ATTACHMENT C1 - Worcester CBOC IOTA FFE 7.16 (1).pdf

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Attached to
Q702--Worcester, MA Activations Contract Amendment 002 Federal contract opportunity
Solicitation number
36C77621Q0332
Issued by
Department of Veterans Affairs Technology Acquisition Center Austin

About this file

Written by GovTribe AI ·

This is a combined synopsis/solicitation from the Department of Veterans Affairs seeking quotes for Initial Outfitting, Transition, and Activation services at the Worcester Outpatient Clinic in Massachusetts. The VA requires a contractor to provide services including project management, site assessments, procurement and installation of furniture and equipment, and staff training from July 2021 through January 2022. The solicitation is set aside for service-disabled veteran-owned small businesses and utilizes NAICS code 541614 with a $15 million size standard. Quotes are due by the date specified in block 8 of the SF1449 form. The VA intends to award a firm-fixed-price contract with options and incorporates FAR provisions and clauses from FAC 2019-02. Questions regarding the solicitation must be submitted by May 24 with 36A77621Q0332 Question in the subject line. The VA will post answers to the Opportunities posting by May 28 and as needed.

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Other files for this federal contract opportunity

Other files attached to Q702--Worcester, MA Activations Contract Amendment 002, newest first.
File Type Posted
36C77621Q0332 0002_1.docx DOCX document
36C77621Q0332 0002.docx DOCX document
ATTACHMENT J - Pricing Worksheet Worcester_.xlsx XLSX spreadsheet
S05 - Vendor Questions Worcester.pdf PDF
ATTACHMENT A - Worcester CBOC IOTA PWS 05142021_.pdf PDF
36C77621Q0332 0001_1.docx DOCX document
Worcester Design 403 Belmont St.pdf PDF
36C77621Q0332 0001.docx DOCX document
ATTACHMENT I - Meeting Minutes template.pdf PDF
ATTACHMENT H - Wage Rate Determination.pdf PDF
ATTACHMENT F - VSC Security Request Forms.pdf PDF
36C77621Q0332.docx DOCX document
ATTACHMENT E - Contract Staff Roster.pdf PDF
ATTACHMENT D - Full Schedule - 06.26.2020.pdf PDF
ATTACHMENT B - TRAVEL AUTHORIZATION REQUEST.pdf PDF
ATTACHMENT G - QASP.docx DOCX document
ATTACHMENT C2 - Worcester Equipment Planning for IOTA.xlsx XLSX spreadsheet
ATTACHMENT A - Worcester CBOC IOTA PWS 05142021.pdf PDF
36C77621Q0332_1.docx DOCX document
ATTACHMENT J - Pricing Worksheet Worcester.xlsx XLSX spreadsheet
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Project Room Contents

WORCESTER CBOC

REVISION 07/16/2020

SPACE PROGRAM USING PACT PROTOTYPE CRITERIA

WORCESTER, MA

VISN: 1 State: MA Station ID: 631 Station Name: Northampton

Installation: VA Medical Center

Project Room Contents

Privacy Act – FOR OFFICIAL USE ONLY (Page 2)

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: SRLW1 Room Area: 60 Agency Room Name: Alcove, Wheelchair Staff: 0 Criteria Room Name: Alcove, Wheelchair Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M4705 Wheelchair, Patient Transport, Folding 1 EA 536 536 VV

M4710 Wheelchair, Patient, Bariatric, Transport, Folding 1 EA 1,716 1,716 VV

Total Content Costs for this Room: 2,252

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: WTF03 Room Area: 200 Agency Room Name: Waiting, PACT Family Staff: 0 Criteria Room Name: Waiting, PACT Family Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA 46 46 VV

A6046 Artwork, Decorative, With Frame 1 EA 521 521 VV

F0206 Chair, Side, Bariatric, With Arms 1 EA 748 748 VV

F0215 Chair, Child's 4 EA 43 172 VV

F0305 Chair, Waiting Room, Single 2 EA 627 1,254 VV

F0760 Table, Child's 1 EA 227 227 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F2300 Rack, Magazine, Wall Mounted 1 EA 255 255 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

Total Content Costs for this Room: 3,324

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: RCP03 Room Area: 200 Agency Room Name: Reception Staff: 0

Project Room Contents (03 May 2018 11:05AM ET)

Privacy Act – FOR OFFICIAL USE ONLY (Page 3)

Criteria Room Name: Reception Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 3 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 3 EA 0 0 VV

A6105 Counter, Reception Control, Built-In 1 EA 7,797 7,797 CC . A

F0275 Chair, Swivel, High Back 3 EA 642 1,926 VV

F0420 Cabinet, Filing, Lateral, Half Height 3 EA 625 1,875 VV

F2000 Basket, Wastepaper, Fire Resistant 2 EA 51 102 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 3 EA 1,524 4,572 VV . A

