Attachment B - Draft Facility Locations - 36C77624Q0357.xlsx
XLSX spreadsheet 78 KB Posted
- Attached to
- 6835--VISN 15 - Medical Gases
- Solicitation number
- 36C77624Q0357
About this file
This document appears to be an attachment to a pre-solicitation for medical gases for the Department of Veterans Affairs VISN 15 region, solicitation number 36C77624Q0357. The attachment provides a draft list of VA facilities in the region, including their address, facility type (e.g. main hospital, community-based outpatient clinic, etc.), whether the cylinders are VA-owned or vendor-owned, the current vendor, details on the bulk oxygen tanks (age, size, ownership), and onsite facility access requirements. The pre-solicitation is seeking information on the medical gas requirements for these VA facilities, including delivery schedules, sales tax exemptions, and facility footprint details. Vendors are asked to provide this information by emailing Tanya.Kuza@va.gov. No specific response or award dates are provided.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment C - Questions - 36C77624Q0357.pdf | ||
| 36C77624Q0357.docx | DOCX document | |
| RFI - VISN 15 Medical Gases - 36C77624Q0357.pdf | ||
| Attachment A - Draft Schedule of Items - 36C77624Q0357.xlsx | XLSX spreadsheet |
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Text version
VISN 15
Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current vendor by name) IF VA owned cylinders (identify which med gases..carbon, oxygen,etc) email to: Tanya.Kuza@va.gov Sales Tax Exemption form per main station define delivery dates/times for each station and CBOC (example Tuesdays at 11am) amount of MAIN HOSPTIAL footprint by square feet Age of Bulk 02 tank (if known) Bulk 02 current owner of tanks (Identify the vendor by name or VA owned) Bulk 02 current size of main Bulk 02 current size of reserve Identify onsite facility access requirements for Vendors Facility Name Identify Main/CBOC/Vet Center/Research Facility Address City State Zip Code site double check on location names and address VA owned or Vendor owned cylinders (Identify the current…
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