RFQ HSCG84-11-Q-AA5372 SCHEDULE OF SUPPLIES - EXCEL FORMAT.xls

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CUSTOMIZED DENTAL APPLIANCES
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HSCG84-11-Q-AA5372
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RFQ HSCG84-11-Q-AA5372 SCHEDULE OF SUPPLIES IN EXCEL FORMAT

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BASE YEAR + FOUR OPTIONS

CLINDESCRIPTIONEST QTYU/IU/PTotal EST AMT - Base Year (10/1/2011-9/30/2012)U/PTotal EST AMT - Option One (10/1/2012-9/30/2013)U/PTotal EST AMT - Option Two (10/1/2013-9/30/2014)U/PTotal EST AMT - Option Three (10/1/2014-9/30/2015)U/PTotal EST AMT - Option Four (10/1/2015-9/30/2016)Total Estimated Five Year Amount
FIXED/REMOVABLE PROSTHODONTICS AND ADDITIONAL ITEMS
X001Metal Ceramics
X001AAReflex PFM- Porcelain Fused to High Noble Metal125Each
X001ABGoldtech Bio 2000 (High Noble Gold) Crown125Each
X001ACGoldtech Bio 2000 (High Noble Gold) Bridge, per unit75Each
X001ADPorcelain Labial Margin25Each
X001AEPorcelain 360 Margin25Each
X001AFPorcelain Jacket, Bonded Crown25Each
X001AGPorcelain Bonded Veneer25Each
X001AHBridges of 5 more units, per unit25Each
X002Metal Free
X002AAPorcelain Fused to Zirconium Oxide Core, Cementable Crown or Bridge125Each
X002ABPorcelain Fused to Zirconium Oxide Core, Bridge125Each
X002ACEmpress Esthetic (Shading Technique) Crown, Inlay, Veneer25Each
X002ADIPS Empress Esthetic - Layering Technique - Crown Veneer25Each
X002AEIPS Empress Esthetic Veneers50Each
X002AFPorcelain Inlay25Each
X002AGPorcelain Onlay25Each
X003Full Metal
X003AAGold Crowns and Bridges per unit100Each
X003ABTucker Techniques Gold Inlay25Each
X003ACGold Post, separate75Each
X003ADGold Post, attached25Each
X003AEGold Onlay25Each
X004Additional Services
X004AACrown Fitted Under Partial (additional charge)100Each
X004ABClasp Index System25Each
X004ACStress Breaker25Each
X004ADDiagnostic Wax-Up, Occlusal, per tooth25Each
X004AEDiagnostic Wax-Up, Esthetic, per tooth25Each
X004AFAcrylic Temporary, per tooth25Each
X004AGAcrylic Temporary, per tooth, with reinforcement25Each
X004AHTransfer or Reduction Coping25Each
X004AIDie Trim100Each
REMOVABLE PROSTHODONTICS
X005Full Dentures
X005AASet Up and Process25Each
X005ABCustom Tray25Each
X005ACBite Rim25Each
X006Partial Dentures
X006AAPremium Chrome Framework75Each
X006ABStandard75Each
X006ACComplex25Each
X006ADSet Up and Process25Each
X006AEAltered Cast25Each
X006AFWrought Wire Clasp50Each
X006AGFlipper/Treatment Partial25Each
X006AHFlipper, One or Two Teeth25Each
X006AIEach Additional Tooth25Each
X006AJWire Clasp100Each
X006AKThermo Splint Classic125Each
X006ALThermo Splint Hard Face125Each
X006AMThermo Splint Custom Fit125Each
X007Orthodontics
X007AASnore Guard125Each
X007ABPlaysafe (mouthguard)200Each
X007ACLaser Welding25Each
X007ADRelines & Repairs25Each
X008Removables
X008AAHard Night Guard25Each
X008ABHard Night Guard with Soft Liner10Each
X008ACEssix Appliance25Each
X008ADNesbitt Complete25Each
X008AELucitone FRS25Each
X008AFThermo-Flex Clasp25Each
X008AGBleaching Tray25Each
X008AHSurgical Stint25Each
X009Partial Add-Ons
X009AABacking for Facing1Each
X009ABBoxing for Tube Tooth1Each
X009ACOcclusal Onlay1Each
X009ADMetal Dummy1Each
X009AEA-P Bar1Each
X009AFKennedy Bar1Each
X009AGLingual Plate1Each
X009AHD.E. Hinge1Each
X009AISwing-Lock1Each
RESTORATIONS
