W912QR21R0008_Specs_PhaseB_Vol3_110601-0007.pdf

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Construction of the VA Medical Center (VAMC) Project in Louisville, KY
Solicitation number
W912QR21R0008
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This document provides details of a federal contract opportunity for construction of a new VA medical center campus in Louisville, KY. The U.S. Army Corps of Engineers Louisville District intends to issue a Request for Proposal for construction services over $500 million to replace aging facilities at the existing Robley Rex VAMC with a new 104 bed hospital, parking structures for over 2,600 cars, campus infrastructure and utilities on a 34 acre site. The single phase solicitation will use a best value evaluation approach considering technical factors such as past performance, management plan and key personnel experience, and price. The contract duration is 1,554 calendar days from notice to proceed and proposals are due in December 2020. The project falls under NAICS 236220 and is unrestricted.

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Project Room Contents (09 Feb 2021 03:23PM ET)

Privacy Act – FOR OFFICIAL USE ONLY (Page 1)

Project Room Contents

VAMC LOUISVILLE REPLACEMENT (CERTIFIED FINAL)

CERTIFIED FINAL (CF)

LOUISVILLE, KY

Projected Year: 2017 Midpoint Year: 2019

VISN: 9 State: KY Station ID: 603 Station Name: Louisville

Installation: VA Medical Center

Project Created: 25 Aug 2014 05:05PM ET by Eric Hunt Space Plan Last Edited: 08 Feb 2021 03:27AM ET by Chris Phillips

Contents List Created: 23 Jul 2014 04:08PM ET by Chris Phillips Contents List Last Edited: 09 Feb 2021 03:17PM ET by Chris Phillips

Report Generated: 09 Feb 2021 03:23PM ET

W912QR21R0008_Specs_PhaseB_Vol3_110601-0007

Utility Code Legend

Equipment Specification and Utility Summary

Code Plumbing Electrical Medical Gas Misc Gas Non-Medical Gas Misc

A Hot and cold water 120 volt, conventional outlet Oxygen Steam Natural gas Earth ground

B Cold water and drain 120 volt, special outlet Vacuum Nitrogen gas Liquid propane gas Lead lined walls

C Hot water and drain 208/220 volt Air, low pressure (30 PSIG) max Nitrous oxide Methane Remote alarm ground

D Cold and hot water and drain 120 and 208/220 volt Air, high pressure (85 PSIG) max Nitrogen and nitrous oxide gas Butane Empty conduit with pull cord

E Treated water and drain 440 volt, 3 phase Oxygen and vacuum Carbon dioxide gas Propane Vent to atmosphere

F Cold, hot and treated water and drain Special electrical requirements Oxygen and medical air (50 PSIG) Liquid carbon dioxide Hydrogen gas Special gas requirements

G Cold and treated water and drain 208/220 volt, 3 phase Oxygen, vacuum and medical air (50

PSIG)

Liquid nitrogen Reserved Liquid gas requirements

H Hot and treated water and drain Vacuum and HP air (85 PSIG) minimum

Acetylene gas RF/Magnetic shielding

I Drain only

J Cold water only Wall/ceiling support required

K Medical air (50 PSIG) Empty conduit/pullcord & wall/ceiling support req

L Vacuum and LP air (30 PSIG) maximum

M Earth ground and wall/ceiling support req

P Lead lined walls and wall/ceiling support req

T CAT 6 to nearest T-Comm Room

NOTE: Values shown are based on standard typicals used for programming purposes. The contractor remains responsible to develop and coordinate the design/construction in accordance with actual equipment selection.

Privacy Act – FOR OFFICIAL USE ONLY (Page 2)

Department: AFGE Functional Area: ADMIN SPACE Room Code: CRA01 Room Area: 140 Agency Room Name: Conference Room, Small Staff: 0

Criteria Room Name: Conference Room, Small Blueprint #: 0B6224

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A5145 Hook, Garment, Double, SS, Surface Mounted 4 EA CC

A5212 Bracket, Television, Wall-Mounted, Tilt/Angle 1 EA VV

F0295 Chair, Stacking 8 EA VV

F0705 Table, Computer, Small 1 EA VV F0755 Table, Conference, Wood 1 EA VV

M4 - 48" x 36"

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M2 - 43"

M0507 Video Teleconferencing System 1 EA VV . A M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

Department: AFGE Functional Area: ADMIN SPACE Room Code: OFA03 Room Area: 80 Agency Room Name: Office Administrative Staff: 1

