VISN 4 West DME CLINs.xlsx

XLSX spreadsheet 33 KB Posted

Attached to
N065: Durable Medical Equipment (DME) services - VISN 4 West Medical Centers
Solicitation number
36C24427Q0004
Issued by

About this file

This file is a pricing spreadsheet that outlines the Contract Line Item Numbers (CLINs) for Durable Medical Equipment (DME) services supporting VISN 4 West Medical Centers under solicitation 36C24427Q0004. The spreadsheet identifies the specific medical centers within the VISN 4 West network that require DME services, including storage, delivery, installation, and repair. The document serves as a structured pricing template that allows offerors to submit costs associated with providing these services across the designated facilities.

The CLINs detailed in the spreadsheet establish the contractual line items against which vendors will propose pricing for the full range of DME support services. This pricing framework aligns with the Performance Work Statement (PWS) and Request for Quote (RFQ) attachments referenced in the solicitation, enabling the Department of Veterans Affairs to evaluate vendor proposals on a consistent basis across all VISN 4 West locations. The spreadsheet functions as a critical component of the solicitation package, ensuring transparent and comparable cost submissions from all prospective contractors.

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OP 1

PERIOD OF PERFORMANCE – ORDERING PERIOD 1, October 21, 2026 – October 20, 2027
CLINLOCATIONSERVICE **(See PWS)ESTIMATED AmountUNIT OF MEASUREUNIT PRICEAMOUNT
0001DME WestRate for pick-up or delivery. The charge required for scheduling the delivery or pick up appointment with the patient or his/her caregiver; storage, delivery, assembly, set-up, installation and adjustment of basic DME; reclaiming the DME (including disassembly, un-installation and pick up); providing patient instructions for use, care, maintenance & basic trouble-shooting of the DME; and completing a delivery certification.
0001 AAAltoona MC750EA$ - 0
0001 ABButler MC344EA$ - 0
0001 ACErie MC593EA$ - 0
0001 ADPittsburgh MC3,114EA$ - 0
0002DME WestREPAIR SERVICE: Repair service for all DME and wheelchairs to restore items picked-up to first class condition will be made on the basis of an hourly rate with agreement reached on a per job basis with the Prosthetic Representative and Prosthetics, prior to any repair service, except in cases of emergency. See section 4.5 of PWS for tiers.
0002 AAAltoona MC850JOB$ - 0
0002 ABButler MC369JOB$ - 0
0002 ACErie MC371JOB$ - 0
0002 ADPittsburgh MC2,380JOB$ - 0
0003DME WestINSTALLATION/ASSESSMENT of VA supplied grab bars. This unit rate is the cost for installation of each individual grab bar installed.
0003 AAAltoona MC200EA$ - 0
0003 ABButler MC234EA$ - 0
0003 ACErie MC172EA$ - 0
0003 ADPittsburgh MC930EA$ - 0
0004DME WestAFTER HOURS/EMERGENCY DELIVERY: The Contractor will offer emergency delivery service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week.
0004 AAAltoona MC0EA$ - 0
0004 ABButler MC4EA$ - 0
0004 ACErie MC1EA$ - 0
0004 ADPittsburgh MC24EA$ - 0
0005DME WestAFTER HOURS/EMERGENCY REPAIR: The Contractor will offer emergency repair service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week. See section 4.5 of PWS for tiers.
0005 AAAltoona MC0JOB$ - 0
0005 ABButler MC0JOB$ - 0
0005 ACErie MC1JOB$ - 0
0005 ADPittsburgh MC5JOB$ - 0
0006DME WestCLEANING/PROCESSING OF VA EQUIPMENT: All equipment picked-up from patient will be stored separately from clean equipment within the Contractor’s storage facility until the equipment that has been cleaned, tagged and bagged.
0006 AAAltoona MC0EA$ - 0
0006 ABButler MC0EA$ - 0
0006 ACErie MC0EA$ - 0
0006 ADPittsburgh MC0EA$ - 0
0007DME WestCOMPLEX POWER CHAIRS: With adjustable seating 60 minutes to put together, 90 minutes to set-up, 1 follow-up visit Certified Technician
0007 AAAltoona MC5EA$ - 0
0007 ABButler MC3EA$ - 0
0007 ACErie MC44EA$ - 0
0007 ADPittsburgh MC360EA$ - 0
0008DME WestINSTALLATION/SET-UP Installation and set-up of VA owned Telehealth equipment.
0008 AAAltoona MC50EA$ - 0
0008 ABButler MC0EA$ - 0
0008 ACErie MC0EA$ - 0
0008 ADPittsburgh MC0EA$ - 0
0009DME WestRate for patient-specific equipment pick-up at designated VA Facility.
0009 AAAltoona MC0EA$ - 0
0009 ABButler MC0EA$ - 0
0009 ACErie MC0EA$ - 0
0009 ADPittsburgh MC750EA$ - 0
TOTAL Ordering Period 1 Price$ - 0

