HomeMy WebLinkAboutContract 59761CSC No. 59761
FORT WORTH
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between Bound Tree
Medical, LLC ("Vendor") and the City of Fort Worth, ("City"), a Texas home rule municipality.
1. This Cooperative Purchase Agreement;
2. Exhibit A — Links to BuyBoard Vendor Price List and Discount Structure;
3. Exhibit B — BuyBoard Cooperative Agency Contract Number 704-23; and
4. Exhibit C — Conflict of Interest Questionnaire.
Exhibits A, B, and C which are attached hereto and incorporated herein, are made a part of this
Agreement for all purposes. Exhibit A is attached via a document that contains links that contain the
entire contents of Exhibit A. Vendor agrees to provide City with the services and goods included in
Exhibit A pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all
exhibits thereto.
City shall pay Vendor in accordance with the fee schedule in Exhibit A and in accordance with
the provisions of this Agreement. Total payment made under this Agreement for the first year by City
shall not exceed One Hundred Thousand Dollars and Zero Cents ($100,000.00). Vendor shall not
provide any additional items or services or bill for expenses incurred for City not specified by this
Agreement unless City requests and approves in writing the additional costs for such services. City shall
not be liable for any additional expenses of Vendor not specified by this Agreement unless City first
approves such expenses in writing.
The term of this Agreement is effective beginning on the date is signed by the Assistant City
Manager below ("Effective Date") and expires May 31, 2024 ("Expiration Date"). Upon Expiration of
this Term, the Agreement shall renew automatically under the same terms and conditions for up to two
(2) one-year renewal periods unless City or Vendor provides the other party with a notice of non -renewal
at least 60 days before the expiration of the Initial Term or renewal period. However, if funds are not
appropriated, the City may cancel the Agreement 30 calendar days after providing written notification
to the Vendor.
Vendor agrees that City shall, until the expiration of three (3) years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to
and the right to examine at reasonable times any directly pertinent books, documents, papers and records,
including, but not limited to, all electronic records, of Vendor involving transactions relating to this
Agreement at no additional cost to City. Vendor agrees that City shall have access during normal
working hours to all necessary Vendor facilities and shall be provided adequate and appropriate work
space in order to conduct audits in compliance with the provisions of this section. City shall give Vendor
reasonable advance notice of intended audits.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined
to have been delivered when (1) hand -delivered to the other party, its agents, employees, servants or
representatives, (2) delivered by facsimile with electronic confirmation of the transmission, or (3)
received by the other party by United States Mail, registered, return receipt requested, addressed as
follows:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 1 of 140
To CITY:
To VENDOR:
City of Fort Worth Bound Tree Medical, LLC
Attn: Fernando Costa, Attn.: Jon McGrew,
Assistant City Manager Associate Vice President
200 Texas Street, Fort Worth, TX 76102-6314 500 Tuttle Crossing, Blvd
Facsimile: (817) 392-8654 Dublin, OH 43016
With copy to Fort Worth City Attorney's Office Office Phone: 800-533-0523
at same address
The undersigned represents and warrants that he or she has the power and authority to execute this
Agreement and bind the respective Vendor.
CITY OF FORT WORTH:
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
By:
responsible for the monitoring and administration
Name: Fernando Costa
of this contract, including ensuring all performance
Title: Assistant City Manager
and reporting requirements.
Date:
Jul 12, 2023
Digitall signed by Loraine
an
LO,G%l17��Da
_ 3:55-05'00'
By:
APPROVAL RECOMMENDED:
Name: Loraine Coleman
Title: Administrative Services Manager
Digitally signed by Robert
Robert Alldredge Dadeedg23.07.1207:35:48-OS'00'
By:
APPROVED AS TO FORM AND LEGALITY:
Name: Robert A. Alldredge Jr.
Title: Executive Assistant Chief
c�J
By:
°
o, koad
ATTEST: a� F'"' '°
Name: Jessika J. Williams
�'��
Title: Assistant City Attorney
� .;�4cxa °any4�z osga4>
By:
CONTRACT AUTHORIZATION:
Name: Jannette S. Goodall
M&C: N/A
Title: City Secretary
VENDOR:
Bound Tree Medical, LLC
By. S10� WMc61-eK/ r
Name: Jon McGrew
Title: Associate Vice President
Jul 10, 2023 OFFICIAL RECORD
Date' CITY SECRETARY
FT. WORTH, TX
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 2 of 140
EXHIBIT A
https://app.buyboard.com/Shop/Products?term=704-23
https://app.buyboard.comShopProductshandler=vendorcontract&contractid=867&vendorid=4540
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 3 of 140
7 U
ON
i 1 1 10i_A�11�
April 17, 2023
Sent Via Email: Submitbids@Boundtree.com
Christopher Fyffe
Bound Tree Medical (Bound Tree Medical LLC)
5000 Tuttle Crossing Blvd.
Dublin, OH 43016
Welcome to BuyBoard!
P.O. Box 400, Austin, Texas 78767
800.695.2919 • info@buyboard.com • buyboard.com
Re: Notice of The Local Government Purchasing Cooperative ContractAward; Proposal Invitation No. 704-
23, First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company
a BuyBoard@ contract based on the above -referenced Proposal Invitation. The contract is effective for an
initial one-year term of June 1, 2023, through May 31, 2024, and may be subject to two possible one-year
renewals. Please refer to the Proposal Invitation for the contract documents, including the General Terms
and Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 704-23 at:
www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract
award, and only those awarded items may be sold through the BuyBoard contract. All sales must comply
with the contract terms and must be at or below the awarded pricing as set forth in the General Terms and
Conditions.
The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded
that, in accordance with the General Terms and Conditions, all purchase orders must be
processed through the BuyBoard. Except as expressly authorized in writing by the Cooperative's
administrator, you are not authorized to process a purchase order received directly from a Cooperative
member that has not been processed through the BuyBoard or provided to the Cooperative. If you receive
a purchase order directly from a Cooperative member that you have reason to believe has not been received
by the Cooperative or processed through the BuyBoard, you must promptly forward a copy of the purchase
order by email to info@buyboard.com.
A list of Cooperative members is available on the buyboard.com website. The BuyBoard vendor relations
staff will be contacting you to assist with the resources available and to provide any support you may need
as an awarded BuyBoard vendor.
On behalf of the Cooperative, we appreciate your interest in the Cooperative and we are looking forward
to your participation in the program. If you have any questions, feel free contact me at 800-695-2919.
Sincerely,
Ava Benford, Cooperative Procurement Manager
Texas Association of School Boards, Inc.,
Administrator for The Local Government Purchasing Cooperative
v.02.01.2021
Endorsed by A TASAV ME
4
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 4 of 140
Board®
National Purchasing Cooperative
April 17, 2023
Sent Via Email: Submitbids@Boundtree.com
Christopher Fyffe
Bound Tree Medical (Bound Tree Medical LLC)
5000 Tuttle Crossing Blvd.
Dublin, OH 43016
Welcome to BuyBoard!
Re: Notice of National Purchasing Cooperative Award; Proposal Invitation No. 704-23, First Aid, Emergency Medical, and
Athletic Trainer Supplies and Equipment
Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a BuyBoard@
contract based on the above -referenced Proposal Invitation. The contract is effective for an initial one-year term of June 1,
2023, through May 31, 2024, and may be subject to two possible one-year renewals. Please refer to the Proposal Invitation
for the contract documents, including the National Purchasing Cooperative Vendor Award Agreement and General Terms and
Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 704-23 at
www.buvboard.com/vendor. Only items marked as awarded to your company are included in this contract award, and only
those awarded items may be sold through the BuyBoard contract. All sales must comply with the contract terms and must
be at or below the awarded pricing as set forth in the General Terms and Conditions.
The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded that, in
accordance with the General Terms and Conditions, all purchase orders from National Cooperative members
must be processed through the BuyBoard. Except as expressly authorized in writing by the Cooperative's administrator,
you are not authorized to process a purchase order received directly from a National Cooperative member that has not been
processed through the BuyBoard or provided to the Cooperative. If you receive a purchase order directly from a National
Cooperative member that you have reason to believe has not been received by the National Cooperative or processed through
the BuyBoard, you must promptly forward a copy of the purchase order by e-mail to info@buyboard.com
A list of National Cooperative members is available on the buyboard.com website. The BuyBoard vendor relations staff will
be contacting you to assist with resources available and provide any support you may need as an awarded BuyBoard vendor.
On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any questions,
feel free to contact me at 800-695-2919.
Sincerely,
.41-Pi`�
Ava Benford, Cooperative Procurement Manager
Texas Association of School Boards, Inc.,
Procurement Administrator for the National Purchasing Cooperative
v.02.01.2021
Texas 78767-0400
119 • buyboard.com
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23
Page 5 of 140
1�
Boar d
PURCHASWO COOPERATIVE
12007 Research Boulevard . Austin, Texas 78759-2439 . PH: 800-695-2919 . ¢uvboard.com
PROPOSER'S ACCEPTANCE AND AGREEMENT
Proposal Invitation Name: First Aid, Emergency Proposal Due Date/Ooenina Date and Time:
Medical, and Athletic Trainer Supplies and
Equipment January 26, 2023, at 4:00 PM
Proposal Invitation Number: 704-23
Contract Term: June 1, 2023, through May 31,
2024, with two possible one-year renewals.
Location of Proposal ODenina:
Texas Association of School Boards, Inc.
BuyBoard Department
12007 Research Blvd.
Austin, TX 78759
Anticipated Cooperative Board Meetina Date:
April 2023
By s/gnature below, the undersigned acknowledges and agrees that you are author/zed to submit th/s
Proposal, Includ/ng making all acknowledgements, consents, and cert/f/catlons herein, on behalf of Proposer
and, to the best of your knowledge, the Informat/on prov/ded Is true, accurate, and complete.
Bound Tree Medical, LLC
Name of Proposing Company
5000 Tuttle Crossing Blvd.
Street Address
Dublin, OH 43016
City, state, zip
800-533-0523
01 /25/2023
Date
Company Official
Jon' McGrew
Printed Name of Authorized Company Official
Associate Vice President, Pricing
Telephone Number of Authorized Company Official Position or Title of Authorized Company Official
877-311-2437
Fax Number of Authorized Company Official
31-1739487
Federal ID Number
Page 10 of 71
Proposal Forms COMMISVCS v.08,11 2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 6 of 140
Board'
PURCH/1SWO COOMATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 600-695-2919 • buvboard.com
REOUIRED FORMS CHECKLIST
(Please check (,/) the following)
0 Reviewed/Completed: Proposer's Acceptance and Agreement
(PROPOSAL FORMS PART 1: COMPLIANCE FORMS
Fx1 Reviewed/ComDleted: Proposal Acknowledgements
n Reviewed/Completed: Felony Conviction Disclosure
0 Reviewed/ComDleted: Resident/Nonresident Certification
El Reviewed/ComDleted: Debarment Certification
0 Reviewed/Completed: Vendor Employment Certification
0 Reviewed/ComDleted: No Boycott Verification
0 Reviewed/ComDleted: No Excluded Nation or Foreign Terrorist Organization Certification
0 Reviewed/ComDleted: Historically Underutilized Business Certification
0 Reviewed/ComDleted: Acknowledgement of BuyBoard Technical Requirements
M Reviewed/ComDleted: Construction -Related Goods and Services Affirmation
0 Reviewed/ComDleted: Deviation and Compliance
0 Reviewed/ComDleted: Vendor Consent for Name Brand Use
0 Reviewed/ComDleted: Confidential/Proprietary Information
0 Reviewed/ComDleted: EDGAR Vendor Certification
Reviewed/ComDleted: Compliance Forms Signature Page
PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS
El Reviewed/ComDleted: Vendor Business Name
0 Reviewed/ComDleted: Vendor Contact Information (complete in electronicproposalsubmission system)
0 Reviewed/ComDleted: Federal and State/Purchasing Cooperative Experience
0 Reviewed/ComDleted: Governmental References
Fx 1 Reviewed/ComDleted: Company Profile
Reviewed/Completed: Texas Regional Service Designation (complete in electonicpmposalsubmission system)
F1 Reviewed/ComDleted: State Service Designation (complete in electronleproposal submission system)
❑ ReviewedX-omD[eted: National Purchasing Cooperative Vendor Award Agreement (vendors serving outside Teams only)
0 Reviewed/Completed: Local/Authorized Seller Listings
n ReviewedlComDleted: Manufacturer Dealer Designation
0 Reviewed/ComDleted: Proposal Invitation questionnaire
❑ Reviewed/ComDleted: Vendor Request to Self -Report BuyBoard Purchases (optional)
0 Reviewed/ComDleted: Proposal Specifications Discount (%) off Catalog/Pticelist and/or other required pricing
information induding Catalogs/Pricelists (or no bid response) must be submitted with the Proposal or the Proposal will not
be considered.
PMPMI Forms COMMl5VC5 v.08.11.2021
Page 39 of 71
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 7 of 140
Dggoard`ASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buvboard.com
PROPOSAL SPECIFICATION SUMMARY
The categories and items specified for this Proposal Invitation are summarized below. For full Proposal
Specifications, you must review and complete the Proposal Specification information in the electronic proposal
submission system in accordance with the Instructions to Proposers (or, if submitting a hard copy Proposal, timely
request and complete the Proposal Specification Form in accordance with the Instructions to Proposers).
PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be
considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format,
with Excel or searchable PDF preferred. No oauer catalogs or manufacturer/vendor websites will be accented.
Section I: First Aid Eauioment. Products, and Suoolies
1. Discount (%} off catalog/pricelist for First Aid Equipment and Supplies.
Z. Discount (%} off catalog/pricelist for First Aid Furniture.
3. Discount (%} off catalog/pricelist for Bleeding Control Stations,
4. Discount (%) off catalog/pricelist for All Other First Aid, Health, and Nursing Products.
Section II: Athletic Trainer/Rehabilitation Equipment, Products, and Sunolies
5. Discount (%) off catalog/pricelist for Athletic Trainer/Rehabilitation Equipment and Supplies.
6. Discount (%) off catalog/pricelist for Athletic Trainer/ Rehabilitation Furniture.
7. Discount (%) off catalog/pricelist for All Other Athletic Trainer/Rehabilitation Products.
Section III: Emergency Medical Eauioment. Products. and Suoolies
8. Discount (%) off catalog/pricelist for Emergency Medical Equipment and Supplies.
9. Discount (%) off catalog/pricelist for All Other Emergency Medical Products.
Section IV: Pharmaceuticals and Vaccines
10. Discount (%) off catalog/pricellst for Pharmaceuticals and Vaccines.
11. Discount (%) off catalog/pricellst for Intra-Venous Pharmaceutical Supplies.
12. Discount (%) off catalog/pdcelist for Drug Testing Kits and Supplies.
Section V: Audiologv Eauioment and Other Related Items
13. Discount (%) off catalog/pricelist for Audiology Equipment, Hearing Aids, and Other Related Items.
Section VI: Drua/Diagnostic/Laboratory Testina Services
14. Discount (%) off catalog/pricelist for Drug and Alcohol Diagnostic Testing Services (onsite and offsite including
laboratory services),
Section VII: Installation and Repair Service
15. Hourly Labor Rate for Installation/ Repair Service of First Aid, Athletic Trainer/Rehabilitation, and
Emergency Medical Equipment and Products - Not to Exceed hourly labor rate for Installation/Repair Service of
Equipment and Products.
16. Hourly Labor Rate for Installation/Repair of Audiology Equipment and Products - Not to Exceed hourly labor
rate for Installadon/Repair Service of Equipment and Products.
Page 38 of 71 Proposal Forms COKIVSKS v.08.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 8 of 140
Bound Tree Medical Information
Contact: Chris Fyffe
Address: 5000 Tuttle Crossing Blvd
Dublin, OH 43016
Phone: (800) 533-0523
Fax: (877) 311-2437
Toll Free: (800) 533-0523
Email: submitbids@boundtree.com
Web Address: www.boundtree.com
By submitting your response, you certify that you are authorized to represent and bind your company.
Christopher Fyffe
Signature
Submitted at 112512023 04:11:04 PM (CT)
Requested Attachments
Christopher. Fyffe@Boundtree.com
Email
Exceptions and/or Detailed Information Related to Discount % and/or Discount - Additional Detail.pdf
Hourly Labor Rate Proposed
In PDF format and if necessary, vendor shall attach detailed information regarding exceptions to pricing and/or
discount percentage and define the services that are proposed to be provided. NOTE: IF DETAILED INFORMATION IS
NOT SUBMITTED, PROPOSAL MAY NOT BE CONSIDERED. (Please DO NOT password protect uploaded files.)
BuyBoard Proposal Invitation No. 704-23 First Aid, Submission BuyBoard Proposal No 704-23_Signed.pdf
Emergency Medical, and Athletic Trainer Supplies and
Equipment
REQUIRED -In PDF format, upload all proposal invitation documents available for download at vendor.buyboard.com
including any additional pages, as necessary. NOTICE: DO NOT complete proposal forms in internet browser. No data
will be stored. Download file to computer and complete proposal forms prior to submitting. (Please DO NOT password
protect uploaded files.)
Catalog/Pricelist
2022-2023 Bound Tree Catalog.pdf
REQUIRED -In Excel or PDF format, upload catalog(s)/pricelist(s) in accordance with proposal invitation instructions.
Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or Proposal will not be considered. No paper
catalogs or manufacturer/vendor websites will be accepted. File size must not exceed 250MB. (Please DO NOT
password protect uploaded files.)
Company Profile
Bound Tree Medical Company Profile.docx
REQUIRED -Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard
website. If your company is awarded a Contract under this Proposal Invitation, please provide a brief company
description that you would like to have included with your company profile on the BuyBoard website. Submit your
company profile in a separate file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any
content provided for inclusion on the BuyBoard website. The Cooperative reserves the right to exclude or remove any
content in its sole discretion, with or without prior notice, including but not limited to any content deemed by the
Cooperative to be inappropriate, irrelevant to the Contract, inaccurate, or misleading.)
IRS Form W-9 Request for Taxpayer Identification Number and Bound Tree Medical, LLC W-9 2023.pdf
Certification
REQUIRED -In PDF format, upload W-9 form. (Please DO NOT password protect uploaded files.)
Page 3 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 9 of 140
Response Attachments
BuyBoard Item List.pdf
Detailed Item list with discount and pricing.
Bid Attributes
1 1 Federal Identification Number
Federal Identification Number
131-1739487
2 1 HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification
HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification
3 No Israel Boycott Certification
A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly
or partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees
for goods or services unless the contract contains a written verification from the company that it: (1) does not
boycott Israel; and (2) will not boycott Israel during the term of the contract. (TEX. GOV'T CODE Ch. 2270).
Accordingly, this certification form is included to the extent required by law.
"Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that
is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a
person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for
ordinary business purposes. TEX. GOV'T CODE §808.001(1).
By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor
does not boycott Israel and will not boycott Israel during the term of any contract awarded under this Proposal
Invitation, that this certification is true, complete and accurate, and that I am authorized by my company to make this
certification.
Yes
4 No Excluded Nation or Foreign Terrorist Organization Certification
Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a
contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization
— specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas
Government Code §§806.051, 807.051, or 2252.153. (A company that the U.S. Government affirmatively declares
to be excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to
a foreign terrorist organization is not subject to the contract prohibition.)
By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas
Comptroller's list identified above; that this certification is true, complete and accurate; and that I am authorized by
my company to make this certification.
Yes 1
5 MWBE/HUB Status Certification
A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women
Business Enterprise or "MWBE" and all referred to in this form as a "HUB") is encouraged to indicate its HUB
certification status when responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications
for awarded Vendors that properly indicate and document their HUB certification on this form.
certify that my company has been certified as a MWBE/HUB in the following categories: (Please check an that
apply)
Page 4 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 10 of 140
6 Minority Owned Business
Minority Owned Business
❑ Minority Owned Business (Yes)
7 Women Owned Business
Women Owned Business
❑ Women Owned Business (Yes)
8 Service -Disabled Veteran Owned Business
Service -Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a service -connected
disability as defined by 38 U.S.C. § 101(16), and who has a disability rating of 20% or more as determined by the U.
S. Department of Veterans Affairs or Department of Defense)
❑ Service -Disabled Veteran Owned Business (Yes)
9 Certification Number
Certification Number
No response
1 Name of Certifying Agency
U Certifying Agency
No response
1 Non-MWBE/HUB
1 My company has NOT been certified as a MWBE/HUB
0 Non -HUB (Yes)
L12Vendor General Contact Information
Proposal/Contract General Contact Information
1 Vendor Proposal/Contract Contact Name
3 Vendor Proposal/Contract Contact Name
Christopher Fyffe
1 Vendor Proposal/Contract Contact E-mail Address
4 Vendor Proposal/Contract Contact E-mail Address
Submitbids@Boundtree.com
1 Vendor Proposal/Contract Mailing Address
5 Vendor Proposal/Contract Mailing Address
15000 Tuttle Crossing Blvd.
1 Vendor Proposal/Contact Mailing Address - City
6 Vendor Proposal/Contact Mailing Address - City
Dublin
1 Vendor Proposal/Contact Mailing Address - State
7 Vendor Proposal/Contact Mailing Address - State (Abbreviate State Name)
IOH
Page 5 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 11 of 140
1 Vendor Proposal/Contact Mailing Address - Zip Code
8 Vendor Proposal/Contact Mailing Address - Zip Code
143016
1 Vendor Proposal/Contact Phone Number
9 Vendor Proposal/Contact Phone Number (xxx-xxx-=oo
1614-760-5374
2 Vendor Proposal/Contact Extension Number
U Vendor Proposal/Contact Extension Number
1 800-533-0523 X 5374
2 Company Website
1 Company Website (www.xxxxx.com)
l www.boundtree.com
2 Purchase Orders Contact Information
2 All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
• I will use the internet to receive Purchase Orders at the following address
Yes I
2 Purchase Order E-mail Address
3 Purchase Order E-mail Address
Submitbids@Boundtree.com
2 Purchase Order Contact Name
4 Purchase Order Contact Name
Customer Service
2 Purchase Order Contact Phone Number
5 Purchase Order Contact Phone Number (xxx-xxx-)o=)
1 800-533-0523
2 Purchase Order Contact Extension Number
6 Purchase Order Contact Extension Number
No response
2 Alternate Purchase Order E-mail Address
7 Alternate Purchase Order E-mail Address
ordersoh@boundtree.com
Page 6 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 12 of 140
2 Alternate Purchase Order Contact Name
8 Alternate Purchase Order Contact Name
Customer Service
2 Alternate Purchase Order Contact Phone Number
9 Alternate Purchase Order Contact Phone Number (xxx-xxx-xxxx)
1 800-533-0523
3 Alternate Purchase Order Contact Extension Number
0 Alternate Purchase Order Contact Extension Number
No response
3
1
Purchase Orders Contact Information
All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
• Purchase Orders may be received by the Designated Dealer(s) identified on my company's Dealer
Designation form as provided to the Cooperative administrator. I understand that my company shall remain
responsible for the Contract and the performance of all Designated Dealers under and in accordance with
the Contract.
Yes I
3 I Request for Quotes (RFQ)
2 Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs:
3 Request for Quote (RFQ) E-mail Address
3 Request for Quote (RFQ) E-mail Address
submitbids@Boundtree.com
3 Request for Quote (RFQ) Contact Name
4 Request for Quote (RFQ) Contact Name
SubmitBids
3 Request for Quote (RFQ) Contact Phone Number
5 Request for Quote (RFQ) Contact Phone Number (xxx-xxx-=(c)
1 800-533-0523
3 Request for Quote (RFQ) Contact Extension Number
6 Request for Quote (RFQ) Contact Extension Number
No response
3 Alternate Request for Quote (RFQ) E-mail Address
7 Alternate Request for Quote (RFQ) E-mail Address
ordersoh@boundtree.com
Page 7 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 13 of 140
3 Alternate Request for Quote (RFQ) Contact Name
8 Alternate Request for Quote (RFQ) Contact Name
No response
3 Alternate Request for Quote (RFQ) Contact Phone Number
9 Alternate Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx)
No response
4 Alternate Request for Quote (RFQ) Contact Extension Number
U Alternate Request for Quote (RFQ) Contact Extension Number
No response
4 Invoices
Your company will be billed monthly for the service fee due under a Contract awarded under this Proposal
Invitation. All invoices are available on the BuyBoard website and e-mail notifications will be sent when
they are ready to be retrieved.
4 Invoices
2 Please choose only one (11 of the following options for receipt of invoices and provide the requested
information:
(a) Service fee invoices and related communications should be provided directly to my company at:
or
(b) In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following
billing agent:
If Vendor authorizes a billing agent to receive and process service fee invoices, in accordance with the General Terms and Conditions of the Contract,
Vendor specifically acknowledges and agrees that nothing in that designation shall relieve Vendor of its responsibilities and obligations under the
Contract including, but not limited to, payment of all service fees under any Contract awarded Vendor.
Service fee invoices and notices direct to company I
4 Invoice Company Name
3 Invoice Company Name
Bound Tree Medical, LLC
4 Invoice Company Department Name
4 Invoice Company Department Name
Customer Service
4 Invoice Contact Name
5 Invoice Contact Name
Customer Service
4 Invoice Mailing Address
6 Invoice Mailing Address (P.O. Box or Street Address)
15000 Tuttle Crossing Blvd.
Page 8 of 31 pages Vendor: Bound Tree Medical 704-23
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4 Invoice Mailing Address - City
7 Invoice Mailing Address - City
Dublin
4 Invoice Mailing Address - State
8 Invoice Mailing Address - State (Abbreviate State Name)
�OH
4 Invoice Mailing Address - Zip Code
9 Invoice Mailing Address (Zip Code)
143016
5 Invoice Contact Phone Number
U Invoice Contact Phone Number (xxx-xxx-xxxx)
1 800-533-0523
5 Invoice Contact Extension Number
Invoice Contact Extension Number
No response
5 Invoice Contact Fax Number
2 Invoice Contact Fax Number (xxx-xxx-xxxx)
No response
5 Invoice Contact E-mail Address
3 Invoice Contact E-mail
customerservice@boundtree.com
5 Invoice Contact Alternate E-mail Address
4 Invoice Contact Alternate E-mail Address
No response
5 Billing Agent Company Name
5 Billing Agent Company Name
No response
5 Billing Agent Department Name
6 Billing Agent Department Name
No response
5 Billing Agent Contact Name
7 Billing Agent Contact Name
No response
5 Billing Agent Mailing Address
8 Billing Agent Mailing Address (P.O. Box or Street Address)
No response
Page 9 of 31 pages Vendor: Bound Tree Medical 704-23
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5 Billing Agent Mailing Address - City
9 Billing Agent Mailing Address - City
No response
6 Billing Agent Mailing Address - State
U Billing Agent Mailing Address - State (Abbreviate State Name)
No response
6 Billing Agent Mailing Address - Zip Code
Billing Agent Mailing Address - Zip Code
No response
6 Billing Agent Contact Phone Number
2 Billing Agent Contact Phone Number (xxx-xxx-xxxx)
No response
6 Billing Agent Contact Extension Number
3 Billing Agent Contact Extension Number
No response
6 Billing Agent Fax Number
4 Billing Agent Fax Number
No response
6 Billing Agent Contact E-mail Address
5 Billing Agent Contact E-mail Address
No response
6 Billing Agent Alternative E-mail Address
6 Billing Agent Alternative E-mail Address
No response
6 Shipping Via
7 Common Carrier, Company Truck, Prepaid and Add to Invoice, or Other
Common Carrier
6 Payment Terms
8 Note: Vendor payment terms must comply with the BuyBoard General Terms and Conditions and the Texas Prompt
Payment Act (Texas Government Code Ch. 2251).
0% Net 30
6 Vendor's Internal/Assigned Reference/Quote Number
9 Vendor's Internal/Assigned Reference/Quote Number
1 7679/19912
Page 10 of 31 pages Vendor: Bound Tree Medical 704-23
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7 State or Attach Return Policy
U Note: Only return requirements and processes will be deemed part of Vendor's return policy. Any unrelated contract
terms, terms of sale, or other information not specifically related to return requirements and processes included in
Vendor's return policy shall not apply to any awarded Contract unless specifically included as a deviation in the
Deviation and Compliance Form and accepted by the Cooperative.
See bid response for return policy
7 Electronic Payments
1 Are electronic payments acceptable to your company?
Yes
7 Credit Card Payments
2 Are credit card payments acceptable to your company?
Yes I
7
3
Texas Regional Service Designation
Texas Regional Service Designation - Refer to Form in Proposal Invitation
The Cooperative (referred to as "Texas Cooperative" in this form and in the State Service Designation form) offers
vendors the opportunity to service its members throughout the entire State of Texas. If you do not plan to service all
Texas Cooperative members statewide, you must indicate the specific regions you will service on this form. If you
propose to serve different regions for different products or services included in your Proposal, you must complete
and submit a separate Texas Regional Service Designation form for each group of products and clearly indicate the
products or services to which the designation applies. By designating a region or regions, you are certifying that
you are authorized and willing to provide the proposed products and services in those regions. Designating
regions in which you are either unable or unwilling to provide the specified products and services shall be
grounds for either rejection of your Proposal or, if awarded, termination of your Contract. Additionally, if you
do not plan to service Texas Cooperative members (i.e., if you will service only states other than Texas), you must
so indicate on this form.
7 Company Name
4 Company Name
Bound Tree Medical, LLC
7 Texas Regional Service Designation
5 Select only one of the following options. If you select "I will NOT serve all Regions of Texas", you must then
check the individual Regions you wish to serve.
JAII Regions
7 Region 1
6 Region 1 - Edinburg
1 Region 1 (1)
7 Region 2
7 Region 2 - Corpus Christi
❑ Region 2 (2)
7 Region 3
8 Region 3 - Victoria
❑ Region 3 (3)
Page 11 of 31 pages Vendor: Bound Tree Medical 704-23
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7
Region 4
9
Region 4 - Houston
❑ Region 4 (4)
8
Region 5
0
Region 5 - Beaumont
0 Region 5 (5)
8
Region 6
1
Region 6 - Huntsville
0 Region 6 (6)
8
Region 7
2
Region 7 - Kilgore
0 Region 7 (7)
8
Region 8
3
Region 8 - Mount Pleasant
0 Region 8 (8)
8
Region 9
4
Region 9 - Wichita Falls
0 Region 9 (9)
8
Region 10
5
Region 10 - Richardson
0 Region 10 (10)
8
Region 11
6
Region 11 - Fort Worth
0 Region 11 (11)
8
Region 12
7
Region 12 - Waco
0 Region 12 (12)
8
Region 13
8
Region 13 - Austin
0 Region 13 (13)
8
Region 14
9
Region 14 - Abilene
0 Region 14 (14)
9
Region 15
0
Region 15 - San Angelo
0 Region 15 (15)
Page 12 of 31 pages Vendor: Bound Tree Medical 704-23
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9
Region 16
Region 16 - Amarillo
❑ Region 16 (16)
9
Region 17
2
Region 17 - Lubbock
0 Region 17 (17)
9
Region 18
3
Region 18 - Midland
0 Region 18 (18)
9
Region 19
4
Region 19 - El Paso
0 Region 19 (19)
9
Region 20
5
Region 20 - San Antonio
0 Region 20 (20)
9
6
State Service Designation
State Service Designation - Refer to Form in Proposal Invitation.
As set forth in the Proposal Invitation, it is the Cooperative's intent that other governmental entities in the United
States have the opportunity to purchase goods or services awarded under the Contract, subject to applicable state
law, through a piggy -back award or similar agreement through the National Purchasing Cooperative BuyBoard. If
you plan to service the entire United States or only specific states, you must complete this form accordingly. (Note:
If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional Service
Designation form.) In addition to this form, to be considered for a piggy -back award by the National
Purchasing Cooperative, you must have an authorized representative sign the National Purchasing
Cooperative Vendor Award Agreement that follows this form.
If you serve different states for different products or services included in your Proposal, you must complete and
submit a separate State Service Designation form for each group of products and clearly indicate the products or
services to which the designation applies. By designating a state or states, you are certifying that you are
authorized and willing to provide the proposed products and services in those states. Designating states in which
you are either unable or unwilling to provide the specified products and services shall be grounds for either
rejection of your Proposal or, if awarded, termination of your Contract.
9 Company Name
7 Company Name
Bound Tree Medical, LLC
9 State Service Designation
8 Select only one of the following options
the individual States you wish to serve.
Al I States
9 Alabama
9 Alabama
0 Alabama (AL)
If you select "I will NOT serve all States", you must then check
Page 13 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Alaska
0 0 Alaska
0 Alaska (AK)
1 Arizona
Arizona
0 Arizona (AZ)
1 Arkansas
0 Arkansas
❑ Arkansas (AR)
1 California
0 California (Public Contract Code 20118 & 20652)
3
0 California (CA)
1 Colorado
0 Colorado
4
0 Colorado (CO)
1 Connecticut
5 Connecticut
0 Connecticut (CT)
1 Delaware
0 Delaware
0 Delaware (DE)
1 District of Columbia
0 District of Columbia
7
0 District of Columbia (DC)
1 Florida
0 Florida
8
0 Florida (FL)
1 Georgia
9 Georgia
0 Georgia (GA)
1 Hawaii
U Hawaii
0 Hawaii (HI)
1 Idaho
1 Idaho
1
0 Idaho (ID)
Page 14 of 31 pages Vendor: Bound Tree Medical 704-23
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1
Illinois
1 2
Illinois
0 Illinois (IL)
1
Indiana
1
Indiana
❑ Indiana (IN)
1
Iowa
4
Iowa
❑ Iowa (IA)
1
Kansas
1
Kansas
❑ Kansas (KS)
1
Kentucky
1
6
Kentucky
0 Kentucky (KY)
1
Louisiana
1
Louisiana
0 Louisiana (LA)
1
Maine
1
Maine
0 Maine (ME)
1
Maryland
9
Maryland
0 Maryland (MD)
1
Massachusetts
0
6
Massachusetts
❑ Massachusetts (MA)
1
Michigan
2
1
Michigan
1 Michigan (MI)
1
Minnesota
2
Minnesota
❑ Minnesota (MN)
1
Mississippi
2
3
Mississippi
❑ Mississippi (MS)
Page 15 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Missouri
2 Missouri
mot❑ Missouri (MO)
1 Montana
222 Montana
❑ Montana (MT)
1 Nebraska
2 Nebraska
6
21 Nebraska (NE)
1 Nevada
2 Nevada
❑ Nevada (NV)
1 New Hampshire
2 New Hampshire
8
1 New Hampshire (NH)
1 New Jersey
2 9 New Jersey
1 New Jersey (NJ)
1 New Mexico
3 New Mexico
0 New Mexico (NM)
1 New York
3 New York
1
21 New York (NY)
1 North Carolina
3 North Carolina
2
0 North Carolina (NC)
1 North Dakota
3 North Dakota
3
0 North Dakota (ND)
1 Ohio
4 Ohio
0 Ohio (OH)
1 Oklahoma
3 Oklahoma
5
0 Oklahoma (OK)
Page 16 of 31 pages Vendor: Bound Tree Medical 704-23
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1
Oregon
6
Oregon
❑ Oregon (OR)
1
Pennsylvania
3
7
Pennsylvania
❑ Pennsylvania (PA)
1
Rhode Island
3
Rhode Island
❑ Rhode Island (RI)
1
South Carolina
3
9
South Carolina
❑ South Carolina (SC)
1
South Dakota
4
0
South Dakota
1 South Dakota (SD)
1
Tennessee
Tennessee
❑ Tennessee (TN)
1
Texas
4
Texas
❑ Texas (TX)
1
Utah
3
Utah
❑ Utah (UT)
1
Vermont
4
Vermont
❑ Vermont (VT)
1
Virginia
444
Virginia
1 Virginia (VA)
1
Washington
4
6
Washington
❑ Washington (WA)
1
West Virginia
4
7
West Virginia
❑ West Virginia (WV)
Page 17 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Wisconsin
8 Wisconsin
❑ Wisconsin (WI)
44 Wyoming
Wyoming
0 Wyoming (WY)
Bid Lines
Section I: First Aid Eauipment. Products, and SuaDlies
Discount (%) off catalog/pricelist for First Aid Equipment and Supplies. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No Daner cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 18 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 24 of 140
2 Section I: First Aid Eauiament. Products. and SuaDlies
Discount (%) off catalog/pricelist for First Aid Furniture. Catalog/Pricelist MUST be included or proposal will not
be considered.
No Bid
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Page 19 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 25 of 140
3 Section I: Eauipment. Products. and Supplies
Discount (%) off catalog/pricelist for Bleeding Control Stations. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 20 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 26 of 140
4 Section I: Eauiament. Products. and Suoolies
Discount (%) off catalog/pricelist for All Other First Aid, Health, and Nursing Products. Catalog/Pricelist
MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 21 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 27 of 140
5 Section II: Athletic Trainer/Rehabilitation Eauipment. Products. and SuaDlies
Discount (%) off catalog/pricelist for Athletic Trainer/Rehabilitation Equipment and
Supplies. Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 22 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 28 of 140
6 Section II: Athletic Trainer/Rehabilitation Eauir)ment. Products. and Sunalies
Discount (%) off catalog/pricelist for Athletic Trainer/Rehabilitation Furniture. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 23 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 29 of 140
7 Section II: Athletic Trainer/Rehabilitation Eauir)ment. Products. and Sunalies
Discount (%) off catalog/pricelist for All Other Athletic Trainer/Rehabilitation Products. Catalog/Pricelist
MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 24 of 31 pages Vendor: Bound Tree Medical 704-23
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8 Section III: Emeraencv Medical Eauipment. Products. and Supplies
Discount (%) off catalog/pricelist for Emergency Medical Equipment and Supplies. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 25 of 31 pages Vendor: Bound Tree Medical 704-23
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9 Section III: Emeraencv Medical Eauioment. Products. and SuDolies
Discount (%) off catalog/pricelist for All Other Emergency Medical Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 26 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Section IV: Pharmaceuticals and Vaccines
0
Discount (%) off catalog/pricelist for Pharmaceuticals and Vaccines. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 27 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Section IV: Pharmaceuticals and Vaccines
1
Discount (%) off catalog/pricelist for Intra-Venous Pharmaceutical Supplies. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 28 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Section IV: Pharmaceuticals and Vaccines
2
Discount (%) off catalog/pricelist for Drug Testing Kits and Supplies. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 29 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Section V: Audioloav Eauipment and Other Related Items
3 --
Discount (%) off catalog/pricelist for Audiology Equipment, Hearing Aids, and Other Related
Items. Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 30 of 31 pages Vendor: Bound Tree Medical 704-23
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1 Section VI: Drua/Diaanostic/Laboratory Testina Services
4 - - -
Discount (%) off catalog/pricelist for Drug and Alcohol Diagnostic Testing Services (onsite and offsite
including
laboratory services). Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Supplies Only
1 Section II: Installation and Reaair Service
5
Hourly Labor Rate for Installation/Repair Service of First Aid, Athletic Trainer/Rehabilitation, and
Emergency Medical Equipment and Products - Not to Exceed hourly labor rate for Installation/Repair
Service of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate No Bid
1 Section II: Installation and Reaair Service
6
Hourly Labor Rate for Installation/Repair Service of Audiology Equipment and Products - Not to Exceed
hourly labor rate for Installation/Repair Service of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate
Response Total: $0.00
Page 31 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 37 of 140
Bound Tree
Your Partner In EMS
Nationwide Distribution
5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.bGundtree.com
For operational efficiency and faster disaster response, Bound Tree operates 5 distribution centers
nationwide plus a dedicated kitting facility. 96% of all our customers can be reached using UPS Ground
within 2 business days.
OFFICES
Bound Tree Medical
5000 Tuttle Crossing Blvd.
Dublin, OH 43016
DISTRIBUTION CENTERS
Grand Prairie, TX
Bound Tree Medical
2911 S. Great Southwest Parkway
Suite 200
Grand Prairie, TX 75052
Elizabethtown, PA
Bound Tree Medical
1605 Zeager Road
Elizabethtown, PA 17022
Visalia, CA
Bound Tree Medical
2243 N. Plaza Drive
Visalia, CA 93291
Flower Mound, TX
Bound Tree Medical
1420 Lakeside Parkway
Suite 105
Flower Mound, TX 75028
Greenwood, IN
Bound Tree Medical
1033 Collins Road, Suite A
Greenwood, IN 46143
Jacksonville, FL
Bound Tree Medical
2619 Ignition Drive, Suite 2
Jacksonville, FL 32218
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 38 of 140
Bound Tree
Your Partner In EMS
Customer Service
5000 Tuttle Crossing Blvd. Dublin, OH 43016
614.760.5000 www.boundtree.com
Bound Tree Medical is focused on providing service to meet the needs of our customers throughout
the United States. We have a deep commitment to help those that help others. The specialized
market that we serve drives us to create the best possible solutions for our customers. We are here to
serve you.
Our nationwide toll -free Customer Service line is 800-533-0523. Bound Tree Medical routes calls by
origin of the zip code of the caller which, results in more customer awareness among those agents
responding to customer calls.
There are a variety of methods to place orders and verify pricing:
1) Internet: Customers have access to real-time pricing and stock availability 24 hours a day, 7 days
a week. www.boundtree.com
2) Email: Orders may be emailed to customer service at customerservice(a-)-boundtree.com.
3) Phone: Our dedicated team of customer service representatives can answer questions or take
your orders from 7:30 AM to 8:00 pm EST.
4) Fax: Our nationwide toll -free fax line is available 24 hours a day at 800-257-5713.
5) Mail: Orders may be mailed to our corporate office. An order form is included in the back of our
catalog for convenience.
The Customer Service Department is comprised of 27 staff members. Customer Service
Representatives respond to inbound calls and make outbound calls to customers to provide
information regarding product availability, shipment and delivery schedule changes. These same
representatives are available to answer questions about shipments or process returns when
necessary.
If an item goes onto a long term backorder, Bound Tree will work to find equivalent substitute items
for the backorder. If it is the customer preference to approve all substituted items, Bound Tree
Customer Service will seek approval prior to shipping sub items.
Bound Tree Medical is proud to offer our customers access to an Emergency Disaster Support line at
800-863-0953, which operates 24 hours a day, 7 days per week. It is staffed by on -call managers,
who are accessible through routing of calls to cell phones. After leaving a message, a return call is
originated within 20 minutes.
Bound Tree Medical allows customers to purchase on open account. The proper account application
must be completed and submitted. Bound Tree Medical will assign an account number to each
application. Each account has one bill ing/payables address but may have several shipping/receiving
addresses.
In addition, the Federal Drug Administration (FDA) requires Bound Tree Medical to retain a Medical
Director (physician) signature, contact information and license photocopy when purchasing legend
items and/or pharmaceuticals.
Customers may purchase by Master Card, VISA, Discover or American Express. Prepaid orders are
also accepted
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 39 of 140
„ Bound Tree
Your Partner In EMS
Return Policy
5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.boundtree.com
Prior to returning a product, please contact Bound Tree's Customer Service Department at 800.533.0523
within 7 days of receiving the product to obtain a return merchandise authorization ("RMA”) number. This will
help us expedite your return and allow us to give you the proper credit. Once you have received your RMA
number please follow the return policy guidelines below.
Subject to the guidelines below, Bound Tree will accept returns and rectify the error at no cost to you if: (i)
you received expired product; or (ii) Bound Tree makes an error in fulfilling or shipping your order. In such
case, you must notify us within 15 days of receiving the product.
Please follow the return policy guidelines below:
Non -returnable Items Include:
1. A product that is "buy to order."
2. A product that is "non -stock."
3. Items listed as "non -returnable."
4. Items that have been marked or engraved.
5. Items returned with broken packaging or not in original packaging.
6. Any sterile product that has been opened or items determined by Bound Tree not to be in resalable
condition.
7. Product that is more than 60 days older than the shipment date.
8. Recertified equipment.
9. Pharmaceutical products.
Return Policy Guidelines:
1. Items returned within 45 days of the shipment date will not be subject to a restocking fee.
2. Items returned 46-60 days from the shipment date may be subject to a restocking fee.
3. Items older than 60 days from the shipment date will not be accepted in our warehouse and will be
returned to the customer at customer's expense.
4. Please write the RMA number clearly on the package label.
5. Send the package freight prepaid. Please reference the RMA to locate the return address.
6. Returns must be received by Bound Tree within 15 days of issuance of RMA number.
7. Items received without an RMA number will not be eligible for credit.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 40 of 140
Bound Tree
Your Partner In EMS
RETURN FOR REPAIRS
5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.boundtree.com
Items returned for repair must be prepared according to the most recent OSHA requirements. Items must be
properly cleaned and verified with a statement on the outside of the package. Proof of purchase must also be
included with all manufacturer warranty repairs. Please contact our Customer Service Department for
additional information.
CLAIMS
All claims for damage occurring in transit must be made upon receipt of goods by customer directly to the
carrier and documented with photos. Please save all boxes and packing material. All shipment errors must
be reported immediately upon receipt to Bound Tree Customer Service.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 41 of 140
kj,. Bound Tree
Your Partner In EMS 5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.boundtree.com
Online Ordering Capabilities
a. Bound Tree Medical provides a user-friendly online ordering system with advanced features that
restrict user access to predefined products that can be approved for purchase using a predefined
purchasing path with maximum or minimum users as defined by the contracted customer.
b. The advanced user platform of BoundTree.com allows customers to self-administer (add/delete)
their specific product offering based on the entire Bound Tree Medical online catalog.
c. Users on BoundTree.com can gather information and prepare self-administered reports based on
up to two years of historical data.
• Trends can be tracked by running reports that can include all shipping locations, or that
can be tailored to a specific shipping address.
• A purchase summary report can be self -generated to view total products purchased over a
selected period of time.
• The purchase summary report can be sorted in ascending order by total sales per item.
• Purchase summary reports and items per month reports can be self -exported in
spreadsheet format for additional evaluation.
• The purchase summary report provides item usage totals based on monthly, quarterly and
yearly expenditures.
• Reports can be self -exported in spreadsheet format.
d. Product name, short description and detailed descriptions are maintained for items on
BoundTree.com. Product photography is uploaded to the website based on manufacturer
availability. Custom photography is also available to supplement manufacturer -supplied items.
e. A "sold by" column is available on product detail pages to clearly describe available units of
measure.
f. Purchase requisition and order processing paths are predefined and self-administered by an
online administrator. User roles include "order submitters" and "order approvers". Multiple -levels
of approvers can be established with the option to auto -forward orders awaiting approval with no
activity.
g. Unit and total price for each order are displayed in the shopping cart checkout process.
h. A web administrator can setup and self-administer user IDs which trigger an' e-mail to the user for
password setup. Self-administered password reset tools are available to users.
The system does permit an administrator to specify maximum quantities that can be ordered for a
given item on a single order. Quotas provide a way for an administrator to self-administer total
purchases. To maintain maximum item thresholds, order approvers can monitor and adjust each
item on purchase requests throughout the approving and purchasing process.
The purchase requisition process provides date and time stamps for all purchase requisition
activities.
k. Invoice history is posted on BoundTree.com for user access.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 42 of 140
7 u
il
i 1 1 1
April 17, 2023
Sent Via Email: Submitbids@Boundtree.com
EXHIBIT B
Christopher Fyffe
Bound Tree Medical (Bound Tree Medical LLC)
5000 Tuttle Crossing Blvd.
Dublin, OH 43016
Welcome to BuyBoard!
P.O. Box 400, Austin, Texas 78767
800.695.2919 • info@buyboard.com • buyboard.com
Re: Notice of The Local Government Purchasing Cooperative ContractAward; Proposal Invitation No. 704-
23, First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company
a BuyBoard@ contract based on the above -referenced Proposal Invitation. The contract is effective for an
initial one-year term of June 1, 2023, through May 31, 2024, and may be subject to two possible one-year
renewals. Please refer to the Proposal Invitation for the contract documents, including the General Terms
and Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 704-23 at:
www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract
award, and only those awarded items may be sold through the BuyBoard contract. All sales must comply
with the contract terms and must be at or below the awarded pricing as set forth in the General Terms and
Conditions.
The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded
that, in accordance with the General Terms and Conditions, all purchase orders must be
processed through the BuyBoard. Except as expressly authorized in writing by the Cooperative's
administrator, you are not authorized to process a purchase order received directly from a Cooperative
member that has not been processed through the BuyBoard or provided to the Cooperative. If you receive
a purchase order directly from a Cooperative member that you have reason to believe has not been received
by the Cooperative or processed through the BuyBoard, you must promptly forward a copy of the purchase
order by email to info@buyboard.com.
A list of Cooperative members is available on the buyboard.com website. The BuyBoard vendor relations
staff will be contacting you to assist with the resources available and to provide any support you may need
as an awarded BuyBoard vendor.
On behalf of the Cooperative, we appreciate your interest in the Cooperative and we are looking forward
to your participation in the program. If you have any questions, feel free contact me at 800-695-2919.
Sincerely,
Ava Benford, Cooperative Procurement Manager
Texas Association of School Boards, Inc.,
Administrator for The Local Government Purchasing Cooperative
v.02.01.2021
Endorsed by A TASAV ME
4
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 43 of 140
Board®
National Purchasing Cooperative
April 17, 2023
Sent Via Email: Submitbids@Boundtree.com
Christopher Fyffe
Bound Tree Medical (Bound Tree Medical LLC)
5000 Tuttle Crossing Blvd.
Dublin, OH 43016
Welcome to BuyBoard!
Re: Notice of National Purchasing Cooperative Award; Proposal Invitation No. 704-23, First Aid, Emergency Medical, and
Athletic Trainer Supplies and Equipment
Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a BuyBoard@
contract based on the above -referenced Proposal Invitation. The contract is effective for an initial one-year term of June 1,
2023, through May 31, 2024, and may be subject to two possible one-year renewals. Please refer to the Proposal Invitation
for the contract documents, including the National Purchasing Cooperative Vendor Award Agreement and General Terms and
Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 704-23 at
www.buvboard.com/vendor. Only items marked as awarded to your company are included in this contract award, and only
those awarded items may be sold through the BuyBoard contract. All sales must comply with the contract terms and must
be at or below the awarded pricing as set forth in the General Terms and Conditions.
The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded that, in
accordance with the General Terms and Conditions, all purchase orders from National Cooperative members
must be processed through the BuyBoard. Except as expressly authorized in writing by the Cooperative's administrator,
you are not authorized to process a purchase order received directly from a National Cooperative member that has not been
processed through the BuyBoard or provided to the Cooperative. If you receive a purchase order directly from a National
Cooperative member that you have reason to believe has not been received by the National Cooperative or processed through
the BuyBoard, you must promptly forward a copy of the purchase order by e-mail to info@buyboard.com
A list of National Cooperative members is available on the buyboard.com website. The BuyBoard vendor relations staff will
be contacting you to assist with resources available and provide any support you may need as an awarded BuyBoard vendor.
On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any questions,
feel free to contact me at 800-695-2919.
Sincerely,
.41-Pi`�
Ava Benford, Cooperative Procurement Manager
Texas Association of School Boards, Inc.,
Procurement Administrator for the National Purchasing Cooperative
v.02.01.2021
Texas 78767-0400
119 • buyboard.com
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23
Page 44 of 140
1�
Boar d
PURCHASWO COOPERATIVE
12007 Research Boulevard . Austin, Texas 78759-2439 . PH: 800-695-2919 . ¢uvboard.com
PROPOSER'S ACCEPTANCE AND AGREEMENT
Proposal Invitation Name: First Aid, Emergency Proposal Due Date/Ooenina Date and Time:
Medical, and Athletic Trainer Supplies and
Equipment January 26, 2023, at 4:00 PM
Proposal Invitation Number: 704-23
Contract Term: June 1, 2023, through May 31,
2024, with two possible one-year renewals.
Location of Proposal ODenina:
Texas Association of School Boards, Inc.
BuyBoard Department
12007 Research Blvd.
Austin, TX 78759
Anticipated Cooperative Board Meetina Date:
April 2023
By s/gnature below, the undersigned acknowledges and agrees that you are author/zed to submit th/s
Proposal, Includ/ng making all acknowledgements, consents, and cert/f/catlons herein, on behalf of Proposer
and, to the best of your knowledge, the Informat/on prov/ded Is true, accurate, and complete.
Bound Tree Medical, LLC
Name of Proposing Company
5000 Tuttle Crossing Blvd.
Street Address
Dublin, OH 43016
City, state, zip
800-533-0523
01 /25/2023
Date
Company Official
Jon' McGrew
Printed Name of Authorized Company Official
Associate Vice President, Pricing
Telephone Number of Authorized Company Official Position or Title of Authorized Company Official
877-311-2437
Fax Number of Authorized Company Official
31-1739487
Federal ID Number
Page 10 of 71
Proposal Forms COMMISVCS v.08,11 2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 45 of 140
Board'
COOMATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buvboard.com
PROPOSAL FORMS PART 1: COMPLIANCE FORMS
INSTRUCTIONS:
Proposer must review and complete all forms in this Proposal Forms Part 1:
■ Proposal Acknowledgements
■ Felony Conviction Disclosure
■ Resident/ Nonresident Certification
Debarment Certification
■ Vendor Employment Certification
■ No Boycott Verification
■ No Excluded Nation or Foreign Terrorist Organization Certification
■ Historically Underutilized Business Certification
■ Acknowledgement of BuyBoard Technical Requirements
■ Construction -Related Goods and Services Affirmation
■ Deviation and Compliance
■ Vendor Consent for Name Brand Use
■ Confidential/Proprietary Information
■ EDGAR Vendor Certification
■ Compliance Forms Signature Page
An authorized representative of Proposer must initial in the bottom rioht corner of each oaae where indicated
and complete and sign the Compliance Forms Signature Page. Proposer's failure to fully complete, initial, and
sign forms as required may result in your Proposal being rejected as non -responsive.
PROPOSAL ACKNOWLEDGEMENTS
The proposing company ("you" or"your'? hereby acknowledges and agrees as follows:
1. You have carefully examined and understand all information and documentation associated with this Proposal Invitation,
Including the Instructions to Proposers, General Information, General Terms and Conditions, attachments/forms,
appendices, item specifications, and line Items (collectively "Requirements');
2. By your response ("Proposal's to this Proposal Invitation, you propose to supply the products or services submitted at
the pricing quoted in your Proposal and in strict compliance with the Requirements, unless specific deviations or
exceptions are noted In the Proposal;
3. By your Proposal, you acknowledge and certify all items set forth in the General Terms and Conditions, Section B.12
(Certifications), including all non -collusion certifications and certifications regarding legal, ethical, and other matters set
forth therein.
4. Any and all deviations and exceptions to the Requirements have been noted in your Proposal on the required form and
no others will be claimed;
Initial:,
Page 11 of 71
Proposal Forms COMMISKS v.08.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 46 of 140
Vgoard-
PuRmsinacoopamvE
12007 Research Boulevard • Austin, Texas 78759-2439 . PH: 800-695-2919 . buyWard.com
5. If the Cooperative accepts any part of your Proposal and awards you a Contract, you will furnish all awarded products or
services at the pricing quoted and in strict compliance with the Requirements (unless specific deviations or exceptions
are noted on the required form and accepted by the Cooperative), including without limitation the Requirements related
to:
a. conducting business with Cooperative members, including offering pricing to members that is the best you offer
compared to similarly situated customers in similar circumstances;
b. payment of a service fee in the amount specified and as provided for in this Proposal Invitation;
c. the possible award of a piggy -back contract by the National Purchasing Cooperative or nonprofit entity, in which
event you will offer the awarded products and services in accordance with the Requirements; and
d. submitting price sheets or catalogs In the proper format as required by the Cooperative as a prerequisite to activation
of your Contract;
6. You have clearly identified on the Included form any information in your Proposal that you believe to be confidential or
proprietary or that you do not consider to be public information subject to public disclosure under the Texas Public
Information Act or similar public information law;
7. The Individual submitting this Proposal is duty authorized to enter into the contractual relationship represented by this
Proposal Invitation on your behalf and bind you to the Requirements, and such individual (and any Individual signing a
form or Proposal document) is authorized and has the requisite knowledge to provide the information and make the
representations and certifications required In the Requirements;
8. You have carefully reviewed your Proposal, and certify that all information provided is true, complete, and accurate to
the best of your knowledge, and you authorize the Cooperative to take such action as it deems appropriate to verify such
Information; and
9. Any misstatement, falsification, or omission in your Proposal, whenever or however discovered, will be grounds for
disqualifying you from consideration for a contract award under this Proposal Invitation, termination of a contract award,
or any other remedy or action provided for in the General Terms and Conditions or by law.
FELONY CONVICTION DISCLOSURE
Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of Contractor)
states: "A person or business entity that enters Into a contract with a school district must give advance notice to the district
if the person or an owner or operator has been convicted of a felony. The notice must include a general description of the
conduct resulting in the conviction of a felony."
Section 44.034 further states in Subsection (b): "A school district may terminate a contract with a person or business
entity If the district determines that the person or business entity failed to give notice as required by Subsection (a) or
misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for
services performed before the termination of the contract."
Please check M one of the followino:
❑ My company Is a publicly -held corporation. (Advance notice requirement does not apply to publidy-held corporation.)
X My company is not owned or operated by anyone who has been convicted of a felony.
❑ My company is owned/operated by the following individual(s) who has/have been convicted of a felony:
Name of Felon(s): n/a
Details of Conviction(s): n/a
Initial:
Page 12 of 71
Proposal Forms COMM/SVCS v.08.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 47 of 140
FRegrg,
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buvboard.com
RESIDENT/NONRESIDENT CERTIFICATION
Chapter 2252, Subchapter A, of the Texas Government Code establishes certain requirements applicable to proposers who
are not Texas residents. Under the statute, a "resident" proposer Is a person whose principal place of business is in Texas,
Including a contractor whose ultimate parent company or majority owner has its principal place of business in Texas. A
"nonresident" proposer is a person who Is not a Texas resident. Please indicate the status of your company as a "resident'
proposer or a "nonresident" proposer under these definitions.
Please check fV) one of the followina:
❑ I certify that my company is a Resident Proposer.
■❑ I certify that my company is a Nonresident Proposer.
If your company Is a Nonresident Proposer, you must provide the following Information for your resident state (the state In
which your company's principal place of business Is located):
Bound Tree Medical, LLC
Company Name
Dublin
city
5000 Tuttle Crossing Blvd.
Address
OH 43016
State Zip Code
A. Does your resident state require a proposer whose principal place of business is In Texas to under -price proposers
whose resident state Is the same as yours by a prescribed amount or percentage to receive a comparable contract?
❑ Yes El No
B. What is the prescribed amount or percentage? $ n/a or n'a %
DEBARMENT CERTIFICATION
By signature on the Compliance Forms Signature Page, I certify that neither my company nor an owner or principal of my
company has been debarred, suspended or otherwise made ineligible for participation In Federal Assistance programs under
Executive Order 12549, "Debarment and Suspension," as described in the Federal Register and Rules and Regulations.
Neither my company nor an owner or principal of my company is currently listed on the government -wide exclusions in SAM,
debarred, suspended, or otherwise excluded by agencies or declared Ineligible under any statutory or regulatory authority.
My company agrees to immediately notify the Cooperative and all Cooperative members with pending purchases or seeking
to purchase from my company If my company or an owner or principal is later listed on the government -wide exclusions in
SAM, or Is debarred, suspended, or otherwise excluded by agencies or declared Ineligible under any statutory or regulatory
authority.
VENDOR EMPLOYMENT CERTIFICATION
Section 44.031(b) of the Texas Education Code establishes certain criteria that a school district must consider when
determining to whom to award a contract. Among the criteria for certain contracts Is whether the vendor or the vendor's
ultimate parent or majority owner (1) has Its principal place of business in Texas; or (II) employs at least 500 people in Texas.
If neither your company nor the ultimate parent company or majority owner has its prncpal place of business In Texas, does
your company, ultimate parent company, or majority owner employ at least 500 people in Texas?
Please check (,/) one of the followina:
❑ Yes [] No
Initiial: 1 ` L
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City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 48 of 140
DBoard
PURCNASlNO CODPERATIVE
12007 Research Boulevard • Austln, Texas 78759-2439 • PH: 800-695-2919 ' "vboardcaln
NO BOYCOTT VERIFICATION
A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly or
partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees for goods
or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel and will
not boycott Israel during the term of the contract (TEx. Gov`T CODE Ch. 2271), (2) does not boycott energy companies and
will not boycott energy companies during the term of the contract (TEx. Gov`r CODE Ch. 2274 effective September 1, 2021),
and (3) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade
association and will not discriminate during the term of the contract against a firearm entity or firearm trade association (TEX.
Gov`r CODE Ch. 2274 effective September 1, 2021). Accordingly, this certification form Is included to the extent required by
law.
"Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is
intended to penalize, Inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity
doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business
purposes. TEx. Gov'TCODE §808.001(1).
"Boycott energy company" means, without an ordinary business purpose, refusing to deal with, terminating business activities
with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations with
a company because the company: (A) engages in the exploration, production, utilization, transportation, sale, or
manufacturing of fossil fuel -based energy and does not commit or pledge to meet environmental standards beyond applicable
federal and state law; or (B) does business with a company described by Paragraph (A). TEx. Gov`T CODE §809.001(1)
(effective September 1, 2021).
"Discriminate against a firearm entity or firearm trade association" means, (A) with respect to the entity or association, to:
(i) refuse to engage In the trade of any goods or services with the entity or association based solely on its status as a firearm
entity or firearm trade association; (II) refrain from continuing an existing business relationship with the entity or association
based solely on its status as a firearm entity or firearm trade association; or (III) terminate an existing business relationship
with the entity or association based solely on its status as a firearm entity or firearm trade association; and (B) does not
include: (i) the established policies of a merchant, retail seller, or platform that restrict or prohibit the listing or selling of
ammunition, firearms, or firearm accessories; and (ii) a company's refusal to engage in the trade of any goods or services,
decision to refrain from continuing an existing business relationship, or decision to terminate an existing business relationship:
(aa) to comply with federal, state, or local law, policy, or regulations or a directive by a regulatory agency; or (bb) for any
traditional business reason that is specific to the customer or potential customer and not based solely on an entity's or
association's status as a firearm entity or firearm trade association. TEx. GOv'T CODE §2274.001(3) (effective September 1,
2021).
By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor does not
boycott Israel, boycott energy companies, or discriminate against a firearm entity or firearm trade association and will not
do so during the term of any contract awarded under this Proposal Invitation, that this certification is true, complete and
accurate, and that I am authorized by my company to make this certification.
Initial: il)v(
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City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 49 of 140
Board'
PUACHASJNG COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 ' PH: 800-695-2919 • buvhoard.rom
NO EXCLUDED NATION OR FOREIGN TERRORIST ORGANIZATION CERTIFICATION
Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a contract with
a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization — specifically, any
company identified on a list prepared and maintained by the Texas Comptroller under Texas Government Code §§806.051,
807.051, or 2252.153. (A company that the U.S. Government affirmatively declares to be excluded from its federal sanctions
regime relating to Sudan, Iran, or any federal sanctions regime relating to a foreign terrorist organization Is not subject to
the contract prohibition.)
By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas Comptroller's list
identified above; that this certification is true, complete and accurate; and that I am authorized by my company to make this
certification.
HISTORICALLY UNDERUTILIZED BUSINESS CERTIFICATION
A Proposer that has been certified as a Historically Underutilized Business (also known as a M[nority/Women Business
Enterprise or "MWBE" and all referred to in this form as a "HUB' is encouraged to indicate its HUB certification status when
responding to this Proposal Invitation. The BuyBoard webslte will indicate HUB certifications for awarded Vendors that
properly indicate and document their HUB certification on this form. Please check (N/)_all that anoly:
❑ I certify that my company has been certified as a HUB In the following categories:
❑ Minority Owned Business ❑ Women Owned Business
❑ Service -Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a
service -connected disability as defined by 38 U.S.C. § 101(15), and who has a disability rating
of 20% or more as determined by the U. S. Department of Veterans Affairs or Department of
Defense)
Certification Number:
Name of Certifying Agency:
El My company has NOT been certified as a HUB.
ACKNOWLEDGEMENT OF BUYBOARD TECHNICAL REOUIREMENTS
Vendor shall review the BuyBoard Technical Requirements included in this Proposal Invitation. By signature on the Compliance
Forms Signature Page, the undersigned affirms that Proposer has obtained a copy of the BuyBoard Technical Requirements,
has read and understands the requirements, and certifies that Vendor is able to meet and will comply with those requirements
except as follows: [List and explain BuyBoard Technical Requirements, if any, to which your company cannot or will Lot
comply.]
Bound Tree Medical, LLC can comply with the technical requirements provided.
Note: In accordance with the General Terms and Conditions of the Contract, to the extent Vendor is awarded a Contract
under this Proposal Invitation but is unable or unwilling to meet the applicable BuyBoard Technical Requirements, the
information available on the BuyBoard for Vendor's awarded products or services may be limited, potentially placing Vendor
at a disadvantage and Impacting the ability of Cooperative members to search, find, review, and purchase Vendor's awarded
products and services on the BuyBoard website. Further, to the extent Vendor has acknowledged ability to meet and comply
with the BuyBoard Technical Requirements, any subsequent failure or refusal by Vendor to promptly provide information
upon request to the Cooperative administrator In accordance with those technical requirements may be deemed an event of
default under the Contract. Initial:
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City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 50 of 140
Board"
�1ASWQra17VE
12007 Research Boulevard I Austin, Texas 78759-2439 • PH: 800-695-2919 • buVbverd_carn
CONSTRUCTION -RELATED GOODS AND SERVICES AFFIRMATION
The Cooperative issued the BuyBoard Procurement and Construction -Related Goods and Services Advisory for Texas Members
(" Advisory'7, which provides information specifically relevant to the procurement of construction -related goods and services
by Texas Cooperative members. The Advisory, available at buvboard.com/Vendor/Resources.asox, provides an overview of
certain legal requirements that are potentially relevant to a Cooperative member's procurement of construction or
construction -related goods and services, including those for projects that may involve or require architecture, engineering or
independent testing services. A copy of the Advisory can also be provided upon request. Because many BuyBoard contracts
Include goods or installation services that might be considered construction -related, Proposer must make this Construction
Related -Goods and Services Affirmation regardless of type of goods or services associated with this Proposal Invitation.
A contract awarded under this Proposal Invitation covers only the specific goods and/or services awarded by the Cooperative.
As explained in the Advisory ("Advisory" j, Texas law prohibits the procurement of architecture or engineering
services through a purchasing cooperative. This Proposal Invitation and any Contract awarded thereunder
does not include such services. Architecture or engineering services must be procured by a Cooperative
member separately, in accordance with the Professional Services Procurement Act (Chapter 2254 of the Texas
Government Code) and other applicable law and local policy.
By signature on the Compliance Forms Signature Page, Proposer affirms that Proposer has obtained a copy of the Advisory,
has read and understands the Advisory, and is authorized by Proposer to make this affirmation. If Proposer sells construction -
related goods or services to a Cooperative member under a Contract awarded under this Proposal Invitation, Proposer will
comply with the Advisory and applicable legal requirements, make a good faith effort to make its Cooperative member
customers or potential Cooperative member customers aware of such requirements, and provide a Cooperative member with
a copy of the Advisory before accepting the memberrs Purchase Order or other agreement for construction -related goods or
services.
Initial: k_)1'<-`
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WPURCHpoard-
ASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • hrvbnxird,{onI
DEVIATION AND COMPLIANCE
If your company intends to deviate from the General Terms and Conditions, Proposal Specifications or other requirements
assodated with this Proposal Invitation, you MUST list all such deviations on this form, and provide complete and detailed
information regarding the deviations on this form or an attachment to this form. Prior to completing this form, Vendor
shall review the General Terms and Conditions section B.4 (Deviations from Item Specifications and General
Terms and Conditions). Please note that, as provided in section B.4, certain provisions of the General Terms
and Conditions are NOT subject to deviation, and certain deviations will be deemed rejected without further
action by the Cooperative. Any attempted deviation, whether directly or indirectly, to provisions identified in
this Proposal Invitation as not subject to deviation shall be deemed rejected by the Cooperative and, unless
otherwise withdrawn by Vendor, may result in Vendor's Proposal being rejected in its entirety.
The Cooperative will consider any deviations in its contract award decision and reserves the right to accept or reject a proposal
based upon any submitted deviation.
In the absence of any deviation identified and described In accordance with the above, your company must fully comply with
the General Terms and Conditions, Proposal Specifications and all other requirements associated with this Proposal Invitation
if awarded a Contract under this Proposal Invitation. A deviation will not be effective unless accepted by the Cooperative.
The Cooperative, by and through the Cooperative administrator, may, in its sole discretion, seek clarification from and/or
communicate with Proposer(s) regarding any submitted deviation, consistent with general procurement principles of fair
competition. The Cooperative reserves the right to accept or reject a Proposal based upon any submitted deviation.
Please check (d) one of the followina:
❑■ NO; Deviauons
❑ YeS; Deviations
List and fully explain any deviations you are submitting:
n/a
Initial• W�
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City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 52 of 140
Bo
FIIRCHASNiOard# CODMA71YE
12007 Research Boulevard • Austin, Texas 78759-2439 1 PH: 800-695-2919 ' buyboard.corn
VENDOR CONSENT FOR NAME BRAND USE
BuyBoard members seeking to make purchases using a Contract awarded under this Proposal Invitation may view information
regarding awarded Vendors, including but not limited to product catalogs, pricelists, pricing, and Proposals, through the
BuyBoard website. To Improve and enhance the experience of BuyBoard members seeking to procure goods and services
under the Contract utilizing the BuyBoard website, any Vendor logo, product Images, and similar brand and trademark
information provided by Vendor for purposes of the Contract ("Vendor Information) may be posted on the BuyBoard website.
You acknowledge that, by submitting your Proposal, unless you specifically opt out below, you consent to use
of your company's Vendor Information on the BuyBoard website if awarded a Contract. You further acknowledge
that whether, where, and when to Include the Vendor Information on the BuyBoard website shall be at the sole discretion of
the BuyBoard Administrator. Vendor retains, however, the right of general quality control over the BuyBoard Administrator's
authorized display of proprietary Vendor Information. Neither the BuyBoard nor its administrator will be responsible for the
use or distribution of Vendor Information by BuyBoard members or any other third party using the BuyBoard website. This
Vendor Consent shall be effective for the full term of the Contract, Including renewals, unless Vendor provides a signed,
written notice revoking consent to contractadmin(abuvboard.com. BuyBoard shall have up to thirty days from the date of
receipt of a termination or revocation of a Vendor Consent to remove Vendor information from the BuyBoard website.
This Vendor Consent is subject to the Terms and Conditions of the Contract, Including, but not limited to, those terms
pertaining to Disclaimer of Warranty and Urnitation of Liability, Indemnification, and Intellectual Property Infringement.
Vendor logo files must be submitted in one of the formats set forth in the BuyBoard Technical Requirements. Proposers are
requested to submit this information with Vendor's Proposal. (This consent shall not authorize use of your company's Vendor
Information by BuyBoard if your company is not awarded a Contract.)
OPT OUT:
If your company wishes to opt out of the Vendor Consent for Name Brand Use, you must check the opt out box below. DO
NOTselect th/s box unless your company Is opt/ng out of th/s Vendor Consent for Name Brand Use.
❑ By checking this box, Vendor hereby declines to provide consent for use of Vendor Information (as defined herein) on
the BuyBoard website. By opting out, Vendor acknowledges and agrees that, if Vendor is awarded a Contract
under this Proposal Invitation, information available on the BuyBoard for Vendor's awarded products or
services may be limited, potentially placing Vendor at a disadvantage and impacting the ability of
Cooperative members to search, find, review, and purchase Vendor's awarded products and services on the
BuyBoard website.
Initial: v
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Board'
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • Ljjard.C�iM
CONFIDENTIAL,/ PROPRIETARY INFORMATION
A. Public Disclosure Laws
All Proposals, forms, documentation, catalogs, pricelists, or other materials submitted by Vendor to the Cooperative in
response to this Proposal Invitation, may be subject to the disclosure requirements of the Texas Public Information Act (Texas
Government Code chapter 552,001, et. seq.) or similar disclosure law. Proposer must clearly identify on this form any
Information in its Proposal (including forms, documentation, or other materials submitted with the Proposal) that Proposer
considers proprietary or confidential. If Proposer fails to properly Identify the information, the Cooperative shall have no
obligation to notify Vendor or seek protection of such information from public disclosure should a member of the public or
other third party request access to the information under the Texas Public Information Act or similar disclosure law. When
required by the Texas Public Information Act or other disclosure law, Proposer may be notified of any third -party request for
information in a Proposal that Proposer has Identified In this form as proprietary or confidential.
Does your Proposal (including forms, documentation, catalogs, pricelists, or other materials submitted with the Proposal)
contain information which Vendor considers proprietary or confidential?
Please check W) one of the followinq:
NO, I certify that none of the information included with this Proposal Is considered confidential or proprietary.
aYES, I certify that this Proposal contains information considered confidential or proprietary and all such information is
specifically Identified on this form.
If you responded "YES", you must clearly identify below the specific Information you consider confidential or proprietary. List
each page number, form number, or other information sufficient to make the information readily Identifiable. The Cooperative
and Cooperative administrator shall not be responsible for a Proposer's failure to clearly identify information considered
confidential or proprietary. Further, by submitting a Proposal, Proposer acknowledges that the Cooperative and Cooperative
administrator will disclose information when required by law, even if such information has been identified herein as
information Vendor considers confidential or proprietary.
Confidential / Proprietary Information:
The attached pricing file with catalog price and discount is to be considered confidential and for Buy Board Member use only, and should not be shared with other bidders.
(Affaah additional sheets if needed,)
Initial:
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PVPoard;
ASWo cooMATIvF
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' buvboard.com
S. Cot)vright Information
Does your Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal)
contain copyright information?
Please check (VI one of the following:
NO, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does not
contain copyright information.
ClYES, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does
contain copyright information.
If you responded "YES", clearly Identify below the specific documents or pages containing copyright information.
Copyright Information: n/a
(Attach additional sheets if needed.)
C. Consent to Release Confidential/Proorietarv/Convrioht Information to BuvBoard Members
BuyBoard members (Cooperative and nonprofit members) seeking to make purchases through the BuyBoard may wish to
view information included in the Proposals of awarded Vendors, If you identified Information on this form as confidential,
proprietary, or subject to copyright, and you are awarded a BuyBoard contract, your acceptance of the BuyBoard contract
award constitutes your consent to the disclosure of such Information to BuyBoard members, including posting of such
information on the secure BuyBoard website for members. Note: Neither the Cooperative nor Cooperative administrator will
be responsible for the use or distribution of Information by BuyBoard members or any other party.
D. Consent to Release Propsosal Tabulation
Notwithstanding anything in this Confidential/Proprietary Information form to the contrary, by submitting a Proposal, Vendor
consents and agrees that, upon Contract award, the Cooperative may publicly release, including posting on the public
BuyBoard website, a copy of the proposal tabulation and award information for the Contract Including Vendor name; proposed
catalog/pricelist name(s); proposed percentage discount(s), hourly labor rate(s), or other specified pricing; and Vendor award
or non -award information.
Initial: k_ �N �
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DVPoard-
PURCHASNO C130KRATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buvboard.com
EDGAR VENDOR CERTIFICATION
(2 CFR Part 200 and Appendix II)
When a Cooperative member seeks to procure goods and services using funds under a federal grant or contract, specific
federal laws, regulations, and requirements may apply in addition to those under state law. This Includes, but Is not limited
to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requirements for
Federal Awards, 2 CFR 200 (sometimes referred to as the "Uniform Guidance" or new "EDGAR'l. All Vendors submitting a
Proposal must complete this EDGAR Certification Form regarding Vendor's willingness and ability to comply with certain
requirements which may be applicable to specific Cooperative member purchases using federal grant funds. Completed
forms will be made available to Cooperative members for their use while considering their purchasing options when using
federal grant funds. Cooperative members may also require Vendors to enter Into ancillary agreements, in addition to the
terms and conditions of the BuyBoard contract, to address the member's specific contractual needs, including contract
requirements for a procurement using federal grants or contracts,
For each of the Items below, Vendor should certify Vendor's agreement and ablllty to comply, where
applicable, by having Vendors authorized representative check the applicable boxes, Initial each page, and
sign the Compliance Forms Signature Page. If you fall to complete any Item In this form, the Cooperative will
consider and may list the Vendor's response on the BuyBoard as "NO,' the Vendor Is unable or unwilling to
comply. A "NO" response to any of the items may, if applicable, impact the ability of a Cooperative member to purchase
from the Vendor using federal funds.
1. Vendor Violation or Breach of Contract Terms:
Contracts for more than the simplified acquisition threshold, which is the inflation adjusted amount determined by the Civilian
Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 USC 1908, must
address administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and
provide for such sanctions and penalties as appropriate.
Provisions regarding Vendor default are included In the BuyBoard General Terms and Conditions, including Section E.18,
Remedies for Default and Termination of Contract. Any Contract award will be subject to such BuyBoard General Terms and
Conditions, as well as any additional terms and conditions in any Purchase Order or Cooperative member andllary contract
agreed upon by Vendor and the Cooperative member which must be consistent with and protect the Cooperative member at
least to the same extent as the BuyBoard Terms and Conditions. The remedies under the Contract are In addition to any
other remedies that may be available under law or in equity. By submitting a Proposal, you agree to these Vendor violation
and breach of contract terms.
A YES, I agree. ❑ NO, I do not agree.
2. Termination for Cause or Convenience:
For any Cooperative member purchase or contract in excess of $10,000 made using federal funds, you agree that the following
term and condition shall apply:
fie Cooperative member may tenninate or cancel any Purchase Order under this Contract at any lime, with or without cause,
by providing seven (7) business days advance written notice to the Vendor. If this Agreement is terminated in accordance
with this Paragraph, the Cooperative member shall only be required to pay Vendor for goods or services delivered to the
Cooperative member prior to the termination and not otherwise returned in accordance with Vendor's return policy. If the
Cooperative member has paid Vendor for goods or services not yet provided as of the date of termination, Vendor shall
Immediately refund such payment(s).
If an altemate provision for termination of a Cooperative member purchase for cause and convenience, including the manner
by which it will be effected and the basis for settlement, Is Included in the Cooperative member's Purchase Order or ancillary
agreement agreed to by the Vendor, the Cooperative member's provision shall control. \
A YES, I agree. ❑ NO, I do not agree. Initial: J
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Board
PURCHASING COOPERATIVE
12007 Research Boulevard - Austin, Texas 78759-2439 • PH: 800-695-2919 - buvboard.com
3. Equal Employment Opportunity:
Except as otherwise provided under 41 CFR Part 60, all Cooperative member purchases or contracts that meet the definition
of 'federally assisted construction contract" in 41 CFR Part 60-1.3 shall be deemed to Include the equal opportunity clause
provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319,
12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246
Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR Part 60, "Office of Federal Contract
Compliance Programs, Equal Employment Opportunity, Department of Labor."
The equal opportunity clause provided under 41 CFR 60-1.4(b) is hereby incorporated by reference. Vendor agrees that such
provision applies to any Cooperative member purchase or contract that meets the definition of "federally assisted construction
contract" in 41 CFR Part 60-1.3 and Vendor agrees that it shall comply with such provision.
11 YES, I agree. ❑ NO, I do not agree.
4. Davis -Bacon Act:
When required by Federal program legislation, Vendor agrees that, for all Cooperative member prime construction
contracts/purchases in excess of $2,000, Vendor shall comply with the Davis -Bacon Act (40 USC 3141-3144, and 3146-3148)
as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to Contracts
Covering Federally Financed and Assisted Construction'. In accordance with the statute, Vendor is required to pay wages to
laborers and mechanics at a rate not less than the prevailing wages specified in a wage determinate made by the Secretary
of Labor. In addition, Vendor shall pay wages not less than once a week.
Current prevailing wage determinations issued by the Department of Labor are available at beta.sam.gov. Vendor agrees
that, for any purchase to which this requirement applies, the award of the purchase to the Vendor Is conditioned upon
Vendor's acceptance of the wage determination.
Vendor further agrees that it shall also comply with the Copeland "Anti -Kickback" Act (40 USC 3145), as supplemented by
Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed
In Whole or in Part by Loans or Grants from the United States'). The Act provides that each contractor or subrecipient must
be prohibited from Inducing, by any means, any person employed In the construction, completion, or repair of public work,
to give up any part of the compensation to which he or she is otherwise entitled.
I YES, I agree. ❑ NO, I do not agree.
S. Contract Work Hours and Safety Standards Act:
Where applicable, for all Cooperative member contracts or purchases in excess of $100,000 that involve the employment of
mechanics or laborers, Vendor agrees to comply with 40 USC 3702 and 3704, as supplemented by Department of Labor
regulations (29 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is required to compute the wages of every mechanic and
laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided
that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in
excess of 40 hours In the work week.
The requirements of 40 USC 3704 are applicable to construction work and provide that no laborer or mechanic must be
required to work In surroundings or under working conditions which are unsanitary, hazardous or dangerous. These
requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or
contracts for transportation or transmission of intelligence.
A YES, I agree. ❑ NO, I do not agree.
Initial•
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Boar�i4
�St�eari��
12007 Research Boulevard * Austin, Texas 78759-2439 • PH: 800-695-2919 • buvt> rd.com
6. Right to Inventions Made Under a Contract or Agreement:
If the Cooperative member's Federal award meets the definition of "funding agreement" under 37 CFR 401.2(a) and the
recipient or subrecipient wishes to enter Into a contract with a small business firm or nonprofit organization regarding the
substitution of parties, assignment or performance or experimental, developmental, or research work under that "funding
agreement," the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions Made
by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,"
and any Implementing regulations issued by the awarding agency.
Vendor agrees to comply with the above requirements when applicable.
11 YES, I agree. ❑ NO, I do not agree.
7. Clean Air Act and Federal Water Pollution Control Act:
Clean Air Act (42 USC 7401-7671q.) and the Federal Water Pollution Control Act (33 USC 1251-1387), as amended — Contracts
and subgrants of amounts in excess of $150,000 must contain a provision that requires the non -Federal award to agree to
comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act (42 USC 7401-7671q.) and
the Federal Water Pollution Control Act, as amended (33 USC 1251-1387). Violations must be reported to the Federal
awarding agency and the Regional Office of the Environmental Protection Agency (EPA).
When required, Vendor agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Clean
Air Act and the Federal Water Pollution Control Act.
11 YES, I agree. ❑ NO, I do not agree.
8. Debarment and Suspension:
Debarment and Suspension (Executive Orders 12549 and 12689) — A contract award (see 2 CFR 180.220) must not be made
to parties listed on the government -wide exclusions in the System for Award Management (SAM), in accordance with the
OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1966 Comp. p. 189) and 12689 (3 CFR
Part 1989 Comp. p. 235), "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended,
or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than
Executive Order 12549.
Vendor certifies that Vendor is not currently listed on the government -wide exclusions in SAM, is not debarred, suspended,
or otherwise excluded by agencies or dedared Ineligible under statutory or regulatory authority other than Executive Order
12549. Vendor further agrees to Immediately notify the Cooperative and all Cooperative members with pending purchases or
seeking to purchase from Vendor if Vendor is later listed on the government -wide exclusions in SAM, or is debarred,
suspended, or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than
Executive Order 12549.
At YES, I agree. ❑ NO, I do not agree.
9. Byrd Anti -Lobbying Amendment:
Byrd Anti -Lobbying Amendment (31 USC 1352) - Vendors that apply or bid for an award exceeding $100,000 must 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 USC 1352. Each tier must 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
non -Federal award. As applicable, Vendor agrees to file all certifications and disdosures required by, and otherwise comply
with, the Byrd Anti -Lobbying Amendment (31 USC 1352).
A YES, I agree. ❑ NO, I do not agree.
Initial_
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Dggoard
ASING COOPERATIVE
12007 Research Boulevard . Austin, Texas 78759-2439 . Phi: 800-695-2919 . buvboard.corn
10. Procurement of Recovered Materials:
For Cooperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste
Disposal Act, as amended by the Resource Conservation and Recovery Act where applicable and provide such Information
and certifications as a Cooperative member may require to confirm estimates and otherwise comply. The requirements of
Section 6002 Include procuring only Items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR
Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory
level of competition, where the purchase price of the Item exceeds $10,000 or the value of the quantity acquired during the
preceding fiscal year exceeded $10,000; procuring solid waste management services In a manner that maximizes energy and
resource recovery, and establishing an affirmative procurement program for procurement of recovered materials identified in
the EPA guidelines.
11 YES, I agree. ❑ NO, I do not agree.
11. Domestic Preferences for Procurements:
Where appropriate and consistent with law, 2 CFR §200.322 contains certain considerations for domestic preferences for
procurements which may be applicable to Cooperative members using federal funds. When required by a Cooperative
member, Vendor agrees to provide such information or certification as may reasonably be requested by the Cooperative
member regarding Vendor's products, Including whether goods, products, or materials are produced in the United States,
8 YES, I agree. ❑ NO, I do not agree.
12. Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment
2 CFR §200.216 prohibits expending federal loan or grant funds to procure or obtain certain telecommunications and video
surveillance services or equipment. To the extent applicable and when required by a Cooperative member, Vendor agrees to
provide such information or certification as may reasonably be requested by the Cooperative member to confirm whether
any telecommunications or video surveillance services or equipment provided by Vendor is covered equipment or covered
services under 2 CFR §200.216,
A YES, I agree. ❑ NO, I do not agree.
13. Profit as a Separate Element of Price:
For purchases using federal funds in excess of the Simplified Acquisition Threshold, a Cooperative member may be required
to negotiate profit as a separate element of the price. See, 2 CFR 200.324(b). When required by a Cooperative member,
Vendor agrees to provide information and negotiate with the Cooperative member regarding profit as a separate element of
the price for a particular purchase. However, Vendor agrees that the total price, including profit, charged by Vendor to the
Cooperative member shall not exceed the awarded pricing, including any applicable discount, under Vendor's Cooperative
Contract.
11 YES, I agree. ❑ NO, I do not agree.
14. General Compliance and Cooperation with Cooperative Members:
In addition to the foregoing specific requirements, Vendor agrees, In accepting any Purchase Order from a Cooperative
member, It shall make a good faith effort to work with Cooperative members to provide such information and to satisfy such
requirements as may apply to a particular Cooperative member purchase or purchases including, but not limited to, applicable
recordkeeping and record retention requirements.
A YES, I agree. ❑ NO, I do not agree.
Initial• •._�I
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Wpoard"
ASING CGOPERAnVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buvboard.com
COMPLIANCE FORMS SIGNATURE PAGE
By initialing pages and by signature below, I certify that I have reviewed the following forms; that the information provided
therein is true, complete, and accurate; and that I am authorized by my company to make all certifications, consents,
acknowledgements, and agreements contained herein:
• Proposal Acknowledgements
■ Felony Conviction Disclosure
■ Debarment Certification
■ Resident/Nonresident Certification
■ Vendor Employment Certification
■ No Boycott Verification
• No Excluded Nation or Foreign Terrorist Organization Certification
• Historically Underutilized Business Certification
• Construction -Related Goods and Services Affirmation
■ Acknowledgement of BuyBoard Technical Requirements
■ Deviation and Compliance
■ Vendor Consent for Name Brand Use
■ Confidential/Proprietary Information
■ EDGAR Vendor Certification
Bound Tree Medical, LLC
Compa y Name
Signa 7e of Authorized Company Official
Jon McGrew - Associate Vice President, Pricing
Printed Name and Tide
01 /25/2023
Date
Page 25 of 71
Proposal forms COMM/SVCS v,08,11,2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 60 of 140
Board
PORCHASIHO COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • L-uvbvard.cum
PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS
INSTRUCTIONS:
Proposer must completely and accurately provide all Information requested in the following Vendor Information Forms or
your Proposal may be rejected as non -responsive:
■ Vendor Business Name
■ Vendor Contact Information
■ Federal and State/Purchasing Cooperative
Experience
■ Governmental References
■ Company Profile
■ Texas Regional Service Designation
■ State Service Designation
■ National Purchasing Cooperative Vendor Award
Agreement (Vendors serving outside Texas only)
■ Local/Authorized Seller Listings
■ Manufacturer Dealer Designation
■ Proposal Invitation Questionnaire
■ Vendor Request to Self -Report BuyBoard
Purchases (optional)
To the extent any information requested is not applicable to your company, you must so indicate on the form.
VENDOR BUSINESS NAME
By submitting a Proposal, Vendor Is seeking to enter into a legal contract with the Cooperative. As such, Vendor must be an
Individual or legal business entity capable of entering Into a binding contract.
Name of Pr000sina Comoanv:
(List Me &gd name of the company seeking to ronbact with the Cooperative. Do Afflist an assumed name, dba, aka, etc here. Such information may
be provided below, if you are submitting a joint proposal with another entity to provide the same proposed goads or services, each submitting entity should
complete a separate vendor information form. Separately operating legal business entities, even if afrfllated enhbes, which propose to provide goods or
services separately must submit their own Proposals.)
Please check fdl one of the followina:
Tvoe of Business: ❑ Individual/Sole Proprietor ❑ Corporation IN Limited Liability Company ❑ Partnership
❑ Other {Specify:
State of Incorporation (if applicable): Ohio
Federal Emalover Identification Number: 31-1739487
(Vendor must include a completed Z& W-9 form with their Proposal)
Name by which Vendor, if awarded. wishes to be identified on the BuvBoard: (Note., lfdifferentthan the Name of Proposing
Company listed above, only valid trade names (dba, aka, etr.) of the Proposing Company may be used and a copy of your Assumed Name Certifrcate(s), if
applicable, must be attached.)
Page 26 of 71
Proposal Forms COMMISVCS vM.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 61 of 140
Form Request for Taxpayer Give Form to the
(Rev. October2018) 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
cD
xo
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
ca
following seven boxes.
certain entities, not individuals; see
a
instructions on page 3):
9
❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
U)
single -member LLC
Exempt payee code (rf any)
`a
❑✓ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► P
2
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)
.0
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
is
code (if any)
vanother
LLC that not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
'£
Is disregarded from the owner should check the appropriate box for the tax classification of Its owner.
m
❑ Other (see instructions) ►
Waak•: ro.ttowm rr,W,t&md wWd• ft U.S.)
a.
5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional)
15000 Tuttle Crossing Blvd
5 City, state, and ZIP code
Dublin, OH 43016
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a I I — m
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 I Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
M31 - 1I7I3 9I4 8 7
JiM 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. 1 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. 1 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 ► �11. _ ► b
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
Date Do- Q( f 0-.�' --)Q a :i,
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X
Form W-9 (Rev. 10-2018)
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 62 of 140
Bo
ruacl�asr�oard' caaMAME
12007 Research Boulevard • Austin, Texas 78759-2439 . PH: 800-695-2919 - bUvboard.com
VENDOR CONTACT INFORMATION
Vendor shall provide the requested Vendor Contact Informatlon In the electronic proposal submisslon system
Including contract, purchase order, RFQ, and Involce contacts (or, Ifsubmltt/ng a hard copy Proposal, timely
request and complete the Vendor Contactlnformatlon form In accordance w/th the Instructlons to Proposers).
FEDERAL AND STATE/ PURCHASING COOPERATIVE EXPERIENCE
The Cooperative strives to provide Cooperative members with the best services and products at the best prices available from
Vendors with the technical resources and ability to serve Cooperative members. Please respond to the following questions.
I. Provide the dollar value of sales to or through purchasing cooperatives at or based on an established catalog or market
price during the previous 12-month period or the last fiscal year: $ $6,290,691 . (The period of the 12-month
period is 01/01/2022 / 12131/2022 ). In the event that a dollar value is not an appropriate measure of the sales, provide
and describe your own measure of the sales of the item(s).
2. By submitting a proposal, you agree that, based on your written discounting policies, the discounts you offer the
Cooperative are equal to or better than the best price you offer other purchasing cooperatives for the same items under
equivalent circumstances.
3. Provide the information requested below for other purchasing cooperatives for which Proposer currently serves, or in
the past has served, as an awarded vendor. Rows should be added to accommodate as many purchasing cooperatives
as required.
1. Federal General Services Administration N N
2. T-PASS (state of Texas)
N N
3. OMNIA Partners
N N
4. Sourcewell (NIPA)
N N
5. E&I Cooperative
N N
6. Houston -Galveston Area Council (HGAC)
7. Choice Partners
8. The Interlocal Purchasing System (TIPS)
9. Other
Y
Medical Supplies
❑ MY COMPANY DOES NOT CURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYPE CONTRACTS.
CURRENT BUYBOARD VENDORS
If you are a current BuyBoard vendor in the same contract category as proposed in this Proposal Invitation, indicate the
discount for your current BuyBoard contract and the proposed discount in this Proposal. Explain any difference between your
current and proposed discounts.
Current Discount (0/6): 28% + Some exclusions Proposed Discount (%): 28% + Some exclusions
Exolanation: Slight variances is the manufacturers excluded exists due to product type and underlying costs.
Page 27 of 71
Proposal Fomts COMM(SVCS v.08.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 63 of 140
Vpoard"
ASIHO COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • burboard,com
GOVERNMENTAL REFERENCES
For your Proposal to be considered, you must supply a minimum of five (5) individual govemmental entity references. The
Cooperative may contact any and all references provided as part of the Proposal evaluation. Provide the Information requested
below, Including the existing pricing/discounts you offer each customer. The Cooperative may determine whether
pricing/discounts are fair and reasonable by comparing pricing/discounts stated in your Proposal with the pricing/discounts
you offer other governmental customers. Attach additional pages if necessary.
Quantity/
Entity Name Contact Phone# Email Address Discount Volume
1 San Francisco Fire Department Andy Zanoff, 415-717-6876 Andy.Zanoff@sfgov.org. Net Priced--$500K Annually
z Fire Department City of New York Douglas Isaacs, 718-999-2790 doug.isaacs@fdny.nyc.gov Net Priced -$500K Annually
3 Priority Ambulance Steve Blackburn, 614-354-4702 sblackburn@priorityambulance.com Net Priced -$211VI Annually
4 City of Columbus Division of Fire Scott Ellis, 614-221-3132 seellis@columbus.gov Net Priced -$1M Annually
5 Baltimore City Fire Department FFPM Lamont M Clark II, 410-396-2718 Lamont.clarkii@baltimorecity.gov Net Priced-$750K Annually
Do you ever modify your written policies or standard ovemmental sales practices as identified in the above chart to give
better discounts (lower pricing) than indicated? YES f] NO K If YES, please explain:
COMPANY PROFILE
Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard website. If your
company Is awarded a Contract under this Proposal Invitation, please provide a brief company description that you would
like to have included with your company profile on the BuyBoard website. Submit your company profile in a separate
file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any content provided for Inclusion on
the BuyBoard website. The Cooperative reserves the right to exclude or remove any content in its sole discretion, with or
without prior notice, Including but not limited to any content deemed by the Cooperative to be inappropriate, irrelevant to
the Contract, inaccurate, or misleading.)
Page 28 of 71
Proposal rams CDMMISVLS v,0&11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 64 of 140
Bound Tree
Your Partner In EMS
www.boundtree.com
5000 Tuttle Crossing Blvd. Dublin, OH 43016
Bound Tree
614.760.5000 www.boundtree.com
Why Choose Bound Tree?
As Your Partner in EMS for over 45 years, we've made it our mission to help you save minutes and lives. We
strive to understand your unique needs and provide you with the right products, services and support to best
meet those needs.
The Right Products
Bound Tree offers a full line of emergency medical supplies, equipment and pharmaceuticals from some of the
industry's leading healthcare manufacturers.
• Curaplex° Products Curaplex° by Bound Tree offers a robust portfolio of everyday products and specialty
solutions at an extraordinary value.
• Kittina Solutions Pre -assembled kits provide a cost-effective, convenient way to prepare for a wide variety
of emergency scenarios.
• Pharmaceuticals Bound Tree offers a full line of EMS pharmaceuticals and accessories, including Class
II and Class IV drugs.
The Right Services
Bound Tree offers valuable services to increase efficiency and accuracy, reduce liability and positively impact
your bottom line. Services such as inventory and asset management, online ordering for controlled substances
and emergency disaster support can save time and reduce overall costs.
• Asset Manaaement Solutions Bound Tree Medical's asset management solutions, UCaplt and Operative
IQ, can help you with the challenges you face today. Both solutions offer unique ways to streamline your
operations making them more efficient and effective.
• Emeraencv Disaster Suaaort A 24-hour resource for agencies that encounter incidents that require
immediate deployment of emergency medical supplies.
The Right Support
Bound Tree is dedicated to providing best -in -class support. This includes a dedicated Account Manager and a
team of highly -knowledgeable Customer Service Representatives as well as additional educational resources
and continuing education through Bound Tree University.
• Nationwide Distribution Six distribution centers are strategically positioned across the nation for
operational efficiency and disaster response.
• Dedicated Account Manaaers Our EMS -experienced Account Managers know state and local
requirements, best practices, industry information and innovative product offerings.
• Bound Tree Universitv The educational hub for EMS that provides free online CEUs and hundreds of
articles, videos, a -Books and more to learn about critical topics in EMS.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 65 of 140
Board"
PURCHASING CDMYRATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 • PH: 800-695-2919 ' buvboard.com
TEXAS REGIONAL SERVICE DESIGNATION
7hls form must be completed In the electronic proposal submisslon system (or if submitt/na a hard cog 1
Proposal, tlrxrely rer nest and rom rye the form In accordance with the Instructlon.s to Provo-vers),
The Cooperative (referred to as "Texas Cooperative" In this form and In the State Service Designation form) offers vendors
the opportunity to service its members throughout the entire State of Texas. In the electronic proposal submission system,
you must indicate If you will service Texas Cooperative members statewide or, if you do not plan to service all Texas
Cooperative members statewide, you must indicate the specific regions you will service. If you propose to serve different
regions for different products or services Included in your Proposal, you must complete and submit a separate Texas Regional
Service Designation form for each group of products and clearly Indicate the products or services to which the designation
applies. (Additional forms can be obtained by contacting bids(a)buvboard.com at least five (5) business days prior to
the Proposal Due Date.). By designating a region or regions, you are certlfying that you are authorized and willing
to provide the proposed products and services In those reglons. Des/gnating regions In which you are elther
unable or unwilling to pro vide the specified products and services shall be grounds for either rejectlon of your
Proposal or, If awarded, terminatlon of your Contract. Additionally, if you do not plan to service Texas Cooperative
members (i.e., if you will service only states other than Texas), you must so indicate on the form In the electronic or000sal
submission system.
Regional Education Service Centers
- I -I-, 14... w-
Reaion and Headauarters
1
Edinburg
2
Corpus Christi
3
Victoria
4
Houston
5
Beaumont
6
Huntsville
d
7
Kilgore
8
Mount Pleasant
9
Wichita Falls
l
10
Richardson
11
Fort Worth
j J
12
13
Waco
Austin
14
Abilene
15
San Angelo
16
Amarillo
17
Lubbock
18
Midland
19
El Paso
20
San Antonio
*Can Support All Regions
Page 29 of 71
Proposal Fanre COMM/SVCS v.08.IL2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 66 of 140
B and
PVRCWING CDDMA77VE
12007 Research Boulevard . Austin, Texas 78759-2439 • PH. 800-695-2919 ' biwboard.com
STATE SERVICE DESIGNATION
This form must be completed In the electronic proposal submission system for. lfsubM1ttJno a hard copy
ProL;osal. t1m ely1 h In accordancewv th thf rn ctLc?ns to Prpposers).
As set forth in the Proposal Invitation, it Is the Cooperative's Intent that other governmental entities in the United States have
the opportunity to purchase goods or services awarded under the Contract, subject to applicable state law, through a piggy-
back award or similar agreement through the National Purchasing Cooperative BuyBoard. If you plan to service the entire
United States or only specific states, you must comDlete the State Service Deslanation information in the electronic DroDosal
submission system. (Note: If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional
Service Designation form.) In addition to this form, to be considered for a piggy -back award by the Natlonal
Purchasing Cooperative, you must have an authorized representative sign the National Purchasing
Cooperative Vendor Award Agreement that follows this page.
If you serve different states for different products or services Included In your Proposal, you must complete and submit a
separate State Service Designation form for each group of products and clearly indicate the products or services to which the
designation applies. {Additional forms can be obtained by contacting bids0buvboard.com at least five (5) business
days Drior to the Proposal Due Date.) By designating a state or states, you are certifying that you are authorized
and willing to provide the proposed products and services In those states. Designating states In which you are
either unable or unwllling to provide the specified products and services shall be grounds for either rejection
of your Proposal or, If awarded, termination of your Contract.
X ■ I will service all states in the United States.
■ I will not service all states in the United States.
Alabama
Alaska
Nebraska
Arizona
Nevada
Arkansas
New Hampshire
California (Public Contract Code 20118 & 20652)
New Jersey
Colorado
New Mexico
Connecticut
New York
Delaware
North Carolina
District of Columbia
North Dakota
Florida
Ohio
Georgia
Oklahoma
Hawaii
Oregon
Idaho
Pennsylvania
Illinois
Rhode Island
Indiana
South Carolina
Iowa
South Dakota
Kansas
Tennessee
Kentucky
Texas
Louisiana
Utah
Maine
Vermont
Maryland
Virginia
Massachusetts
Washington
Michigan
West Virginia
Minnesota
Wisconsin
Mississippi
Wyoming
Missouri
Montana
Proposal Forms COMMINCS v.09.11.2021
Page 30 of 71
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 67 of 140
AMPpard-
COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 , PH: 800-695-2919 • kivboard.com
NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT
In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this Proposal
Invitation may be "piggy -backed" by another governmental entity. The National Purchasing Cooperative Is an
intergovernmental purchasing cooperative formed by certain school districts outside of Texas to serve Its members throughout
the United States. If you agree to be considered for a piggy -back award by the National Purchasing Cooperative, you agree
to the following terms and agree to serve National Purchasing Cooperative members in the states you have indicated on the
State Service Designation form, in your Proposal.
By signing this form, Proposer (referred to in this Agreement as "Vendor") agrees as follows:
1. Vendor acknowledges that if The Local Government Purchasing Cooperative ("Texas Cooperative'? awards Vendor a
contract under this Proposal Invitation ("Underlying Award'?, the National Purchasing Cooperative ("National Cooperative'l
may - but is not required to - "piggy -back" on or re -award all or a portion of that Underlying Award ("Piggy -Back Award).
By signing this National Cooperative Vendor Award Agreement ("Agreement'), Vendor accepts and agrees to be bound by
any such Piggy -Back Award as provided for herein.
2. In the event National Cooperative awards Vendor a Piggy -Back Award, the National Cooperative Administrator ("BuyBoard
Administrator"j will notify Vendor in writing of such Piggy -Back Award, which award shall commence on the effective date
stated in the Notice and end on the expiration date of the Underlying Award, subject to annual renewals as authorized in
writing by the BuyBoard Administrator. Vendor agrees that no further signature or other action is required of Vendor in order
for the Piggy -Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or
changes to this Agreement by Vendor will be binding on National Cooperative, unless such changes are agreed to by its
BuyBoard Administrator in writing.
3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same unit pricing and
same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying
Award. However, nothing in this Agreement prevents Vendor from offering National Cooperative members better (i.e., lower)
competitive pricing and more favorable terms and conditions than those in the Underlying Award.
4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation Form
of this Proposal Invitation. Any changes to the states designated on the State Service Designation Form must be approved
In writing by the BuyBoard Administrator,
5. Vendor agrees to pay National Cooperative the service fee provided for in the Underlying Award based on the amount of
purchases generated from National Cooperative members through the Piggy -Back Award. Vendor shall remit payment to
National Cooperative on such schedule as it specifies (which shall not be more often than monthly). Further, upon request,
Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative members,
vendor invoices, and/or such other documentation regarding those purchase orders as the Cooperative's administrators may
require in their reasonable discretion for purposes of reviewing and verifying purchase activity. Vendor further agrees that
National Cooperative shall have the right, upon reasonable written notice, to review Vendor's records pertaining to purchases
made by National Cooperative members in order to verify the accuracy of service fees.
6. Vendor agrees that the Underlying Award, including its General Terms and Conditions, are adopted by reference to the
fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and responsibilities
that would ordinarily Inure to the Texas Cooperative pursuant to the Underlying Award shall inure to National Cooperative;
and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying Award shall Inure to
Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the only parties to this
Agreement, and that nothing in this Agreement has application to other third parties, including the Texas Cooperative. In the
event of conflict between this Agreement and the terms of the Underlying Award, the terms of this Agreement shall control,
and then only to the extent necessary to recondle the conflict.
Pwposal Forms COMMlSVCS v.08.11.2021
Page 31 of 71
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 68 of 140
DMard'
O COOPERATIVE
12007 Research Boulevard I Austin, Texas 78759-2439 * PH: 800-695-2919 • bUybyard.c4rn
7. This Agreement shall be govemed and construed in accordance with the laws of the State of Rhode Island and venue for
any dispute shall lie in the federal district court of Alexandria, Virginia.
8. Vendor acknowledges and agrees that the award of a Piggy -Back Award is within the sole discretion of National
Cooperative, and that this Agreement does not take effect unless and until National Cooperative awards Vendor a Piggy -Back
Award and the BuyBoard Administrator notifies Vendor in writing of such Piggy -Back Award as provided for herein.
WHEREFORE, by signing below Vendor agrees to the foregoing and warrants that it has the authority to enter into this
Agreement.
Bound Tree Medical, LLC
Name f Vendor
Signa of Authorized Company Official
01 /25/2023
Date
704-23
Proposal Invitation Number
Jon McGrew
Printed Name of Authorized Company Official
Page 32 of 71
Proposal Forms COMMISVCS v.06.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 69 of 140
o rd
PURCHASMO COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buvboard.com
LOCATION/AUTHORIZED SELLER LISTINGS
If you have more than one location/authorized seller that will service a Contract awarded under this Proposal Invitation,
please list each location/authorized seller below. If additional sheets are required, please duplicate this form as necessary.
NOTE: Awarded Vendors shall remain responsible for all aspects of the Contract, including processing of Purchase Orders,
and shall be responsible for the performance of all locations and authorized sellers under and in accordance with the Contract.
If you are a product manufacturer and wish to des/gnate Deslgnated Dealers as defined /n the General Terms
and Condition to receive Cooperat/ve member Purchase Orders on your behalf, you must complete the
Manufacturer Deslgnated Dealer form.
This contract will be serviced by Bound Tree Medical Christopher Fyffe 5000 Tuttle Crossing Blvd
and product will be shipped from closest warehouse Dublin, Ohio 43016
'all Warehouse locations are attached for reference 614-760-5374
677-311-2437
Page 33 of 71 Proposal Forms COMMISVCS v.08.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 70 of 140
Bo
PIlRCHASlNOard" COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 , PH: 800-695-2919 • buMard.com
MANUFACTURER DEALER DESIGNATION
If Vendor is a manufacturer that sells products through a dealer network and wishes to designate a dealer or multiple dealers
("Designated Dealers') to receive Cooperative member Purchase Orders on Vendor's behalf, you must complete this form for
each dealer you wish to designate.
Regardless of any Designated Dealers submitted by Vendor, Vendor specifically agrees and acknowledges that any such
designations are for Vendor's convenience only and shall not, if Vendor is awarded a Contract, relieve Vendor of any
obligations under the Contract, including payment of Cooperative service fees on all Purchase Orders submitted to Vendor or
any Designated Dealer. In accordance with the General Terms and Conditions, an awarded Vendor shall remain responsible
and liable for all of Its obligations under the Contract and the performance of both Vendor and any of Vendor's Designated
Dealers under and In accordance with the Contract and remain subject to all remedies for default thereunder, Including, but
not limited to suspension and termination of Vendor's Contract for nonpayment of service fees.
If awarded, Vendor authorizes the Cooperative, in its sole discretion, to list any Vendor Designated Dealers in the BuyBoard
system and to receive Purchase Orders directly from Cooperative members on behalf of Vendor. To the extent a Vendor with
Designated Dealers receives a Purchase Order directly, it shall be the responsibility of Vendor to appropriately process such
Purchase Order in accordance with the Contract, including but not limited to timely forwarding such Purchase Order to a
Designated Dealer for processing.
The Cooperative reserves the right, in its sole discretion, to refuse addition of, or request removal of, any Designated Dealer,
and Vendor agrees to immediately require such Designated Dealer to cease accepting Purchase Orders or otherwise acting
on Vendor's behalf under the Contract. Further, the Cooperative administrator shall be authorized to remove or suspend any
or all Designated Dealers from the BuyBoard at any time in its sole discretion.
If you wish to designate a dealer to service a contract awarded under this Proposal Invitation, please list the Designated
Dealer below. If you wish to designate multiple dealers, please duplicate this form as necessary.
n/a
Designated Dealer Name
n/a
Designated Dealer Address
n/a
city
n/a
Phone Number
n/a
Email address
Designated Dealer Contact Person
n/a n/a
state Zip
n/a
Fax Number
n/a
Designated Dealer Tax ID Number* (*attach W-9)
Page 34 of 71
Proposal Forms COMWSVCs v 08.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 71 of 140
i B and -
PURCHAM0 CODMA n VE
12007 Research Boulevard ' Austin, Texas 78759-2439 - PM: 800.695-2919 ' buvboard.com
PROPOSAL INVITATION OUESTIONNAIRE
The Cooperative will use your responses to the questions below in evaluating your Proposal and technical and financial
resources to provide the goods and perform the services ("Work') under the BuyBoard contract contemplated by this Proposal
Invitation {" Contract's. Proposers must fully answer each question, numbering your responses to correspond to the
questions/numbers below. Proposers must complete below or attach your responses to this questionnaire and submit in one
document with your Proposal. You must submit the questionnaire and responses with your Proposal or the
Proposal will not be considered.
1. List the number of years Proposer has been in business and former business names (if applicable). Note whether your
company is currently for sale or Involved in any transaction that would significantly alter its business or result In acquisition
by another entity.
Bound Tree Medical originated 45 years ago. We incorporated at Bound Tree Medical, LLC in 2000.
2. Describe the resources Proposer has to manage staff and successfully perform the Work contemplated under this
Contract. State the number and summarize the experience of company personnel who may be utilized for the Work,
including those who will be available to Cooperative members for assistance with project development, technical issues,
and product selection for Work associated with this Contract.
Bound Tree Medical offers dedicated sales, customer service, and pricing teams
to properly serve our customers with questions, order placement, and delivery.
With 6 warehouses country -wide (including Grand Prairie, Texas and Flower
Mound, TX), product isdelivered in a timely manner.
3. Marketina Strategy: For your Proposal to be considered, you must submit the Marketing Strategy you will use if the
Cooperative accepts all or part of your Proposal, (Ex_ _ample: Explain how your company will initially inform Cooperative
members of your BuyBoard Contract, and how you will continue to support the BuyBoard for the duration of the Contract
term.) Attach additional pages if necessary.
If awarded, we intend to send a professionally created PDF "Announcement"
informing our customers of our BuyBoard participation and qualification
as well as our catalog. We will also continue to review customer requests for pricing
against BuyBoard to share the program and savings they are eligible for.
Proposal Farms COMMISVCS v.08.11.2021
Page 35 of 71
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 72 of 140
Bars
PUKKAZI10 CODPERATIVE
12007 Research Boulevard I Austin, Texas 78759.2439 • PH: 800-695-2919 • buvboard.com
4. Describe Proposer's financial capability to perform the Contract. State or describe the firm's financial strength and rating,
bonding opacity, and insurance coverage limits. State whether the firm, or any of the firm's past or present owners,
principal shareholders or stockholders, or officers, have been a debtor party to a bankruptcy, receivership, or insolvency
proceeding in the last 7 years, and identify any such debtor party by name and relationship to or position with your firm.
As a leader in the EMS market, we we have the network and financial capacity
to support BuyBoard and it's members. Our firm and it's owner's have not been the
debtor party to a bankruptcy, receivership, or insolvency. Our Insurance information
is attached for review. Let us know if additional information is needed.
S. Does your company have any outstanding financial judgments and/or is It currently in default on any loan or financing
agreement? If so, provide detailed information on the nature of such items and prospects for resolution.
We have no outstanding financial judgments or loans/financing in default.
6. List all contracts, if any, in the last 10 years on which Proposer has defaulted, failed to complete or deliver the work, or
that have been terminated for any reason. For each such contract, provide the project name, scope, value and date and
the name of the procuring entity. Fully explain the circumstances of the default, failure to complete or deliver the work,
or termination.
7V77
7. List all litigation or other legal proceedings (including arbitration proceedings), if any, in the last 10 years brought against
your firm, or any of the firm's past or present owners, principal shareholders or stockholders, officers, agents or
employees, that relate to or arise from a contract similar to this Contract or the Work contemplated under this Contract.
Provide the style of the lawsuit or proceeding (name of parties and court or tribunal in which filed), nature of the claim,
and resolution or current status.
n/a
Proposal Forms COMMJSVCS v.08,11 2021
Page 36 of 71
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 73 of 140
Board'
PURCH/1SWO COOMATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 600-695-2919 • buvboard.com
REOUIRED FORMS CHECKLIST
(Please check (,/) the following)
0 Reviewed/Completed: Proposer's Acceptance and Agreement
(PROPOSAL FORMS PART 1: COMPLIANCE FORMS
Fx1 Reviewed/ComDleted: Proposal Acknowledgements
n Reviewed/Completed: Felony Conviction Disclosure
0 Reviewed/ComDleted: Resident/Nonresident Certification
El Reviewed/ComDleted: Debarment Certification
0 Reviewed/Completed: Vendor Employment Certification
0 Reviewed/ComDleted: No Boycott Verification
0 Reviewed/ComDleted: No Excluded Nation or Foreign Terrorist Organization Certification
0 Reviewed/ComDleted: Historically Underutilized Business Certification
0 Reviewed/ComDleted: Acknowledgement of BuyBoard Technical Requirements
M Reviewed/ComDleted: Construction -Related Goods and Services Affirmation
0 Reviewed/ComDleted: Deviation and Compliance
0 Reviewed/ComDleted: Vendor Consent for Name Brand Use
0 Reviewed/ComDleted: Confidential/Proprietary Information
0 Reviewed/ComDleted: EDGAR Vendor Certification
Reviewed/ComDleted: Compliance Forms Signature Page
PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS
El Reviewed/ComDleted: Vendor Business Name
0 Reviewed/ComDleted: Vendor Contact Information (complete in electronicproposalsubmission system)
0 Reviewed/ComDleted: Federal and State/Purchasing Cooperative Experience
0 Reviewed/ComDleted: Governmental References
Fx 1 Reviewed/ComDleted: Company Profile
Reviewed/Completed: Texas Regional Service Designation (complete in electonicpmposalsubmission system)
F1 Reviewed/ComDleted: State Service Designation (complete in electronleproposal submission system)
❑ ReviewedX-omD[eted: National Purchasing Cooperative Vendor Award Agreement (vendors serving outside Teams only)
0 Reviewed/Completed: Local/Authorized Seller Listings
n ReviewedlComDleted: Manufacturer Dealer Designation
0 Reviewed/ComDleted: Proposal Invitation questionnaire
❑ Reviewed/ComDleted: Vendor Request to Self -Report BuyBoard Purchases (optional)
0 Reviewed/ComDleted: Proposal Specifications Discount (%) off Catalog/Pticelist and/or other required pricing
information induding Catalogs/Pricelists (or no bid response) must be submitted with the Proposal or the Proposal will not
be considered.
PMPMI Forms COMMl5VC5 v.08.11.2021
Page 39 of 71
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 74 of 140
Dggoard`ASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buvboard.com
PROPOSAL SPECIFICATION SUMMARY
The categories and items specified for this Proposal Invitation are summarized below. For full Proposal
Specifications, you must review and complete the Proposal Specification information in the electronic proposal
submission system in accordance with the Instructions to Proposers (or, if submitting a hard copy Proposal, timely
request and complete the Proposal Specification Form in accordance with the Instructions to Proposers).
PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be
considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format,
with Excel or searchable PDF preferred. No oauer catalogs or manufacturer/vendor websites will be accented.
Section I: First Aid Eauioment. Products, and Suoolies
1. Discount (%} off catalog/pricelist for First Aid Equipment and Supplies.
Z. Discount (%} off catalog/pricelist for First Aid Furniture.
3. Discount (%} off catalog/pricelist for Bleeding Control Stations,
4. Discount (%) off catalog/pricelist for All Other First Aid, Health, and Nursing Products.
Section II: Athletic Trainer/Rehabilitation Equipment, Products, and Sunolies
5. Discount (%) off catalog/pricelist for Athletic Trainer/Rehabilitation Equipment and Supplies.
6. Discount (%) off catalog/pricelist for Athletic Trainer/ Rehabilitation Furniture.
7. Discount (%) off catalog/pricelist for All Other Athletic Trainer/Rehabilitation Products.
Section III: Emergency Medical Eauioment. Products. and Suoolies
8. Discount (%) off catalog/pricelist for Emergency Medical Equipment and Supplies.
9. Discount (%) off catalog/pricelist for All Other Emergency Medical Products.
Section IV: Pharmaceuticals and Vaccines
10. Discount (%) off catalog/pricellst for Pharmaceuticals and Vaccines.
11. Discount (%) off catalog/pricellst for Intra-Venous Pharmaceutical Supplies.
12. Discount (%) off catalog/pdcelist for Drug Testing Kits and Supplies.
Section V: Audiologv Eauioment and Other Related Items
13. Discount (%) off catalog/pricelist for Audiology Equipment, Hearing Aids, and Other Related Items.
Section VI: Drua/Diagnostic/Laboratory Testina Services
14. Discount (%) off catalog/pricelist for Drug and Alcohol Diagnostic Testing Services (onsite and offsite including
laboratory services),
Section VII: Installation and Repair Service
15. Hourly Labor Rate for Installation/ Repair Service of First Aid, Athletic Trainer/Rehabilitation, and
Emergency Medical Equipment and Products - Not to Exceed hourly labor rate for Installation/Repair Service of
Equipment and Products.
16. Hourly Labor Rate for Installation/Repair of Audiology Equipment and Products - Not to Exceed hourly labor
rate for Installadon/Repair Service of Equipment and Products.
Page 38 of 71 Proposal Forms COKIVSKS v.08.11.2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 75 of 140
Bound Tree Medical Information
Contact: Chris Fyffe
Address: 5000 Tuttle Crossing Blvd
Dublin, OH 43016
Phone: (800) 533-0523
Fax: (877) 311-2437
Toll Free: (800) 533-0523
Email: submitbids@boundtree.com
Web Address: www.boundtree.com
By submitting your response, you certify that you are authorized to represent and bind your company.
Christopher Fyffe
Signature
Submitted at 112512023 04:11:04 PM (CT)
Requested Attachments
Christopher. Fyffe@Boundtree.com
Email
Exceptions and/or Detailed Information Related to Discount % and/or Discount - Additional Detail.pdf
Hourly Labor Rate Proposed
In PDF format and if necessary, vendor shall attach detailed information regarding exceptions to pricing and/or
discount percentage and define the services that are proposed to be provided. NOTE: IF DETAILED INFORMATION IS
NOT SUBMITTED, PROPOSAL MAY NOT BE CONSIDERED. (Please DO NOT password protect uploaded files.)
BuyBoard Proposal Invitation No. 704-23 First Aid, Submission BuyBoard Proposal No 704-23_Signed.pdf
Emergency Medical, and Athletic Trainer Supplies and
Equipment
REQUIRED -In PDF format, upload all proposal invitation documents available for download at vendor.buyboard.com
including any additional pages, as necessary. NOTICE: DO NOT complete proposal forms in internet browser. No data
will be stored. Download file to computer and complete proposal forms prior to submitting. (Please DO NOT password
protect uploaded files.)
Catalog/Pricelist
2022-2023 Bound Tree Catalog.pdf
REQUIRED -In Excel or PDF format, upload catalog(s)/pricelist(s) in accordance with proposal invitation instructions.
Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or Proposal will not be considered. No paper
catalogs or manufacturer/vendor websites will be accepted. File size must not exceed 250MB. (Please DO NOT
password protect uploaded files.)
Company Profile
Bound Tree Medical Company Profile.docx
REQUIRED -Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard
website. If your company is awarded a Contract under this Proposal Invitation, please provide a brief company
description that you would like to have included with your company profile on the BuyBoard website. Submit your
company profile in a separate file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any
content provided for inclusion on the BuyBoard website. The Cooperative reserves the right to exclude or remove any
content in its sole discretion, with or without prior notice, including but not limited to any content deemed by the
Cooperative to be inappropriate, irrelevant to the Contract, inaccurate, or misleading.)
IRS Form W-9 Request for Taxpayer Identification Number and Bound Tree Medical, LLC W-9 2023.pdf
Certification
REQUIRED -In PDF format, upload W-9 form. (Please DO NOT password protect uploaded files.)
Page 3 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 76 of 140
Response Attachments
BuyBoard Item List.pdf
Detailed Item list with discount and pricing.
Bid Attributes
1 1 Federal Identification Number
Federal Identification Number
131-1739487
2 1 HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification
HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification
3 No Israel Boycott Certification
A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly
or partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees
for goods or services unless the contract contains a written verification from the company that it: (1) does not
boycott Israel; and (2) will not boycott Israel during the term of the contract. (TEX. GOV'T CODE Ch. 2270).
Accordingly, this certification form is included to the extent required by law.
"Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that
is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a
person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for
ordinary business purposes. TEX. GOV'T CODE §808.001(1).
By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor
does not boycott Israel and will not boycott Israel during the term of any contract awarded under this Proposal
Invitation, that this certification is true, complete and accurate, and that I am authorized by my company to make this
certification.
Yes
4 No Excluded Nation or Foreign Terrorist Organization Certification
Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a
contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization
— specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas
Government Code §§806.051, 807.051, or 2252.153. (A company that the U.S. Government affirmatively declares
to be excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to
a foreign terrorist organization is not subject to the contract prohibition.)
By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas
Comptroller's list identified above; that this certification is true, complete and accurate; and that I am authorized by
my company to make this certification.
Yes 1
5 MWBE/HUB Status Certification
A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women
Business Enterprise or "MWBE" and all referred to in this form as a "HUB") is encouraged to indicate its HUB
certification status when responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications
for awarded Vendors that properly indicate and document their HUB certification on this form.
certify that my company has been certified as a MWBE/HUB in the following categories: (Please check an that
apply)
Page 4 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 77 of 140
6 Minority Owned Business
Minority Owned Business
❑ Minority Owned Business (Yes)
7 Women Owned Business
Women Owned Business
❑ Women Owned Business (Yes)
8 Service -Disabled Veteran Owned Business
Service -Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a service -connected
disability as defined by 38 U.S.C. § 101(16), and who has a disability rating of 20% or more as determined by the U.
S. Department of Veterans Affairs or Department of Defense)
❑ Service -Disabled Veteran Owned Business (Yes)
9 Certification Number
Certification Number
No response
1 Name of Certifying Agency
U Certifying Agency
No response
1 Non-MWBE/HUB
1 My company has NOT been certified as a MWBE/HUB
0 Non -HUB (Yes)
L12Vendor General Contact Information
Proposal/Contract General Contact Information
1 Vendor Proposal/Contract Contact Name
3 Vendor Proposal/Contract Contact Name
Christopher Fyffe
1 Vendor Proposal/Contract Contact E-mail Address
4 Vendor Proposal/Contract Contact E-mail Address
Submitbids@Boundtree.com
1 Vendor Proposal/Contract Mailing Address
5 Vendor Proposal/Contract Mailing Address
15000 Tuttle Crossing Blvd.
1 Vendor Proposal/Contact Mailing Address - City
6 Vendor Proposal/Contact Mailing Address - City
Dublin
1 Vendor Proposal/Contact Mailing Address - State
7 Vendor Proposal/Contact Mailing Address - State (Abbreviate State Name)
IOH
Page 5 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 78 of 140
1 Vendor Proposal/Contact Mailing Address - Zip Code
8 Vendor Proposal/Contact Mailing Address - Zip Code
143016
1 Vendor Proposal/Contact Phone Number
9 Vendor Proposal/Contact Phone Number (xxx-xxx-=oo
1614-760-5374
2 Vendor Proposal/Contact Extension Number
U Vendor Proposal/Contact Extension Number
1 800-533-0523 X 5374
2 Company Website
1 Company Website (www.xxxxx.com)
l www.boundtree.com
2 Purchase Orders Contact Information
2 All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
• I will use the internet to receive Purchase Orders at the following address
Yes I
2 Purchase Order E-mail Address
3 Purchase Order E-mail Address
Submitbids@Boundtree.com
2 Purchase Order Contact Name
4 Purchase Order Contact Name
Customer Service
2 Purchase Order Contact Phone Number
5 Purchase Order Contact Phone Number (xxx-xxx-)o=)
1 800-533-0523
2 Purchase Order Contact Extension Number
6 Purchase Order Contact Extension Number
No response
2 Alternate Purchase Order E-mail Address
7 Alternate Purchase Order E-mail Address
ordersoh@boundtree.com
Page 6 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 79 of 140
2 Alternate Purchase Order Contact Name
8 Alternate Purchase Order Contact Name
Customer Service
2 Alternate Purchase Order Contact Phone Number
9 Alternate Purchase Order Contact Phone Number (xxx-xxx-xxxx)
1 800-533-0523
3 Alternate Purchase Order Contact Extension Number
0 Alternate Purchase Order Contact Extension Number
No response
3
1
Purchase Orders Contact Information
All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
• Purchase Orders may be received by the Designated Dealer(s) identified on my company's Dealer
Designation form as provided to the Cooperative administrator. I understand that my company shall remain
responsible for the Contract and the performance of all Designated Dealers under and in accordance with
the Contract.
Yes I
3 I Request for Quotes (RFQ)
2 Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs:
3 Request for Quote (RFQ) E-mail Address
3 Request for Quote (RFQ) E-mail Address
submitbids@Boundtree.com
3 Request for Quote (RFQ) Contact Name
4 Request for Quote (RFQ) Contact Name
SubmitBids
3 Request for Quote (RFQ) Contact Phone Number
5 Request for Quote (RFQ) Contact Phone Number (xxx-xxx-=(c)
1 800-533-0523
3 Request for Quote (RFQ) Contact Extension Number
6 Request for Quote (RFQ) Contact Extension Number
No response
3 Alternate Request for Quote (RFQ) E-mail Address
7 Alternate Request for Quote (RFQ) E-mail Address
ordersoh@boundtree.com
Page 7 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 80 of 140
3 Alternate Request for Quote (RFQ) Contact Name
8 Alternate Request for Quote (RFQ) Contact Name
No response
3 Alternate Request for Quote (RFQ) Contact Phone Number
9 Alternate Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx)
No response
4 Alternate Request for Quote (RFQ) Contact Extension Number
U Alternate Request for Quote (RFQ) Contact Extension Number
No response
4 Invoices
Your company will be billed monthly for the service fee due under a Contract awarded under this Proposal
Invitation. All invoices are available on the BuyBoard website and e-mail notifications will be sent when
they are ready to be retrieved.
4 Invoices
2 Please choose only one (11 of the following options for receipt of invoices and provide the requested
information:
(a) Service fee invoices and related communications should be provided directly to my company at:
or
(b) In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following
billing agent:
If Vendor authorizes a billing agent to receive and process service fee invoices, in accordance with the General Terms and Conditions of the Contract,
Vendor specifically acknowledges and agrees that nothing in that designation shall relieve Vendor of its responsibilities and obligations under the
Contract including, but not limited to, payment of all service fees under any Contract awarded Vendor.
Service fee invoices and notices direct to company I
4 Invoice Company Name
3 Invoice Company Name
Bound Tree Medical, LLC
4 Invoice Company Department Name
4 Invoice Company Department Name
Customer Service
4 Invoice Contact Name
5 Invoice Contact Name
Customer Service
4 Invoice Mailing Address
6 Invoice Mailing Address (P.O. Box or Street Address)
15000 Tuttle Crossing Blvd.
Page 8 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 81 of 140
4 Invoice Mailing Address - City
7 Invoice Mailing Address - City
Dublin
4 Invoice Mailing Address - State
8 Invoice Mailing Address - State (Abbreviate State Name)
�OH
4 Invoice Mailing Address - Zip Code
9 Invoice Mailing Address (Zip Code)
143016
5 Invoice Contact Phone Number
U Invoice Contact Phone Number (xxx-xxx-xxxx)
1 800-533-0523
5 Invoice Contact Extension Number
Invoice Contact Extension Number
No response
5 Invoice Contact Fax Number
2 Invoice Contact Fax Number (xxx-xxx-xxxx)
No response
5 Invoice Contact E-mail Address
3 Invoice Contact E-mail
customerservice@boundtree.com
5 Invoice Contact Alternate E-mail Address
4 Invoice Contact Alternate E-mail Address
No response
5 Billing Agent Company Name
5 Billing Agent Company Name
No response
5 Billing Agent Department Name
6 Billing Agent Department Name
No response
5 Billing Agent Contact Name
7 Billing Agent Contact Name
No response
5 Billing Agent Mailing Address
8 Billing Agent Mailing Address (P.O. Box or Street Address)
No response
Page 9 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 82 of 140
5 Billing Agent Mailing Address - City
9 Billing Agent Mailing Address - City
No response
6 Billing Agent Mailing Address - State
U Billing Agent Mailing Address - State (Abbreviate State Name)
No response
6 Billing Agent Mailing Address - Zip Code
Billing Agent Mailing Address - Zip Code
No response
6 Billing Agent Contact Phone Number
2 Billing Agent Contact Phone Number (xxx-xxx-xxxx)
No response
6 Billing Agent Contact Extension Number
3 Billing Agent Contact Extension Number
No response
6 Billing Agent Fax Number
4 Billing Agent Fax Number
No response
6 Billing Agent Contact E-mail Address
5 Billing Agent Contact E-mail Address
No response
6 Billing Agent Alternative E-mail Address
6 Billing Agent Alternative E-mail Address
No response
6 Shipping Via
7 Common Carrier, Company Truck, Prepaid and Add to Invoice, or Other
Common Carrier
6 Payment Terms
8 Note: Vendor payment terms must comply with the BuyBoard General Terms and Conditions and the Texas Prompt
Payment Act (Texas Government Code Ch. 2251).
0% Net 30
6 Vendor's Internal/Assigned Reference/Quote Number
9 Vendor's Internal/Assigned Reference/Quote Number
1 7679/19912
Page 10 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 83 of 140
7 State or Attach Return Policy
U Note: Only return requirements and processes will be deemed part of Vendor's return policy. Any unrelated contract
terms, terms of sale, or other information not specifically related to return requirements and processes included in
Vendor's return policy shall not apply to any awarded Contract unless specifically included as a deviation in the
Deviation and Compliance Form and accepted by the Cooperative.
See bid response for return policy
7 Electronic Payments
1 Are electronic payments acceptable to your company?
Yes
7 Credit Card Payments
2 Are credit card payments acceptable to your company?
Yes I
7
3
Texas Regional Service Designation
Texas Regional Service Designation - Refer to Form in Proposal Invitation
The Cooperative (referred to as "Texas Cooperative" in this form and in the State Service Designation form) offers
vendors the opportunity to service its members throughout the entire State of Texas. If you do not plan to service all
Texas Cooperative members statewide, you must indicate the specific regions you will service on this form. If you
propose to serve different regions for different products or services included in your Proposal, you must complete
and submit a separate Texas Regional Service Designation form for each group of products and clearly indicate the
products or services to which the designation applies. By designating a region or regions, you are certifying that
you are authorized and willing to provide the proposed products and services in those regions. Designating
regions in which you are either unable or unwilling to provide the specified products and services shall be
grounds for either rejection of your Proposal or, if awarded, termination of your Contract. Additionally, if you
do not plan to service Texas Cooperative members (i.e., if you will service only states other than Texas), you must
so indicate on this form.
7 Company Name
4 Company Name
Bound Tree Medical, LLC
7 Texas Regional Service Designation
5 Select only one of the following options. If you select "I will NOT serve all Regions of Texas", you must then
check the individual Regions you wish to serve.
JAII Regions
7 Region 1
6 Region 1 - Edinburg
1 Region 1 (1)
7 Region 2
7 Region 2 - Corpus Christi
❑ Region 2 (2)
7 Region 3
8 Region 3 - Victoria
❑ Region 3 (3)
Page 11 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 84 of 140
7
Region 4
9
Region 4 - Houston
❑ Region 4 (4)
8
Region 5
0
Region 5 - Beaumont
0 Region 5 (5)
8
Region 6
1
Region 6 - Huntsville
0 Region 6 (6)
8
Region 7
2
Region 7 - Kilgore
0 Region 7 (7)
8
Region 8
3
Region 8 - Mount Pleasant
0 Region 8 (8)
8
Region 9
4
Region 9 - Wichita Falls
0 Region 9 (9)
8
Region 10
5
Region 10 - Richardson
0 Region 10 (10)
8
Region 11
6
Region 11 - Fort Worth
0 Region 11 (11)
8
Region 12
7
Region 12 - Waco
0 Region 12 (12)
8
Region 13
8
Region 13 - Austin
0 Region 13 (13)
8
Region 14
9
Region 14 - Abilene
0 Region 14 (14)
9
Region 15
0
Region 15 - San Angelo
0 Region 15 (15)
Page 12 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 85 of 140
9
Region 16
Region 16 - Amarillo
❑ Region 16 (16)
9
Region 17
2
Region 17 - Lubbock
0 Region 17 (17)
9
Region 18
3
Region 18 - Midland
0 Region 18 (18)
9
Region 19
4
Region 19 - El Paso
0 Region 19 (19)
9
Region 20
5
Region 20 - San Antonio
0 Region 20 (20)
9
6
State Service Designation
State Service Designation - Refer to Form in Proposal Invitation.
As set forth in the Proposal Invitation, it is the Cooperative's intent that other governmental entities in the United
States have the opportunity to purchase goods or services awarded under the Contract, subject to applicable state
law, through a piggy -back award or similar agreement through the National Purchasing Cooperative BuyBoard. If
you plan to service the entire United States or only specific states, you must complete this form accordingly. (Note:
If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional Service
Designation form.) In addition to this form, to be considered for a piggy -back award by the National
Purchasing Cooperative, you must have an authorized representative sign the National Purchasing
Cooperative Vendor Award Agreement that follows this form.
If you serve different states for different products or services included in your Proposal, you must complete and
submit a separate State Service Designation form for each group of products and clearly indicate the products or
services to which the designation applies. By designating a state or states, you are certifying that you are
authorized and willing to provide the proposed products and services in those states. Designating states in which
you are either unable or unwilling to provide the specified products and services shall be grounds for either
rejection of your Proposal or, if awarded, termination of your Contract.
9 Company Name
7 Company Name
Bound Tree Medical, LLC
9 State Service Designation
8 Select only one of the following options
the individual States you wish to serve.
Al I States
9 Alabama
9 Alabama
0 Alabama (AL)
If you select "I will NOT serve all States", you must then check
Page 13 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 86 of 140
1 Alaska
0 0 Alaska
0 Alaska (AK)
1 Arizona
Arizona
0 Arizona (AZ)
1 Arkansas
0 Arkansas
❑ Arkansas (AR)
1 California
0 California (Public Contract Code 20118 & 20652)
3
0 California (CA)
1 Colorado
0 Colorado
4
0 Colorado (CO)
1 Connecticut
5 Connecticut
0 Connecticut (CT)
1 Delaware
0 Delaware
0 Delaware (DE)
1 District of Columbia
0 District of Columbia
7
0 District of Columbia (DC)
1 Florida
0 Florida
8
0 Florida (FL)
1 Georgia
9 Georgia
0 Georgia (GA)
1 Hawaii
U Hawaii
0 Hawaii (HI)
1 Idaho
1 Idaho
1
0 Idaho (ID)
Page 14 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 87 of 140
1
Illinois
1 2
Illinois
0 Illinois (IL)
1
Indiana
1
Indiana
❑ Indiana (IN)
1
Iowa
4
Iowa
❑ Iowa (IA)
1
Kansas
1
Kansas
❑ Kansas (KS)
1
Kentucky
1
6
Kentucky
0 Kentucky (KY)
1
Louisiana
1
Louisiana
0 Louisiana (LA)
1
Maine
1
Maine
0 Maine (ME)
1
Maryland
9
Maryland
0 Maryland (MD)
1
Massachusetts
0
6
Massachusetts
❑ Massachusetts (MA)
1
Michigan
2
1
Michigan
1 Michigan (MI)
1
Minnesota
2
Minnesota
❑ Minnesota (MN)
1
Mississippi
2
3
Mississippi
❑ Mississippi (MS)
Page 15 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 88 of 140
1 Missouri
2 Missouri
mot❑ Missouri (MO)
1 Montana
222 Montana
❑ Montana (MT)
1 Nebraska
2 Nebraska
6
21 Nebraska (NE)
1 Nevada
2 Nevada
❑ Nevada (NV)
1 New Hampshire
2 New Hampshire
8
1 New Hampshire (NH)
1 New Jersey
2 9 New Jersey
1 New Jersey (NJ)
1 New Mexico
3 New Mexico
0 New Mexico (NM)
1 New York
3 New York
1
21 New York (NY)
1 North Carolina
3 North Carolina
2
0 North Carolina (NC)
1 North Dakota
3 North Dakota
3
0 North Dakota (ND)
1 Ohio
4 Ohio
0 Ohio (OH)
1 Oklahoma
3 Oklahoma
5
0 Oklahoma (OK)
Page 16 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 89 of 140
1
Oregon
6
Oregon
❑ Oregon (OR)
1
Pennsylvania
3
7
Pennsylvania
❑ Pennsylvania (PA)
1
Rhode Island
3
Rhode Island
❑ Rhode Island (RI)
1
South Carolina
3
9
South Carolina
❑ South Carolina (SC)
1
South Dakota
4
0
South Dakota
1 South Dakota (SD)
1
Tennessee
Tennessee
❑ Tennessee (TN)
1
Texas
4
Texas
❑ Texas (TX)
1
Utah
3
Utah
❑ Utah (UT)
1
Vermont
4
Vermont
❑ Vermont (VT)
1
Virginia
444
Virginia
1 Virginia (VA)
1
Washington
4
6
Washington
❑ Washington (WA)
1
West Virginia
4
7
West Virginia
❑ West Virginia (WV)
Page 17 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 90 of 140
1 Wisconsin
8 Wisconsin
❑ Wisconsin (WI)
44 Wyoming
Wyoming
0 Wyoming (WY)
Bid Lines
Section I: First Aid Eauipment. Products, and SuaDlies
Discount (%) off catalog/pricelist for First Aid Equipment and Supplies. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No Daner cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 18 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 91 of 140
2 Section I: First Aid Eauiament. Products. and SuaDlies
Discount (%) off catalog/pricelist for First Aid Furniture. Catalog/Pricelist MUST be included or proposal will not
be considered.
No Bid
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Page 19 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 92 of 140
3 Section I: Eauipment. Products. and Supplies
Discount (%) off catalog/pricelist for Bleeding Control Stations. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 20 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 93 of 140
4 Section I: Eauiament. Products. and Suoolies
Discount (%) off catalog/pricelist for All Other First Aid, Health, and Nursing Products. Catalog/Pricelist
MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 21 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 94 of 140
5 Section II: Athletic Trainer/Rehabilitation Eauipment. Products. and SuaDlies
Discount (%) off catalog/pricelist for Athletic Trainer/Rehabilitation Equipment and
Supplies. Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 22 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 95 of 140
6 Section II: Athletic Trainer/Rehabilitation Eauir)ment. Products. and Sunalies
Discount (%) off catalog/pricelist for Athletic Trainer/Rehabilitation Furniture. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 23 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 96 of 140
7 Section II: Athletic Trainer/Rehabilitation Eauir)ment. Products. and Sunalies
Discount (%) off catalog/pricelist for All Other Athletic Trainer/Rehabilitation Products. Catalog/Pricelist
MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper cataloas or
manufacturer/vendor websites will be accented.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 24 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 97 of 140
8 Section III: Emeraencv Medical Eauipment. Products. and Supplies
Discount (%) off catalog/pricelist for Emergency Medical Equipment and Supplies. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 25 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 98 of 140
9 Section III: Emeraencv Medical Eauioment. Products. and SuDolies
Discount (%) off catalog/pricelist for All Other Emergency Medical Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 26 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 99 of 140
1 Section IV: Pharmaceuticals and Vaccines
0
Discount (%) off catalog/pricelist for Pharmaceuticals and Vaccines. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 27 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 100 of 140
1 Section IV: Pharmaceuticals and Vaccines
1
Discount (%) off catalog/pricelist for Intra-Venous Pharmaceutical Supplies. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 28 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 101 of 140
1 Section IV: Pharmaceuticals and Vaccines
2
Discount (%) off catalog/pricelist for Drug Testing Kits and Supplies. Catalog/Pricelist MUST be included or
proposal will not be considered.
Total: 1 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 29 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 102 of 140
1 Section V: Audioloav Eauipment and Other Related Items
3 --
Discount (%) off catalog/pricelist for Audiology Equipment, Hearing Aids, and Other Related
Items. Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Select items at 10% off
Page 30 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 103 of 140
1 Section VI: Drua/Diaanostic/Laboratory Testina Services
4 - - -
Discount (%) off catalog/pricelist for Drug and Alcohol Diagnostic Testing Services (onsite and offsite
including
laboratory services). Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 28% 1
Item Notes: PROPOSAL NOTE: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be
considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a readily available and
readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or
manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Supplies Only
1 Section II: Installation and Reaair Service
5
Hourly Labor Rate for Installation/Repair Service of First Aid, Athletic Trainer/Rehabilitation, and
Emergency Medical Equipment and Products - Not to Exceed hourly labor rate for Installation/Repair
Service of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate No Bid
1 Section II: Installation and Reaair Service
6
Hourly Labor Rate for Installation/Repair Service of Audiology Equipment and Products - Not to Exceed
hourly labor rate for Installation/Repair Service of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate
Response Total: $0.00
Page 31 of 31 pages Vendor: Bound Tree Medical 704-23
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 104 of 140
Bound Tree
Your Partner In EMS
Nationwide Distribution
5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.bGundtree.com
For operational efficiency and faster disaster response, Bound Tree operates 5 distribution centers
nationwide plus a dedicated kitting facility. 96% of all our customers can be reached using UPS Ground
within 2 business days.
OFFICES
Bound Tree Medical
5000 Tuttle Crossing Blvd.
Dublin, OH 43016
DISTRIBUTION CENTERS
Grand Prairie, TX
Bound Tree Medical
2911 S. Great Southwest Parkway
Suite 200
Grand Prairie, TX 75052
Elizabethtown, PA
Bound Tree Medical
1605 Zeager Road
Elizabethtown, PA 17022
Visalia, CA
Bound Tree Medical
2243 N. Plaza Drive
Visalia, CA 93291
Flower Mound, TX
Bound Tree Medical
1420 Lakeside Parkway
Suite 105
Flower Mound, TX 75028
Greenwood, IN
Bound Tree Medical
1033 Collins Road, Suite A
Greenwood, IN 46143
Jacksonville, FL
Bound Tree Medical
2619 Ignition Drive, Suite 2
Jacksonville, FL 32218
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 105 of 140
Bound Tree
Your Partner In EMS
Customer Service
5000 Tuttle Crossing Blvd. Dublin, OH 43016
614.760.5000 www.boundtree.com
Bound Tree Medical is focused on providing service to meet the needs of our customers throughout
the United States. We have a deep commitment to help those that help others. The specialized
market that we serve drives us to create the best possible solutions for our customers. We are here to
serve you.
Our nationwide toll -free Customer Service line is 800-533-0523. Bound Tree Medical routes calls by
origin of the zip code of the caller which, results in more customer awareness among those agents
responding to customer calls.
There are a variety of methods to place orders and verify pricing:
1) Internet: Customers have access to real-time pricing and stock availability 24 hours a day, 7 days
a week. www.boundtree.com
2) Email: Orders may be emailed to customer service at customerservice(a-)-boundtree.com.
3) Phone: Our dedicated team of customer service representatives can answer questions or take
your orders from 7:30 AM to 8:00 pm EST.
4) Fax: Our nationwide toll -free fax line is available 24 hours a day at 800-257-5713.
5) Mail: Orders may be mailed to our corporate office. An order form is included in the back of our
catalog for convenience.
The Customer Service Department is comprised of 27 staff members. Customer Service
Representatives respond to inbound calls and make outbound calls to customers to provide
information regarding product availability, shipment and delivery schedule changes. These same
representatives are available to answer questions about shipments or process returns when
necessary.
If an item goes onto a long term backorder, Bound Tree will work to find equivalent substitute items
for the backorder. If it is the customer preference to approve all substituted items, Bound Tree
Customer Service will seek approval prior to shipping sub items.
Bound Tree Medical is proud to offer our customers access to an Emergency Disaster Support line at
800-863-0953, which operates 24 hours a day, 7 days per week. It is staffed by on -call managers,
who are accessible through routing of calls to cell phones. After leaving a message, a return call is
originated within 20 minutes.
Bound Tree Medical allows customers to purchase on open account. The proper account application
must be completed and submitted. Bound Tree Medical will assign an account number to each
application. Each account has one bill ing/payables address but may have several shipping/receiving
addresses.
In addition, the Federal Drug Administration (FDA) requires Bound Tree Medical to retain a Medical
Director (physician) signature, contact information and license photocopy when purchasing legend
items and/or pharmaceuticals.
Customers may purchase by Master Card, VISA, Discover or American Express. Prepaid orders are
also accepted
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 106 of 140
„ Bound Tree
Your Partner In EMS
Return Policy
5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.boundtree.com
Prior to returning a product, please contact Bound Tree's Customer Service Department at 800.533.0523
within 7 days of receiving the product to obtain a return merchandise authorization ("RMA”) number. This will
help us expedite your return and allow us to give you the proper credit. Once you have received your RMA
number please follow the return policy guidelines below.
Subject to the guidelines below, Bound Tree will accept returns and rectify the error at no cost to you if: (i)
you received expired product; or (ii) Bound Tree makes an error in fulfilling or shipping your order. In such
case, you must notify us within 15 days of receiving the product.
Please follow the return policy guidelines below:
Non -returnable Items Include:
1. A product that is "buy to order."
2. A product that is "non -stock."
3. Items listed as "non -returnable."
4. Items that have been marked or engraved.
5. Items returned with broken packaging or not in original packaging.
6. Any sterile product that has been opened or items determined by Bound Tree not to be in resalable
condition.
7. Product that is more than 60 days older than the shipment date.
8. Recertified equipment.
9. Pharmaceutical products.
Return Policy Guidelines:
1. Items returned within 45 days of the shipment date will not be subject to a restocking fee.
2. Items returned 46-60 days from the shipment date may be subject to a restocking fee.
3. Items older than 60 days from the shipment date will not be accepted in our warehouse and will be
returned to the customer at customer's expense.
4. Please write the RMA number clearly on the package label.
5. Send the package freight prepaid. Please reference the RMA to locate the return address.
6. Returns must be received by Bound Tree within 15 days of issuance of RMA number.
7. Items received without an RMA number will not be eligible for credit.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 107 of 140
Bound Tree
Your Partner In EMS
RETURN FOR REPAIRS
5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.boundtree.com
Items returned for repair must be prepared according to the most recent OSHA requirements. Items must be
properly cleaned and verified with a statement on the outside of the package. Proof of purchase must also be
included with all manufacturer warranty repairs. Please contact our Customer Service Department for
additional information.
CLAIMS
All claims for damage occurring in transit must be made upon receipt of goods by customer directly to the
carrier and documented with photos. Please save all boxes and packing material. All shipment errors must
be reported immediately upon receipt to Bound Tree Customer Service.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 108 of 140
kj,. Bound Tree
Your Partner In EMS 5000 Tuttle Crossing Blvd. Dublin, OH 43016 614.760.5000 www.boundtree.com
Online Ordering Capabilities
a. Bound Tree Medical provides a user-friendly online ordering system with advanced features that
restrict user access to predefined products that can be approved for purchase using a predefined
purchasing path with maximum or minimum users as defined by the contracted customer.
b. The advanced user platform of BoundTree.com allows customers to self-administer (add/delete)
their specific product offering based on the entire Bound Tree Medical online catalog.
c. Users on BoundTree.com can gather information and prepare self-administered reports based on
up to two years of historical data.
• Trends can be tracked by running reports that can include all shipping locations, or that
can be tailored to a specific shipping address.
• A purchase summary report can be self -generated to view total products purchased over a
selected period of time.
• The purchase summary report can be sorted in ascending order by total sales per item.
• Purchase summary reports and items per month reports can be self -exported in
spreadsheet format for additional evaluation.
• The purchase summary report provides item usage totals based on monthly, quarterly and
yearly expenditures.
• Reports can be self -exported in spreadsheet format.
d. Product name, short description and detailed descriptions are maintained for items on
BoundTree.com. Product photography is uploaded to the website based on manufacturer
availability. Custom photography is also available to supplement manufacturer -supplied items.
e. A "sold by" column is available on product detail pages to clearly describe available units of
measure.
f. Purchase requisition and order processing paths are predefined and self-administered by an
online administrator. User roles include "order submitters" and "order approvers". Multiple -levels
of approvers can be established with the option to auto -forward orders awaiting approval with no
activity.
g. Unit and total price for each order are displayed in the shopping cart checkout process.
h. A web administrator can setup and self-administer user IDs which trigger an' e-mail to the user for
password setup. Self-administered password reset tools are available to users.
The system does permit an administrator to specify maximum quantities that can be ordered for a
given item on a single order. Quotas provide a way for an administrator to self-administer total
purchases. To maintain maximum item thresholds, order approvers can monitor and adjust each
item on purchase requests throughout the approving and purchasing process.
The purchase requisition process provides date and time stamps for all purchase requisition
activities.
k. Invoice history is posted on BoundTree.com for user access.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 109 of 140
Vendor
Bound Tree Medical (Bound Tree Medical LLC)
Contact
Customer Service
Phone
800-533-0523
Email
Submitbids@Boundtree.com
Vendor Website
www.boundtree.com
TIN
31-1739487
Address Line 1
5000 Tuttle Crossing Blvd
Vendor City
Dublin
Vendor Zip
43016
Vendor State
OH
Vendor Country
USA
Delivery Days
10
Freight Terms
FOB Destination
Payment Terms
0% Net 30
Shipping Terms
Freight prepaid by vendor and added to invoice
Ship Via
Common Carrier
Designated Dealer
No
EDGAR Received
Yes
Service -disabled Veteran Owned
No
Minority Owned
No
Women Owned
No
National
No
No Foreign Terrorist Orgs Yes
No Israel Boycott
Yes
MWBE
No
ESCs
All Texas Regions
States
All States
Contract Name
First Aid, Emergency Medical, and Athletic Trainer Supplies
and Equipment
Contract No.
704-23
Effective
06/01/2023
Expiration
05/31/2026
Accepts RFQs
Yes
Quote Reference Number
7679/19912
Return Policy
See bid response for return policy
7/3/2023 3:01 PM
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 113 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
I1. Discount (%) Off Catalog /Pricelist for First Aid Equipment and Supplies.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
B&E Medical Supply and
3M Ortho price list
o
10%
Yes
Equipment LLC
Dooley Tackaberry, Inc.
3M price list
20%
No
B&E Medical Supply and
3M price list
10%
No
Equipment LLC
B&E Medical Supply and
Addto price list
10%
Yes
Equipment LLC
B&E Medical Supply and
ADI Medical price list
10%
Yes
Equipment LLC
AED123
AED123 First Aid price list
40%
Yes
Alert Services
Alert Services Sports Med price list
12%
Yes
Pocket Nurse Enterprises, Inc.
Amico price list
8%
No
B&E Medical Supply and
Andover Coated price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Apothecary Products price list
10%
Yes
Equipment LLC
B&E Medical Supply and
B.F. Ascher & Co. price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
No
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Pocket Nurse Enterprises, Inc.
CAE price list
8%
No
CandS Safety Supply
CandS Safety Supply - First Aid price list
20%
Yes
Medwheels Inc.
Cardiac Science price list
15%
Yes
B&E Medical Supply and
Cardinal price list
o
10%
Yes
Equipment LLC
M-Pak, Inc.
Cardio Partners/Aed Superstore price list
10%
Yes
Radia Enterprises dba Career
Career Uniforms price list
o
30 /o
No
Uniforms
B&E Medical Supply and
Carma Labs price list
o
10%
Yes
Equipment LLC
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
Yes
Corporation of Texas
M-Pak, Inc.
CPR 1/AED Leader price list
12%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 114 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies
and Equipment No. 704-23
1. Discount (%) Off Catalog /Pricelist for First Aid Equipment and Supplies.
B&E Medical Supply and
Curaplex price list
o
10%
Yes
Equipment LLC
Medwheels Inc.
Defib Tech price list
15%
Yes
DetectaChem
Detectachem - MobileDetect price list
3%
No
B&E Medical Supply and
Dial Corporation price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
DJO price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Duck price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Dukal price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Dynarex price list
o
10%
Yes
Equipment LLC
M-Pak, Inc.
Eleven 10 price list
10%
Yes
B&E Medical Supply and
Exel International price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Global Glove price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Gojo price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Graham -Field price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Havel's Inc. price list
o
10%
Yes
Equipment LLC
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
Yes
Henry Schein, Inc.
Henry Schein Sports Medicine Catalog
18%
No
B&E Medical Supply and
Henry Schein price list
o
10%
No
Equipment LLC
B&E Medical Supply and
Johnson &Johnson price list
o
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
No
B&E Medical Supply and
Labelmaster price list
10%
Yes
Equipment LLC
Laerdal Medical Corporation
Laerdal Medical Corporation price list
12%
Yes
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
No
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 115 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
1. Discount (%) Off Catalog /Pricelist for First Aid Equipment and Supplies.
B&E Medical Supply and
Laerdal Medical price list
o
10%
No
Equipment LLC
Life -Assist, Inc.
Life -Assist price list
31%
Yes
B&E Medical Supply and
Major Pharmaceuticals price list
10%
Yes
Equipment LLC
M-Pak, Inc.
MasVida price list
12%
No
B&E Medical Supply and
Mckesson price list
o
10%
Yes
Equipment LLC
Medco Supply Company
Medco Sports Medicine Catalog
25%
Yes
B&E Medical Supply and
Medical Action price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Medipurpose price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Medique Pharmaceuticals price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Medline price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Medsource price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Med-Tech price list
o
10%
Yes
Equipment LLC
Medwheels Inc.
Medwheels Inc. price list
15%
Yes
B&E Medical Supply and
New World Imports price list
10%
Yes
Equipment LLC
North American Rescue LLC
North American Rescue price list
0%
Yes
B&E Medical Supply and
Parker Medical price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
B&E Medical Supply and
Pocket Nurse price list
o
10%
Yes
Equipment LLC
QuadMed, Inc
QuadMed - Medical supplies price list
10%
Yes
Ruby Red Solutions L.L.0
Ruby Red Solutions Catalog
20%
No
B&E Medical Supply and
Safetec of America, Inc. price list
o
10%
Yes
Equipment LLC
M-Pak, Inc.
Sam Medical price list
10%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 116 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
1 1. Discount (%) Off Catalog /Pricelist for First Aid Equipment and Supplies.
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - First Aid Equipment price list
40%
Yes
Medwheels Inc.
Stryker price list
25%
Yes
B&E Medical Supply and
Tetra Medical price list
10%
Yes
Equipment LLC
Unipak Corporation
Unipack Corporation - Gloves & PPE price list
34%
Yes
B&E Medical Supply and
Upshield price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Waterjel Technologies price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Welch Allyn price list
10%
Yes
Equipment LLC
William V. MacGill and Co.
William V. MacGill and Co. Catalog
6%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 117 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
12. Discount (%) Off Catalog /Pricelist for First Aid Furniture.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Dooley Tackaberry, Inc.
ACME United price list
20%
No
Alert Services
Alert Services Sports Med price list
12%
No
Pocket Nurse Enterprises, Inc.
Amico price list
8%
No
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
No
Pocket Nurse Enterprises, Inc.
CAE price list
8%
No
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
M-Pak, Inc.
CPR 1/AED Leader price list
12%
No
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
Yes
Henry Schein, Inc.
Henry Schein Sports Medicine Catalog
18%
No
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
No
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
No
Life -Assist, Inc.
Life -Assist price list
31%
No
M-Pak, Inc.
MasVida price list
12%
Yes
Medco Supply Company
Medco Sports Medicine Catalog
25%
No
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
QuadMed, Inc
QuadMed - Medical supplies price list
10%
No
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - First Aid Furniture price list
40%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
Medwheels Inc.
Winco price list
15%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 118 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
13. Discount (%) Off Catalog /Pricelist for Bleeding Control Stations.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Alert Services
Alert Services Sports Med price list
12%
No
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
M-Pak, Inc.
Cardio Partners/Aed Superstore price list
10%
No
Medwheels Inc.
Chinook price list
10%
Yes
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
M-Pak, Inc.
CPR 1/AED Leader price list
12%
No
Cardio Partners, Inc.
Curaplex Stop the Bleed List price list
10%
Yes
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
No
Henry Schein, Inc.
Henry Schein Sports Medicine Catalog
18%
No
Dooley Tackaberry, Inc.
JUNKIN Safety price list
7%
No
Life -Assist, Inc.
Life -Assist price list
31%
No
Medco Supply Company
Medco Sports Medicine Catalog
25%
No
Medwheels Inc.
Medwheels Inc. price list
10%
Yes
B&E Medical Supply and
North America Rescue price list
10%
Yes
Equipment LLC
M-Pak, Inc.
North American Rescue price list
10%
No
North American Rescue LLC
North American Rescue price list
0%
Yes
QuadMed, Inc
QuadMed - Medical supplies price list
10%
Yes
M-Pak, Inc.
Sam Medical price list
10%
No
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Bleeding Control Stations price list
40%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 119 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
14. Discount (%) Off Catalog /Pricelist for All Other First Aid, Health, and Nursing Products.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Alert Services
Alert Services Sports Med price list
12%
Yes
B&E Medical Supply and
B&E Medical Supply - All Other 1st Aid, Health products price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Ambu price list
10%
Yes
Equipment LLC
B&E Medical Supply and
American Diagnostic Corp. price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Amico price list
8%
Yes
B&E Medical Supply and
Bard Medical Divison price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
Yes
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Pocket Nurse Enterprises, Inc.
CAE price list
8%
Yes
Radia Enterprises dba Career
Career Uniforms price list
30%
Yes
Uniforms
B&E Medical Supply and
Chanby, Inc. price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Cornish Medical Rehab Edition VI price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Curaplex price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Dick Medical price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Dukal price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Dynarex price list
o
10%
Yes
Equipment LLC
Dooley Tackaberry, Inc.
FERNO WASHINGTON price list
10%
Yes
Gaumard Scientific Company, Inc.
Gaumard Scientific Company price list
2%
Yes
B&E Medical Supply and
Globe Scientific price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Graham -Field price list
o
10%
Yes
Equipment LLC
DiaMedical USA Equipment LLC
Healthcare Ed & Medical Equipment price list
5%
Yes
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
Yes
Henry Schein, Inc.
Henry Schein Sports Medicine Catalog
18%
No
B&E Medical Supply and
Henry Schien Inc. price list
o
10%
No
Equipment LLC
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 120 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
14. Discount (%) Off Catalog /Pricelist for All Other First Aid, Health, and Nursing Products.
B&E Medical Supply and
Heritage Bag Comp price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Honeywell Safety Products price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
Yes
Laerdal Medical Corporation
Laerdal Medical Corporation price list
12%
Yes
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
No
Life -Assist, Inc.
Life -Assist price list
31%
Yes
B&E Medical Supply and
Maco Intl price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Magnum Medical price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Mayflower Splint Co price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Mckesson Brand price list
10%
Yes
Equipment LLC
Medco Supply Company
Medco Sports Medicine Catalog
25%
Yes
B&E Medical Supply and
Medline price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Medsource Labs price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Miltex-Integra price list
10%
Yes
Equipment LLC
Medwheels Inc.
NDC price list
10%
Yes
B&E Medical Supply and
PediaTape price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
B&E Medical Supply and
Precision Dynamics Corp price list
o
10%
Yes
Equipment LLC
QuadMed, Inc
QuadMed - Medical supplies price list
10%
Yes
Ruby Red Solutions L.L.0
Ruby Red Solutions Catalog
20%
Yes
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
B&E Medical Supply and
Standard Textile price list
10%
Yes
Equipment LLC
Sterlington Medical
Sterlington Medical - All Other First Aid price list
40%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 121 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
14. Discount (%) Off Catalog /Pricelist for All Other First Aid, Health, and Nursing Products.
B&E Medical Supply and
Trajan Scientific Americas, Inc. price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Transmed Company
o
10%
Yes
Equipment LLC
Unipak Corporation
Unipack Corporation - Gloves & PPE price list
34%
Yes
B&E Medical Supply and
Welch -Allyn price list
10%
Yes
Equipment LLC
William V. MacGill and Co.
William V. MacGill and Co. Catalog
6%
Yes
B&E Medical Supply and
Wy'East Medical price list
10%
Yes
Equipment LLC
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 122 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
15. Discount (%) Off Catalog /Pricelist for Athletic Trainer/Rehabilitation Equipment and Supplies.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Alert Services
Alert Services Sports Med price list
12%
No
Pocket Nurse Enterprises, Inc.
Amico price list
8%
No
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
No
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Pocket Nurse Enterprises, Inc.
CAE price list
8%
No
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
Yes
Corporation of Texas
Medwheels Inc.
Dynarex price list
15%
Yes
Life -Assist, Inc.
Life -Assist price list
31%
No
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
No
Henry Schein, Inc.
Henry Schein Sports Medicine Catalog
18%
No
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
No
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
No
Medco Supply Company
Medco Sports Medicine Catalog
25%
Yes
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
School Health Corp
School Health - Sports Medicine Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Athletic Trainer price list
40%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
Dooley Tackaberry, Inc.
ZOLL price list
10%
No
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 123 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
16. Discount (%) Off Catalog /Pricelist for Athletic Trainer/Rehabilitation Furniture.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Alert Services
Alert Services Sports Med price list
12%
No
Pocket Nurse Enterprises, Inc.
Amico price list
8%
No
Dooley Tackaberry, Inc.
ANSELL price list
30%
No
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
No
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Pocket Nurse Enterprises, Inc.
CAE price list
8%
No
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
No
Henry Schein, Inc.
Henry Schein Sports Medicine Catalog
18%
No
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
No
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
No
Life -Assist, Inc.
Life -Assist price list
31%
No
Medco Supply Company
Medco Sports Medicine Catalog
25%
Yes
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
School Health Corp
School Health - Sports Medicine Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Athletic Rehab price list
40%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
Medwheels Inc.
Winco price list
10%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 124 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
17. Discount (%) Off Catalog /Pricelist for All Other Athletic Trainer/Rehabilitation Products.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Dooley Tackaberry, Inc.
3M price list
20%
No
Alert Services
Alert Services Sports Med price list
12%
Yes
Pocket Nurse Enterprises, Inc.
Amico price list
8%
No
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
No
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Pocket Nurse Enterprises, Inc.
CAE price list
8%
Yes
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
Yes
Corporation of Texas
Frio -Hydration, LLC
Frio -Hydration price list
20%
Yes
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
Yes
Henry Schein, Inc.
Henry Schein Sports Medicine Catalog
18%
No
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
Yes
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
Yes
Life -Assist, Inc.
Life -Assist price list
31%
Yes
Medco Supply Company
Medco Sports Medicine Catalog
25%
Yes
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
School Health Corp
School Health - Sports Medicine Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Athletic Other Products price list
40%
Yes
Medwheels Inc.
VIVE Health price list
15%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 125 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
18. Discount (%) Off Catalog /Pricelist for Emergency Medical Equipment and Supplies.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Dooley Tackaberry, Inc.
ACME UNITED price list
20%
Yes
AED Service America
AED Service America price list
13%
Yes
AED123
AED123 First Aid price list
40%
Yes
Alert Services
Alert Services Sports Med price list
12%
No
Pocket Nurse Enterprises, Inc.
Amico price list
8%
No
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
No
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Pocket Nurse Enterprises, Inc.
CAE price list
8%
No
Cardio Partners, Inc.
Cardio Partners AccessoriesPM price list
10%
Yes
M-Pak, Inc.
Cardio Partners/Aed Superstore price list
10%
Yes
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
M-Pak, Inc.
CPR 1/AED Leader price list
12%
Yes
AED123
Cubix Safety price list
25%
Yes
Cardio Partners, Inc.
Defibtech price list (10-30%)
10%
Yes
AED123
Defibtech price list
20%
Yes
DetectaChem
Detectachem - MobileDetect price list
3%
No
DiaMedical USA Equipment LLC
Healthcare Ed & Medical Equipment price list
5%
Yes
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
No
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
No
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
Yes
Laerdal Medical Corporation
Laerdal Medical Corporation price list
6%
Yes
Life -Assist, Inc.
Life -Assist price list
31%
Yes
M-Pak, Inc.
MasVida price list
12%
No
Medco Supply Company
Medco Sports Medicine Catalog
25%
Yes
Medwheels Inc.
Medwheels Inc. - First Aid Only price list
10%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 126 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
18. Discount (%) Off Catalog /Pricelist for Emergency Medical Equipment and Supplies.
North American Rescue LLC
North American Rescue price list
0%
Yes
AED123
Philips
30%
Yes
Cardio Partners, Inc.
Philips AEDs price list (20%-25%)
20%
Yes
Cardio Partners, Inc.
Physio Control/Heartsine price list
19%
Yes
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
QuadMed, Inc
QuadMed - EMS Supplies price list
10%
Yes
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Emergency Medical price list
40%
Yes
AED123
Stryker price list
20%
Yes
Unipak Corporation
Unipack Corporation - Gloves & PPE price list
34%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
6%
Yes
AED123
ZOLL price list
20%
Yes
Cardio Partners, Inc.
ZOLL/Cardiac Science price list (2.5%-31%)
3%
No
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 127 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
19. Discount (%) Off Catalog /Pricelist for All Other Emergency Medical Products.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Alert Services
Alert Services Sports Med price list
12%
Yes
B&E Medical Supply and
Alied health Care Prod price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Amico price list
8%
Yes
B&E Medical Supply and
Bard price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
Yes
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
B&E Medical Supply and
Bound Tree price list
10%
No
Equipment LLC
B&E Medical Supply and
Bull Head Safety price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
CAE price list
8%
Yes
B&E Medical Supply and
Cancer Diagnostics price list
o
10%
Yes
Equipment LLC
B&E Medical Supply and
Cardio Partners price list
10%
Yes
Equipment LLC
M-Pak, Inc.
Cardio Partners/Aed Superstore price list
10%
Yes
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
Yes
Corporation of Texas
M-Pak, Inc.
CPR 1 price list
12%
Yes
DetectaChem
Detectachem - MobileDetect price list
3%
Yes
B&E Medical Supply and
Duracell Co price list
o
10%
Yes
Equipment LLC
M-Pak, Inc.
Eleven 10 price list
10%
Yes
B&E Medical Supply and
Fisher Scientific price list
o
10%
Yes
Equipment LLC
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
Yes
Pocket Nurse Enterprises, Inc.
Kb Port price list
8%
Yes
B&E Medical Supply and
Laerdal Medical Corp price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
Yes
Laerdal Medical Corporation
Laerdal Medical Corporation price list
6%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 128 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
19. Discount (%) Off Catalog /Pricelist for All Other Emergency Medical Products.
Life -Assist, Inc.
Life -Assist price list
31%
Yes
B&E Medical Supply and
LMA-North America price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Maco Intl price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Mada Medical Products Inc. price list
10%
Yes
Equipment LLC
M-Pak, Inc.
MasVida price list
12%
Yes
B&E Medical Supply and
McKesson brand price list
o
10%
Yes
Equipment LLC
Medco Supply Company
Medco Sports Medicine Catalog
25%
Yes
B&E Medical Supply and
Medsource international price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Nasco Healthcare price list
o
10%
Yes
Equipment LLC
Medwheels Inc.
NDC price list
10%
Yes
B&E Medical Supply and
North American Rescue price list
o
10%
Yes
Equipment LLC
North American Rescue LLC
North American Rescue price list
0%
Yes
B&E Medical Supply and
B&E Medical Supply - Other Emergency Medical Products price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Phasein AB price list
10%
Yes
Equipment LLC
B&E Medical Supply and
Physio Control Corp price list
10%
Yes
Equipment LLC
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
QuadMed, Inc
QuadMed - EMS Supplies price list
10%
Yes
Cardio Partners, Inc.
Red Cross CPR Training price list
25%
Yes
B&E Medical Supply and
Rg Medical Diagonostics price list
o
10%
Yes
Equipment LLC
M-Pak, Inc.
Sam Medical price list
10%
Yes
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Other Emergency Products price list
40%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 129 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
19. Discount (%) Off Catalog
/Pricelist for All Other Emergency Medical Products.
B&E Medical Supply and
o
Teleflex LLC price list 10% Yes
Equipment LLC
Unipak Corporation
Unipack Corporation - Gloves & PPE price list 34% Yes
B&E Medical Supply and
Western Medical price list 10% Yes
Equipment LLC
William V. MacGill and Co. William V. MacGill and Co. Catalog 6% Yes
Dooley Tackaberry, Inc.
ZOLL price list 10% No
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 130 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
110. Discount (%) Off Catalog /Pricelist for Pharmaceuticals and Vaccines.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
No
Life -Assist, Inc.
Life -Assist price list
31%
No
Medwheels Inc.
NDC price list
10%
No
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Pharmaceuticals price list
40%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 131 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
I11. Discount (%) Off Catalog /Pricelist for Intra-Venous Pharmaceutical Supplies.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
No
Life -Assist, Inc.
Life -Assist price list
31%
No
Medwheels Inc.
NDC price list
10%
No
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Intra-Venous price list
40%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 132 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
112. Discount (%) Off Catalog /Pricelist for Drug Testing Kits and Supplies.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
DetectaChem
Detectachem - MobileDetect price list
3%
Yes
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
Yes
Life -Assist, Inc.
Life -Assist price list
31%
No
Medwheels Inc.
NDC price list
10%
No
School Health Corp
School Health - Health Services Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Drug Testing price list
40%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 133 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
113. Discount (%) Off Catalog /Pricelist for Audiology Equipment, Hearing Aids, and Other Related Items.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Pocket Nurse Enterprises, Inc.
Amico price list
8%
No
Pocket Nurse Enterprises, Inc.
Body Interact price list
8%
No
Bound Tree Medical, LLC
Bound Tree Catalog
28%
No
Pocket Nurse Enterprises, Inc.
CAE price list
8%
No
Cornish Medical Electronics
Cornish Medical Rehab Edition VI price list
10%
No
Corporation of Texas
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
Yes
Pocket Nurse Enterprises, Inc.
KbPort price list
8%
No
Pocket Nurse Enterprises, Inc.
Laerdal Medical Corporation price list
8%
No
Life -Assist, Inc.
Life -Assist price list
31%
Yes
Medwheels Inc.
NDC price list
10%
No
Pocket Nurse Enterprises, Inc.
Pocket Nurse Enterprises price list (5% - 20%)
5%
Yes
School Health Corp
School Health - Special Education Catalog
12%
Yes
School Nurse Supply, Inc.
School Nurse Supply Catalog
10%
Yes
Sterlington Medical
Sterlington Medical - Audiology Equipment price list
40%
Yes
William V. MacGill and Co.
William V. MacGill and Co. Catalog
5%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 134 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
114. Discount (%) Off Catalog /Pricelist for Drug and Alcohol Diagnostic Testing Services.
Vendor Name
Vendor Catalog Information
Percent
Award
Discount
Bound Tree Medical, LLC
Bound Tree Catalog
28%
Yes
DetectaChem
Detectachem - MobileDetect price list
3%
Yes
HeartSafe America, Inc.
HeartSafe price list (5% - 30%)
5%
No
Life -Assist, Inc.
Life -Assist price list
31%
No
Medwheels Inc.
Medwheels Inc. price list
10%
Yes
Sterlington Medical
Sterlington Medical - Drug and Alcohol price list
40%
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 135 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
15. Hourly Labor Rate for Installation/Repair Service of First Aid, Athletic Trainer/Rehabilitation, andEmergency
Medical Equipment and Products.
Vendor Name Vendor Catalog Information Bid Price Award
HeartSafe America, Inc.
Not to Exceed hourly labor rate for Installation/Repair Service of
30.00
Yes
Equipment and Products.
AED123
Not to Exceed hourly labor rate for Installation/Repair Service of
$
47.00
Yes
Equipment and Products.
Not to Exceed hourly labor rate for Installation/Repair Service of
$
75.00
Yes
Sterlington Medical
Equipment and Products.
Not to Exceed hourly labor rate for Installation/Repair Service of
$
125.00
Yes
Medwheels Inc.
Equipment and Products.
Not to Exceed hourly labor rate for Installation/Repair Service of
$
150.00
Yes
Cardio Partners, Inc.
Equipment and Products.
Cornish Medical Electronics
Not to Exceed hourly labor rate for Installation/Repair Service of
350.00
Yes
Corporation of Texas
Equipment and Products.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 136 of 140
Board -
PURCHASING COOPERATIVE
The Local Government Purchasing Cooperative
For the Period 06/01/2023 to 05/31/2024
Final Catalog Award Report for First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment No. 704-23
16. Hourly Labor Rate for Installation/Repair of Audiology Equipment and Products.
Vendor Name Vendor Catalog Information Bid Price
Sterlington Medical Not to Exceed hourly labor rate for Installation/Repair Service of $ 75.00
Audiology Equipment and Products.
Medwheels Inc. Not to Exceed hourly labor rate for Installation/Repair Service of $ 125.00
Audiology Equipment and Products.
Award
Yes
Yes
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 137 of 140
EXHIBIT C
CONFLICT OF INTEREST DISCLOSURE REQUIREMENT
Pursuant to Chapter 176 of the Local Government Code, any person or agent of a person who
contracts or seeks to contract for the sale or purchase of property, goods, or services with a local
governmental entity (i.e. The CITY of Fort Worth) must disclose in the Questionnaire Form CIO
("Questionnaire") the person's affiliation or business relationship that might cause a conflict of
interest with the local governmental entity. Bylaw, the Questionnaire must be filed with the Fort
Worth CITY Secretary no later than seven days after the date the person begins contract
discussions or negotiations with the CITY, or submits an application or response to a request for
proposals or bids, correspondence, or another writing related to a potential agreement with the
CITY. Updated Questionnaires must be filed in conformance with Chapter 176.
A copy of the Questionnaire Form CIO is enclosed with the submittal documents. The form is
also available at http://www.ethics.state.tx.us/forms/CIQ.Ddf.
If you have any questions about compliance, please consult your own legal counsel. Compliance
is the individual responsibility of each person or agent of a person who is subject to the filing
requirement. An offense under Chapter 176 is a Class C misdemeanor.
NOTE: If you are not aware of a Conflict of Interest In any business relationship that you
might have with the CITY, state Vendor name In the # 1, use NIA In each of the areas on the
form. However, a signature is required in the #7 box in all cases.
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 138 of 140
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.S. 23. 84th Log.. Regular SossiorR OFFICE USE ONLY
Ths %mrkr== a bwV fiWd in accordarcawiM Chapmr 176 Local Gorerrerwrn Gods, by a wodol rrflo 02to rkaeweva
has a txrwu m relatronshp as da(us6d by Section 176,00tll a) wM a lord gwarnimantal arciy and fhe
verxiur MOMS laquro(nDn% UrKU SOCW 176 006(a
lily law = qu=znnatr0 ititLSt be bind wen the records a&rwwraxx or the local gwommorm army m4 star
than the 7th business deli attst the date the Yorldor boo mow aware of lass alit regwo tho Ad.'emerd to bo
Hod Sao Samr,Yr 176 DOQJ 1). tna' Gomnffwl Code.
A vendor cm=ts an o"..nnso d C)e vendor kr mrVy viola SectYxl 176 006 local Gaenmont Code. An
otionsa undol iris sodkxl is a >TlSdonuum
J Name of lrondor who has a business relationship with kcal gmemmeMl ontrty
Bound Trec Mcdical, LLC
J
Ctrecir this box If you are tldng an update to o previously [sled qusstionrrairo. (7ha taw rogtsos Thal you fdo en updated
compWGd criostionnaue wFh the apprWima fling authority not lator than tha 7th business day after the data on wtch
you bacamo awaro that tho orfginaly t lad quostitm=ra was mcomplato of inaccutato )
J Name of local govemmont officer about whom the Information Is being disclosed.
NIA
Uama of atticor
J Describe each amploynwnt of otter busirwss relationship with the local govommont offlcw. or a family member of the
of icor, as described by Section 176,0031a)(2)(A). Also describe any (amity relationship with the local govommont officer
Complot* subparts A and 8 for each employment or busireso relationship described Attach additional pagos to this Form
CICI as nocowwry.
A Is tho loc l govommont officw Or a family member of the olticar rocoiv� or I." to rooarva twaoie ncomo,
other than tm aztmoM income. from the vwxW
Yes f7 No
B. Is the vendor receiving or Ikoty to roe rvo taxabio moome. other Haan IrrvVZmGnt Income. train of at the dxocbon
of the local government officer or a family member ct trta offcur AND the taxable income rs not rocwred from tho
tocol govornm n1al entrty7
aYes allo
J Qsscflbo each employment of businow relationship that thevondor named In Section 1 maintains with a corporation or
other business entity with respect to which the local govommont otbeof sorvos es an offtcet or director. or holds on
ownership Interest of one percent or more.
J
❑Check Mz box d tho vendor has g,,ron the local government officer or a famnfy mombw of the otfseer one or more grhs
as dasaftcl m SoCtion 176.003(a)(2H6), oxcWng gins dasa-Wd an SocUw 176.0034a•1),
J t11i!C,=MS"
1 07/06/2023
hie ng bus+r>ess with tiro 0oremr�l or#y Uag
corm prorrdeaby Texas *%- othics.stale tK us Revned Ltf2021
City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 139 of 140
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local Government Code may be found at http Www statutes legis state tx us
Docs/LG htnVLG 176 him For easy reference, below are some of the sections pied on this form
Local Government Code 6176.001(1-al:'Business relationshsp' means a connection between two or more parlfes
based on commercial activity of one of the parpes. The term do?s not include a connection based on
(A) a transaction that is subject to rate or tee regulation by a federal, state or local governmental entity of an
agency of a federal, state, or focal governmenial entity,
(B) a transaction conducted at a price and sub}?ct to terms available to the publx or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular examination by, and teporting to that agency
Local Government Code 4176.003(a)(21(AI and (B):
(a) A local government officer shall file a conflicts disclosure statement w th respect to a vendor if
(2) the vendor
(A) has an employment or olhe► business relationship with the local government officer or a
lamiy member of the officer 1W results in the officer or family member receiving laxable
ir%coGmre, other than investment income. that exceeds 52,50O during the 12-month period
preceding thedate Thal tine officer becomes aware that
(i) a contract between the local govemmentai entity and vendor has been executed
cr
(ill the local governmental entity is considering entering Into a contract with the
vendor;
(B) has given to the local government officer or a family member o1 the officer one or more grits
that have an aggregate value of more than $100 in the 12- rtavlr period preceding the date the
officer becomes aware that
(ij a contract between the local governmental entity and vendor has been executed, or
;it) the local governmental entity is considering entering into a contract with the vendor
(a) Avendor shall tile a completed conflict of Interest questionnaire it the vendor has a business relationship
with a local governmental entity and
(1) has an employment or other business relationship with a local government officer at that local
governmental entryy, or a family member of the officer, described by Section 176.043(a)(2)(A);
(2) has given a local government officer o1 that local governmental entity, or a family member of the
officer one or more giffswith the aggregate value specified by Section 176.003(a)(2KB), excluding any
gift described by Section 176 003(a-1) or
(3) has a family relationship with a local govemment otlicer of that local governmental entity
(a-1) The completed conflict of Interest questionnah a must be filed with the appropriate records administrator
not later than the seventh business day after the later of
(1) the date that the vendor
(A) beg•ns discussions or negohations to enter into a contract with the local governmental
entity; or
(B) submits to the local governmental enmy an applicatwn response to a request fa proposals
or bids, corresponaence, or another writing related to a potential contract with the local
governmental entry; or
(2) the date the vendor becrrries aware
(A) of an employment of other business relationship with a local government officer. or a
family member of the officer, described by Subsedion (a,,
(B) that the vendor has given one or more gifts described by Subsection (a); or
(Cl of a family relationship with a local governmenl officer
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City of Fort Worth and Tree Bound Medical LLC - Cooperative Agency Contract BuyBoard 704-23 Page 140 of 140