Attachment 5 - 36H79725R0003 Contract Price Book Template.xlsx

XLSX spreadsheet 1 MB Posted Nov 18, 2025

Attached to: Radiology & Imaging FY2025 Solicitation
Solicitation number: 36H79725R0003
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12

About this file

Written by GovTribe AI · Nov 18, 2025

The file is a Contract Price Book Template (Attachment 5) for Solicitation 36H79725R0003, which is a Request for Proposal (RFP) for Radiology Imaging Systems and Accessories issued by the Department of Veterans Affairs National Acquisition Center. The solicitation is structured for a five-year base period with an additional five-year option period, targeting multiple contract awards under NAICS code 334517. The solicitation will close on Tuesday, February 3, 2026, at 12:00 PM CT, with a question submission deadline of Thursday, December 18, 2025, at 12:00 PM CT. Questions should be submitted to Ms. LaTonya Whiteside at LaTonya.Whitside@va.gov using Attachment #9.

While the specific details of the price book template are not visible in the provided file content, the attachment is part of the VA's solicitation for high-tech medical equipment, specifically focusing on radiology and imaging systems. The template is likely intended to provide vendors with a standardized format for submitting pricing information for their proposed radiology and imaging products and accessories.

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Other files

File	Type	Posted
36H79725R0003 0004.docx	DOCX document	Sep 9, 2026
36H79725R0003 0004.pdf	PDF	Sep 9, 2026
36H79725R0003 0002 TO RFP SF30.pdf	PDF	Mar 18, 2026
36H79725R0003 RFP AMENDMENT 0002.pdf	PDF	Mar 18, 2026
Solicitation 36H79725R0003 Description.docx	DOCX document	Mar 18, 2026
36H79725R0003 0002.docx	DOCX document	Jan 20, 2026
36H79725R0003 RFP AMENDMENT.pdf	PDF	Jan 20, 2026
GOVERNMENT RESPONSE-Attachment 9 36H79725R0003 RFP .xlsx	XLSX spreadsheet	Jan 20, 2026
Attachment 9 - 36H79725R0003 RFP Question Matrix.xlsx	XLSX spreadsheet	Nov 24, 2025
36H79725R0003 RFP.docx	DOCX document	Nov 18, 2025
Attachment 4 - 36H79725R0003 VA and DLA - Modality Matrix v.3.xlsx	XLSX spreadsheet	Nov 18, 2025
Attachment 7 - 36H79725R0003 VA Information System Security-Privacy REVISED.pdf	PDF	Nov 18, 2025
Attachment 8 - 36H79725R0003 OIG Review Requirements.pdf	PDF	Nov 18, 2025
Attachment 10 - Medical Air Bridge MAB DLA Only.pdf	PDF	Nov 18, 2025
Attachment 3 - 36H79725R0003 Discount and Pricing Information DPI Worksheet VA and DLA.docx	DOCX document	Nov 18, 2025
Copy of Attachment 9 - 36H79725R0003 RFP Question Matrix.xlsx	XLSX spreadsheet	Nov 18, 2025
Attachment 1 - 36H79725R0003 DICOM Conformance Requirements.pdf	PDF	Nov 18, 2025
Attachment 6- 36H79725R0003 VHA Business Associate Application BAA 2025.pdf	PDF	Nov 18, 2025
DFARS and DLAD Clauses-KO.docx	DOCX document	Nov 18, 2025
Attachment 2 - 36H79725R0003 VA10091.pdf	PDF	Nov 18, 2025