OP 2

PERIOD OF PERFORMANCE – ORDERING PERIOD 2, October 21, 2027 – October 20, 2028
CLINLOCATIONSERVICE **(See PWS)ESTIMATED AmountUNIT OF MEASUREUNIT PRICEAMOUNT
1001DME WestRate for pick-up or delivery. The charge required for scheduling the delivery or pick up appointment with the patient or his/her caregiver; storage, delivery, assembly, set-up, installation and adjustment of basic DME; reclaiming the DME (including disassembly, un-installation and pick up); providing patient instructions for use, care, maintenance & basic trouble-shooting of the DME; and completing a delivery certification.
1001 AAAltoona MC750EA$ - 0
1001 ABButler MC344EA$ - 0
1001 ACErie MC593EA$ - 0
1001 ADPittsburgh MC3,114EA$ - 0
1002DME WestREPAIR SERVICE: Repair service for all DME and wheelchairs to restore items picked-up to first class condition will be made on the basis of an hourly rate with agreement reached on a per job basis with the Prosthetic Representative and Prosthetics, prior to any repair service, except in cases of emergency. See section 4.5 of PWS for tiers.
1002 AAAltoona MC850JOB$ - 0
1002 ABButler MC369JOB$ - 0
1002 ACErie MC371JOB$ - 0
1002 ADPittsburgh MC2,380JOB$ - 0
1003DME WestINSTALLATION/ASSESSMENT of VA supplied grab bars. This unit rate is the cost for installation of each individual grab bar installed.
1003 AAAltoona MC200EA$ - 0
1003 ABButler MC234EA$ - 0
1003 ACErie MC172EA$ - 0
1003 ADPittsburgh MC930EA$ - 0
1004DME WestAFTER HOURS/EMERGENCY DELIVERY: The Contractor will offer emergency delivery service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week.
1004 AAAltoona MC0EA$ - 0
1004 ABButler MC4EA$ - 0
1004 ACErie MC1EA$ - 0
1004 ADPittsburgh MC24EA$ - 0
1005DME WestAFTER HOURS/EMERGENCY REPAIR: The Contractor will offer emergency repair service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week. See section 4.5 of PWS for tiers.
1005 AAAltoona MC0JOB$ - 0
1005 ABButler MC0JOB$ - 0
1005 ACErie MC1JOB$ - 0
1005 ADPittsburgh MC5JOB$ - 0
1006DME WestCLEANING/PROCESSING OF VA EQUIPMENT: All equipment picked-up from patient will be stored separately from clean equipment within the Contractor’s storage facility until the equipment that has been cleaned, tagged and bagged.
1006 AAAltoona MC0EA$ - 0
1006 ABButler MC0EA$ - 0
1006 ACErie MC0EA$ - 0
1006 ADPittsburgh MC0EA$ - 0
1007DME WestCOMPLEX POWER CHAIRS: With adjustable seating 60 minutes to put together, 90 minutes to set-up, 1 follow-up visit Certified Technician
1007 AAAltoona MC5EA$ - 0
1007 ABButler MC3EA$ - 0
1007 ACErie MC44EA$ - 0
1007 ADPittsburgh MC360EA$ - 0
1008DME WestINSTALLATION/SET-UP Installation and set-up of VA owned Telehealth equipment.
1008 AAAltoona MC50EA$ - 0
1008 ABButler MC0EA$ - 0
1008 ACErie MC0EA$ - 0
1008 ADPittsburgh MC0EA$ - 0
1009DME WestRate for patient-specific equipment pick-up at designated VA Facility.
1009 AAAltoona MC0EA$ - 0
1009 ABButler MC0EA$ - 0
1009 ACErie MC0EA$ - 0
1009 ADPittsburgh MC750EA$ - 0
TOTAL Ordering Period 2 Price$ - 0

