Pricing for Selected Incontinence Supplies

ITB No. 071I8200032

Appendix I

PRICING FOR SELECTED INCONTINENCE SUPPLIES

Item No. / Unit / Code and Description / Monthly
Quantity
Limit / Estimated
Annual Quantity* / Unit Cost
Per Item / Total Bid Amount / Referenced
Brands/Manufacturers / Proposed Brands/Manufacturers /
(1) / EA / A4310 Insertion tray without drainage bag and without catheter (accessories only) / 2 / 4,106 / $______/ $______/ Mentor UT7010 10 cc
Mentor UT7030 30 cc
AMSINO AS880 10 cc
AMSINO AS890 30 cc
(2) / EA / A4311 Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating, (Teflon, silicone, silicone elastomer or hydrophilic, etc.) / 2 / 0 / $______/ $______/ Mentor UT8100 Series
Bard 800 Series
(3) / EA / A4312 Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone / 2 / 0 / $______/ $______/ Baxter S100 Series
(4) / EA / A4314 Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex w/coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.) / 2 / 0 / $______/ $______/ Mentor UT8185 Series
(5) / EA / A4315 Insertion tray with drainage bag, with indwelling catheter, foley type, two-way, all silicone / 2 / 0 / $______/ $______/ Kendall 6900 Series
(6) / EA / A4320 Irrigation tray with bulb or piston syringe, any purpose / 30 / 1,459 / $______/ $______/ Mentor UT1001 (Bulb)
Mentor UT1002 (Piston)
AMSINO AS130 (Bulb)
AMSINO AS136 (Piston)
(7) / EA / A4322 Irrigation syringe, bulb or piston, each / 30 / 18,788 / $______/ $______/ Mentor UT1004
Amsino AS011 (Bulb)
(8) / EA / A4349 Male external catheter (G) / 96 / 7,992 / $______/ $______/ Mentor 9200
Mentor 5000 Series
Mentor 8000 Series
(9) / EA / A4349 Male external catheter (G) with adhesive strip, each / 96 / 29,517 / $______/ $______/ Mentor 7200 Series
(10) / EA / A4326 Male external catheter, specialty type, e.g., inflatable, faceplate, etc. each / 30 / 1,581 / $______/ $______/ Mentor 7800, 7850, 8205, 8100, 8200, 8305, 8400
Hollister 9897, 9898
(11) / EA / A4328 Female external urinary collection device; pouch, each / 10 / 0 / $______/ $______/ Hollister 9840
(12) / EA / A4330 Perianal fecal collection pouch with adhesive, each / 10 / 105 / $______/ $______/ Hollister 9821, 9822
Convatec 650078
(13) / EA / A4331 Extension drainage tubing, any type, any length, with connector/adapter, for us with urinary leg bag or urostomy pouch, each / 4 / 4,192 / $______/ $______/ Mentor 475, 7092
AMSINO AS311
(14) / EA / A4333 Urinary catheter anchoring device, adhesive skin attachment / 4 / 52 / $______/ $______/ Mentor 4065
(15) / EA / A4334 Urinary catheter anchoring device, leg strap / 6 / 296 / $______/ $______/ Kendall 8887600149
(16) / EA / A4335 Belted/Unbelted Undergarment WO Sides / 150 / 1,337,268 / $______/ $______/ Select Belt Less, PBE 2078
Select Day + Belt Less,
PBE 2694
Select Belted, PBE 2650
Select Night Time, PBE 2695
Select, PBE 2693
Kendall Surety Beltless, 23230
Humanicare 30073
Kendall Slip-On UG Belted 1500A
Kendall Belted Undergarment MD-171B10
Kimberly-Clark Depends 19640, 19696
