Exhibit L. Unit Price List.pdf

EXHIBIT L

RLP NO. 36C24421R0073

LEASE NO. 36C24422L0018

Legend: C = Contractor, V = VA

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

EXAM/TREATMENT ROOM (ETM) OFDO1 18

C/C A5180

TRACK, CUBICLE CURTAIN, SURFACE MOUNTED,

W/CURTAIN 1

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) 1

C/C

STAND ALONE HANDWASHING SINK (VITREOUS CHINA

W/FAUCET) 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C HAND SANITIZER, WALL MOUNTED 1

V/C F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V DESK, MOBILE 1

V/V F2000 BASKET, WASTEPAPER 1

V/V M1801 LAP TOP, DOCKING STATION W/FLAT PANEL MONITOR 1

V/V M9025 TABLE, EXAMINATION/TREATMENT 1

V/V A5106 SHARPS CONTAINER, WALL MOUNTED 1

V/V F0205 CHAIR, SIDE WITH ARMS 2

V/V F0340 STOOL, SELF ADJUSTING 1

V/V M7905 MOBILE ELECTRONIC VITAL SIGNS MONITOR 1

Contractor to Complete

UNIT PRICE LIST

V.A. COMMUNITY BASED OUTPATIENT CLINIC

Lease Title: CRAWFORD CBOC

RLP 36C224421R0073

VHA OUTPATIENT CLINIC SPACE PLANNING CRITERIA

TREATMENT ROOM, EXAM

INITIALS: ______ Lessor ________ Gov't Page 1

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V M4100

INTEGRATED WALL SYSTEM (OTOSCOPE,

OPTHALMOSCOPE, THERMOETER, MANUAL BP) 1

SUBTOTAL

EXAM/TREATMENT ROOM (ETM) OFDO1 3

C/C A5180

TRACK, CUBICLE CURTAIN, SURFACE MOUNTED,

W/CURTAIN 1

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) 1

C/C

STAND ALONE HANDWASHING SINK (VITREOUS CHINA

W/FAUCET) 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C HAND SANITIZER, WALL MOUNTED 1

V/C F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V DESK, MOBILE 1

V/V F2000 BASKET, WASTEPAPER 1

V/V M1801 LAP TOP, DOCKING STATION W/FLAT PANEL MONITOR 1

V/V A5106 SHARPS CONTAINER, WALL MOUNTED 1

V/V F0205 CHAIR, SIDE WITH ARMS 2

V/V F0340 STOOL, SELF ADJUSTING 1

V/V M7905 MOBILE ELECTRONIC VITAL SIGNS MONITOR 1

V/V M4100

INTEGRATED WALL SYSTEM (OTOSCOPE,

OPTHALMOSCOPE, THERMOETER, MANUAL BP) 1

SUBTOTAL

EXAM/TREAMENT MODULES (ETM) EXRG4 2

ANCILLARY SERVICE, EXAM

SPECIALTY EXAM ROOM

INITIALS: ______ Lessor ________ Gov't Page 2

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A5180

TRACK, CUBICLE CURTAIN, SURFACE MOUNTED,

W/CURTAIN 1

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C LIFT, PATIENT 625LB CEILING MOUNTED (Required in only one of the exam rooms) 1

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) 1

C/C

STAND ALONE HANDWASHING SINK (VITREOUS CHINA

W/FAUCET) 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C HAND SANITIZER, WALL MOUNTED 1

V/C F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V DESK, MOBILE 1

V/V F2000 BASKET, WASTEPAPER 1

V/V M1801 LAP TOP, DOCKING STATION W/FLAT PANEL MONITOR 1

V/V M9025 TABLE, EXAMINATION/TREATMENT 1

V/V A5106 SHARPS CONTAINER, WALL MOUNTED 1

V/V F0205 CHAIR, SIDE WITH ARMS 2

V/V F0340 STOOL, SELF ADJUSTING 1

V/V M7905 MOBILE ELECTRONIC VITAL SIGNS MONITOR 1

V/V M4100

INTEGRATED WALL SYSTEM (OTOSCOPE,

OPTHALMOSCOPE, THERMOETER, MANUAL BP) 1

SUBTOTAL

SUPPORT 1

C/C RECEPTACLES, DUPLEX 1

WHEEL CHAIR SCALE LOCATION

INITIALS: ______ Lessor ________ Gov't Page 3

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

V/C IN-FLOOR WHEELCHAIR SCALE 1

SUBTOTAL

EXAM/TREAMENT MODULES (ETM) TLTM1 4

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C A5109 GRAB BARS, SS, 1 1/4" DIA. AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 1

C/C A5165 SHELF T-45, SS, 12"WX5"D 1

C/C A5200 DISPENSER, TOILET PAPER W/UTILITY SHELF, SS, 2-ROLL 1

C/C P-418 LAVATORY, VITREOUS CHINA, WITH FAUCET 1

C/C

NURSE CALL PULL CHORD, STATION, 2-WALL MOUNTED

LIGHTS 1

C/C P-103 TOILET, WALL HUNG, W/SEAT 1

C/C SMALL WALL MOUNTED WASTE RECEPTACLE 1

C/C TOILET SEAT COVER HOLDER, WALL MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