OP 3

PERIOD OF PERFORMANCE – ORDERING PERIOD 3, October 21, 2028 – October 20, 2029
CLINLOCATIONSERVICE **(See PWS)ESTIMATED AmountUNIT OF MEASUREUNIT PRICEAMOUNT
2001DME WestRate for pick-up or delivery. The charge required for scheduling the delivery or pick up appointment with the patient or his/her caregiver; storage, delivery, assembly, set-up, installation and adjustment of basic DME; reclaiming the DME (including disassembly, un-installation and pick up); providing patient instructions for use, care, maintenance & basic trouble-shooting of the DME; and completing a delivery certification.
2001 AAAltoona MC750EA$ - 0
2001 ABButler MC344EA$ - 0
2001 ACErie MC593EA$ - 0
2001 ADPittsburgh MC3,114EA$ - 0
2002DME WestREPAIR SERVICE: Repair service for all DME and wheelchairs to restore items picked-up to first class condition will be made on the basis of an hourly rate with agreement reached on a per job basis with the Prosthetic Representative and Prosthetics, prior to any repair service, except in cases of emergency. See section 4.5 of PWS for tiers.
2002 AAAltoona MC850JOB$ - 0
2002 ABButler MC369JOB$ - 0
2002 ACErie MC371JOB$ - 0
2002 ADPittsburgh MC2,380JOB$ - 0
2003DME WestINSTALLATION/ASSESSMENT of VA supplied grab bars. This unit rate is the cost for installation of each individual grab bar installed.
2003 AAAltoona MC200EA$ - 0
2003 ABButler MC234EA$ - 0
2003 ACErie MC172EA$ - 0
2003 ADPittsburgh MC930EA$ - 0
2004DME WestAFTER HOURS/EMERGENCY DELIVERY: The Contractor will offer emergency delivery service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week.
2004 AAAltoona MC0EA$ - 0
2004 ABButler MC4EA$ - 0
2004 ACErie MC1EA$ - 0
2004 ADPittsburgh MC24EA$ - 0
2005DME WestAFTER HOURS/EMERGENCY REPAIR: The Contractor will offer emergency repair service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week. See section 4.5 of PWS for tiers.
2005 AAAltoona MC0JOB$ - 0
2005 ABButler MC0JOB$ - 0
2005 ACErie MC1JOB$ - 0
2005 ADPittsburgh MC5JOB$ - 0
2006DME WestCLEANING/PROCESSING OF VA EQUIPMENT: All equipment picked-up from patient will be stored separately from clean equipment within the Contractor’s storage facility until the equipment that has been cleaned, tagged and bagged.
2006 AAAltoona MC0EA$ - 0
2006 ABButler MC0EA$ - 0
2006 ACErie MC0EA$ - 0
2006 ADPittsburgh MC0EA$ - 0
2007DME WestCOMPLEX POWER CHAIRS: With adjustable seating 60 minutes to put together, 90 minutes to set-up, 1 follow-up visit Certified Technician
2007 AAAltoona MC5EA$ - 0
2007 ABButler MC3EA$ - 0
2007 ACErie MC44EA$ - 0
2007 ADPittsburgh MC360EA$ - 0
2008DME WestINSTALLATION/SET-UP Installation and set-up of VA owned Telehealth equipment.
2008 AAAltoona MC50EA$ - 0
2008 ABButler MC0EA$ - 0
2008 ACErie MC0EA$ - 0
2008 ADPittsburgh MC0EA$ - 0
2009DME WestRate for patient-specific equipment pick-up at designated VA Facility.
2009 AAAltoona MC0EA$ - 0
2009 ABButler MC0EA$ - 0
2009 ACErie MC0EA$ - 0
2009 ADPittsburgh MC750EA$ - 0
TOTAL Ordering Period 3 Price$ - 0

