VA259-17-R-0100-A00010004.xlsx

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AMENDMENT 9
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VA25917R0100
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This is a price schedule for respiratory home medical equipment and services required by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19. The schedule lists line items for initial setup, monthly rental, maintenance, and purchase of various oxygen equipment including concentrators, portable oxygen systems, liquid oxygen systems, ventilators, nebulizers, suction machines, and percussive vests. It also includes training, equipment delivery, maintenance, and replacement of supplies. The total period of performance covers an initial base year from November 2017 to September 2018 with four optional one-year extensions. Pricing is required for each equipment type and associated service.

VA259-17-R-0100 A00010 Attachment 1, Salt Lake City CLINS.xlsx

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PRICE SCHEDULE
VA SALT LAKE CITY HEALTH CARE SYSTEM
PERIOD OF PERFORMANCE: BASE YEAR NOVEMBER 1, 2017 TO SEPTEMBER 30, 2018
LINE ITEMHCPSC CODEDESCRIPTION OF SERVICESESTIMATED ANNUAL QUANTITYUNIT OF ISSUEUNIT PRICEESTIMATED TOTAL
0001E1390Initial set up of Rental Concentrators : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.3,600Each
0001AAE1390Monthly Rental of Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.43,200Each
0001ABE1390Equipment Maintenance of Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.10,800Each
0002E1390Initial set up of Rental of Low Decibel Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.500Each
0002AAE1390Monthly Rental of Low Decibel Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.6,000Each
0002ABE1390Equipment Maintenance Low Decibel Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.1,500Each
0003E1390Initial set up of Rental of High Flow Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.130Each
0003AAE1390Monthly Rental of High Flow Rental Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.1,560Each
0003ABE1390Equipment Maintenance of High Flow Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.390Each
0004E1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 2Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004AAE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 2Ltr continuous flow that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ABE1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 3Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004ACE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 3Ltr continuous flow. that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ADE1392Rental of Portable Oxygen Concentrator: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. )300Each
0004AEE1392Rental of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards.200Each
0005E0431Initial Set up of Portable Gaseous System Sizes C, D, E, MM, H: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders.100Each
0005AAE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes: C, D, and E.4,500Each
0005ABE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding cylinders, sizes: MM, H.500Each
0005ACE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C)168,000Each
0005ADE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, MM, H)2,000Each
0006E0439Initial Set Up Of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0006AAE0439Monthly Rental of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.144Each
0007E0442Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents (LBS).36,000LBS
0008E0434Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0008AAE0434Monthly Rental of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.120Each
0009E0465Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009AAE0465Monthly Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009ABE0465Maintenanceof Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment.120Each
0009ACE0465Rental of Ventilator System: Contractor to deliver the replacement of all consumable supplies, per manufacture guidelines.120Each
0010E0565Initial set up of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010AAE0565Monthly Rental of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010ABE0565Rental of Air Compressor: Contractor to deliver the replacement of associated supplies ,per manufacture guidelines.(Heated, and NON-heated LVN set ups)240Each
0011VA120CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs.200Each
0012E0600Set-up of Suction Machine: Delivery, Set-up, and Training of VA owned Suction Machine (stationary/portable). To include all necessary supplies.1Each
0012AAE0600Set-up of Suction Machine: Contractor to deliver the replacement of consumable supplies.1
0012ABE0600Set-up of Suction Machine: Retrieval of government owned suction machine with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.1Each
0013VA120Set-up of Nebulizer: Delivery, Set-up, and Training of VA owned Nebulizers. To include all necessary supplies.20Each
0013AAVA120Set-up of Nebulizer: Contractor to deliver the replacement of associated supplies.240Each
0014VA120Set-up of Cough Assist: Delivery, Set-up, and Training of VA owned cough assist device.120Each
0014AAVA120Set-up of Cough Assist: Contractor to deliver the replacement of associated supplies. To include all necessary supplies.120Each
