Attachment D.11 - Three Sample Packs - Bills of Materials.xlsx

XLSX spreadsheet 25 MB Posted

Attached to
6515--Custom Sterile Surgical Procedure Packs VISNs 5, 9, 10, 12, 15, 16, &23
Solicitation number
36C77625R0017
Issued by

About this file

This is a bills of materials spreadsheet listing sample packs for custom sterile surgical procedure packs. The document serves as an attachment (D.11) providing detailed materials lists for three sample surgical packs, supporting a solicitation (36C77625R0017) from the VA Technology Acquisition Center for custom sterile procedure packs serving VISNs 5, 9, 10, 12, 15, 16, and 23.

The solicitation is for a single 5-year IDIQ firm-fixed price contract to provide custom sterile surgical procedure packs to approximately 35 VA Medical Centers and CBOCs. The work falls under NAICS code 339113 (Surgical Appliance and Supplies Manufacturing) with an 800-employee size standard. The contractor will be responsible for all aspects including labor, materials, sterilization, transportation, equipment, supervision, quality assurance, electronic communication, ordering, reporting, and delivery of the packs while maintaining compliance with regulations.

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Other files

File Type Posted
Attachment D.2 - Schedule of Items - Custom Packs Amended 3.xlsx XLSX spreadsheet
36C77625R0017 0003 Custom Sterile Procedure Packs.pdf PDF
Attachment D.12 - Sample Pack Evaluation Checklist Amended.pdf PDF
Attachment D.2 - Schedule of Items - Custom Packs Amended 2.xlsx XLSX spreadsheet
36C77625R0017 0002 - Custom Packs Amendment 2.pdf PDF
Attachment D.14 - Country Codes.xlsx XLSX spreadsheet
Attachment D.8 - Bills of Materials VISN 15 Amended.xlsx XLSX spreadsheet
Attachment D.6 - Bills of Materials VISN 10 Amended.xlsx XLSX spreadsheet
Attachment D.10 - Bills of Materials VISN 23 Amended.xlsx XLSX spreadsheet
36C77625R0017 0001 Custom Packs Amendment.pdf PDF
Attachment D.7 - Bills of Materials VISN 12 Amended.xlsx XLSX spreadsheet
Attachment D.11 - Three Sample Packs-Bills of Materials Amended.xlsx XLSX spreadsheet
Attachment D.5 - Bills of Materials VISN 9 Amended.xlsx XLSX spreadsheet
Attachment D.2 - Schedule of Items - Custom Packs Amended.xlsx XLSX spreadsheet
Attachment D.9 - Bills of Materials VISN 16 Amended.xlsx XLSX spreadsheet
Attachment D.4 - Bills of Materials VISN 5 Amended.xlsx XLSX spreadsheet
Attachment D.8 - Bills of Materials VISN 15.xlsx XLSX spreadsheet
Attachment D.13 - Custom Pack Experience.docx DOCX document
Attachment D.2 - Schedule of Items - Custom Packs.xlsx XLSX spreadsheet
Attachment D.4 - Bills of Materials VISN 5.xlsx XLSX spreadsheet
Attachment D.5 - Bills of Materials VISN 9.xlsx XLSX spreadsheet
36C77625R0017_1.docx DOCX document
Attachment D.12 - Sample Pack Evaluation Checklist.pdf PDF
Attachment D.6 - Bills of Materials VISN 10.xlsx XLSX spreadsheet
Attachment D.3 - Custom Pack Monthly Reporting Tool.xlsx XLSX spreadsheet
Attachment D.1 - Delivery Locations.pdf PDF
Attachment D.10 - Bills of Materials VISN 23.xlsx XLSX spreadsheet
Attachment D.9 - Bills of Materials VISN 16.xlsx XLSX spreadsheet
Attachment D.7 - Bills of Materials VISN 12.xlsx XLSX spreadsheet
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#1 BASIC PACK