(17) / EA / A4338 Indwelling catheter, foley type, two-way latex w/coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.) each / 2 / 2,360 / $______/ $______/ Mentor UC2500 Series
Mentor UC2300 Series
AMSINO AS4000 Series
(18) / EA / A4340 Indwelling catheter, specialty type, e.g. Coude, mushroom, wing, etc., each / 5 / 10 / $______/ $______/ Mentor UC6000 and 6500 Series
(19) / EA / A4344 Indwelling catheter, foley type, two-way, all silicone, each
*XX Denotes French Size / 5 / 3,640 / $______/ $______/ Mentor AA61XX Series
Mentor AA6CXX Series
Mentor AASC23XX Series
AMSINO AS40000 Series
(20) / EA / A4351 Intermittent urinary catheter, straight tip, each / 150 / 906,925 / $______/ $______/ Mentor NC1000 Series
Mentor UC1000
Mentor 110 Series
Mentor 200 Series
Mentor 300 Series
Mentor 400 Series
AMSINO AS861000 Series
(21) / EA / A4351-U4 Intermittent urinary catheter, straight tip, each / 150
Under age 21 / 0 / $______/ $______/ Astra-Tech (Lofric) 900000, 940000, 9300000 Series
Mentor 4100, 4200, 4300, 4400 Series
(22) / EA / A4352 Intermittent urinary catheter, coude (curved) tip, each / 150 / 112,409 / $______/ $______/ Mentor 500 Series
Mentor 600 Series
Mentor 800 Series
Mentor UC6000 Series
(23) / EA / A4352-U4 Intermittent urinary catheter, coude (curved) tip, each / 150
Under age 21 / 14,375 / $______/ $______/ Astra-Tech (Lofric) 960000 Series
Mentor 4600, 4800 Series
(24) / EA / A4357 Bedside drainage bag, day or night, with or without anti-reflux device, with or w/o tube, each / 3 / 5,970 / $______/ $______/ Mentor UB0400 Series
Mentor UB0500
Bard 802001
AMSINO AS332
(25) / EA / A4358 Urinary leg bag, vinyl, with or w/o tube, each
*XX Denotes French Size / 10 / 4,307 / $______/ $______/ Mentor UB0600
Mentor UB0950
AMSINO AS300 Series
Mentor 9000
(26) / OZ / A4402 Lubricant / 10 OZ. / 10,545 / $______/ $______/ Fougera 20536, 20537
Fougera 20543
(27) / EA / T4521 Adult size brief / diaper small, each / 300 / 2,022,720 / $______/ $______/ Select PBE 2620
Tranquility Full Fit PBE 2120
Attends Attends 10 Classic BREZ1010
Hook & Loop Kendall 63062
Tenna Specialty Brief SCA 66150
FQ IB Brief IB-011
(28) / EA / T4522 Adult size brief / diaper medium, each / 300 / 5,199,504 / $______/ $______/ Select Full fit, PBE 2624
Basic Care, PBE 2724
Select Care, PBE 2924
Soft & Breathable, PBE2627
Wings Supreme Kendall 9501
Hook & Loop Kendall 63063
Hook & Loop Kendall 63073
Attends BR0820 Briefs 8
Attends BR0920 Briefs 9
Attends 10 Breathable BRBC1020
Attends 10 Briefs BREZ1020
Tena Ultra Brief Med SCA 68121
FQ Per-Fit Breathable PF-012/1
(29) / EA / T4523 Adult size brief / diaper large, each / 300 / 5,001,512 / $______/ $______/ Select Full Fit, PBE 2634
Basic Care, PBE 2734
Select Care, PBE 2934
Soft & Breathable, PBE2628, 2728
Wings Supreme Kendall 9502
Hook & Loop Kendall 63064
Hook & Loop Ultra Kendall 63074
Attends BR0830 Briefs 8
Attends BR0930 Briefs 9
Attends 10 Breathable BRBC1030
Attends 10 Briefs BREZ1030
Tena Ultra Brief Large SCA68122
FQ Per-Fit Breathable PF-013/1