X010Implant Base Restorations
X010AASoft Tissue Model25Each
X010ABImplant Labor Standard25Each
X010ACImplant Labor Complex25Each
X010ADSurgical Stint25Each
X010AEAtlantis Custom Abutment Titanium25Each
X010AFAtlantis Custom Abutment Titanium – Gold Hue25Each
X010AGAtlantis Custom Abutment Zirconia25Each
X010AHBiomet 3i Encode Abutment25Each
X010AIProcera Titanium Abutment25Each
X010AJProcera Zirconia Abutment25Each
X010AKDuralay Jig for Implant Positioning25Each
X010ALCustom Implant Tray25Each
X011Metal to Ceramic Restorations
X011AACast Veneer25Each
X011ABCut & Cast Shallow Rest10Each
X011ACMaryland Bridge - Anterior10Each
X011ADMaryland Bridge - Posterior10Each
X011AEMetal Thimble (Telescope)10Each
X011AFMilled Telescope Coping10Each
X011AGMilled Lingual Bar10Each
X011AHMilled Lingual Arm10Each
X011AIMilled in Lock10Each
X012Metal Free Restorations
X012AAProcera Zirconia (for posterior single units)25Each
X012ABProcera Alumina (for anterior single units)25Each
X013Composite Restorations
X013AASculpture Plus Crown25Each
X013ABSculpture Plus Bridge25Each
X013ACSculpture Plus Inlay/Onlay25Each
X014Miscellaneous
X014AAAcrylic Laminate Veneer50Each
X014ABAcrylic Facing50Each
X014ACOmnivac Stint125Each
X014ADElastic Mandibular Advancement (EMA)125Each
X014AE3I Encode - Zirconia25Each
X014AFStraumann Etkon Abutment- Titanium25Each
X014AGStraumann Etkon Abutment- Zirconia25Each
X014AHCustom Threaded Abutment10Each
X014AIModel Mount - Plastic Articulator10Each
X014AJe.max inlay10Each
X014AKe.max crown (stain technique)10Each
X014ALe.max crown (cut back/layer technique)10Each
X014AMe.max veneer (stain technique)10Each
X014ANe.max veneer (cut back/layer technique)10Each
X014AOEmpress Cosmo Post10Each
X014APEmpress Esthetic Veneer - Layering Technique10Each
X014AQEmpress Inlay/Onlay10Each
X014AREmpress Veneer10Each
X014ASFull Contour Zirconia Crown10Each
X014ATAthlete's Edge Sportsguard - Light50Each
X014AUAthlete's Edge Sportsguard - Medium50Each
X014AVAthlete's Edge Sportsguard - Heavy50Each
X014AWSilent Nite Sleep Appliance50Each
X014AXSoft Night Guard50Each
X014AYEtch Maryland Bridge (for re-etches and return from try-ins only)25Each
X015Orthodontic Services
X015AA“C” Clasps Soldered to Labial Bow25Each
X015AB3-Way Expansion Screw25Each
X015ACAcrylic Added to Labial Arch25Each
X015ADAcrylic Plate25Each
X015AEAcrylic Spacer25Each
X015AFAdams Clasp25Each
X015AGAnterior Bite Plate25Each
X015AHArticulated Study Model25Each
X015AIBand and Loop Space Maintainer25Each
X015AJBanded Palatal Expander25Each
X015AKBands25Each
X015ALBi-HeliX25Each
X015AMBilateral Molar Distalizer25Each
X015ANBionator to Close (No Midline screw)25Each
X015AOBionator to Close (One Midline screw)25Each
X015APBionator to Open (No Midline screw)25Each
X015AQBionator to Open (One Midline screw)25Each
X015ARBluegrass Roller25Each
X015ASBonded Lingual Retainer25Each
X015ATBonded Lingual Retainer (Braided Wire)25Each
X015AUBonded Lingual Retainer (Round Wire)25Each
X015AVBonded Lingual Retainer (Twisted Wire)25Each
X015AWBonded Palatal Expander25Each
X015AXBuccal Tube Clasp25Each
X015AYCantilever Herbst25Each
X015AZCetlin Distalizing Spring25Each
X015BAOrtho Study Models25Each
X015BBCuspid to Cuspid Adapted Labial Arch25Each
X015BCCuspid to Cuspid Automatic Labial Arch25Each
X015BDCuspid to Cuspid Flat Wire Labial Arch25Each
X015BECuspid to Cuspid Labial Arch25Each