Total Content Costs for this Room: 16,322

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: RCHK2 Room Area: 43 Agency Room Name: Kiosk, Patient Check-In Staff: 0 Criteria Room Name: Kiosk, Patient Check-In Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

M1890 Kiosk, Educational, Stand-Up 2 EA 4,505 9,010 VV . A

Total Content Costs for this Room: 9,010

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: NCWD4 Room Area: 100 Agency Room Name: Alcove, Volunteer Staff: 0 Criteria Room Name: Alcove, Volunteer Blueprint #:

Privacy Act – FOR OFFICIAL USE ONLY (Page 4)

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

C02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 36x24x22 1 EA 865 865 CC

C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 1 EA 1,040 1,040 CC

CB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 1 EA 729 729 CC

CT030 Countertop, High Pressure Laminate 1 LF 66 66 CC

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VV

K1552 Brewer, Coffee, Auto, Elect, 3 Burner, Front/Back 1 EA 1,251 1,251 VV J A

Total Content Costs for this Room: 4,167

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: CLSC2 Room Area: 20 Agency Room Name: Workstation, Patient Education Staff: 0 Criteria Room Name: Workstation, Patient Education Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

E0042 Workcenter, Computer, Free Standing, 48" W 1 EA 2,636 2,636 VV

F0280 Chair, Swivel, Low Back 1 EA 494 494 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

Total Content Costs for this Room: 4,705

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: CLSC2 Room Area: 20

Privacy Act – FOR OFFICIAL USE ONLY (Page 5)

Agency Room Name: Workstation, Patient Education Staff: 0 Criteria Room Name: Workstation, Patient Education Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

E0042 Workcenter, Computer, Free Standing, 48" W 1 EA 2,636 2,636 VV

F0280 Chair, Swivel, Low Back 1 EA 494 494 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

Total Content Costs for this Room: 4,705

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: WTPC2 Room Area: 700 Agency Room Name: Waiting Staff: 0 Criteria Room Name: Waiting, PACT 2 Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA 46 46 VV

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 2 EA 114 228 VV

A5220 Bracket, Television, Wall Backing 2 EA 94 188 CC

A6046 Artwork, Decorative, With Frame 4 EA 521 2,084 VV

F0206 Chair, Side, Bariatric, With Arms 18 EA 748 13,464 VV

F0305 Chair, Waiting Room, Single 146 EA 627 91,542 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F2300 Rack, Magazine, Wall Mounted 1 EA 255 255 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M0512 Television, HDTV, Large Screen, 60" 3 EA 3,916 11,748 VV . A

Total Content Costs for this Room: 119,656

Privacy Act – FOR OFFICIAL USE ONLY (Page 6)

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: LOBBY / RECEPTION AREA Room Code: RCHK2 Room Area: 43 Agency Room Name: Kiosk, Patient Check-In Staff: 0 Criteria Room Name: Kiosk, Patient Check-In Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

M1890 Kiosk, Educational, Stand-Up 2 EA 4,505 9,010 VV . A

Total Content Costs for this Room: 9,010

Total Content Costs for this Functional Area: 173,151

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: PEHW2 Room Area: 40 Agency Room Name: Alcove, Height / Weight Accessible Station Staff: 0 Criteria Room Name: Alcove, Height / Weight Accessible Station Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M4045 Scale, Wheelchair, Portable, 1000 lb Capacity 1 EA 3,210 3,210 VV

Total Content Costs for this Room: 3,210

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: OFDC2 Room Area: 125 Agency Room Name: Consult Room, Patient Aligned Care Team (PACT) Staff: 1 Criteria Room Name: Consult Room, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 7)

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT030 Countertop, High Pressure Laminate 3 LF 66 198 CC

F0205 Chair, Side With Arms 3 EA 556 1,668 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F0740 Table, Occasional, Lamp 1 EA 346 346 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

Total Content Costs for this Room: 7,434

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: PEHW1 Room Area: 15 Agency Room Name: Alcove, Height / Weight Station Staff: 0 Criteria Room Name: Alcove, Height / Weight Station Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1011 Telephone, Desk, 1 Line 1 EA 0 0 VV

E0222 Worksurface, Computer, O/H Cab, Wall Mtd, 48" W 1 EA 2,364 2,364 VV . A

F0210 Chair, Side, Without Arms 1 EA 367 367 VV

F0275 Chair, Swivel, High Back 1 EA 642 642 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 8)

M4040 Scale, Weighing, 300 Pound Capacity 1 EA 496 496 VV

Total Content Costs for this Room: 5,494

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: EXPA1 Room Area: 125 Agency Room Name: Exam Room, Patient Aligned Care Team (PACT) Staff: 0 Criteria Room Name: Exam Room, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A1066 Mirror, Float Glass, With SS Frame 1 EA 85 85 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VV

