Attachment 3CLINS_PricingSheet8-13-2026.xlsx
XLSX spreadsheet 51 KB Posted
- Attached to
- 6835--Med Gas Supply and Cylinder Rental
- Solicitation number
- 36C24E26Q0099
About this file
This is a pricing sheet template for a Request for Quote (RFQ) solicitation for medical gas supply and cylinder rental services. The solicitation number is 36C24E26Q0099, issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4 (VISN 4). The contract is a Total Small Business Set-Aside with a NAICS code of 325120 (Industrial Gas Manufacturing) and PSC code 6835 (Medical Gases), with a business size standard of 1,200 employees. The period of performance runs from September 30, 2026, through September 29, 2031.
The pricing sheet (Attachment 3) serves as the template for offerors to submit their pricing for the required medical gas supply and cylinder rental services. All offerors must be registered in the System for Award Management (SAM) database to be eligible for award. This solicitation was issued under Federal Acquisition Circular (FAC) 2026-01 effective March 13, 2026, and incorporates FAR provisions and clauses as supplemented by Veterans Affairs Acquisition Regulations (VAAR). The pricing submission must follow specific instructions outlined in Attachment 2 of the solicitation package.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment 1 STATEMENT OF WORK 6-30-2026.docx | DOCX document | |
| Attachment 2 Clauses_provisions_Submit_Eval.docx | DOCX document | |
| 36C24E26Q0099_1.docx | DOCX document | |
| previousQuestions and answers.docx | DOCX document |
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Text version
Items
| ITEM NUMBER | DESCRIPTION | CONTRACT PERIOD | POP BEGIN | POP END | QUANTITY | UNIT OF MEASURE | LINE ITEM IS | UNIT PRICE | Total |
| 0001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/30/26 | 9/29/27 | 96 | EA | Priced | $0.00 | $0.00 |
| 0002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/30/26 | 9/29/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0003 | OX RX-E Medical Oxygen E tank | Base | 9/30/26 | 9/29/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/30/26 | 9/29/27 | 4380 | EA | Priced | $0.00 | $0.00 |
| 0005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/30/26 | 9/29/27 | 4380 | EA | Priced | $0.00 | $0.00 |
| 0006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/30/26 | 9/29/27 | 1460 | EA | Priced | $0.00 | $0.00 |
| 0007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/26 | 9/29/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/26 | 9/29/27 | 48 | EA | Priced | $0.00 | $0.00 |
| 0009 | Annual Audit | Base | 9/30/26 | 9/29/27 | 1 | EA | $0.00 | $0.00 | |
| 1001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/30/27 | 9/29/28 | 96 | EA | Priced | $0.00 | $0.00 |
| 1002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/30/27 | 9/29/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1003 | OX RX-E Medical Oxygen E tank | Base | 9/30/27 | 9/29/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/30/27 | 9/29/28 | 4380 | EA | Priced | $0.00 | $0.00 |
| 1005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/30/27 | 9/29/28 | 4380 | EA | Priced | $0.00 | $0.00 |
| 1006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/30/27 | 9/29/28 | 1460 | EA | Priced | $0.00 | $0.00 |
| 1007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/27 | 9/29/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/27 | 9/29/28 | 48 | EA | Priced | $0.00 | $0.00 |
| 1009 | Annual Audit | Base | 9/30/27 | 9/29/28 | 1 | EA | $0.00 | $0.00 | |
| 2001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/30/28 | 9/29/29 | 96 | EA | Priced | $0.00 | $0.00 |
| 2002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/30/28 | 9/29/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2003 | OX RX-E Medical Oxygen E tank | Base | 9/30/28 | 9/29/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/30/28 | 9/29/29 | 4380 | EA | Priced | $0.00 | $0.00 |
| 2005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/30/28 | 9/29/29 | 4380 | EA | Priced | $0.00 | $0.00 |
| 2006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/30/28 | 9/29/29 | 1460 | EA | Priced | $0.00 | $0.00 |
| 2007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/28 | 9/29/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/28 | 9/29/29 | 48 | EA | Priced | $0.00 | $0.00 |
