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SOLICITATION FOR OFFERS OUTPATIENT CLINIC[INSERT LOCATION OF FACILITY]MAY 2009SFO No. VA-101-XX-RP-XXXXDepartment / Functional AreaRoomCodeQty ofRooms FunctionSCHEDULE B--SPECIAL REQUIREMENTS: Functional Room ListEquipmentSymbol orJSN Code Item Description Qty Unit Cost Extension Subtotal NotesCG050Cabinet, Wall, 2 Shelf, SlidingGlass Door, Sloping Top,38x48x13 1 $1,427.00 $1,427.00Countertop, High PressureCT030 Laminate 14 $70.00 $980.00F3050 Whiteboard, Dry Erase 1 $196.00 $196.00Exam / Treatment Modules (ETM) EXRG4 5 NS: Nurse Triage Room $3,185.00Dispenser, Paper Towel, SS,A5080 Surface Mounted 1 $67.00 $67.00Track, Cubicle Curtain, SurfaceA5180 Mounted 12 $7.00 $84.00A5165 Shelf T-45, SS, 12"w x 5"d 1 $55.00 $55.00A1066 Mirror, SS Framed, 24x36 1 $75.00 $75.00Lavatory, Vitreous China, withP-418 Sensor Faucet 1 $298.00 $298.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00M1620Holder, Chart, Patient, Wall orDoor Mounted 1 $28.00 $28.00Exam / Treatment Modules (ETM) OFD03 65 NS: Office, Physician / Provider $975.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00Exam / Treatment Modules (ETM) PHDS1 5 NS: Prescription Receiving Station $1,825.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00P-418 Lavatory, Vitreous China, withSensor Faucet 1 $298.00 $298.00Exam / Treatment Modules (ETM) RCA01 NR NS: Storage, Crash Cart No Additional Schedule B ItemsExam / Treatment Modules (ETM) TLTU1 2 NS: Toilet, Staff $2,048.00A1066 Mirror, SS Framed, 24x36 1 $75.00 $75.00Gastroenterology (GI) TRPE1 1A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00A5109 Grab Bars, SS, 1-1/2" Dia AR $175.00 $175.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00A5165 Shelf T-45, SS, 12"w x 5"d 1 $55.00 $55.00A5202 Dispenser, Toilet Paper w/UtilityShelf, SS, 2-Roll 1 $74.00 $74.00P-418 Lavatory, Vitreous China, withSensor Faucet 1 $298.00 $298.00P-103 Toilet, Wall Hung, w/seat 1 $265.00 $265.00Screening Proctoscopy /Sigmoidoscopy Room $6,277.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00A5180 Track, Cubicle Curtain, SurfaceMounted 12 $7.00 $84.00C03F0 Cabinet, Base, 1 Shelf, 2 Half-Drawer, 2 Door, 36x30x22 2 $1,024.00 $2,048.00C03P0 Cabinet, Sink, 2 Door, 30" W 1 $915.00 $915.00CE030 Cabinet,, Wall, 2 Shelf, GlassDoors, Sloping Top, 38x30x13 2 $789.00 $1,578.00CS090 Sink, SS, Single Compartment,7.5x19x16 ID 1 $912.00 $912.00______Lessor Gov't_______Part III: Special Requirements -- Schedule B___ of _____ Pages
SOLICITATION FOR OFFERS OUTPATIENT CLINIC[INSERT LOCATION OF FACILITY]Department / Functional AreaRoomCodeQty ofRooms FunctionSCHEDULE B--SPECIAL REQUIREMENTS: Functional Room ListEquipmentSymbol orJSN Code Item Description Qty Unit Cost Extension Subtotal NotesCT030M1620Countertop, High PressureLaminate 9 $70.00 $630.00Holder, Chart, Patient, Wall orDoor Mounted 1 $28.00 $28.00Gastroenterology (GI) TLTU1 1 Toilet, Patient $1,024.00A1066 Mirror, SS Framed, 24x36 1 $75.00 $75.00Dermatology (Derm) TRGS1 1A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00A5109 Grab Bars, SS, 1-1/2" Dia AR $175.00 $175.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00A5165 Shelf T-45, SS, 12"w x 5"d 1 $55.00 $55.00A5202 Dispenser, Toilet Paper w/UtilityShelf, SS, 2-Roll 1 $74.00 $74.00P-418 Lavatory, Vitreous China, withSensor Faucet 1 $298.00 $298.00P-103 Toilet, Wall Hung, w/seat 1 $265.00 $265.00Dermatology Procedure /Treatment Room $562.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00A5180 Track, Cubicle Curtain, SurfaceMounted 12 $7.00 $84.00A5165 Shelf T-45, SS, 12"w x 5"d 1 $55.00 $55.00P-418Lavatory, Vitreous China, withSensor Faucet 1 $298.00 $298.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00M1620 Holder, Chart, Patient, Wall orDoor Mounted 1 $28.00 $28.00Dermatology (Derm) LBDE1 1 Dermatology Laboratory $4,098.00A5080Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00Dermatology (Derm) MEDP1 1C0045 Frame, Apron, 1 Drawer, 4x36x22 1 $420.00 $420.00C01C0 Cabinet, Base, 1 Shelf, 1 Drawer, 1Door, 36x18x22 1 $890.00 $890.00C01D0 Cabinet, Base, 4 Drawer,36x18x22 1 $780.00 $780.00C02Q0 Cabinet, Sink, 1 Door, 36x24x22 1 $650.00 $650.00CG040Cabinet, Wall, 2 Shelf, SlidingGlass Door, Sloping Top,38x36x13 1 $1,291.00 $1,291.00Dermatology Medication Prep /Storage Room $4,951.00C04P0 Cabinet,Sink, 2 Door, 36x36x22 1 $994.00 $994.00C02D0CT050CS090Cabinet, Base, 4 Drawer,36x24x22 1 $1,087.00 $1,087.00Countertop, SS, w/IntegralBacksplash 1 $531.00 $531.00Sink, SS, Single Compartment,Intergal w/ SS Top, 7.5x19x16 ID 1 $912.00 $912.00______Lessor Gov't_______Part III: Special Requirements -- Schedule BMAY 2009SFO No. VA-101-XX-RP-XXXX___ of _____ Pages
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Department ofVeterans AffairsOffice
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MAY 2009SOLICITATION FOR OFFERS OUT
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Refer to Part I Section 10 and the
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GSA FORM 1364A - PROPOSAL TO LEASE
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Block 8a(4)Annual Rate per Rentable
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For purposes of the price evaluatio
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IV. SECTION IV -OWNER IDENTIFICATIO
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