65--PSAS-607-Home O2 Bill December 2015 - 607-Q62814

VA69D-16-J-1523 BASIS OF AWARD: This item will be procured under 38 USC § 8123 which states: "The Secretary may procure prosthetic appliances and necessary services required in the fitting, supplying, and training and use of prosthetic appliances by purchase, manufacture, contract, or in such other manner as the Secretary may determine to be proper, without regard to any other provision of law." SECURITY & PRIVACY CONTROL: The Certification & Accreditation (C&A) requirements of VHA Handbook 6500.6 do not apply to this requirement; therefore, a Security Accreditation package is not required. No C&A or MOU/ISA is required. Sensitive information exposure as part of this contract involves applicable security controls within the facility as part of the VA Information Security Program. If there are any questions related to privacy, please have a member of your staff contact the VA Privacy Service at 202-461-6309. If there are any questions related to the information security, please have a member of your staff contact the Office of Cyber Security at 304-262-7733. SCHEDULE OF SUPPLIES/SERVICES AND PRICES/COSTS (SF 1449, Continuation of Blocks 19 - 24) Contractor shall provide the following items for the William S. Middleton Memorial Veterans Hospital in Madison, WI. All items shall be delivered FOB Destination in accordance with the delivery schedule. The following items are offered by THH ACQUISITION LLC I and are known to meet the VA's needs. Offeror shall provide the following Brand Name or Equal items: Item Information CLIN DESCRIPTION OF SUPPLIES/SERVICES QTY UNIT UNIT PRICE AMOUNT 0001 Home Oxygen Monthly Billing Billing Month November 2015 Total Patients 763 1.00 EA GRAND TOTAL Page 2 of 2