SUBTOTAL

EXAM/TREATMENT MODULES (ETM) MEDP1 1

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, QUAD 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C C0200 CABINET, BASE, 4 DRAWER, 96X24X22 1

C/C C1050 COUNTERTOP, SS, W/INTERGRAL BACKSPLASH 1

C/C CS090

SINK, SS, SINGLE COMPATMENT, INTERGAL W/SS TOP

7.5X19X16 ID 1

MEDICATION ROOM

PATIENT TOILET, UNISEX (BHS/PRIMARY CARE)

INITIALS: ______ Lessor ________ Gov't Page 4

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C CG050

CABINET, WALL 2 SHELF, SLIDING GLASS DOOR, SLOPING

TOP 38X48X13 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V A5106 SHARPS CONTAINER, WALL MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V R6200 REFRIGERATOR, 5 CU FT 1

V/V FREEZER 1

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

SUBTOTAL

EXAM/TREATMENT MODULES (ETM) CRA01 AR

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE AR

C/C RECEPTACLES, QUAD AR

C/C

ELECTIRCAL & DATA CONNECTIONS TO MODULAR

FURNITURE AR

C/C F2310 RACK, PAMPHLET WALL MOUNTED AR

V/V F0275 CHAIR, SWIVEL, HIGH BACK AR

V/V MODULAR FURNITURE AR

V/V F2000 BASKET, WATEPAPER AR

V/V F3200 CLOCK, BATTERY 12" DIAMETER AR

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR AR

V/V M1825 PRINTER/FAX/SCANNER AR

SUBTOTAL

ADMINISTRATION 1

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 6

HBPC SHARED OFFICE SPACE

PACT AND ANCILLARY PACT SHARED WORK AREA

INITIALS: ______ Lessor ________ Gov't Page 5

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C RECEPTACLES, QUAD 6

C/C

ELECTIRCAL & DATA CONNECTIONS TO MODULAR

FURNITURE AR

C/C F2310 RACK, PAMPHLET WALL MOUNTED 6

V/C M0507 VIDEO TELECONFERENCING SYSTEM 1

V/V F0275 CHAIR, SWIVEL, HIGH BACK 6

V/V MODULAR FURNITURE 6

V/V F2000 BASKET, WATEPAPER 6

V/V F3200 CLOCK, BATTERY 12" DIAMETER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 6

SUBTOTAL

HEALTH CARE ADMINISTRATION (HAS) RECP1 1

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 7

C/C RECEPTACLES, QUAD 7

C/C C0038 RAIL, APRON, 4X42X1 6

C/C C0039 RAIL, APRON, 4X48X1 6

C/C C0045 FRAME, APRON, 2 DRAWER, 4X36X22 6

C/C COO46 FRAME, APRON, 2 DRAWER, 4X48X22 6

C/C C06M0

CABINET, UNDER COUNTER, PULL-OUT BOARD, 2 DRAWER,

3 FILE DRAWER, 30X18X22 6

C/C CT030

COUNTERTOP, HIGH PRESURE LAMINATE, W/GROUMET

HOLES, W/30" EXTENSION 6

C/C

SECURED SLIDING GLASS WINDOWS WITH LOCKS AND

FINGER PULLS 6

V/C SANITIZER, HAND 1

V/V F0280 CHAIR, SWIVEL, LOW BACK 6

V/V F2000 BASKET, WASTEPAPER 6

V/V F2540 SHREDDER, PAPER SECURITY 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 COMPUTER W/DUAL FLAT PANEL MONITORS 6

V/V M1840 PRINTER/COPIER/FAX COBMINATION 1

CENTRAL RECEPTION COUNTER AND SUPPLEMENTAL OFFICE EQUIPMENT

INITIALS: ______ Lessor ________ Gov't Page 6

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V LAB CHECK IN COMPUTER 1

SUBTOTAL

ADMINISTRATION 1 ADMINISTRATION SUPPLY CLOSET

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

C/C RECEPTACLES, DUPLEX 1

C/C M2070 SHELVING STORAGE 77hx36wx18d AR

WOMEN'S HEALTH/GYN EXRG3 3

C/C A5180

TRACK, CUBICLE CURTAIN, SURFACE MOUNTED,

W/CURTAIN 1

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) 1

C/C

STAND ALONE HANDWASHING SINK (VITREOUS CHINA

W/FAUCET) 1

C/C DESK, MOBILE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C HAND SANITIZER, WALL MOUNTED 1

V/C F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

V/V M9025 TABLE, GYN EXAMINATION/TREATMENT 1

V/V A5106 SHARPS CONTAINER, WALL MOUNTED 1

V/V F0205 CHAIR, SIDE WITH ARMS 2

EXAM ROOM

INITIALS: ______ Lessor ________ Gov't Page 7

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V F0340 STOOL, SELF ADJUSTING 1