A5108 Waste Disposal Unit, Sharps 1 CS 212 212 VV

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 157 157 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VV

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT030 Countertop, High Pressure Laminate 3 LF 66 198 CC

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,851 1,851 VV

F0206 Chair, Side, Bariatric, With Arms 1 EA 748 748 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

F2310 Rack, Pamphlet, Wall Mounted 1 EA 175 175 VV

F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VV

M0506 Television, Flat Screen 1 EA 542 542 VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 9)

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

M1825 Printer, Computer 1 EA 815 815 VV . A

M4040 Scale, Weighing, 300 Pound Capacity 1 EA 496 496 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 191 191 VV

M4116 Monitor, Vital Signs 1 EA 2,444 2,444 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,555 1,555 VV . A

M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,134 1,134 VV . A

M9025 Table, Examination/Treatment, With Cabinet 1 EA 1,874 1,874 VV . A

Total Content Costs for this Room: 18,092

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: TPG01 Room Area: 60 Agency Room Name: Toilet, PACT Patient Staff: 0 Criteria Room Name: Toilet, PACT Patient Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 297 297 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 208 208 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 157 157 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

P3000 Lavatory, Vitreous China, Straight Back 1 EA 383 383 CC D

P9050 Toilet, Wall Hung, Siphon Jet 1 EA 830 830 CC B

Total Content Costs for this Room: 2,303

Privacy Act – FOR OFFICIAL USE ONLY (Page 10)

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: EXW01 Room Area: 125 Agency Room Name: Exam Room, Women's Health Staff: 1 Criteria Room Name: Exam Room, Women's Health Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VV

A5108 Waste Disposal Unit, Sharps 1 CS 212 212 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VV

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT030 Countertop, High Pressure Laminate 3 LF 66 198 CC

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,851 1,851 VV

F0205 Chair, Side With Arms 1 EA 556 556 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

F2310 Rack, Pamphlet, Wall Mounted 1 EA 175 175 VV

F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

M3072 Frame, Infectious Waste Bag w/Lid 1 EA 439 439 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 191 191 VV

M4116 Monitor, Vital Signs 1 EA 2,444 2,444 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,555 1,555 VV . A

M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,134 1,134 VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 11)

M9025 Table, Examination/Treatment, With Cabinet 1 EA 1,874 1,874 VV . A

Total Content Costs for this Room: 16,244

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: TRPR1 Room Area: 180 Agency Room Name: Procedure Room, General Staff: 0 Criteria Room Name: Procedure Room, General Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1011 Telephone, Desk, 1 Line 1 EA 0 0 VV

A1132 Rail, Accessory Mounting, Length As Required 1 LF 100 100 VC . . . . . J 6530

A1203 Lift System, Overhead, Bariatric 1 EA 14,613 14,613 CC . F . . . J

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VV

A5108 Waste Disposal Unit, Sharps 1 CS 212 212 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 14 FT 7 98 VV

C02Q0 Cabinet, Sink, U/C/B, 1 Door, 36x24x22 1 EA 709 709 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT020 Countertop, Solid Surface 1 LF 180 180 CC

E0915 Locker, Supply, Medication, Wall Mtd, 23"W x 20"D 1 EA 3,870 3,870 VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,851 1,851 VV

F0205 Chair, Side With Arms 1 EA 556 556 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3010 Board, Bulletin, 48 x 48 1 EA 144 144 VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 12)

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA 95 95 VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA 79 79 VV . . A . . . 6680

M0765 Regulator, Vacuum 2 EA 309 618 VV . . B . . . 6515

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA 539 539 VV

M3072 Frame, Infectious Waste Bag w/Lid 1 EA 439 439 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 191 191 VV

M4116 Monitor, Vital Signs 1 EA 2,444 2,444 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,555 1,555 VV . A

M4255 Stand, IV, Adjustable 1 EA 428 428 VV

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA 5,679 5,679 VV

M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,134 1,134 VV . A

M7405 Light, Exam, Ceiling Mounted 1 EA 3,013 3,013 CC . F

M7710 Electrocardiograph, 12 Lead, Portable 1 EA 14,012 14,012 VV . A

M8810 Stand, Mayo 1 EA 745 745 VV

M9025 Table, Examination/Treatment, With Cabinet 1 EA 1,874 1,874 VV . A

Total Content Costs for this Room: 60,428

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: TPB01 Room Area: 60 Agency Room Name: Toilet, General Procedure Room Patient Staff: 0 Criteria Room Name: Toilet, General Procedure Room Patient Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 297 297 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 208 208 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 2 EA 157 314 CC

Privacy Act – FOR OFFICIAL USE ONLY (Page 13)