X015BFCustom Fit Band25Each
X015BGDewey25Each
X015BHDiastama Closing Spring25Each
X015BIDistal Jet25Each
X015BJDistal Shoe25Each
X015BKDouble Helix Spring25Each
X015BLDouble Tube25Each
X015BMDouble Tube with Hook25Each
X015BNExpansion Arch25Each
X015BOExpansion Screw25Each
X015BPFan Type Banded Palatal Expander25Each
X015BQFan Type Expansion Screw25Each
X015BRFinger Clasp25Each
X015BSFinger Spring25Each
X015BTFixed Bite Plate25Each
X015BUFixed Lower Expansion Appliance25Each
X015BVFixed Upper/Removable Lower Herbst25Each
X015BWFlip Lock Advancement Shims25Each
X015BXFlip Lock Herbst Kit25Each
X015BYFlip Lock Lower Arm25Each
X015BZFlip Lock Pivot25Each
X015CAFlip Lock Upper Left Arm25Each
X015CBFlip Lock Upper Right Arm25Each
X015CCFrankel II25Each
X015CDGrummons (All Metal Pendex)25Each
X015CEHaas Palatal Expander25Each
X015CFHabit Crib25Each
X015CGHawley Retainer with “C” Clasps25Each
X015CHHawley Retainer with Adams Clasp25Each
X015CIHawley Retainer with Arrow Clasps25Each
X015CJHawley Retainer with Ball Clasps25Each
X015CKHawley Retainer with Modified “C” Clasp25Each
X015CLHawley Retainer with No Clasp25Each
X015CMHawley Retainer with Occlusal Rests25Each
X015CNHerbst25Each
X015COHook25Each
X015CPJasper Jumper25Each
X015CQKois Deprogramer25Each
X015CRLingual Arch25Each
X015CSLingual Arch with Adjustment Loop25Each
X015CTLingual Sheath25Each
X015CU6031E Lingual Tube25Each
X015CVLip Bumper25Each
X015CWLip Bumper with Acrylic Pads25Each
X015CXLower Schwarz25Each
X015CYLower Three Way Sagittal25Each
X015CZModified Hawley Retainer with Adams Clasp25Each
X015DAModified Spring Aligner25Each
X015DBNAM Appliance25Each
X015DCNance25Each
X015DDNord Flange25Each
X015DEOne Tooth Expansion Screw25Each
X015DFOrthopedic Corrector to Close (2)25Each
X015DGOrthopedic Corrector to Close (3)25Each
X015DHOrthopedic Corrector to Open (2)25Each
X015DIOrthopedic Corrector to Open (3)25Each
X015DJOverlapping Habit Cribs25Each
X015DKOverlapping Spring25Each
X015DLPalatal Thumb Habit Crib25Each
X015DMPendex25Each
X015DNPendulum25Each
X015DOPontic Added to Appliance25Each
X015DPQuad Helix25Each
X015DQRemovable Lingual Arch25Each
X015DRRemovable Lower Herbst25Each
X015DSRemovable Nance25Each
X015DTRemovable Quad Helix25Each
X015DUSpace Closing Screw25Each
X015DVSpace Regainer25Each
X015DWSpring Aligner25Each
X015DXSpring Aligner with Adams Clasps25Each
X015DYSpring Aligner with Mushroom Spring25Each
X015DZSpring Aligner with Occlusal Rests25Each
X015EASpring Aligner with Wire Extension25Each
X015EBSpur25Each
X015ECStandard Rapid Palatal Expander25Each
X015EDStep Down Lingual Arch25Each
X015EEStep Down Lingual Arch with Adjust25Each
X015EFThumb Thrust Appliance25Each
X015EGTongue Spinner25Each
X015EHTongue Thrust and Tongue Habit Appliance25Each
X015EITongue Habit Appliance25Each
X015EJTranspalatal Nance25Each
X015EKTrim Study Model25Each
X015ELTrue Love Acrylic Color25Each
X015EMTwin Block25Each
X015ENUnilateral Molar Distalizer25Each
X015EOUpper Schwarz25Each
X015EPUpper Three Way Sagittal25Each
X015EQUpper Two Way Sagittal25Each
X015ERW-Arch25Each
X015ESWrap Around Hawley Retainer25Each
X015ETWrap Around Hawley Retainer with Clasp25Each
X015EUWrap Around Labial Arch25Each
X015VDuplication of Models25Each
TOTAL ESTIMATED AMOUNTBase$One$Two$Three$Four$$

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