V/V M7905 MOBILE ELECTRONIC VITAL SIGNS MONITOR 1

V/V M4100

INTEGRATED WALL SYSTEM (OTOSCOPE,

OPTHALMOSCOPE, THERMOETER, MANUAL BP) 1

V/V MOBILE CART 1

SUBTOTAL

WOMEN'S HEALTH/GYN TLTU1 3

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C A5109 GRAB BARS,SS, 1 1/4" DIA. AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A5165 SHELF T-45, SS, 12"WX5"D 1

C/C A5200 DISPENSER, TOILET PAPER W/UTILITY SHELF, SS, 2-ROLL 1

C/C P-418 LAVATORY, VITREOUS CHINA, WITH FAUCET 1

C/C A5090 DISPOSAL, SANITARY NAPKIN, SS, SURFACE MOUNTED 1

C/C P-103 TOILET, WALL HUNG, W/SEAT 1

C/C

NURSE CALL PULL CHORD, STATION, 2-WALL MOUNTED

LIGHTS 1

C/C SMALL WALL MOUNTED TRASH RECEPTACLE 1

C/C TABLE, DAIPER CHANGING, WALL MOUNTED 1

C/C TOILET SEAT COVER HOLDER, WALL MOUNTED 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/V F2000 BASKET, WASTEPAPER, ROUND METAL 1

V/V MOBILE CART 1

SUBTOTAL

ADMINISTRATION OPMH1 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

TOILET, PATIENT

MANAGER/SUPERVISOR OFFICE

INITIALS: ______ Lessor ________ Gov't Page 8

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

V/C F3200 CLOCK, BATTERY 12" DIAMETER 1

V/C HAND SANITIZER 1

V/V F0110 FILE W/HUTCH 3-SHELF 1

V/V F0205 CHAIR, SIDE WITH ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F0405 CABINET, FILING, FULL HEIGHT, 4-5 DRAWER 1

V/V F0635 DESK, L-SHAPE 1

V/V F2000 BASKET, WATEPAPER 1

V/V M1801 LAP TOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

SUBTOTAL

EXAM/TREATMENT MODULES (ETM) TRGM1 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A5180

TRACK, CUBICLE CURTAIN, SURFACE MOUNTED,

W/CURTAIN 1

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS AND HANDWASHING SINK

(VITREOUS CHINA W/FAUCET) 1

C/C SLIDING GLASS WINDOW W/SS SHELF AND FINGER PULLS 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C SANITIZER, HAND 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V DESK, MOBILE 1

V/V M7405 MOBILE EXAM LIGHT 1

V/V MOBILE CART 1

V/V A5106 BASKET, WASTPAPER 1

MULTIPURPOSE PROCEDURE ROOM

INITIALS: ______ Lessor ________ Gov't Page 9

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V F0205 CHAIR, SIDE W/ARMS 2

V/V F0340 STOOL, SELF ADJUSTING 1

V/V F2000 SHARPS CONTAINER, WALL MOUNTED 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

V/V M4116 MOBILE ELECTRONIC VITAL SIGNS MONITOR 1

V/V M4200 INTEGRATED WALL SYSTEM (Otoscope, Ophthalmoscope, Thermometer, Manual BP) 1

V/V M8810 STAND, MAYO 1

V/V TABLE, EXAMINATION/TREATMENT 1

SUBTOTAL

DAY TREATMENT CENTER OFDC1 8

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

V/C SANITIZER, HAND 1

V/V F0635 DESK, DOUBLE PEDESTAL 1

V/V F0110 FILE W/HUTCH 3-SHELF 1

V/V F0205 CHAIR, SIDE W/ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F2000 BASKET, WATEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAP TOP, DOCKING STATIONS, W/FLAT PANEL MONITOR 1

SUBTOTAL

EYE CLINIC EYOT2 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 4

TREATMENT ROOM, EYE CARE PROVIDER

BEHAVIORAL HEALTH CONSULT ROOMS

INITIALS: ______ Lessor ________ Gov't Page 10

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C RECEPTACLES, QUAD 5

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C

M1620 CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) 1

C/C

STAND-ALONE HANDWASHING SINK (VITREOUS CHINA W/

FAUCET SENSOR)

C/C DESK, MOBILE 1

C/C CS200 SINK, SS, SINGLE COMPARTMENT 12x28x16 ID 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V.C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V A5106 SHARPS CONTAINER 1

V/V F0205 CHAIR, SIDE W/ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F2000 BASKET, WATEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

V/V M5016 DESK, REFRACTION W/CONSOLE, W/O SINK 1

V/V F0340 STOOL, SELF ADJUSTING 1

V/V M5520 LENSOMETER 1

V/V M5530 LAMP SLIT, W/APPLANATION TONOMETER 1

V/V M5535 OPHTHALMOSCOPE, BINOCULAR, INDIRECT 1

V/V M5545 OPHTHALOMETER/KERATOMETER 1

V/V M5600 UNIT, EXAM, EYE, W/MOTOR CHAIR, PHOROPTER 1

V/V M5700 FRAME SET, LENS, TRIAL 1

SUBTOTAL

DAY TREATMENT CENTER OFD03 1 PM&R SUITE

INITIALS: ______ Lessor ________ Gov't Page 11

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, QUAD 8

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C P-418 STAND-ALONE HANDWASHING SINK (VITREOUS CHINA W/

FAUCET)

