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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 NotesSecure Areas OFA03 1 Data Processing Space $99.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00F3010 Bulletin Board, 48" x 48" 1 $84.00 $84.00Secure Areas PHOD2 1 Dispensing $365.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00P-414 Lavatory, Vitreous China, withWrist Blade Faucet 1 $298.00 $298.00Secure Areas PHBS1 NR Drug Receiving, Breakdown andVerification AreaSecure Areas PHMP1 1 Extemporaneous Compounding $67.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00Secure Areas PHOD1 1 Filling and Assembly $916.00Dispenser, Paper Towel, SS,A5080 Surface Mounted 1 $67.00 $67.00P1960 Eyewash, Countertop 1 $551.00 $551.00P-414Lavatory, Vitreous China, withWrist Blade Faucet 1 $298.00 $298.00No Additional Schedule B ItemsSecure Areas PHMP2 NR Mail Out No Additional Schedule B ItemsSecure Areas OFA02 7 Office $210.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00Secure Areas SEC01 1 Office, Secretary and Waiting $30.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00Secure Areas PHIV3 1 Oncology: Preparation Area $12,449.00 Comply with USP Secure Areas XXYYC 1Secure Areas PHBS2 1L2335 Cabinet, Biosafety, Class 2, B2, 4ft 1 $12,449.00 $12,449.00Oncology: Preparation AreaAnteroom $2,419.00Dispenser, Paper Towel, SS,A5080 Surface Mounted 1 $67.00 $67.00F3230 Rack, Hat / Coat, Wall Mounted 1 $102.00 $102.00P-520Sink, Surgeon's Scrub, SensorControl, 28x22 1 $2,250.00 $2,250.00Oncology: Storage and Clean /Decontamination Area $4,674.00C03G0CT050Cabinet, SS, Base, 2 Shelf, 2 Door,36x30x22 2 $744.00 $1,488.00Countertop, SS, w/IntegralBacksplash 6 $531.00 $3,186.00Comply with USP Comply with USP Secure Areas XXYYC 1 Oncology: Clean Corridor $426.00 Comply with USP F3230 Rack, Hat / Coat, Wall Mounted 1 $102.00 $102.00Secure Areas JANC1 1M2055Shelving, Floorstanding, Steel, 5Adjustable Shelves, 36x84x18 1 $324.00 $324.00Oncology: Housekeeping AidsCloset HAC $1,934.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00A5135 Rack, Mop, T-10, Wall Mounted 1 $211.00 $211.00CD045 Cabinet, SS, Wall, T-7, 2 Shelf, 2Doors, Sloping Top, 36x48x12 1 $1,242.00 $1,242.00P-502 Sink, Service, Corner, FloorMounted 1 $414.00 $414.00Comply with USP ______Lessor Gov't_______Part III: Special Requirements -- Schedule B___ of _____ Pages
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 NotesSecure Areas OFA03 1 Oncology: Reference Area $99.00A5145 Coat Hook, SS, Surface Mounted 1 $15.00 $15.00F3010 Bulletin Board, 48" x 48" 1 $84.00 $84.00Secure Areas PHMP2 NR Prepackaging No Additional Schedule B ItemsSecure Areas SRR01 1 Refrigeration / Freezer Area $26,690.00L7100 Room, Controlled Environment 1 $26,690.00 $26,690.00Secure Areas PHOD2 1 Storage, Active $365.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00P-414 Lavatory, Vitreous China, withWrist Blade Faucet 1 $298.00 $298.00Secure Areas SSS01 1 Storage, Controlled Substance /Secured Dispensing $365.00A5080 Dispenser, Paper Towel, SS,Surface Mounted 1 $67.00 $67.00P-414 Lavatory, Vitreous China, withWrist Blade Faucet 1 $298.00 $298.00Secure Areas SRHM1 NR Storage, Flammable No Additional Schedule B ItemsSecure Areas SRCS1 NRStorage, Prosthetic and MedicalSuppliesSecure Areas TLTU1 1 Toilet, Staff $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 $265.00No Additional Schedule B ItemsPhysical Medicine and Rehabiltation (PMR)Occupational Therapy (OT) OTGC1 NR Treatment Clinic No Additional Schedule B ItemsOccupational Therapy (OT) SRE01 NR Storage, Equipment No Additional Schedule B ItemsOccupational Therapy (OT) OFA02 1 Clinic Office $30.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00Physical Therapy (PT) DR001 1 Dressing Room $336.00A1066 Mirror, SS Framed, 20x48 1 $95.00 $95.00A5021 Bench, Dressing, Wall Mounted 1 $211.00 $211.00A5145 Coat Hook, SS, Surface Mounted 2 $15.00 $30.00Physical Therapy (PT) 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 $298.00______Lessor Gov't_______Part III: Special Requirements -- Schedule B___ of _____ Pages
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Department ofVeterans AffairsOffice
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MAY 2009SOLICITATION FOR OFFERS OUT
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SOLICITATION FOR OFFERS OUTPATIENT
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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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