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R24-130 1 RESOLUTION NO. R24-130 3 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF BOYNTON 4 BEACH, FLORIDA, APPROVING A PIGGYBACK AGREEMENT BETWEEN THE 5 CITY AND BOUND TREE MEDICAL, LLC FOR THE PURCHASE OF MEDICAL 6 SUPPLIES; PROVIDING AN EFFECTIVE DATE; AND FOR ALL OTHER 7 PURPOSES. 8 9 WHEREAS, on August 11, 2023, the County of Volusia, a political subdivision of the State 10 of Florida, issued an "Invitation to Bid" (ITB) to solicit responses for the purchase of Medical 11 Supplies ("Supplies") for which it received a total of eight (8) responses; and 12 WHEREAS, the County of Volusia found Bound Tree Medical, LLC ("Vendor"), to be a 13 responsive, responsible bidder and awarded it a three (3) year agreement, Agreement No. 23-B- 14 136AK, commencing November 2, 2023, with two (2) additional one-year renewal options; and 15 WHEREAS, the City desires to obtain Supplies on an as-needed basis; and 16 WHEREAS, the City's Purchasing Policy Section X — Alternatives to Formal Sealed Bids, 17 provides authority for the City to acquire or contract for services without utilizing a sealed 18 competitive method or the written quotations methods where the desired services are the subject 19 of an agreement that utilizes another government entity's contract, provided that the contract 20 was awarded based strictly on competitive bidding; and 21 WHEREAS, to acquire Supplies to be stocked at the Warehouse for the City's EMS services 22 within the City, the City's Materials and Distribution Division is requesting the City enter into a 23 Piggyback Agreement with the Vendor to obtain Supplies; and 24 WHEREAS, the City and Vendor have agreed to allow the City to piggyback the County 25 of Volusia's Agreement; and 26 WHEREAS, the City Commission, upon the recommendation of staff, has deemed it to be 27 in the best interests of the citizens and residents of the City to approve a Piggyback Agreement 28 between the City and Bound Tree Medical, LLC, for the purchase of medical supplies. 29 30 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF BOYNTON 31 BEACH, FLORIDA, THAT: 32 SECTION 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as 33 being true and correct and are hereby made a specific part of this Resolution upon adoption. 34 SECTION 2. The City Commission of the City of Boynton Beach, Florida, does hereby 35 approve a Piggyback Agreement, between Bound Tree Medical, LLC and the City for medical 36 supplies purchase (the "Piggyback Agreement"), in form and substance similar to that attached as 37 "Exhibit A". 38 SECTION 3. The City Commission of the City of Boynton Beach, Florida, hereby 39 authorizes the City Manager to execute a Piggyback Agreement and such other related 40 documents as may be necessary to accomplish the purpose of this Resolution. 41 SECTION 4. One fully executed original of the Piggyback Agreement shall be retained 42 by the City Clerk as a public record of the City. A copy of the fully executed Piggyback Agreement 43 shall be provided to Michael Dauta to forward to the Vendor. 44 SECTION 5. This Resolution shall take effect in accordance with law. 45 46 47 48 49 [signatures on following page] 50 51 52 53 54 55 56 57 58 PASSED AND ADOPTED this 18th day of June 2024. 59 CITY OF BOYNTON BEACH, FLORIDA 60 YES NO 61 Mayor—Ty Penserga i- 62 / 63 Vice Mayor—Aimee Kelley 64 65 Commissioner—Angela Cruz 66 67 Commissioner—Woodrow L. Hay 68 69 Commissioner—Thomas Turkin ✓ 70 71 VOTE 72 AT T:, 73 ' c 74 � 75 Mayle=r.- esus, MPA, MC T 76 City Cl.. Mayor 77 ,�NT ON BF`z,, 78 ;k� ee°RAr '••�C' .;, APPROVED AS TO FORM: 79 (Corporate Seal) S o•;`o 5 r • y , F-; ORF�EO 80 i • 81 0 82 �� '•••...0• c,`� ;' Shawna G. Lamb Ft City Attorney ' P rDr PIGGYBACK AGREEMENT BETWEEN THE CITY OF BOYNTON BEACH AND BOUND TREE MEDICAL, LLC This Piggyback Agreement is made as of this ggy g day o , 2024, by and between BOUND TREE MEDICAL, LLC, with a principal address of 500 Tuttle Crossing Blvd., Dublin. Ohio 43016, hereinafter referred to as "Vendor," and the CITY OF BOYNTON BEACH, a municipal corporation organized and existing under the laws of Florida, with a business address of 100 East Ocean Avenue, Boynton Beach, Florida 33435, hereinafter referred to as"City." RECITALS WHEREAS, on August 11, 2023, the County of Volusia, a political subdivision of the State of Florida, issued an"Invitation to Bid"(ITB) to solicit responses for the purchase of Medical Supplies ("Supplies") for which it received a total of eight (8) responses; and WHEREAS, the County of Volusia found Bound Tree Medical, LLC ("Vendor"), to be a responsive, responsible bidder, and awarded it a three (3) year agreement, Agreement No. 23-B- 136AK (the "Master Agreement"), commencing November 2, 2023, with two (2) additional one- year renewal options; and WHEREAS, the City desires to obtain Supplies on an as-needed basis; and WHEREAS,the City's Purchasing Policy Section X—Alternatives to Formal Sealed Bids, provides authority for the City to acquire or contract for services without utilizing a sealed competitive method or the written quotations methods where the desired services are the subject of an agreement that utilizes another government entity's contract, provided that the contract was awarded based strictly on competitive bidding; and WHEREAS, in order to acquire Supplies to be stocked at the Warehouse for the City's EMS services within the City, the City's Materials and Distribution Division is requesting the City enter into a Piggyback Agreement with Vendor to obtain Supplies; and WHEREAS, the City and Vendor have agreed to allow the City to piggyback the Master Agreement, a copy of which is attached as Exhibit"A." NOW, THEREFORE. in consideration of the mutual covenants contained herein, and for other valuable consideration received, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows: Piggyback Contract—Hound Tree Medical LLC I AGREEMENT 1. The foregoing recitals are true and correct and are hereby incorporated into this Agreement. 2. TERM: The term of this Agreement commences on November 2, 2023, and will remain in effect until November 1, 2026, with two (2) one-year renewal options ("Term"). The City Manager is authorized to execute amendments renewing the Agreement on behalf of the City.The initial term and any subsequent renewals of this Agreement are subject to the renewal or extension of the Master Agreement. If the Master Agreement expires or is terminated during the Term, this Agreement shall terminate no later than six months after such expiration or termination of the Master Agreement. 3. CONTRACT TERMS: The Vendor agrees to provide Supplies to the City on an as- needed basis, as provided in Vendor's Proposal attached as Exhibit"A" on the same terms and in the same manner as set forth in the Master Agreement,except as otherwise provided herein. All recitals, representations, and warranties of Vendor made by Vendor in the Master Agreement are restated as if set forth fully herein, made for the benefit of the City, and incorporated herein, except that all references to the "County of Volusia" are hereby replaced with the "City of Boynton Beach." The City shall compensate Vendor pursuant to the rates set forth in the Master Agreement for the Supplies in an annual amount not to exceed $150,000.00. 4. NOTICES: All Notices to the City shall be in writing by certified mail return receipt requested, or customarily used overnight transmission with proof of delivery, sent to: City: Daniel Dugger, City Manager City of Boynton Beach P.O. Box 310 Boynton Beach, Florida 33425 Telephone: (561) 742-6010 Facsimile: (561) 742-6090 Copy: Shawna G. Lamb, City Attorney City of Boynton Beach P.O. Box 310 Boynton Beach, Florida 33425 Telephone: (561) 742-6010 Facsimile: (561) 742-6090 5. INVOICES AND PAYMENT: Invoices must identify the PO number and should be mailed to: Boynton Beach Materials and Distribution Department Attn: Michael Dauta 222 NE 991 Ave Boynton Beach, FL 33435. Invoices shall show the nature of the service and dates(s) of service. Invoices based on hourly rates shall show the actual hours worked, person performing services, nature of the service,hourly rate,and dates(s)of service. Invoices may be submitted no more frequently Pigg}back Contract—Bound Tree Medical,LLC than monthly. However, all services rendered prior to September 30th of any given year are required to be invoiced by September 30th of that year. Vendor shall provide W-9 with first invoice. The fee shall be paid based on receipt of a proper invoice in accordance with the invoice schedule indicated above. Payment will be made within 45 days of receipt of a proper invoice in accordance with the Local Government Prompt Payment Act, Section 218.70, et al., Florida Statutes. No payment made under this Agreement shall be conclusive evidence of the performance of this Agreement by Vendor, either wholly or in part, and no payment shall be construed to be an acceptance of or to relieve Vendor of liability for the defective, faulty or incomplete rendition of the services. 6. TAX EXEMPT: Prices applicable to City do not include applicable state and local sales, use,and related taxes.The City is exempt from state and local sales and use taxes and shall not be invoiced for the same. Upon request, City will provide Vendor with proof of tax- exempt status. 7. SOVEREIGN IMMUNITY: Nothing contained in this Agreement nor contained herein shall be considered nor construed to waive City's rights and immunities under the common law or section 768.28, Florida Statutes, as may be amended. 8. ATTORNEY'S FEES: In the event that either Party brings suit for enforcement of the Agreement, each Party shall bear its own attorney's fees and court costs. 9. PUBLIC RECORDS: Sealed documents received by the City in response to an invitation are exempt from public records disclosure until thirty (30) days after the opening of the Bid unless the City announces intent to award sooner, in accordance with Florida Statutes 119.07. The City is a public agency subject to Chapter 119, Florida Statutes. The Vendor shall comply with Florida's Public Records Law. Specifically, the Vendor shall: A. Keep and maintain public records required by the City to perform the service; B. Upon request from the City's custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in chapter 119, Fla. Stat. or as otherwise provided by law; C. Ensure that public records that are exempt or that are confidential and exempt from public record disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and, following completion of the contract, Vendor shall destroy all copies of such confidential and exempt records remaining in its possession once the Vendor transfers the records in its possession to the City; and D. Upon completion of the contract, Vendor shall transfer to the City, at no cost to the City, all public records in Vendor's possession All records stored electronically by Vendor must be provided to the City, upon request from the City's custodian of public Piggy back Contract—Bound Tree Medical.LLC records, in a format that is compatible with the information technology systems of the City. E. IF THE VENDOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE VENDOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS: CITY CLERK OFFICE 100 E. OCEAN AVENUE BOYNTON BEACH, FLORIDA, 33435 561-742-6060 CitvClerk(a bbfl.us 10. SCRUTINIZED COMPANIES - 287.135 AND 215.473: By execution of this Agreement, Vendor certifies that Vendor is not participating in a boycott of Israel. The Vendor further certifies that Vendor is not on the Scrutinized Companies that Boycott Israel list, not on the Scrutinized Companies with Activities in Sudan List, and not on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or has Vendor been engaged in business operations in Syria. Subject to limited exceptions provided in state law, the City will not contract for the provision of goods or services with any scrutinized company referred to above. Submitting a false certification shall be deemed a material breach of contract. The City shall provide notice, in writing, to the Vendor of the City's determination concerning the false certification. The Vendor shall have five (5) days from receipt of notice to refute the false certification allegation. If such false certification is discovered during the active contract term, the Vendor shall have ninety (90) days following receipt of the notice to respond in writing and demonstrate that the determination of false certification was made in error. If the Vendor does not demonstrate that the City's determination of false certification was made in error, then the City shall have the right to terminate the contract and seek civil remedies pursuant to Section 287.135, Florida Statutes, as amended from time to time. 11. E-VERIFY: Vendor shall comply with Section 448.095, Fla. Stat., "Employment Eligibility," including the registration and use of the E-Verify system to verify the work authorization status of employees. Failure to comply with Section 448.095, Fla. Stat. shall result in termination of this Agreement. Any challenge to termination under this provision must be filed in the Circuit Court no later than 20 calendar days after the date of termination. If this Agreement is terminated for a violation of the statute by Vendor, Vendor may not be awarded a public contract for a period of one(l) year after the date of termination. 12. DISPUTES: Any disputes that arise between the parties with respect to the performance of this Agreement, which cannot be resolved through negotiations, shall be submitted to a court of competent jurisdiction exclusively in Palm Beach County, Florida. This Agreement shall be construed under Florida Law. Pigg)back Contract—Bound Tree Medical,LLC 4 13. EXECUTION OF THE AGREEMENT: This Agreement will take effect once signed by both parties. This Agreement may be signed by the parties in counterparts, which together shall constitute one and the same agreement among the parties. A facsimile signature shall constitute an original signature for all purposes. Each person signing this Agreement on behalf of either Party individually warrants that he or she has full legal power to execute the Addendum on behalf of the Party for whom he or she is signing and to bind and obligate such Party with respect to all provisions contained in this Agreement 14. TERMINATION FOR CONVENIENCE: This Agreement may be terminated by the City for convenience upon fourteen (14)calendar days of written notice by the terminating party to the other party for such termination in which event the Vendor shall be paid its compensation for services performed to the termination date, including services reasonably related to termination. In the event that the Vendor abandons the Agreement or causes it to be terminated, the Vendor shall indemnify the City against loss pertaining to this termination. 15. TERMINATION FOR CAUSE: In addition to all other remedies available to City, this Agreement shall be subject to cancellation by City for cause, should Vendor neglect or fail to perform or observe any of the terms, provisions, conditions, or requirements herein contained, if such neglect or failure shall continue for a period of thirty(30)calendar days' after receipt by Vendor of written notice of such neglect or failure. 16. INDEMNIFICATION: Vendor shall indemnify and hold harmless the City, its elected and appointed officers, agents, assigns and employees, consultants, separate Vendors, any of their subcontractors,or sub-subcontractors, from and against claims,demands,or causes of action whatsoever, and the resulting losses, damages, costs, and expenses, including but not limited to attorneys' fees, including paralegal expenses, liabilities, damages, orders, judgments, or decrees, sustained by the City arising out of or resulting from (A) Vendor's performance or breach of Agreement, (B) acts or omissions, negligence, recklessness, or intentional wrongful conduct by Vendor's, its agents, employees, subcontractors, participants, and volunteers, and (C) Vendor's failure to take out and maintain insurance as required under this Agreement. Vendor's shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits, or actions of any kind or nature in the name of the City, where applicable, including appellate proceedings, and shall pay all costs,judgments, and attorneys' fees which may issue thereon. The obligations of this section shall survive indefinitely regardless of termination of the Agreement. 17. INSURANCE: At the time of execution of this Agreement, Vendor shall provide the City with a copy of its Certificate of Insurance reflecting the insurance coverage required by the Master Agreement. The Certificate of Insurance shall name the City of Boynton Beach, and its officers, employees and agents as an additional insured. 18. LIMITATION OF LIABILITY: Notwithstanding any provision of the Agreement to which it is applicable, City shall not be liable or responsible to Vendor beyond the amount remaining due to Vendor under the Agreement,regardless of whether said liability be based in tort, contract, indemnity or otherwise; and in no event shall City be liable to Vendor for punitive or exemplary damages or for lost profits or consequential damages. 19. INDEPENDENT CONTRACTOR: The Agreement does not create an Piggy back Contract—Bound Tree Medical.LLC employee/employer relationship between the Parties. It is the intent of the Parties that Vendor is an independent contractor pursuant to the Agreement and shall not be considered the City's employee for any purpose. 20. COMPLIANCE WITH LAWS: Vendor hereby warrants and agrees that at all times material to the Agreement, Vendor shall perform its obligations in compliance with all applicable federal, state, and local laws, rules, and regulations, including section 501.171, Florida Statutes. Non-compliance may constitute a material breach of the Agreement. 21. ASSIGNMENT: In the event this Agreement and any interests granted herein shall be assigned, transferred, or otherwise encumbered, under any circumstances by Vendor, Vendor must gain prior written consent from City thirty (30) business days before such transfer. For purposes of this Agreement, any change of ownership of Company shall constitute an assignment that requires City's approval. Notwithstanding the foregoing, Vendor may, without City's consent,assign this Agreement in whole or in part as part of a corporate reorganization, consolidation, merger, or sale of substantially all of its assets related to this Agreement. Vendor shall provide City written notice of any such corporate reorganization,consolidation, merger, or sale of substantially all of its assets related to this Agreement within thirty (30) calendar days of such event. 