65--RESPIRONICS SUPPLY ORDER JESSE BROWN VA MEDICAL CENTER CHICAGO, IL 60612

VA69D-16-F-3196 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 +1 (555) 000-0000. If there are any questions related to the information security, please have a member of your staff contact the Office of Cyber Security at +1 (555) 000-0000. SCHEDULE OF SUPPLIES/SERVICES AND PRICES/COSTS (SF 1449, Continuation of Blocks 19 - 24) Contractor shall provide the following items for the Jesse Brown VA Medical Center in Chicago, IL. All items shall be delivered FOB Destination in accordance with the delivery schedule. The following items are offered by Jordan Reses Supply Company, LLC and are known to meet the VA's needs. Item Information CLIN DESCRIPTION OF SUPPLIES/SERVICES QTY UNIT UNIT PRICE AMOUNT 0001 remstar auto a flex with humidifier system one -60 series ds560hs LOCAL STOCK NUMBER: DS560HS 100 EA 0002 bipap auto biflex with sd card and humidifier system one 60 series LOCAL STOCK NUMBER: DS760HS 12 EA 0003 amara silicone ff with reduced size frame and headgear LOCAL STOCK NUMBER: 1090227 50 EA 0004 mask amara view minimal contact full face mask with headgear medium LOCAL STOCK NUMBER: 1090623 50 EA 0005 mask comfortgel blue full with headgear large LOCAL STOCK NUMBER: 1081872 50 EA 0006 mask comfortgel blue full with headgear xtra large LOCAL STOCK NUMBER: 1081873 50 EA 0007 filter foam kit, 1 pack black LOCAL STOCK NUMBER: 1063091 200 PG 0008 chin straps 302425 LOCAL STOCK NUMBER: 302425 50 EA GRAND TOTAL