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

P3005 Lavatory, Vitreous China, Bariatric 1 EA 5,057 5,057 CC D

P9056 Toilet, Floor Mounted, Bariatric 1 EA 460 460 CC B

Total Content Costs for this Room: 6,764

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: TPG01 Room Area: 60 Agency Room Name: Toilet, Women's Health Exam Room Patient Staff: 0 Criteria Room Name: Toilet, Women's Health Exam Room Patient Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 297 297 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 208 208 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 157 157 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

P3000 Lavatory, Vitreous China, Straight Back 1 EA 383 383 CC D

P9050 Toilet, Wall Hung, Siphon Jet 1 EA 830 830 CC B

Total Content Costs for this Room: 2,303

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: CLSC4 Room Area: 360 Agency Room Name: Shared Medical Appointment Room - Conference room and

Classroom Staff: 0

Privacy Act – FOR OFFICIAL USE ONLY (Page 14)

Criteria Room Name: Shared Medical Appointment Room Blueprint #:

Room Comments: class room and conference room accessible from the lobby area

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

E0945 Cart, Computer, Mobile 2 EA 1,938 3,876 VV

F0295 Chair, Stacking 16 EA 76 1,216 VV

F0435 Cabinet, Storage, Multi Media 1 EA 1,503 1,503 VV

F0860 Table, Mobile 4 EA 946 3,784 VV

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

F2250 Camcorder, Hand Held, HD, Zoom, w/Microphone 1 EA 2,883 2,883 VV

F3060 Whiteboard, Projection Screen Combination 1 EA 625 625 VV

M0506 Television, Flat Screen 1 EA 542 542 VV . A

M1801 Computer, Microprocessing, w/Flat Panel Monitor 2 EA 1,524 3,048 VV . A

Total Content Costs for this Room: 17,719

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: SRE01 Room Area: 100 Agency Room Name: Storage, Shared Medical Appointments Staff: 0 Criteria Room Name: Storage, Shared Medical Appointments Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

M2055 Shelving, Storage, Wire, CRS, w/Adjustable Shelves 4 EA 853 3,412 VV

Total Content Costs for this Room: 3,412

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: WRTM1 Room Area: 240 Agency Room Name: Team Work Area Staff: 0

Privacy Act – FOR OFFICIAL USE ONLY (Page 15)

Criteria Room Name: Team Work Area Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 4 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 2 EA 0 0 VV

E0123 Workstation, Straight, Free Standing, 72" W 4 EA 7,669 30,676 VV . A

F0275 Chair, Swivel, High Back 4 EA 642 2,568 VV

F0420 Cabinet, Filing, Lateral, Half Height 2 EA 625 1,250 VV

F2000 Basket, Wastepaper, Fire Resistant 4 EA 51 204 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 4 EA 1,524 6,096 VV . A

Total Content Costs for this Room: 40,844

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: RCA06 Room Area: 20 Agency Room Name: Alcove, Medication Staff: 0 Criteria Room Name: Alcove, Medication Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

EA VV B A

Total Content Costs for this Room: 46,700

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: RCA01 Room Area: 20 Agency Room Name: Alcove, Resuscitation Cart Staff: 0 Criteria Room Name: Alcove, Resuscitation Cart Blueprint #:

Privacy Act – FOR OFFICIAL USE ONLY (Page 16)

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M7660 Defibrillator/Monitor/Recorder, Portable 1 EA 2,454 2,454 VV . A

Total Content Costs for this Room: 2,454

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: WKTM3 Room Area: 240 Agency Room Name: Workroom, Patient Aligned Care Team (PACT) - Extended

Team Staff: 2

Criteria Room Name: Workroom, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 4 EA 0 0 VV

A1011 Telephone, Desk, 1 Line 2 EA 0 0 VV

A6046 Artwork, Decorative, With Frame 1 EA 521 521 VV

E0120 Workstation, Straight, Free Standing, 60" W 2 EA 6,246 12,492 VV . A

F0275 Chair, Swivel, High Back 2 EA 642 1,284 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 625 625 VV

F2000 Basket, Wastepaper, Fire Resistant 2 EA 51 102 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 4 EA 1,524 6,096 VV . A

Total Content Costs for this Room: 21,170

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: CFR01 Room Area: 300 Agency Room Name: Training Room, Staff - Edu. Res. Rm Staff: 0 Criteria Room Name: Training Room, Staff Blueprint #:

Privacy Act – FOR OFFICIAL USE ONLY (Page 17)

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1020 Telephone, Conferencing System 1 EA 592 592 VV . A . . . T

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA 114 114 VV

A5220 Bracket, Television, Wall Backing 1 EA 94 94 CC

A6046 Artwork, Decorative, With Frame 1 EA 521 521 VV

F0220 Chair, Conference 6 EA 550 3,300 VV

F0601 Credenza, Performance 1 EA 8,537 8,537 VV . A

F0755 Table, Conference, Wood 2 EA 2,419 4,838 VV

F0765 Table, Folding / Nesting 2 EA 1,687 3,374 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M0507 Video Teleconferencing System 1 EA 12,792 12,792 VV . A