| 2009 | Annual Audit | Base | 9/30/28 | 9/29/29 | 1 | EA | $0.00 | $0.00 | |
| 3001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/30/29 | 9/29/30 | 96 | EA | Priced | $0.00 | $0.00 |
| 3002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/30/29 | 9/29/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3003 | OX RX-E Medical Oxygen E tank | Base | 9/30/29 | 9/29/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/30/29 | 9/29/30 | 4380 | EA | Priced | $0.00 | $0.00 |
| 3005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/30/29 | 9/29/30 | 4380 | EA | Priced | $0.00 | $0.00 |
| 3006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/30/29 | 9/29/30 | 1460 | EA | Priced | $0.00 | $0.00 |
| 3007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/29 | 9/29/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/29 | 9/29/30 | 48 | EA | Priced | $0.00 | $0.00 |
| 3009 | Annual Audit | Base | 9/30/29 | 9/29/30 | 1 | EA | $0.00 | $0.00 | |
| 4001 | LQ NI 230 Liquid nitrogen tank on wheels w digital gauge | Base | 9/30/30 | 9/29/31 | 96 | EA | Priced | $0.00 | $0.00 |
| 4002 | CSP CO2 ANA-50 CO2 Anerobic grade 50 lb tank | Base | 9/30/30 | 9/29/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4003 | OX RX-E Medical Oxygen E tank | Base | 9/30/30 | 9/29/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4004 | 12 Medical Gas Cylinders - Daily Rental (12 x 365 = 4380 days) | Base | 9/30/30 | 9/29/31 | 4380 | EA | Priced | $0.00 | $0.00 |
| 4005 | 12 Specialty Gas Cylinders- Daily Rental (12 x 365 = 4380 days) | Base | 9/30/30 | 9/29/31 | 4380 | EA | Priced | $0.00 | $0.00 |
| 4006 | 4 Liquid Cylinders - Daily Rental (4 x 365 = 1460 days) | Base | 9/30/30 | 9/29/31 | 1460 | EA | Priced | $0.00 | $0.00 |
| 4007 | Delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/30 | 9/29/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4008 | Fuel Surcharge per delivery (4 deliveries per month) (4 x 12 = 48) | Base | 9/30/30 | 9/29/31 | 48 | EA | Priced | $0.00 | $0.00 |
| 4009 | Annual Audit | Base | 9/30/30 | 9/29/31 | 1 | EA | $0.00 | $0.00 | |
| $0.00 |
Unit of Measure of Cylinder is not available in the system and therefore was not used.
FOB Destination for all
Alternative CLIN set-up will not be considered. This includes grouping and a daily versus a monthly rate.
RefData
| Discount Type | YN | Options | Receipt Type | Line Item is | FOB | State Code | State Description |
| Percent | Yes | Base | Quantity | Priced | (none) | AK | Alaska |
| Amount | No | Option 1 | Amount | NSP | Origin | AL | Alabama |
| Option 2 | N/C | Destination | AR | Arkansas | |||
| Option 3 | AS | American Samoa | |||||
| Option 4 | AZ | Arizona | |||||
| Option 5 | CA | California | |||||
| Option 6 | CO | Colorado | |||||
| Option 7 | CT | Connecticut | |||||
| Option 8 | DC | District of Columbia | |||||
| Option 9 | DE | Delaware | |||||
| Option 10 | FL | Florida | |||||
| FM | Federal States of Micronesia | ||||||
| GA | Georgia | ||||||
| GU | Guam | ||||||
| HI | Hawaii | ||||||
| IA | Iowa | ||||||
| ID | Idaho | ||||||
| IL | Illinois | ||||||
| IN | Indiana | ||||||
| KS | Kansas | ||||||
| KY | Kentucky | ||||||
| LA | Louisiana | ||||||
| MA | Massachusetts | ||||||
| MD | Maryland | ||||||
| ME | Maine | ||||||
| MH | Marshall Islands | ||||||
| MI | Michigan | ||||||
| MN | Minnesota | ||||||
| MO | Missouri | ||||||
| MP | Northern Mariana Islands | ||||||
| MS | Mississippi | ||||||
| MT | Montana | ||||||
| NC | North Carolina | ||||||
| ND | North Dakota | ||||||
| NE | Nebraska | ||||||
| NH | New Hampshire | ||||||
| NJ | New Jersy | ||||||
| NM | New Mexico | ||||||
| NV | Nevada | ||||||
| NY | New York | ||||||
| OH | Ohio | ||||||
| OK | Oklahoma | ||||||
| OR | Oregon | ||||||
| PA | Pennsylvania | ||||||
| PR | Puerto Rico | ||||||
| PW | Palau | ||||||
| RI | Rhode Island | ||||||
| SC | South Carolina | ||||||
| SD | South Dakota | ||||||
| TN | Tennessee | ||||||
| TX | Texas | ||||||
| UT | Utah | ||||||
| VA | Virginia | ||||||
| VI | Virgin Islands | ||||||
| VT | Vermont | ||||||
| WA | Washington | ||||||
| WI | Wisconsin | ||||||
| WV | West Virginia | ||||||
| WY | Wyoming |
File details come from the government source that posted it. Updated .