ATTACHMENT D_Price Cost Schedule_36C10X26Q0119.xlsx

XLSX spreadsheet 23 KB Posted

Attached to
6515--Duodenoscope Image Controller FAR 6. 103-1 Only One Responsible Source
Solicitation number
36C10X26Q0119
Issued by

About this file

This is a Price Cost Schedule template for a Request for Quotation (RFQ) solicitation 36C10X26Q0119 issued by the Department of Veterans Affairs Strategic Acquisition Center for Boston Scientific EXALT Model D Duodenoscope Image Controllers (Part Number M00542430). The procurement is conducted under FAR 6.103-1 (Only One Responsible Source authority), with the intended source being Veterans Healthcare Supply Solutions (VHSS), a Service Disabled Veteran Owned Small Business. The schedule requires quoters to submit proposed unit prices for a single line item (CLIN 0001) across a base year and four option years, with estimated quantities of 20 units per year. Quoters must complete all yellow-highlighted spaces in the template, including proposed unit prices, a 3% Service Level Agreement (SLA) fee, total evaluated prices by year, delivery timeframe in days after receipt of order (ARO), and commercial pricing reference.

The template accommodates both the Boston Scientific OEM solution and equivalent products from alternative sources, requiring quoters proposing equivalent items to provide manufacturer name, description, and part numbers. All calculations must be verified for accuracy by the quoter, and the pricing submitted must align with the technical proposal. This acquisition is structured as a single combined synopsis and solicitation with no separate written solicitation to follow, and quoters must reference ATTACHMENT B for the detailed product description and specifications. Quoters proposing solutions other than the specified Boston Scientific controller must clearly identify their proposed manufacturer and equivalent product information in the designated columns.

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Other files

File Type Posted
Attachment A_ RFQ 36C10X26Q0119.pdf PDF
ATTACHMENT C_Sales Reporting Tool_36C10X26Q0119.xlsx XLSX spreadsheet
ATTACHMENT E_Template for Industry Questions_36C10X26Q0119.xlsx XLSX spreadsheet
36C10X26Q0119_2.docx DOCX document
ATTACHMENT B_Product Description_36C10X26Q0119.docx DOCX document

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Text version

EXALT CONTROLLER

CLINManufacturer NameManufacturer Part NumberItem DescriptionUnit of Measure (UOM)Estimated Quantity (Base Year)Estimated Quantity (Opt Year 1)Estimated Quantity (Opt Year 2)Estimated Quantity (Opt Year 3)Estimated Quantity (Opt Year 4)Manufacturer NameManufacturer Part NumberItem DescriptionContractor Part Number (if different from OEM)Unit of MeasureQuantity per UOMDelivery Days AROCommercial PriceProposed Unit
Price (Base Year)SLA (3%)Total Price (Unit Price plus SLA)
Base YearProposed Unit
Price (Option Year 1)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 1Proposed Unit
Price (Option Year 2)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 2Proposed Unit
Price (Option Year 3)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 3Proposed Unit
Price (Option Year 4)SLA (3%)Total Price (Unit Price plus SLA)
Option Year 4Total Evaluated Price (with 3% SLA and estimated quantities) - Base YearTotal Evaluated Price (with 3% SLA and estimated quantities) - Option Year 1Total Evaluated Price (with 3% SLA and estimated quantities) - Option Year 2Total Evaluated Price (with 3% SLA and estimated quantities) - Option Year 3Total Evaluated Price (with 3% SLA and estimated quantities) - Option Year 4Total Evaluated Price
0001Boston ScientificM00542430EXALT CONTROLLEREA2020202020$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$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$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$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$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$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$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
Totals:$0.00$0.00$0.00$0.00$0.00$0.00
*OFFEROR IS TO COMPLETE ALL "YELLOW" HIGHLIGHTED SPACES
**ARO = Delivery Days After Receipt of Order
Quoters proposing equivalent product must enter Name of Manufacturer for its proposed solution, Description and Part Number(s), etc. starting at Column K. If the Quoter’s proposed solution does not require a particular CLIN, the Quoter shall indicate such by writing N/A, None, or Zero (0). Also, the items priced in the Pricing volume must correspond with the items proposed in Quoter’s Technical volume as the brand name or equivalent solution. NOTE: Quoters are responsible for ensuring that all calculations are correct.

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