22. AGREEMENT SUBJECT TO FUNDING: The Agreement shall remain in full force and effect only as long as the expenditures provided for in the Agreement have been appropriated by the City Commission of the City of Boynton Beach in the annual budget for each fiscal year of this Agreement, and is subject to termination based on lack of funding. Early termination by City due to loss of funding shall not obligate Vendor to refund any prepaid fees. 23. ENTIRE AGREEMENT.The Agreement, including the Master Agreement,sets forth the entire Agreement between the City and the Vendor with respect to the subject matter of this Agreement. This Agreement supersedes all prior and contemporaneous negotiations, understandings,and agreements, written or oral, between the parties.This Agreement may not be modified except by the parties' mutual agreement set forth in writing and signed by the parties. 24. SEVERABILITY. If any provision of this Agreement or application thereof to any person or situation shall, to any extent, be held invalid or unenforceable, the remainder of this Agreement,and the application of such provisions to persons or situations other than those as to which it shall have been held invalid or unenforceable, shall not be affected thereby, and shall continue in full force and effect, and be enforced to the fullest extent permitted by law. Signature Page to follow Piggyback Contract—Bound Tree Medical.LLC IN WITNESS OF THE FOREGOING,the parties have set their hands and seals the day and year first written above. cITY f F BOYNTON BEACH,FLORIDA BOUN7PIE MED 1 ,L3,,C Dame P ugger, Citi►, . t : •er�� ( atture)),, Company 40Corey Case Print Name of Authorized Official Chief Marketing Officer Title Approved as to Form: 4a410 J V,i/7 7,‘ Shawna G. Lamb, City Attorney (Corporate Seal) Attest/Authenticated: Attes - •/Authenticated: - r-t 1. ...71.17.7A 1 le- ( ignature), W tness Dwight Lowry Maylee DF s, City Clerk Print Name ..... ........ ... " �F B 0 YNT j ;....'-GORP0'. " :/A A 1, 1$ L # 19�RgTE0;_,: It .�' Piggy back Contract-Bound Tree Medical LLC 7 EXHIBIT A AGREEMENT BETWEEN COUNTY OF VOLUSIA,FLORIDA AND BOUND TREE MEDICAL, LLC Piggyback Contract—Bound Tree Medical,LLC 8 County of Volusia Purchasing and Contracts Pam Wilsky, Director Volusia County 123 W.Indiana Ave.,DeLand,FL 32720 FLORIDA PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies RESPONSE DEADLINE: September 7, 2023 at 3:01 pm Report Generated: Thursday, October 26, 2023 Bound Tree Medical, LLC Proposal CONTACT INFORMATION Company: Bound Tree Medical, LLC Email: submitbids@boundtree.com Contact: Christopher Fyffe Address: 5000 Tuttle Crossing Blvd Dublin, OH 43016 Phone: (800) 533-0523 Website: www.boundtree.com Submission Date: Sep 7, 2023 1:38 PM PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies ADDENDA CONFIRMATION Addendum #1 Confirmed Sep 7, 2023 9:15 AM by Christopher Fyffe Addendum #2 Confirmed Sep 7, 2023 9:15 AM by Christopher Fyffe QUESTIONNAIRE 1. Do you agree to this special condition.* Pass By checking yes,the vendor agrees to the special conditions as contained in this section: Due to the nature of the services to be provided and the potential impact to the County for loss, the Contractor cannot disclaim consequential or special damages related to the performance of this Agreement. The Contractor shall be responsible and accountable for any and all damages, directly or indirectly, caused by the actions or inaction of its employees, staff, or Subcontractors. There are no limitations to this liability. Yes 2. Do you agree to comply with the E-verify requirements? * Pass The Contractor shall utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the Contractor/Consultant on or after the effective date of this Agreement and thereafter during the remaining term of the Agreement, including Subcontractors. Any subcontract entered into by Contractor with any Subcontractor performing work under PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 2 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies this contract shall include the following language: "The Subcontractor shall utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the Contractor on or after the effective date of this Agreement and thereafter during the remaining term of the Agreement."The Contractor covenants and agrees that if it is found in violation of this section or the Executive Order, such violation shall be a material breach of this Agreement and Contractor shall indemnify, defend and hold harmless the County from any fines or penalties levied by a government agency, including the loss or repayment of grant funds by the County. Yes 3. Do you agree to comply with the FEMA federal contract provisions?* Pass This Agreement and the products/services provided may be utilized in the event of declared State/Federal Emergency, and Contractors shall comply with the applicable sections of Exhibit III, Federal Contract Provisions. Yes 4. Please complete and upload the Federal Contract Provisions. * Pass Please download the below documents, complete, and upload. • Federal Contract Provisions... Signed-Volusia_Federa I_Contract_Provisions_23-B-136AK.pdf PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 3 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies 5. Contractor/Proposer attestation* Pass By checking yes, the Contractor/Proposer acknowledges that information provided in the response is true and correct and agrees to all terms and conditions contained in this solicitation and related exhibits. Contractor/Proposer further agrees and acknowledges that no proprietary or confidential information has been submitted and that the submission of a response is final. Responses may be withdrawn by the Contractor/Proposer prior to the closing/offer date. Following the closing/offer date, Contractor/Proposer understands that a response may not be withdrawn. By submitting this proposal or entering into this contract, Contractor/Proposer acknowledges that all documents submitted are public records and agrees that any records maintained, generated, received, or kept in connection with, or related to the performance of services or delivery of products provided under this proposal or contract are public records subject to the public records disclosure requirements of Florida Statutes sec. 119 et seq., and Article I, section 24 of the Florida Constitution. Yes 6. Submission of Offers * Pass The County of Volusia is requesting written bids for the service and/or product(s) detailed within this solicitation. If your company is interested in submitting a bid to provide this service and/or product(s), please provide the requested information in this ITB, complete the included forms, and submit these documents via your response through the County's eProcurement Portal by the date and time posted. Bids received after the posted date and time may not be considered. Do not submit confidential information, proprietary information and/or trade secrets. **By checking yes, the vendor acknowledges the information provided above regarding offer submission. Yes 7. Name and Title of Authorized Agent of the firm (from General Terms and Conditions)* Pass PROPOSAL DOCUMENT REPORT Invitation For Bid- Medical Supplies Page 4 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies Vendor acknowledges that the name and title of the signatory (the "Authorized Signatory"), as completed below, is authorized to execute contracts/agreements with the County of Volusia, and that submitting a bid via the County's eProcurement Portal shall be the act of and attributable to the Authorized Signatory to bind the company. By submitting this Agreement electronically, the Authorized Signatory does thereby adopt the electronic or conformed submittal as authorized firm commitment and for use as an official record by the County of Volusia. If the below-named individual is not an authorized agent of the firm, as listed with the Florida Division of Corporations (Sunbiz), a Memorandum of Authority shall be uploaded giving that individual authorization to commit the firm to a contract. Please provide the Complete Name and Title which shall indicate acknowledgment. Shawn Saylor- Chief Financial Officer 8. Do you or any owner(s), principal(s), or officer(s)of your firm currently serve on any Volusia County board(s) or committee(s)?* Pass Please indicate response. No 9. If you indicated YES to Volusia County board/committee question above... Pass If you indicated YES to the question above regarding owners, principals, or officers of the firm serving on any Volusia County board(s) or committee(s), please list the individual's full name(s) and the board(s) and/or committee(s) on which they serve. NONE 10. Scope of Work(from General Terms and Conditions)* Pass PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 5 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies By checking 'yes', vendor acknowledges that they have fully read and understand the above Scope of Work/Technical Specifications and will furnish said product or services according to the specifications or scope of work detailed within this ITB if awarded. Yes 11. REVISIONS I ADDENDA I QUESTIONS&ANSWERS * Pass By selecting YES below, participants are confirming that they have reviewed revisions and all answers to questions published and any addenda up until the bid closing date and have given consideration to all information in preparing the response to this solicitation. Selecting YES will serve as confirmation of acknowledgement. Yes 12. Please provide Proof of Insurance* Pass Please provide Proof of Insurance- evidence of required insurance coverage or proof of insurability in the amounts indicated. If available, a properly completed ACORD Form is preferable. Upon award, final forms must contain the correct solicitation and/or project number and Volusia County contact person. Firms that have owner/operators that have filed a "Notice of Election to be Exempt" shall submit a copy with the response County_of_Volusia-570096605409.pdf 13. Hold Harmless Agreement. * Pass Please download the below documents, complete, and upload. • Hold Harmless Agreement(492... Edit-Hold_Harmless_Agreement(492425)_Volusia.pdf PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 6 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies 14. Forms BID SUBMITTAL FORM * Pass Please download the Bid Submittal form from the attachment section, complete and upload. Signed-Volusia_Bid_Submittal_Form(492426).pdf W9* Pass W-9.pdf FLORIDA DEPARTMENT OF STATE, DIVISION OF CORPORATIONS' DETAIL BY ENTITY NAME REPORT * Pass Florida Department of State, Division of Corporations' Detail by Entity Name Report Provide a Florida Department of State, Division of Corporations' detail by entity name report for your firm, available at www.sunbiz.org. The Respondent shall be required, upon notification of recommendation of award, to register with the Florida Department of State Division of Corporations at www.sunbiz.org in order to provide services under the resulting Contract. Detail_by_Entity_Name_Report-GetDocument.pdf CERTIFICATION AFFIDAVIT BY PRIME CONTRACTOR AS LOCAL BUSINESS* Pass Certification Affidavit by Prime Contractor as Local Business Vendor acknowledges that, as the respondent: • Vendor has been in business for a minimum of six (6) months prior to the date of this submission PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 7 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies • Vendor acknowledges the ability to provide proof of local business presence in the form of a business tax receipt from a local jurisdiction per Volusia County local preference ordinance found at https://www.volusia.org/core/fileparse.php/4537/urlt/Local-Preference-from-M uniCode.pdf By selecting 'Yes', I acknowledge the local preference requirements and understand these requirements shall remain for the entire term of the agreement. I further understand that failure to notify the County of Volusia of any change in status as a result of an awarded agreement may result in breach. No CERTIFICATION AFFIDAVIT OF SUBCONTRACTOR AS LOCAL BUSINESS * Pass The respondent certifies to the best of its knowledge and belief, that any subcontractor/supplier in accordance with a response to this solicitation: • Subcontractor/supplier has been in business for a minimum of six (6) months prior to the date of this submission • Subcontractor/supplier acknowledges the ability to provide proof of local business presence in the form of a business tax receipt from a local jurisdiction per Volusia County local preference ordinance found at https://www.volusia.org/core/fileparse.php/4537/urlt/Local-Preference-from-MuniCode.pdf By selecting 'Yes', I acknowledge the subcontractor local preference requirements and understand these requirements shall remain for the entire term of the agreement. I further understand that failure to notify the County of Volusia of any change in status as a result of an awarded agreement may result in breach. No BUSINESS TAX RECEIPT * PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 8 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies Pass Please attach Business Tax Receipt. To be responsive to this solicitation, each Respondent who is currently required to have a Business Tax Receipt (BTR) at the time of submittal shall provide a copy of their current BTR. There are two exceptions to this ITB submission requirement: 1. If Respondent's business does not have a physical location in Lake, Orange, Osceola, Seminole, or Volusia County, no submission is required, OR 2. If Respondent's business type is exempt, submit with proposal a Proof of Exemption Form, approved by the Volusia County Treasury and Billing Director, located at https://www.volusia.org/core/fileparse.php/6090/urlt/Proof-of-Exemption.pdf. For more information and to access Ch. 114, Article I, Sect. 114-1 of the Volusia County Code of Ordinances, go to: http://www.volusia.org/services/financial-and-administrative-services/revenue-services/local-business-tax/business-tax-frequently- asked questions.stml Document upload Business_Tax_Receipt_Responsel.pdf CONFLICT OF INTEREST * Pass The award of this solicitation is subject to Chapter 112, Florida Statutes. All respondents must disclose with their response the name of any officer, director, or agent who is also an employee of the County of Volusia. Further, all respondents must disclose the name of any County of Volusia employee who owns, directly or indirectly, an interest of the Respondent's/Supplier's firm or any of its subsidiaries associated with this project. I certify that this proposal is made without prior understanding, agreement or connection with any corporation, firm or person submitting a proposal for the same services, and is in all respects fair and without collusion or fraud. Respondent shall select 'No' if a conflict of interest as defined in this question does NOT exist. Please select 'Yes' if a conflict of interest as defined in this question DOES exist and shall be further described in the explanation below. PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 9 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies No ENTER EXPLANATION OF THE CONFLICT OF INTEREST AS INDICATED ABOVE. * Pass If no conflict of interest enter :NONE NONE . PUBLIC ENTITY CRIME* Pass Public Entity Crimes - Pursuant to Section 287.133(12)(a) of the Florida Statutes, a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Submittal Package (Bid Response) on a contract to provide any goods or services to a public entity, may not submit a bond on a contract with a public entity for the construction or repair of a public building or public work, may not submit Submittal Package (Bid Response) on leases of real property to a public entity may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 for Category Two ($25,000)for a period of 36 months from the date of being placed on the convicted vendor list. Respondent should read carefully all provisions of 287.133 and 287.134, Florida Statutes (2005). By selecting 'Yes', the Respondent represents and warrants that the submission of its response/proposal does not violate Section 287.133, Florida Statutes (2005), nor Section 287.134, Florida Statutes (2005) or their successor. In addition to the foregoing, the Respondent represents and warrants that Respondent, Respondent's subcontractors and Respondent's implementer, if any, is not under investigation for violation of such statutes. Yes SCRUTINIZED COMPANIES CERTIFICATION * PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 10 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies Pass Per State of Florida Statute s. 287.135(5) Suppliers (companies) must acknowledge and agree to the 'Certification Regarding Prohibition Against Contracting with Scrutinized Companies' paragraph listed below. Respondents shall agree by marking the option below. Respondents neglecting to respond may be disqualified from consideration of award and deemed non-responsive. I hereby certify that neither the responding entity, nor any of its wholly owned subsidiaries, majority-owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit have been placed on the Scrutinized Companies That Boycott Israel List created pursuant to s. 215.4725 of the Florida Statutes, or are engaged in a boycott of Israel. In addition, if this solicitation is for a contract for goods or services where the total contract value is one million dollars ($1,000,000) or more, I hereby certify that neither the responding entity, nor any of its wholly owned subsidiaries, majority- owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit are on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s. 215.473 of the Florida Statutes, or are engaged in business operations in Cuba or Syria as defined in said statute. I understand and agree that the County may immediately terminate any contract resulting from this Solicitation upon written notice if the responding entity (or any of those related entities of respondent as defined above by Florida law) are found to have submitted a false