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SOLICITATION FOR OFFERS OUTPATIENT CLINIC[INSERT LOCATION OF FACILITY]Department / Functional AreaRoomCodeDermatology (Derm) OPDU1 1Qty 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 $1,427.00Dermatology PhototherapyTreatment Room $6,277.00A5080Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00Dermatology (Derm) SHWR1 1A5145 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 $912.00CT030 Countertop, High PressureLaminate 9 $70.00 $630.00M1620 Holder, Chart, Patient, Wall orDoor Mounted 1 $28.00 $28.00Dermatology Phototherapy ShowerRoom $848.00A1066 Mirror, SS Framed, 24x36 1 $75.00 $75.00A5080 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 2 $15.00 $30.00A5180 Track, Cubicle Curtain, SurfaceMounted 4 $7.00 $28.00P-418 Lavatory, Vitreous China, withSensor Faucet 1 $298.00 $298.00Seat, Folding, Accessible Shower 1 $175.00 $175.00Nutrition (Dietetics) CLR02 1 Classroom $2,531.00F3050 Whiteboard, w/ Sliding Panels 1 $1,423.00 $1,423.00M0410Screen, Projection, RecessedCeiling Mounted, ManualOperation, 69x92 Viewing Area,120" Diagonal 1 $1,108.00 $1,108.00Nutrition (Dietetics) OFA02 3 Office, Dietician $90.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00Oncology (ONC) OPCT1 1 Chemotherapy Treatment Room $27,494.00A1107 Rail System, Utility, Med Gas 3 $7,421.00 $22,263.00A5145 Coat Hook, SS, Surface Mounted 3 $15.00 $45.00Track, Cubicle Curtain, SurfaceA5180 Mounted 18 $7.00 $126.00F2310 Rack, Pamphlet, Wall Mounted 1 $140.00 $140.00A5210 Bracket, Television, Wall Mounted,Adjustable Arm 3 $296.00 $888.00A1165 Track, IV, Ceiling Mounted 72 $56.00 $4,032.00Oncology (ONC) TLTU1 1 Toilet, Patient $1,024.00______Lessor Gov't_______Part III: Special Requirements -- Schedule BMAY 2009SFO No. VA-101-XX-RP-XXXX___ of _____ Pages
SOLICITATION FOR OFFERS OUTPATIENT CLINIC[INSERT LOCATION OF FACILITY]Department / Functional AreaRoomCodeOncology (ONC) OFA02 1Qty ofRooms FunctionSCHEDULE B--SPECIAL REQUIREMENTS: Functional Room ListEquipmentSymbol orJSN Code Item Description Qty Unit Cost Extension Subtotal NotesA1066 Mirror, SS Framed, 24x36 1 $75.00 $75.00A5080 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 $265.00Office, Data Coordination / TumorRegistry $30.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00Oncology (ONC) LBVP1 1 Oncology Lab $2,050.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00P2450 Valve, Mixing Thermostatic 1 $2,035.00 $2,035.00Women's Health / GYN EXRG8 1 Exam Room $665.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00A5180 Track, Cubicle Curtain, SurfaceMounted 16 $7.00 $112.00A5165 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 $28.00Womens's Health / GYN TLTU1 1 Toilet, Patient $1,024.00A1066 Mirror, SS Framed, 24x36 1 $75.00 $75.00A5080 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 $265.00Orthopedics (Ortho) OPCR1 1 Cast Room $10,857.00A1107 Rail System, Utility, Med Gas 1 $7,421.00 $7,421.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00A5180 Track, Cubicle Curtain, SurfaceMounted 14 $7.00 $98.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00P-418 Lavatory, Vitreous China, withSensor Faucet 1 $298.00 $298.00P-507 Sink, SS, Single Compartment,12x22x16 ID, w/ IntegralDrainboard (w/out corrugations) 1 $2,250.00 $2,250.00______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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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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