Solicitation 36C77625R0017 - Custom Sterile Procedure Packs
Pack Name
BASIC PACK (sample #1): If providing an alternate, it shall be equal to the item requested (complete columns G - H).
Customer Fill In (1 of 3) Pack Components
Component NamesManufacturer NameManufacturer Part No.Country of OriginUnit of Issue

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

See Unit of Issue Codes TabQty per packSubstitution Permitted (Y/N)Alternate ManufacturerAlternate Manufacturer Part No.Alternate's Country of Origin
BAG BEDSIDE UTILITY LARGE 6 X 12Tidi Products950251EA1N
TRAY RECTANGULAR 11X9.5X2Spt Plastics614OREA1N
YANKAUER SUCTION INSTRUMENT W/BULB TIPRobert Busse Hospital Disposable2986EA1N
GAUZE 4 X 4 16-PLY SPONGE X-RAY NSAMD Ritmed6006EA10N
SYRINGE 10-12ML LUER-LOKTransfersSYR110010EA3N
BLADE NO.15 CS RIB NEWOR NecessitiesMDS15015LBNEA1N
NDL CNTR 20CT FM MAGOR NecessitiesNS9102EA1N
SUCTION TUBING, 1/4" X 12', NON- STERILECardinal Health Medical Products428779EA1N
MAYO STAND COVER 23 X 54 E SMS REINFORCEO&M Halyard Inc78656EA1N
TOWEL OR BLUEPrimary Care14937EA4N
TOWEL, 18 X 21, ABSORBENT, WH, FOLDEDEVS Plus75289EA4N
GOWN SURG XL PREV PLUSProximaSPT-2307PTMEA3N
TOWEL OR BLUEProxima14937EA1N
TABLE COVER, 50" X 90", BULK FOLDOR SpecialitiesPE61024EA1N
DNQ pouch BR 17.25x22.75 3MLSPT Packaging49803EA1N
CTN 24 1/4X14 1/4X26 1/2 UNPTDAnesthesia335673EA1N
Customer Fill In (2 of 3 ) Interior Labels/Exterior Labels/Packaging/Cartons
Label/Package/Carton NameBrief Description from BOMPack Level or Case Level

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

Is the label for a case or an individual pack

INTERIOR LABELLabel is located inside the dust cover on top of the contents, front side.Pack
Label shall contain PACK NAME AND CONTENTS (OR) COMPONENT DETAILS
Label to include country of origin for each item in parethesis after item description
Label shall state "DISPOSABLE - SINGLE USE ONLY"
Label shall state HOSPITAL NAME, CATALOG NUMBER, LOT NUMBER, USE BY DATE, CONTRACT NUMBER, STATION NUMBER, DATE OF MFG
At the bottom of the label it shall state "NOTE. **ONLY THE COMPONENTS MARKED WITH THE SYMBOL IN THE LIST ABOVE CONTAIN LATEX."
**See Image 1 for example**
IMAGE 1
This is label tear here blank.
EXTERIOR LABELThis is label to be placed on exterior shipping carton. Label shall state Product Number, Pack Description, Expiration Date, Case Quantity, Sample Pack Number, Vendor Name, Facility Name and Address. (If Applicatable) Contains Latex MaterialPack
**See Image 1 for example**
Customer Fill In (3 of 3) Special Packaging Requirements
Special Packaging Requirement Name (i.e.. Sterilization, configuration etc.)Brief Description from BOMComponent OR Entire Pack

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

If for a component, enter manufacturer part number. If for the entire pack enter "entire pack"

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

Is the label for a case or an individual pack Configuration See images below. Entire pack

Photo Examples

Figure 1 Figure 2 Figure 3

Figure 2

Basic Pack contents label inside dust cover on top of outer wrap, shall be visible.