certification or any of the following occur with respect to the company or a related entity: (i) it has been placed on the Scrutinized Companies that Boycott Israel List, or is engaged in a boycott of Israel, or (ii) for any contract for goods or services of one million dollars ($1,000,000) or more, it has been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or it is found to have been engaged in business operations in Cuba or Syria. By selecting 'Yes', the respondent acknowledges and agrees to the 'Certification Regarding Prohibition Against Contracting with Scrutinized Companies.' Yes PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 11 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies DRUG-FREE WORKPLACE * Pass By selecting "Yes", Respondent hereby acknowledges it has implemented the requirements of Florida statute 287.087 and is in compliance with the requirements of a drug-free workplace program. Yes CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION * Pass By selecting 'Yes', the Respondent certifies to the best of its knowledge and belief, that the firm and any subcontractor/supplier in accordance with a response to this solicitation: • are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency • have not within a three-year period preceding this bid proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. • are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in the previous paragraph of this certification. • have not within a three (3) year period preceding this bid proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. Yes ENTER EXPLANATION OF THE 'NO' RESPONSE TO THE CERTIFICATION REGARDING DEBARMENT,* Pass PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 12 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies Enter explanation of the 'No' response to the Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion. OR Enter NONE if not applicable NONE 15. Additional Information DO YOU ACCEPT ELECTRONIC FUNDS TRANSFER (EFT)? * Pass Yes IF YES TO EFT QUESTION ABOVE, PROVIDE PERCENTAGE: * Pass If you indicated YES to accepting Electronic Funds Transfer, what percentage discount will you offer when accepting payment via EFT? No discount for EFT. PAYMENT TERMS * Pass Will you offer a discount for payment terms less than the County's NET45? If so, please provide the % and day requirement for the discount. (Example: 5%for payment within 30 days) Zero Net 30 Days PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 13 PROPOSAL DOCUMENT REPORT ITB No. 23-B-136AK Medical Supplies PLEASE SUBMIT YOUR TOTAL NUMBER OF EMPLOYEES. * Pass 291 ARE YOU A SOLE PROPRIETOR? * Pass No REFERENCES * Pass Please download the below documents, complete, and upload. • References Form(492427).pdf Edit-Volusia_References_Form(492427).pdf PRICE COMPARISON AND ATTACHMENT B--FIXED PERCENTAGE OFF LIST PRICE* Pass Please upload Attachment A--Price Comparison and Attachment B--Fixed Percentage Off List Price Edit-Attachment_A--Price_Comparison-Revised_Version_2.xlsxEdit-Attachment_B= _Fixed_Percentage_Off_List_Price.xlsxPercentage_Off_Cata log=_Static_Discount.doc PROPOSAL DOCUMENT REPORT Invitation For Bid-Medical Supplies Page 14 BID SUBMITTAL FORM The undersigned hereby declare(s) that [firm name] Bound Tree Medical, LLC. has carefully examined the specifications to furnish the products and/or services detailed in the technical specifications or scope of work and will furnish said product or services according to the specifications or scope of work detailed within this ITB. I hereby certify that I.have read and understand the requirements of this Invitation to Bid and that I, as the proposer, will comply with all requirements, and that I am duly authorized to execute this proposal/offer document and any contract(s) and/or other transactions required by award of this ITB. Vendor hereby acknowledges that the submittal has been approved by an authorized signatory with the firm who is authorized to execute contracts/agreements with the County of Volusia. Vendor further agrees that by submitting the proposal electronically, the authorized signatory does thereby accept and acknowledge use as an official record with Volusia County. Further, as attested to by below signature, I will provide the required insurance, per the Required Types of Insurance, upon notification of recommendation of award. The vendor acknowledges that information provided in this bid is true and correct: Signature Authorized Signatory Shawn Saylor Printed Name Chief Financial Officer 09:j7 2023 Title Date Bound Tree Medical LLC Company Name 5000 Tuttle Crossing Bls d Full Address 800 533 0523 877 311 2437 submttbids a boundtree corn Telephone Fax E mail Address 070556204 31-1739487 Dun&Bradstreet M Federal 113 M r�1 t pet exe�p�o e \a,Seer°\e ce�P osc ° gu5\ress�aX�r\a\ce��ar�e' \e of�o\�S�a Cov\d�r,tre \ca\\oca�°r e°\ or010 P s sc a. s eXempt�tom rotrave a ed,0Et teo :::::::° of J°\use a\ca\ ��c d°es r Med\ca\State o ee Me d.\,�ee gourd(� \re gout a °r. Gourty. e�eC ate 0 Ce {\c ed how d\101 \�d ran 0 �efl\r�`\r G l;. r f Bound Tree Medical, LLC. Is exempt from providing the Business Tax Receipt per exemption#1 1. "If Respondent's business does not have a physical location in Lake,Orange, Osceola, Seminole, or Volusia County, no submission is required,OR" Bound Tree Medical, LLC does not have physical location in Lake, Orange, Osceola, Seminole, or Volusia County. Included however are the Bound Tree Medical State of Florida Certification of Status as well as DEA Certification and VAWD Certification. State of Florida Department of State I certify from the records of this office that BOUND TREE MEDICAL, LLC is an Ohio limited liability company authorized to transact business in the State of Florida, qualified on October 12, 2001. The document number of this limited liability company is MO1000002310. I further certify that said limited liability company has paid all fees due this office through December 31, 2017, that its most recent annual report was filed on April 5, 2017, and that its status is active. I further certify that said limited liability company has not filed a Certificate of Withdrawal. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Fourteenth day of December, 2017 ec, • /A1,7* vith. t: , t. -- -z,-'--. '-iir ::,1- VA% 04NAA `AP` -' 0, Secretary of ec, *yob Tracking Number:CU6760952214 To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateOfStatus/C ertificateAuth entication DEA REGISTRATION THIS REGISTRATION FEE CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE NUMBER EXPIRES PAID UNITED STATES DEPARTMENT OF JUSTICE RB0615659 07-31-2023 $1850 DRUG ENFORCEMENT ADMINISTRATION WASHINGTON D.C.20537 SCHEDULES BUSINESS ACTIVITY ISSUE DATE 2,2N,3, DISTRIBUTOR 06-06-2022 3N,4,5 Sections 304 and 1008 (21 USC 824 and 958) of the Controlled BOUND TREE MEDICAL, LLC Substances Act of 1970, as amended, provide that the Attorney 2619 IGNITION DR STE 2 General may revoke or suspend a registration to manufacture, JACKSONVILLE, FL 322183555 distribute,dispense.import or export a controlled substance THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF OWNERSHIP,CONTROL,LOCATION,OR BUSINESS ACTIVITY, AND IT IS NOT VALID AFTER THE EXPIRATION DATE. CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE UNITED STATES DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION WASHINGTON D.C. 20537 DEA REGISTRATION THIS REGISTRATION FEE NUMBER EXPIRES PAID RB0615659 07-31-2023 $1850 SCHEDULES BUSINESS ACTIVITY ISSUE DATE 2,2N,3, DISTRIBUTOR 06-06-2022 3N,4,5 cD BOUND TREE MEDICAL, LLC Sections 304 and 1008(21 USC 824 and 958)of the °' 2619 IGNITION DR STE 2 Controlled Substances Act of 1970. as amended N JACKSONVILLE, FL 322183555 provide that the Attorney General may revoke or suspend a registration to manufacture, distribute dispense, import or export a controlled substance. THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF OWNERSHIP, CONTROL, LOCATION, OR BUSINESS ACTIVITY, AND IT IS NOT VALID AFTER THE EXPIRATION DATE. DEA REGISTRATION THIS REGISTRATION FEE CONTROLLED SUBSTANCE/REGULATED CHEMICAL NUMBER EXPIRES PAID REGISTRATION CERTIFICATE RB0615659 07-31-2023 $1850 UNITED STATES DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION SCHEDULES BUSINESS ACTIVITY ISSUE DATE WASHINGTON D.C.20537 2,2N,3, DISTRIBUTOR 06-06-2022 3N,4,5 Sections 304 and 1008(21 USC 824 and 958)of the BOUND TREE LLC Controlled Substances Act of 1970,as amended,provide BO 2619 IGNITION MEDICAL,STE 2 that the Attorney General may revoke or suspend a registration to manufacture,distribute,dispense,import or JACKSONVILLE, FL 322183555 export a controlled substance. THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF OWNERSHIP,CONTROL,LOCATION,OR BUSINESS ACTIVITY, AND IT IS NOT VALID AFTER THE EXPIRATION DATE. • REQUESTING MODIFICATIONS TO YOUR REGISTRATION CERTIFICATE To request a change to your registered name,address,the drug s REPORT schedule or the drug codes you handle,please N O) CHANGES 1.visit our web site at deadiversion.usdoj.gov -or 2 call our customer Service Center at 1-(800)882-9539 -or 3.submit your change(s)in writing to'. PROMPTLY Drug Enforcement Administration P.O.Box 2639 Springfield,VA 22152-2639 0 See Title 21 Code of Federal Regulations,Section 1301 51 u_ for complete instructions You have been registered to handle the following chemical/drug codes: NABP ACCREDITED DRUG DISTRIBUTOR Bound Tree Medical, LLC located at 2619 Ignition Dr Ste #2, Jacksonville, FL, 32218 This business has met all the drug distributor criteria set in place by the National Association of Boards of Pharmacy® (NABP®). The current status of this business's accreditation may also be verified by visiting the drug distributor section on the NABP website, located at: www.nabp.pharmacy/programs/d rug-distributor/accredited-facilities!. 12/06/2022 to 12/05/2025 Lemrey"Al" Carter, PharmD, MS, RPh Period of Accreditation Executive Director/Secretary AG ORO® DATE�MZM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.If d SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c PRODUCER CONTACT y NAME: Aon Risk Services Northeast, Inc. PHONE -7122FAX Columbus OH office (A/C.No.Ell): (866) 283 (A/CNo.): (800) 363-0105 '0O 445 Hutchinson Avenue EMAIL 71 Suite 900 ADDRESS: Columbus OH 43235 USA INSURER(S)AFFORDING COVERAGE NAIC C INSURED INSURERA: ProAssurance Specialty insurance Company 17400 Sarnova, Inc., Bound Tree Medical, LLC INSURERB: Federal Insurance company 20281 5000 Tuttle Crossing Blvd. Dublin OH 43016 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570096605409 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested NSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD VIVD POLICY NUMBER ((MM/DD/YYYY (MM/DD/VYYY) LIMITS B X COMMERCIAL GENERALLIABILnY • 36073395 12/01/2022 12/01/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE n OCCUR DAMAGE TO RENTED — $1,000,000 PREMISES(Ea occurrence) MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $1,000,000 p GEN'L AGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $2,000,000 in POLICY n JECT n LOC PRODUCTS-COMP/OPAGG Excluded rn o OTHER: 0 n B 7363-09-65 12/01/2022 12/01/2023 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $1,000,000 .. X ANY AUTO BODILY INJURY(Per person) z OWNED —SCHEDULED BODILY INJURY(Per accident) att AUTOS -AUTOS ONLY —NON-0WNED PROPERTY DAMAGE CO HIRED AUTOS ONLY _AUTOS ONLY (Per accident) w r B 78197881 12/01/202212/01/2023 $10,000,000' V X UMBRELLA LIAR X OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 • X DED RETENTIONS]-0,000 WORKERS COMPENSATION AND PER STATUTE OTH- EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER I EXECUTIVE E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NI E.L.DISEASE-EA EMPLOYEE H yyen,describe under DESCRIPTK)N OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT A Products Liab N220H380021 12/01/2022 12/01/2023 Aggregate Limit $10,000,000— Claims Made Agg Deductible $150,000 M Per Occ Limit $10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,mey be attached N more apace Is required) county of volusia is included as Additional Insured in accordance with the policy provisions of the General Liability policy. Vi CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ■ County of Vol usi a AUTHORIZED REPRESENTATIVE V 123 W. Indiana Ave., Rm. 302 DeLand FL 32720-4608 usA : �. �.0 c�,.a W is ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000037575 LOC#: AC-ORE" ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY NAMED INSURED Aon Risk services Northeast, Inc. sarnova, Inc. , Bound Tree Medical, LLC POLICY NUMBER See Certificate Number: 570096605409 CARRIER NAIC CODE see Certificate Number: 570096605409 EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR ADDL SUBR POLICY NUMBER LIMITS LTR TYPE OF INSURANCE INSD WVD EFFECTIVE EXPIRATION DATE DATE (MM/DD/YYYY) (MM/DD/YYYY) OTHER A Products Liab N22oH380021 12/01/2022 12/01/2023 Per occ $50,000 claims Made Deductible ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD SARNINC-01 JGOLDBERG ACC)RO DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/16/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of suchpendorsement(s). PRODUCER NAMEACT Daniel R.Gunter Thompson Flanagan Executive Liability Group PHONE 312 239-2890 FAX 312 263-1551 626 W.Jackson Blvd.5th Floor (ac,No,Ext):( ) ( ):( ) Chicago,IL 60661 ADDRIESS:dgunter@thompsonflanagan.com INSURER(S)AFFORDING COVERAGE NAIC i INSURER A:Travelers Property Casualty Co.of America 25674 INSURED INSURER B: Sarnova,Inc.Bound Tree Medical,LLC INSURER C: 5000 Tuttle Crossing Blvd. P.O.Box 8023 INSURER D: Dublin,OH 43016 INSURERE: 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSI1 ADDL SUBR POLICY EFF POLICY EXP LTTYPE OF INSURANCE NSD PAID' POLICY NUMBER IMM/DD/YYYY) IMM/DD/YYYYI LNIITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) S PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I JECT LOC PRODUCTS-COMP/OP AGG $ OTHER S AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ AUTOS ONLY — NON-OWNED O OS ONEDY PROPERTY pAMAGE (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTIONS 5 A WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY PER ER H- ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N UB 3P279151 12/1/2022 12/1/2023 E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 5 1,000,000 It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE County of Volusia Director of Purchasing 123 Indiana Ave Deland,FL 32720 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 00 03 13 (00) - 001 POLICY NUMBER: UB-3P279151-20-13-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. DATE OF ISSUE: 12-22-20 ST ASSIGN: PAGE 1 OF1 2023 FOREIGN LIMITED LIABILITY COMPANY ANNUAL REPORT FILED DOCUMENT# M01000002310 Jan 25, 2023 Entity Name: BOUND TREE MEDICAL, LLC Secretary of State 2673731109CC Current Principal Place of Business: 5000 TUTTLE CROSSING BLVD DUBLIN, OH 43016 Current Mailing Address: PO BOX 8023 DUBLIN, OH 43016-2023 US FEI Number: 31-1739487 Certificate of Status Desired: No Name and Address of Current Registered Agent: C T CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 US The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Authorized Person(s) Detail : Title MM Title AUTHORIZED REPRESENTATIVE Name BEMS HOLDINGS, LLC Name PRESTEL,JEFFREY Address 5000 TUTTLE CROSSING BLVD Address 5000 TUTTLE CROSSING BLVD City-State-Zip: DUBLIN OH 43016 City-State-Zip: DUBLIN OH 43016 Title AUTHORIZED REPRESENTATIVE Title AUTHORIZED REPRESENTATIVE Name HUGHES, DARRELL Name MERIWEATHER,ROBERT Address 5000 TUTTLE CROSSING BLVD Address 5000 TUTTLE CROSSING BLVD City-State-Zip: DUBLIN OH 43016 City-State-Zip: DUBLIN OH 43016 Title AUTHORIZED REPRESENTATIVE Name SAYLOR,SHAWN Address 5000 TUTTLE CROSSING BLVD City-State-Zip: DUBLIN OH 43016 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am a managing member or manager of the limited liability company or the receiver or trustee empowered to execute this report as required by Chapter 605,Florida Statutes;and that my name appears above,or on an attachment with all other like empowered. SIGNATURE:DARRELL HUGHES SECRETARY 01/25/2023 Electronic Signature of Signing Authorized Person(s)Detail Date ITB 23-B-136AK Medical Supplies Exhibit A--Price List-REVISED Version 2 M-» Additions/revisions for Version 2 are in blue. Volusia County nae�ow IDem Unit of Measure Cost per unit of ( n9 9 Number Pent Off Ust Addftlonal Information Includi n total number of Item Description (box,carton,each, Discount measure(after items in the unft of measure) etc.) discount) 1 Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealed BX 52.00% 1.95001330-85300,Desc:Curaplex Alcohol Prep Pad,Medium, in sterile pouches-Medium 2 JS in x 1 in 2 Tourniquets Rolled tourniquet in size lin.x 18in.-Latex Free BG 64.00% 19.5100 4000,Desc:Curaplex Tourniquet 1 in x 18 in,Blue,Rolle 3 Sheets,Fitted 36x90(Stryker) CS 47.00%_ 60.3200)esc:Curaplex XPS Fitted Sheet,36 in x 90 in,Light Blue, 4 X Series-Electrodes BlueSensor-Pedi/Adult 10/Pk PK 59.00% 2.0500)5,Desc:Electrodes,BlueSensor SP,Medium Size,Pedia 5 Extension Set,Safeday,w/Spin Lock 8 in. EA 57.00% 0.9000 Curaplex 8"Exten Set,Rmvble Sure-Lok,NeedleFree Co 6 Bandaids(ea)box 100-3/4 x 3" BX 56.00% 1.3600)1BX,Desc:Bandage,Adhesive,plastic,3/4 in x 3 in,ster 7 IV Flush Syringe,NS 10 ml Prefilled EA 78.00% 0.4000 0,Desc:IV flush syringe,Normal Saline,10m1 Prefilled ii 8 VENI-GARD(IV)DRESSING ADULT BX 67.00% 20.0000#36002MS,Desc:Curaplex IV Guard IV Dressing,Breatl 9 Glucometer-Lancets 21 Gauge Safety Lancets,Depth penetration:2.2mm,1 Y,in L BX 64.00% 7.5400 BTM#2764-70721,Desc:Curaplex Safety Lancet,21g 1 10 CYNCH-LOCK WHITE BG 60.00% 26.2000 G2291,Desc:Tamper Evident Seal,Cynch-Lok,White,N 11 IV Cath,20ga x 1.25 Smiths Medical ViaValve Safety IV Catheters with Blood Control EA 54.00% 1.7000 IV Catheter,ViaValve Safety w/Blood Control,20 ga x 1. 