OP 4

PERIOD OF PERFORMANCE – ORDERING PERIOD 4, October 21, 2029 – October 20, 2030
CLINLOCATIONSERVICE **(See PWS)ESTIMATED AmountUNIT OF MEASUREUNIT PRICEAMOUNT
3001DME WestRate for pick-up or delivery. The charge required for scheduling the delivery or pick up appointment with the patient or his/her caregiver; storage, delivery, assembly, set-up, installation and adjustment of basic DME; reclaiming the DME (including disassembly, un-installation and pick up); providing patient instructions for use, care, maintenance & basic trouble-shooting of the DME; and completing a delivery certification.
3001 AAAltoona MC750EA$ - 0
3001 ABButler MC344EA$ - 0
3001 ACErie MC593EA$ - 0
3001 ADPittsburgh MC3,114EA$ - 0
3002DME WestREPAIR SERVICE: Repair service for all DME and wheelchairs to restore items picked-up to first class condition will be made on the basis of an hourly rate with agreement reached on a per job basis with the Prosthetic Representative and Prosthetics, prior to any repair service, except in cases of emergency. See section 4.5 of PWS for tiers.
3002 AAAltoona MC850JOB$ - 0
3002 ABButler MC369JOB$ - 0
3002 ACErie MC371JOB$ - 0
3002 ADPittsburgh MC2,380JOB$ - 0
3003DME WestINSTALLATION/ASSESSMENT of VA supplied grab bars. This unit rate is the cost for installation of each individual grab bar installed.
3003 AAAltoona MC200EA$ - 0
3003 ABButler MC234EA$ - 0
3003 ACErie MC172EA$ - 0
3003 ADPittsburgh MC930EA$ - 0
3004DME WestAFTER HOURS/EMERGENCY DELIVERY: The Contractor will offer emergency delivery service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week.
3004 AAAltoona MC0EA$ - 0
3004 ABButler MC4EA$ - 0
3004 ACErie MC1EA$ - 0
3004 ADPittsburgh MC24EA$ - 0
3005DME WestAFTER HOURS/EMERGENCY REPAIR: The Contractor will offer emergency repair service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week. See section 4.5 of PWS for tiers.
3005 AAAltoona MC0JOB$ - 0
3005 ABButler MC0JOB$ - 0
3005 ACErie MC1JOB$ - 0
3005 ADPittsburgh MC5JOB$ - 0
3006DME WestCLEANING/PROCESSING OF VA EQUIPMENT: All equipment picked-up from patient will be stored separately from clean equipment within the Contractor’s storage facility until the equipment that has been cleaned, tagged and bagged.
3006 AAAltoona MC0EA$ - 0
3006 ABButler MC0EA$ - 0
3006 ACErie MC0EA$ - 0
3006 ADPittsburgh MC0EA$ - 0
3007DME WestCOMPLEX POWER CHAIRS: With adjustable seating 60 minutes to put together, 90 minutes to set-up, 1 follow-up visit Certified Technician
3007 AAAltoona MC5EA$ - 0
3007 ABButler MC3EA$ - 0
3007 ACErie MC44EA$ - 0
3007 ADPittsburgh MC360EA$ - 0
3008DME WestINSTALLATION/SET-UP Installation and set-up of VA owned Telehealth equipment.
3008 AAAltoona MC50EA$ - 0
3008 ABButler MC0EA$ - 0
3008 ACErie MC0EA$ - 0
3008 ADPittsburgh MC0EA$ - 0
3009DME WestRate for patient-specific equipment pick-up at designated VA Facility.
3009 AAAltoona MC0EA$ - 0
3009 ABButler MC0EA$ - 0
3009 ACErie MC0EA$ - 0
3009 ADPittsburgh MC750EA$ - 0
TOTAL Ordering Period 4 Price$ - 0

