Attachment 5 - Both VA and DLA - Contract Price Book Template (v.2).xlsx
XLSX spreadsheet 64 KB Posted
- Attached to
- JOINT DEFENSE LOGISTICS AGENCY AND VETERANS ADMINISTRATION RADIOLOGY AND IMAGING SYSTEMS PROGRAM
- Solicitation number
- SPE2D1-15-R-0001
About this file
This document contains a template for a federal contract price book modification request. The template requires contractors to provide pricing details for equipment and services, including list prices, applicable discounts, minimum and maximum pricing, invoice and quote numbers from commercial sales, and explanations for any differences from existing contract pricing. Contractors must populate the template to propose modifications to an existing General Services Administration contract for radiology and imaging systems between the Defense Logistics Agency and Veterans Administration. Relevant details include pricing ranges, references to commercial customers and invoices, and requirements to note reasons for any price variations from current contracted items.
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Dropdown
| Addition | MR |
| Deletion | CT |
| Prince Increase | X-Ray |
| Price Decrease | Interventional |
| Description Change | Nuclear |
| COO Change | PET/CT |
| Ultrasound | |
| BMD | |
| Surgery | |
| CR | |
| Printers (Imagers) | |
| Training and Accessories |
OFFER-CATALOG
| Contractor: | COMPANY XYZ | Input the invoice number of most recent invoice. Must have been issued within the last 12 months. 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 this is a change to existing item or there is no GPO, Invoice, or quote a similar item or replacement an existing contract item, provide p/n of existing item. Complete the Reasonableness note field with details describing the differences between proposed and existing item that justifies any price difference. | List Price from attached invoice, GPO or quote | Discount 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 prices are lower than offered price. If similar/replacement is being offered, provide explanation for item and item pricing, particularly if there is a difference in pricing. | |
| Contract #: | SPE2D1-09-D-8###/V797P-6####x | |||||||||||
| Mod #: | PENDING | |||||||||||
| Req Date: | ##-##-#### | 1 |
EIE Desktop Technologies: Select Modality or
| Enter System Name | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | 26 | 27 | 28 | 29 | 30 | 31 | 32 | 33 | 34 | 35 | 36 | 37 | 38 | 39 | 40 | 41 | 42 | 43 | 44 | 45 | 46 | 47 | 48 | 49 | 50 |
| Modification Request | Catalog Number (MANUFACTURER P/N) | Short Description | Long Description | UOM | List | ||||||||||||||||||||||||||||||||||||||||||||
| Price | Discount Percentage 1 | Discount Percentage 2 | Discount Percentage 3 | Discount Percentage 4 | Discount Percentage 5 | Discount Percentage 6 | Discount Percentage 7 | Discount Percentage 8 | Discount Percentage 9 | Discount Percentage 10 | Discount Percentage 11 | Discount Percentage 12 | Discount Percentage 13 | Discount Percentage 14 | Discount Percentage 15 | Discount Percentage 16 | Discount Percentage 17 | Discount Percentage 18 | Discount Percentage 19 | Discount Percentage 20 | Discount Percentage 21 | Discount Percentage 22 | Discount Percentage 23 | Discount Percentage 24 | Discount Percentage 25 | Discount Percentage 26 | Discount Percentage 27 | Discount Percentage 28 | Discount Percentage 29 | Discount Percentage 30 | Discount Percentage 31 | Discount Percentage 32 | Discount Percentage 33 | Discount Percentage 34 | Discount Percentage 35 | Discount Percentage 36 | Discount Percentage 37 | Discount Percentage 38 | Discount Percentage 39 | Discount Percentage 40 | Discount Percentage 41 | Discount Percentage 42 | Discount Percentage 43 | Discount Percentage 44 | Discount Percentage 45 | Discount Percentage 46 | Discount Percentage 47 | Discount Percentage 48 | Discount Percentage 49 |
| (last updated) | MANUFACTURER | DEALER/DISTRIBUTOR P/N | Pricing and Discount | ||||||||||||||||||||||||||||||||||||||||||||||
| Details | Min_Disc | Max_Disc | Max Net Price | Min Net Price | Invoice Number | GPO | Quote Number | Commercial Customer | Similar Item or Item being Replaced | Comparison List | Comparison Discount | Comparison Net | Net Price Difference | Reasonableness Note | |||||||||||||||||||||||||||||||||||
| Deletion | 1 | WIDGET | 3T MRI | EA | $ 100.00 | 10.00% | 20.00% |
1:
% 10 - $99.90
2:
| % 20 - $99.80 | 10.00% | 20.00% | $90.00 | $80.00 | |||||
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Define each Discount Percentage by entering the Modality or System name in the boxes below
LOOKUP
| Catalog Number | Short Description | Long Description | UOM | List | ||
| Price | Max_Disc | |||||
| (Best) | Min Net Price | |||||
| (Best) | Min_Disc | Max Net Price | MANUFACTURER | DEALER/DISTRIBUTOR P/N | COO | MOD NUMBER |
(last updated)
1 WIDGET 3T MRI EA $ 100.00 20% $80.00 10% $90.00 0 0 0 BASIC
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