Figure 2 = top of pack Figure 9 = bottom of pack

Components wrapped in 1 each blue wrap, 50 x 90 bulk fold1 each OR blue towel,
3 each XL gowns4 each towels, 18 x 21, white, absorbent, folded
Figure 4Figure 5Figure 6

4 each OR towels Blue, Lint Free 1 each mayo stand cover, 23 x 54 E SMS reinforce 1 each #15 blade, 3 each syringe 10 CC, 1 each 10-pack gauze, 4x4 ply, sponge, x-ray detectable, non-sterile, 1 each suction tubing, 1/4"x12' non-sterile, Figure 7 Figure 8 Figure 9

1 each needle counter 20 count open just to show which is in Figure 6 1 each tray rectangular 11.9.5 x 2, 1 NDL CNTR (needle holder) 20 count FM MAG.

All items in Figures 2 - 7 shall be placed inside the tray.

Items listed in Figure 9 shall be placed under the tray 1 each bedside bag

#2 GENERAL SURGERY PACK

Pack Name
General Surgery Pack (sample #2): If providing an alternate, it shall be equal to the item requested (complete columns G - H).
Customer Fill In (1 of 3) Pack Components
Component NamesManufacturer NameManufacturer Part No.Country of OriginUnit of Issue

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

See Unit of Issue Codes TabQty per packSubstitution Permitted (Y/N)Alternate ManufacturerAlternate Manufacturer Part No.Alternate's Country of Origin
SYR 50CC BULBC. R. BARD INC.(UROLOGICAL)0935280EACH1N
SYR 10CC L/LBECTON DICKINSON AND CO301029EACH2N
BLADE #15 CARBASPEN SURGICAL PRODUCTS INC371115EACH2N
BAG 7WX10L POLY 2MLCANTWELL-CLEARY CO.20F-0710EACH1N
MASTISOL 2/3CC VIALFERNDALE LABORATORIES INC052348EACH1N
TRAY FOAM 18 X 14 X 5/8VERITIV OPERATING COMPANY10265242EACH1N
COUNTER NDL DBL MAG XLG 60CTCARDINAL HEALTHCARE31155297EACH1N
GAUZE SPONGE 4X8 12PLY XR 10'SCARDINAL HEALTHCARE7462EACH10N
PAD TELFA 8 X 3 2 SIDE MYLARCARDINAL HEALTHCARE12388EACH1N
STRIP STERI 1/4 X 4 5'S3M COMPANYR1546NSEACH1N
LABEL CUST. PRE-PRINT. SURVEYR R DONNELLEY & SONS COSURVEY FORMEACH1N
TAPE CLOSURE LABEL LOGOMASA CORPORATION10702386/10702387EACH2N
LABEL 3 1/2 X10R R DONNELLEY & SONS CO3510EACH1N
TEGADERM 4 X 4.753M COMPANY1626WNSEACH2N
BAG HEADER 21 X 30BEMIS HEALTHCARE PACKAGING100000098258EACH1N
BAG SUTURE CLEAR 20X18 W/TAPECLARK CONTAINER INC2018EACH1N
NDL 25G X 1.5' SAFETYBECTON DICKINSON AND CO305767EACH2N
CORRECT MED LABEL SYSTEMANSELL SANDEL MEDICAL3300PNSEACH1N
CARTON23X15X23 SWWESTROCK CP LLC519720EACH1N
GOWN XLG FAB REIN ULTRAHALYARD SALES LLC79512EACH1N
GOWN LG FAB REIN ULTRAO&M HALYARD INC79511EACH1N
CAUTERY ROCKER W/EDGE BLADEUS SURGICAL CORPORATIONE2350H-GNSBEACH1N
TOWEL ABSORB. WHITE 17 X 20LITTLE RAPIDS CORP - OEM50585EACH1N
TOWEL ABSORB. WHITE 17 X 20LITTLE RAPIDS CORP - OEM50585EACH1N
POUCH TYVEK 8' X 12'AMCOR FLEXIBLES HEALTHCARE INC027710EEACH1N
TOWEL OR BLUE XR W/GOLD STITCHUS MEDCO INCTOWELXRNSB BLUE 400EACH10N
LAP SPONGE 18X18 XR 5S NO RINGUS MEDCO INC1818 W1900PACK5N
COVER TABLE 60 X 90 HDO&M HALYARD INC42307NSEACH1N
LINER POLY 43X48 16 MICATLANTIC CORPORATION17-50500EACH1N
LABELS- DOT BLANK LIMITEDULINE SHIPPING SUPPLIESS-17372EACH1N
DRAPE XLG 76' X 96' HANDIBINO&M HALYARD INC47632EACH1N