0014AB'VA120Set-up of Cough Assist: Retrieval of government owned cough Assist with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.120Each
0015VA120Set-up of Percussive Vest: Set-up, and Training of VA owned Percussive Vests.10Each
0015AAVA120Set-up of Percussive Vest: Contractor to deliver the replacement of associated supplies.10Each
0015ABVA120Set-up of Percussive Vest: Retrieval of government owned cough Assist with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.10Each
0016E600Purchase of Suction Machine: Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction machine, Stationary electric, to include all supplies.36Each
0016AAE600Purchase of Suction Machine: Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Machine, Portable electric with battery back up, to include all supplies.36Each
0016ABE600Purchase of Suction Machine: Contractor to deliver the replacement of associated supplies.36Each
0017E0570Purchase of Nebulizer: Purchase, Delivery, Set-up, and Training of Contractor Model Compressor Nebulizers. To include all necessary supplies.1Each
0017AAE0570Purchase of Nebulizer: Contractor to deliver the replacement of associated supplies.1Each
0018E0482Purchase of Cough Assist: Purchase, Delivery, Set-up, and Training of Contractor Model Cough Assist Device.60Each
0018AAE0482Purchase of Cough Assist: Contractor to deliver the replacement of associated supplies.60Each
0019A7025Purchase of Percussive Vest: Purchase, Delivery, Set-up, and Training of Contractor Model Percussive Vests.5Each
0020E1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for Simply Go. VA staff will determine number based on travel itinerary.100Each
0020AAE1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for Simply Go Mini. VA staff will determine number based on travel itinerary.100Each
0020ABE1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for I-GO. VA staff will determine number based on travel itinerary.100Each
0021VA120Set-up of Airvo: Set-up, Training of VA owned Airvo.60Each
0021AAVA120Set-up of Airvo: Contractor to perform maintenance as prescribed by manufacture guidelines of VA owned Airvo .60Each
0022VA120Setup- of CPAP/Bi Levels: VA issued CPAP/Bi-Levels shall be set-up by an RRT, CRT, or RN.36Each
0022VA120Setup- of CPAP/Bi Levels: Oxygen enrichment attachments: oxygen enrichment adapter and pressure (relief) valve necessary shall be provided by the Contractor as prescribed for bleed in oxygen.2,000Each
ESTIMATED TOTAL
PERIOD OF PERFORMANCE: OPTION YEAR 1 OCTOBER 1, 2018 TO SEPTEMBER 30, 2019
LINE ITEMHCPSC CODEDESCRIPTION OF SERVICESESTIMATED ANNUAL QUANTITYUNIT OF ISSUEUNIT PRICEESTIMATED TOTAL
0001E1390Initial set up of Rental Concentrators : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.3,600Each
0001AAE1390Monthly Rental of Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.43,200Each
0001ABE1390Equipment Maintenance of Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.10,800Each
0002E1390Initial set up of Rental of Low Decibel Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.500Each
0002AAE1390Monthly Rental of Low Decibel Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.6,000Each
0002ABE1390Equipment Maintenance Low Decibel Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.1,500Each
0003E1390Initial set up of Rental of High Flow Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.130Each
0003AAE1390Monthly Rental of High Flow Rental Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.1,560Each
0003ABE1390Equipment Maintenance of High Flow Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.390Each
0004E1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 2Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004AAE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 2Ltr continuous flow that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ABE1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 3Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004ACE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 3Ltr continuous flow. that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ADE1392Rental of Portable Oxygen Concentrator: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. )300Each
0004AEE1392Rental of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards.200Each
0005E0431Initial Set up of Portable Gaseous System Sizes C, D, E, MM, H: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders.100Each
0005AAE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes: C, D, and E.4,500Each
0005ABE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding cylinders, sizes: MM, H.500Each
0005ACE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C)168,000Each
0005ADE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, MM, H)2,000Each
0006E0439Initial Set Up Of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0006AAE0439Monthly Rental of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.144Each
0007E0442Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents (LBS).36,000LBS
0008E0434Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0008AAE0434Monthly Rental of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.120Each
0009E0465Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009AAE0465Monthly Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009ABE0465Maintenanceof Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment.120Each
