0 - SF1449.pdf
PDF 222 KB Posted
- Attached to
- CTS Services in Columbus, OH
- Solicitation number
- 15BCTS22Q00000001
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 4 - SubK Plan 11.12.20.pdf | ||
| 2 - Business Quotation Information March 2019.pdf | ||
| 3 - Technical Quotation Information 2021.docx | DOCX document | |
| 1 - SOW Oct 2020.pdf | ||
| 5 - Whistleblower Info.pdf | ||
| 0 - Cover LetterEMAIL.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
15BCTS22Q00000001 Page 1 of 60
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30
1. REQUISITION NUMBER PAGE 1 OF
5. SOLICITATION NUMBER
15BCTS22Q00000001
2. CONTRACT NO. 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
Stephen A. Deffenbaugh sadeffenbaugh@bop.gov
b. TELEPHONE NUMBER (No collect calls)
202-598-3483
8. OFFER DUE DATE / LOCAL
TIME
10/12/2021 14:00 ET
CODE 15BCTS
Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contractng 320 First Street NW Room 901-5 Washington, DC 20534
9. ISSUED BY X UNRESTRICTED OR SET ASIDE: % FOR
SMALL BUSINESS
HUBZONE SMALL
BUSINESS
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
WOMEN-OWNED SMALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOMEN-OWNED
SMALL BUSINESS PROGRAM
EDWOSB
8(A)
NAICS:
SIZE STANDARD: $16,500,000
10. THE ACQUISITION IS
SEE
SCHEDULE
11. DELIVERY FOR FOB DESTINATION
UNLESS BLOCK IS MARKED
NET 30
12. DISCOUNT TERMS
13a. THIS CONTRACT IS A
RATED ORDER UNDER DPAS
(15 CFR 700)
13b. RATING
X RFQ IFB RFP
14. METHOD OF SOLICITATION
15B500CODE15. DELIVER TO
Federal Bureau of Prisons Northeast Regional Office
US CUSTOM HOUSE, 7TH FLOOR
2ND & CHESTNUT
PHILADELPHIA, PA 19106
CODE 15BCTS16. ADMINISTERED BY
Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contractng 320 First Street NW Room 901-5 Washington, DC 20534
Stephen A. Deffenbaugh
(O) 202-598-3483 sadeffenbaugh@bop.gov
FACILITY
CODE
CODE
TELEPHONE NO.
17a. CONTRACTOR/
OFFEROR
15B500CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons Northeast Regional Office
US CUSTOM HOUSE, 7TH FLOOR
2ND & CHESTNUT
PHILADELPHIA, PA 19106
BOP-RSD-CRBCTS-BILL-PHL@bop.gov
17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN
OFFER SEE ADDENDUM
18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS
CHECKED
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
Delivery Date: 10/01/2021
Provide community-based Outpatient Substance Use and Mental Health Treatment Services to Federal offenders residing in a residential re-entry center or home confinement in the Columbus, OH area.
See Continuation Sheet(s) (Use Reverse and/or Attach Additional Sheets as Necessary)
25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)
X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA X ARE ARE NOT ATTACHED
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ____ COPIES TO
ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH
OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE
TERMS AND CONDITIONS SPECIFIED.