Criteria Room Name: Administrative Office, System Furniture Blueprint #: 0B6219

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

E0045 Workcenter, Computer, Free Standing, 60" W 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 3)

F0115 Bookcase, Open, 5 Shelf 1 EA VV

F0205 Chair, Side With Arms 2 EA VV M1

F0275 Chair, Swivel, High Back 1 EA VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A M1 - Dual monitors

Department: AFGE Functional Area: ADMIN SPACE Room Code: OFA03 Room Area: 80 Agency Room Name: Office Administrative Staff: 1

Criteria Room Name: Administrative Office, System Furniture Blueprint #: 0B6220

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

E0045 Workcenter, Computer, Free Standing, 60" W 1 EA VV F0115 Bookcase, Open, 5 Shelf 1 EA VV

F0205 Chair, Side With Arms 2 EA VV M1

F0275 Chair, Swivel, High Back 1 EA VV F2000 Basket, Wastepaper, Fire Resistant 1 EA VV

Users state that all must be plastic

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A M1 - Dual monitors

Department: AFGE Functional Area: ADMIN SPACE Room Code: OFA03 Room Area: 80 Agency Room Name: Office Administrative Staff: 1

Privacy Act – FOR OFFICIAL USE ONLY (Page 4)

Criteria Room Name: Administrative Office, System Furniture Blueprint #: 0B6221

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

E0045 Workcenter, Computer, Free Standing, 60" W 1 EA VV

F0115 Bookcase, Open, 5 Shelf 1 EA VV

F0205 Chair, Side With Arms 2 EA VV M1

F0275 Chair, Swivel, High Back 1 EA VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A M1 - Dual monitors

Department: AFGE Functional Area: ADMIN SPACE Room Code: RPR03 Room Area: 60 Agency Room Name: Alcove, Copier / Printer Staff: 1

Criteria Room Name: Alcove, Copier / Printer Blueprint #: 0B6222A

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

F0465 Cabinet, Storage, 2 Door, 5 Shelf 1 EA VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F2026 Container, Recycling, Large 1 EA VV

F2550 Shredder, Paper Heavy Duty 1 EA VV . A

M1810 Copier, Floor Standing, Digital 1 EA VV . B

Department: AFGE Functional Area: ADMIN SPACE

Privacy Act – FOR OFFICIAL USE ONLY (Page 5)

Room Code: OFA02 Room Area: 100 Agency Room Name: Office, Union President Staff: 1

Criteria Room Name: Office, Administrative, System Furniture Blueprint #: 0B6223

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

E0078 Workstation, L-Shaped w/Peninsula, Free Std, 78x72 1 EA VV . A M1 - 66" x 72"

F0115 Bookcase, Open, 5 Shelf 1 EA VV F0205 Chair, Side With Arms 2 EA VV

M1

F0275 Chair, Swivel, High Back 1 EA VV

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3200 Clock, Battery, 12" Diameter 1 EA VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A M1 - Dual monitors

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: RECEPTION AREAS

Room Code: RECP3 Room Area: 150 Agency Room Name: Escort / Messenger Service Staff: 0

Criteria Room Name: Escort / Messenger Service Blueprint #: 1B4205

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

E0123 Workstation, Straight, Free Standing, 72" W 1 EA VV . A M14 - 96" Wide, 42" High Panels, w/ Mobile Pedestal

F0275 Chair, Swivel, High Back 2 EA VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 6)

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F2540 Shredder, Paper, Security 1 EA VV . A

F3200 Clock, Battery, 12" Diameter 1 EA VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1840 Printer/Copier/Fax Combination 1 EA VV . A

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: CLINIC (MAS) RECEPTION - CENTRAL CONTROL AND

PROCESSING UNIT

Room Code: SRLW1 Room Area: 60 Agency Room Name: Storage, Wheelchair and Stretcher Staff: 0

Criteria Room Name: Storage, Wheelchair and Stretcher Blueprint #: 3B6102A

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M4705 Wheelchair, Patient Transport, Folding 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: CLINIC (MAS) RECEPTION - CENTRAL CONTROL AND

PROCESSING UNIT

Room Code: BX001 Room Area: 40 Agency Room Name: Vending Machine Area Staff: 0

Criteria Room Name: Vending Machine Area Blueprint #:

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A6030 Machine, Vending 2 EA VV . A To be leased by VCS

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

Privacy Act – FOR OFFICIAL USE ONLY (Page 7)

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: CLINIC (MAS) RECEPTION - CENTRAL CONTROL AND