M0512 Television, HDTV, Large Screen, 60" 1 EA 3,916 3,916 VV . A

Total Content Costs for this Room: 38,179

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: CFR01 Room Area: 240 Agency Room Name: Conference Room - Staff Area Staff: 0 Criteria Room Name: Conference Room Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1020 Telephone, Conferencing System 1 EA 592 592 VV . A . . . T

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA 114 114 VV

A5220 Bracket, Television, Wall Backing 1 EA 94 94 CC

A6046 Artwork, Decorative, With Frame 1 EA 521 521 VV

F0220 Chair, Conference 6 EA 550 3,300 VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 18)

F0601 Credenza, Performance 1 EA 8,537 8,537 VV . A

F0755 Table, Conference, Wood 2 EA 2,419 4,838 VV

F0765 Table, Folding / Nesting 2 EA 1,687 3,374 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M0507 Video Teleconferencing System 1 EA 12,792 12,792 VV . A

M0512 Television, HDTV, Large Screen, 60" 1 EA 3,916 3,916 VV . A

Total Content Costs for this Room: 38,179

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: UCCL1 Room Area: 60 Agency Room Name: Utility Room, Clean Staff: 0 Criteria Room Name: Utility Room, Clean Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

E0903 Locker, Supply, w/Shelves, Wall Mtd, 23"W x 20"D 2 EA 2,441 4,882 VV

E0906 Locker, Supply, General, Wall Mtd, 23"W x 20"D 2 EA 3,065 6,130 VV

E0912 Locker, Supply, Med Surg, Wall Mtd 2 EA 3,416 6,832 VV

E1500 Rail, MOD, W/MNTD, HX144XD 1 EA 732 732 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

P8710 Utility Center, Plumbing Connection 1 EA 96 96 CC D

Total Content Costs for this Room: 18,723

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: SRE01 Room Area: 30 Agency Room Name: Storage, Medical Equipment Staff: 0 Criteria Room Name: Storage, Medical Equipment Blueprint #:

Privacy Act – FOR OFFICIAL USE ONLY (Page 19)

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

M2055 Shelving, Storage, Wire, CRS, w/Adjustable Shelves 4 EA 853 3,412 VV

Total Content Costs for this Room: 3,412

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: SL001 Room Area: 200 Agency Room Name: Lounge, Staff Staff: 0 Criteria Room Name: Lounge, Staff Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A1080 Mirror, Posture, Wall Mounted 1 EA 386 386 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA 224 224 VV

A5220 Bracket, Television, Wall Backing 1 EA 94 94 CC

C02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 36x24x22 1 EA 865 865 CC

C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 1 EA 1,040 1,040 CC

C04P0 Cabinet, Sink, U/C/B, 2 Door, 36x36x22 1 EA 743 743 CC

CB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 2 EA 729 1,458 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT020 Countertop, Solid Surface 7 LF 180 1,260 CC

F0225 Chair, Dining Room 4 EA 257 1,028 VV

F0795 Table, Dining 1 EA 689 689 VV

F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 266 266 VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 20)

F3065 Whiteboard/Bulletin Board, Combination 1 EA 352 352 VV

K1552 Brewer, Coffee, Auto, Elect, 3 Burner, Front/Back 1 EA 1,251 1,251 VV J A

K4665 Oven, Microwave, Consumer 1 EA 287 287 VV . A

M0515 Television, HD, 40" Class 1 EA 520 520 VV . A . . . M

R7250 Refrigerator/Freezer, 20 Cubic Feet 1 EA 1,347 1,347 VV . A

Total Content Costs for this Room: 12,991

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

Room Code: LR001 Room Area: 60 Agency Room Name: Locker, Staff Personal Property Staff: 0 Criteria Room Name: Locker, Staff Personal Property Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1030 Locker, 2 Person, Over/Under 12 EA 287 3,444 VV

A1080 Mirror, Posture, Wall Mounted 1 EA 386 386 CC

Total Content Costs for this Room: 3,830

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

Room Code: TNPG1 Room Area: 60 Agency Room Name: Toilet, Staff Staff: 0 Criteria Room Name: Toilet, Staff Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 297 297 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 334 334 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 208 208 CC

Privacy Act – FOR OFFICIAL USE ONLY (Page 21)

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 157 157 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

P3200 Lavatory, Vitreous China, Slab Type w/Sens Op Fauc 1 EA 721 721 CC D

P9051 Toilet, Floor Mounted, Siphon Jet 1 EA 449 449 CC B

Total Content Costs for this Room: 2,594

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

Room Code: TNPG1 Room Area: 60 Agency Room Name: Toilet, Staff Staff: 0 Criteria Room Name: Toilet, Staff Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 297 297 CC