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH, WALL MOUNTED 1

V/C HAND SANITIZER 1

V/V F0635 DESK, MOBILE 2

V/V

F0205 CHAIR, SIDE W/ARMS

V/V F2000 BASKET, WASTEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V PM&R EQUIPMENT AR

SUBTOTAL

DAY TREATMENT CENTER 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 3

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH, WALL MOUNTED 1

V/C HAND SANITIZER 1

V/V F0635 DESK, DOUBLE PEDESTAL 1

V/V 4-DRAWER VERTICAL FILE 1

V/V F0205 CHAIR, SIDE W/ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F2000 BASKET, WATEPAPER 1

PM&R CONSULT ROOMS

INITIALS: ______ Lessor ________ Gov't Page 12

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V PT EXAM TABLE 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

SUBTOTAL

DAY TREATMENT CENTER 1

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C A5109 GRAB BARS, SS, 1 1/4" DIA. AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 1

C/C A5165 SHELF T-45, SS, 12"WX5"D 1

C/C A5200 DISPENSER, TOILET PAPER W/UTILITY SHELF, SS, 2-ROLL 1

C/C P-418 LAVATORY, VITREOUS CHINA, WITH FAUCET 1

C/C

NURSE CALL PULL CHORD, STATION, 2-WALL MOUNTED

LIGHTS 1

C/C P-103 TOILET, WALL HUNG, W/SEAT 1

C/C SMALL WALL MOUNTED WASTE RECEPTACLE 1

C/C TOILET SEAT COVER HOLDER, WALL MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

SUBTOTAL

DAY TREATMENT CENTER 1

V/V RECEPTACLES, DUPLEX 1

V/V LOCKERS W/BENCH AR

SUBTOTAL

DAY TREATMENT CENTER 1

V/V RECEPTACLES, DUPLEX 1

SUBTOTAL

PM&R LINEN ROOM

PM&R RESTROOM

PM&R CHANGING AREA/LOCKERS

INITIALS: ______ Lessor ________ Gov't Page 13

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

DAY TREATMENT CENTER 1

V/V RECEPTACLES, DUPLEX 1

C/C M2070 SHELVING STORAGE 77hx36wx18d AR

SUBTOTAL

SOCIAL WORK OPMH1 4

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

V/C SANITIZER, HAND 1

V/V F0635 DESK, DOUBLE PEDESTAL 1

V/V F0110 FILE W/HUTCH 3-SHELF 1

V/V F0205 CHAIR, SIDE W/ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F2000 BASKET, WATEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAP TOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

SUBTOTAL

ADMINISTRATION OPMH1 1

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 2

C/C RECEPTACLES, DUPLEX 2

V/V F0205 CHAIR, SIDE WITH ARMS 1

V/V F0635 DESK, 48" 1

V/V F2000 BASKET, WASTEPAPER 1

V/V F3200 CLOCK, BATTERY 12" DIAMETER 1

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

V/V PATIENT ID CAMERA 1

PATIENT ID ALCOVE

SOCIAL WORK OFFICES

PM&R STORAGE

INITIALS: ______ Lessor ________ Gov't Page 14

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V PAINTED BLUE WALL AR

SUBTOTAL

LABORATORIES LBVP1 1

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, QUAD 4

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) 1

C/C

STAND-ALONE HANDWASHING SINK (VITREOUS CHINA

W/FAUCET) 1

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 4

C/C

NURSE CALL PUSH BUTTON, STATION, WALL MOUNTED

LIGHT 3

V/C DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C SANITIZER, HAND 3

V/V A5106 SHARPS CONTAINER 3

V/C GLOVER HOLDER, WALL MOUNTED 3

V/C SANI-CLOTH HOLDER, WALL MOUNTED 1

V/V E0948 CART, GENERAL STORAGE, MOBILE 1

V/V F2000 BASKET, WASTEPAPER 3

V/V M1410

CHAIR, BLOOD DONOR, RECLINER, MANUAL OR

PNEUMATIC 3

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

V/V M3072 FRAME, INFECTIOUS WASTE BAG W/LID 3

V/C F3200 CLOCK, BATTERY 12"DIAMETER 1

SUBTOTAL

LABORATORIES TLTU1 1

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C SMALL TRASH RECEPTACLE, WALL MOUNTED 1

C/C A5109 GRAB BARS,SS, 1 1/4" DIA. AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A5165 SHELF T-45, SS, 12"WX5"D 1

TOILET, URINE SPECIMENT COLLECTION

LAB PHLEBOTOMY

INITIALS: ______ Lessor ________ Gov't Page 15

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A5200 DISPENSER, TOILET PAPER W/UTILITY SHELF, SS, 2-ROLL 1

C/C P-418 LAVATORY, VITREOUS CHINA, WITH FAUCET 1

C/C P-103 TOILET, WALL HUNG, W/SEAT 1

C/C

NURSE CALL PULL CHORD, STATION, 2-WALL MOUNTED

LIGHTS 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

C/C TOILET SEAT COVER, WALL MOUNTED 1

SUBTOTAL

TELE-HEALTH TRGM1 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, QUAD 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C UPPER CABINETS (W/LOCKS) 2