PROCESSING UNIT

Room Code: SRLW1 Room Area: 0 Agency Room Name: Storage, Wheelchair and Stretcher Staff: 0

Criteria Room Name: Storage, Wheelchair and Stretcher Blueprint #: 3B6401A

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M4705 Wheelchair, Patient Transport, Folding 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: RCA01 Room Area: 30 Agency Room Name: Alcove, EKG Staff: 0

Criteria Room Name: ALCOVE, AED (AUTOMATIC EXTERNAL DEFIBRILLATOR) Blueprint #: 1B4207A

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

M7710 Electrocardiograph, 12 Lead, Portable 2 EA VV . A

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: BRAR2 Room Area: 30 Agency Room Name: Anteroom, Isolation Staff: 0

Criteria Room Name: ANTEROOM, ISOLATION, POSITIVE PRESSURE Blueprint #: 1B4330A

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1066 Mirror, Float Glass, With SS Frame 1 EA CC A5075 Dispenser, Soap, Disposable 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

F2010 Basket, Wastepaper, Step-On 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 8)

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: BRAR2 Room Area: 30 Agency Room Name: Anteroom, Isolation Staff: 0

Criteria Room Name: ANTEROOM, ISOLATION, POSITIVE PRESSURE Blueprint #: 1B4430A

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A5075 Dispenser, Soap, Disposable 1 EA VV A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

F2010 Basket, Wastepaper, Step-On 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: COM02 Room Area: 100 Agency Room Name: Communications, Ambulance Dispatch Staff: 0

Criteria Room Name: Communications, Ambulance Dispatch Blueprint #: 1B4124

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV E0123 Workstation, Straight, Free Standing, 72" W 2 EA VV . A

M7 - 84" Wide, 42" High Panels

F0275 Chair, Swivel, High Back 2 EA VV

F0420 Cabinet, Filing, Lateral, Half Height 1 EA VV F2000 Basket, Wastepaper, Fire Resistant 1 EA VV

Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV F3200 Clock, Battery, 12" Diameter 1 EA VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 2 EA VV . A M1 - Dual monitors

M1840 Printer/Copier/Fax Combination 1 EA VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 9)

M4125 Radio Communication System 1 SY VV . F

U0410 Mobile Pedestal File w/Cushion top 2 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: CRA01 Room Area: 200 Agency Room Name: Conference Room/Team Room/Multipurpose Staff: 0

Criteria Room Name: Conference Room, Small Blueprint #: 1B4129

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A5145 Hook, Garment, Double, SS, Surface Mounted 3 EA CC

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV F0220 Chair, Conference 10 EA VV

F0465 Cabinet, Storage, 2 Door, 5 Shelf 1 EA VV

F0705 Table, Computer, Small 1 EA VV

F0755 Table, Conference, Wood 2 EA VV M11 - 60" x 48"

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3200 Clock, Battery, 12" Diameter 1 EA VV M0506 Television, Flat Screen 1 EA VV . A

M2 - 43"

M0507 Video Teleconferencing System 1 EA VV . A

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A M1 - Dual monitors

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: SL002 Room Area: 240

Privacy Act – FOR OFFICIAL USE ONLY (Page 10)

Agency Room Name: Consultant/Resident Documentation Room (Team Room) Staff: 0 Criteria Room Name: Team Interaction Station (COF) Blueprint #: 1B4121

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 5 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5145 Hook, Garment, Double, SS, Surface Mounted 5 EA CC E0117 Workstation, Straight, Free Standing, 48" W 2 EA VV . A

M8 - 42" Wide, 66" High Panels W/ Overhead Bin

E0120 Workstation, Straight, Free Standing, 60" W 1 EA VV . A M2 - 60" Wide, 66" High Panels, w/ Overhead Bin

E0120 Workstation, Straight, Free Standing, 60" W 1 EA VV . A M6 - 54" Wide, 66" High Panels w/ Overhead Bin

E0123 Workstation, Straight, Free Standing, 72" W 1 EA VV . A M2 - 72" Wide, 66" High Panels, w/ Overhead Bin

F0225 Chair, Dining Room 4 EA VV M1

F0275 Chair, Swivel, High Back 5 EA VV

F0705 Table, Computer, Small 1 EA VV

F0795 Table, Dining 1 EA VV M1 - 36" x 36"

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3200 Clock, Battery, 12" Diameter 1 EA VV

M1801 Computer, Microprocessing, w/Flat Panel Monitor 5 EA VV . A M1 - Dual monitors

