ATTACHMENT C_Sales Reporting Tool_36C10X26Q0119.xlsx

XLSX spreadsheet 44 KB Posted Apr 10, 2026

Attached to: 6515--Duodenoscope Image Controller FAR 6. 103-1 Only One Responsible Source
Solicitation number: 36C10X26Q0119
Issued by: Department of Veterans Affairs Headquarters

About this file

Written by GovTribe AI · Apr 10, 2026

This is a Sales Reporting Tool template designed for quarterly reporting of sales activity under VA contract 36C10X26Q0119 for Boston Scientific EXALT Model D Duodenoscope Image Controllers (PN M00542430).

The template provides a structured format for contractors to report sales quantities across 22 line items corresponding to specific Veterans Affairs facilities and healthcare networks nationwide. Reporting elements include CLIN/SLIN designation, product description, contract/part number, unit price inclusive of Service Level Agreement (SLA) fees, and quarterly quantity sold data organized by VA facility. The template encompasses all major VA regional networks including New England Healthcare System, New York/New Jersey VA Health Care Network, VA Pittsburgh Healthcare System, VA Capitol Health Care Network, and networks extending through the Midwest, South, Southwest, and Pacific regions. The sales reporting tool calculates total quarterly quantities sold, total sales revenue by line item, total sales across all items, quarterly sales multiplied by unit price, total quarterly sales inclusive of SLA fees, anticipated SLA amounts, total sales without SLA (to be uploaded separately to Pay.gov), and SLA received for Hines Fiscal tracking purposes. The template is blank with all quantity and price fields defaulted to zero, indicating this is the unfilled template version awaiting contractor data entry for FY 2026 reporting periods.

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Other files

File	Type	Posted
Attachment A_ RFQ 36C10X26Q0119.pdf	PDF	Apr 10, 2026
ATTACHMENT D_Price Cost Schedule_36C10X26Q0119.xlsx	XLSX spreadsheet	Apr 10, 2026
ATTACHMENT B_Product Description_36C10X26Q0119.docx	DOCX document	Apr 10, 2026
ATTACHMENT E_Template for Industry Questions_36C10X26Q0119.xlsx	XLSX spreadsheet	Apr 10, 2026
36C10X26Q0119_2.docx	DOCX document	Apr 10, 2026

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Sheet2

11	7	9	32	6	6	9	20		30	10	10	25	25		14	26	13	21	11	15		7	5	5	7	10	5	10	18	26	7		31	15	21	33		5	16	7	12	11	21	14	14		18	16	14
1	1	1	1	1	1	1	1		2	2	2	2	2		3	3	3	3	3	3		4	4	4	4	4	4	4	4	4	4		5	5	5	5		6	6	6	6	6	6	6	6		7	7	7
402	405	518	523	608	631	650	689		528	528A5	528 A6	528A7	528 A8		526	561	620	630	630A4	632		460	503	529	540	542	562	595	642	646	693		512	512A5	613	688		517	558	565	590	637	652	658	659		508	509	521
Togus	White River Jct	Bedford	Boston (Roxbury and Brockton)	Manchester	Northhampton	Providence	VA Connecticut (Newington)	1	Buffalo (Batavia)	Canadaigua	Bath	Syracuse	Albany	2	Bronx	VA New Jersey (Lyons and East Orange)	VA Hudson Valley (CastlePoint and Montrose)	New York	Brooklyn	Northport	3	Wilmington	Altoona	Butler	Clarksburg	Coatesville	Erie	Lebanon	Philadelphia	VA Pittsburgh (Pittsburgh HD)	VAMC Wilkes-Barre	4	VA Maryland	Perry Point	Martinsburg	Washington	5	Beckley	Durham	Fayetteville	Hampton	Asheville	Richmond	Salem	Salisbury	6	Atlanta	Augusta	Birmingham (posted stock purchased and reported by Tuscaloosa)

Sales Report

Contractor:

Contract Number:

FY 2026

Reporting Quarter: ___ Qtr		Line Item(s)	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22
			CLIN/SLIN:
			Description/Salient Characteristics
			Contract/Part Number:
			Price Inclusive of SLA Fee:
	VISN	FACILITY	VA New England Healthcare System	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item	Quantity Sold of Item
	1	402	Togus, ME
	1	405	White River Junction, VT
	1	518	Bedford, MA
	1	523	Boston HCS
	1	608	Manchester, NH
	1	631	Northampton, MA
	1	650	Providence, RI
	1	689	Connecticut HCS
	New York/New Jersey VA Health Care Network
	2	526	Bronx, NY
	2	528	Buffalo, NY
	2	528A5	Canandaigua, NY
	2	528A6	Bath, NY
	2	528A7	Syracuse, NY
	2	528A8	Albany, NY
	2	561	New Jersey HCS
	2	620	Hudson Valley HCS
	2	630	New York HHS
	2	632	Northport, NY
	VA Pittsburgh Healthcare System
	4	460	Wilmington, DE
	4	503	Altoona, PA
	4	529	Butler, PA
	4	542	Coatesville, PA
	4	562	Erie, PA
	4	595	Lebanon, PA
	4	642	Philadelphia, PA
	4	646	Pittsburgh HCS
	4	693	Wilkes-Barre, PA
	VA Capitol Health Care Network
	5	512	Maryland HCS
	5	517	Beckley, WV
	5	540	Clarksburg, WV
	5	581	Huntington, WV
	5	613	Martinsburg, WV
	5	688	Washington DC
	VA Mid-Atlantic Health Care Network
	6	558	Durham, NC
	6	565	Fayetteville, NC
	6	590	Hampton, VA
	6	637	Asheville, NC
	6	652	Richmond, VA
	6	658	Salem, VA
	6	659	Salisbury, NC
	VA Southeast Network
	7	508	Atlanta, GA
	7	509	Augusta, GA
	7	521	Birmingham, AL
	7	534	Charleston, SC
	7	544	Columbia, SC
	7	557	Dublin, GA
	7	619	Central Alabama HCS
	7	679	Tuscaloosa
	VA Sunshine Healthcare Network
	8	516	Bay Pines, FL
	8	546	Miami, FL
	8	548	West Palm Beach, FL
	8	573	N. Florida/S. Georgia HCS
	8	672	San Juan, PR
	8	673	Tampa, FL
	8	675	Orlando, FL
	VA MidSouth Healthcare Network
	9	596	Lexington, KY
	9	603	Louisville, KY
	9	614	Memphis, TN
	9	621	Mountain Home, TN
	9	626	Tennessee Valley HCS
	VA Healthcare System
	10	506	Ann Arbor, MI
	10	515	Battle Creek, MI
	10	538	Chillicothe, OH
	10	539	Cincinnati, OH
	10	541	Cleveland, OH
	10	552	Dayton, OH
	10	553	Detroit, MI
	10	583	Indianapolis, IN
	10	610	Northern Indiana HCS
	10	655	Saginaw, MI
	10	757	Columbus, OH
	VA Great Lakes Health Care System
	12	537	Chicago, IL
	12	550	Illiana HCS
	12	556	North Chicago, IL
	12	578	Hines, IL
	12	585	Iron Mountain, MI
	12	607	Madison, WI
	12	676	Tomah, WI
	12	695	Milwaukee, WI
	VA Heartland Network
	15	589	Kansas City, MO
	15	589A4	Columbia, MO
	15	589A5	Eastern Kansas HCS
	15	589A7	Wichita, KS
	15	657	St. Louis, MO
	15	657A4	Poplar Bluff, MO
	15	657A5	Marion, IL
	South Central VA Health Care Network
	16	502	Alexandria, LA
	16	520	Biloxi, MS
	16	564	Fayetteville, AR
	16	580	Houston, TX
	16	586	Jackson, MS
	16	598	Central Arkansas HCS
	16	629	New Orleans, LA
	16	667	Shreveport, LA
	VA Heart of Texas Health Care Network
	17	504	Amarillo, TX
	17	519	West Texas HCS
	17	549	North Texas HCS
	17	671	South Texas HCS
	17	674	Central Texas HCS
	17	740	Texas Valley Coastal Bend HCS
	17	757	El Paso, TX
	Rocky Mountain Network
	19	436	Montana HCS
	19	442	Cheyenne, WY
	19	554	Eastern Colorado HCS
	19	575	Grand Junction, CO
	19	623	Muskogee, OK
	19	635	Oklahoma City, OK
	19	660	Salt Lake City HCS
	19	666	Sheridan, WY
	Northwest Network
	20	463	Alaska VAHSRO
	20	531	Boise, ID
	20	648	Portland, OR
	20	653	Roseburg HCS
	20	663	Puget Sound HCS
	20	668	Spokane, WA
	20	687	Walla Walla, WA
	20	692	White City, OR
	Sierra Pacific Network
	21	358	Manila, Philippines
	21	459	VA Pacific Islands HCS
	21	570	Central California HCS
	21	593	Southern Nevada HCS
	21	612	Northern California HCS
	21	640	Palo Alto HCS
	21	654	Sierra Nevada HCS
	21	662	San Francisco, CA
	Desert Pacific Healthcare Network
	22	501	New Mexico HCS
	22	600	Long Beach HCS
	22	605	Loma Linda, CA
	22	644	Phoenix, AZ
	22	649	Northern Arizona HCS
	22	664	San Diego HCS
	22	678	Southern Arizona HCS
	22	691	Greater Los Angeles HCS
	VA Midwest Health Care Network
	23	437	Fargo, ND
	23	438	Sioux Falls, SD
	23	568	Black Hills HCS
	23	618	Minneapolis, MN
	23	636	Omaha, NE
	23	636A6	Central Iowa HCS
	23	636A8	Iowa City, IA
	23	656	St. Cloud, MN
	Null	764	CMOP

Total Quarterly Quantity Sold	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Total Quantity Sold of All Items	0
Total Quarterly Quantity Sold x Price	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
Total Quarterly Sales inclusive of the SLA	$0.00
Anticipated SLA	$0.00
Total Sales amount without the SLA(Figure uploaded in Pay.gov)	$0.00
SLA Received (For HINES FISCAL ONLY)

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File details come from the government source that posted it. Updated Apr 10, 2026.