12 Sterile Pads 2 x 2 BX 52.00% 1.3800 79-3322BX,Desc:Gauze sponge,sterile,2 in x 2 in,8 ply 13 IV Cath,18ga x 1.25 Smiths Medical ViaValve Safety IV Catheters with Blood Control EA 54.00% 1.7000 V Catheter,ViaValve Safety w/Blood Control,18 ga x 1.2 14 Macro 10 Drop Set w/ports EA 47.00% 1.3200:uraplex IV Admin Set,10 Drp,83in,Pre-Prcd Y-Site,SrLk 15 Chlorascrub Prep Pad-Swab(ea) BX 42.00% 34.2600.0,Desc:Prevantics 1.6m1 Swabstick 3.15%CHG/70%Is( 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C EA 45.00% 8.3600 CAPNOLINE PLUS NON INTUBATED,ORAL NASAL W/02 17 Sod Chloride,Fluid Injection,0.9%NaCL SOOmI EA 71.00% 3.20001001,Desc:IV Solution,Sodium Chloride 0.9%500m1 Bal 18 Needle-Safety,18ga X 1 BX 56.00% 14.3100)BX,Desc:Safety Needles,Magellan,18 ga x 1 in.,sterile 19 Sheets,Drape Paper 40X90 CS 43.00% 22.7900 BTM#3271-44100,Desc:Curaplex Bed Sheet,Tissue/Pc 20 Pillow case,disposable 22in x 30in CS 55.00% 18.0000 4125,Desc:Curaplex Disposable Pillow Case,22x30 inch 21 Emesis Bag,1000cc-1000cc l6in x 6in PK 65.00% 9.8400 esc:Curaplex Emesis Bag,1000cc,Clear,Cardboard Rim 22 Syringe Only Luer Lock,3CC 3mL 3 Y.in x%in EA 58.00% 0.0800 TM#1633-30303,Desc:Syringe Only,3cc,Luer Lock,10 23 Sod Chloride,Fluid Injection 0.9%NaCI,1000m1 EA 62.00% 3.2500 1#7800-09,Desc:IV Solution,Sodium Chloride 0.9%10( 24 Kling,3 inch Non-sterile EA 47.00% 0.2600)6EA,Desc:Conforming stretch bandage,gauze,3 in.,ni 25 Cold Pack 6 X 8 1/4 IN EA 80.00% 0.3900 1431-770004,Desc:Curaplex Cold Pack-Large-7in x' 26 Zofran-Ondansetron 4mg/2m1 SDV BX 83.00% 8.4000 y.25-BTM#6130-05,Desc:Ondansetron 4mg,2m1 vial 27 ALBUTEROL 2.5MG/3ML BX 70.00% 4.9600-BTM#9501-25,Desc:ALBUTEROL 0.083% 2.5MG,3M 28 Epi,1:1000 lmg/lml Ampule 2043 PK 46.00% 128.4000.0-BTM#103-10,Desc:Epinephrine 1mg,lml ampule 1 29 Ipratropium Bromide 0.02%2.5m1 BX 85.00% 6.2700 M#9801-30,Desc:IPRATROPIUM BROMIDE 0.02% 0.5r 30 SOLU-MEDROL,125 MG,2 ML VIAL BX 40.00% 261.4900'M#0409-0047-22,Desc:Solu-Medrol,125mg,2m1 ACT 31 NARCAN Pre-Filled 2MG 2MLSYR PK 30.00% 391.930041#1469-1,Desc:Naloxone 2mg,2m1 prefilled fixed need 32 EPI 1:10,000 1 MG 10 ML LUER JET PK 32.00% 113.9000 A#373316,Desc:Epinephrine 1:10000,1mg,10m1 Luer. 33 AMIODARONE 150MG 3ML VIAL PK 60.00% 56.2500 616-03,Desc:*MFG B/O'AMIODARONE 150MG 3ML 34 Sodium Bicarbonate,8.4%,50m1 Prefilled PK 35.00% 179.3000 VI#371035,Desc:Sodium Bicarbonate 8.4%50m1 Luer 11 35 Dextrose 10%,Fluid Injection,250m1 EA 80.00% 2.9900 BTM#7520-20,Desc:IV Solution,Dextrose 10%250m1 36 LIDOCAINE 2%100MG 5ML ANSYR SYRINGE BX 43.00% 61.4400 D74490301,Desc:LIDOCAINE 2%100MG 5ML ANSYR SY 37 Ketorolac 30mg/m1 lml SDV BX 75.00% 48.0000 Qty.25-BTM#0701-03,Desc:Ketorolac 30mg,lml vial 38 Nitro-BID 2%Ointment 1gm UD BX 41.00% 132.5900 8-BTM#0326-08,Desc:NITRO-BID 2%OINTMENT 1GIW 39 ATROPINE 1MG 10ML LUER JET PK 27.00% 122.7000 BTM#371006,Desc:ATROPINE 1MG 10ML LUER JET 1 40 ASPIRIN CHILD ORANGE 81MG BT 65.00% 0.7100 BTM#911316,Desc:Aspirin 81mg Chewable,Orange Fl 41 Tranexamic Acid 100mg/ml,10m1 Vial BX 70.00% 121.8900-BTM#0166-41,Desc:Tranexamic Acid 100mg/ml,10m REVISED Version 2 posted on 08-30-2023 Page 1 of 2 ITB 23-B-136AK Medical Supplies I.i Exhibit A--Price List-REVISED Version 2 Additions/revisions for Version 2 are in blue. Vdlusia County rioe.ow IIIIIL Unit of Measure Percent Off List Cost per unit of Additional Information(including specifying total number of Item Description (box,carton,each, measure(after etc.) Discount discount) Items in the unit of measure) 42 Diphenhydramine(Benedryl),50mg/m1 iml SDV 2035 EA 47.00% 5.6000 M• 1000200,D- :Di. . . -50 :/ I 1 I 43 Glutose,15mg-Lemon PK 59.00% 20.6500.-BTM#664365,Desc:Glucose Gel,Orange,15gm 15/. 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET BX 26.00% 123.9700: IA. 6Wii Gac C huud• : . I e is 45 Magnesium Sulfate 50%5 gm,10 ml Vial BX 47.00% 65.3600 BTM#064-11,Desc:Magnesium Sulfate 50%5gm,10 46 Adenosine 6 mg,2m1 vial BX 52.00% 40.5900 Qty.10-BTM#0318-02,Desc:Adenosine 6mg,2m1 Vial 47 Levophed 0.1%4mg,4m1 vial BX 44.00% 241.5300 .10-BTM#3375-04,Desc:LEVOPHED 4MG,4ML VIAL 48 Norepinephrine 4mg,4m1(1mg/m1) BX 61.00% 64.3000 10-BTM#0997-10,Desc:Norepinephrine 1mg/ml,4m1 49 Nitrostat 0.4mg tabs BT 30.00% 77.5600_�I•)a ___:_Ll••73____la•17Ie 110,Rflt_____e 50 Amiodarone,50mg/m13m1 Vial PK 60.00% 56.2500 616-03,Desc:*MEG B/O*AMIODARONE 150MG 3ML 51 C4 Midazolam 2mg/2m1 Vial BX 71.00% 29.5400' -:T # I - le c: 4 IDA • 1 1 M I 52 Q Fentanyl 0.05mg/m1 2m1 SDV BX 59.00% 64.4800 #6027-25,Desc:C2 Fentanyl,0.05mg/ml,2m1 Vial,25/ 53 C3 Ketamine,100mg/5m1 Vial BX 57.00% 104.2900 I-BTM#2051-05,Desc:C3 KETAMINE 100MG/ML,5M 54 ETOMIDATE 20 MG 10 ML VIAL BX 50.00% 74.2600 .10-BTM#6695-01,Desc:Etomidate,20mg,10m1 Vial 55 Succinylcholine 200mg,10m1 Vial EA 49.00% 53.9000 25-1,Desc:*DS ONLY*Succinylcholine 200mg,10m1 vi. 56 Amidate(Etomidate),40mg 20mI Vial EA 61.00% 19.6800 TM#1012750,Desc:*DS ONLY*Amidate(Etomidate)4 57 Veauonlum 10mg,10m1 vial(powder) BX 71.00% 93.7500 V9Giilr>t)QMUM ii/iK11ti•LIlI1af fIla=M1e1fIZ• Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version 2 posted on 08-30-2023 Page 2 of 2 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price ..,` Volusia County FLORIDA Product Manufacturer Name % Fixed Product Manufacturer Name % Fixed Discount Discount 3M 30% Biomedix 30% Aaron Medical #N/A Bio-Nova #N/A Abboject 30% Bowman Medical Products 30% Abbott 30% Brunswick Biomedical #N/A Acme 30% BurnFree Products 30% Act-O-Vial 30% Burron Medical #N/A ADC Proscope 30% Caradyne #N/A Advantage Medical #NIA Care Line 30% Aearo Company #N/A Cast Products 30% Alliance Medical #NIA Cath-Wrap #N/A Allied Healthcare #NIA Cavacide 30% Alpha-Protec 30% Centennial Products #N/A Alpine #N/A Certified Safety Manufacturing #NIA Ambu 38% CFT, Inc. (Life Mask) #N/A Ambu-Perfit 38% Chaston #N/A AMBV 38% .Chord Engineering #N/A Ames #N/A Chronimed #N/A Amsino Amsafe 30% ColoplastlSween 30% Anatomical Chart Company #N/A Compliance Medical 30% Anthony Medica Products #N/A Conmed 38% Argyle 30% Cook 30% Ashland Mills #N/A Corpack Medsystems (BLD) #N/A B & B Medical #N/A Covedein 30% B & F Medical #N/A Cumberland Swan #N/A B Braun Medical 44% Curaplex 40% Bacti-Stat 30% Cypress Medical #N/A Ballard #N/A Dey Laboratories #N/A Banta Healthcare 30% DHD Healthcare #N/A Bard Parker 30% DHD Healthcare (Pegasus) #N/A Baush & Lomb #NIA Diamond Products #N/A Baxter 40% Digit-Safety #N/A Bay Corporation 30% _. Diversified Disposables #N/A Bayer 30% Doctors Research Group #N/A BC Group International #N/A Donovan Industries #N/A BCI, Inc. (SIMS) #N/A Dukal Corp. 30% BD 35% Duraclear 38% Bdg #N/A Dynarex 30% Becton/Dickenson 35% E M Innovations 30% Bedford Laboratories #NIA E. Fougera #N/A Bemis 30% Easy-Go-Vac #N/A , Berman 30% Eco-Flex #NIA Beshaw Medical #NIA Ecolab Professional Products 30% Bio-Detek #NIA Emergency Medical Instruments (EMI) 30% Biolife #N/A Emergency Prods & Research (EP&R) 30% EMP 30% Impact Instrumentation #N/A Engineered Medical Systems 30% IMS 30% Enternet medical #NIA IMS/Amphastar 30% Ethox 30% Infection Control Technology #N/A EValuMed #N/A INFU-SURG #N/A Page 1 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price Volusiia RIDA County FLO Product Manufacturer Name % Fixed Product Manufacturer Name °A) Fixed Discount Discount Exel International 30% 1-Tec/EMS, LLP 30% Expert-Med #N/A Ivax Pharmaceuticals (Zonith Goldline) #N/A Faretec 30% J &J Critikon #N/A Ferno 20% Jobet Institute #N/A Firehouse Medical #N/A Johnson & Johnson 30% First Aid Direct #NIA Junkin Safety Appliance 30% First Horizon #NIA Kapler #N/A Flambeau Products 30% Kendall 30% Fleming Industries 30% Kimberly Clark 30% Flexicon 30% Kimberly-Clark (Ballard Medical) 30% Forerunner 30% Kool-Press 30% Fujisawa Pharmaceuticals #NIA Laerdal Medical 12% Futuremed America #N/A Laerdal/Bemis 12% Gainor Medical #N/A Lead-Lok #N/A Gam #N/A Life-Tech #N/A Gam Ind #NIA Lumiscope Medical Products #N/A Gam Milti #NIA Lyo-Ject #N/A General Medical #NIA M & M Industries #N/A GKR Industries #NIA Mabis 30% Glucometer/Elite X1 #N/A Mabis Healthcare 30% Graham Field 30% Maco International 30% Graphic Control #NIA Macosta-Medical USA #NIA Greenline/Sunmed 35% Mada medical 30% H.I. Bouton #NIA Magnum Medical 30% Harcourt Health Sciences #NIA Magnus #N/A Hartwell Medical 25% Mallinkrodt Medical #N/A Hawkpaks.com 30% Marine Rescue products #N/A HeadStart #N/A Maxxim Medical (Winfield) #N/A Healthink #N/A Medafor, Inc. #N/A Healthmark Industries 30% Medex 30% Heartstart FR 30% Medical Action Industries 30% Heart Stream Forerunner #N/A Medical Device Group #NIA Hermitage #N/A Medical Devices International 30% Hoosier Medical Devices #NIA Medical Specialties 30% Hospira 30% Medical Supplies Depot #N/A Hospitak #NIA Medical Technology Products #N/A Hot Shield USA #NIA Medin Corp. #N/A Hudson 30% Medix Choice #NIA Hy-Tape 30% Medline Industries 30% Medovations #NIA Pharmacia & UpJohn #N/A Melker 30% Philadelphia Cervical Collars 30% Mercury Medical 30% Philly 30% Meridian Technologies 25% Physio Control 30% Mertag Products #N/A Pigeon Mountain Industries #NIA Metrex 30% Pinnacle Technology Group 30% MicroFlex Synetron 30% Polamedco #NIA Minto Research & Development 30% Poly Systems #N/A Moldex-Metrix 30% Posey 30% Moneghan Medical 30% Precision Charts 30% Page 2 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price = �_ VolusLOi.a RIDA Cunty Fo Product Manufacturer Name % Fixed Product Manufacturer Name % Fixed Discount Discount Moore Medical 30% Precision Dynamics #N/A Morrison Medical #N/A Precision Medical 30% Mortan 30% Premium Plastics #N/A Motion Medical Distribution 30% Prestige Medical 30% MPI Outdoors #N/A Pride of Florida #N/A MSA Patient Monitoring #N/A Progressive Medical International #N/A Multisorb Technologies #N/A Promar Industries #N/A Murphy Et Tube 35% Propper Manufacturing #N/A Nasco 25% Protective-Jelco 30% National Webbing Products #N/A Q-Teknologies #N/A Needi Safety Supply #N/A R & B Fabrications 30% Nellcor 30% R & D Batteries 30% NeoTech 30% Rapid Deployment Products #N/A Neotech Products 30% Reeves Manufacturing 30% New Medical Technology #N/A Repro-Med Systems 30% New United Distributing Co. #N/A Respiratory Distributors #N/A Niosh 30% Respiratory Ventilator Products #N/A Nitroderm #N/A Respironics #N/A Nomin Medical #N/A Reusch 30% North American Rescue 25% Revivant Corporation #N/A NutraMax Products #N/A Rico Suction Labs 30% 02 Solutions #N/A Roc Hampton Medical 30% Omega Medical #N/A Safetec of America 30% Omni Therm #N/A Safety Equipment Company #N/A Omron Health #N/A Safety International 30% 0-Two Medical Technologies 30% SafGard Medical Products 30% Owen Mumford 30% Saf-T-Vac #N/A Pacific Safety Products #N/A Sage 30% Paddock Laboratories 30% Salter Labs #N/A Para Pac #N/A Sani-Cloths Plus 30% Parker Laboratories 30% Saunders Manufacturing 30% Paul Dubin Company #NIA Sea berg Company 30% PDI 30% Sharps Compliance 30% Pelican Products 30% Sherwood #N/A Page 3 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price Volusia County LOAM^ Product Manufacturer Name % Fixed Product Manufacturer Name % Fixed Discount Discount Shipped Medical Technologies #N/A Triad #N/A Shradder #N/A Tri-anim 30% Smiths Medical ASD (Portex) 30% Trinity Laboratories #N/A Snowbird Mountain Gear #N/A TW Medical #NIA Splash Shield 30% Underwater Kinetics #N/A Sporicidin International #N/A Unomedical (Maersk Medical) #N/A Spur 38% VentLab #N/A SSCOR 18% Veriflo Medical #N/A Statcorp 30% Vermont Medical #N/A Stearns Manufacturing #N/A Victor Medical #N/A Sterilix (USA) #NIA Vortran #N/A Sun-Med 35% Waismed 30% Sunrise Medical (DeVilbiss) 30% Weaver & Company #N/A Superior #N/A Welch Allyn 30% Surgical Specialties #N/A Western Medica #NIA Surgilance 35% WestMed #N/A Surgilube 30% Wet Pruf 30% Sween Corp. #N/A Wholesale Tape #N/A Swift First Aid #N/A Winefield Ind. #N/A Syrex-Neptune #N/A Wolfe Tory Medical 30% Tec Laboratories #N/A Yankhauer 18% Tech+Med Industries #NIA Zefon Medical Products #N/A Techstyles, Inc. 30% Zoll 30% Teledyne Analytical Instruments #N/A Terumo 30% Teva #N/A The Battery Bank 30% Thermo #N/A Thin Red Line #N/A Thomas 25% Tidi 30% Timely Medical Innovations #N/A Tinker Medical Devices #N/A Page 4 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price Volusia RIDA County FLO Product Manufacturer Name % Fixed Product Manufacturer Name % Fixed Discount Discount Additonal Proposed Manufacturers % Fixed Additonal Proposed Manufacturers % Fixed Not Listed Above Discount Not Listed Above Discount CURAPLEX Kits 30 Page 5 of 5 Bound Tree Alimmimpr Your Partner In EMS 5000 Tuttle Crossing Blvd. Dublin,OH 43016 614.760.5000 www.boundtree.com To Whom It May Concern: In response to your bid ITB 23-B-136AK, Bound Tree Medical is pleased to offer 30% off of the prices on supplies for all other manufacturers on www.boundtree.com not specifically listed on this bid. In order to provide a percentage off list discount, it is necessary for Bound Tree to exclude certain product categories or manufacturer products. This is largely due to the cost variability of these items as a result of market demand and raw material costs. Products excluded from the percentage off bid include the following: Manufacturers Excluded Product Cate ories Excluded 5.11 Tactical Ca.ital E.ui.ment Cardio Partners Custom Kits Kin:Fisher Medical Invento & Secure Stora:e S stems Phili s s Medical Kin: Vision and Airwa s Thermal An:el Preventative Maintenance •inflow Su.ra:lottic Airwa s and Kits Recertified AEDs Service Contracts We are pleased to provide you with a competitive bid for the emergency medical supplies and equipment that you are seeking. Please contact our Bids and Contracts Department at 800-533-0523 with any questions. Thank you. Sincerely, Dwight Lowry Pricing Analyst Bound Tree Medical, LLC ***NOT APPLICABLE FOR BOUND TREE MEDICAL, LLC. SEE WORKERS COMPENSATION INSURANCE AND WAIVER OF SUBJIGATION ATTACHED*** HOLD HARMLESS AGREEMENT I, , (print owner's name), am the owner of (print company name), an incorporated/unincorporated business operating in the State of Florida. As such, I am bound by all laws of the state of Florida, including but not limited to those regarding the workers' compensation law. I hereby affirm that I or [the above-named business] employs fewer than four employees, all of whom are listed below, including myself, and therefore, the business is exempt from the statutory requirement for workers' compensation insurance for its employees. I certify that I will provide the County of Volusia with the name of each new employee together with all required waivers and releases for each prior to any employee being allowed to work to provide services under the Contract set forth below. If any such employee is allowed to work without a signed waiver and release, such action will be a material breach of this Agreement. All signed waivers and releases shall be furnished before the commencement of any work by an employee or the undersigned to the County Project Manager or designated county representative. On , 20 , the County of Volusia and I or (the above-named business) entered into a Contract for (please insert name of Contract) (hereinafter"Agreement") which is incorporated by reference herein. On behalf of myself,my business, and the employees listed below, I and they hereby agree to waive and release any and all workers' compensation claims or liens under Chapter 440, Florida Statutes, against the County of Volusia and its agents, officials and employees, arising from any work or services provided under the Agreement whether or not it shall be alleged or determined that the act was caused by intention, or through negligence or omission of the County of Volusia or its agents, officials and employees or subcontractors. In the event that a workers' compensation claim or lien is made against the County of Volusia and/or its agents, officials or employees by myself or my employees or agents as a result of any work or services performed under the Agreement, I agree to indemnify, keep and hold harmless the County of Volusia, Florida, its agents, officials and employees, against all injuries, deaths, losses, damages, claims, liabilities, judgments, costs and expenses, direct, indirect or consequential (including,but not limited to, fees and charges of attorneys and other professionals) arising out of the Agreement with the County of Volusia, whether or not it shall be alleged or determined that the act was caused by intention or through negligence or omission of the County of Volusia or its employees, agents, or subcontractors. I or the above-named business shall pay all charges of attorneys and all costs and other expenses incurred in connection with the indemnity provided herein, and if any judgment shall be rendered against the County of Volusia in any action indemnified hereby, I or the above-named business shall, at my or its own expense, satisfy and discharge the same. The foregoing is not intended nor should it be construed as, a waiver of sovereign immunity of the COUNTY OF VOLUSIA under Section 768.28, Florida Statutes. ***NOT APPLICABLE FOR BOUND TREE MEDICAL, LLC. SEE WORKERS COMPENSATION INSURANCE AND WAIVER OF SUBJIGATION ATTACHED*** Owner: (print name) (signature) Employee 1: (print name) (signature) Employee 2: (print name) (signature) Employee 3: (print name) (signature) STATE OF COUNTY OF Sworn to and subscribed before me this day of , 20 , by , who is/are personally known to me or who has/have produced as identification. NOTARY PUBLIC—STATE OF Type or print name: Commission No.: (Seal) Commission Expires: SARNINC-01 JGOLDBERG ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/16/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER €ACT Daniel R.Gunter Thompson Flanagan Executive Liability Group PHON(NC,,No,Ex0:(312)239-2890 T(AAc,No):(312)263-1551 626 W.Jackson Blvd.5th Floor Chicago,IL 60661 Wass;dgunter@thompsonflanagan.com INSURERS)AFFORDING COVERAGE NAIC S INSURER A:Travelers Property Casualty Co.of America 25674 INSURED INSURER B: Samova,Inc.Bound Tree Medical,LLC INSURER c 5000 Tuttle Crossing Blvd. P.O.Box 8023 INSURER D: Dublin,OH 43016 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY MCP LTR TYPE TYPE OF INSURANCE NSD SWVD POLICY NUMBER POLICY YYYt OIWDONYYY1 LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR REMISES(EaTO ENTED occurrence) $ MED EXP(My one person) $ PERSONAL&ADV INJURY 3 GEN.