Solicitation - modification - VISN bulk oxygen

Added: Dec 06, 2016 2:08 pm Modified: Mar 01, 2017 2:34 pmTrack Changes PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

30c. DATE SIGNED

31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

75

















VA244-17-Q-0130

2/17/2017

ANDREA AULTMAN-SMITH (andrea.aultman-smith@va.gov)

610-384-7711 X3228

3/10/2017

2:00 PM EST

36C244

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 4

SAO EAST

HYBRID 1 TEAM

COATESVILLE VA MEDICAL CENTER

1400 BLACK HORSE HILL ROAD

COATESVILLE, PA 19320-2096



X

100





X









325120

1000 Employees







N/A

X







SEE FACILITY REQUIREMENTS FOR A LIST

DESCRIPTION OF VISN SITE SPECIFIC

REQUIREMENTS.





36C244

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 4

SAO EAST - HYBRID 1 TEAM - CVAMC

1400 BLACK HORSE HILL ROAD

COATESVILE, PA 19320-2096

































AUSTIN PAYMENT CENTER

DEPARTMENT OF VETERANS AFFAIRS

FINANCIAL SERVICE CENTER

P. O. BOX 149971

AUSTIN, TX 78714-9971

(877)-353-9791

(512)-460-5429



See CONTINUATION Page

VISN 4 MEDICAL GRADE BULK OXYGEN



CONTRACTOR SHALL SUPPLY AND DELIVER MEDICAL GRADE OXYGEN

TO THE VISN 4 FACILITIES LISTED IN THE FACILITY REQUIREMENTS

(SEE SECTION B.5)OF THIS SOLICITATION.





THIS SOLICITATION IS A 100% SERVICE DISABLED VETERAN OWNED



SMALL BUSINESS (SDVOSB) SET-ASIDE.



ALL SDVOSB CONTRACTORS MUST BE CVE CERTIFIED IN ORDER TO QUALIFY

RECEIVE AN AWARD.



PLEASE READ THIS SOLICITATION IN ITS ENTIREY. BE SURE TO



COMPLETE ALL AREAS WHERE CONTRACTOR INFORMATION IS REQUESTED.



ALL ITEMS TO BE PROVIDED IN ACCORDANCE WITH REQUIREMENTS OF

THE STATEMENT OF WORK (SOW). CONTRACTOR SHALL COMPLY WITH ALL

APPLICABLE WAGE RATES AND APPLICABLE LAWS. ALL QUESTIONS MUST BE

BE IN WRITING. CUT OFF DATE FOR QUESTIONS IS 3/03/2017.

$0.00



See CONTINUATION Page



3670160 048 820100 2631 0100441S9



X



X







X

1









ANDREA AULTMAN-SMITH

CO - NCO415L2-1368











SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: CONTRACTOR PLEASE FILL-IN

b. GOVERNMENT: CONTRACTING OFFICER 36C244

ANDREA AULTMAN-SMITH, CO HYBRID TEAM 1

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 4

COATESVILLE VA MEDICAL CENTER

1400 BLACK HORSE HILL ROAD

COATESVILLE, PA 19320

TEL: 610-384-7711 X3228

EMAIL: andrea.aultman-smith@va.gov



2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X]

52.232-34, Payment by Electronic Funds Transfer Other Than System For Award Management, or

[X]

52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

AUSTIN PAYMENT CENTER

DEPARTMENT OF VETERANS AFFAIRS

FINANCIAL SERVICE CENTER

P. O. BOX 149971

AUSTIN, TX 78714-9971



5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO

DATE



















6. CHANGE AUTHORITY:

Only a Warranted Contracting Officer, acting with the limits of his warrant, is authorized to change the terms and conditions of this contract. If any other than a Contracting Officer attempts to change the terms and conditions of this contract, contact the Contracting Officer signing this document immediately. Acting on direction from other than the Contracting Officer may result in the related performance being determined to be accomplished at risk.











































B.2 SCOPE OF WORK

1. General

1.1 The purpose of this solicitation is to establish a committed source of supply of medical-grade liquid bulk oxygen for the facilities included in this Statement of Work. If the Government facility does not own its own bulk oxygen tank, the contractor shall also provide a contractor-owned tank with an appropriate back-up system approved by the COR. (I.e. reserve tank or cylinder bank). Specifications for each facility are listed in the Facility Requirements Schedule of Supplies section of this Statement of Work. This requirement will be set-aside for SDVOSB Business concern under NAICS code 325120 in accordance with FAR 19.001 (Non-Manufacturing Rule) and will be evaluated based on Lowest Price Technically Acceptable.

