Federal Supply Schedule V797P4814A

The Department of Veterans Affairs

Federal Supply Service

Authorized Federal Supply Schedule Price List

(Incorporates Amendment/Modification Number 0007)

Effective July 1, 2012

On-line access to contract ordering information, terms and conditions, up-to-date pricing, and the option to create an electronic delivery order are available through GSA Advantage!, a menu-driven database system.

The INTERNET address for GSA Advantage is: GSAAdvantage.gov.

Medical Equipment and Supplies FSC Group 65, Part II, Section A

FSC Class: 6510

Contract No: V797P-4814a

For more information on ordering Federal Supply Schedules click on the FSS Schedules button at fss.gsa.gov.

Contract Period: June 15, 2005 through June 14, 2015.

Contractor:

HemCon Medical Technologies, Inc.

10575 SW Cascade Avenue, Suite 130

Portland, Oregon 97223-4363 Phone: (503) 245-0459, Customer Solutions Dept., ext. 300

Customer Solutions Dept. Fax: (971) 223-1000 Website: www.hemcon.com

Contract Administration Source: Customer Solutions Dept., ext. 300

Business Size: Small

Tax Identification Number (TIN): 93-1321343 http://www.hemcon.com/

CUSTOMER INFORMATION:

1a. Table of awarded special item number(s) with appropriate cross-reference to item descriptions and awarded price(s).

SIN(s) Page A4a 4

1b. Identification of the lowest priced model number and lowest unit price for that model for each special item number awarded in the contract. This price is the Government price based on a unit of one, exclusive of any quantity/dollar volume, prompt payment, or any other concession affecting price. Those contracts that have unit prices based on the geographic location of the customer, should show the range of the lowest price, and cite the areas to which the prices apply.

2. Maximum order: $ 100,000.

3. Minimum order: $ 34.10.

4. Geographic coverage (delivery area): 50 states, Washington D.C., and Puerto Rico.

5. Point(s) of production (city, county, and State): Portland, Oregon (Washington County).

6. Discount from list prices or statement of net price: Basic discount for FSS GSA contract is between 36.0% and 51.5% discount from list price, depending on product.

7. Quantity discounts: Quantity / volume discount for FSS GSA contract is 41.8% discount from list price on quantities of

5,000 and over.

8. Payment terms: 1% 15 days, Net 30 days.

9a. Notification that Government purchase cards are accepted up to the micro-purchase threshold:

Accept up to and above the micro-purchase threshold of $3,000 to $10,000; no additional discounts.

9b. Notification whether Government purchase cards are accepted or not accepted above the micro-purchase threshold.

Government purchase cards are accepted.

10. Foreign items (list items by country of origin): None.

11a. Time of delivery: Within 30 days After Receipt of Order (ARO).

11b. Expedited Delivery: None.

11c. Overnight and 2-day delivery: Standard ship method is Ground. Faster ship methods (overnight, 2-day and 3-day) are available at an additional price; contact HemCon for rate estimate for faster ship methods.

11d. Urgent Requirements: Not applicable.

12. F.O.B. point: F.O.B. Destination, 50 States, including Washington, D.C., and Puerto Rico.

13a. Ordering address:

HemCon Medical Technologies, Inc.

10575 SW Cascade Avenue, Suite 130 Portland, Oregon 97223-4363 USA Telephone: 503-245-0459 or Toll-free 877-247-0196. Customer Solutions Dept., extension 300.

Customer Solutions Dept. Fax: 971-223-1000

13b. Ordering procedures: For supplies and services, the ordering procedures, information on Blanket Purchase

Agreements (BPA’s), and a sample BPA can be found at the GSA/FSS Schedule homepage (fss.gsa.gov/schedules).

14. Payment address:

HemCon Medical Technologies, Inc.

10575 SW Cascade Avenue, Suite 130 Portland, Oregon 97223-4363 USA Telephone: 503-245-0459 or Toll-free 877-247-0196. Customer Solutions Dept., extension 300.

Customer Solutions Dept. Fax: 971-223-1000

15. Warranty provision and Return Goods Policy.

See attachment #1, HemCon Medical Technologies Inc - Terms of Sale.

