Attachment C_Sales Reporting Tool_NX EQ Irrigation Systems for Endoscopy.xlsx

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Attached to
6515--NX EQ Irrigation Systems for Endoscopy (VA-26-00041944)
Solicitation number
36C10X26R0030
Issued by

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Written by GovTribe AI ·

This is a Sales Reporting Tool template for tracking quarterly sales of NX EQ Irrigation Systems for Endoscopy across the Department of Veterans Affairs (VA) healthcare system. The spreadsheet is designed for contractors to report sales data by facility and VISN (Veterans Integrated Service Network) for FY 2026, with columns for up to 22 line items and rows representing all VA medical facilities organized by their respective VISNs and regional healthcare networks. The template captures essential sales metrics including quantity sold per facility, contract pricing inclusive of Service Level Agreement (SLA) fees, total quarterly quantities and sales amounts, anticipated SLA adjustments, and sales figures without SLA for payment processing through Pay.gov.

The reporting tool covers 23 VISNs and approximately 150 VA facilities nationwide, including locations in all 50 states and US territories (Puerto Rico and Philippines). Contractors must report monthly or quarterly sales performance by specific facility codes and CLINs/SLINs, with the template tracking cumulative sales data and financial reporting requirements. The tool requires input of contract/part numbers, unit prices, and line item descriptions, and includes a CMOP (Central Mail Order Pharmacy) category for centralized ordering. This standardized reporting mechanism enables the VA to monitor contractor sales performance across its nationwide healthcare network and track compliance with contract terms and SLA obligations.

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Other files

File Type Posted
36C10X26R0030 0001.docx DOCX document
Attachment G_Template for Industry Questions_NX EQ Irrigation Systems for Endoscopy.xlsx XLSX spreadsheet
Attachment B_Product Description_NX EQ Irrigation Systems for Endoscopy.docx DOCX document
36C10X26R0030_1.docx DOCX document
Attachment F_Past Performance Questionnaire_NX EQ Irrigation Systems for Endoscopy.docx DOCX document
Attachment H_Certification of Recall or Safety Issue_NX EQ Irrigation Systems for Endoscopy.docx DOCX document
Attachment E_Past Performance References_NX EQ Irrigation Systems for Endoscopy.docx DOCX document
Attachment D_Price Cost Schedule_NX EQ Irrigation Systems for Endoscopy.xlsx XLSX spreadsheet
Attachment A_RFP 36C10X26R0030_NX EQ Irrigation Systems for Endoscopy.docx DOCX document

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Sheet2

117932669203010102525142613211115755710510182673115213351671211211414181614
11111111222223333334444444444555566666666777
402405518523608631650689528528A5528 A6528A7528 A8526561620630630A4632460503529540542562595642646693512512A5613688517558565590637652658659508509521
TogusWhite River JctBedfordBoston (Roxbury and Brockton)ManchesterNorthhamptonProvidenceVA Connecticut (Newington)1Buffalo (Batavia)CanadaiguaBathSyracuseAlbany2BronxVA New Jersey (Lyons and East Orange)VA Hudson Valley (CastlePoint and Montrose)New YorkBrooklynNorthport3WilmingtonAltoonaButlerClarksburgCoatesvilleErieLebanonPhiladelphiaVA Pittsburgh (Pittsburgh HD)VAMC Wilkes-Barre4VA MarylandPerry PointMartinsburgWashington5BeckleyDurhamFayettevilleHamptonAshevilleRichmondSalemSalisbury6AtlantaAugustaBirmingham (posted stock purchased and reported by Tuscaloosa)

Sales Report

Contractor:
Contract Number:

FY 2026

Reporting Quarter: ___ QtrLine Item(s)12345678910111213141516171819202122
CLIN/SLIN:
Description/Salient Characteristics
Contract/Part Number:
Price Inclusive of SLA Fee:
VISNFACILITYVA New England Healthcare SystemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of ItemQuantity Sold of Item
1402Togus, ME
1405White River Junction, VT
1518Bedford, MA
1523Boston HCS
1608Manchester, NH
1631Northampton, MA
1650Providence, RI
1689Connecticut HCS
New York/New Jersey VA Health Care Network
2526Bronx, NY
2528Buffalo, NY
2528A5Canandaigua, NY
2528A6Bath, NY
2528A7Syracuse, NY
2528A8Albany, NY
2561New Jersey HCS
2620Hudson Valley HCS
2630New York HHS
2632Northport, NY
VA Pittsburgh Healthcare System
4460Wilmington, DE
4503Altoona, PA
4529Butler, PA
4542Coatesville, PA
4562Erie, PA
4595Lebanon, PA
4642Philadelphia, PA
4646Pittsburgh HCS
4693Wilkes-Barre, PA
VA Capitol Health Care Network
5512Maryland HCS
5517Beckley, WV
5540Clarksburg, WV
5581Huntington, WV
5613Martinsburg, WV
5688Washington DC
VA Mid-Atlantic Health Care Network
6558Durham, NC
6565Fayetteville, NC
6590Hampton, VA
6637Asheville, NC
6652Richmond, VA
6658Salem, VA
6659Salisbury, NC
VA Southeast Network
7508Atlanta, GA
7509Augusta, GA
7521Birmingham, AL
7534Charleston, SC
7544Columbia, SC
7557Dublin, GA
7619Central Alabama HCS
7679Tuscaloosa
VA Sunshine Healthcare Network
8516Bay Pines, FL
8546Miami, FL
8548West Palm Beach, FL
8573N. Florida/S. Georgia HCS
8672San Juan, PR
8673Tampa, FL
8675Orlando, FL
VA MidSouth Healthcare Network
9596Lexington, KY
9603Louisville, KY
9614Memphis, TN
9621Mountain Home, TN
9626Tennessee Valley HCS
VA Healthcare System
10506Ann Arbor, MI
10515Battle Creek, MI
10538Chillicothe, OH
10539Cincinnati, OH
10541Cleveland, OH
10552Dayton, OH
10553Detroit, MI
10583Indianapolis, IN
10610Northern Indiana HCS
10655Saginaw, MI
10757Columbus, OH
VA Great Lakes Health Care System
12537Chicago, IL
12550Illiana HCS
12556North Chicago, IL
12578Hines, IL
12585Iron Mountain, MI
12607Madison, WI
12676Tomah, WI
12695Milwaukee, WI
VA Heartland Network
15589Kansas City, MO
15589A4Columbia, MO
15589A5Eastern Kansas HCS
15589A7Wichita, KS
15657St. Louis, MO
15657A4Poplar Bluff, MO
15657A5Marion, IL
South Central VA Health Care Network
16502Alexandria, LA
16520Biloxi, MS
16564Fayetteville, AR
16580Houston, TX
16586Jackson, MS
16598Central Arkansas HCS
16629New Orleans, LA
16667Shreveport, LA
VA Heart of Texas Health Care Network
17504Amarillo, TX
17519West Texas HCS
17549North Texas HCS
17671South Texas HCS
17674Central Texas HCS
17740Texas Valley Coastal Bend HCS
17757El Paso, TX
Rocky Mountain Network
19436Montana HCS
19442Cheyenne, WY
19554Eastern Colorado HCS
19575Grand Junction, CO
19623Muskogee, OK
19635Oklahoma City, OK
19660Salt Lake City HCS
19666Sheridan, WY
Northwest Network
20463Alaska VAHSRO
20531Boise, ID
20648Portland, OR
20653Roseburg HCS
20663Puget Sound HCS
20668Spokane, WA
20687Walla Walla, WA
20692White City, OR
Sierra Pacific Network
21358Manila, Philippines
21459VA Pacific Islands HCS
21570Central California HCS
21593Southern Nevada HCS
21612Northern California HCS
21640Palo Alto HCS
21654Sierra Nevada HCS
21662San Francisco, CA
Desert Pacific Healthcare Network
22501New Mexico HCS
22600Long Beach HCS
22605Loma Linda, CA
22644Phoenix, AZ
22649Northern Arizona HCS
22664San Diego HCS
22678Southern Arizona HCS
22691Greater Los Angeles HCS
VA Midwest Health Care Network
23437Fargo, ND
23438Sioux Falls, SD
23568Black Hills HCS
23618Minneapolis, MN
23636Omaha, NE
23636A6Central Iowa HCS
23636A8Iowa City, IA
23656St. Cloud, MN
Null764CMOP
Total Quarterly Quantity Sold0000000000000000000000
Total Quantity Sold of All Items0
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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