OP 5

PERIOD OF PERFORMANCE – ORDERING PERIOD 5, October 21, 2030 – October 20, 2031
CLINLOCATIONSERVICE **(See PWS)ESTIMATED AmountUNIT OF MEASUREUNIT PRICEAMOUNT
4001DME WestRate for pick-up or delivery. The charge required for scheduling the delivery or pick up appointment with the patient or his/her caregiver; storage, delivery, assembly, set-up, installation and adjustment of basic DME; reclaiming the DME (including disassembly, un-installation and pick up); providing patient instructions for use, care, maintenance & basic trouble-shooting of the DME; and completing a delivery certification.
4001 AAAltoona MC750EA$ - 0
4001 ABButler MC344EA$ - 0
4001 ACErie MC593EA$ - 0
4001 ADPittsburgh MC3,114EA$ - 0
4002DME WestREPAIR SERVICE: Repair service for all DME and wheelchairs to restore items picked-up to first class condition will be made on the basis of an hourly rate with agreement reached on a per job basis with the Prosthetic Representative and Prosthetics, prior to any repair service, except in cases of emergency. See section 4.5 of PWS for tiers.
4002 AAAltoona MC850JOB$ - 0
4002 ABButler MC369JOB$ - 0
4002 ACErie MC371JOB$ - 0
4002 ADPittsburgh MC2,380JOB$ - 0
4003DME WestINSTALLATION/ASSESSMENT of VA supplied grab bars. This unit rate is the cost for installation of each individual grab bar installed.
4003 AAAltoona MC200EA$ - 0
4003 ABButler MC234EA$ - 0
4003 ACErie MC172EA$ - 0
4003 ADPittsburgh MC930EA$ - 0
4004DME WestAFTER HOURS/EMERGENCY DELIVERY: The Contractor will offer emergency delivery service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week.
4004 AAAltoona MC0EA$ - 0
4004 ABButler MC4EA$ - 0
4004 ACErie MC1EA$ - 0
4004 ADPittsburgh MC24EA$ - 0
4005DME WestAFTER HOURS/EMERGENCY REPAIR: The Contractor will offer emergency repair service for all equipment. The patient/caregiver will be instructed on emergent phone numbers in case of equipment breakdown. Emergency is defined as life sustaining. Service will be available 24 hours a day, 7 days a week. See section 4.5 of PWS for tiers.
4005 AAAltoona MC0JOB$ - 0
4005 ABButler MC0JOB$ - 0
4005 ACErie MC1JOB$ - 0
4005 ADPittsburgh MC5JOB$ - 0
4006DME WestCLEANING/PROCESSING OF VA EQUIPMENT: All equipment picked-up from patient will be stored separately from clean equipment within the Contractor’s storage facility until the equipment that has been cleaned, tagged and bagged.
4006 AAAltoona MC0EA$ - 0
4006 ABButler MC0EA$ - 0
4006 ACErie MC0EA$ - 0
4006 ADPittsburgh MC0EA$ - 0
4007DME WestCOMPLEX POWER CHAIRS: With adjustable seating 60 minutes to put together, 90 minutes to set-up, 1 follow-up visit Certified Technician
4007 AAAltoona MC5EA$ - 0
4007 ABButler MC3EA$ - 0
4007 ACErie MC44EA$ - 0
4007 ADPittsburgh MC360EA$ - 0
4008DME WestINSTALLATION/SET-UP Installation and set-up of VA owned Telehealth equipment.
4008 AAAltoona MC50EA$ - 0
4008 ABButler MC0EA$ - 0
4008 ACErie MC0EA$ - 0
4008 ADPittsburgh MC0EA$ - 0
4009DME WestRate for patient-specific equipment pick-up at designated VA Facility.
4009 AAAltoona MC0EA$ - 0
4009 ABButler MC0EA$ - 0
4009 ACErie MC0EA$ - 0
4009 ADPittsburgh MC750EA$ - 0
TOTAL Ordering Period 5 Price$ - 0

TOTALS

YEARTOTAL PRICE
Ordering period 1 - 07/01/2025-06/30/2026$ - 0
Ordering period 2 - 07/01/2026-06/30/2027$ - 0
Ordering period 3 - 07/01/2027-06/30/2028$ - 0
Ordering period 4 - 07/01/2028-06/30/2029$ - 0
Ordering period 5 - 07/01/2029-06/30/2030$ - 0
GRAND TOTAL$0.00

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