29. AWARD OF CONTRACT: REF. _____________________________ OFFER
DATED _________________ . YOUR OFFER ON SOLICITATION (BLOCK 5)
INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN,
IS ACCEPTED AS TO ITEMS:
30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)
30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (TYPE OR PRINT)
Stephen Deffenbaugh
31c. DATE SIGNED
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STANDARD FORM 1449 (REV. 2/2012)
Prescribed by GSA - FAR (48 CFR) 53.212
001-22
15BCTS22Q00000001 Page 2 of 60
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: _________________________________
32b. SIGNATURE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
PARTIAL FINAL
33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED
CORRECT FOR
COMPLETE PARTIAL FINAL
36. PAYMENT 37. CHECK NUMBER
38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)
41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE
42b. RECEIVED AT (Location)
42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS
STANDARD FORM 1449 (REV. 2/2012) BACK
15BCTS22Q00000001 Page 3 of 60
Table of Contents
Section Description Page Number
1 Solicitation/Contract Form 2 Commodity or Services Schedule 3 Contract Clauses
52.242-15 Stop-Work Order (Aug 1989)
52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE
2004)
52.218-000 CONTINUING CONTRACT PERFORMANCE DURING A PANDEMIC INFLUENZA
OR OTHER NATIONAL EMERGENCY (May 2008) 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) DJAR-PGD-15-03 Security of Department Information and Systems 52.203-3 Gratuities (Apr 1984) 52.212-4 Contract Terms and Conditions-Commercial Items (Oct 2018) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-2 Privacy Act (Apr 1984) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Dec 2013) 52.253-1 Computer Generated Forms (Jan 1991) 52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020) 52.242-13 Bankruptcy (July 1995) 52.204-12 Unique Entity Identifier Maintenance (Oct 2016)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR
2011) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders- Commercial Items (Sep 2021) 52.216-19 Order Limitations (Oct 1995) 52.216-18 Ordering (Aug 2020) 52.217-8 Option to Extend Services (Nov 1999) 52.216-21 Requirements (Oct 1995) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.232-18 Availability of Funds (Apr 1984) 52.232-19 Availability of Funds for the Next Fiscal Year (Apr 1984) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (June 2016)
4 List of Attachments 5 Solicitation Provisions
52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation (Jan 2017) 52.212-3 Offeror Representations and Certifications-Commercial Items (Feb 2021) 52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct 2020) 52.212-1 Instructions to Offerors-Commercial Items (Sep 2021) 52.204-22 Alternative Line Item Proposal (Jan 2017) 52.204-7 System for Award Management (Oct 2018) 52.204-16 Commercial and Government Entity Code Reporting (Aug 2020) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998) 52.216-1 Type of Contract (Apr 1984) 52.217-5 Evaluation of Options (July 1990)
15BCTS22Q00000001 Page 4 of 60
Section 2 - Commodity or Services Schedule
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0001 Substance Use Intake Screening (2005) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0002 Substance Use Individual Counseling (2010) - Estimated 48 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
2,880 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0003 Substance Use Intake Assessment & Report (2011) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0004 Dual Diagnosis Intake Assessment & Report (2012) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0005 Substance Use Group Counseling (2020) - Estimated 72 units per Inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
4,320 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0006 Substance Use Family Counseling (2030) - Estimated 24 units per Inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0007 MAT - Buprenorphine Follow-Up and Report (4002) - Estimated 6 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0008 MAT - Naltrexone Follow-Up and Report (4003) - Estimated 6 units per inmate
Base Year - 11/1/2021-10/31/2022
30 EA $________ $_________________
15BCTS22Q00000001 Page 5 of 60
PSC: G004
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0009 MAT - Administration of Buprenorphine (4020) - Estimated 168 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0010 MAT - Buprenorphine and Administration (4021) - Estimated 168 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0011 MAT - Administration of Buprenorphine Injection (4030) - Estimated 6 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0012 MAT - Buprenorphine and Administration of Injection (4031) - Estimated 6 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0013 MAT - Administration of Naltrexone (4040) - Estimated 6 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0014 MAT - Naltrexone and Administration (4041) - Estimated 6 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0015 MAT - Psychiatric Evaluation & Report (4050) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
4 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0016 Mental Health Intake Screening (5005) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0017 Mental Health Assessment & Report (5011) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
24 EA $________ $_________________
15BCTS22Q00000001 Page 6 of 60
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0018 Psychiatric Evaluation and Report (5030) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0019 Crisis Intervention Evaluation & Report (6000) - Estimated 1 unit per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
3 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0020 Mental Health Individual Counseling (6010) - Estimated 48 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
1,632 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0021 Mental Health Group Counseling (6020) - Estimated 48 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0022 Case Management Services (6030) - Estimated 24 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
72 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0023 Mental Health Family Counseling (6031) - Estimated 24 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0024 Administration of Medication (6050) - Estimated 6 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0025 Medication Monitoring and Report (6051) - Estimated 5 units per inmate
Base Year - 11/1/2021-10/31/2022
PSC: G004
170 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Substance Use Intake Screening (2005) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
Firm Fixed Price
10 EA $________ $_________________
15BCTS22Q00000001 Page 7 of 60