16. Export packing charges, if applicable: Not applicable.

17. Terms and conditions of Government purchase card acceptance (any thresholds above the micro-purchase level).

Government commercial credit cards are accepted for purchases up to $10,000; no additional discounts.

18. Terms and conditions of rental, maintenance, and repair (if applicable): Not applicable.

19. Terms and conditions of installation (if applicable): Not applicable.

20. Terms and conditions of repair parts indicating date of parts price lists and any discounts from list prices (if applicable): Not applicable.

20a. Terms and conditions for any other services (if applicable): Not applicable.

21. List of service and distribution points (if applicable): Not applicable.

22. List of participating dealers (if applicable).

Cardinal Health;

Owens & Minor;

Other authorized GSA resellers.

23. Preventive maintenance (if applicable): Not applicable.

24a. Special attributes such as environmental attributes (e.g., recycled content, energy efficiency, and/or reduced pollutants): Not applicable.

24b. If applicable, indicate that Section 508 compliance information is available on Electronic and Information Technology

(EIT) supplies and services and show where full details can be found (e.g. contractor’s website or other location.)

The EIT standards can be found at: www.Section508.gov/: Not applicable.

25. Data Universal Number System (DUNS) number: 116661344.

26. Notification regarding registration in Central Contractor Registration (CCR) database: Yes, expires 04/28/2012.

HemCon Medical Technologies, Inc.

AUTHORIZED FEDERAL SUPPLY SCHEDULE PRICE LIST

Amended: July 1, 2012

Contract No: V797P-4814a

SIN

HemCon Product Number Product Description

Unit of Measure

Net FSS Net Price (with IFF)

ChitoFlex® PRO

A-4a

(old pn 110) ChitoFlex® PRO Dressing, 3x28 inch, single. Each $141.51

GuardaCare® PRO

A-4a

(old pn 135) GuardaCare® PRO, 2x2 inch 8-ply, box of 10. Box $64.22

A-4a

(old pn 135) GuardaCare® PRO, 2x2 inch 8-ply, case of 100. Case $642.21

A-4a

(old pn 136) GuardaCare® PRO, 4x4 inch 8-ply, box of 10. Box $128.64

A-4a

(old pn 136) GuardaCare® PRO, 4x4 inch 8-ply, case of 100. Case $1,286.43

2” x 2” HemCon® Bandages PRO

A-4a 1001 (old pn 104)

HemCon® Bandage PRO, 2x2 inch, single.

Each

$18.65

A-4a 1001 (old pn 104)

HemCon® Bandage PRO, 2x2 inch, box of 5.

Box

$93.27

A-4a 1001 (old pn 104)

HemCon® Bandage PRO, 2x2 inch, case of 100.

Case

$1,865.33

2” x 4” HemCon® Bandages PRO

A-4a 1002 (old pn 105)

HemCon® Bandage PRO, 2x4 inch, single. Each $39.88

A-4a 1002 (old pn 105)

HemCon® Bandage PRO, 2x4 inch, box of 5. Box $199.40

A-4a 1002 (old pn 105)

HemCon® Bandage PRO, 2x4 inch, case of 100. Case $3,987.94

4” x 4” HemCon® Bandages PRO

A-4a 1003 (old pn 101)

HemCon® Bandage PRO, 4x4 inch, single. Each $75.38

A-4a 1003 (old pn 101)

HemCon® Bandage PRO, 4x4 inch, box of 5. Box $376.88

A-4a 1003 (old pn 101)

HemCon® Bandage PRO, 4x4 inch, case of 100. Case $7,537.69

A-4a 1062 (old pn 302)

HemCon® Training Bandage PRO, 4x4 inch, single. Each $10.57

HemCon Patch® PRO

A-4a 1004 (old pn 129)

HemCon Patch® PRO, 1.5x 1.5 inch, box of 10. Box $186.53

A-4a 1004 (old pn 129)

HemCon Patch® PRO, 1.5x1.5 inch, case of 100. Case $1,865.33

(Not applicable: Items available for expedited delivery are noted in this price list.)

See Attachment #1 to Federal Supply Schedule Price List:

HemCon Medical Technologies Inc - Terms of Sale, revised 10-19-2009.