SOURCES SOUGHT
65 -- Anesthesia Breathing Circuits
- Notice Date
- 11/24/2009
- Notice Type
- Sources Sought
- NAICS
- 339113
— Surgical Appliance and Supplies Manufacturing
- Contracting Office
- Defense Logistics Agency, DLA Acquisition Locations, Defense Supply Center Philadelphia - Medical, 700 Robbins Avenue, Philadelphia, Pennsylvania, 19111-5096
- ZIP Code
- 19111-5096
- Solicitation Number
- APP01-0911-002
- Archive Date
- 12/30/2009
- Point of Contact
- Toni Massenburg, Phone: 202 782-3666, Tracy Martin-Tilghman, Phone: 2027823663
- E-Mail Address
-
toni.massenburg@us.army.mil, tracy.martintilghman@us.army.mil
(toni.massenburg@us.army.mil, tracy.martintilghman@us.army.mil)
- Small Business Set-Aside
- N/A
- Description
- 65-Medical Supplies-Potential Sources Sought A.General Information. The Northeast Region (TRBO Reg. 1), a military integrated delivery network, comprised of 47 Army, Navy, Air Force, Marine Corps, and U.S. Coast Guard Medical Treatment Facilities (MTFs) in the states of Maine, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, Pennsylvania, New Jersey, Delaware, Maryland, Virginia, and the District of Columbia including institutional and operational healthcare settings announces a Request for Regional Incentive Agreement Quotation (RFRIAQ) for the standardization of ANESTHESIA BREATHING CIRCUITS. This product line includes but is not limited to the Anesthesia Breathing Circuits which help facilitate and enhance infection prevention and control efforts in the healthcare setting, reducing the opportunity for cross-contamination. The current infection control guidelines for anesthesia breathing circuits require single-patient use or high-level disinfection of breathing tubes, y-connectors, and reservoir bags. The primary objective of this program is to standardize the quality of care across this region based on a best value determination that represents the clinically preferred product or source(s) at the best possible price. It is also intended that standardized product be obtained through the DoD Prime Vendor Program. The secondary objective of this standardization initiative is the potential of decreasing the existing Stock Keeping Unit’s (SKUs) and thus dollars held as inventory. The below item detail of the products being purchased within the region will be used to target and cross-match product lists submitted by the vendor. This process will ensure the minimum requirements of the Region are met and help identify possible candidates for elimination (i.e. like product items), as well as potentially minimizing the number of SKUs included in a subsequent incentive agreement. The major facilities in the Northeast Region include, but are not limited to Walter Reed Army Medical Center (Washington, DC), National Naval Medical Center (Bethesda, MD), Malcolm Grow Medical Center (Andrews AFB, MD), Dewitt Healthcare System (FT Belvoir, VA), Keller Army Community Hospital (West Point, NY), and Kimbrough Ambulatory Care Center (FT Meade, MD). This standardization action is part of the Medical/Surgical Prime Vendor program executed by the Defense Supply Center Philadelphia (DSCP), Directorate of Medical Materiel. In order to participate, your company MUST have a Distribution and Pricing Agreement (DAPA) and a separate commercial agreement with the Prime Vendors for the program. This is pursuant to the DAPA clause by which DAPA holders agree to the Standardization process and to allow Prime Vendors to distribute their products. This RFRIAQ will result in Regional Incentive Agreements (RIA’s) that supplement the Prime Vendor Program. The RFQ will not result in a contract award. For additional information regarding DSCP’s Prime vendor program please access their web site at https://dmmonline.dscp.dla.mil. The resulting Regional Incentive Agreement (RIA) will be for a base period of two years (24 months) from date of selection with three one year (12 months) option periods (not to exceed 5 years.) Anticipated selection date is March 2010. The evaluation will be based on clinical, technical, and pricing factors. Clinical/performance and technical/company factors will be weighted more heavily than price. The Technical/Company and Clinical/Performance evaluation factors, when combined, are considered significantly more important than cost or price. As the technical and clinical evaluation results become more equal, price will become more important. The selection will be determined utilizing Best value/ trade-off criteria. The selection of a single vendor is anticipated. However, if no single vendor can meet the total requirement of the Region, the Government reserves the right to make two or more selections for RIAs. In this event, selection would be based on a combination of MTF preference and product availability. Point of Contact: Toni Massenburg, (202) 782-3666, toni.massenburg@us.army.mil. B.Products & Performance Required. The Northeast Region is seeking product line items in the category of ANESTHESIA BREATHING CIRCUITS, which at a minimum includes the high volume lines below. Within this region, this product line has an estimated annual dollar requirement of $273,726. This forecast is based on historical prime