0009ACE0465Rental of Ventilator System: Contractor to deliver the replacement of all consumable supplies, per manufacture guidelines.120Each
0010E0565Initial set up of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010AAE0565Monthly Rental of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010ABE0565Rental of Air Compressor: Contractor to deliver the replacement of associated supplies ,per manufacture guidelines.(Heated, and NON-heated LVN set ups)240Each
0011VA120CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs.200Each
0012E0600Set-up of Suction Machine: Delivery, Set-up, and Training of VA owned Suction Machine (stationary/portable). To include all necessary supplies.1Each
0012AAE0600Set-up of Suction Machine: Contractor to deliver the replacement of consumable supplies.1
0012ABE0600Set-up of Suction Machine: Retrieval of government owned suction machine with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.1Each
0013VA120Set-up of Nebulizer: Delivery, Set-up, and Training of VA owned Nebulizers. To include all necessary supplies.20Each
0013AAVA120Set-up of Nebulizer: Contractor to deliver the replacement of associated supplies.240Each
0014VA120Set-up of Cough Assist: Delivery, Set-up, and Training of VA owned cough assist device.120Each
0014AAVA120Set-up of Cough Assist: Contractor to deliver the replacement of associated supplies. To include all necessary supplies.120Each
0014AB'VA120Set-up of Cough Assist: Retrieval of government owned cough Assist with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.120Each
0015VA120Set-up of Percussive Vest: Set-up, and Training of VA owned Percussive Vests.10Each
0015AAVA120Set-up of Percussive Vest: Contractor to deliver the replacement of associated supplies.10Each
0015ABVA120Set-up of Percussive Vest: Retrieval of government owned cough Assist with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.10Each
0016E600Purchase of Suction Machine: Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction machine, Stationary electric, to include all supplies.36Each
0016AAE600Purchase of Suction Machine: Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Machine, Portable electric with battery back up, to include all supplies.36Each
0016ABE600Purchase of Suction Machine: Contractor to deliver the replacement of associated supplies.36Each
0017E0570Purchase of Nebulizer: Purchase, Delivery, Set-up, and Training of Contractor Model Compressor Nebulizers. To include all necessary supplies.1Each
0017AAE0570Purchase of Nebulizer: Contractor to deliver the replacement of associated supplies.1Each
0018E0482Purchase of Cough Assist: Purchase, Delivery, Set-up, and Training of Contractor Model Cough Assist Device.60Each
0018AAE0482Purchase of Cough Assist: Contractor to deliver the replacement of associated supplies.60Each
0019A7025Purchase of Percussive Vest: Purchase, Delivery, Set-up, and Training of Contractor Model Percussive Vests.5Each
0020E1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for Simply Go. VA staff will determine number based on travel itinerary.100Each
0020AAE1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for Simply Go Mini. VA staff will determine number based on travel itinerary.100Each
0020ABE1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for I-GO. VA staff will determine number based on travel itinerary.100Each
0021VA120Set-up of Airvo: Set-up, Training of VA owned Airvo.60Each
0021AAVA120Set-up of Airvo: Contractor to perform maintenance as prescribed by manufacture guidelines of VA owned Airvo .60Each
0022VA120Setup- of CPAP/Bi Levels: VA issued CPAP/Bi-Levels shall be set-up by an RRT, CRT, or RN.36Each
0022VA120Setup- of CPAP/Bi Levels: Oxygen enrichment attachments: oxygen enrichment adapter and pressure (relief) valve necessary shall be provided by the Contractor as prescribed for bleed in oxygen.2,000Each
ESTIMATED TOTAL
PERIOD OF PERFORMANCE: OPTION YEAR 2 OCTOBER 1, 2019 TO SEPTEMBER 30, 2020
LINE ITEMHCPSC CODEDESCRIPTION OF SERVICESESTIMATED ANNUAL QUANTITYUNIT OF ISSUEUNIT PRICEESTIMATED TOTAL
0001E1390Initial set up of Rental Concentrators : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.3,600Each
0001AAE1390Monthly Rental of Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.43,200Each
0001ABE1390Equipment Maintenance of Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.10,800Each
0002E1390Initial set up of Rental of Low Decibel Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.500Each
0002AAE1390Monthly Rental of Low Decibel Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.6,000Each
0002ABE1390Equipment Maintenance Low Decibel Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.1,500Each
0003E1390Initial set up of Rental of High Flow Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.130Each
0003AAE1390Monthly Rental of High Flow Rental Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.1,560Each
0003ABE1390Equipment Maintenance of High Flow Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.390Each