Label/Package/Carton Name Brief Description from BOM Pack Level or Case Level Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

Is the label for a case or an individual pack

INTERIOR LABELLabel is located inside the dust cover on top of the contents, front side.Pack
Label shall contain PACK NAME AND CONTENTS (OR) COMPONENT DETAILS
Label to include country of origin for each item in parethesis after item description
Label shall state "DISPOSABLE - SINGLE USE ONLY"
Label shall state HOSPITAL NAME, CATALOG NUMBER, LOT NUMBER, USE BY DATE, CONTRACT NUMBER, STATION NUMBER, DATE OF MFG
At the bottom of the label it shall state "NOTE. **ONLY THE COMPONENTS MARKED WITH THE SYMBOL IN THE LIST ABOVE CONTAIN LATEX."
**See Image 1 for example**
IMAGE 1
This is label tear here blank.
EXTERIOR LABELThis is label to be placed on exterior shipping carton. Label shall state Product Number, Pack Description, Expiration Date, Case Quantity, Sample Pack Number, Vendor Name, Facility Name and Address. (If Applicatable) Contains Latex MaterialPack
**See Image 1 for example**
Customer Fill In (3 of 3) Special Packaging Requirements
Special Packaging Requirement Name (i.e.. Sterilization, configuration etc.)Brief Description from BOMComponent OR Entire Pack

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

If for a component, enter manufacturer part number. If for the entire pack enter "entire pack"

Is the label for a case or an individual pack Configuration See images below. Entire pack

Photo Examples

Figure 1 Figure 2 Figure 3

Figure 2

General Surgery Pack contents label inside dust cover on top of Cover, Table 60X90 HD.1 each Drape XLG 76"X96" Handibin,
1 each Towel, Absorb. White 17X201 each Towel, Absorb. White 17 x 20, white, 1 each Gown, LG Fab Rein Ultra
Figure 4Figure 5Figure 6

1 each Gown, XLG Fab Rein Ultra, 1 each Gauze Sponge 4X8 12 Ply XR 10's Pouch, Tyvek 8"X12" with contents listed in Figure 6 1 each Strip, Steri 1/4X4, 5's 2 each Tegaderm, 4X4.75 1 each Mastisol, 2/3 cc, Vial 1 each Pad, Telfa 8X3, 2 side Mylar Figure 7 Figure 8 Figure 9

10 each Towel OR Blue XR W/Gold Stitch, 1 each Cautery, Rocker W/Edge Blade, 1 each Syr, 50CC Bulb, 1 each Lap Sponge 18X18 XR 5S No Ring, 1 each Bag, 7WX10L Poly 2ML with contents shown in Figure 8. 1 each Counter, Ndl Dbl Mag XLG 60Ct, 1 each Correct Med Label System, 2 each Blade, #15 Carb, 2 each Ndl, 25GX1.5" Safety, 2 each Syr, 10cc L/L 1 each Bag, Suture Clear 20X18 W/Tape on top of 1 each Tray, Foam 18X14X5/8

#3 UROLOGY PACK

Pack Name
Urology Pack (sample #3): If providing an alternate, it shall be equal to the item requested (complete columns G - H).
Customer Fill In (1 of 3) Pack Components
Component NamesManufacturer NameManufacturer Part No.Country of Origin

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

See Unit of Issue Codes Tab Unit of Issue Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