vendor sales during a recent 12-month period. The top high volume usage lines for this project are shown in the Technical/Company Criteria below. At the request of the Northeast Regional MTFs, vendors will provide on-site support and in-servicing during implementation, conversion information, prime vendor order numbers, and itemization of the brands, types and packaging information of the products supplied by the vendor. C.Instructions to Vendors. DAPA holders interested in participating in this standardization initiative should email their detailed responses to the technical/company criteria and (1) Company name and address, (2) Company POC (Name and Phone Number, Fax Number, and E-mail address) to Toni Massenburg, (202) 782-3666, toni.massenburg@us.army.mil or Tracy Martin-Tilghman, (202) 782-3663, tracy.martintilghman@us.army.mil as a back-up. Submissions must be received by COB 5:00 PM EST on the specified closing date/time of this sources sought notice. Vendors that fail to meet this submittal deadline will be disqualified from participating in the standardization process. This process will include vendor requirements to provide electronic responses to technical criteria, no charge samples for clinical evaluation, and submission of electronic best price quotes. Due to the potential for email to be lost in transmission, from network security, etc., vendors are strongly encouraged to confirm with the Region that its initial submission, quote and literature actually arrived at the Region via email. Each submitting vendor is advised to confirm receipt, allowing adequate time for resubmission before the due date/time, should a problem occur with the first submission. Vendors that do not meet the deadline of COB 5:00PM EST on the date listed for closing (per the FBO RFQ), will be disqualified from further consideration in the standardization initiative. All email communications between vendors and the Region should be digitally signed by the issuer. D. Evaluation Criteria. The Tri-Service Product Review Board (TPRB) is the governing body of the standardization process. This board includes clinicians and logisticians from the Military Treatment Facilities within the Northeast Region. They are the deciding officials for this initiative. The Region intends to evaluate quotes and select a vendor or vendors, on initial submissions/quotes. Vendor quotes should contain the vendor's best product matches for the products or product lines requested in this announcement. Vendor quotes should contain the vendor's best tiered-pricing discounts off of the vendor's DAPA pricing (based on committed volume of 80% of the total requirements of the MTFs in the Region). (Note: vendors that fail to submit a discount from DAPA will be disqualified. Note: Where lower FSS prices are available, DAPA holders are required by previous agreement to provide the FSS price as the DAPA price. Vendors shall not quote FSS prices as the discounted price for purposes of this standardization initiative.) However, the Region reserves the right to conduct discussions and request revised quotes, if determined necessary. The Region reserves the right to limit the number of quotes to the greatest number that will permit an efficient competition among vendors. The Region reserves the right to make a down-selection during the evaluation process based on considerations of efficient competition. The TPRB votes for the best value for a single or multiple vendor selection(s). A multiple selection is only a possibility if no single vendor can meet the total requirement of the Region and would be based on a combination of MTF preference and product availability. Phase I – Technical/Company Evaluation Process: Interested vendors are to respond to this FBO announcement by emailing their detailed responses and required documentation to toni.massenburg@us.army.mil by the required response date. Vendors are required to meet/provide responses to the technical/company criteria stated below. All technical/company criteria are weighted equally. The responses will be reviewed by the Clinical Product Team (CPT) and determine the acceptability of each vendor. After the review of the technical/company criteria, those vendors who meet the following technical/company criteria will be qualified/invited to participate in the clinical/performance evaluation process as well as the price analysis process and will be requested to submit their best product/price proposed package discount quotes via an email communication with each vendor. In general, “acceptability for the purposes of validation of technical/company criteria is defined as follows: Generally, responses to all questions in the technical/company criteria demonstrate that: (1) based on the vendors’ responses, the evaluators have reasonable confidence that the line of products and /or services submitted meet the medical standards of care of the community, applicable to such products and services; (2) the vendor’s information provided is factually correct. Any misrepresentation of information will disqualify the vendor from further consideration. NOTE: Specific technical/company criteria will require an additional, more-specific definition