RFB 24 - 003
ATTACHMENT A – COST FORM
Vendor Name: ___
Instructions:
Vendors shall enter pricing on this cost sheet.
Vendors shall not alter the language or format of the price sheet or they shall be deemed non-responsive.
Vendors shall not add additional information to the cost sheet(s) or they shall be deemed non-responsive.
Vendors shall enter cost as final (not estimated or average) amounts or they shall be deemed non-responsive.
| Cost | |
| Description | Qty | Cost |
|---|
| One (1) 2023 One Exam Room Mobile Clinic ADA units with a 2023 Van E350
DRW 1 passenger & driver capability (or similar vehicle) with the following accessories:
• Blood Draw Chair/ Phlebotomy Chair
• ADA Compliant Lift
• Overall Length 22' 11.5"
• 110V Outlet
• Double W/C Lift Door - Deluxe
• Braun Century Lift NCL919, 34" Wide
• Pull 110V 12 Gauge Cable for Rooftop A/C
• Wheel Liners Stainless Steel E350/450 w/Valve Ext.
• Exam Bench
• Check In Desk with Desk Chair
• Accucold Medical Grade Refrigerator 5.5 cu ft
• Sharps Disposable System
• Waiting Area Bench
• Eye Wash Station
• Vent Fan Header Compartment w/ Cover
• Smoke/Carbon Detector | 1 | |
| | |