(30) / EA / T4524 Adult size brief / diaper x-large, each / 300 / 2,457,654 / $______/ $______/ Select Full Fit, PBE 2635
Basic Care, PBE 2735
Select Care, PBE 2935
Soft & Breathable, PBE 2629
Hook & Loop Kendall 63065
Hook & Loop Ultra Kendall 63075
Attends BR0840 Briefs 8
Attends BR0940 Briefs 9
Attends 10 Breathable BRBC1040
Attends 10 Briefs BREZ1040
FQ Per-Fit Breathable PF-014/1
(31) / EA / T4525 Adult size pull on small, each / 150 / 417,926 / $______/ $______/ Select Sm, PBE 2604
Sure Care Protective Underwear Kendall 1605
Attends 7 PaperPak APP0710
Dignity Humanicare 46076
(32) / EA / T4526 Adult size pull on medium, each / 150 / 2,105,078 / $______/ $______/ Select Med, PBE 2605
Sure Care Protective Underwear Kendall 1605
Attends 7 APP0720
Dignity Humanicare 46077
Tena Plus SCA 72339
FQ Per-Fit PF-512
(33) / EA / T4527 Adult size pull on large, each / 150 / 2,339,702 / $______/ $______/ Select Lg, PBE 2606
Sure Care Protective Underwear Kendall 1615
Attends 7 PaperPak APP0730
Dignity Humanicare 46078
Tena Plus SCA 72339
FQ Per-Fit PF-513
(34) / EA / T4528 Adult size pull on x-large, each / 150 / 1,906,913 / $______/ $______/ Select XLG, PBE 2607
Sure Care Protective Underwear Kendall 1625
Attends 7 PaperPak APP0740
Dignity Humanicare 46079
Tena Plus SCA 72439
FA Per-Fit PF-514
FQ Prevail Extra (XXL-Bariatric PV-517)
(35) / EA / T4529 Pediatric size brief / diaper small / medium, each / 300 / 137,479 / $______/ $______/ Curity Ultra Fits Kendall 80018 Curity Utra Fits Kendall 80028
Huggies Ultratrim SZ1-2 HG52164
Huggies Ultratrim SZ3 HG211980
(36) / EA / T4530 Pediatric size brief / diaper large, each / 300 / 1,467,011 / $______/ $______/ Curity Ultra Fits Kendall 80038CF
Curity Ultra Fits Kendall 80048
Huggies Ultratrim SZ5 XL HG211994
Huggies Ultratrim SZ4 Lrg HG211987
(37) / EA / T4531 Pediatric size pull on small /medium, each / 150 / 241,372 / $______/ $______/ Run Around, Md. Boy
Kendall 70063B
Run Around, Md. Girl
Kendall 70063G
Huggies Youth Pull On Briefs 2T-3T MED Boy HG86171,
Huggies Youth Pull On Briefs 2T-3T MED Girl HG86172
Curity Sleeppants Kendall 70073
(38) / EA / T4532 Pediatric size pull on large, each / 150 / 139,704 / $______/ $______/ Run Around Lg. Boy,
Kendall 70064B
Run Around Lg. Girl,
Kendall 70064G
Huggies Youth Pull On Briefs 3T-4T BOYS HG86173
Huggies Youth Pull On Briefs 3T-4T GIRLS HG86174
(39) / EA / T4533 Youth size brief / diaper, each / 300 / 2,927,606 / $______/ $______/ Tranquility PBE 2166
Select PBE 2666
Select Toddler + PBE 2665
Attends Briefs 10 Classic Youth Diaper BRCL1000
Curity Ultra Fits Kendall 80058
Huggies Ultratrim SZ6 HG212001
(40) / EA / T4534 Youth size pull on, each / 150 / 1,092,456 / $______/ $______/ Select Extra Small Brief,
PBE 2603
RunAround X-Lg. Boy
Kendall 70065B
RunAround X-Lg. Girl
Kendall 70065G
Huggies Pull-Up 4T-5T Boy HG86175
Huggies Pull-Up 4T-5T Girl HG86182
Curity Sleeppants Kendall 70074
Curity Sleeppants Kendall 70075
(41) / EA / T4535 Disposable liner / shield / pad, each / 300 / 9,137,190 / $______/ $______/ Booster Pad, PBE 2760