of “technical acceptability.” The specific standard for technical acceptability will be set forth with the individual statement of each criterion, as required. The following equally weighted Technical/Company Evaluation Criteria have been established for this standardization initiative: 1.Vendor MUST provide a complete line of Anesthesia Breathing Circuit products. A ‘complete line of product’ is defined as the MTF’s requirements for usage items in the product line. Usage items are defined in the Medical/Surgical Prime Vendor contract statement of work, as DAPA items ordered at least once per month, and at least one unit per order. The ability for the vendor to provide these items is considered critical and failure by them to do so will result in the vendor not being included in this standardization effort. a.At a minimum, this product line consists of a complete line of sterile, standard circuit configurations and a full line of single-use anesthesia breathing circuit components in both adult and pediatric sizes, regular and expandable tubing, as well as adult and pediatric single-limb circuits, HME/HEPA filters, bags, masks, connectors, gas sampling lines, oxygen and suction tubing, and yankauers. Vendors are required to supply items listed below. Product Kits to SendItem DescriptionQuantity Adult Anesthesia Breathing Circuits5 kits 1 dead space elbow with gas sampling port 1 wye connector 2 corrugated/expandable tubes 80 inch 2 filters HME 1 clear, air cushion mask size 6 1 breathing bag 3L 1 oxygen tubing 1 yankaeur 14FR 1 suction tubing Pediatric Anesthesia Breathing Circuits2 kits 1 dead space elbow with gas sampling port 1 wye connector 2 corrugated/expandable tubes 40-60 inch 2 filters HME 1 clear, air cushion mask size 4 1 breathing bag 1 or 2L 1 oxygen tubing 1 yankaeur 8FR 1 suction tubing b.Vendor MUST provide a complete list of items supplied (manufactured and/or distributed by brands) via catalog, and product literature in response to this RFQ with initial submittal. Vendors are required to supply items listed in all sizes, lengths, configurations, accessories, and components to meet all of the procedural needs. (Vendors who do not have a complete product line as above will be disqualified in Phase I). 2.Vendor MUST have a DAPA for the Anesthesia Breathing Circuits product line. Vendor MUST provide DAPA number with initial submittal. (Note that vendors without a DAPA number will be disqualified in Phase I). 3.Vendor MUST have a separate agreement with the prime vendor (currently, the prime vendor is Owens & Minor) for Anesthesia Breathing Circuits in the Northeast Region. (Note that vendors whose products are not available through the regional PV will be disqualified in Phase I.) Vendor MUST provide supporting documentation (four digit code) of agreement with Prime Vendor with initial submittal. 4.Vendors MUST submit discounts off DAPA for all products included in this standardization initiative. (Note: vendors that fail to submit a discount from DAPA will be disqualified. Note: Where lower FSS prices are available, DAPA holders are required by previous agreement to provide the FSS price as the DAPA price. Vendors shall not quote FSS prices as the discounted price for purposes of this standardization initiative.) Vendors who do not provide discounts off DAPA for ALL products in Phase II will be disqualified. 5.Vendor MUST provide all history of back orders and recalls that occurred during the most recent 12-month period for Anesthesia Breathing Circuit products, including dates, duration, cause, and resolution. Vendors will not have an opportunity to provide additional information on back orders and recall during any subsequent stage in this evaluation. Vendors are encouraged to submit all information deemed relevant (i.e., positive resolutions, etc.) in response to this RFQ. The Government will not contact any provided points of contact in response to this question. Vendors should not provide point of contact information in response to this question. 6.Vendor MUST provide competent Anesthesia Breathing Circuit products that are mandatory to the safe and effective delivery of oxygen and anesthetic gases to the patient and are safe, reliable, and meet ISO and ASTM standards that are an integral part of the purpose for the Anesthesia Breathing Circuits. Vendors MUST identify these features of their products that provide for patient safety and provide literature to support this in response to this RFQ with initial submittal. 