C/C P-418 SINGLE SINK, VITREOUS CHINA, WITH FAUCET 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C SANITIZER, HAND 1

V/C SANI-CLOTH HOLDER, WALL MOUNTED 1

V/C GLOVER HOLDER, WALL MOUNTED 1

V/V A5106 SHARPS CONTAINER 1

V/V F0635 DESK, DOUBLE PEDESTAL 1

V/V F0205 CHAIIR, SIDE WITYH ARMS 2

V/V F2000 BASKET, WASTEPAPER 1

V/V F3200 CLOCK, BATTERY 12" DIAMETER 1

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

SUBTOTAL

CONSULT ROOMS

INITIALS: ______ Lessor ________ Gov't Page 16

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

TELE-HEALTH TRGM1 2

C/C A5180

TRACK, CUBICLE CURTAIN, SURFACE MOUNTED,

W/CURTAIN 1

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, QUAD 4

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) 1

C/C

STAND ALONE HANDWASHING SINK (VITREOUS CHINA

W/FAUCET) 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C HAND SANITIZER, WALL MOUNTED 1

V/C F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

V/V M9025 TABLE, EXAMINATION/TREATMENT 1

V/V A5106 SHARPS CONTAINER, WALL MOUNTED 1

V/V F0205 CHAIR, SIDE WITH ARMS 2

V/V F0340 STOOL, SELF ADJUSTING 1

V/V M7905 MOBILE ELECTRONIC VITAL SIGNS MONITOR 1

V/V M4100

INTEGRATED WALL SYSTEM (OTOSCOPE,

OPTHALMOSCOPE, THERMOETER, MANUAL BP) 1

SUBTOTAL

ADMINISTRATION OFA01 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

SHARED STAFF OFFICE

EQUIPMENT/EXAM/TREATMENT ROOM (DEM)

INITIALS: ______ Lessor ________ Gov't Page 17

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C RECEPTACLES, DUPLEX 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

V/C SANITIZER, HAND 1

V/V F0275 CHAIR, SWIVEL, HIGH BACK 2

V/V F0405 CABINET, FILING, FULL HEIGHT, 4-5 DRAWER 2

V/V F0635 DESK, WORKSTATIONS 2

V/V F2000 BASKET, WASTEPAPER 2

V/V F3200 CLOCK, BATTERY 12" DIAMETER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 2

SUBTOTAL

OUT PATIENT CARE WRC01 1

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 6

C/C RECEPTACLES, QUAD 6

C/C TELEVISION CABLE, JACK, AND WIRING AR

C/C A5210 BRACKET, TELEVISION, WALL MOUNTER W/ADJUST ARM 1

C/C F2300 RACK, MAGAZINE, WALL MOUNTED 1

C/C F2310 RACK, PAMPHLET, WALL MOUNTED 1

V/V F0305 CHAIR, WAITING ROOM, SINGLE AR

V/V F2420 TABLE, WAITING ROOM, SINGLE AR

V/V F2000 BASKET, WASTEPAPER 2

V/V F3200 CLOCK, BATTERY 12" DIAMETER 1

V/V M0510 TELEVISION 1

C/C

COFFEE STATION - CASEWORK TO INCLUDE COUNTERTOP

WITH BOTH LOWER/UPPER CABINETS AND HANDWASHING

SINK (VITREOUS CHINA W/ FAUCET), GROMMET HOLE FOR

TRASH RECEPTACLE 1

V/V KIOSK 4

SUBTOTAL

OUTPATIENT CARE WRCO1 1 VOLUNTEER RECEIVING/MYHEALTHeVET AREA (WAITING ROOM)

C/C RECEPTACLES, DUPLEX 2

LOBBY, WAITING AREA

INITIALS: ______ Lessor ________ Gov't Page 18

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 2

C/C CT030

COUNTERTOP, HIGH PRESURE LAMINATE, W/GROMMET

HOLES, W/30" EXTENSION, INCLUDE LOWER CABINETS

(W/LOCKS) 1

SUBTOTAL

OUT PATIENT CARE SRLW1 1 STORAGE, WHEELCHAIR

C/C RECEPTACLES, DUPLEX 1

V/V M4705 WHEELCHAIR, PATIENT TRANPORT AR

SUBTOTAL

CANTEEN SERVICE SL001 1 STAFF LUNCH/BREAK ROOM

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, QUAD 4

C/C C02C0

CASE WORK TO INCLUDE COUNTEROP WITH BOTH UPPER

AND LOWER CABINETS WITH HANDWASHING SS SINK

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/V F0225 CHAIR, DINING ROOM AR