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Dropdown

Request

Discounts

Unit Of Sale

COO

COO 3 - CHAR

Buyer

Current Date

Contract Number

ECAT Contracts

Modification Number

Vendor

Modification Request Date

Price Support 1

Price Support 2

Price Support 3

Price Support 4

Price Support 5

Type of Commercial Customer

Type of Price Support

Engineer 1

Engineer 2

Engineer Approval Date

Contracting Officer

Pricing Findings 1

Pricing Findings 2

Pricing Findings 3

Pricing Findings 4

Pricing Findings 5

Program

Document Type

Modality

Modality Discount

Addition

Flat Rate Discount

AFG

P00001

GPO discounts/pricing

invoices corresponding to the submitted GPO discounts/pricing

commercial invoices

commercial invoices for similar items

cost breakdown

GPO

equal

Patient Monitoring and Capital Equipment Program

Word

Modality/Category 1

Discount Percentage 1

Deletion

Break Point 1

ALA

P00002

commercial quotes

Commercial Customer

equal or better

Radiology and Imaging Systems Program

PDF

N/A

Price Increase

Break Point 2

ALB

P00003

a mix of commercial invoices and quotes

less favorable

N/A

Price Decrease

Break Point 3

DZA

P00004

more favorable

N/A

Part Number Change

Break Point 4

ASM

P00005

N/A

Description Change

Break Point 5

AND

P00006

N/A

Other or Multiple Changes

AGO

P00007

N/A

AIA

P00008

N/A

ATA

P00009

N/A

ATG

P00010

N/A

ARG

P00011

N/A

ARM

P00012

N/A

ABW

P00013

N/A

AUS

P00014

N/A

AUT

P00015

N/A

AZE

P00016

N/A

BHS

P00017

N/A

BHR

P00018

N/A

BGD

P00019

N/A

BRB

P00020

N/A

BLR

P00021

N/A

BEL

P00022

N/A

BLZ

P00023

N/A

BEN

P00024

N/A

BMU

P00025

N/A

BTN

P00026

N/A

BOL

P00027

N/A

BIH

P00028

N/A

BWA

P00029

N/A

BVT

P00030

N/A

BRA

P00031

ERROR:#N/A

IOT

P00032

ERROR:#N/A

BRN

P00033

ERROR:#N/A

BGR

P00034

ERROR:#N/A

BFA

P00035

ERROR:#N/A

BDI

P00036

ERROR:#N/A

KHM

P00037

ERROR:#N/A

CMR

P00038

ERROR:#N/A

CAN

P00039

ERROR:#N/A

Component - RUS

P00040

ERROR:#N/A

Component - IND

P00041

ERROR:#N/A

Component - CHN

P00042

ERROR:#N/A

Component - PAK

P00043

ERROR:#N/A

Component - MYS

P00044

ERROR:#N/A

Component - IDN

P00045

ERROR:#N/A

Component - IRQ

P00046

ERROR:#N/A

Component - IRN

P00047

ERROR:#N/A

Component - LKA

P00048

ERROR:#N/A

CPV

P00049

ERROR:#N/A

CYM

P00050

CAF

TCD

CHL

CHN

CXR

CCK

COL

COM

COG

COD

COK

CRI

CIV

HRV

CUB

CYP

CZE

DNK

DJI

DMA

DOM

ECU

EGY

SLV

GNQ

ERI

EST

ETH

FRO

FLK

FJI

FIN

FRA

GUF

PYF

ATF

GAB

GMB

GEO

DEU

GHA

GIB

GBR

GRC

GRL

GRD

GLP

GUM

GTM

GGY

GIN

GNB

GUY

HTI

HMD

HND

HKG

HUN

ISL

IND

IDN

IRN

IRQ

IRL

IMN

ISR

ITA

JAM

JPN

JEY

JOR

KAZ

KEN

KIR

XKX

KWT

KGZ

LAO

LVA

LBN

LSO

LBR

LBY

LIE

LTU

LUX

MAC

MKD

MDG

MWI

MYS

MDV

MLI

MLT

MHL

MTQ

MRT

MUS

MYT

MEX

FSM

MDA

MCO

MNG

MNE

MSR

MAR

MOZ

MMR

NAM

NRU

NPL

NLD

ANT

NCL

NZL

NIC

NER

NGA

NIU

NFK

PRK

MNP

NOR

OMN

PAK

PLW

PSE

PAN

PNG

PRY

PER

PHL

PCN

POL

PRT

PRI

QAT

REU

ROU

RUS

RWA

BLM

SHN

KNA

LCA

MAF

SPM

VCT

WSM

SMR

STP

SEN

SRB

SYC

SLE

SGP

SVK

SVN

SLB

SOM

ZAF

SGS

KOR

ESP

LKA

SDN

SUR

SJM

SWZ

SWE

CHE

SYR

TWN

TJK

TZA

THA

TLS

TGO

TKL

TON

TTO

TUN

TUR

TKM

TCA

TUV

UGA

UKR

ARE

USA

UMI

URY

UZB

VUT

VAT

VEN

VNM

VGB

VIR

WLF

ESH

YEM

ZMB

ZWE

OFFER-CATALOG

Contractor:

INPUT VENDOR

Total Item Count:

Input the reason(s) for Product Change(s) and/or Deletion(s)

Input the discountinued Part Number (Only applicable if "Part Number Change" was selected as request reason)

Input the invoice number of most recent invoice. Actual invoice must also be provided. Also complete Commercial Customer, Comparison List, Comparison Discount, Comparison Net, and Net Price Difference columns.

If a vendor has a GPO(s), provide the name of GPO(s). Also complete Comparison List, Comparison Discount, Comparison Net, and Net Price Difference columns.

If there are no invoices or GPO pricing but the item has been quoted to commercial customers, provide quote number to correspond to attached quote (may be audited later on to confirm invoice price was the same as quoted price). Also complete Commercial Customer, Comparison List, Comparison Discount, Comparison Net, and Net Price Difference columns.

Provide the commercial customer name for invoice or quote.

If there is no invoice, GPO or quote for offered item, and offered item is similar to or a replacement of an existing contract item, provide P/N of existing item. Complete the Reasonableness Note field with details describing the differences between offered item and existing item that justifies any price difference.

List Price from attached invoice, GPO or quote.

Discount Percentage from attached invoice, GPO or quote.

Net Price from attached invoice, GPO or quote.

Provide net price difference between offered net price and comparison net price from invoice, GPO, quote or similar/replacement item.

Provide explanation, if any, if the comparison price is lower than offered price. If similar/replacement item is being offered, provide an explanation of item differences, to include item pricing, particularly if there is a difference in pricing.

In this column, provide the Commcerical List Price, as reflected in the most current Commercial Price List, for ALL items being requested for ADDITION or undergoing a PRICE CHANGE. Additionally, a copy of a current and dated Commercial Price List shall be submitted, ideally in excel format

Contract #:

SPE2D1-20-D-00#/VA797H-2#-D-####

Solicitation #:

36H79725R0003

Modification #:

P0000#

NOTE: DELETIONS MUST BE THE LAST ACTION TAKEN DUE TO AN EMBEDDED FORMATTING CONFLICT. DO NOT PRESS THE DELETE BUTTON UNLESS THE ONLY ITEMS REMAINING IN THE RFM SPREADSHEET REQUIRE A "DELETION" ACTION.

Modality/Category 1

Request

Manufacturer Part Number

Dealer/Distributor Part Number

Country Of Origin

Unit Of Sale

Manufacturer

Short Description

Long Description

Modality/Category

List

Price

Discount Percentage 1

N/A

Pricing and Discount

Details

Min_Disc

Max_Disc

Max Net Price

Min Net Price

Modification Number

Notes

Product Change(s)/Deletion(s)

Discontinued Part Number

Invoice Number

GPO

Quote Number

Commercial Customer