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT [ JI LOC PRODUCTS-COMP/OP AGG 3 OTHER' COMBIS AUTOMOBILE LIABILITY ccident)SI LIMIT $ ANY AUTO _ BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED gtOPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident ._ 3 S UMBRELLA LIAB OCCUR EACH OCCURRENCE 3 EXCESS LIAB __ CLAIMS-MADE AGGREGATE DED RETENTIONS I S A WORKERS COMPENSATION XOTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN UB 3P279151 12/1/2022 12/1/2023 E.L.EACHACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED', NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE County of a Director of Purchasing 123 Indianaa Ave Ave Deland.FL 32720 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TRAVELERS J WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 00 03 13 (00) - 001 POLICY NUMBER: UB-3P279151-20-I3-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. DATE OF ISSUE: 12-22-20 ST ASSIGN: PAGE 1 OF1 REFERENCES Agency#1 City of Tampa Fire Department Address 2619 Ignition Dr Ste #2, Jacksonville, FL, 32218 City, State, ZIP Tampa, FL 33602 Contact Person Barbara Tripp, Fire Chief E-mail barbara.tripp@tampagov.net Phone: 352-406-2573 Date(s) of Service 2010 to Present Type of Service Providing Medical Supplies and Pharma Comments: Agency#2 Fire Department City of New York Address 9 Metro Tech Center City, State, ZIP Brooklyn, NY 11201 Contact Person Douglas Isaacs, MD, Deputy Medical Director E-mail doug.isaacs@fdny.nyc.gov Phone: 718-999-2790 Date(s)of Service 2010 to Present Type of Service Providing Medical Supplies and Pharma Comments: Agency#3 San Francisco Fire Department Address 1415 Evans Avenue City, State, ZIP San Francisco, CA 34124 Contact Person Andy Zanoff, EMS Captain E-mail Andy.Zanoff@sfgov.org Phone: 415-717-6876 Date(s) of Service 2010 to Present Type of Service Providing Medical Supplies and Pharma Comments: ITB 23-B-136AK FEDERAL CONTRACT PROVISIONS Contractor agrees to comply with all requirements checked below Equal Employment Opportunity for all contracts for construction work which is defined as the construction, rehabilitation, alteration,conversion,extension, demolition or repair of buildings,highways,or other changes or improvements to real property, including facilities providing utility services. The term also includes the supervision, inspection,and other onsite functions incidental to the actual construction. This requirement applies to all FEMA grant and c4oncrptiye agreement_txo8rams. During the performance of this contract,the contractor agrees as follows: (1)The contractor will not discriminate against any employee or applicant for employment because of race,color, religion,sex,sexual orientation, gender identity,or national origin.The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race,color,religion,sex,sexual orientation,gender identity,or national origin. Such action shall include,but not be limited to the following: Employment,upgrading,demotion,or transfer;recruitment or recruitment advertising;layoff or termination;rates of pay or other forms of compensation;and selection for training, including apprenticeship.The contractor agrees to post in conspicuous places,available to employees and applicants for employment,notices to be provided setting forth the provisions of this nondiscrimination clause. (2)The contractor will,in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race,color,religion, sex,sexual orientation,gender identity,or national origin. (3)The contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about,discussed,or disclosed the compensation of the employee or applicant or another employee or applicant This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information,unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation,proceeding,hearing,or action, including an investigation conducted by the employer,or is consistent with the contractor's legal duty to furnish information. (4) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding,a notice to be provided advising the said labor union or workers'representatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (5)The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules,regulations,and relevant orders of the Secretary of Labor. (6)The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965,and by rules, regulations,and orders of the Secretary of Labor,or pursuant thereto,and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,regulations,and orders. (7)In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules,regulations,or orders,this contract may be canceled,terminated,or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965,or by rule,regulation,or order of the Secretary of Labor,oras otherwise provided by law. Page 1of9 ITB 23-B-136AK (8)The contractor will include the portion of the sentence immediately preceding paragraph(1)and the provisions of paragraphs (I) through (8) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency,the contractor may request the United States to enter into such litigation to protect the interests of the United States. The applicant further agrees that it will be bound by the above equal opportunity clause with respect to its own employment practices when it participates in federally assisted construction work: Provided,That if the applicant so participating is a State or local government,the above equal opportunity clause is not applicable to any agency, instrumentality or subdivision of such government which does not participate in work on or under the contract. The applicant agrees that it will assist and cooperate actively with the administering agency and the Secretary of Labor in obtaining the compliance of contractors and subcontractors with the equal opportunity clause and the rules, regulations, and relevant orders of the Secretary of Labor,that it will furnish the administering agency and the Secretary of Labor such information as they may require for the supervision of such compliance, and that it will otherwise assist the administering agency in the discharge of the agency's primary responsibility for securing compliance. The applicant further agrees that it will refrain from entering into any contract or contract modification subject to Executive Order 11246 of September 24, 1965, with a contractor debarred from, or who has not demonstrated eligibility for,Government contracts and federally assisted construction contracts pursuant to the Executive Order and will carry out such sanctions and penalties for violation of the equal opportunity clause as may be imposed upon contractors and subcontractors by the administering agency or the Secretary of Labor pursuant to Part ll. Subpart D of the Executive Order. In addition, the applicant agrees that if it fails or refuses to comply with these undertakings,the administering agency may take any or all of the following actions:Cancel,terminate,or suspend in whole or in part this grant(contract, loan, insurance,guarantee); refrain from extending any further assistance to the applicant under the program with respect to which the failure or refund occurred until satisfactory assurance of future compliance has been received from such applicant; and refer the case to the Department of Justice for appropriate legal proceedings. 0 Davis Bacon Act Equal Employment Opportunity applies to all contracts for construction work as defined above. The Davis-Bacon Act only applies to the Emergency Management Preparedness grant Program, Homeland Security Grant Program, NonprofitSecurity Grant Program Tribal Homeland Security Grant Program, Port £ecwrity^Grant Program, and Transit Security Grant Program. It DOES NOT appb to other FEMA grant and cooperative agreement programs, including the Public Assistance Program. a All transactions regarding this contract shall be done in compliance with the Davis-Bacon Act(40 U.S.C. 3141-3144,and 3146-3148)and the requirements of 29 CFR. pt. 5 as may be applicable.The contractor shall comply with 40 U.S.C. 3141-3144,and 3146-3148 and the requirements of 29 C.F.R.pt.5 as applicable. b. Contractors are required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. c. Additionally,contractors are required to pay wages not less than once a week. ❑ Copeland Anti-Kickback Act This requirement applies to all contracts for construction or repair work above $2,000 in situations where the Davis-Bacon Act alRapplies. It DOES NOT atrnly to the FEMA Public Assistance Program. Page 2 of 9 ITB 23-B-136AK a Contractor. The contractor shall comply with 18 U.S.C. §874,40 U.S.C. § 3145,and the requirements of 29 C.F.R.pt.3 as may be applicable,which are incorporated by reference into this contract. b Subcontracts.The contractor or subcontractor shall insert in any subcontracts the clause above and such other clauses as FEMA may by appropriate instructions require, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all of these contract clauses. c. Breach. A breach of the contract clauses above may be grounds for termination of the contract, and for debarment as a contractor and subcontractor as provided in 29 C.F.R.§5.12." ® Contract Work Hours and Safety Standards Act This requirement applies to all FEMA coflractLawarded by the non- federal entity in excess of$100,000 under grant and cooperative at reement programs that involve the employment of mechanics or_)abprers. It is applicable to construction wor};,These requirements do not app y to theyurchase of supplies or materials or articles ordinarily available on the open market,or contracts for transportation or transmission of intelligence. Compliance with the Contract Work Hours and Safety Standards Act. (I) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one- half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. (2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph(b)(I)of this section the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory),for liquidated damages.Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph(b)(I)of this section,in the sum of$27 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph(b)(1)of this section. (3) Withholding for unpaid wages and liquidated damages.The County of Volusia or State of Florida shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor,or any other federally-assisted contract subject to the Contract Work Hours and Safety Standards Act,which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph(b)(2)of this section. (4) Subcontracts.The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (b)(I)through(4)of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs(b)(I)through(4)of this section. ® Riehts to Inventions Made Under a Contract or Agreement If the FEMA award meets the definition of"funding agreement" under 37C.F.R. § 401.2(a)and the nun-Federal entity wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that "funding agreement,"the non-Federal entity must comply with the requirements of 37 C.F.R.Part 401 (Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants,Contracts and Cooperative Page 3 of 9 ITB 23-B-136AK Agreements),and any implementing regulations issued by FEMA. See 2 C.F.R. Part 200,Appendix 11(F) This requirement applies to "funding agreements." but it DOES NOT apply to the Public Assistance, Hazard Mitigation Grant Program, Fire Management Assistance Grant Program, Crisis Counseling Assistance and Training Grant Program, Disaster Case Management Grant Program,and Federal Assistance to Individuals and Households — Other Needs Aitistance Grant Program.as FEMA awards under these programs do not meet the definition "funding agreement." Clean Air Act and the Federal Water Pollution Control Act This requirement applies to contracI awarded by a non-federal entity of amounts in excess of$I :Q00 under a federalsrant. Clean Air Act I. The contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act,as amended,42 U.S.C. §7401 et seq. 2. The contractor agrees to report each violation to the County of Volusia(County)and understands and agrees that the County will, in turn,report each violation as required to assure notification to the Federal Emergency Management Agency,and the appropriate Environmental Protection Agency Regional Office. 3. The contractor agrees to include these requirements in each subcontract exceeding$150,000 financed in whole or in part with Federal assistance provided by FEMA. Federal Water Pollution Control Act 1. The contractor agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Federal Water Pollution Control Act,as amended,33 U.S.C. 1251 et seq. 2. The contractor agrees to report each violation to the County of Volusia(County)and understands and agrees that the County will, in turn,report each violation as required to assure notification to the Federal Emergency Management Agency,and the appropriate Environmental Protection Agency Regional Office 3. The contractor agrees to include these requirements in each subcontract exceeding$150,000 financed in whole or in part with Federal assistance provided by FEMA, Debarment and Suspension This requirement aulics tn.al! FEMA grant and cooperative agreement programs, Suspension and Debarment 1. This contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R. pt. 3000. As such, the contractor is required to verify that none of the contractor's principals(defined at 2 C.F.R. § 180.995)or its affiliates(defined at 2 C.F.R.§ 180.905)are excluded(defined at 2 C.F.R. § 180.940)or disqualified(defined at 2 C F R. §180.935). 2 The contractor must comply with 2 C.F R. pt. I80, subpart C and2 C.F.R. pt. 3000, subpart C, and must include a requirement to comply with these regulations in any lower tier covered transaction it enters into. 3 This certification is a material representation of fact relied upon by State of Florida and County of Volusia. If it is later determined that the contractor did not comply with 2 C.F.R.pt. 180,subpart C and 2 C.F.R.pt.3000, subpart C, in addition to remedies available to State of Florida and County of Volusia, the Federal Government may pursue available remedies, including but not limited to suspension and or debarment. 4 The bidder or proposer agrees to comply with the requirements of2 C.F.R. pt. 180,subpart C and 2 C.F.R. Page 4 of 9 ITB 23-B-136AK pt.3000,subpart C while this offer is valid and throughout the period of any contract that may arise from this offer.The bidder or proposer further agrees to include a provision requiring such compliance in its lower tier covered transactions. If applicable, contractors must sign and submit to the non-federal entity the certification in Appendix A, ® Byrd Anti-Lobbying Amendment This requirement applies to all FEMA grant and cooperative agreement programs. Contractors that apply or bid for a contract of$100,000 or more under a federal grant must file the required certification.See 2 C.F.R. Part 200, Appendix 11(1);31 U.S.C. § 1352;and 44 C.F.R.Part 18. Byrd Anti-Lobbying Amendment,31 U.S.C. § 1352(as amended) Contractors who apply or bid for an award of 5100,000 or more shall file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a Member of Congress,officer or employee of Congress,or an employee of a Member of Congress in connection with obtaining any Federal contract, grant, or any other award covered by 31 U.S.C. § 1352. Each tier shall also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award.Such disclosures are forwarded from tier to tier up to the recipient who in turn will forward the certification(s) to the awarding agency. If applicable,contractors must sign and submit to the non-federal entity the certification in Appendix B. • Procurement Of Recovered Materials This requirement applies to all contracts awarded by a non- federal entity under FEMA grant and cooperative agreement programs. In the performance of this contract,the Contractor shall make maximum use of products containing recovered materials that are EPA-designated items unless the product cannot be acquired 1. Competitively within a timeframe providing for compliance with the contract performance schedule; 2. Meeting contract performance requirements;or 3. At a reasonable price. Information about this requirement, along with the list of EPA- designated items, is available at EPA's Comprehensive Procurement Guidelines web site, https: .www.epa.govrsmm comprehensive- procurement- guideline-cpg-program. The Contractor also agrees to comply with all other applicable requirements of Section 6002 of the Solid Waste Disposal Act. • Access to Records The following access to records requirements apply to this contract. 1. The Contractor agrees to provide State of Florida, County of Volusia, the FEMA Administrator, the Comptroller General of the United States,or any of their authorized representatives access to any books, documents, papers, and records of the Contractor which are directly pertinent to this contract for the purposes of making audits,examinations, excerpts,and transcriptions. 2. The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed, 3. The Contractor agrees to provide the FEMA Administrator or his authorized representatives access to construction or other work sites pertaining to the work being completed under the contract. 4. In compliance with the Disaster Recovery Act of 2018,the State of Florida, County of Volusia,and the Page 5 of 9 ITB 23-B-136AK Contractor acknowledge and agree that no language in this contract is intended to prohibit audits or internal reviews by the FEMA Administrator or the Comptroller General of the United States. Changes To be eligible for FEMA assistance under the non-Federal entity's FEMA grant or cooperative agreement,the cost of the change, modification, change order, or constructive change must be allowable,allocable, within the scope of its grant or cooperative agreement,and reasonable for the completion of project scope. FEMA recommends, therefore, that a non-Federal entity include a changes clause in its contract that describes how, if at all, changes can be made by either party to alter the method, price, or schedule of the work without breaching the contract.The language of the clause may differ depending on the nature of the contract and the end- item procured. Department of Homeland Security(DHS)Seal.Logo,and Flags Recipients must obtain permission prior to using the DHS seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency officials.See DHS Standard Terms and Conditions: Version 8.1 (2018). The contractor shall not use the DHS seal(s),logos,crests,or reproductions of flags or likenesses of DHS agency officials without specific FEMA pre-approval. • Compliance with Federal Law, Regulations,and Executive Orders This is an acknowledgement that FEMA financial assistance will be used to fund all or a portion of the contract. The contractor will comply with all applicable Federal law, regulations, executive orders, FEMA policies, procedures,and directives." • No Obligation by Federal Government The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the non- Federal entity,contractor,or any other party pertaining to any matter resulting from the contract. • Program Fraud and False or Fraudulent Statements or Related Acts The Contractor acknowledges that 31 U.S.C.Chap.38(Administrative Remedies for False Claims and Statements) applies to the Contractor's actions pertaining to this contract. 