V/V F0795 TABLE, DINING ROUND AR

V/V F2000 BASKET, WASTEPAPER 2

V/V F3200 CLOCK, BATTERY 12" DIAMETER 1

V/V K4665 OVEN, MICROWAVE 2

V/V R7000 REFRIGERATOR 2

V/V TV MONITOR W/VTEL CAPABILITY 1

V/V WATER DISPENSING MACHINE 1

SUBTOTAL

SUPPORT 1 LOCKER ROOM

V/V RECEPTACLES, DUPLEX 1

V/V LOCKERS AR

SUBTOTAL

EXAM/TREATMENT MODULES (ETM) CRA01 2 MULTIPURPOSE CONFERENCE

INITIALS: ______ Lessor ________ Gov't Page 19

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE (FLOOR MOUNTED, AS REQUIRED) AR

C/C RECEPTACLES, QUAD AR

C/C MULTI MEDIA CABLE, JACK, AND WIRING AR

C/C F3230 RACK, HAT/COAT, WALL MOUNTED 1

C/C

PORTABLE WALL TO DIVIDE LARGE CONFERENCE ROOM IN

TO 2 ROOMS (Install in only one conference room) 1

V/V F0220 CHAIR, CONFERENCE AR

V/V F0465 CABINTET STORAGE, 2 DOOR, 5 SHELF 1

V/V F0755 TABLE, CONFERENCE, WOOD 1

V/V F2000 BASKET, WASTEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M0507 VIDEO TELECONFERENCING SYSTEM 1

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

SUBTOTAL

SUPPORT COMC1 1 IT/TELEPHONE EQUIPMENT ROOM

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE AR

C/C RECEPTACLES, QUAD AR

C/C A0900 RELAY RACK, ALUMINUM 2

C/C A0901 CABLE MANAGEMENT, HORIZONTAL BASE UNIT AR

C/C A0902 REAR WIRE FRAME AR

C/C A0903 REAR HINGED COVER, FOR LAN RACK AR

C/C A0904 FIBER OPTIC CABINET, 36 PORT, RACH MOUNTED 2

C/C A0905 ADAPTER PANEL WITH COUPLERS, BLUE, 6 PORT, SM/MM AR

C/C A0906

ADAPTER PANEL WITH COUPLERS, YELLOW, 6 PORT,

SM/MM AR

C/C A0908 PATCH PANEL, 110 BLOCK/RJ-45, CAT 6E, 4 PORT 568A AR

INITIALS: ______ Lessor ________ Gov't Page 20

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A0910 PATCH PANEL, 110 BLOCK/RJ-45, CAT 6E, 96 PORT 568A AR

C/C FIRE-TREATED PLYWOOD AR

V/C A0911 POWER SUPPLY, UNINTERRUPTABLE, RACK MOUNTED 2

V/V A0912 BATTERY PACK, EXTENDED FOR USE WITH UPS (A0911) 1

V/V A0913 SWITCH, LOCAL AREA NETWORK (LAN) 1

V/V A0914 MANAGEMENT PROCESSOR MODULE FOR LAN SWITCH 1

V/V A0915 POWER SUPPLY, 725 W FOR LAN SWITCH 1

V/V A0916 SWITCHING MODULE, DESKTOP, FAST ETHERNET 1

V/V A0917

SWITCHING MODULE, UM FIBER, GIGABIT ETHERNET

SERVER 1

V/V A0918 SWITCHING MODULE, SM, GIGABIT ETHERNET SERVER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

SUBTOTAL

SUPPORT UCCL1 2 UTILITY ROOM, CLEAN (LOGISTICS & SPS)

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

C/C RECEPTACLES, DUPLEX 2

SUBTOTAL

SUPPORT USCL1 1 UTILITY ROOM, SOILED

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

C/C RECEPTACLES, DUPLEX 2

C/C C02C0

CASEWORK TO INCLUDE COUNTERTOP WITH

UPPER/LOWER CABINETS AND HANDWASHING SINK

(VITREOUS CHINA W/FAUCET) 1

C/C CS200

SINK,SS,SINGLE COMPARTMENT, 12x28x16 ID WITH SS

COUNTEROP 1

C/C SLIDING GLASS WINDOW W/SS SHELF AND FINGER PULLS 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEK, SS, SURFACE MOUNTED 1

INITIALS: ______ Lessor ________ Gov't Page 21

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V A5106 SHARPS CONTAINER 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH HOLDER, WALL MOUNTED 1

V/V F2020 CAN, TRASH, 44 GALLON 1

V/V M3072 FRAME, INFECTIOUS WASTE BAG W/LID 1

SUBTOTAL

SUPPORT XXYYC 2 WATER FOUNTAIN AREA

C/C R2202

FOUNTAIN, WATER, CRS, WALL MOUNTED, 1-HANDICAP, 1-

STANDARD 1

SUBTOTAL

ADMINISTRATION TLTU1 1 PUBLIC TOILET, FEMALE (WAITING ROOM)

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C A5109 GRAB BARS,SS, 1 1/4" DIA. AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A5165 SHELF T-45, SS, 12"WX5"D 1