1.2 The quantities shown in the Schedule of Supplies and Services are estimates of each facility s annual requirements. There is no express or implied guarantee that these quantities will be purchased. The base contract period for all contracts awarded under this solicitation will be April 1, 2017 or date of award, whichever is earlier, and will end on March 31, 2018. Please note that if this contract includes the installation of contractor-owned equipment it will include a 90 day transition period at the beginning and end of the contract period. (See page 7, paragraph 5.1). Any contract awarded under the solicitation will include four (4) one-year option periods which may be exercised by the Government.

1.3 Contractor will be provided with names and contact information of primary and back-up Contracting Officer Technical Representative (COR) upon award of this solicitation for each ordering facility. This applies to all deliveries regardless of time or day of execution. Tanks(s) will be filled to maximum functional capacity at each refilling procedure unless otherwise specified in the facility requirements or as agreed upon in a written document signed and dated by the COR. At the time of each delivery, contractor must provide a legible signed and dated written document that identifies the tank level prior to fill, the level after fill, and the quantity delivered. This document must be counter-signed by the facility representative supervising the delivery. The COR is responsible for local contract administration issues such as ordering and providing specific delivery instructions. A letter of delegation that outlines the COR s specific responsibilities will be provided to the contractor and COR at the time of contract award. Within 15 days after notification of contract award, the contractor shall meet with the COR to ensure mutual understanding of facility requirements relating to the ordering method and specific details of any delivery instructions that are included in the solicitation Schedule of Supplies and Services. The facility COR shall forward a written copy of the mutual agreement signed by both parties to the Contracting Officer for incorporation into the contract by written modification within 30 days after contract award. If agreement cannot be reached between the contractor and COR regarding any issue that the COR has delegation from the CO to administer, then the matter shall be referred to the Contracting Officer for resolution.



B.5 FACILITY REQUIREMENTS

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

DELAWARE- Wilmington VAMC

0001a

Base:

20,000

CCF

$__________

0002a

Base Tank Rental Fee:

Monthly

$__________

1001a

Option Yr 1:

20,000

CCF

$__________

1002a

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001a

Option Yr 2:

20,000

CCF

$__________

2002a

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001a

Option Yr 3:

260000

CCF

$__________

3002a

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001a

Option Yr 4

20,000

CCF

$__________

4002a

Option Yr 3 Tank Rental Fee:

Monthly

$__________

5001a

Emergency Delivery Fee:





$__________

VA Medical Center COR: Damon Taylor

1601 Kirkwood Highway Phone: (302) 633-5372

Wilmington, DE 19805 Email: Damon.Taylor2@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: None

Delivery Instructions: Delivery shall be Monday thru Friday, 8:00 am to 4:00 pm. Driver must contact Biomedical at 302-633-5372 to gain access to enclosure for main and reserve tanks. Alternate point of contact is Facilities at 302-633-5270.

Oxygen, Medical Liquid Bulk

Tank Capacity: 1500 gallons CO/GO: CO

B/U Type: Liquid B/U Capacity: 250 gallons CO/GO: CO

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

PENNSYLVANIA- ALTOONA VAMC

0001b

Base:

35,500

CCF

$__________

0002b

Base Tank Rental Fee:

Monthly

$__________

1001b

Option Yr 1:

35,500

CCF

$__________

1002b

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001b

Option Yr 2:

35,500

CCF

$__________

2002b

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001b

Option Yr 3:

35,500

CCF

$__________

3002b

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001b

Option Yr 4:

35,500

CCF

$__________

4002b

Option Yr 4 Tank Rental Fee:

Monthly

$__________

5001b

Emergency Delivery Fee:





$__________

VA Medical Center COR: Melissa Flick

Facilities Service (10F)

2907 Pleasant Valley Blvd Phone: (814) 943-8164 x7249

Altoona, PA 16602-4377 Email: Melissa.Flick@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: None

Delivery Instructions: Monday through Friday. 7:30am to 4:30 pm

Oxygen, Medical Liquid Bulk

Tank Capacity: 1543 gallons CO/GO: CO

B/U Type: RST B/U Capacity: 428 gallons CO/GO: CO

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

PENNSYLVANIA- COATESVILLE VAMC

0001d

Base:

78,000

CCF

$__________

0002d

Base Tank Rental Fee:

Monthly

$__________

1001d

Option Yr 1:

78,000

CCF

$__________

1002d

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001d

Option Yr 2:

78,000

CCF

$__________

2002d

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001d

Option Yr 3:

78,000

CCF

$__________

3002d

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001d

Option Yr 4:

70,000

CCF

$__________

4002d

Option Yr 4 Tank Rental Fee:

Monthly

$__________

5001d

Emergency Delivery Fee:





$__________

VA Medical Center COR: David Gibson

1400 Blackhorse Rd. Phone: (610) 384-7711 x3204

Coatesville, PA 19320 Email: David.Gibson5@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: None

Delivery Instructions: Hours for delivery are 8am through 4pm Monday through Friday. No holidays or weekends. Driver must notify Bio Med upon delivery to access the tanks. Bio-Med will oversee the fill.