A4995 Table, Diaper Changing, Wall Mounted 1 EA 334 334 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 208 208 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 157 157 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

P3200 Lavatory, Vitreous China, Slab Type w/Sens Op Fauc 1 EA 721 721 CC D

Privacy Act – FOR OFFICIAL USE ONLY (Page 22)

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: LR001 Room Area: 60 Agency Room Name: Locker, Staff Personal Property Staff: 0 Criteria Room Name: Locker, Staff Personal Property Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1030 Locker, 2 Person, Over/Under 12 EA 287 3,444 VV

A1080 Mirror, Posture, Wall Mounted 1 EA 386 386 CC

Total Content Costs for this Room: 3,830

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: SL001 Room Area: 200 Agency Room Name: Lounge, Staff Staff: 0 Criteria Room Name: Lounge, Staff Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A1080 Mirror, Posture, Wall Mounted 1 EA 386 386 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA 224 224 VV

A5220 Bracket, Television, Wall Backing 1 EA 94 94 CC

C02C0 Cabinet, U/C/B, 1 Shelf, 1 Drawer, 1 DO, 36x24x22 1 EA 865 865 CC

C02D0 Cabinet, U/C/B, 4 Drawer, 36x24x22 1 EA 1,040 1,040 CC

C04P0 Cabinet, Sink, U/C/B, 2 Door, 36x36x22 1 EA 743 743 CC

CB020 Cabinet, W/H, 2 Shelf, 1 DO, Sloping Top, 38x24x13 2 EA 729 1,458 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

Privacy Act – FOR OFFICIAL USE ONLY (Page 23)

CT020 Countertop, Solid Surface 7 LF 180 1,260 CC

F0225 Chair, Dining Room 4 EA 257 1,028 VV

F0795 Table, Dining 1 EA 689 689 VV

F2015 Basket, Wastepaper, Metal/Plastic,2 Swinging Doors 1 EA 266 266 VV

F3065 Whiteboard/Bulletin Board, Combination 1 EA 352 352 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

K1552 Brewer, Coffee, Auto, Elect, 3 Burner, Front/Back 1 EA 1,251 1,251 VV J A

K4665 Oven, Microwave, Consumer 1 EA 287 287 VV . A

M0515 Television, HD, 40" Class 1 EA 520 520 VV . A . . . M

R7250 Refrigerator/Freezer, 20 Cubic Feet 1 EA 1,347 1,347 VV . A

Total Content Costs for this Room: 12,991

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: SRE01 Room Area: 30 Agency Room Name: Storage, Medical Equipment Staff: 0 Criteria Room Name: Storage, Medical Equipment Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

M2055 Shelving, Storage, Wire, CRS, w/Adjustable Shelves 4 EA 853 3,412 VV

Total Content Costs for this Room: 3,412

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: CFR01 Room Area: 240 Agency Room Name: Conference Room - Staff Area Staff: 0 Criteria Room Name: Conference Room Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code

Privacy Act – FOR OFFICIAL USE ONLY (Page 24)

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1020 Telephone, Conferencing System 1 EA 592 592 VV . A . . . T

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA 114 114 VV

A5220 Bracket, Television, Wall Backing 1 EA 94 94 CC

A6046 Artwork, Decorative, With Frame 1 EA 521 521 VV

F0220 Chair, Conference 6 EA 550 3,300 VV

F0601 Credenza, Performance 1 EA 8,537 8,537 VV . A

F0755 Table, Conference, Wood 2 EA 2,419 4,838 VV

F0765 Table, Folding / Nesting 2 EA 1,687 3,374 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M0507 Video Teleconferencing System 1 EA 12,792 12,792 VV . A

M0512 Television, HDTV, Large Screen, 60" 1 EA 3,916 3,916 VV . A

Total Content Costs for this Room: 38,179

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: WKTM3 Room Area: 240 Agency Room Name: Workroom, Patient Aligned Care Team (PACT) - Extended

Team Staff: 2

Criteria Room Name: Workroom, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 4 EA 0 0 VV

A1011 Telephone, Desk, 1 Line 2 EA 0 0 VV

A6046 Artwork, Decorative, With Frame 1 EA 521 521 VV

E0120 Workstation, Straight, Free Standing, 60" W 2 EA 6,246 12,492 VV . A

F0275 Chair, Swivel, High Back 2 EA 642 1,284 VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA 625 625 VV

F2000 Basket, Wastepaper, Fire Resistant 2 EA 51 102 VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 25)

