D.1 Reference Contract Worksheet.docx
DOCX document 18 KB Posted
- Attached to
- Q201--In-Home Oxygen and In-home Ventilator Services Southern Arizona VA Health Care System
- Solicitation number
- 36C26221R0121
About this file
This document provides details for an upcoming federal contract opportunity with the Department of Veterans Affairs for in-home oxygen and ventilator services. The Southern Arizona VA Healthcare System seeks a contractor to provide oxygen and ventilator equipment, delivery, set-up, instruction and maintenance for approximately 1,800 patients receiving in-home oxygen services and 10 patients receiving in-home ventilator services. All offerors must be registered in the System for Award Management database and verified in the Vet-Biz Registry. The contract will be an Indefinite Delivery/Indefinite Quantity contract with Firm-Fixed Prices issued on or around August 10, 2021 via solicitation on SAM.gov. No questions will be answered prior to the solicitation release.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C26221R0121 0003.docx | DOCX document | |
| 36C26221R0121 0002.docx | DOCX document | |
| Amendment 0002_Updated D.3 Pricing Worksheet SAVAHCS (Tucson).xlsx | XLSX spreadsheet | |
| D.5 VHA Directive 1193 COVID 2019 Vaccination Program.pdf | ||
| 36C26221R0121 0001.docx | DOCX document | |
| D.2.6 DOL Wage Determination Yuma County.docx | DOCX document | |
| D.2.5 DOL Wage Determination Maricopa _ Pinal Counties.docx | DOCX document | |
| D.3 Price Worksheet SAVAHCS.xlsx | XLSX spreadsheet | |
| 36C26221R0121_1.docx | DOCX document | |
| D.2.4 DOL Wage Determination Pima County.docx | DOCX document | |
| D.2.1 DOL Wage Determination Cochise County.docx | DOCX document | |
| D.2.3 DOL Wage Determination La Paz County.docx | DOCX document | |
| D.4 Geographic Coverage Area_SAVAHCS.docx | DOCX document | |
| D.2.2 DOL Wage Determination Graham_Greenlee_Santa Cruz Counties.docx | DOCX document |
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Text version
Attachment D.1 – Reference Contract Worksheet for Offeror’s Response to Factor 1 – Experience Reference Contract Number ______
| The legal name of entity with whom the Offeror held the contract |
| (examples: Molina Healthcare, VA Long Beach Healthcare system, VISN 22 |
Contract Number
Whether the contract was for in-home oxygen services, in-home ventilator services or both
A description providing details of the specific tasks the Offeror performed under that Contract
| In what geographic location the Offeror performed these services |
| (example: Los Angeles and Orange counties) |
The dates during which the Offeror performed the contract
| The number of patients to whom the Offeror provided in-home oxygen services or in-home ventilator services, or both, under that contract – break out and specify numbers separately for in-home oxygen services and in-home ventilator services |
| Number of in-home oxygen patients served each month __________ |
Number of in-home ventilator patients served each month __________
Whether the provided reference contract is for services provided by the Offeror or provided by a proposed subcontractor of the Offeror’s
Whether the Offeror or its proposed subcontractor was the prime contractor or a subcontractor for that provided reference contract
The name, phone number, and email address of a person at the entity with whom the Offeror (or Offeror’s proposed subcontractor) held the contract who can verify the information the Offeror provides in the narrative description for this factor
File details come from the government source that posted it. Updated .