1 hereby certify that I have read and understand the requirements of these Federal Contract Provisions and that I,as the Respond nt,will withrents. x P Authorized Signature Shawn Saylor Printed Name Chief Financial Officer 09 07 2023 Title Date Bound Tree Medical,LLC. Company Name 5000 Tuttle Crossing Blvd.,Dublin,OH 43016 Full Address 800.533.0523 877.311.2437 submitbids@boundtree.com Telephone Fax E-mail Address Page 6 of 9 ITB 23-B-136AK APPENDIX A, CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION- LOWER TIER COVERED TRANSACTIONS FOR FEDERAL AID CONTRACTS It is certified that neither the below identified firm nor its principals are presently suspended,proposed for debarment, declared ineligible,or voluntarily excluded from participation in this transaction by any federal department or agency. Name of Consultant/Contractor. Bound Tree Medical, LLC. By: Shawn Saylor P Date: 09/07/2023 Title: Chief Financial Officer Instructions for Certification (Applicable to all subcontracts,purchase orders and other lower tier transactions requiring prior F ONA approval or estimated to cost$25,000 or more-2 CFR Parts 180 and 1200) a. By signing and submitting this proposal,the prospective lower tier is providing the certification set out below. b. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into.If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department, or agency with which this transaction originated may pursue available remedies, including suspension and or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous by reason of changed circumstances. d. The terms "covered transaction," "debarred," "suspended," "ineligible," "participant," "person," "principal," and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts I80 and 1200. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. "First Tier Covered Transactions"refers to any covered transaction between a grantee or sub-grantee of Federal funds and a participant (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant" refers to the participant who has entered into a covered transaction with a grantee or sub-grantee of Federal funds(such as the prime or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction with a First Tier Participant or other Lower Tier Participants(such as subcontractors and suppliers). e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into,it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,suspended,declared ineligible,or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled"Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the$25,000 threshold. Page 7 of 9 ITB 23-B-136AK g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended,debarred,or otherwise ineligible to participate in covered transactions.To verify the eligibility of its principals,as well as the eligibility of any lower tier prospective participants,each participant may, but is not required to,check the Excluded Parties List System website(https: www.epls.gov ),which is compiled by the General Services Administration. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause.The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph e of these instructions,if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Page 8 of 9 ITB 23-B-136AK APPENDIX B,CERTIFICATION REGARDING LOBBYING Certification for Contracts,Grants, Loans,and Cooperative Agreements The undersigned certifies,to the best of his or her knowledge and belief,that: I. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency,a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract,grant,loan,or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract,grant, loan, or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure Form to Report Lobbying," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements)and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352,title 31,U.S.Code.Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. The Contractor, Bound Tree Medical, LLC.,certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition,the Contractor understands and agrees that the provisions of 31 U.S.C. Chap. 38, Administrative Remedies for False Claims and Statements, apply to this certification and disclosure, if any. Signature of Contractor's. uthorized Official Shawn Saylor-Chief Financial Officer Name and Title of Contractor's Authorized Official 09,07/2023 Date Page 9 of 9 Request for Taxpayer Give Form to the Forth (Rev.October 2018) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. Bound Tree Medical LLC 2 Business name/disregarded entity name,if different from above a, 3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1.Check only one of the 4 Exemptions(codes apply only to eri following seven boxes. certain entities,not individuals;see a instructions on page 3): g 0 Individual/sole proprietor or 0 C Corporation 0 S Corporation 0 Partnership 0 Trust/estate single-member LLC Exempt payee code(rf any) ❑✓ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► P Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting 'V LLC If the LLC Is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code(if any) E another LLC that Is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that d is disregarded from the owner should check the appropriate box for the tax classification of its owner, ❑ Other(see Instructions)► rte.,a accountr main Wow/ouhide u,•U..S. rhd 5 Address(number,street,and apt.or suite no.)See Instructions. Requester's name and address(optional) A 5000 Tuttle Crossing Blvd 6 City,state,and ZIP code Dublin,OH 43016 7 List account number(s)here(optional) Part i Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid I Social security number backup withholding.For individuals,this is generally your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other — — entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN, later, or Note:If the account is In more than one name,see the instructions for line 1.Also see What Name and Employer Identification number Number To Give the Requester for guidelines on whose number to enter. 3 1 — 1 7 3 9 4 8 7 Part II Certification Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.I am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later. Sign signature of � Here U.S.person► f J'�1 1•r tt t) - N70— Date► CM I o'3 I Q a General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its Instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018) i Volusia County FLORIDA COUNTY OF VOLUSIA, FLORIDA RECOMMENDATION AND NOTICE OF AWARD SOLICITATION NUMBER: 23-B-136AK SOLICITATION TITLE: Medical Supplies SOLICITATION CLOSING DATE: September 7, 2023 TIME: 3:01 PM RESPONSE*1 RESPONSE 2 RESPONSE 3 Qultek Consultants, Inc. Agni Enterprises, LLC dba Head to Heal Safey Supplies BVH Marketing, Inc. Tariq Khurshid Subbarayan R Pochi Yoel Katz 355 SW 162 Avenue, Pembroke Pines, FL 33027 7950 NW 155"'Street, Suite 102, Miami Lakes, FL 210 Fairmount Ave.,Jersey City, NJ 07306 (954)675-5681 (305)712--6653 (718)208-4380 (See attached for pricing details.) (See attached for pricing details.) (See attached for pricing details.) RESPONSE 4 RESPONSE 5 RESPONSE 6 Bound Tree Medical,LLC Henry Schein, Inc. Life-Assist,Inc. Shawn Saylor Jeff Klinger Bryan Holiday 5000 Tuttle Crossing Blvd.,Dublin,OH 43016 135 Duryea Road, Melville, NY 11747 11277 Sunrise Park Drive,Rancho Cordova,CA 95742 " (800)533-0523 (800)845-3550 (800)824-6016 (See attached for pricing details.) (See attached for pricing details.) (See attached for pricing details.) I RESPONSE 7 RESPONSE 8 QuadMed,Inc. School Health Corporation Dale Van Pelt Sam Medine 11210-1 Phillips Industrial Blvd East,Jacksonville,FL 32256 5600 Apollo Dr., Rolling Meadows, IL 60008 (904)880-2323 866-323-5465 (See attached for pricing details.) (See attached for pricing details.) Opened by: Andrew Kokitus, NIGP-CPP Witnessed by: Heidi Ott Tabulated by: Andrew Kokitus Date Posted: October 26, 2023 Award Effective Date: November 2,2023 Recommendation of Award (ROA): Qultek Consultants, Inc., Agni Enterprises, LLC, BVH Marketing, Inc., Bound Tree Medial, LLC, Henry Schein, Inc., Life-Asisst, Inc., QuadMed, Inc., and School Health Corporation. Approved by* Pay w�` Pamela Wilsky, NIGP-CPP, CPPO, CPPB Director of Purchasing and Contract Award will be effective five (5) days from posting of this notice. Qultek Consultants, Inc. ITB 23-B-136AK Medical Supplies Exhibit A-Price List-tEVISED Version 2 Additions/revisions lur Version 2 are in blue. Volusia w�o�County sw UnIt of Measure Cost per unit of Item Percent Off List Additional Information(including specifying total number of Item Description (box,carton,each, measure(after Number ) Discount discount) In the unit of measure) etc.1 Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealed 200 Pads Per Box 1.00%$4.11 Per Box 200 Unit in sterile pouches-Medium 2 X in x 1 in 2 Tourniquets Rolled tourniquet in size lin.x 18in.-Latex Free 100/PK 1.00%$2.93 Each 100/PK 3 Sheets,Fitted 36x90(Stryker) 30/CASE 1.00% $118.73 CS 30 Per case 4 X Series-Electrodes BlueSensor-Pedi/Adult 10/Pk 10 per Pack 1.00% $6.43 per pk 10 per/PK 5 Extension Set,Safeday,w/Spin Lock 8 In. _100/cs 1.00% $578.13 Per CS 100/cs 6 Bandaids(ea)box 100-3/4 x 3" 100 Per Box 1.00%$6.73 Per Box 100/Per Box 7 IV Flush Syringe,NS 10 ml Prefilled 100/Box 1.00%$111 Per Box 100/Box 8 VENI-GARD(IV)DRESSING ADULT 100 Per Box 1.00% $85.83 Per Box 100/Box 9 Glucometer-Lancets?1 Gauer, ..,rety Lancets,Depth penetration:2.2mm,1 S4 in L 1000/PK 1.00% $69.00 Per PK 1000/PK 10 CYNCH-LOCK WHITE 100/PK 1.00%$27.48 Per PK 100/PK 11 IV Cath,20ga x 1.25 miths Medical ViaValve Safety 1V Catheters with Blood Control 100/PK 1.00%$436.25 Per PK 100/PK 12 Sterile Pads 2 x 2 100/PK 1.00%$6.25 Per PK 100/PK 13 IV Cath,18ga x 1.25 '-s Medical ViaValve Safety IV Catheters with" 1 Con I 100/PK 1.00%$436.25 Per PK 100/PK 14 Macro 10 Drop Set w/ports 100/PK 1.00%$206.99 Per PK 100/PK 15 Chlorascrub Prep Pad-Swab(ea) 100/PK 1.00% $75.99 Per PK 100/PK 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C 24/Box 1.00%$598.5 Per Box 24/Box 17 Sod Chloride,Fluid Injection,0.9%NaCL 500mI 24/Box 1.00%$225.12 Per Box 24/Box 18 Needle-Safety,18ga X 1 100/Box 1.00% $31.23 Per Box 100/Box 19 Sheets,Drape Paper 40X90 50/PK 1.00% $44.99 Per PK 50/PK 20 Pillow case,disposable 100/PK 1.00%$39.05 Per PK 100/PK 21 Emesis Bag,1000cc- 5in 25/Pk 1.00% $48.78 Per PK 25/PK 22 Syringe Only Luer Lock, ".0 3mL 3 Y.in x 50/PK 1.00% $22.20 Per PK 50/PK 23 Sod Chloride,Fluid Injection 0.9%NaCI,1000m1 12/Case 1.00%$111.75 Per Case 12/Case 24 Kling,3 inch 12/Box 1.00%$3.36 Per Box 12/Box 25 Cold Pack 6 X 8 1/4 IN 12/Box 1.00%$30.36 Per Box 12/Box 26 Zofran-Ondansetron 4mg/2m1SDV Per/Val Each 1.00%$16.23 Per Val Each 27 ALBUTEROL 2.5MG/3ML 25/Box 1.00%$18.58 Per Box 25/Box 28 Epi,1:1000 lmg/lml Ampule 2043 Each 1.00%$38.11 Each Each 29 Ipratropium Bromide 0.02%2.5ml 25/Pack 1.00%$592.18 Per Pack 25/Pack 30 SOLU-MEDROL,125 MG,2 ML VIAL 25/Pack 1.00%$473.75 Per Pack 25/Pack 31 NARCAN Pre-Filled 2MG 2ML SYR Each 1.00%$59.93 Each Each 32 EPI 1:10,000 1 MG 10 ML LUER JET 10/Pk 1.00%$234.87 Per PK 10/PK 33 AMIODARONE 150MG 3ML VIAL 100/Box 1.00% $1636.25 Per Box 100/Box 34 Sodium Bicarbonate,8.4%,SOml Prefilled 10/Pack 1.00% $441.12 Per Pack 30/Pak 35 Dextrose 10%,Fluid Injection,250m1 36/Case 1.00% $402.75 Per Case 36/Case 36 LIDOCAINE 2%100MG 5ML ANSYR SYRINGE 10/Box 1.00% $374.62 Per Box 10/Box 37 Ketorolac 30mg/m1 lmi SDV 25/Box 1.00% $399.98 Per Box 25/Box 38 Nitro-BID 2%Ointment 1gm UD 48/Box 1.00% $284.25 PerBox 48/Box 39 ATROPINE 1MG 10ML LUER JET 10/Box 1.00% $331.25 Per Box 10/Box 40 ASPIRIN CHILD ORANGE 81MG 35/per Bottle 1.00%5.12/Bottle 1 Bottle 41 Tranexamic Acid 100mg/ml,10ml Vial 10/Box 1.00% $399.98 Per Box 10/Box REVISED Version. posted on 08-30-2023 Page 1 of 2 Qultek Consultants,Inc. ITB 23-B-136AK Medical Supplies Exhibit A--Price Ust-RLviSED Version 2 .✓--,_ ions for Version 2 are in blue. Volusia County Item Unit of Measure Cost per unit of Item Description (box,carton,each, Percent Off List measure(after Additional Information(Including specifying total number of Number etc.) Discount discount) items in the unit of measure) 42 Di•henhydramine(Bend ),50m: ml lml SDV 2035 25/Box 1.00%$62.48 PerBox 25/Box 43 Glutose,15mg-Lemon 3/PK 1.00%$22.23 Per PK 3/PK 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET 10/Box 1.00% $209.98 Per Box 10/Box 45 Magnesium Sulfate 50%5 gm,10 ml Vial 10/Box 1.00% $324.87 Per Box 10/Box 46 Adenosine 6 mg,2m1 vial 10/Box 1.00% S 374.87 Per Box 10/Box 47 Levophed 0.1%4mg,4ml vial 10/Box 1.00%$499.98 Per Box 10/Box 48 Norepinephrine 4mg,4m1(1mg/ml) --- 49 Nitrostat 0.4mg tabs 25 Tablet/Bottle 1.00% $26.26 Per Bottle 1 Bottle 50 Amiodarone,50mg/m13m1 Vial 10/Box 1.00% $211.25 Per Box 10/Box 51 C4 Midazolam 2mg/2ml Vial 25/Box 1.00% $93.73 Per Box 25/Box 52 C2 Fentanyl 0.05mg/m12ml SDV 25/Box 1.00% $93.73 Per Box 25/Box 53 0 Ketimine,100mg/Sml Vial 10 Vials/Tray, 1.00% $237.50 Per Tray 10 Val Tray 54 ETOMIDATE 20 MG 10 ML VIAL 10/Box 1.00%$199.98 Per Box 10/Box 55 Succinylcholine 200mg,10m1 Vial 25/Box 1.00%$187.48 Per Box 25/Box 56 Amidate Etomidate,40 •20m1 Vial 10/Box 1.00%5199.98 Per Box 10/Box 57 Vecuronium 1i •,10m1 vial powder) 10/Box 1.00%$403.75 Per Box 10/Box Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version 2 posted on 08-30-2023 Page 2 of 2 AGNI Enterprises, LLC ITB 23-B-136AK Medical Supplies Exhibit A--Price Ust-ittVlSc.Version 2 f.--^ :ions for Version 2 are in blue. Volusia n,ow County rao Unit of Measure Cost per unit of Item Percent Off List Additional Information(Including specifying total number of Number Item Description (box,carton,each, Discount measure(after items in the unit of measure) etc.) discount) Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealed 1n sterile pouches-Medium 2'/.in x 1 in Each 20.00% 0.1229 'Price quoted for Each.But sold as 200/Box ` 2 Tourniquets Rolled tourniquet in '-- n.x 181n.-Latex Free 250/bg,4 bg/cs 20.00% " 211.0938 *Price quoted for 250/bg,4 bg/cs 3 Sheets,Fitted 36x90(Stryker) ,/bg,6 bg/cs 20.00%_ 150.9000 'Price quoted for 5/bg,6 bg/cs 4 X Series-Electrodes BlueSensor-Pedi/Adult 10/Pk _ No bid 5 Extension Set,Safeday,w/Spin Lock 8 in. No bid 6 Bandaids(ea)box 100-3/4 x 3" 100/Box,24 BX/CA 20.00% 76.5120 *Price quoted for 100/Box,24 BX/CA 7 IV Flush Syringe,NS 10 ml Prefilled 30/bx,6 bx/cs _ 20.00% 131.0000 •Price quoted for 30/bx,6 bx/cs 8 VENI-GARD(IV)DRESSING ADULT No bid 9 Glucometer-Lancets 21 Gauge Safety Lancets,Depth penetr' •,:2.2mm,1 34 in L 100/BOX 20.00% 40.1880 •Price quoted for 100/BOX 10 CYNCH-LOCK WHITE 100/Package 20-00% 71.3880 •Price quoted for 100/Package 11 IV Cath,20ga x 1.25 ^i'hs Medical ViaValve Safety IV Catheter,with nlnnd inn r.&' 50/bx,4 bx/cs 20.00% 209.8281 'Price quoted for 50/bx,4 bx/cs 12 Sterile Pads 2 x 2 100/bx,24 bx/cs 20.00% 99.6500 'Price quoted for 100/bx,24 bx/cs 13 IV Cath,1.8ga x 1.25 •.miths Medical ViaValve S ^ters with Blood Control 50/bx,4 bx/cs _ 20.00% 209.8281 •Price quoted for 50/bx,4 bx/cs 14 Macro 10 Drop Set w/ports No bid 15 Chlorascrub Prep Pad-Swab(ea) 100/bx,10 bx/cs 20.00% 0.2142 'Price quoted for Each.But sold as 100/bx,10 bx/cs 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C No bid 17 Sod Chloride,Fluid Injection,0.9%NaCL 500m1 No bid 18 Needle-Safety,18ga X 1 100/bx,8 bx/cs 20.00% 131.6375 'Price quoted for 100/bx,8 bx/cs 19 Sheets,Drape Paper 40X90 50/Case 20.00% 70.7880 'Price quoted for 50/Case 20 Pillow case,disposable in x 30in 100/cs 20.00% 89.1625 •Price quoted for 100/cs 21 Emesis Bag,1000cc- 1cc 161n x 61n 100/cs 20.00% 91.1880 •Price quoted for 100/cs 22 Syringe Only Luer Lock,3CC 3mL 3 Y.in x Y.in 100/bg,10 bg/cs 20.00% 112.5000 •Price quoted for 100/bg,10 bg/cs 23 Sod Chloride,Fluid Injection 0.9%Naa,1000mi No bid 24 Kling,3 inch 12/Box,8 BX/CA 20.00% 45.9840 `Price quoted for 12/Box,8 BX/CA 25 Cold Pack 6 X 8 1/4 IN 24/cs 20.00% 66.5125 'Price quoted for 24/cs 26 Zofran-Ondansetron 4mg/2m1 SDV No bid 27 ALBUTEROL 2.5MG/3ML No bid 28 Epi,1:1000 1mg/lml Ampule 2043 No bid 29 Ipratropium Bromide 0.02%2.5m1 No bid 30 SOLU-MEDROL,125 MG,2 ML VIAL No bid 31 NARCAN Pre-Filled 2MG 2ML SYR No bid 32 EPI 1:10,000 1 MG 10 ML LUER JET No bid 33 AMIODARONE 150MG 3ML VIAL No bid 34 Sodium Bicarbonate,8.4%,50m1 Prefilled No bid 35 Dextrose 10%,Fluid Injection,250m1 No bid 36 LIDOCAINE 2%100MG SML ANSYR SYRINGE No bid 37 Ketorolac 30mg/m11ml SDV No bid 38 Nitro-BID 2%Ointment 1gm UD No bid 39 ATROPINE 1MG 10ML LUER JET No bid 40 ASPIRIN CHILD ORANGE 81MG No bid 41 Tranexamic Acid 100mg/ml,10m1 Vial No bid REVISED Version. posted on 08-30-2023 Page 1 of 2 Agni Enterprises ITB 23-8-136AK Medical Supplies Exhibit A--Price List--:EVISED Version 2 ;JIG,:ons;rev,.,cr,,-ur Version 2 are in blue. Volugia County saoeivA Unit of Measure Percent Off List Cost per unit of Additional Information(induding specifying total number of Item Description (box,carton,each, measure(after etc) Discount discount) Items in the unit of measure) 42 Diphenhydramine(Benedryl),50mg/ml 1m1SDV 2035 --No bid 43 Glutose,15mg-Lemon --No bid 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET --No bid 45 Magnesium Sulfate 50%5 gm,10 ml Vial --No bid 46 Adenosine 6 mg,2m1vial --No bid 47 Levophed 0.1%4mg,4ml vial --No bid 48 Norepinephrine 4mg,4m1(1mg/ml) --No bid 49 Nitrostat 0.4mg tabs --No bid SO Amiodarone,50mg/ml 3ml Vial --No bid 51 C4 Midazolam 2mg/2mi Vial --No bid 52 C2 Fentanyl 0.05mg/mi 2m1 SDV --No bid 53 C3 Ketamine,100mg/5mi Vial --No bid 54 ETOMIDATE 20 MG 10 ML VIAL --No bid 55 Succinylcholine 200mg,10m1 Vial --No bid 56 Amidate(Etomidate),40mg 20m1 Viai --No bid 57 Vecuronium 10mg,1Oml vial(powder) --No bid Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version"posted on 08-30-2023 Page 2 of 2 BVH Marketing, Inc. ITB 23-B-136AK Medical Supplies Exhibit A--Price List-+EVISED Version 2 - �dr;�uons�re,visions tnr Version 2 are in blue. Volusia nCio2ounty o Unit of Measure Cost per unit of Item Percent Off List Additional Information(including specifying total number of Number Item Description (box,carton,each, Discount measure(after items in the unit of measure) etc.) discount) 1 Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealer; 200(eaches)BX 25.00% 2.5000 Item#1113 's-Medium 2Y.inx1in 2 Tourniquets Rolled tournic -- lin.x 18in.-Latex Free 250 package 25.00%. 23.5000 Item#CH5060 3 Sheets,Fitted 36x90(Stryker) NO BID 4 X Series-Electrodes BlueSensor-Peds/Adult 10/Pk NO BID 5 Extension Set,Safeday,w/Spin Lock 8 in. NO BID 6 Bandaids(ea)box 100-3/4 x 3" 100/bx or 24bx/cs 25.00% bx$2.80 cs$66 Item#3611 7 IV Flush Syringe,NS 10 ml Prefilled 100 box 25.00% 67.0000 item#1210-BP SALINE filled 8 VENI-GARD(IV)DRESSING ADULT NO BID 9 Glucometer-Lancets " ,rcty Lancets,Depth penetration:2.2mm,1 15 in L NO BID 10 CYNCH-LOCK WHITE NO BID 11 IV Cath,20ga x 1.25 niths Medical ViaValve Safety IV Catheters with Blood Control NO BID 12 Sterile Pads 2 x 2 50/bx or 1500/cs 50.00%bx$2.00 cs$60.24 ITEM#9026122(4 ply) 13 IV Cath,18ga x 1.25 ilve safety IV Catheters with Blood Control NO BID 14 Macro 10 Drop Set w/ports NO BID 15 Chlorascrub Prep Pad-Swab(ea) NO BID 16 X Series-Smart Capnollne Plus,Adult/Intermediate N/C NO BID 17 Sod Chloride,Fluid Injection,0.9%NaCL 500m1 cs/24 bottles 25.00% 39.0000 Item#6270 Is 250m1(500m1 is not avail.) 18 Needle-Safety,18ga X 1 NO BID 19 Sheets,Drape Paper 40X90 NO BID 20 Pillow case,disposable •ri NO BID 21 Emesis Bag,1000cc- n x 6in ,package 24 50.00% 9.0000 Item#9010105 22 Syringe Only Luer Lock,3CC 3rn'. •in x NO BID 23 Sod Chloride,Fluid Injection 0.9%NaCl,1000m1 cs/24 bottles 25.00% 39.0000 Item#6270 is 250m1(1000m1 is not avail.) 24 Kling,3 Inch Non-ste• box 24 or 96/cs 50.00%box:$6 cs:$24 Item#9027134 25 Cold Pack 6 X 8 1/4 IN each or cs/24 25.00% each:$1.00 cs:$15.° Item#20104 6"x 8-3/4 large 26 Zofran-Ondansetron 4mg/2ml SDV NO BID 27 ALBUTEROL 2.5MG/3ML NO BID 28 Epi,1:1000 lmg/Iml Ampule 2043 NO BID 29 Ipratropium Bromide 0.02%2.5m1 NO BID 30 SOLU-MEDROL,125 MG,2 ML VIAL NO BID 31 NARCAN Pre-Filled 2MG 2ML SYR NO BID 32 EPI 1:10,0001 MG 10 ML LUER JET NO BID 33 AMIODARONE 150MG 3ML VIAL NO BID 34 Sodium Bicarbonate,8.4%,50m1 Prefilled NO BID 35 Dextrose 10%,Fluid Injection,250m1 NO BID 36 LIDOCAINE 2%100MG 5ML ANSYR SYRINGE NO BID 37 Ketorolac 30mg/ml lml SDV NO BID 38 Nitro-BID 2%Ointment 1gm UD NO BID 39 ATROPINE 1MG 10ML LUER JET NO BID 40 ASPIRIN CHILD ORANGE B1MG NO BID 41 Tranexamic Acid 100mg/ml,10m1 Vial NO BID REVISED Versi,4 posted on 08-30-2023 Page 1 of 2 BVH Marketing, Inc. ITB 23-B-136AK Medical Supplies Exhibit A—Price List- _VISED Version 2 ;4110 Additions/revisions Jersion 2 are in blue. Vollusid R10A Cunty Rt0o Unit of Measure Cost per unit of Percent Off List Additional Information(including specifying total number of Item Description (box,carton,each, measure(after etc.) Discount discount) Items in the unit of measure) 42 Diphenhydramine(Benedryl),Som: ml lm)SDV 2035 NO BID 43 Glutose,15mg-Lemon NO BID 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET NO BID 45 Magnesium Sulfate 50%5 gm,10 ml Vial NO BID 46 Adenosine 6 mg,2m1 vial NO BID 47 Levophed 0.1%4mg,4m1 vial NO BID 48 Norepinephrine 4mg,4m1(1mg/ml) NO BID 49 Nitrostat 0.4mg tabs NO BID 50 Amiodarone,50mg/ml 3m1 Vial NO BID 51 C4 Midazolam 2mg/2m1 Vial NO BID 52 C2 Fentanyl 0.05mg/m12mI SDV NO BID 53 C3 Ketamine,100mg/5m1 Vial NO BID 54 ETOMIDATE 20 MG 10 ML VIAL NO BID 55 Sucdn kholine 200mg,10m1 Vial NO BID 56 Amidate(Etomidate),40mg 20mI Vial NO BID 57 Veaircnlum 10mg,10m1 vial(powder) NO BID Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version posted on 08-30-2023 Page 2 of 2 Bound Tree ITB 23-B-136AK Medical Supplies Exhibit A--Price List- _VISED Version 2 Addu:,. version 2 are in blue. Volu{1D111DAsia County Unit of Measure Cost per unit of ( n9 spry. 9 Item ff List Additional Information includi in total number of D letription (box carton,each, measure(after Number etc.) Discount discount) items In the unit of measure) Irla? i, :ice. 1 Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealed BX 52.00% 1.9500 330-85300,Desc:Curaplex Alcohol Prep Pad,Medium, sterile pouches-Medium 2 X in x 1 In 2 Tourniquets Rolled tourniquet i'- •e lin.x 18in.-Latex Free BG 64.00% 19.5100 4000,Desc:Curaplex Tourniquet 1 in x 18 in,Blue,Rolle 3 'Sheets,Fitted 36x90(Stryker) CS 47.00% 60.3200)esc:Curaplex XPS Fitted Sheet,36 in x 90 in,Light Blue, 4 X Series-Electrodes BlueSensor-Pedi/Adult 10/Pk PK 59.00% 2.0500 35,Desc:Electrodes,BlueSensor SP,Medium Size,Pedia 5 Extension Set,Safeday,w/Spin Lock 8 in. •EA 57.00% 0.9000 Curaplex 8"Exten Set,Rmvble Sure-Lok,NeedleFree Cc 6 Bandaids(ea)box 100-3/4 x 3" BX 56.00% 1.3600')1BX,Desc:Bandage,Adhesive,plastic,3/4 in x 3 in,ster 7 IV Flush Syringe,NS 10 ml Prefilled EA 78.00% 0.4000 X,Desc:IV flush syringe,Normal Saline,10m1 Prefilled ii 8 VENI-GARD(IV)DRESSING ADULT BX 67.00% 20.000018 36002MS,Desc:Curaplex IV Guard IV Dressing,Breati 9 Glucometer-Lancets% Safety Lancets,Depth penetration:2.2mm,1'.,In I BX 64.00% 7.5400 BTM#2764-70721,Desc:Curaplex Safety Lancet,21g 1 10 CYNCH-LOCK WHITE BG 60.00% 26.2000 02291,Desc:Tamper Evident Seal,Cynch-Lok,White,N 11 IV Cath,20ga x 1.25 Smiths Medical ViaValve Safety IV Catheters with Blr'nci Contro; EA 54.00% 1.7000 IV Catheter,ViaValve Safety w/Blood Control,20 ga x 1. 12 Sterile Pads 2 x 2 BX 52.00% 1.3800 79-3322BX,Desc:Gauze sponge,sterile,2 in x 2 In,8 ply 13 IV Cath,18ga x 1.25 :Medical ViaValve Safety IV Catheters with n' -'trol EA 54.00% 1.7000 V Catheter,ViaValve Safety w/Blood Control,18 ga x 1.2 14 Macro 10 Drop Set w/ports EA 47.00% 1.3200'uraplex IV Admin Set,10 Drp,83in,Pre-Prcd Y-Site,SrLk 15 Chlorascrub Prep Pad-Swab(ea) BX 42.00% 34.2600.0,Desc:Prevantics 1.6m1 Swabstick 3.15%CHG/70%Is< 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C EA _ 45.00% 8.3600 CAPNOLINE PLUS NON INTUBATED,ORAL NASAL W/02 17 Sod Chloride,Fluid Injection,0.9%NaCL 500m1 EA 71.00% 3.2000 001,Desc:IV Solution,Sodium Chloride 0.9%500m1 8a6 18 Needle-Safety,18ga X 1 BX 56.00% 14.310068X,Desc:Safety Needles,Magellan,18 ga x 1 in.,sterile 19 Sheets,Drape Paper 40X90 CS 43.00% 22.7900 BTM#3271-44100,Desc:Curaplex Bed Sheet,Tissue/Pc 20 Pillow case,disposable CS 55.00% 18.0000 4125,Desc:Curaplex Disposable Pillow Case,22x30 inch 21 Emesis Bag,1000cc- PK 65.00% 9.8400 esc:Curaplex Emesis Bag,1000cc,Clear,Cardboard Rim 22 Syringe Only Luer Lock, EA 58.00% 0.0800 TM#1633-30303,Desc:Syringe Only,3cc,Luer Lock,10 23 Sod Chloride,Fluid Injection 0.9%NaCl,1000m1 EA 62.00% 3.2500 1#7800-09,Desc:IV Solution,Sodium Chloride 0.9%10f 24 Kling,3 inch EA 47.00% 0.2600'16EA,Desc:Conforming stretch bandage,gauze,3 in.,n 25 Cold Pack 6 X 8 1/4 IN EA 80.00% 0.3900 1431-77000-T,Desc:Curaplex Cold Pack-Large-7In x 26 Zofran-Ondansetron 4mg/2m1 SDV BX 83.00% 8.4000 y.25-BTM#6130-05,Desc:Ondansetron 4mg,2m1 vial 27 ALBUTEROL 2.5MG/3ML BX 70.00% 4.9600 BTM#9501-25,Desc:ALBUTEROL 0.083% 2.5MG,3M 28 Epi,1:1000 lmg/lml Ampule 2043 PK 46.00% 128.4000 0-BTM#103-10,Desc:Epinephrine 1mg,1m1 ampule 1 29 Ipratropium Bromide 0.02%2.5ml BX 85.00% 6.2700 M#9801-30,Desc:IPRATROPIUM BROMIDE 0.02% 0.5r 30 SOLU-MEDROL,125 MG,2 ML VIAL BX 40.00% 261.4900'MU 0409-0047-22,Desc:Solu-Medrol,125mg,2m1 ACT 31 NARCAN Pre-Filled 2MG 2ML SYR PK 30.00% 391.93001'#1469-1,Desc:Naloxone 2mg,2m1 prefilled fixed need 32 EPI 1:10,000 1 MG 10 ML LUER JET PK 32.00% 113.9000+18 373316,Desc:Epinephrine 1:10000,1mg,10m1 Luer 33 AMIODARONE 150MG 3ML VIAL PK 60.00% 56.2500 616-03,Desc:`MFG B/0'AMIODARONE 150MG 3ML 34 Sodium Bicarbonate,8.4%,50m1 Prefilled PK 35.00% 179.3000 N8 371035,Desc:Sodium Bicarbonate 8.4%50m1 Luer A 35 Dextrose 10%,Fluid Injection,250m1 EA 80.00% 2.9900 BTM#7520-20,Desc:IV Solution,Dextrose 10%250m1 36 LIDOCAINE 2%100MG 5ML ANSYR SYRINGE BX 43.00% 61.4400 074490301,Desc:LIDOCAINE 2%100MG 5ML ANSYR SY 37 Ketorolac 30mg/mI lml SDV BX 75.00% 48.0000 Qty.25-BTM#0701-03,Desc:Ketorolac 30mg,lml vial 38 Nitro-BID 2%Ointment 1gm UD BX 41.00% 132.5900 8-BTM#0326-08,Desc:NITRO-BID 2%OINTMENT 1GN 39 ATROPINE 1MG 10ML LUER JET PK 27.00% 122.7000 BTM#371006,Desc:ATROPINE 1MG 10ML LUER JET 1 40 ASPIRIN CHILD ORANGE 81MG BT 65.00% 0.7100 BTM#911316,Desc:Aspirin 81mg Chewable,Orange Fl 41 Tranexamic Acid 100mg/ml,10mI Vial BX 70.00% 121.8900 BTM#0166-41,Desc:Tranexamic Acid 100mg/ml,10m REVISED Version?posted on 08-30-2023 Page 1 of 2 Bound Tree ITB 23-B-136AK Medical Supplies Exhibit A--Price List- ;.VISED Version 2 ')::�j" version 2 are in blue. Vblusia County IMPRIPIIII_ Unit of Measure Cost per unit of Rem Percent Off List Additional Information(induding specifying total number of Number fteT Description (tax,carton,each, Discount measure(after items in the unit of measure) etc.) discount) 42 Di..- y.r.mi -(:•n>.ryl) h..: ul ml IV 135 EA 47.00% 5.6000 .. ��:� �� r •. •r. • • •, 43 Glutose,15mg-Lemon PK 59.00% 20.6500•-BTM#664365,Desc:Glucose Gel,Orange,15gm 15/. 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET BX 26.00% 123.9700•TM#373304,Desc:Calcium Chloride 1gm,10m1 Luer J: 45 Magnesium Sulfate 50%5 gm,10 ml Vial BX 47.00% 65.3600 BTM#064-11,Desc:Magnesium Sulfate 50%5gm,10 46 Adenosine 6 mg,2m1 vial BX 52.00% 40.5900 Qty.10-BTM#0318-02,Desc:Adenosine 6mg,2m1 Vial 47 Levophed 0.1%4mg,4m1vial BX 44.00% 241.5300 y.10-BTM#3375-04,Desc:LEVOPHED 4MG,4ML VIAL 48 Norepinephrine 4mg,4m1(1mg/ml) BX 61.00% 64.3000 10-BTM#0997-10,Desc:Norepinephrine 1mg/ml,4ml 49 Nitrostat 0.4mg tabs BT 30.00% 77.5600 .100-BTM#0418-24,Desc:NITROSTAT TABS SL 0.4M e 50 Amiodarone,50mg/ml 3m1 Vial PK 60.00% 56.2500 616-03,Desc:`MFG 8/0*AMIODARONE 150MG 3ML 51 C4 Midazolam 2mg/2m1 Vial BX 71.00% 29.5400'5-BTM#2305-17,Desc:C4 MIDAZOLAM 2MG,2ML VI 52 C2 Fentanyl 0.05mg/m12m1 SDV BX 59.00% 64.4800 #6027-25,Desc:C2 Fentanyl,0.05mg/ml,2m1Vial,25/ 53 C3 Ketamine,100mg/Sml Vial BX 57.00% 104.29001-BTM#2051-05,Desc:C3 KETAMINE 100MG/ML,5M1. 54 ETOMIDATE 20 MG 10 ML VIAL BX 50.00% 74.2600 .10-BTM#6695-01,Desc:Etomidate,20mg,10m1Vial 55 Succinylcholine 200mg,1DmI Vial EA 49.00% 53.9000 25-1,Desc:'OS ONLY"Succinylcholine 200mg,10m1 vi 56 Amidate(Etomidate),40mg 20m1 Vial EA 61.00% 19.6800 TM#1012750,Desc:'DS ONLY'Amidate(Etomidate)4 57 Vecuronlum 10mg,10mI vial(powder BX 71.00% 93.7500 h!Lbg9Gcliza 9xel 13e79PJuit.:,'.[�O1SI�9!_\�iYe Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Versior posted on 08-30-2023 Page 2 of 2 Henry Schein, Inc. ITB 23-B-136AK Medical Supplies Exhibit A-Price List-.:.VISLD Version 2 __-----_ Ad-; "s/revisio. 'ersion 2 are in blue. Volusia County Unit of Measure Cost per unit of Item Percent Off List Additional Information(Including specifying total number of Number Description (box,carton,each, Discount measure(after items in the unit of measure) etc.) discount) Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealed 1 200/bx 34.00% 1.1500 HS#5702219 in sterile pc .in x l in 2 Tourniquets 250/pk,l0pk/cs 34.00% 273.8100 HS#7003662 3 Sheets,Fitted 36x90(Stryker) 30/cs 34.00% 46.3400 HS#7001685 4 X Series-Electrodes BlueSensor-Pedl/Adult 10/Pk 10/pk 34.00% 2.3300 HS#1944591 5 Extension Set,Safeday,w/Spin Lock 8 in. 100/cs 34.00% 93.9200 HS#4996066,Amsino AE3108 6 Bandaids(ea)box 100-3/4 x 3" 100/bx 34.00% 0.9600 HS#1126138 7 IV Flush Syringe,NS 10 ml Prefilled 30/bx 34.00% 8.4700 HS#1454403 8 VENI-GARD(IV)DRESSING ADULT 100/bx 34.00% 20.0000 HS#7006261,Dyna rex 4609 9 Glucometer-Lancets 21 Gaug'' .,ncets,Depth p. ration:2.2r in l 100/bx 34.00% 4.4000 HS#9007980 10 CYNCH-LOCK WHITE 100/pk 34.00% 27.0900 HS#2132693 11 IV Cath,20ga x 1.25'+miths Mecical ViaValve Safety IV Catheters with Blood Control EA 34.00% 1.3800 HS#7020666 ' 12 Sterile Pads 2 x 2 100/bg 34.00% 2.0300 HS#1408399 13 IV Cath,18ga x 1.25 `Is Medical ViaValve Safety IV Catheters with Blood Control EA 34.00% 1.3800 HS#7020669 14 Macro 10 Drop Set w/ports EA 34.00% 1.1300 HS#7000469 15 Chlorascrub Prep Pad-Swab(ea) 100/bx 34.00% 15.1500 HS#6020035 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C EA 34.00% 8.4100 H5#7020157,Maslmo 4459 17 Sod Chloride,Fluid Injection,0.9%NaCL 500m1 _EA 34.00% 3.3800 HS#1004737 18 Needle-Safety,18ga X 1 100/bx 34.00%, 11.2800 HS#5700337 19 Sheets,Drape Paper 40X90 50/cs _ 34.00% 34.7600 HS#1169305 20 Pillow case,disposable 'in x 3r 100/cs 34.00% 21.2300 HS#1016311,21x30 21 Emesis Bag,1000cc- "cc 1E- 200/cs 34.00% 82.2200 HS#7005328 22 Syringe Only Luer Lock, 100/bx 34.00% 3.5000 HS#5702873 23 Sod Chloride,Fluid Injection 0.9%NaCl,1000m1 EA 34.00% 3.3800 HS#1002808 24 Kling,3 inch Non-sterile 12/bx 34.00% 1.0400 HS#2670032 25 Cold Pack 6 X 8 1/4 IN EA 34.00% 0.7400 HS#2670027,Dynrex 4512,5"x9" 26 Zofran-Ondansetron 4mg/2m1 SDV 25/bx 34.00% 11.2500 HS#1259100 27 ALBUTEROL 2.5MG/3ML 25/bx _ 34.00% 5.9500 HS#1434079 28 Epl,1:1000 lmg/1m1 Ampule 2043 10/bx 34.00% 155.5400 HS#1289991 29 Ipratropium Bromide 0.02%2.5ml 25/bx 34.00% 5.7700 HS#1162118 30 SOLU-MEDROL,125 MG,2 ML VIAL 25/bx 34.00% 281.3700 HS#3820015 31 NARCAN Pre-Filled 2MG 2ML SYR 10/bx 34.00% 165.2800 HS#1182155 32 EPI 1:10,0001 MG 10 ML LUER JET 10/bx 34.00% 135.0900 HS#1435799 33 AMIODARONE 150MG 3ML VIAL 25/bx 34.00% 43.6700 HS#1380951 34 Sodium Bicarbonate,8.4%,50m1 Prefilled 10/bx 34.00% 202.3500 HS#1191715 35 Dextrose 10%,Fluid Injection,250m1 EA 34.00% 3.0300 HS#5073334 36 LIDOCAINE 2%100MG 5ML ANSYR SYRINGE 10/bx 34.00% 68.1600 HS#1046865 37 Ketorolac 30mg/ml lml SDV 25/bx 34.00% 30.8300 HS#1404657 38 Nltro-BID 2%Ointment 1gm UD 48/bx 34.00% 142.4600 HS#1910000 39 ATROPINE 1MG 10ML LUER JET 10/bx 34.00% 121.4900 HS#2580091 40 ASPIRIN CHILD ORANGE 81MG 36/btl 34.00% 0.9100 HS#1439689 41 Tranexamic Acid 100mg/ml,10m1Vial 10/bx 34.00% 41.8700 HS#1425395 REVISED Version posted on 08-30-2023 Page 1 of 2 Henry Schein, Inc. ITB 23-B-136AK Medical Supplies Exhibit A--Price Llst--(EVISED Version 2 -124 Additions/revs.,-:...ur Version 2 are in blue. VOIuSia(Aunty FL01. Item Unit of Measure Cost per unit of Item Description Percent Off List Additional Information(including specifying total number of Number pti (box,carton,each, measure(after etc.) Discount discount) items in the unit of measure) 42 Dlphenhydramine(Benedryl),50mg/ml lml SDV 2035 25/bx 34.00% 25.5700 HS#3759452 43 Glutose,15mg-Lemon 3/Pk 34.00% 4.3700 HS#1246672,Transcend 6531 Strawberry 44 CALCIUM CHLORIDE 1GM,10 MI LUER JET 10/bx 34.00% 150.0700 HS#1046889 45 Magnesium Sulfate 50%5 gm,10 ml Vial 25/bx 34.00% 63.2800 HS#1314652 46 Adenosine 6 mg,2m1 vial 10/bx 34.00% 94.4700 HS#1357662 47 Levophed 0.1%4mg,4m1 vial 10/bx 34.00% 64.2400 HS#1435719 48 Norepinephrine 4mg,4ml(1mg/mf) 10/bx 34.00% 20.5400 HS#1325682 49 Nitrostat 0.4mg tabs 4 btls of 25 34.00% 28.2200 HS#1328659 50 Amiodarone,50mg/m13m1 Vial 25/bx 34.00% 43.6700 HS#1380951,repeat of#33 51 C4 Midazolam 2mg/2ml Vial 25/bx 34.00% 17.0900 HS#1402328 52 C2 Fentanyl 0.05mg/m1 2ml SDV 25/bx 34.00% 68.6500 HS#1046538 53 C3 Ketamine,100mg/5ml Vial 10/bx 34.00% 122.6900 HS#1381043 54 ETOMIDATE 20 MG 10 ML VIAL 10/bx 34.00% 40.3300 HS#1425112 55 Succinylcholine 21. .,10m1 Vial 25/bx 34.00% 97.0300 HS#1417627 56 Amidate(Etomidate,40mg 20m1 Vial 10/bx 34.00% 57.3900 HS#1423080 57 Vecuronium 10mg,10m1 vial(powder) 10/bx 34.00% 35.4900 H5#1357642 Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version posted on 08-30-2023 Page 2 of 2 Life-Assist, Inc. ITB 23-B-136AK Medical Supplies Exhibit A-Price List-;EVISED Version 2 Additions/revisions 'Version 2 are in blue. lbIusia County .aoe IDA - Item Unit of Measure Percent Off List Cost per unit of Additional Information(including specifying total number of Number Item Description (box,carton,each, measure(after ) Discount discount) items in the unit of measure) etc.1 Alcohol prep pad(each)Saturated with 7nu,isopropyl relcnhol,7-ply,non-woven pad,Sealed n sterile pouches-Medium 2 Y.in x Box 43.00% 2.4200 LA Item#:AL1007,Box-200,6.5 x 3 cm 2 Tourniquets Rolled tourniquet in size lin.x 18in.-Latex Free Box 43.00% 29.3600 LA Item#:TQ3139,Box-250,1"x 18" 3 Sheets,Fitted 36x90(Stryker) Case 43.00% 74.0700 LA Item#:BS4250,Case-50,36"x 90" 4 X Series-Electrodes BlueSensor-Pedi/Adult 10/Pk Pack 43.00% 2.6500 LA Item#:EL9010SP,Pack-10 5 Extension Set,Safeday,w/Spin Lock 8 in. Each 43.00% 2.1000 LA Item#:IV352290 6 Bandaids(ea)box 100-3/4 x 3" Box 43.00% 1.7100 LA Item#:BA3601,Box-100,3/4"x 3" 7 IV Flush Syringe,NS 10 ml Prefilled Each 43.00% 0.8300 LA Item#:DR1010B 8 VENI-GARD(IV)DRESSING ADULT Box 43.00% 47.3100 LA Item#:114431,Box-100 9 Glucometer-Lancets 21 Gauge ••,r Lancets,Depth pe: •i'rn,1 u in 1 Box 43.00% 15.1100 LA Item#:GU1240,Box-100,21G,2.2mm 10 CYNCH-LOCK WHITE Bag 43.00% 30.5000 LA Item if:HCL_18319-WHT,Bag-100,Sub 11 IV Cath,20ga x 1.25 -piths Medica l'V,aValve Satety IV Catheters wite iifoo.t..ontra Each 43.00% 2.0000 LA Item#:11326600 12 Sterile Pads 2 x 2 Box 43.00% 1.2000 LA Item#:BJ6122,Box-25 13 IV Cath,18ga x 1.25 Medical ViaValve Safety IV Catheters with 1 Control Each 43.00% 2.0000 LA Item#:IT326500 14 Macro 10 Drop Set w/ports Each 43.00% 1.8500 LA Item#:IV110,Sub 15 Chlorascrub Prep Pad-Swab(ea) _Each 43.00% 1.7100 LA Item#:AL93040 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C Each 43.00% 5.9900 LA Item#:P056012,Sub 17 Sod Chloride,Fluid Injection,0.9%NaCL 500m1 Each 43.00% 6.2400 LA Item#:SL8001 18 Needle-Safety,18ga X 1 Each 43.00% 0.0700 LA Item#:IT18GA,Sub 19 Sheets,Drape Paper 40X90 Case 43.00% 41.4700 LA Item#:B5918302,Case-100 20 Pillow case,disposable 221 r Case 43.00% 33.9200 LA Item#:B5703,Case-100 21 Emesis Bag,1000cc-5000:. =in x 6in Each 43.00% 1.2800 LA Item#:PA56,1000cc 22 Syringe Only Luer Lock,3CC 3mL 3 Y.in x14 in Each 43.00% 0.1000 LA Item#:IT26200,3cc 23 Sod Chloride,Fluid Injection 0.9%NaCI,1000m1 Each 43.00% 6.4100 LA Item#:SL7800-09 24 Kling,3 inch Bag 43.00% 2.2500 LA Item#:BJ603,Bag-12,Sub 25 Cold Pack 6 X 8 1/4 IN Each 43.00% 0.7000 LA Item#:DI9850 26 Zofran-Ondansetron 4mg/2ml SDV Each 43.00% 1.2100 LA Item#:DR6130-05 27 ALBUTEROL 2.5MG/3ML Box 43.00% 9.0900 LA Item#:DR9501-25,Box-25 28 Epi,1:1000lmg/iml Ampule 2043 Box 43.00% 132.2400 LA Item#:DR0103-10,Box-10 29 Ipratropium Bromide 0.02%2.5m1 Box 43.00% 16.8200 LA Item#:DR9801-01,Box-30 30 SOLU-MEDROL,125 MG,2 ML VIAL Each 43.00% 10.2600 LA Item#:DR0047-22 31 NARCAN Pre-Filled 2MG 2MLSYR Each 43.00% 32.8000 LA Item#:DR3369-00 32 EPI 1:10,000 1 MG 10 ML LUER JET Each 43.00% 9.8000 LA Item#:DR3318-01 33 AMIODARONE 150MG 3ML VIAL Each 43.00% 4.9900 LA Item#:DR9875-25 34 Sodium Bicarbonate,8.4%,50m1Prefilled Each 43.00% 15.6900 LA Item#:DR3352-00 35 Dextrose 10%,Fluid Injection,250m1 Each 43.00% 5.4200 LA Item#:51_5202 36 LIDOCAINE 2%100MG 5ML ANSYR SYRINGE Box 43.00% 58.4300 LA Item#:OR1323-01,Box-10 37 Ketorolac 30mg/m11ml SDV Box 43.00% 71.2500 LA Item#:DR0072-25,Box-25 38 Nitro-BID 2%Ointment 1gm UD Box 43.00% 136.8000 LA Item#:DR0326-08,Box-48 39 ATROPINE 1MG 10ML LUER JET Each 43.00% 9.7500 LA Item#:DR3340-O0 40 ASPIRIN CHILD ORANGE 81MG Each 43.00% 1.1300 LA Item#:MD150 41 Tranexamic Acid 100mg/ml,10mI Vial Each 43.00% 5.6400 LA Item#:DR66008-10,Sub REVISED Version 2 posted on 08-30-2023 Page 1 of 2 Life-Assist, Inc. 118 23-B-136AK Medical Supplies Exhibit A--Price List'EVISED Version 2 Version 2 are in blue. 11°111i:1,45r MY is Number iItem Description Unit of Measure it of - Percent Off List Cost per unAdditional Information(including specifying total number of (box,carton,each, measure(after Disoount items in the unit of measure) etc.) discount) 42 Diphenhydramine(Benedryl),50mg/m11mISDV 2035 Each 43.00% 1.4700 LA Item#:DR0376-25 43 Glutose,15mg-Lemon Each 43.00% 3.4200 LA Item#:MD62 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET Each 43.00% 9.4100 LA Item#:DR3304-00 45 Magnesium Sulfate 50%5 gm,10 ml Vial Each 43.00% 3.5600 LA Item#:DR0064-11 46 Adenosine 6 mg,2mIvial Each 43.00% 7.7000 LA Item#:DR0318-02 47 Levophed 0.1%4mg,4m1vial Each 43.00% 22.8000 LA Item#:DR0997-10 48 Norepinephrine 4mg,4m1(1mg/m1) Each 43.00% 22.8000 LA Item#:DR0997-10,Duplicate of Item#47 49 Nitrostat 0.4mg tabs Each 43.00% 23.6600 LA Item#:DR0639-45 50 Amiodarone,50mg/m13m1Vial Each 43.00% 4.9900 LA Item#:DR9875-25,Sub 51 C4 Midazolam 2mg/2m1 Vial Box 43.00% 45.8900 LA Item#:DR6057-26,Box-25,Sub C2 Fentanyl 0.05mg/m12mISDy = C3 Ketarnine,100mg/Sml Vial Box 43.00% 64.9800 127.5400 LA Item#:DR9094-22,Box-25,Sub Box 43.00% LA Item#:DR2051-05,Box-10 54 ETOMIDATE 20 MG 10 ML VIAL Each 43.00% 9.0600 LA Item#:DR9506-10 55 Succinylcholine 21 1 .,10mI Vial Each 43.00% 10.5500 LA Item#:DR9338-25 56 Amidate(Etomidate,40mg 20m1 Vial Each 43.00% 11.4000 IA Item#:DR9507-10 57 Vecuronium 10 .,lOmI vial(powder) Box 43.00% 151.0500 LA Item#:DR1632-01,Box-10 Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version posted on 08-30-2023 Page 2 of 2 QuadMed ITB 23-B-136AK Medical Supplies ExhibitA--Price List- EVISED Version 2 ,liew.:._. iseaiatt Additions/rev:;:" Version 2 are in blue. Volusia County Unit of Measure Cost per unit of h 9 Item Percent Off List Additional Information(includingin total number of Number item Description (box,carton,each, measure(after ) Discount discount) items in the unit of measure) etc.1 Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealed ruches-Medium 2 Y.in x 1 in EACH 31.56% 1.5400 200/BX 2 Tourniquets Rolled tourniquet in size lin.x 18in.-Latex Free BOX 28.07% 23.7000 250/CS,Blue 3 Sheets,Fitted 36x90(Stryker) EACH 6.89% 120.9900 50/CS 4 X Series-Electrodes BlueSensor-Pedi/Adult 10/Pk 35.05% 3.0200 10/PK 5 Extension Set,Safeday,w/Spin Lock 8 in. BOX 56.74% 0.9300 1/EA 6 Bandaids(ea)box 100-3/4 x 3" ,Case 54.92% 1.3300 100/BX 7 IV Flush Syringe,NS 10 ml Prefilled Case 38.44% 80.0000 240/CS 8 VENI-GARD(IV)DRESSING ADULT PACK 50.39% 19.8200 100/BX 9 Glucometer-Lancets?1 Gauge Safety Lancets,Depth penetration:2.2mm,1 h in L BOX 79.46% 4.9200 100/BX 10 CYNCH-LOCK WHITE 19.67% 33.7000 100/PACK 11 IV Cath,20ga x 1.25 dical ViaValve Safety IV Catheters with.. a Control BOX 47.35% 84.2200 50/BX 12 Sterile Pads 2 x 2 _Case 55.44% 1.2700 50/BX 13 IV Cath,18ga x 1.25 ..Medical ViaV7, safety IV Catheters with, d Control 47.35% 84.2200 50/8X 14 Macro 10 Drop Set w/ports 55.51% 1.0900 1/EA 15 Chlorascrub Prep Pad-Swab(ea) 28.15% 21.5200 100/BX 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C 27.96% 10.4100 1/EA 17 Sod Chloride,Fluid Injection,0.9%NaCL 500m1 _No-Bid 18 Needle-Safety,18ga X 1 _ _ 28.52% 14.2600 19 Sheets,Drape Paper 40X90 30.87% 54.2700 50/CASE 60"x 84" 20 Pillow case,disposable ^v zn:,.. _ 29.97% 38.4800 100/CS 21 Emesis Bag,1000cc-1000: 67.65% 5.1600 12/PK 22 Syringe Only Luer Lock,3CC 3mL 3'. 65.56% 6.8700 100/BX 23 Sod Chloride,Fluid Injection 0.9%NaCI,1000m1 No-Bid 24 Kling,3 inch 50.91% 2.4300 12/BX 25 Cold Pack 6 X 8 1/4 IN 21.21% 14.9300 24/CS 6.2"X 8.5" 26 Zofran-Ondansetron 4mg/2m1SDV No-Bid 27 ALBUTEROL2.5MG/3ML No-Bid 28 Epi,1:1000 lmg/lml Ampule 2043 No-Bid 29 Ipratropium Bromide 0.02%2.5m1 No-Bid } 30 SOLU-MEDROL,125 MG,2 ML VIAL No-Bid 31 NARCAN Pre-Filled 2MG 2ML SYR No-Bid 32 EPI 1:10,000 1 MG 10 ML LUER JET No-Bid 33 AMIODARONE 150MG 3ML VIAL No-Bid 34 Sodium Bicarbonate,8.4%,50m1 Prefilled No-Bid 35 Dextrose 10%,Fluid Injection,250m1 No-Bid 36 LIDOCAINE 2%100MG SMLANSYR SYRINGE No-Bid 37 Ketorolac 30mg/ml lml SDV No-Bid 38 Nitro-BID 2%Ointment 1gm UD No-Bid 39 ATROPINE 1MG 1OML LUER JET No-Bid 40 ASPIRIN CHILD ORANGE 81MG 57.45% 1.1700 32/Bottle 41 Tranexamic Acid 100mg/mI,10m1 Vial No-Bid REVISED Version posted on 08-30-2023 Page 1 of 2 QuadMed ITB 23-B-136AK Medical Supplies Exhibit A—Price List- ti.VISED Version 2 �yya Additions/rev,.. Version 2 are in blue. Volusia County Item Unit of Measure Percent Off List Cost per unit of Additional Informationincludin Number Item Description (box,carton,each, measure(after Information(including specifying total number of etc.) Discount discount) items in the unit of measure) 42 Diphenhydramine(Benedryl),50m1 ml lml SOV 2035 --No-Bid 43 Glutose,15mg-Lemon EACH 29.53% 5.2500 1 EA 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET — No-Bid 45 Magnesium Sulfate 50%5 gm,10 ml Vial No-Bid 46 Adenosine 6 mg,2ml vial --No-Bid 47 Levophed 0.1%4mg,4m1 vial --No-Bid 48 Norepinephrine 4mg,4m1(1mg/ml) --No-Bid 49 Nitrostat 0.4mg tabs --No-Bid 50 Amiodarone,50mg/m13m1 Vial --No-Bid 51 C4 Midazolam 2mg/2m1 Vial --No-Bid 52 C2 Fentanyl 0.05mg/m1 2m1 SDV --No-Bid 53 C3 Ketamine,100mg/5ml Vial --No-Bid 54 ETOMIDATE 20 MG 10 ML VIAL --No-Bid 55 Sucdnylcholine 200mg,10m1 Vial --No-Bid 56 Amidate(Etomidate),40mg 20m1 Vial --No-Bid 57 Veouronhxn 10mg,10m1 vial(powder) --No-Bid Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version 2 posted on 08-30-2023 Page 2 of 2 School Health Corporation ITB 23-B-136AK Medical Supplies Exhibit A—Price List-REVISED Version 2 __ Additions/rev . r Version 2 are in blue. Volusia County .aow,o. - Item ii. Lint of Measure Cost per unit of Item Description Percent Off List Additional Information(including specifying total number of Number P (box,carton,each, Discount measure(after items in the unit of measure) etc.) discount) 1 Alcohol prep pad(each)Saturated with 70%isopropyl alcohol,2-ply,non-woven pad,Sealed 200/BOX 12.00% 2.6400 1040441, in sterile pouches-Medium 2%in x 1 in 2 Tourniquets Rolled tourniquet in size lin.x 18in.-Latex Free EACH 12.00% 0.2500 27717, 3 Sheets,Fitted 36x90(Stryker) NO BID 4 X Series-Electrodes BlueSensor-fedi/Adult 10/Pk NO BID 5 Extension Set,Safeday,w/Spin Lock 8 in. NO BID — 6 Bandaids(ea)box 100-3/4 x 3" 100/BX 12.00% 2.7700 32005, 7 IV Flush Syringe,NS 10 ml Prefilled NO BID 8 VENI-GARD(IV)DRESSING ADULT NO BID 9 Glucometer-Lancets 21 Gauge Safety Lancets,Depth penetration:2.2mm,1'/.in I NO BID 10 CYNCH-LOCK WHITE NO BID — 11 IV Cath,20ga x 1.25`-"chs Medical ViaValve Safety IV Catheters with iBinod Cr: NO BID 12 Sterile Pads 2 x 2 100/bx 12.00% 4.1900 27542, 13 IV Cath,18ga x 1.25 -s Medical ViaValve' -ry IV Catheters with Blood Cone I NO BID 14 Macro 10 Drop Set w/ports NO BID 15 Chlorascrub Prep Pad-Swab(ea) NO BID 16 X Series-Smart Capnoline Plus,Adult/Intermediate N/C NO BID 17 Sod Chloride,Fluid Injection,0.9%NaCL 500m1 NO BID 18 Needle-Safety,18ga X 1 NO BID 19 Sheets,Drape Paper 40X90 50/CS 12.00% 32.5700 21045-40"X 72" 20 Pillow case,disposable '!n x 30in 100/CS — 12.00% 34.4700 21187-21"X 29"100/CASE 21 Emesis Bag,1000cc- `cc 16in x 6in 24/B)( .• 12.0016_ 15.7000 1039119-24/PK 22 Syringe Only Luer Lock,3CC 3mL 3 Y.in x 14 in NO BID 23 Sod Chloride,Fluid Injection 0.9%NaCI,1000ml NO BID 24 Kling,3 inch Non-sterile NO BID 25 Cold Pack 6 X 8 1/4 IN 16/CS 12.00% 11.7800 37271-6"X 8"16/CS 26 Zofran-Ondansetron 4mg/2m1 SDV NO BID 27 ALBUTEROL 2.5MG/3ML NO BID 28 Epi,1:1000 lmg/lml Ampule 2043 NO BID 29 Ipratropium Bromide 0.02%2.5m1 NO BID 30 SOLU-MEDROL,125 MG,2 ML VIAL NO BID 31 NARCAN Pre-Filled 2MG 2ML SYR NO BID 32 EPI 1:10,000 1 MG 10 ML LUER JET NO BID 33 AMIODARONE 150MG 3ML VIAL NO BID 34 Sodium Bicarbonate,8.4%,50m1 Prefilled NO BID 35 Dextrose 10%,Fluid Injection,250m1 NO BID 36 LIDOCAINE 2%100MG 5ML ANSYR SYRINGE NO BID 37 Ketorolac 30mg/m11m1 SDV NO BID 38 Nitro-BID 2%Ointment 1gm UD NO BID 39 ATROPINE 1MG 10ML LUER JET NO BID 40 ASPIRIN CHILD ORANGE 81MG 36/131L 12.00% 0.8700 44520, 41 Tranexamic Acid 100mg/ml,10m1 Vial NO BID REVISED Version posted on 08-30-2023 Page 1 of 2 ITB23-B-136AK School Health Corporation Medical Supplies Exhibit A—Price List-*EVISED Version 2 . Additions/revis..:.,:;,r Version 2 are in blue. VOlusia County .LonlOA - Number Unit of Measure Cost per unit of Item Description Percent Off List Additional Information(including specifying total number of Number P (box,carton,each, Discount measure(after items in the unit of measure) etc.) discount) ill Diphenhydramine(Benedryl),50mg/ml lmi SDV 2035 —NOD 43 Glutose,15mg-Lemon 3/PK 12.00% 4.8900 1035140-ORANGE 3/PK 44 CALCIUM CHLORIDE 1GM,10 ML LUER JET —NO BID 45 Magnesium Sulfate 50%5 gm,10 ml Vial —NO BID 46 Adenosine 6 mg,2m1 vial —NO BID 47 Levophed 0.1%4mg,4m1 vial —NO BID 48 Norepinephrine 4mg,4m1(1mg/ml) —NO BID 49 Nitrostat 0.4mg tabs —NO BID 50 Amiodarone,50mg/m13m1 Vial —NO BID 51 C4 Midazolam 2mg/2m1 Vial —NO BID 52 (2 Fentanyl 0.05mg/mi 2ml SDV —NO BID 53 C3 Ketamine,100mg/Sml Vial —NO BID 54 ETOMIDATE 20 MG 10 ML VIAL —NO BID 55 Succinylcholine 200mg,10m1 Vial —NO BID 56 Amidate(Etomidate),40mg 20m1 Vial —NO BID 57 Vecuronium 10mg,10mI vial(powder) —NO BID Please list the percent discount off list price and the cost per unit of measure net of any discounts. Discount off list price shall remain constant throughout term of agreement. Proposers do not need to bid on all items. REVISED Version 2 posted on 08-30-2023 Page 2 of 2 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price +� Voluka County FLONIDA Product Manufacturer Name % Fixed Product Manufacturer Name °A Fixed Discount Discount 3M 30% Biomedix 30% Aaron Medical #N/A Bio-Nova #N/A Abboject 30% _Bowman Medical Products 30% Abbott 30% Brunswick Biomedical #NIA Acme 30% BurnFree Products 30% Act-O-Vial 30% Burron Medical #N/A ADC Proscope 30% Caradyne #N/A Advantage Medical #N/A Care Line 30% Aearo Company #N/A Cast Products 30% Alliance Medical #N/A Cath-Wrap #N/A Allied Healthcare #N/A Cavacide 30% Alpha-Protec 30% Centennial Products #N/A Alpine #N/A Certified Safety Manufacturing #N/A Ambu 38% ,CFT, Inc. (Life Mask) #N/A Ambu-Perfit 38% Chaston #N/A AMBV 38% Chord Engineering #NIA Ames #N/A Chronimed #N/A Amsino Amsafe 30% Coloplast/Sween 30% Anatomical Chart Company #N/A Compliance Medical 30% Anthony Medica Products #N/A Conmed 38% Argyle 30% Cook 30% Ashland Mills #N/A Corpack Medsystems (BLD) #N/A B & B Medical #N/A Covedein 30% B & F Medical #N/A Cumberland Swan #N/A B Braun Medical 44% Curaplex 40% , Bacti-Stat 30% Cypress Medical #N/A Ballard #N/A Dey Laboratories #N/A Banta Healthcare 30% DHD Healthcare #N/A Bard Parker 30% DHD Healthcare (Pegasus) #N/A Baush & Lomb #N/A Diamond Products #N/A Baxter 40% Digit-Safety #N/A Bay Corporation 30% Diversified Disposables #N/A Bayer 30% Doctors Research Group #N/A BC Group International #N/A Donovan Industries #N/A BCI, Inc. (SIMS) #N/A Dukal Corp. 30% BD 35% Duraclear 38% Bdg #N/A Dynarex 30% Becton/Dickenson 35% E M Innovations 30% Bedford Laboratories #N/A E. Fougera #N/A Bemis 30% Easy-Go-Vac #N/A Berman 30% Eco-Flex #N/A Beshaw Medical #NIA Ecolab Professional Products 30% Bio-Detek #N/A Emergency Medical Instruments (EMI) 30% Biolife #N/A Emergency Prods & Research (EP&R) 30% EMP 30% Impact Instrumentation #N/A Engineered Medical Systems 30% IMS 30% Enternet medical #N/A IMS/Amphastar 30% Ethox 30% Infection Control Technology #N/A EValuMed #N/A INFU-SURG #N/A Page 1 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price Volusia County FLORIDA Product Manufacturer Name % Fixed Product Manufacturer Name (% Fixed Discount Discount Exel International 30% I-Tec/EMS, LLP 30% Expert-Med #N/A Ivax Pharmaceuticals (Zonith Goldline) #N/A Faretec 30% J &J Critikon #N/A Ferno 20% Jobet Institute #N/A Firehouse Medical #N/A Johnson & Johnson 30% First Aid Direct #NIA Junkin Safety Appliance 30% First Horizon #N/A Kapler #N/A Flambeau Products 30% Kendall 30% Fleming Industries 30% Kimberly Clark 30% Flexicon 30% Kimberly-Clark (Ballard Medical) 30% Forerunner 30% Kool-Press 30% Fujisawa Pharmaceuticals #N/A Laerdal Medical 12% Futuremed America #N/A Laerdal/Bemis 12% Gainor Medical #N/A Lead-Lok #NIA Gam #N/A Life-Tech #NIA Gam Ind #N/A Lumiscope Medical Products #N/A Gam Milti #NIA Lyo-Ject #N/A General Medical #NIA M & M Industries #N/A GKR Industries #NIA Mabis 30% Glucometer/Elite X1 #NIA Mabis Healthcare 30% Graham Field 30% Maco International 30% Graphic Control #N/A Macosta-Medical USA #N/A Greenline/Sunmed 35% Mada medical 30% H.I. Bouton #N/A Magnum Medical 30% Harcourt Health Sciences #N/A gnus #N/A Hartwell Medical 25% Mallinkrodt Medical #N/A Hawkpaks.com 30% Marine Rescue products #NIA HeadStart #N/A Maxxim Medical (Winfield) #N/A Healthink #N/A Medafor, Inc. #N/A Healthmark Industries 30% Medex 30% Heartstart FR 30% Medical Action Industries 30% Heart Stream Forerunner #N/A Medical Device Group #N/A Hermitage #N/A Medical Devices International 30% Hoosier Medical Devices #N/A Medical Specialties 30% Hospira 30% Medical Supplies Depot #N/A Hospitak #N/A Medical Technology Products #N/A Hot Shield USA #N/A Medin Corp. #N/A Hudson 30% Medix Choice #NIA Hy-Tape 30% Medline Industries 30% Medovations #N/A Pharmacia & UpJohn #N/A Melker 30% Philadelphia Cervical Collars 30% Mercury Medical 30% Philly 30% Meridian Technologies 25% Physio Control 30% Mertag Products #N/A Pigeon Mountain Industries #N/A Metrex 30% Pinnacle Technology Group 30% MicroFlex Synetron 30% Polamedco #N/A Minto Research & Development 30% Poly Systems #N/A Moldex-Metrix 30% Posey 30% Moneghan Medical 30% Precision Charts 30% Page 2 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price �____L--+-4 Volusia County FLORIDA Product Manufacturer Name % Fixed Product Manufacturer Name % Fixed Discount Discount Moore Medical 30% Precision Dynamics #N/A Morrison Medical #N/A Precision Medical 30% Mortan 30% Premium Plastics #N/A Motion Medical Distribution 30% Prestige Medical 30% MPI Outdoors #N/A Pride of Florida #N/A MSA Patient Monitoring #N/A Progressive Medical International #N/A Multisorb Technologies #NIA Promar Industries #N/A Murphy Et Tube 35% Propper Manufacturing #N/A Nasco 25% Protective-Jelco 30% National Webbing Products #N/A Q-Teknologies #N/A Needi Safety Supply #N/A R & B Fabrications 30% Nellcor 30% R & D Batteries 30% NeoTech 30% Rapid Deployment Products #N/A Neotech Products 30% Reeves Manufacturing 30% New Medical Technology #N/A Repro-Med Systems 30% New United Distributing Co. #N/A Respiratory Distributors #N/A Niosh 30% Respiratory Ventilator Products #N/A Nitroderm #N/A Respironics #N/A Nomin Medical #N/A Reusch 30% North American Rescue 25% Revivant Corporation #N/A NutraMax Products #N/A Rico Suction Labs 30% 02 Solutions #N/A Roc Hampton Medical 30% Omega Medical #N/A Safetec of America 30% Omni Therm #N/A Safety Equipment Company #N/A Omron Health #N/A Safety International 30% 0-Two Medical Technologies 30% SafGard Medical Products 30% Owen Mumford 30% Saf-T-Vac #N/A Pacific Safety Products #N/A Sage 30% Paddock Laboratories 30% Salter Labs #N/A Para Pac #N/A Sani-Cloths Plus 30% Parker Laboratories 30% Saunders Manufacturing 30% Paul Dubin Company #N/A Seaberg Company 30% PDI 30% Sharps Compliance 30% Pelican Products 30% Sherwood #N/A Page 3 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price Volusia County FLORIDA Product Manufacturer Name % Fixed Product Manufacturer Name % Fixed Discount Discount Shippert Medical Technologies #N/A Triad #N/A Shradder #N/A Tri-anim 30% Smiths Medical ASD (Portex) 30% Trinity Laboratories #N/A Snowbird Mountain Gear #N/A TW Medical #N/A Splash Shield 30% Underwater Kinetics #N/A Sporicidin International #N/A Unomedical (Maersk Medical) #N/A Spur 38% VentLab #N/A SSCOR 18% Veriflo Medical #N/A Statcorp 30% Vermont Medical #N/A Stearns Manufacturing #N/A Victor Medical #N/A Sterilix (USA) #N/A Vortran #N/A Sun-Med 35% Waismed 30% Sunrise Medical (DeVilbiss) 30% Weaver &Company #N/A Superior #N/A Welch Allyn 30% Surgical Specialties #N/A Western Medica #NIA Surgilance 35% WestMed #N/A Surgilube 30% Wet Pruf 30% Sween Corp. #N/A Wholesale Tape #N/A Swift First Aid #NIA Winefield Ind. #N/A Syrex-Neptune #N/A Wolfe Tory Medical 30% Tec Laboratories #N/A Yankhauer 18% Tech+Med Industries #NIA Zefon Medical Products #N/A Techstyles, Inc. 30% Zoll 30% Teledyne Analytical Instruments #N/A Terumo 30% Teva #N/A The Battery Bank 30% Thermo #NIA Thin Red Line #N/A Thomas 25% Tidi 30% Timely Medical Innovations #N/A Tinker Medical Devices #NIA Page 4 of 5 ITB 23-B-136AK Attachment B Fixed Percentage Off List Price Volusia Count) FLORIDA Product Manufacturer Name % Fixed Product Manufacturer Name % Fixed Discount Discount` Additonal Proposed Manufacturers % Fixed Additonal Proposed Manufacturers % Fixed Not Listed Above Discount Not Listed Above Discount CURAPLEX Kits 30 Page 5 of 5 Bound Tree ‘; Your Partner In EMS 5000 Tuttle Crossing Blvd. Dublin,OH 43016 614.760.5000 www.boundtree.com To Whom It May Concern: In response to your bid ITB 23-B-136AK, Bound Tree Medical is pleased to offer 30% off of the prices on supplies for all other manufacturers on www.boundtree.com not specifically listed on this bid. In order to provide a percentage off list discount, it is necessary for Bound Tree to exclude certain product categories or manufacturer products. This is largely due to the cost variability of these items as a result of market demand and raw material costs. Products excluded from the percentage off bid include the following: Manufacturers Excluded Product Categories Excluded 5.11 Tactical Capital Equipment Cardio Partners Custom Kits KingFisher Medical Inventory& Secure Storage Systems Philips Medical King Vision and Airways Thermal Angel Preventative Maintenance Qinflow Supraglottic Airways and Kits Recertified AEDs Service Contracts We are pleased to provide you with a competitive bid for the emergency medical supplies and equipment that you are seeking. Please contact our Bids and Contracts Department at 800-533-0523 with any questions. Thank you. Sincerely, Dwight Lowry Pricing Analyst Bound Tree Medical, LLC