0027 Substance Use Individual Counseling (2010) - Estimated 48 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
2,304 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0028 Substance Use Intake Assessment & Report (2011) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0029 Dual Diagnosis Intake Assessment & Report (2012) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0030 Substance Use Group Counseling (2020) - Estimated 72 units per Inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
3,456 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0031 Substance Use Family Counseling (2030) - Estimated 24 units per Inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0032 MAT - Buprenorphine Follow-Up and Report (4002) - Estimated 6 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0033 MAT - Naltrexone Follow-Up and Report (4003) - Estimated 6 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0034 MAT - Administration of Buprenorphine (4020) - Estimated 168 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
672 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0035 MAT - Buprenorphine and Administration (4021) - Estimated 168 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
672 EA $________ $_________________
15BCTS22Q00000001 Page 8 of 60
0036 MAT - Administration of Buprenorphine Injection (4030) - Estimated 6 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0037 MAT - Buprenorphine and Administration of Injection (4031) - Estimated 6 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0038 MAT - Administration of Naltrexone (4040) - Estimated 6 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0039 MAT - Naltrexone and Administration (4041) - Estimated 6 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0040 MAT - Psychiatric Evaluation & Report (4050) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
4 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0041 Mental Health Intake Screening (5005) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0042 Mental Health Assessment & Report (5011) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0043 Psychiatric Evaluation and Report (5030) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0044 Crisis Intervention Evaluation & Report (6000) - Estimated 1 unit per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0045 Mental Health Individual Counseling (6010) - Estimated 48 units per inmate
1,152 EA $________ $_________________
15BCTS22Q00000001 Page 9 of 60
Option Year One - 11/1/2022-10/31/2023
PSC: G004
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0046 Mental Health Group Counseling (6020) - Estimated 48 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
1,152 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0047 Case Management Services (6030) - Estimated 24 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
72 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0048 Mental Health Family Counseling (6031) - Estimated 24 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0049 Administration of Medication (6050) - Estimated 6 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0050 Medication Monitoring and Report (6051) - Estimated 5 units per inmate
Option Year One - 11/1/2022-10/31/2023
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Substance Use Intake Screening (2005) - Estimated 1 unit per inmate
Option Year Two - 11/1/2023-10/31/2024
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0052 Substance Use Individual Counseling (2010) - Estimated 48 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
2,304 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0053 Substance Use Intake Assessment & Report (2011) - Estimated 1 unit per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0054 Dual Diagnosis Intake Assessment & Report (2012) - Estimated 1 unit per inmate
10 EA $________ $_________________
15BCTS22Q00000001 Page 10 of 60
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0055 Substance Use Group Counseling (2020) - Estimated 72 units per Inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
3,456 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0056 Substance Use Family Counseling (2030) - Estimated 24 units per Inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0057 MAT - Buprenorphine Follow-Up and Report (4002) - Estimated 6 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0058 MAT - Naltrexone Follow-Up and Report (4003) - Estimated 6 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0059 MAT - Administration of Buprenorphine (4020) - Estimated 168 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
672 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0060 MAT - Buprenorphine and Administration (4021) - Estimated 168 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
672 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0061 MAT - Administration of Buprenorphine Injection (4030) - Estimated 6 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0062 MAT - Buprenorphine and Administration of Injection (4031) - Estimated 6 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0063 MAT - Administration of Naltrexone (4040) - Estimated 6 units per inmate
Option Year Two - 11/1/2023-10/31/2024
15BCTS22Q00000001 Page 11 of 60
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0064 MAT - Naltrexone and Administration (4041) - Estimated 6 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0065 MAT - Psychiatric Evaluation & Report (4050) - Estimated 1 unit per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
4 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0066 Mental Health Intake Screening (5005) - Estimated 1 unit per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0067 Mental Health Assessment & Report (5011) - Estimated 1 unit per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0068 Psychiatric Evaluation and Report (5030) - Estimated 1 unit per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0069 Crisis Intervention Evaluation & Report (6000) - Estimated 1 unit per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0070 Mental Health Individual Counseling (6010) - Estimated 48 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
1,152 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0071 Mental Health Group Counseling (6020) - Estimated 48 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
1,152 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0072 Case Management Services (6030) - Estimated 24 units per inmate
Option Year Two - 11/1/2023-10/31/2024
72 EA $________ $_________________
15BCTS22Q00000001 Page 12 of 60
0073 Mental Health Family Counseling (6031) - Estimated 24 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0074 Administration of Medication (6050) - Estimated 6 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0075 Medication Monitoring and Report (6051) - Estimated 5 units per inmate
