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HOSPITAL, POST, CAMP OR STATION-QUESTIONNAIRE

General Information.

1. Has purchasing and contracting authority been delegated to you? If so, answer the following:

A.

B.

Provide the title and the organizational location of the
positions to whom this authority has been delegated.

How this authority was delegated and by whom?

C.

Do you purchase for or provide supply support for any other activity or agency (satellited, interservice or through interagency support agreements, grantees, etc.)? If so, list them and provide copies of any formal support agreements initiated.

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2A. Whs is the tal annual dollar volume of stock n and nonstock numbered medical and nonperishable es ordered during the 12-month period ending December 31, 1971 for:

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Requisitions, orders,

& other requests

placed on established

Govt. sources of

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supply as follows:

(1) DSA (DPSC, Phila, Pa

(2) VA (Hines, Ill.)

(3) GSA Depots

Specify location

4) BIA (Gallup, N.M.)

5) PHS (Perry Point,
Md.)

6) Other Govt. In-
stallations
(Specify)

7) Procurement action performed for you by other activities (Specify the Activity)

Total

29.

What is the total annual dollar volure of stock numbered and nonstock numbered medical and nonperishable sistence items ordered during the 12-month period ending December 31, 1971 for:

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What is the total annual dollar volume of stock numbered and nonstock numbered medical and nonperishable sbsistence items ordered during the 12-month period ending December 31, 1971 for:

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3. Provide the government storage points and percentage of support from each fror which your drugs, medical supplies, equipment and nonperishable subsistence iters are received.

4. Under what criteria are you required to submit reports to an inventory control point or higher headquarters containing detail or summary data on items purchased locally? If so, to whom, what elements of data are required and what is the frequency of reporting?

5. Provide listings of line items or copies of Purchase Documents of locally purchased items which would constitute the total dollar volume of purchases indicated in 2B and 2C above during CY 1971 for (1) drugs, (2) other medical materials and (3) nonperishable subsistence, in accordance with FSC classes shown on attached list. If manual or ADP machine listings are provided, portray data in FSC sequence with those items having FSN's listed first in each FSC:

A. Complete item description to include FEN, purchase description, manufacturer's name and part mumber, and specification reference.

b. CY 1971 dollar volume.

c.

Total units purchased in CY 1971 (describe unit, e.g., can size, bottle size, or number of units per case, etc.).

d. Number of times purchased in CY 1971.

e. Average cost per unit.

6. What are the authorizing criteria for exceptions from requesting support from prescribed central or mandatory sources of supply, e.g., emergency requirements, dollar limitation, geographical limitation, item types, etc. Specify the authorizing documentation for each criterion.

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