7. Vendor MUST provide latex safe/free products. Vendor MUST provide list of all latex safe/free items supplied such as catalogs, etc. in response to this RFQ with initial submittal. Phase II Plan – Clinical/Performance Evaluations and Pricing Analysis Process: Clinical/Performance Evaluations 1.Following acceptability of the technical/company criteria, the TRBO, on behalf of the CPT, will request product sample sets from the product group to be sent directly to the to the CPT members at participating Medical Treatment Facilities (MTFs), and will be allowed 14 calendar days from the date of notification to complete the delivery. Product samples must be shipped to arrive at the participating MTF address by COB, 5:00PM EST, (14) calendar days after the notice to ship. Vendors who do not meet the deadline to deliver the product samples by the deadline will be disqualified from this standardization initiative. Note: all vendors must send the TRBO verification regarding the date of shipment from the vendor and final delivery date of the product sample sets. 2.Specific MTFs will evaluate the vendor’s product sample sets against the clinical/performance criteria in a clinical/patient care setting using a Likert scale, with a one to five scoring range. The scale descriptors are: one (1)-not acceptable, two (2)-minimally acceptable, three (3)-acceptable, four (4)-more acceptable, and five (5)-highly acceptable. 3.All clinical/performance criteria are weighted equally. The clinical/performance evaluation period will last for twenty-one (21) calendar days. The CPT has established a target threshold of 3.50 for the Clinical Acceptability of products for standardization. The CPT will determine the actual Acceptability threshold for this standardization initiative -- at or near 3.50 -- depending on the location of any "break" in vendors’ average scores (i.e., a gap between vendors’ average scores). In addition, the CPT may consider how closely scores are clustered near the Acceptability target threshold of 3.50, in determining the actual Acceptability threshold. Vendors scoring below the actual Acceptability threshold will be determined to be clinically Unacceptable, and be disqualified from further consideration for this standardization initiative. Vendors that have been disqualified will be notified in writing at the conclusion of the evaluation process (DSCP approval). 4.To determine acceptability, the CPT, comprised of medical professionals from multiple disciplines from the Northeast Region will evaluate the products based on the evaluation criteria below in a clinical/patient care setting. 5.Vendors will ONLY provide sample products of the items that are requested and being evaluated. Vendors who bring in other product samples or literature on items that are not part of the evaluation process will be disqualified from the evaluation process. Vendor’s presence will not be required for in-servicing prior to the evaluations. Vendors WILL NOT BE ALLOWED TO BE PRESENT during the actual evaluation process of their products or their competitor’s products. 6.Vendors will not be allowed to speak to any hospital staff member regarding the product evaluation, product pricing or price–related factors. Vendors that speak to hospital staff members regarding the product evaluation; pricing or price–related factor will be disqualified from this evaluation process. Clinical/Performance Criteria: 1.The CPT identified that the standards of care that the Northeast Region medical communities adhere to, specifically related to Anesthesia Breathing Circuits, are those that will be the basis for specific technical/company and clinical/performance criteria. The standards are set forth by the following: a. Recommended practices for cleaning, handling, and processing anesthesia equipment. AORN Journal, 01 Apr 05. Anesthesia equipment is a potential vector in the transmission of microorganisms. Proper handling and processing of medications, supplies, and equipment can reduce the risk of infection to the patient. These recommended practices provide guidelines for the handling, cleaning, disposal, and reprocessing of anesthesia equipment and instrumentation. i.Recommended Practice IV - Single-use items (eg, breathing circuits, endotracheal tubes, filters, needles, some LMAs, stylets, suction catheters, syringes) should be used once and discarded in accordance with local, state, and federal regulations. ii.Recommended Practice V - Anesthesia equipment should meet performance and safety criteria established by the practice setting and that is consistent with the manufacturer's written instructions. b. American Association of Nurse Anesthetists’s (AANA) Infection Control Guide, Part III: Infection Control Procedures for Anesthesia Equipment, under Breathing Circuits and Bacterial Filters: i. Bacteria circulates throughout the patient circuit and has been shown to grow and prosper inside the absorber and accessories. Gas flow through the inspiratory side is initially clean and dry, but bacteria from the patient is present in the moist environment of the expiratory side. As a result, a change of breathing circuit and rebreathing bag is necessary to prevent the transfer of bacteria from one patient to another. ii. A bacterial filter placed between the y-piece and the mask or tracheal tube serves to protect the patient and the anesthesia delivery system from contamination. iii.A bacterial filter attached to the inhalation side of the patient circuit is effective for trapping and collecting organisms that may be present in the inspiratory limb of the breathing circuit. Attaching a bacteria filter to the expiratory inlet of the ventilator prevents the spread of bacteria through the expiratory channel and out into the room. This helps reduce the risk of infections being spread to the staff and of cross-contaminations between patients. iv.Each bacterial filter shall be