0004E1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 2Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004AAE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 2Ltr continuous flow that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ABE1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 3Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004ACE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 3Ltr continuous flow. that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ADE1392Rental of Portable Oxygen Concentrator: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. )300Each
0004AEE1392Rental of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards.200Each
0005E0431Initial Set up of Portable Gaseous System Sizes C, D, E, MM, H: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders.100Each
0005AAE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes: C, D, and E.4,500Each
0005ABE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding cylinders, sizes: MM, H.500Each
0005ACE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C)168,000Each
0005ADE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, MM, H)2,000Each
0006E0439Initial Set Up Of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0006AAE0439Monthly Rental of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.144Each
0007E0442Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents (LBS).36,000LBS
0008E0434Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0008AAE0434Monthly Rental of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.120Each
0009E0465Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009AAE0465Monthly Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009ABE0465Maintenanceof Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment.120Each
0009ACE0465Rental of Ventilator System: Contractor to deliver the replacement of all consumable supplies, per manufacture guidelines.120Each
0010E0565Initial set up of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010AAE0565Monthly Rental of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010ABE0565Rental of Air Compressor: Contractor to deliver the replacement of associated supplies ,per manufacture guidelines.(Heated, and NON-heated LVN set ups)240Each
0011VA120CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs.200Each
0012E0600Set-up of Suction Machine: Delivery, Set-up, and Training of VA owned Suction Machine (stationary/portable). To include all necessary supplies.1Each
0012AAE0600Set-up of Suction Machine: Contractor to deliver the replacement of consumable supplies.1
0012ABE0600Set-up of Suction Machine: Retrieval of government owned suction machine with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.1Each
0013VA120Set-up of Nebulizer: Delivery, Set-up, and Training of VA owned Nebulizers. To include all necessary supplies.20Each
0013AAVA120Set-up of Nebulizer: Contractor to deliver the replacement of associated supplies.240Each
0014VA120Set-up of Cough Assist: Delivery, Set-up, and Training of VA owned cough assist device.120Each
0014AAVA120Set-up of Cough Assist: Contractor to deliver the replacement of associated supplies. To include all necessary supplies.120Each
0014AB'VA120Set-up of Cough Assist: Retrieval of government owned cough Assist with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.120Each
0015VA120Set-up of Percussive Vest: Set-up, and Training of VA owned Percussive Vests.10Each
0015AAVA120Set-up of Percussive Vest: Contractor to deliver the replacement of associated supplies.10Each
0015ABVA120Set-up of Percussive Vest: Retrieval of government owned cough Assist with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.10Each
0016E600Purchase of Suction Machine: Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction machine, Stationary electric, to include all supplies.36Each
0016AAE600Purchase of Suction Machine: Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Machine, Portable electric with battery back up, to include all supplies.36Each
0016ABE600Purchase of Suction Machine: Contractor to deliver the replacement of associated supplies.36Each
0017E0570Purchase of Nebulizer: Purchase, Delivery, Set-up, and Training of Contractor Model Compressor Nebulizers. To include all necessary supplies.1Each
0017AAE0570Purchase of Nebulizer: Contractor to deliver the replacement of associated supplies.1Each
0018E0482Purchase of Cough Assist: Purchase, Delivery, Set-up, and Training of Contractor Model Cough Assist Device.60Each
0018AAE0482Purchase of Cough Assist: Contractor to deliver the replacement of associated supplies.60Each
0019A7025Purchase of Percussive Vest: Purchase, Delivery, Set-up, and Training of Contractor Model Percussive Vests.5Each
0020E1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for Simply Go. VA staff will determine number based on travel itinerary.100Each
0020AAE1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for Simply Go Mini. VA staff will determine number based on travel itinerary.100Each
0020ABE1390Daily Rental of Extra batteries for VA owned POC's for travel: Deliver ensure proper function of extra batteries (EACH) for VA owned POC's for I-GO. VA staff will determine number based on travel itinerary.100Each
0021VA120Set-up of Airvo: Set-up, Training of VA owned Airvo.60Each
0021AAVA120Set-up of Airvo: Contractor to perform maintenance as prescribed by manufacture guidelines of VA owned Airvo .60Each
0022VA120Setup- of CPAP/Bi Levels: VA issued CPAP/Bi-Levels shall be set-up by an RRT, CRT, or RN.36Each
0022VA120Setup- of CPAP/Bi Levels: Oxygen enrichment attachments: oxygen enrichment adapter and pressure (relief) valve necessary shall be provided by the Contractor as prescribed for bleed in oxygen.2,000Each