See Unit of Issue Codes TabQty per packSubstitution Permitted (Y/N)Alternate ManufacturerAlternate Manufacturer Part No.Alternate's Country of Origin
SYR 30CC L/LBECTON DICKINSON AND CO301033EA1N
LEGGING 31 X 48O&M HALYARD INC79027EA2N
DRAPE CYSTO TO&M HALYARD INC79540EA1N
SET IRRIG Y TYPE DRIP CHMBRBAXTER - IV SYSTEMS2C4041EA1N
LABEL CUST. PRE-PRINT. SURVEYR R DONNELLEY & SONS COSURVEY FORMEA1N
TAPE CLOSURE LABEL AVID LOGOMASA CORPORATION10702386/10702387EA1N
TAPE CLOSURE LABEL AVID LOGOMASA CORPORATION10702386/10702387EA1N
LABEL 3 1/2 X10R R DONNELLEY & SONS CO3510EA1N
BAG HEADER 19 X 30BEMIS HEALTHCARE PACKAGING100000098082EA1N
CARTON23X15X23 SWWESTROCK CP LLC519720EA1N
GOWN XLG FAB REIN ULTRAHALYARD SALES LLC79512EA1N
TOWEL ABSORB. WHITE 17 X 20LITTLE RAPIDS CORP - OEM50585EA2N
SYR 60CC CATH TIPCARDINAL HEALTHCARE8881160256EA1N
COVER TABLE 60 X 90 HDO&M HALYARD INC42307NSEA1N
LINER POLY 43X48 16 MICATLANTIC CORPORATION17-50500EA1N
DRAPE XLG 76' X 96' HANDIBINO&M HALYARD INC47632EA1N
Customer Fill In (2 of 3 ) Interior Labels/Exterior Labels/Packaging/Cartons
Label/Package/Carton NameBrief Description from BOMPack Level or Case Level

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

Is the label for a case or an individual pack

INTERIOR LABELLabel is located inside the dust cover on top of the contents, front side.Pack
Label shall contain PACK NAME AND CONTENTS (OR) COMPONENT DETAILS
Label to include country of origin for each item in parethesis after item description
Label shall state "DISPOSABLE - SINGLE USE ONLY"
Label shall state HOSPITAL NAME, CATALOG NUMBER, LOT NUMBER, USE BY DATE, CONTRACT NUMBER, STATION NUMBER, DATE OF MFG
At the bottom of the label it shall state "NOTE. **ONLY THE COMPONENTS MARKED WITH THE SYMBOL IN THE LIST ABOVE CONTAIN LATEX."
**See Image 1 for example**
This is label tear here blank.
EXTERIOR LABELThis is label to be placed on exterior shipping carton. Label shall state Product Number, Pack Description, Expiration Date, Case Quantity, Sample Pack Number, Vendor Name, Facility Name and Address. (If Applicatable) Contains Latex MaterialPack
**See Image 1 for example**
Customer Fill In (3 of 3) Special Packaging Requirements
Special Packaging Requirement Name (i.e.. Sterilization, configuration etc.)Brief Description from BOMComponent OR Entire Pack

Mason, Brian C CIV DLA TROOP SUPPORT (USA): Mason, Brian C CIV DLA TROOP SUPPORT (USA):

If for a component, enter manufacturer part number. If for the entire pack enter "entire pack"

Is the label for a case or an individual pack Configuration See images below. Entire pack

Photo Examples

Figure 1 Figure 2 Figure 3

Figure 2

Urology Pack contents label inside dust cover on top of Cover, table 60 X 90 HD, shall be visible.1 Drape XLG 76" X 96" Handibin2 each towels, asorb. White 17 x 20, white, absorbent, 1 each Gown,XLG Fab Rein Ultra
Figure 4Figure 5Figure 6

2 each Legging 31 X 48 1 set, Irrig Y Type Drip Chmbr, 1 each Syr, 30CC L/L, 1 each Syr, 60CC Cath Tip 1 each Drape, Cysto T image1.png image10.png image11.png image2.png image3.png image4.png image5.png image6.png image7.png image8.png image9.png image12.png image21.png image22.png image13.png image14.png image15.png image16.png image17.png image18.png image19.png image20.png image23.jpeg image24.png image25.png image26.png image27.png image28.png image29.png

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