removed at the end of every case and disposed of in an appropriate manner to prevent the spread of bacteria. To minimize water accumulation in the filter, which may increase resistance to flow in the patient circuit, bacterial filters shall not be reused or reprocessed nor used for prolonged periods of time without vigilant observation of the airway pressure gauge and airway pressure monitor to detect and correct any problem that may develop as a result of fluid accumulation in the filter housing. c. FDA: Recognition List Number: 020 Publication Date: 09/09/2008 ISO 5356-1:2004, Anaesthetic and respiratory equipment - Conical connectors: Part 1: Cones and sockets. (Anesthesia): Devices Affected: i. Anaesthetic and respiratory equipment -- conical connectors. Breathing circuits, ventilator tubing, tracheal tubes, tracheostomy tubes, bronchial tubes, PEEP valves, anesthesia gas machines, ventilators, manual emergency ventilators, powered emergency ventilators, airway connectors, bacterial filters, respiratory gas humidifiers, airway connectors and nonrebreathing valves. d. American Society of Anesthesiologists: Recommendations For Infection Control For The Practice Of Anesthesiology (2nd Edition): i. There are insufficient clinical outcome data to support the routine use of bacterial filters for breathing circuits or anesthesia ventilators at this time. A filter should be used on the anesthesia breathing circuit between the patient's airway and the Y-connector prior to contacting a patient with or at high risk for having pulmonary tuberculosis. e. ASTM F1690 - 96(2004) Standard Specification for Humidifiers for Medical Use— Part 1: General Requirements for Active Humidification Systems: ii.This specification includes requirements for the safety and performance of active vaporizing and nebulizing humidification systems, as defined in 3.1.6, suitable for inclusion in breathing systems (both intubated and non-intubated patients). iii.This specification also includes requirements for breathing tubes, including heated breathing tubes (heated-wire breathing circuits), and devices intended to control these heated breathing tubes, heated breathing tube controllers. iv.Reference documents: 1.F1054 Specification for Conical Fittings F1205 Specification for Anesthesia Breathing Tubes 2.F1463 Specification for Alarm Signals in Medical Equipment Used in Anesthesia and Respiratory Care ISO 4135: 1979 Anesthesiology-Vocabulary ISO 8835-2: 1993(E) Inhalation Anesthesia Systems-Part 2: Anesthetic Circle Breathing Systems f.Comparison of manufacturers' specifications for 44 types of heat and moisture exchanging filters by J. Dellamonica, N. Boisseau, B. Goubaux and M. Raucoules-Aimé, British Journal of Anaesthesia 2004 93(4):532-539; doi:10.1093/bja/aeh239. i.Technical aspects of the tests, international standards, and independent validation should be considered when a filter is chosen. ii.Many authorities recommend the use of a bacterial and viral airway filter during anaesthesia to prevent cross-contamination and reduce the need to change breathing circuits. iii.Some bacterial and viral filters also allow humidification and heat-exchange. iv.The two standards for breathing system filters are the International Standards Organisation ISO 9360-1 and the European standard norm EN 13328-1. a.The International Standards Organisation standard ISO 9360 set the following humidification characteristics of heat and moisture exchange filters (HMEF): 1.Control of humidity at entry into the filter; temperature; duration of the test (24 h); gas flows (30, 60 and 90 litres min–1); tidal volume (250, 500, 750 and 1000 ml); and resistance at the end of the test. 2.HMEF must be bacteriologically clean and made to conform with ISO or European standards and good manufacturing practice. 3.A high-performance HMEF might also prevent moisture accumulation in ventilator circuits. v.During anaesthesia, the role of humidification is less clear and microbial filtration capacity more important. Clinical/Performance Criteria: During the pre-source selection procedures, the CPT validated/approved the equally weighted clinical/performance criteria outlined below: 1.(Staff Efficiency of Care/ Patient Safety) The light weight corrugated and expandable tubing is of adequate length and retains memory when extended for ideal positioning. a.Clinicians require the product to resist cracking, ripping, and tearing; expand to allow for a turn of 180 degrees; and retain memory for ideal positioning. b.This criterion will be evaluated in a clinical setting by use of the product on at least (3) patients. c.Evaluator will open/remove product from packaging, easily extend the tubing into proper position, and check for any signs of cracking, ripping, or tearing. d. Evaluator will observe that the tubing retains its memory. e.Evaluator will extend the tubing to allow the operating platform to be turned at least 180 degrees. 2.