M1825 Printer, Computer 1 EA VV . A

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: NBCD2 Room Area: 120

Privacy Act – FOR OFFICIAL USE ONLY (Page 11)

Agency Room Name: Decontamination Shower Staff: 0 Criteria Room Name: Decontamination Shower Blueprint #: 1B4329

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A5075 Dispenser, Soap, Disposable 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

E0963 Cart, General Storage, Mobile 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: SRHM1 Room Area: 150 Agency Room Name: Decontamination Storage Staff: 0

Criteria Room Name: Hazardous Materials Storage Blueprint #: 1B4327

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

F2026 Container, Recycling, Large 1 EA VV

M2055 Shelving, Storage, Wire, CRS, w/Adjustable Shelves 1 EA VV

M2070 Shelving, Storage, 77hx36wx18d 2 EA VV R9600 Shelving, Wire, Aluminum, Mobile 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Isolation Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4430

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

Privacy Act – FOR OFFICIAL USE ONLY (Page 12)

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC Disposable, open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV F0210 Chair, Side, Without Arms 1 EA VV

M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3200 Clock, Battery, 12" Diameter 1 EA VV M0506 Television, Flat Screen 1 EA VV . A

M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 13)

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Isolation Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4330

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530 A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 11 FT CC Disposable, open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 14)

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV M0506 Television, Flat Screen 1 EA VV . A

M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 15)

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4212

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV F0400 Cabinet, Bedside, Door, Drawer 1 EA VV

M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 16)

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110 M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV

M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515 M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4311

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

Privacy Act – FOR OFFICIAL USE ONLY (Page 17)

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV F0210 Chair, Side, Without Arms 1 EA VV

M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

Privacy Act – FOR OFFICIAL USE ONLY (Page 18)

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4312

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV

Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC

Privacy Act – FOR OFFICIAL USE ONLY (Page 19)

Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV F0400 Cabinet, Bedside, Door, Drawer 1 EA VV

M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

Privacy Act – FOR OFFICIAL USE ONLY (Page 20)

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4310

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530 A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV F0400 Cabinet, Bedside, Door, Drawer 1 EA VV

M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 21)

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530 M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110 M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV

M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4216

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

Privacy Act – FOR OFFICIAL USE ONLY (Page 22)

A1015 Telephone, Desk, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC

Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV M0506 Television, Flat Screen 1 EA VV . A

M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 23)

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4315

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530 A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

Privacy Act – FOR OFFICIAL USE ONLY (Page 24)

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC

Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530 M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 25)

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4316

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 26)

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530 M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515

M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Privacy Act – FOR OFFICIAL USE ONLY (Page 27)

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4424

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC A5180 Track, Cubicle, Surface Mounted, With Curtain 11 FT CC

Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

Privacy Act – FOR OFFICIAL USE ONLY (Page 28)

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4422

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530 A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 29)

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 11 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV M0506 Television, Flat Screen 1 EA VV . A

M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

Privacy Act – FOR OFFICIAL USE ONLY (Page 30)

M4255 Stand, IV, Adjustable 1 EA VV

M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV

M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXER1 Room Area: 120 Agency Room Name: Exam Room, Multipurpose Staff: 0

Criteria Room Name: Exam Room, Isolation / Multipurpose Blueprint #: 1B4420

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1015 Telephone, Desk, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530 A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 11 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 31)

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV M1 - 24" x 30"

F3200 Clock, Battery, 12" Diameter 1 EA VV M0506 Television, Flat Screen 1 EA VV . A

M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4255 Stand, IV, Adjustable 1 EA VV M4266 Pump, Volumetric, Infusion, Multiple Line 1 EA VV . A

M4655 Stretcher, Mobile, CRS, 9 Position 1 EA VV M7040 Table, Overbed 1 EA VV

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXRG8 Room Area: 150 Agency Room Name: Exam Room, OB/GYN/ Bariatric use Staff: 0

Privacy Act – FOR OFFICIAL USE ONLY (Page 32)

Criteria Room Name: Exam Room, OB/GYN Blueprint #: 1B4317

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1013 Telephone, Wall Mounted, Multiple Line 1 EA VV A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A1132 Rail, Accessory Mounting, Length As Required 2 LF VV . . . . . J 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530

A5075 Dispenser, Soap, Disposable 1 EA VV A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV F0210 Chair, Side, Without Arms 1 EA VV

M1

F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV M1 - Three Drawer

F2000 Basket, Wastepaper, Fire Resistant 1 EA VV Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