C/C A5200 DISPENSER, TOILET PAPER W/UTILITY SHELF, SS, 2-ROLL 1

C/C P-418 LAVATORY, VITREOUS CHINA, WITH FAUCET 1

C/C A5090 DISPOSAL, SANITARY NAPKIN, SS, SURFACE MOUNTED 1

C/C P-103 TOILET, WALL HUNG, W/SEAT 1

C/C

NURSE CALL PULL CHORD, STATION, 2-WALL MOUNTED

LIGHTS 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

V/V SHARPS CONTAINER 1

C/C TABLE, DAIPER CHANGING, WALL MOUNTED 1

C/C TOILET SEAT COVER HOLDER, WALL MOUNTED 1

C/C SMALL TRASH RECEPTACLE 1

INITIALS: ______ Lessor ________ Gov't Page 22

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

SUBTOTAL

ADMINISTRATION TLTU1 1 PUBLIC TOILET, MALE (WAITING ROOM)

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C A5109 GRAB BARS,SS, 1 1/4" DIA. AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

C/C A5165 SHELF T-45, SS, 12"WX5"D 1

C/C A5200 DISPENSER, TOILET PAPER W/UTILITY SHELF, SS, 2-ROLL 1

C/C P-418 LAVATORY, VITREOUS CHINA, WITH FAUCET 1

C/C A5090 URINAL 1

C/C P-103 TOILET, WALL HUNG, W/SEAT 1

C/C

NURSE CALL PULL CHORD, STATION, 2-WALL MOUNTED

LIGHTS 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/V F2000 BASKET, WASTEPAPER 1

V/V SHARPS CONTAINER 1

C/C TABLE, DIAPER CHANGING, WALL MOUNTED 1

C/C TOILET SEAT COVER HOLDER, WALL MOUNTED 1

SUBTOTAL

SUPPORT JANC1 1 HOUSEKEEPING AIDS CLOSET (HAC)

C/C RECEPTACLES, DUPLEX, FAULT 2

C/C A5135 RAC, MOP, T-10, WALL MOUNTED 1

C/C C0045

CABINET, SS, WALL, T-7, 2-SHELF, 2 DOOR, SLOPING TOP,

36X48X12 1

C/C P-502 SINK, SERVICE, CORNER, FLOOR MOUNTED 1

C/C A5135

SHELF, UTILITY, W/MOP BROOM HOLDERS, SS, SURF

MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

SUBTOTAL

SUPPORT TLTU1 4 TOILET, STAFF

INITIALS: ______ Lessor ________ Gov't Page 23

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A1070 MIRROR, SS FRAMED, 24X36 1

C/C A5109 GRAB BARS,SS, 1 1/4" DIA. AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 1

C/C A5165 SHELF T-45, SS, 12"WX5"D 1

C/C A5200 DISPENSER, TOILET PAPER W/UTILITY SHELF, SS, 2-ROLL 1

C/C P-418 LAVATORY, VITREOUS CHINA, WITH FAUCET 1

C/C P-103 TOILET, WALL HUNG, W/SEAT 1

C/C

NURSE CALL PULL CHORD, STATION, 2-WALL MOUNTED

LIGHTS 1

C/C SMALL WALL MOUNTED TRASH RECEPTACLE 1

C/C TOILET SEAT COVER HOLDER, WALL MOUNTED 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/V F2000 BASKET, WASTEPAPER 1

SUBTOTAL

SUPPORT 3 SUPPLY CLOSETS (BEHAVIORAL HEALTH/EQUIPMENT/PROSTHETICS)

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

C/C RECEPTACLES, DUPLEX 2

C/C M2070 SHELVING STORAGE 77hx36wx18d AR

C/C WALL HOOKS AR

SUBTOTAL

SPECIALTY EXAM 1 AUDIOLOGY SUITE

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C AUDIOLOGY BOOTH 1

V/V F0635 DESK, DOUBLE PEDESTAL 1

V/V F0205 CHAIIR, SIDE WITYH ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

INITIALS: ______ Lessor ________ Gov't Page 24

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

V/V F2000 BASKET, WASTEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

V/V STORAGE CABINET 1

SUBTOTAL

SPECIALTY EXAM 1 AUDIOLOGY THERAPY/ADJUSTMENT ROOM

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 4

C/C RECEPTACLES, QUAD AR

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS (W/LOCKS) AR

C/C

STAND ALONE HANDWASHING SINK (VITREOUS CHINA

W/FAUCET) 1

V/V F0205 CHAIIR, SIDE WITYH ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F2000 BASKET, WASTEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 COMPUTER, W/FLAT PANEL MONITOR 1

V/V STORAGE CABINET 1

SUBTOTAL

SUPPORT 1 SUPPLY CLOSET (OPTOMETRY/AUDIOLOGY)

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

C/C RECEPTACLES, DUPLEX 2

C/C M2070 SHELVING STORAGE 77hx36wx18d AR

C/C WALL HOOKS AR

SUBTOTAL

EXAM/TREATMENT MODULES (ETM) TRGM1 1 OUTPATIENT SURGERY/PROCEDURE SUITE

INITIALS: ______ Lessor ________ Gov't Page 25

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE AR

C/C RECEPTACLES, DUPLEX AR

C/C

CASEWORK TO INCLUDE COUNTERTOP WITH BOTH

LOWER/UPPER CABINETS AND HANDWASHING SINK

(VITREOUS CHINA W/FAUCET) 1

C/C SLIDING GLASS WINDOW W/SS SHELF AND FINGER PULLS 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEL, SS, SURFACE MOUNTED 1