(Staff Efficiency of Care/ Patient Safety) The soft, air-inflatable cushion is ergonomically designed, has a clear body for superior view, and has an inflation valve that allows the cushion to be easily adjusted to provide a safe and conformable fit. a.Clinicians require that the product is engineered with a secure-fit air cushion mask to provide an optimal seal with minimum pressure. b.This criterion will be evaluated in the clinical setting by use of the product on at least (3) patients. c.After applying the mask securely over the mouth and nose with the adjustable strap, the evaluator will examine for any leakage. 3.(Staff Efficiency of Care/ Patient Safety) The product’s single limb swivel connector eliminates kinking problems and helps reduce torque at the patient end. a.Clinicians require that the product effectively prevents kinking problems, making repositioning of the circuits easier. b.This criterion will be evaluated in the clinical setting by use of the product on at least (3) patients. c.The evaluator will examine the swivel connector with the naked eye and determine if there is any torque or kinks. 4. (Staff Efficiency of Care) The product is easy to set up and connect to the anesthesia gas machine and endotracheal tube. a.Clinicians require that product come in a complete kit reducing the necessity to gather and assemble extra components and that the tubing is easy to connect to the gas outflow of the machine and the patient. b.This criterion will be evaluated in a clinical setting by use of the product on at least (3) patients. c.The evaluator will open/remove products from the packaging without having to assemble any of the components and attach to the anesthesia gas machine and endotracheal tube. Evaluator will observe the ease of performing the task. Pricing Analysis Process. Upon completion of the Phase I – Technical/Company Criteria Evaluation, vendors who are found technically acceptable will be qualified/invited to provide their their product samples and price discount quotes concurrently. Vendors will be given 14 calendar days from the date of pricing requests, to submit RIA pricing quotes, in a prescribed electronic spreadsheet format, based upon the requirements of the Northeast Region. Pricing must be received at the TRBO by COB 5:00 PM (EST), fourteen (14) calendar days after the issue date of the vendor notice to submit best product and price quotes. Failure to respond within this timeframe or failure to submit incentive discounts from their DAPA prices will result in the vendor being disqualified from further consideration/ participation. The Region intends to evaluate quotes and select a vendor on initial submissions/quotes. Vendor quotes should contain the vendor's best product matches for the products or product lines requested in this announcement. Vendor quotes should contain the vendor's best tiered-pricing discounts off of the vendor's DAPA pricing (based on committed volume of 80% of the total requirements of the MTFs in the Region). The Region intends to evaluate quotes and select a vendor or vendor(s), without discussions as noted above. However, the Region reserves the right to conduct discussions and request revised quotes, if it is determined to be necessary. If a down-selection is made during the evaluation process, the Region may limit the number of quotes to the greatest number that will permit an efficient competition among vendors. Clinical/performance and technical/company factors will be weighted more heavily than price. The Technical/Company and Clinical/Performance evaluation factors, when combined, are considered significantly more important than cost or price. As the technical and clinical evaluation results become more equal, price will become more important. Pricing will be evaluated based on best value to the government and will be based on a committed volume for a two year (24 months) from date of selection with three one year (12 months) option periods (not to exceed 5 years). The following elements will be considered in the pricing analysis: (1) Impact of RIA prices on the Region. (Post-Standardization Costs). This represents the new estimated annual cost or the total cost post standardization and includes the vendor’s products, and the products that could not be matched. The unmatched lines make it difficult to compare the prices of the various vendors, because the evaluator cannot compare similar product lines for each vendor. Those items that are considered in the high usage category will have a higher impact to the region for the unmatched product line and the end post-standardization costs. (3) Consideration of SKUs by each vendor. The Region intends to reduce the number of SKUs that must be handled per period. Vendors that can supply the complete range of clinically-required product, without unnecessary numbers of SKUs for minimally-differentiated products, will be more likely to provide the best-value solution for the Government in this standardization initiative. (4) Potential Cost Avoidance. Cost avoidance is calculated by subtracting the RIA price from the Distribution and Pricing Agreement (DAPA) price and multiplying by 12-months of usage. This is included as a reporting Matrix. Operational Impact of RIA prices on the Northeast Region are considered more important than other pricing elements. _____________________________________________________________________________ END
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