Option Year Two - 11/1/2023-10/31/2024
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Substance Use Intake Screening (2005) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0077 Substance Use Individual Counseling (2010) - Estimated 48 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
2,304 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0078 Substance Use Intake Assessment & Report (2011) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0079 Dual Diagnosis Intake Assessment & Report (2012) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0080 Substance Use Group Counseling (2020) - Estimated 72 units per Inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
3,456 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0081 Substance Use Family Counseling (2030) - Estimated 24 units per Inmate
Option Year Three - 11/1/2024-10/31/2025
240 EA $________ $_________________
15BCTS22Q00000001 Page 13 of 60
0082 MAT - Buprenorphine Follow-Up and Report (4002) - Estimated 6 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0083 MAT - Naltrexone Follow-Up and Report (4003) - Estimated 6 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0084 MAT - Administration of Buprenorphine (4020) - Estimated 168 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
672 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0085 MAT - Buprenorphine and Administration (4021) - Estimated 168 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
672 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0086 MAT - Administration of Buprenorphine Injection (4030) - Estimated 6 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0087 MAT - Buprenorphine and Administration of Injection (4031) - Estimated 6 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0088 MAT - Administration of Naltrexone (4040) - Estimated 6 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0089 MAT - Naltrexone and Administration (4041) - Estimated 6 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0090 MAT - Psychiatric Evaluation & Report (4050) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
4 EA $________ $_________________
15BCTS22Q00000001 Page 14 of 60
0091 Mental Health Intake Screening (5005) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0092 Mental Health Assessment & Report (5011) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0093 Psychiatric Evaluation and Report (5030) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0094 Crisis Intervention Evaluation & Report (6000) - Estimated 1 unit per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0095 Mental Health Individual Counseling (6010) - Estimated 48 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
1,152 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0096 Mental Health Group Counseling (6020) - Estimated 48 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
1,152 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0097 Case Management Services (6030) - Estimated 24 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
72 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0098 Mental Health Family Counseling (6031) - Estimated 24 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0099 Administration of Medication (6050) - Estimated 6 units per inmate
Option Year Three - 11/1/2024-10/31/2025
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0100 Medication Monitoring and Report (6051) - Estimated 5 units per inmate
Option Year Three - 11/1/2024-10/31/2025
120 EA $________ $_________________
15BCTS22Q00000001 Page 15 of 60
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 Substance Use Intake Screening (2005) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
Firm Fixed Price
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0102 Substance Use Individual Counseling (2010) - Estimated 48 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
2,304 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0103 Substance Use Intake Assessment & Report (2011) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0104 Dual Diagnosis Intake Assessment & Report (2012) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0105 Substance Use Group Counseling (2020) - Estimated 72 units per Inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
3,456 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0106 Substance Use Family Counseling (2030) - Estimated 24 units per Inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0107 MAT - Buprenorphine Follow-Up and Report (4002) - Estimated 6 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0108 MAT - Naltrexone Follow-Up and Report (4003) - Estimated 6 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0109 MAT - Administration of Buprenorphine (4020) - Estimated 168 units per inmate
672 EA $________ $_________________
15BCTS22Q00000001 Page 16 of 60
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0110 MAT - Buprenorphine and Administration (4021) - Estimated 168 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
672 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0111 MAT - Administration of Buprenorphine Injection (4030) - Estimated 6 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0112 MAT - Buprenorphine and Administration of Injection (4031) - Estimated 6 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0113 MAT - Administration of Naltrexone (4040) - Estimated 6 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0114 MAT - Naltrexone and Administration (4041) - Estimated 6 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0115 MAT - Psychiatric Evaluation & Report (4050) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
4 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0116 Mental Health Intake Screening (5005) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0117 Mental Health Assessment & Report (5011) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0118 Psychiatric Evaluation and Report (5030) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
15BCTS22Q00000001 Page 17 of 60
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0119 Crisis Intervention Evaluation & Report (6000) - Estimated 1 unit per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0120 Mental Health Individual Counseling (6010) - Estimated 48 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
1,152 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0121 Mental Health Group Counseling (6020) - Estimated 48 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
1,152 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0122 Case Management Services (6030) - Estimated 24 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