Oxygen, Medical Liquid Bulk

Tank Capacity: Main tank 1500gal. CO/GO: CO

NHCU tank 500 gal.

B/U Type: Main BOC tank. Reserve B/U Capacity: Main- 120gal

CO/GO: CO NHCU 8 bank H reserve cylinder NHCU- 500gal

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a government-owned tank with an appropriate back-up system.

PENNSYLVANIA- ERIE VAMC

0001e

Base:

160,000

CCF

$__________

0002e

Base Tank Rental Fee:

Monthly

$__________

1001e

Option Yr 1:

160,000

CCF

$__________

1002e

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001e

Option Yr 2:

160,000

CCF

$__________

2002e

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001e

Option Yr 3:

160,000

CCF

$__________

3002e

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001e

Option Yr 4:

160,000

CCF

$__________

4002e

Option Yr 4 Tank Rental Fee:

Monthly

$__________

5001e

Emergency Delivery Fee:





$__________

VA Medical Center COR: Brian Goodman

135 E. 38th Street Phone: (814) 860-2727

Erie, PA 16504 Email: brian.goodman@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: None.

Delivery Instructions: Routine deliveries will only be accepted at the Erie VAMC between 0730 and 1530, Monday through Friday (excluding Federal holidays). Emergencies requested by the Erie VA will be accepted outside those hours. The contractor is required to check in at Central Receiving upon arrival on VA grounds. Upon completion of refill, delivery record/receipt is to be signed by VA staff member monitoring refill and the contractor delivery personnel. A copy of the record/receipt is to be provided to the VA. Delivery based on usage recorded per tank level reading. Delivery made at a minimum of every 30 days or as needed.

PENNSYLVANIA- ERIE VAMC (Continued

Oxygen, Medical Liquid Bulk

Tank Capacity: 1500 gallons CO/GO: GO B/U Type: 24 H-cylinders B/U Capacity: 60 gallons CO/GO: GO

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

PENNSYLVANIA- PHILADELPHIA VAMC (Including the Nursing Home)

0001f

Base:

160,000

CCF

$__________

0002f

Base Tank Rental Fee:

Monthly

$__________

1001f

Option Yr 1:

160,000

CCF

$__________

1002f

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001f

Option Yr 2:

160,000

CCF

$__________

2002f

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001f

Option Yr 3:

160,000

CCF

$__________

3002f

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001f

Option Yr 4:

160,000

CCF

$__________

4002f

Option Yr 4 Tank Rental Fee:

Month

$__________

5001f

Emergency Delivery Fee:





$__________

VA Medical Center COR: Julia Velez

3900 Woodland Ave Phone: (215) 823-5989

Philadelphia, PA 19104 Fax: julia.velez@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: None

Delivery Instructions: Facilities will call for refill when tank reaches 80 inches at Woodland Avenue; refill when tank reaches 25 inches at the CLC. This will be the fill instruction for the tanks. Service open 24/7 for deliveries.

Oxygen, Medical Liquid Bulk

Tank Capacity: 6000gal (Woodland Avenue) CO/GO: CO

Tank Capacity: 3000gal (CLC) CO/GO: CO

B/U Type: 2 Tanks B/U Capacity: 1 tank 900 gal - Woodland Avenue

B/U Capacity: 1 tank 525 gal - CLC CO/GO: CO

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

PENNSYLVANIA- PITTSBURGH VAMC Heinz Campus

0001g

Base:

45,000

CCF

$__________

0002g

Base Tank Rental Fee:

Monthly

$__________

1001g

Option Yr 1:

45,000

CCF

$__________

1002g

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001g

Option Yr 2:

45,000

CCF

$__________

2002g

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001g

Option Yr 3:

45,000

CCF

$__________

3002g

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001g

Option Yr 4:

45,000

CCF

$__________

4002g

Option Yr 1 Tank Rental Fee:

Monthly

$__________

5001g

Emergency Delivery Fee:





$__________

VA Medical Center COR: Lynn Portman

Delafield Rd. Phone: (412) 822-3027

Pittsburgh, PA 15215 Email: Lynn.portman@va.gov

Delivery Requirements: 2 Days ARO

Delivery Instructions: The contractor shall deliver medical-grade liquid bulk oxygen for University Dr. and Heinz Campuses of VAPHS. Contact Biomed prior to coming on station for more specific instructions.