V/C SANITIZER, HAND 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH DISPENSER, WALL MOUNTED 1

V/V DESK, MOBILE 1

V/V M7405 MOBILE EXAM LIGHT 1

V/V MOBILE CART 1

V/V A5106 BASKET, WASTPAPER 1

V/V F0340 STOOL, SELF ADJUSTING 1

V/V F2000 SHARPS CONTAINER, WALL MOUNTED 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

V/V M4116 MOBILE ELECTRONIC VITAL SIGNS MONITOR 1

V/V M4200 INTEGRATED WALL SYSTEM (Otoscope, Ophthalmoscope, Thermometer, Manual BP) 1

V/V M8810 STAND, MAYO 1

V/V TABLE, EXAMINATION/TREATMENT 1

SUBTOTAL

SUPPORT UCCL1 2 OUTPATIENT SURGERY - UTILITY ROOM, CLEAN (LOGISTICS & SPS)

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

C/C RECEPTACLES, DUPLEX 2

SUBTOTAL

SUPPORT USCL1 1 OUTPATIENT SURGERY - UTILITY ROOM, SOILED

INITIALS: ______ Lessor ________ Gov't Page 26

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 1

C/C RECEPTACLES, DUPLEX 2

C/C C02C0

CASEWORK TO INCLUDE COUNTERTOP WITH

UPPER/LOWER CABINETS AND HANDWASHING SINK

(VITREOUS CHINA W/FAUCET) 1

C/C CS200

SINK,SS,SINGLE COMPARTMENT, 12x28x16 ID WITH SS

COUNTEROP 1

C/C SLIDING GLASS WINDOW W/SS SHELF AND FINGER PULLS 1

V/C A5075 DISPENSER, SOAP, DISPOSABLE 1

V/C A5080 DISPENSER, PAPER TOWEK, SS, SURFACE MOUNTED 1

V/V A5106 SHARPS CONTAINER 1

V/C GLOVE HOLDER, WALL MOUNTED 1

V/C SANI-CLOTH HOLDER, WALL MOUNTED 1

V/V F2020 CAN, TRASH, 44 GALLON 1

V/V M3072 FRAME, INFECTIOUS WASTE BAG W/LID 1

SUBTOTAL

ADMINISTRATION OFA01 1

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE AR

C/C RECEPTACLES, DUPLEX AR

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 4

V/C SANITIZER, HAND 1

V/V F0275 CHAIR, SWIVEL, HIGH BACK 4

V/V F0405 CABINET, FILING, FULL HEIGHT, 4-5 DRAWER 2

V/V F0635 DESK, WORKSTATIONS 4

V/V F2000 BASKET, WASTEPAPER 2

V/V F3200 CLOCK, BATTERY 12" DIAMETER 1

V/V M1801 LAPTOP, DOCKING STATION, W/FLAT PANEL MONITOR 4

SUBTOTAL

OUTPATIENT SURGERY -SHARED STAFF OFFICE

INITIALS: ______ Lessor ________ Gov't Page 27

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

ADMINISTRATION 3

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

V/C SANITIZER, HAND 1

V/V F0635 DESK, DOUBLE PEDESTAL 1

V/V F0110 FILE W/HUTCH 3-SHELF 1

V/V F0205 CHAIR, SIDE W/ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F2000 BASKET, WATEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAP TOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

SUBTOTAL

ADMINISTRATION 2

C/C A1010

TELECOMMUNICATION/DATA OUTLET JACKS, 1-VOICE, 2-

DATA, 1-SPARE 3

C/C RECEPTACLES, DUPLEX 4

C/C A5145 COAT HOOK, SS, SURFACE MOUNTED 2

V/C SANITIZER, HAND 1

V/V F0635 DESK, DOUBLE PEDESTAL 1

V/V F0110 FILE W/HUTCH 3-SHELF 1

V/V F0205 CHAIR, SIDE W/ARMS 2

V/V F0275 CHAIR, SWIVEL, HIGH BACK 1

V/V F2000 BASKET, WATEPAPER 1

V/V F3200 CLOCK, BATTERY, 12" DIAMETER 1

V/V M1801 LAP TOP, DOCKING STATION, W/FLAT PANEL MONITOR 1

SUBTOTAL

SUPPORT 1 ELECTRICAL ROOM

EQUIPMENT AR

CITC OFFICES

VETERAN CENTER/SERVICE OFFICE

INITIALS: ______ Lessor ________ Gov't Page 28

LEASE NO. 36C24422L0018

DEPARTMENT/FUNCTIONAL AREA

ROOM

CODE

QTY OF

ROOMS

FUNCTION

ACQUIRED/

INSTALLED

EQUIPMENT

SYMBOL OR

JSN CODE

ITEM DESCRIPTION QTY UNIT COST PER ROOM TOTAL

SUBTOTAL

Note: Unit Price List Items are included in the Tenant Improvement Price and are not priced separately from Tenant Improvement.

INITIALS: ______ Lessor ________ Gov't Page 29