 - Old Part Number

5 - Accessory Category

6 - Unit of Issue

Quantity

Unit Price

9 - Commercial Name

10 - Action

11 - Model(s) Supported

12 - Contract Number

13 - Contract CLIN #

14 - HCPCS

15 - BOC

16 - FSC

17 - Package/Box dimensions and weight

Size

1-36 characters

1-30 characters

1-25 characters

0-25 characters

1-30 characters

0 or 2 characters

1-3 characters

1-9 characters

0-60 characters

0-1 characters

0-60 characters

0-19 characters

0-9 characters

0-5 characters

0-4 characters

Description of Data Element

Name of the Vendor

Shall be limited to 30 characters and adhere to DLC naming guidelines

Item's current part number

Item's previous part number (if part number has changed)

Unit of issue for the item. EA (each), PG (package), PR (Pair), KT (Kit)

Quantity of items included in each unit.

Contract price. Enter numbers and decimal only, no dollar signs ($)

Commerical name given by Vendor, 60 character limit includes all spaces

This shall be utilized for updating changes or modifying actions. This block should be left blank if there are no changes or modification. The following codes shall be utilized: 1, items that are discontinued and no longer available with no replacement that should be deleted from contract. 2, items that are being deleted and updated and shall utilize the "Old Part Number" column as well. 3, new items being added to the contract

Vendor shall include any model(s) this item is compatible or associated with. During each modification, vendor shall update this column and refrain from adding an addition line item when a model of compatibility is added to item. 60 character limit includes any spaces and commas.

Contract number (example: 36C79122D0005)

Contract line item number (example: CLIN 0001)

Healthcare Common Procedure Coding System alpha-numeric code associated with product

Budget Object Code

Federal Supply Code

Individual package/box dimensions. Used for determining warehouse space allocation. Please use Length x Width x Height format. Weight in Lbs

Required/Optional

Required

Optional

Required

Optional

Required

Notes

Shall be what is indicated on signed contract

Vendor discretion as long as it adheres to DLC naming guidelines

Vendors updated part number

Vendors previous contract part number

Vendor discretion as long as it adheres to DLC naming guidelines

Use DLC abbreviations listed above. If there is a question contact DLC

IF sold as EA unit quantity will be 1. If sold in a multiple greater than 1 in a single unit, indicate number of units in package.

Price charged by vendor under contract

Vendor discretion as long as it adheres to DLC naming Guidelines

Utilized if changes or modifications are indicated. Once change is listed subsequent listings should be updated and items either removed from listing or updated as indicated.

This shall be all models supported, or compatible with part or accessory. Each model will be delineated by a comma.

Contract number followed by amendment/modification number

Alpha-numeric code consisting of a single alphabetical letter followed by 4 numeric digits

4 digit number

Example OTICON ADAPTER INCL FILTER 654-01-570-00 ADAPTER EA 1 1.20 ADAPTER, INCL. FILTER 3 DREAM440 FASHION POWER BTE 13, UNIQUE FSAHION POWER BTE 13 36C79122D0005 P00001 CLIN 0001 H8500 2696 6515 2 x 2 x 3 inches

Additional Information All fields will remain in the exact place that they are listed here. If they are placed incorrectly attachment will be returned to vendor to be corrected. This allows the DLC to add items properly and efficiently into inventory and ordering systems. If there is a deviation from this format it inhibits the DLC's ability to properly modify contract items.

Ordering Period Pricing

(VENDOR)							Option Year Effective Dates
							XX/XX/XXXX - XX/XX/XXXX	XX/XX/XXXX - XX/XX/XXXX	XX/XX/XXXX - XX/XX/XXXX	XX/XX/XXXX - XX/XX/XXXX	XX/XX/XXXX - XX/XX/XXXX
1 - VENDOR	2 - DLC NAME	3 - PART NUMBER	4 - OLD PART NUMBER	5 - ACCESSORY CATEGORY	6 - UNIT OF ISSUE	7 - QUANTITY	8 - Base Year Price	9 - Option Year 1 Price	10 - Option Year 2 Price	11 - Option Year 3 Price	12 - Option Year 4 Price
		0					0

CURRENT LIST

(VENDOR)

1 - VENDOR

2 - DLC NAME

3 - PART NUMBER

4 - OLD PART NUMBER

5 - ACCESSORY CATEGORY

6 - UNIT OF ISSUE

7 - QUANTITY

8 - UNIT PRICE

9 - COMMERCIAL NAME

10 - ACTION

11 - MODEL(S) SUPPORTED

12 - CONTRACT NUMBER

13 - CONTRACT CLIN #

14 - HCPC CODE

15 - BOC

16 - FSC

17 - PACKAGE/BOX DIMENSIONS AND WEIGHT

18 - CASE QUANTITY

19 - CASE DIMENSIONS AND WEIGHT

20 - PALLET CASE QUANTITY

21 - PALLET DIMENSIONS AND WEIGHT

22 - Commercial Warranty Information

ADDITIONS

(VENDOR)

1 - VENDOR

2 - DLC NAME

3 - PART NUMBER

4 - OLD PART NUMBER

5 - ACCESSORY CATEGORY

6 - UNIT OF ISSUE

7 - QUANTITY

8 - UNIT PRICE

9 - COMMERCIAL NAME

10 - ACTION

11 - MODEL(S) SUPPORTED

12 - CONTRACT NUMBER

13 - CONTRACT CLIN #

14 - HCPC CODE

15 - BOC

16 - FSC

17 - PACKAGE/BOX DIMENSIONS AND WEIGHT

18 - CASE QUANTITY

19 - CASE DIMENSIONS AND WEIGHT

20 - PALLET CASE QUANTITY

21 - PALLET DIMENSIONS AND WEIGHT

DELETIONS

(VENDOR)

1 - VENDOR

2 - DLC NAME

3 - PART NUMBER

4 - OLD PART NUMBER

5 - ACCESSORY CATEGORY

6 - UNIT OF ISSUE

7 - QUANTITY

8 - UNIT PRICE

9 - COMMERCIAL NAME

10 - ACTION

11 - MODEL(S) SUPPORTED

12 - CONTRACT NUMBER

13 - CONTRACT CLIN #

14 - HCPC CODE

15 - BOC

16 - FSC

17 - PACKAGE/BOX DIMENSIONS AND WEIGHT

18 - CASE QUANTITY

19 - CASE DIMENSIONS AND WEIGHT

20 - PALLET CASE QUANTITY

21 - PALLET DIMENSIONS AND WEIGHT

Sheet2

File details come from the government source that posted it. Updated Apr 2, 2026.