M1801 Computer, Microprocessing, w/Flat Panel Monitor 4 EA 1,524 6,096 VV . A

Total Content Costs for this Room: 21,170

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: RCA01 Room Area: 20 Agency Room Name: Alcove, Resuscitation Cart Staff: 0 Criteria Room Name: Alcove, Resuscitation Cart Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M7660 Defibrillator/Monitor/Recorder, Portable 1 EA 2,454 2,454 VV . A

Total Content Costs for this Room: 2,454

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: RCA06 Room Area: 20 Agency Room Name: Alcove, Medication Staff: 0 Criteria Room Name: Alcove, Medication Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

M3150 Distribution System, Medication, Automatic 1 EA 46,700 46,700 VV B A

Total Content Costs for this Room: 46,700

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: WRTM1 Room Area: 240

Criteria Room Name: Team Work Area Blueprint #:

Privacy Act – FOR OFFICIAL USE ONLY (Page 26)

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 4 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 2 EA 0 0 VV

E0123 Workstation, Straight, Free Standing, 72" W 4 EA 7,669 30,676 VV . A

F0275 Chair, Swivel, High Back 4 EA 642 2,568 VV

F0420 Cabinet, Filing, Lateral, Half Height 2 EA 625 1,250 VV

F2000 Basket, Wastepaper, Fire Resistant 4 EA 51 204 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 4 EA 1,524 6,096 VV . A

Total Content Costs for this Room: 40,844

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: CLSC4 Room Area: 360 Agency Room Name: Shared Medical Appointment Room - Conference room and

Classroom Staff: 0

Criteria Room Name: Shared Medical Appointment Room Blueprint #:

Room Comments: class room and conference room accessible from the lobby area

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

E0945 Cart, Computer, Mobile 2 EA 1,938 3,876 VV

F0295 Chair, Stacking 16 EA 76 1,216 VV

F0435 Cabinet, Storage, Multi Media 1 EA 1,503 1,503 VV

F0860 Table, Mobile 4 EA 946 3,784 VV

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

F2250 Camcorder, Hand Held, HD, Zoom, w/Microphone 1 EA 2,883 2,883 VV

F3060 Whiteboard, Projection Screen Combination 1 EA 625 625 VV

M0506 Television, Flat Screen 1 EA 542 542 VV . A

M1801 Computer, Microprocessing, w/Flat Panel Monitor 2 EA 1,524 3,048 VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 27)

Total Content Costs for this Room: 17,719

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

Room Code: TPG01 Room Area: 60 Agency Room Name: Toilet, Women's Health Exam Room Patient Staff: 0 Criteria Room Name: Toilet, Women's Health Exam Room Patient Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 297 297 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 208 208 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 157 157 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

P3000 Lavatory, Vitreous China, Straight Back 1 EA 383 383 CC D

P9050 Toilet, Wall Hung, Siphon Jet 1 EA 830 830 CC B

Total Content Costs for this Room: 2,303

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

Room Code: EXW01 Room Area: 125 Agency Room Name: Exam Room, Women's Health Staff: 1 Criteria Room Name: Exam Room, Women's Health Blueprint #:

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 28)

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VV

A5108 Waste Disposal Unit, Sharps 1 CS 212 212 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VV

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT030 Countertop, High Pressure Laminate 3 LF 66 198 CC

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,851 1,851 VV

F0205 Chair, Side With Arms 1 EA 556 556 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

F2310 Rack, Pamphlet, Wall Mounted 1 EA 175 175 VV

F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

M3072 Frame, Infectious Waste Bag w/Lid 1 EA 439 439 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 191 191 VV

M4116 Monitor, Vital Signs 1 EA 2,444 2,444 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,555 1,555 VV . A

M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,134 1,134 VV . A

M9025 Table, Examination/Treatment, With Cabinet 1 EA 1,874 1,874 VV . A

Total Content Costs for this Room: 16,244

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: TPG01 Room Area: 60 Agency Room Name: Toilet, PACT Patient Staff: 0 Criteria Room Name: Toilet, PACT Patient Blueprint #:

Privacy Act – FOR OFFICIAL USE ONLY (Page 29)

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1067 Mirror, Float Glass, ADA Accessible 1 EA 297 297 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5082 Dispenser, Paper Towel, Sensor, Hands Free 1 EA 208 208 CC

A5090 Disposal, Sanitary Napkin, SS, Surface Mounted 1 EA 51 51 CC

A5109 Grab Bar, 1-1/4" Dia., SS, 2 Wall, W/C Accessible 1 EA 157 157 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

A5200 Dispenser, Toilet Tissue, SS, 2-Roll, Surface Mntd 1 EA 87 87 CC

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

P3000 Lavatory, Vitreous China, Straight Back 1 EA 383 383 CC D

P9050 Toilet, Wall Hung, Siphon Jet 1 EA 830 830 CC B

Total Content Costs for this Room: 2,303

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: EXPA1 Room Area: 125 Agency Room Name: Exam Room, Patient Aligned Care Team (PACT) Staff: 0 Criteria Room Name: Exam Room, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A1066 Mirror, Float Glass, With SS Frame 1 EA 85 85 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA 28 28 VV