Oxygen, Medical Liquid Bulk

Tank Capacity: 3000 gal. Main CO/GO: CO

B/U Type: Tank B/U Capacity: 250gal. Reserve CO/GO: CO

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

PENNSYLVANIA- PITTSBURGH VAMC University Drive

0001h

Base:

80,000

CCF

$__________

0002h

Base Tank Rental Fee:

Monthly

$__________

1001h

Option Yr 1:

80,000

CCF

$__________

1002h

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001h

Option Yr 2:

80,000

CCF

$__________

2002h

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001h

Option Yr 3:

80,000

CCF

$__________

3002h

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001h

Option Yr 4:

80,000

CCF

$__________

4002h

Option Yr 4 Tank Rental Fee:

Monthly

$__________

5001h

Emergency Delivery Fee:





$__________

VA Medical Center COR: Jetson Robinson

University Dr. C Phone: (412) 360-3718

Pittsburgh, PA 15240 Email: Jeston.Robinson@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: None

Delivery Instructions: The contractor shall deliver medical-grade liquid bulk oxygen for University Dr. and Heinz Campuses of VAPHS. Contact Biomed prior to coming on station for more specific instructions.

Oxygen, Medical Liquid Bulk

Tank Capacity: 6000 gal main CO/GO: CO

B/U Type: Tank B/U Capacity: 700 gal reserve CO/GO: CO

Heinz Campus

Base Tank Rental (1500 gallon Main Tank & 260 gallon Reserve tank) & approximately 2 deliveries per month

Contractor will also provide remote telemetry services for oxygen tanks to alert staff to low levels of oxygen

Estimated 45,000 CCF/year

University Dr. Campus

Base Tank Rental (6000 gallon Main Tank & 690 gallon Reserve tank) & approximately 2 deliveries per month

Contractor will also provide remote telemetry services for oxygen tanks to alert staff to low levels of oxygen

Estimated 80,000 CCF/year

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

PENNSYLVANIA- WILKES-BARRE VAMC

0001i

Base:

190,000

CCF

$__________

0002i

Base Tank Rental Fee:

Monthly

$__________

1001i

Option Yr 1:

190,000

CCF

$__________

1002i

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001i

Option Yr 2:

190,000

CCF

$__________

2002i

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001i

Option Yr 3:

190,000

CCF

$__________

3002i

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001i

Option Yr 4:

190,000

CCF

$__________

4002i

Option Yr 1 Tank Rental Fee:

Monthly

$__________

5001i

Emergency Delivery Fee:





$__________



VA Medical Center COR: Joseph Pellicano

1111 East End Blvd Phone: (570) 821-7202

Wilkes-Barre, PA 18711 Email: Joseph.Pellicano@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: None

Delivery Instructions: Delivery shall be arranged when Liquid level on the primary tank is between 40 inches and 60 inches. The contractor shall contact the facility 48 hours prior to delivery in order to arrange for delivery time between Monday-Friday between 8:00am and 3:00pm. Tanks shall be filled to maximum functional capacity at each refill unless otherwise specified.

Oxygen, Medical Liquid Bulk

Tank Capacity: 3000 gal. CO/GO: CO

B/U Type: Tank B/U Capacity: 160 gal. CO/GO: CO

SCHEDULE OF SUPPLIES/SERVICES

Contractor shall provide all equipment, labor, materials, to include tools and parts, transportation, supervision and disposal necessary to distribute and supply medical-grade liquid bulk oxygen. This includes a contractor-owned tank with an appropriate back-up system.

PENNSYLVANIA- LEBANON VAMC

0001k

Base:

230,000

CCF

$__________

0002k

Base Tank Rental Fee:

Monthly

$__________

1001k

Option Yr 1:

230,000

CCF

$__________

1002k

Option Yr 1 Tank Rental Fee:

Monthly

$__________

2001k

Option Yr 2:

230,000

CCF

$__________

2002k

Option Yr 2 Tank Rental Fee:

Monthly

$__________

3001k

Option Yr 3:

230,000

CCF

$__________

3002k

Option Yr 3 Tank Rental Fee:

Monthly

$__________

4001k

Option Yr 4:

230,000

CCF

$__________

4002k

Option Yr 4 Tank Rental Fee:

Monthly

$__________

5001k

Emergency Delivery Fee:





$__________

VA Medical Center COR: Troy Funk

1700 S. Lincoln Avenue Phone: (717) 272-6621 x4362

Lebanon, PA 17042 Email: Troy.Funk@va.gov

Delivery Requirements: 2 Days ARO

Delivery Impediments: Driver must be vigilant of large vehicles due to ongoing major construction.

Delivery Instructions: Contact Logistics at 717 272-6621 x4718 before delivery.

Oxygen, Medical Liquid Bulk

Tank Capacity: 3861 gallons CO/GO: GO

B/U Type: RST B/U Capacity: 2539 gallons CO/GO: GO