Attachment_1_Pricing_Schedule.docx

Attachment 1 Pricing Schedule Request for Quote#

Company Name: Cage: DUNS:

Company Address:

Point of Contact: Email: Phone:

CLIN Description QTY U/I Unit Price Extended Price

MFR Part Number: 061000 Model number: 610 Manufacturer: HARLOFF This requirement is brand name or equal in accordance with the following salient characteristics:

Cabinets must have:

-Industrial rated pressure and vacuum system -Duel rechargeable otoscope wells (welch Allen) -Adequate space to store instrumentation, as well as supply items -Mirror warming feature -Halogen fiber optic light source Input power 100-240v AC, 50/60 Hz -Endoscope caddy -Atomizers

- Dimensions of 33.5”h x 34.5”w x 21”d

*12 Month Warranty

EA

Delivery Date: Date Quote Expires:

By signing below the contractor is verifying the intent to complay will all clauses in the resulting contract.

Name of Individual authorized to sign for company Signature