A5108 Waste Disposal Unit, Sharps 1 CS 212 212 VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA 31 62 CC

Privacy Act – FOR OFFICIAL USE ONLY (Page 30)

A5180 Track, Cubicle, Surface Mounted, With Curtain 12 FT 7 84 VV

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT030 Countertop, High Pressure Laminate 3 LF 66 198 CC

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA 1,851 1,851 VV

F0206 Chair, Side, Bariatric, With Arms 1 EA 748 748 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F2010 Basket, Wastepaper, Step-On 1 EA 242 242 VV

F2310 Rack, Pamphlet, Wall Mounted 1 EA 175 175 VV

F3025 Board, Bulletin, Wood Framed 1 EA 59 59 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M0506 Television, Flat Screen 1 EA 542 542 VV . A

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

M1825 Printer, Computer 1 EA 815 815 VV . A

M4040 Scale, Weighing, 300 Pound Capacity 1 EA 496 496 VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA 191 191 VV

M4116 Monitor, Vital Signs 1 EA 2,444 2,444 VV . A

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA 1,555 1,555 VV . A

M7401 Light, Exam, Mobile, Spotlight, Mobile Stand 1 EA 1,134 1,134 VV . A

M9025 Table, Examination/Treatment, With Cabinet 1 EA 1,874 1,874 VV . A

Total Content Costs for this Room: 18,092

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: PEHW1 Room Area: 15 Agency Room Name: Alcove, Height / Weight Station Staff: 0 Criteria Room Name: Alcove, Height / Weight Station Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code

Privacy Act – FOR OFFICIAL USE ONLY (Page 31)

A1011 Telephone, Desk, 1 Line 1 EA 0 0 VV

E0222 Worksurface, Computer, O/H Cab, Wall Mtd, 48" W 1 EA 2,364 2,364 VV . A

F0210 Chair, Side, Without Arms 1 EA 367 367 VV

F0275 Chair, Swivel, High Back 1 EA 642 642 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M4040 Scale, Weighing, 300 Pound Capacity 1 EA 496 496 VV

Total Content Costs for this Room: 5,494

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: OFDC2 Room Area: 125 Agency Room Name: Consult Room, Patient Aligned Care Team (PACT) Staff: 1 Criteria Room Name: Consult Room, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT030 Countertop, High Pressure Laminate 3 LF 66 198 CC

F0205 Chair, Side With Arms 3 EA 556 1,668 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F0740 Table, Occasional, Lamp 1 EA 346 346 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 32)

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

Total Content Costs for this Room: 7,434

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: OFDC2 Room Area: 125 Agency Room Name: Consult Room, Patient Aligned Care Team (PACT) Staff: 1 Criteria Room Name: Consult Room, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 2 EA 0 0 VV

A1015 Telephone, Desk, Multiple Line 1 EA 0 0 VV

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5145 Hook, Garment, Double, SS, Surface Mounted 1 EA 31 31 CC

CD040 Cabinet, W/H, 2 Shelf, 2 DO, Sloping Top, 38x36x13 1 EA 1,032 1,032 CC

CS010 Sink, SS, Single Compartment, 7.5x12x12 ID 1 EA 994 994 CC D

CT030 Countertop, High Pressure Laminate 3 LF 66 198 CC

F0205 Chair, Side With Arms 3 EA 556 1,668 VV

F0340 Stool, Self Adjusting 1 EA 376 376 VV

F0740 Table, Occasional, Lamp 1 EA 346 346 VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA 51 51 VV

F3200 Clock, Battery, 12" Diameter 1 EA 50 50 VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA 1,524 1,524 VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA 1,058 1,058 VV . B . . . D 7110

Total Content Costs for this Room: 7,434

Department: OUTPATIENT / PACT CLINIC (265) Functional Area: AMBULATORY CARE (PACT) CLINIC - MODIFIED THREE

MODULE

Room Code: EXPA1 Room Area: 125 Agency Room Name: Exam Room, Patient Aligned Care Team (PACT) Staff: 0

Privacy Act – FOR OFFICIAL USE ONLY (Page 33)

Criteria Room Name: Exam Room, Patient Aligned Care Team (PACT) Blueprint #:

JSN Content Name Qty Unit Of Issue Unit Price Total Price

Log Cat/ Acq

Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1010 Telecommunication Outlet 1 EA 0 0 VV

A1012 Telephone, Wall Mounted, 1 Line 1 EA 0 0 VV

A1066 Mirror, Float Glass, With SS Frame 1 EA 85 85 CC

A5075 Dispenser, Soap, Disposable 1 EA 17 17 VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA 89 89 CC

A5107…

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