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36C24926Q0154 – Onsite Mobile Lithotripsy Service – James H. Quillen VA Medical Center D.5
SCHEDULE OF SERVICES
| ITEM NUMBER |
| DESCRIPTION OF SERVICES |
| ESTIMATED QUANTITIES |
| UNIT OF MEASURE |
| UNIT PRICE |
| TOTAL AMOUNT |
ORDERING PERIOD:___
| 0001 |
| Mobile Lithotripsy Laser Equipment and Services Radiologic Technologist to operate Extracorporeal Shock Wave Lithotripsy with C-Arm |
| 200 |
| CASE |
| 0002 |
| Lithotripsy Services |
| 15 |
| CASE |
| 0003 |
| Holmium Laser System, 20watt: Laser, medium beam, 2100nm wavelength, beam focusing mechanism, 650 nm wavelength diode laser visible red-aiming beam, American National Standards Institute (ANSl)-standard laser safety glasses and goggles, laser safety signs, delivery and set-up system, Medical Laser Safety Awareness |
| 15 |
| CASE |
| 0004 |
| Holmium Laser System, 100watt: Laser, medium beam, 2100 nm wavelength, beam focusing mechanism, 650 nm wavelength diode laser visible red-aiming beam, ANSI standards laser safety glasses and goggles, laser safety signs, delivery and set-up system, Medical Laser Safety Awareness (MLSA) - Certified Assistant to operate system. |
| 7 |
| CASE |
| 0005 |
| Green Light XPS Laser System, 180 watts: Laser with XPS Fiber, ANSI-standard laser safety glasses, laser safety signs and goggles, delivery, and set-up system, Medical Laser Safety Awareness (MLSA) - Certified Assistant to operate system . |
| 25 |
| CASE |
| 0006 |
| Aura XP Laser System, 15 watts: Laser, 532 nm pulsed wavelength, fiber delivery system, ANSI-standard laser safety glasses and goggles, laser safety signs, delivery, and set-up system, Medical Laser Safety Awareness (MLSA) - Certified Assistant to operate system. |
| 5 |
| CASE |
| 0007 |
| Extracorporeal Shock Wave Lithotripsy with C-Arm, Radiologic Technologist to operate system and appropriate fibers for this equipment |
| 5 |
| CASE |
| 0008 |
| CO2 (Carbon Dioxide) Laser System: Laser, free beam, 10,650 nm wavelength, continuous wave, ANSI- standard laser safety glasses and goggles, laser safety signs, delivery, and set-up system, Medical Laser Safety Awareness (MLSA) - Certified Assistant to operate system. |
| 5 |
| CASE |
| 0009 |
| Extracorporeal Shock Wave Lithotripsy with C-Arm, Radiologic Technologist to operate system and appropriate fibers for this equipment |
| 15 |
| CASE |
| 0010 |
| Single use Holmium Fibers |
| 15 |
| EACH |
| 0011 |
| 150 - 300 Single use Holmium Fibers |
| 10 |
| EACH |
| 0012 |
| 301 - 400 Single use Holmium Fibers |
| 10 |
| EACH |
| 0013 |
| 550 Single use Holmium Fibers |
| 8 |
| EACH |
| 0014 |
| 900 - 1,000 Single use Holmium Fibers |
| 8 |
| EACH |
| 0015 |
| Fibers for the Green light XPS Laser System |
| 35 |
| EACH |
| 0016 |
| Fibers for the Aura XP Laser System |
| 8 |
| EACH |
| 0017 |
| Fibers for the CO2 Flex Fiber Laser System |
| 7 |
| EACH |
| 0018 |
| Boston Scientific Xpeeda 550 DSL Fiber, Side-firing, Holmium Fiber |
| 20 |
| EACH |
| 0019 |
| Other Holmium Fiber approved for use during the term of this contract |
| 10 |
| EACH |
| 0020 |
| Stand-by/Cancellation charges for items 1-7 above. If VA staff performing procedure determines that the use of the laser is not required, a stand-by/cancellation charge will be incurred when Medical Laser Safety Awareness (MLSA) - Certified Assistant and laser are in the Operating Room. |
| 35 |
| CASE |
| TOTAL PRICE FOR ORDERING PERIOD:___ |
| $___________________________ |
ORDERING INSTRUCTIONS:
ORDERS: This is a Fixed-Price Blanket Purchase Agreement. There will be no exercise of options as this BPA period of performance is continuous during the time from of 05/01/2026 through 04/30/2031. Funds will be obligated on individual Call Orders as they are unilaterally issued by a Contracting Officer, ensuring that each Call Order is fully funded to cover the scope of the work specified. This approach complies with all statutory and regulatory requirements, including the Anti-Deficiency Act, which prohibits the obligation of funds in advance of in excess of appropriations, and all applicable appropriations laws to ensure proper fiscal management and accountability. Each Call Order shall have an established period of performance or delivery date. Individual Call Orders will not exceed a 12 month period.
