ATTACHMENT E - QUARTERLY REPORT TEMPLATE.xlsx
XLSX spreadsheet 17 KB Posted
- Attached to
- 6515--Amendment P0002 | Follow-On Blanket Purchase Agreement (BPA) Electrophysiology (EP) Catheters
- Solicitation number
- 36C10G21R0010
About this file
This document contains a quarterly report template for tracking purchase orders and credit card orders against blanket purchase agreements for electrophysiology catheters. The template includes fields for the BPA and order numbers, clinical item or service category, date, quantity or labor hours, unit type and cost, and station and program office codes. It appears to be a standardized spreadsheet for vendors to report quarterly spending data to the Department of Veterans Affairs for BPAs under solicitation number 36C10G21R0010. This solicitation is for a follow-on BPA for up to 60 months for the acquisition of electrophysiology catheters from multiple contractors. The catheters and products will be used for diagnostic testing and treatment for both invasive and non-invasive cardiac procedures. Contractors must ensure any provided products are FDA approved under the 510K program and properly labeled.
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Other files
| File | Type | Posted |
|---|---|---|
| Line Items Template -Sample.xlsx | XLSX spreadsheet | |
| 36C10G21R0010 0002.docx | DOCX document | |
| 36C10G21R0010 0001_1.docx | DOCX document | |
| Amendment 0001_ EP Catheters_ 36C10G21R0010 .docx | DOCX document | |
| ATTACHMENT F_ SF1449 36C10G21R0010_EP CATHETERS.docx | DOCX document | |
| 36C10G21R0010.docx | DOCX document | |
| ATTACHMENT D_ JJBW_PRICE COST LIST.xlsx | XLSX spreadsheet |
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Text version
Purchase Orders
| Quarterly Report Date: |
| Vendor: |
| BPA# | VA119-14-X-XXXXXX | |||||||
| Order # | VAXXX-1X-X-XXXX | |||||||
| Purchase Order | CLIN (item type, service category) | DATE | QUANTITY/LABOR HOURS | UNIT TYPE (ie., EA) | UNIT COST ($)/LABOR COST ($/HR) | Station Code | Program Office Code | Total |
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| Total | $ - 0 |
| BPA# | VA119-14-X-XXXXXX | |||||||
| Order # | VAXXX-1X-X-XXXX | |||||||
| Purchase Order # | CLIN (item type, service category) | DATE | LABOR HOURS/UNIT COST | UNIT TYPE (ie., EA) | UNIT COST ($) | Station Code | Program Office Code | Total |
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| Total | $ - 0 |
Credit Card Orders
| Quarterly Report Date: |
| Vendor: |
| BPA# | 36C10G21-X-XXXXXX | |||||||
| Order # | 36C10X-X-XXXX | |||||||
| Credit Card | CLIN (item type, service category) | DATE | QUANTITY/LABOR HOURS | UNIT TYPE (ie., EA) | UNIT COST ($)/LABOR COST ($/HR) | Station Code | Program Office Code | Total |
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| Total | $ - 0 |
| BPA# | VA119-14-X-XXXXXX | |||||||
| Order # | VAXXX-1X-X-XXXX | |||||||
| Credit Card | CLIN (item type, service category) | DATE | LABOR HOURS/UNIT COST | UNIT TYPE (ie., EA) | UNIT COST ($) | Station Code | Program Office Code | Total |
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| $ - 0 | ||||||||
| Total | $ - 0 |
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