ATTACHMENT A - PRICE COST SCHEDULE - NX EQ Microwave Therapy Systems Tissue Ablation.xlsx

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NX EQ Microwave Therapy Systems Tissue Ablation
Solicitation number
36C10G25R0040
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This document is a Price Cost Schedule for Microwave Therapy Systems Tissue Ablation, issued by the Veterans Health Administration (VHA) under solicitation number 36C10G25R0040. The spreadsheet details 17 line items (CLINs) for Varian Medical Systems' IntelliBlate Microwave Ablation System, including starter kits, system configurations, probes of various lengths, temperature sensor probes, daily rental fees, technical support services, and warranty options.

The contract is structured with a 12-month base period and four 12-month option periods, targeting VA medical centers nationwide. The equipment is designed for thermal ablation of soft tissue and solid organ regions, using microwave technology for percutaneous coagulation necrosis of unresectable tumors. The pricing schedule includes estimated quantities for each line item across the base and option years, with provisions for 3% service level agreement (SLA) adjustments. While the spreadsheet contains placeholders for unit pricing, no specific prices are filled in, suggesting this is a template for vendor response.

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File Type Posted
36C10G25R0040.pdf PDF
ATTACHMENT C - CONTRACT CLAUSES - NX EQ Microwave Therapy Systems Tissue Ablation.pdf PDF
ATTACHMENT G - PAST PERFORMANCE REFERENCE - NX EQ Microwave Therapy Systems Tissue Ablation.pdf PDF
ATTACHMENT H - CERTIFICATION OF RECALL OR SAFETY ISSUES.pdf PDF
ATTACHMENT B - PRODUCT DESCRIPTION - NX EQ Microwave Therapy Systems Tissue Ablation.pdf PDF
ATTACHMENT D - SOLICITATION PROVISIONS - NX EQ Microwave Therapy Systems Tissue Ablation.pdf PDF
ATTACHMENT E -QUARTERLY SALES REPORTING TOOL - NX EQ Microwave Therapy Systems Tissue Ablation.xlsx XLSX spreadsheet
ATTACHMENT F - PAST PERFORMANCE QUESTIONNAIRE - NX EQ Microwave Therapy Systems Tissue Ablation.pdf PDF

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CLINBrand NamePart NumberItem DescriptionUnit of Measure (UOM)Quantity Per UOMEstimated Quantity (Base Year)Estimated Quantity (Opt Year 1)Estimated Quantity (Opt Year 2)Estimated Quantity (Opt Year 3)Estimated Quantity (Opt Year 4)Manufacturer Part NumberManufacturer NameItem DescriptionContractor Part Number (if different from OEM)Unit of MeasureQuantity per UOMDelivery Days AROCommercial PriceProposed Unit
Price (Base Year)SLA (3%)Total Price (Unit Price plus SLA)
Base YearProposed Unit
Price (Option Year 1)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 1Proposed Unit
Price (Option Year 2)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 2Proposed Unit
Price (Option Year 3)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 3Proposed Unit
Price (Option Year 4)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 4Total Evaluated Price (with 3% SLA and estimated quantities) - Base YearTotal Evaluated Price (with 3% SLA and estimated quantities) - Opt Year 1Total Evaluated Price (with 3% SLA and estimated quantities) - Opt Year 2Total Evaluated Price (with 3% SLA and estimated quantities) - Opt Year 3Total Evaluated Price (with 3% SLA and estimated quantities) - Opt Year 4Total Evaluated Price
0001Varian Medical SystemsIB-MAG-STARTERKITIntelliBlate™ Microwave Ablation System Starter Kit (Comes with CLIN X003 or X004 and Ximitry Probes (one pack of 12 - any combination of CLINs X005, X008, and/or X010)Each144444$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0002Varian Medical SystemsIB-SYS-MAG-SVG-HIntelliBlate™ Microwave Ablation System (includes myAblation Guide deployed on syngo.via View&Go with external computer, mobile cart, power supply/powercord, monitors, masts/stand, software, one year warranty)Each110010$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0003Varian Medical SystemsIB-SYS-MAG-SVGIntelliBlate™ Microwave Ablation System (includes myAblation Guide deployed on syngo.via View&Go, mobile cart, power supply/powercord, monitors, masts/stand, software, one year warranty)Each101001$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0004Varian Medical SystemsIB-SYS-MAG-SYNIntelliBlate™ Microwave Ablation System (includes myAblation Guide deployed on syngo.via workstation, mobile cart, power supply/powercord, monitors, masts/stand, software, one year warranty)Each100100$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0005Varian Medical SystemsIB-XPA-1315IntelliBlate™ Ximitry Probe, 15 cm, 13 ga, Qty 1Each16565656565$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0006Varian Medical SystemsIB-XPA-1315-K3IntelliBlate™ Ximitry Probe, 15 cm, 13 ga, Qty 3Each12020202020$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0007Varian Medical SystemsIB-XPA-1315-K12IntelliBlate™ Ximitry Probe, 15 cm, 13 ga, Qty 12Each11515151515$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0008Varian Medical SystemsIB-XPA-1320IntelliBlate™ Ximitry Probe, 20 cm, 13 ga, Qty 1Each12525252525$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0009Varian Medical SystemsIB-XPA-1320-K3IntelliBlate™ Ximitry Probe, 20 cm, 13 ga, Qty 3Each12525252525$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0010Varian Medical SystemsIB-XPA-1327IntelliBlate™ Ximitry Probe, 27 cm, 13 ga, Qty 1Each12525252525$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0011Varian Medical SystemsIB-XPA-1327-K3IntelliBlate™ Ximitry Probe, 27 cm, 13 ga, Qty 3Each12525252525$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0012Varian Medical SystemsABL-TP-1820Temperature Sensor Probe, 20 cm, 18 ga, Qty 1Each1100100100100100$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0013Varian Medical SystemsIB-MWA-EQIntelliBlate™ System Daily Rental FeeEach13030303030$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0014Varian Medical SystemsIB-MWA-SVCOn-Site Technical Support Service Fee (per case, if needed) (NOTE: Used with CLIN X013)Each13030303030$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0015Varian Medical SystemsIB-COVERED-1YROne Year Warranty and Service Maintenance Agreement (NOTE: Only for CLINs X001 - X004)Each111111$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0016Varian Medical SystemsIB-COVERED-3YRThree Year Warranty and Service Maintenance Agreement (NOTE: Only for CLINs X001 - X004)Each111111$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
0017Varian Medical SystemsIB-COVERED-5YRFive Year Warranty and Service Maintenance Agreement (NOTE: Only for CLINs X001 - X004)Each133333$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0Total Price
*VENDOR IS TO COMPLETE ALL "YELLOW" HIGHLIGHTED SPACES*VENDOR IS TO COMPLETE ALL "YELLOW" HIGHLIGHTED SPACES
**ARO = Delivery Days After Receipt of Order**ARO = Delivery Days After Receipt of Order

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