Select 4.25x14.5, PBE 2671
Select 7x14, PBE 2691
Select 7x17, PBE 2690
Select Extra Absorb, PBE 2681, PBE 2682
Select Shield PBE 2648
Booster Pad PBE 2072
Tranquility Super Plus Trimshield, PBE 2083
Tranquility Regular Trimshield Pad, PBE3037
Male Trimshield Liner, PBE3045
Dignity ThinSerts Humanicare 30054
Humanicare Dignity Natural Liner HC26955, HC26954
Humanicare Stackable Pad HC30053
Humanicare Dignity Plus Super Liner HC30071
Humanicare Dignity Plus Liner HC30075
Humanicare Dignity Briefmates
HC30225
Humanicare Spartan Liners HC40340
Kendall Incontinence Liner KN1100B22, KN1140B16
Attends Shaped Pad SP0400
Serenity extra pads(mod) SCA 48900
FQ Prevail/male guard PV-811
FQ Prevail Pantiliner PV-926
FQ Prevail Day Time Liner PL-100SP0500
Kimberly-Clark Poise Pad 19595
(42) / EA / T4536 Reusable washable underwear any size, each / 10 / 9,632 / $______/ $______/ PBE 2684 MED
PBE 2685 LRG
PBE 2686 XL
Kendall KN700 SMALL
Kendall KN701 MED
Kendall KN702 LRG
Kendall KN703 XL
Kendall KN704M XXL
(43) / EA / T4541 Disposable underpads (e.g., Chux’s), large 23 x 36 / 180 / 9,867,139 / $______/ $______/ Kendall 1093DP
PBE 2673, 2675
(44) / EA / T4542 Disposable underpads (e.g., Chux’s),
small 17 x 24 / 180 / 35,866 / $______/ $______/ PaperPak UFS170
(45) / EA / T4543 Bariatric adult size brief / diaper xx-large, each / 300 / 154,288 / $______/ $______/ PBE Tranquility 2190
Whitestone 43790
(46) / EA / A4649 Misc. Supply / 1 / 42,901 / P. A. Required / No Reference
(47) / EA / A5112 Urinary leg bag; latex / 2 / 0 / $______/ $______/ Mentor 4157, 4175
(48) / EA / A5120 Skin barrier, wipes, 50/box (antiseptic), per wipe / 100 / 17,500 / $______/ $______/ Mentor 44005
(49) / EA / S5199 Personal Care Products / Wipes/Adult/Baby, per wipe / 100 / 10,256,990 / $______/ $______/ Innovative DermAssist 80-301
ABCO Antiseptic Towelettes NDC634915
Kimberly-Clark Huggies Natural Care Wipes (unscented) HG18600
(50) / EA / A6250 Skin sealants, protectants, moisturizers, ointment, any type, any size / 2 / 43,639 / $______/ $______/ Secura Smith & Nephew 2.47 oz 59431500
Kendall Vaseline Constant Care 2 oz KN8884737500
DermaRite Periguard 3.5 oz 00204
(51) / EA / T1500 Diaper/Incontinent pant, reusable/washable / 1 / 0 / $______/ $______/ Select PBE 3080 series
Humanicare 16000 series
Humanicare 40200 series
Humanicare Spartan Unisex Waterproof Pant HC10000 Series
Kendall 689 SML
Kendall 691 MED
Kendall 694 LRG
Kendall 698 XL
(52) / EA / A4354 Insertion Tray with Drainage Bag / 10 / 0 / $______/ $______/ Mentor UT9183
(53) / EA / A4353 Intermittent Urinary Catheter with Insertion Supplies / 150 / 5,360 / $______/ $______/ Mentor 1008, 1012, 1014, 1016, 3110, 3112, 3114, 3116, 3212, 3214, UT8140, UT8150
Subtotal Items 1-53: / $______
GRAND TOTAL BID AMOUNT (subtotal x 3 years): / $______

*Note: If the estimated annual quantity specified is “0”, bidders shall bid a unit cost and use a quantity of “1” to calculate your total bid amount for the item.

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