Privacy Act – FOR OFFICIAL USE ONLY (Page 33)

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110

M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4660 Stretcher, Recovery, Labor 1 EA VV Bariatric/GYN

M7040 Table, Overbed 1 EA VV M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515

M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: EXRG8 Room Area: 150 Agency Room Name: Exam Room, OB/GYN/ Bariatric use Staff: 0

Criteria Room Name: Exam Room, OB/GYN Blueprint #: 1B4321

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1013 Telephone, Wall Mounted, Multiple Line 1 EA VV

A1066 Mirror, Float Glass, With SS Frame 1 EA CC

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530 A1132 Rail, Accessory Mounting, Length As Required 2 LF VV . . . . . J 6530

A1200 Lift System, Overhead, Patient Room 1 EA CC . F . . . J 6530 A5075 Dispenser, Soap, Disposable 1 EA VV

A5077 Dispenser, Hand Sanitizer, Hands-Free 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 34)

A5080 Dispenser, Paper Towel, SS, Surface Mounted 1 EA VV

A5107 Dispenser, Glove, Surgical/Examination, Wall Mntd 1 EA VV Should accommodate 3 size boxes

A5108 Waste Disposal Unit, Sharps 1 CS VV

A5145 Hook, Garment, Double, SS, Surface Mounted 2 EA CC

A5180 Track, Cubicle, Surface Mounted, With Curtain 10 FT CC Open mesh top to allow airflow

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV

E0948 Cart, General Storage, Mobile, 42"H x 32"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV F0340 Stool, Self Adjusting 1 EA VV

F0400 Cabinet, Bedside, Door, Drawer 1 EA VV F2000 Basket, Wastepaper, Fire Resistant 1 EA VV

Users state that all must be plastic

F3050 Whiteboard, Dry Erase 1 EA VV

F3200 Clock, Battery, 12" Diameter 1 EA VV

M0506 Television, Flat Screen 1 EA VV . A M1 - 32"

M0750 Flowmeter, Air, Connect w/50 PSI Supply 1 EA VV . . K . . . 6530

M0755 Flowmeter, Oxygen, Low Flow 1 EA VV . . A . . . 6680

M0765 Regulator, Vacuum 1 EA VV . . B . . . 6515 M1801 Computer, Microprocessing, w/Flat Panel Monitor 1 EA VV . A

M1802 Work Station, Computer, Retractable, Wall Mounted 1 EA VV . B . . . D 7110 M3070 Hamper, Linen, Mobile, w/Lid 1 EA VV

M1

M3072 Frame, Infectious Waste Bag w/Lid 1 EA VV M4100 Sphygmomanometer, Aneroid, Wall Mounted 1 EA VV

M4200 Otoscope/Ophthalmoscope, Wall Mounted 1 EA VV . A

M4660 Stretcher, Recovery, Labor 1 EA VV Bariatric/GYN

M7040 Table, Overbed 1 EA VV

Privacy Act – FOR OFFICIAL USE ONLY (Page 35)

M7405 Light, Exam, Ceiling Mounted 1 EA CC . F

M7845 Monitor, Physiological, Bedside, 4 Channel 1 EA VV . A . . . D 6515 M7910 Thermometer, Electronic 1 EA VV

Department: AMBULATORY CARE - MEDICAL SURGICAL SPECIALTY

CLINIC(262)

Functional Area: EMERGENCY ROOM (ER) / URGENT CARE AREA

Room Code: OPMH4 Room Area: 120 Agency Room Name: Exam Room, Security (contents need to be securable for MH

pt) Staff: 0

Criteria Room Name: Exam Room, Security Blueprint #: 1B4412

JSN Content Name Qty Unit of Issue

Acq Code Util1 Util2 Util3 Util4 Util5 Util6 NSN

A1013 Telephone, Wall Mounted, Multiple Line 1 EA VV

A1107 Rail System , Utility, Gas and Electric 1 EA CC . F G . . A 6530

A5210 Bracket, Television, Wall Mounted, w/Adjust Arm 1 EA VV M1 - Low Profile

E0960 Cart, Lockable, Mobile, 42"H x 49"W x 22"D 1 EA VV

F0210 Chair, Side, Without Arms 1 EA VV M1

F0340 Stool, Self Adjusting 1 EA VV F0400 Cabinet, Bedside, Door, Drawer 1 EA VV

M1 - Three Drawer

F3050 Whiteboard, Dry Erase 1 EA VV

F320…

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated .