Home Oxygen Item Schedule v2 SAM.xlsx

XLSX spreadsheet 24 KB Posted May 8, 2023

Attached to: VA Home Oxygen Services for Central California Federal contract opportunity
Solicitation number: 36C26123Q0583
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21

View the file

Other files for this federal contract opportunity

Other files attached to VA Home Oxygen Services for Central California, newest first.
File	Type	Posted
Item Schedule- CCHCS.xlsx	XLSX spreadsheet	May 19, 2023
36C26123Q0583 VACCHS.pdf	PDF	May 19, 2023
RFQ 36C26123Q0583.pdf	PDF	May 8, 2023
WAGE DETERMINATIONS - Central Cal.pdf	PDF	May 8, 2023
QASP - Home Oxygen.pdf	PDF	May 8, 2023

On GovTribe

Work with this file on GovTribe

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Order Min and Max

The guaranteed minimum award amount for this contract is $2,500.00.

The maximum aggregate value of orders that can be placed under this contract is $3,000,000.00.

The Government does not guarantee it will place any orders under this contract in excess of the guaranteed minimum award amount

Central Cal

ITEM#	ITEM NAME	HCPCS	ITEM DESCRIPTION	CONTRACT PERIOD		ESTIMATED	UNIT	UNIT	TOTAL
		CODE				QUANTITIES	PRICE	(Where just number,	ESTIMATED COST
								unit is "Month.")
1	Rental of Contractor	E1390	Concentrator, Colored Tubing, Adapter	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	330		1	$0.00
	Owned Concentrator		Humidifier (when required), Cannulas or
	System		Masks and other required supplies and
			equipment, including back up systems.
	Priced Per Month		Perform Equipment Maintenance in
			accordance with manufacturer standards.
			At a minimum of once every 90 calendar
			days, visit and assess patient to assure
			equipment complinace, change filters and						1.07
			provide disposable supplies.

1a	Rental of Contractor	E1390	To include all supplies, equipment	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	1	1	$0.00
	Owned Low Decibel		maintenance and 90 calendar day visit as
	Concentrator System		described in Item 1

Priced Per Month

1b	Rental of Contractor	K0738	To include all supplies, equipment	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	1	$0.00
	Owned Home Fill		maintenance and 90 calendar day visit as
	Oxygen System		described in Item 1

Priced Per Month

1c	Rental of Contractor	E1390	To include all supplies, equipment	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	1	$0.00
	Owned Hi Flow		maintenance and 90 calendar day visit as
	Concentrator System		described in Item 1

Priced Per Month

ITEM#	ITEM NAME	HCPCS	ITEM DESCRIPTION	CONTRACT PERIOD		ESTIMATED	UNIT	UNIT	TOTAL
		CODE				QUANTITIES	PRICE	(Where just number,	ESTIMATED COST
								unit is "Month.")
2	Rental of Contractor	E0431	Portable System, Regulator,	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	200		1	$0.00
	Owned Portable O2		Flowmeter, Humidifier, Cannulas,
	Gaseous System for		or Masks, Tubing,
	use with or without		Conserving Device and O2 Tank
	Stationary System		Cylinder Stands capable of holding
	Priced Per Month		12 cylinders, sizes E, D, C & M-6

3	Rental of Contractor	E0439	Resevoir, Regulator, Flowmeter,	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	1	$0.00
	Owned Stationary		Humidifier, Cannulas or Masks, and
	Liquid O2 System		Colored Tubing.

Priced Per Month

4	Rental of Contractor	E0434	Portable Container, Refill Adapter	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	1	$0.00
	Owned Portable		Flowmeter, Cannulas or Masks, and
	Liquid O2 System		Colored Tubing. Resevoir will be provided
			if another Stationary System (e.g.
	Priced Per Month		Concentrator) is rented.

5	Suction Pump	E0600	Purchase, Delivery, Set-up and	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	10	Each	$0.00
			Training of Contractor Home Model
			Respiratory Suction Pump, portable
	Priced Per Each		or stationary electric to include all
			supplies

6	Suction Pump Rental	E0600	Delivery, Set-up, and Training of	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	Each	$0.00
			Contractor Owned Suction Pump to
			Include all supplies
	Priced Per Each

ITEM#	ITEM NAME	HCPCS	ITEM DESCRIPTION	CONTRACT PERIOD		ESTIMATED	UNIT	UNIT	TOTAL
		CODE				QUANTITIES	PRICE	(Where just number,	ESTIMATED COST
								unit is "Month.")
7	Rental of Contractor	E0450	Delivery, Set-up, Training, and	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	4		1	$0.00
	Owned Volume		Maintenance of Contractor Owned
	Ventilator		Stationary or Portable Ventilator, to
			include back up Ventilator and all supplies
	Priced Per Month

8	Government Owned	E0450	Delivery, Set-up, and Training of a	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	Each	$0.00
	Ventilator Set-up		Government Owned Ventilator
			to include all necessary supplies
	Priced Per Each

9	Ventilator	E0450	Maintenance of Government Owned	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	1	$0.00
	Maintenance		Ventilator Systems, to include all
			supplies
	Priced Per Month

10	Air Compressor	E0565	Rental of Contractor Owned and	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	10	1	$0.00
			Maintained continuous or intermittent
			air compressor for use with
			equipment not self contained or
	Priced Per Month		cylinder driven, to include all
			associated supplies

ITEM#	ITEM NAME	HCPCS	ITEM DESCRIPTION	CONTRACT PERIOD		ESTIMATED	UNIT	UNIT	TOTAL
		CODE				QUANTITIES	PRICE	(Where just number,	ESTIMATED COST
								unit is "Month.")
11	Delivery Charge	A9901	Deliveries not made under all other	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0		Each	$0.00
			line items

Priced Per Each

12	Respiratory Therapist	VA120	Government requested Respiratory	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0	Each	$0.00
	Visit		Therapist visit not covered by other
			Line Items
	Priced Per Each

Fresno specific pricing instructions

Line Items 1-1c Require Quarterly Maintenance Visits

				REFILLS - ALL QUANTITIES ARE MONTHLY			ESTIMATED	UNIT
ITEM#	ITEM NAME	HCPCS	ITEM DESCRIPTION		CONTRACT PERIOD		MONTHLY	CYLINDER	UNIT	TOTAL ESTIMATED
		CODE					QUANTITIES	PRICE		MONTHLY COST
R1	E Cylinder	E0443	E Cylinder Refill		Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	2900		Cylinder	$0.00

R2 D Cylinder E0443 D Cylinder Refill Base Period: 04-01-2016 through 05-31-2016 1 June 2023 to 31 May 2024 1 Cylinder $0.00

R3 C Cylinder E0443 C Cylinder Refill Base Period: 04-01-2016 through 05-31-2016 1 June 2023 to 31 May 2024 1 Cylinder $0.00

R4 M-6 Cylinder E0443 M-6 Cylinder Refill Base Period: 04-01-2016 through 05-31-2016 1 June 2023 to 31 May 2024 500 Cylinder $0.00

R5 H Tank E0443 H Tank Refill Base Period: 04-01-2016 through 05-31-2016 1 June 2023 to 31 May 2024 0 Cylinder $0.00

							UNIT PER LB
							PRICE
R6	Liquide Oxygen	E0444	Liquide Oxygen	Base Period: 04-01-2016 through 05-31-2016	1 June 2023 to 31 May 2024	0		LBS	$0.00
			Refill

PRICING TOTAL PAGE

LINE ITEMS 1 THROUGH 12
TOTAL ESTIMATED PRICE - BASE PERIOD	$0.00

LINE ITEMS R1 - R6
TOTAL ESTIMATED PRICE - BASE PERIOD	$0.00

Grand Total (1 Month)	$0.00
Grand Total (12 Month)	$0.00

&"Arial,Bold Italic"Central California (Fresno) Pricing Sheet

&"Arial,Bold Italic"Fresno Page &P O2 Line Items Amendment #1

File details come from the government source that posted it. Updated May 8, 2023.