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STATEMENT OF Requirement
PRICE/COST SCHEDULE

1. GENERAL:
Contractor shall furnish Peritoneal Dialysis (PD) supplies for medical center use and direct delivery to beneficiaries of the VA Medical Center, Kansas City, Missouri. The contractor is responsible for delivering all supplies under this contract directly to the medical center or beneficiary's home, as requested.
2. MEDICAL CENTER USE: An authorized Representative will place all orders for delivery to the VA Medical Center, 4801 E. Linwood Boulevard, Kansas City, Missouri 64128, by issuance of a purchase order.
3. DIRECT DELIVERIES:
Home Peritoneal Dialysis Service will contact the contractor by telephone and give a yearly obligation number for direct delivery beneficiaries. The contractor shall use the appropriate assigned obligation number for the year on all correspondence and invoices. When a VA beneficiary is accepted into the program to receive direct delivery of PD supplies, a prescription is forwarded to the contractor with product name and quantities. It shall be the contractor's responsibility to coordinate with Home Peritoneal Dialysis Service (816-922-2477) the patient's authorized prescribed inventory levels and establish delivery schedules. The contractor shall contact the patient monthly (or as needed) to verify patient's requirements and set up delivery order. In the event a patient needs additional supplies after the monthly order is placed, the patient may contact the contractor via telephone and the contractor may use the mailing system to get supplies to the patient. The contractor is responsible for adhering to all mailing requirements in this matter. Vendor will supply and support any required software needed to access downloadable patient information. This software will be loaded on a VA owned, non-networked device. Vendor will allow VA providers access through a web based portal to provide electronic signatures for patient orders and requests. Vendor will not limit the number of patients that can be started on treatment per month. Vendor will provide a one point of contact model to support the patient and the Nephrology Clinic in the accessing and delivery of all manufacturers peritoneal dialysis (PD) systems currently in the marketplace, including all ancillary items and specialty products outside manufacturer s scope as prescribed by the patient s clinical team. This one point of access supports the Nephrology Clinic in maintaining readiness, flexibility and patient-centric care focused on clinical outcomes and patient satisfaction.
4. PACKING AND MARKING:
All containers are to be marked with the expiration date. All products must provide not less than an eighteen (18) month expiration date. Cases are to be clearly marked, specifying content and handling methods.
5. PATIENT PRIVACY / SECURITY:

a. The Kansas City VA Medical Center at the time the patient is enrolled in the Home Dialysis program will secure a Release of Information from the patient to allow for information to be released to the contract vendor company

b. The contractor shall immediately notify the COTR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor has access.

c. To the extent known by the contractor, the contractor notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, what and where the VA information or assets were placed at risk or compromised), and any other information that the contractor considers relevant.

d. With respect to unsecured protected health information, the contractor is deemed to have discovered a data breach when the contractor knew or should have known of a breach of such information. Upon discovery, the contractor must notify the covered entity of the breach.

e. In instances of theft or break-in or other criminal activity, the contractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident.

The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident.
5. QUALIFICATIONS: Offeror shall be the manufacturer or authorized dealer for the manufacturer of the product for which a quote will be provided.

6. SHIPPING:
All orders shall be shipped F.O.B. Destination, by common carrier, standard delivery within 3 to 5 days ARO (After Receipt of Order). The cost of any other designated shipping options (i.e., overnight, 2nd day, etc) by the VAMC, Kansas City, MO, payment of such shall be the responsibility of the VAMC, Kansas City, MO, contractor shall prepay and add to invoice.
7. INVOICING FOR DIRECT DELIVERIES:
A separate invoice for each individual patient, with name of patient on invoice, shall be submitted at the time of shipment to:

VA Financial Services Center
PO Box 149971
Austin TX 78714-9971

Base Year
Option Year 2
Option Year 3
Option Year 4
Option Year 5

Items shall be brand name or equal

Program Center/Office:
Kansas City VA Medical Center
Date Prepared:
6/23/2022
IGCE POC:
Zakiyyah Stover, 816-861-4700 x56456
Project Title:
PD Supplies - 589-22-3-1399-0032