ESTIMATED TOTAL
PERIOD OF PERFORMANCE: OPTION YEAR 3 OCTOBER 1, 2020 TO SEPTEMBER 30, 2021
LINE ITEMHCPSC CODEDESCRIPTION OF SERVICESESTIMATED ANNUAL QUANTITYUNIT OF ISSUEUNIT PRICEESTIMATED TOTAL
0001E1390Initial set up of Rental Concentrators : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.3,600Each
0001AAE1390Monthly Rental of Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.43,200Each
0001ABE1390Equipment Maintenance of Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.10,800Each
0002E1390Initial set up of Rental of Low Decibel Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.500Each
0002AAE1390Monthly Rental of Low Decibel Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.6,000Each
0002ABE1390Equipment Maintenance Low Decibel Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.1,500Each
0003E1390Initial set up of Rental of High Flow Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 2LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.130Each
0003AAE1390Monthly Rental of High Flow Rental Concentrator: Monthly rental fees for Concentrators >2 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems.1,560Each
0003ABE1390Equipment Maintenance of High Flow Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.390Each
0004E1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 2Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004AAE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 2Ltr continuous flow that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ABE1392Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training, functioning of equipment for 3Ltr continuous flow concentrator. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).100Each
0004ACE1392Daily Rental of Portable Oxygen Concentrator: rental fees for Concentrators functioning of equipment for 3Ltr continuous flow. that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems.100Each
0004ADE1392Rental of Portable Oxygen Concentrator: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. )300Each
0004AEE1392Rental of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards.200Each
0005E0431Initial Set up of Portable Gaseous System Sizes C, D, E, MM, H: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders.100Each
0005AAE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes: C, D, and E.4,500Each
0005ABE0431Monthly Rental of Portable Gaseous System: Contractor to deliver, set-up & ensure proper training, functioning of equipment, for portable system. Portable System, including various tank sizes, regulator for continuous flow, Conserving device (pulse dose regulator) with durable backpack to use with smaller tanks sizes for flows < 4LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding cylinders, sizes: MM, H.500Each
0005ACE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C)168,000Each
0005ADE0443Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, MM, H)2,000Each
0006E0439Initial Set Up Of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0006AAE0439Monthly Rental of Stationary Liquid Oxygen System: Reservoir, Regulator, Flow meter, Humidifier, Cannulas, Masks and colored tubing. Includes one portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.144Each
0007E0442Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents (LBS).36,000LBS
0008E0434Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.5Each
0008AAE0434Monthly Rental of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing.120Each
0009E0465Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009AAE0465Monthly Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies).10Each
0009ABE0465Maintenanceof Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment.120Each
0009ACE0465Rental of Ventilator System: Contractor to deliver the replacement of all consumable supplies, per manufacture guidelines.120Each
0010E0565Initial set up of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010AAE0565Monthly Rental of Air Compressor: Delivery, Set-up, Training of Contractor owned Air Compressor for use with equipment not self contained or cylinder driven. To include all associated supplies (Heated, and NON-heated High flow humidity set ups also expressed at Large volume nebulizers or LVN )20Each
0010ABE0565Rental of Air Compressor: Contractor to deliver the replacement of associated supplies ,per manufacture guidelines.(Heated, and NON-heated LVN set ups)240Each
0011VA120CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs.200Each
0012E0600Set-up of Suction Machine: Delivery, Set-up, and Training of VA owned Suction Machine (stationary/portable). To include all necessary supplies.1Each
0012AAE0600Set-up of Suction Machine: Contractor to deliver the replacement of consumable supplies.1
0012ABE0600Set-up of Suction Machine: Retrieval of government owned suction machine with Storage of VA owned equipment with proper maintenance/cleaning per manufacture guidelines.1Each
0013VA120Set-up of Nebulizer: Delivery, Set-up, and Training of VA owned Nebulizers. To include all necessary supplies.20Each
0013AAVA120Set-up of Nebulizer: Contractor to deliver the replacement of associated supplies.240Each
0014VA120Set-up of Cough Assist: Delivery, Set-up, and Training of VA owned cough assist device.120Each

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