Product Code
Product Name
Pack Factor
Estimated Quantity
5B9866
DIANEAL PD2 SOLUTION 1.5% DEX 2L/2L ULTRABAG
6/CS
100
5B9876
DIANEAL PD2 SOLUTION 2.5% DEX 2L/2L ULTRABAG
6/CS
100
5B9896
DIANEAL PD2 SOLUTION 4.25% DEX 2L/2L ULTRABAG
6/CS
50
5B9868P
DIANEAL PD2 SOLUTION 1.5% DEX 2.5L/3L ULTRABAG
5/CS
200
5B9878P
DIANEAL PD2 SOLUTION 2.5% DEX 2.5L/3L ULTRABAG
5/CS
200
5B9898P
DIANEAL PD2 SOLUTION 4.25% DEX 2.5L/3L ULTRABAG.
5/CS
30
5B4984
EXTRANEAL PD SOLN (2L/3L) ULTRABAG
6/CS
30
5B4986
EXTRANEAL PD SOLN (2.5L/3L) ULTRABAG
5/CS
30
5B9768P
DIANEAL LOW CA 1.5% 2.5L/3L ULTRABAG
5/CS
30
5B9778P
DIANEAL LOW CA 2.5% 2.5L/3L ULTRABAG
5/CS
15
5B9798P
DIANEAL LOW CA 4.25% 2.5L/3L ULTRABAG
5/CS
15
L5B4974
EXTRANEAL PD SOLN (2L/3L)
6/CS
300
L5B4976
EXTRANEAL PD SOLN (2.5L/3L)
5/CS
200
L5B5169
DIANEAL PD2 1.5% DEX 3L/3L
4/CS
200
L5B5179
DIANEAL PD2 2.5% DEX 3L/3L
4/CS
200
L5B5189
DIANEAL PD2 4.25% DEX 3L/3L
4/CS
20
L5B5193
DIANEAL PD2 1.5% DEX 5L/6L
2/CS
700
L5B5194
DIANEAL PD2 2.5% DEX 5L/6L
2/CS
700
L5B5195
DIANEAL PD2 4.25% DEX 5L/6L
2/CS
10
L5B9710
DIANEAL PD2 1.5% DEX 6L/6L
2/CS
2000
L5B9711
DIANEAL PD2 2.5% DEX 6L/6L
2/CS
2000
L5B9712
DIANEAL PD2 4.25% DEX 6L/6L
2/CS
100
L5B5163
DIANEAL PD2 1.5% DEX 1L/1L
12/CS
200
L5B5173
DIANEAL PD2 2.5% DEX 1L/1L
12/CS
200
L5B5183
DIANEAL PD2 4.25% DEX 1L/1L
12/CS
10
L5B5166
DIANEAL PD2 1.5% DEX 2L/2L
6/CS
10
L5B5177
DIANEAL PD2 2.5% DEX 2L/2L
6/CS
10
L5B5187
DIANEAL PD2 4.25% DEX 2L/2L
6/CS
10
L5B4825
DIANEAL LOW CA 1.5% 2L/2L
6/CS
10
L5B9727
DIANEAL LOW CA 2.5% 2L/2L
6/CS
10
L5B9747
DIANEAL LOW CA 4.25% 2L/2L
6/CS
10
L5B9901
DIANEAL LOW CA 1.5% 3L/3L
4/CS
10
L5B9902
DIANEAL LOW CA 2.5% 3L/3L
4/CS
10
L5B9903
DIANEAL LOW CA 4.25% 3L/3L
4/CS
10
L5B4826
DIANEAL LOW CA 1.5% 5L/5L
2/CS
10
L5B5202
DIANEAL LOW CA 2.5% 5L/5L
2/CS
10
L5B5203
DIANEAL LOW CA 4.25% 5L/5L
2/CS
10
L5B9770
DIANEAL LOW CA 1.5% 6L/6L
2/CS
600
L5B9771
DIANEAL LOW CA 2.5% 6L/6L
2/CS
10
L5B9772
DIANEAL LOW CA 4.25% 6L/6L
2/CS
10
5C4456
FLEXICAP DISCONNECT CAP
30/CS
20
L5C4366P
DISCONNECT Y SET CAPD
30/CS
20
5C4145P
CYCLER DRAINAGE SET
30/CS
200
5C4319
IMMOBILIE
30/CS
200
5C4406
CYCLER CARRY CASE PERSONAL
EACH
20
5C4464P
12 FOOT DRAIN EXTENSION SET
30/CS
500
5C4466P
MINI-CAP, DISCONNECT W/PVP-1 S SOLUTION
60/CS
400
5C4480C
12 FOOT PATIENT EXTENSION SET EASY LOCK CONNECTOR
30/CS
500
5C4512
APD DRAIN MANIFOLD
30/CS
60
5C4527
CLAMP SHORT NOSE FOR OUTLET PORT
12/CS
50
5C4957
ULTRA CLAMP
12/CS
150
5C8310L
HOMECHOICE PRO CYCLER RENTAL
EACH
70
5C9320L
AMIA CYCLER LEASE
EACH
200
CONNECTIVITY
AMIA SHARESOURCE CONNECTIVITY
EACH
200
5Z0090
PERSONAL CYCLER FREIGHT
EACH
0
578903
THERMOMETER DIGITAL
EACH
10
777882
SCALE DIGITAL 1.5" LCD
EACH
5
OHA80000018
SPRING SCALE 5000GM X 100GM
EACH
5
942566
HEATING PAD-KING SIZE, 3 HEAT SETTINGS DIMS=24"X13"
EACH
20
MDS80441
IV POLE DBL HOOK FREE STANDING 47"-84"
EACH
5
MDS1725146
BP MONITOR AUTO DIGITAL - LARGE ADULT
EACH
5
MDS1725145
BP MONITOR AUTO DIGITAL - ADULT
EACH
5
L5C4531
INTEGRATED APD SET W/CASSETTE 3 PRONG
30/CS
10
R5C4479C
AUTOMATED PD SET W/CASSETTE 4 PRONG
30/CS
300
5C5479
AMIA AUTOMATED PD SET W/CASSETTE
30/CS
200
R5C4522
HOMECHOICE PRO CARD
6/CS
20
RENEOC
EXPEDITED ORDER FEE - 4 DAY LEAD TIME
EACH
Â
RENEOC
EXPEDITED ORDER FEE - 3 DAY LEAD TIME
EACH
Â
RENEOC
EXPEDITED ORDER FEE - 2 DAY LEAD TIME
EACH
Â
RENEOC
EXPEDITED ORDER FEE - 1 DAY LEAD TIME
EACH
Â
RENEOC
EXPEDITED ORDER FEE - SAME DAY
EACH
Â
RENRED
RE-DELIVERY FEE
EACH
Â
RENACH
AFTER HOURS
EACH
5
RENHPRTN
PRODUCT RETURN CHARGE
EACH
Â
RENOFF
OFF SCHEDULED ORDER FEE
EACH
10
RENFAX
FAXED PRESCRIPTION FEE
EACH
Â
RENVERBAL
PHARMACIST PRESCRIPTION FEE
EACH
Â
RENSERVICE14
14 DAY ORDER CYCLE FEE
EACH
Â
VALKITCL
VALUE KIT CAPD HOME PATIENT USE ONLY
EACH
Â
VALKITAL
VALUE KIT CCPD HOME PATIENT USE ONLY
EACH
Â

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