72 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0123 Mental Health Family Counseling (6031) - Estimated 24 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0124 Administration of Medication (6050) - Estimated 6 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0125 Medication Monitoring and Report (6051) - Estimated 5 units per inmate
Option Year Four - 11/1/2025-10/31/2026
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0126 Substance Use Intake Screening (2005) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
Firm Fixed Price
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0127 Substance Use Individual Counseling (2010) - Estimated 48 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
1,152 EA $________ $_________________
15BCTS22Q00000001 Page 18 of 60
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0128 Substance Use Intake Assessment & Report (2011) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
24 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0129 Dual Diagnosis Intake Assessment & Report (2012) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0130 Substance Use Group Counseling (2020) - Estimated 72 units per Inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
1,728 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0131 Substance Use Family Counseling (2030) - Estimated 24 units per Inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0132 MAT - Buprenorphine Follow-Up and Report (4002) - Estimated 6 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0133 MAT - Naltrexone Follow-Up and Report (4003) - Estimated 6 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0134 MAT - Administration of Buprenorphine (4020) - Estimated 168 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0135 MAT - Buprenorphine and Administration (4021) - Estimated 168 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
336 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0136 MAT - Administration of Buprenorphine Injection (4030) - Estimated 6 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
12 EA $________ $_________________
15BCTS22Q00000001 Page 19 of 60
0137 MAT - Buprenorphine and Administration of Injection (4031) - Estimated 6 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0138 MAT - Administration of Naltrexone (4040) - Estimated 6 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0139 MAT - Naltrexone and Administration (4041) - Estimated 6 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0140 MAT - Psychiatric Evaluation & Report (4050) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
2 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0141 Mental Health Intake Screening (5005) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0142 Mental Health Assessment & Report (5011) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0143 Psychiatric Evaluation and Report (5030) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0144 Crisis Intervention Evaluation & Report (6000) - Estimated 1 unit per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
3 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0145 Mental Health Individual Counseling (6010) - Estimated 48 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
576 EA $________ $_________________
15BCTS22Q00000001 Page 20 of 60
0146 Mental Health Group Counseling (6020) - Estimated 48 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
576 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0147 Case Management Services (6030) - Estimated 24 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0148 Mental Health Family Counseling (6031) - Estimated 24 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0149 Administration of Medication (6050) - Estimated 6 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0150 Medication Monitoring and Report (6051) - Estimated 5 units per inmate
Potential Six Month Extension - 11/1/2026-4/30/2027
PSC: G004
60 EA $________ $_________________
Please note that for all therapy sessions 30 minutes = 1 unit
2.1 Continuation of SF1449, Block 20
CONTINUATION OF SF-1449, BLOCK 20
SCHEDULE OF SUPPLIES/SERVICES
The contractor shall be capable of providing outpatient substance use and mental health services to offenders confined in community-based programs. The contractor shall provide a physical location from where all required services can be provided. The location where services are to be provided should be within a 10 mile radius of Columbus City Hall, 90 W. Broad St. Columbus, OH 43215.
The location must also be located within a half-mile walking distance from a public transportation stop stop.
All references to Residential Re-Entry Center (RRC) and Community Correctional Center (CCC) shall be treated equally for the purpose of this contract.
The anticipated total contract period is 5 years (to begin upon the effective date of contract award). The anticipated performance start date is November 1, 2021.
Community Treatment Services Decisional Rule Criteria Lowest Price Technically Acceptable:
Each quotation will be initially reviewed to determine that all document submission requirements listed under Addendum to FAR 52.212-1, Instructions to Offerors-Commercial Items, are met. By using the documentation submitted with each quotation, an initial review will also be conducted to determine whether or not it meets the minimum requirements contained in the Decisional Rule Criteria below. Any quotation not meeting this criteria may not receive any further consideration for award.
Quotes must clearly demonstrate at the time of submission, unless otherwise stated, the capability to meet the Decisional Rule Criteria below. Quotes will be rated "Acceptable" or "Unacceptable" based on the Decisional Rule Criteria. Quoters receiving an "Unacceptable" rating will be advised of their elimination from the procurement. Quoters receiving an "Acceptable" rating shall be considered for award.
15BCTS22Q00000001 Page 21 of 60
Community Treatment Services 2020 Decisional Rule Criteria -LPTA
1. Facility Requirement – Proposed Location(s): The Quoter must provide treatment at performance sites that meet the specified restrictions, space requirements, ADA compliance guidelines, and that do not present safety risks to the community. [SOW 7.1 & 7.2.1]
2. List addresses for all proposed performance sites, including subcontractors, who will provide the following services, Substance Use Disorder, Mental Health, and MAT Services, and that are within: a 10 mile radius from Columbus, OH, City Hall, 90 W. Broad St, Columbus OH 43215, and 0.5 mile walking distance to a local public transportation stop.
3. Submit a deed, lease, bill of sale, option or intent to lease, or option to buy in the name of the Quoter, or subcontractor, if applicable, for all addresses listed in 1a.
4. Provide the methods and means that will be used to ensure individual and group rooms will be private and confidential during treatment sessions. [SOW 7.1.1]
5. Submit an office diagram (see attached example) for each proposed performance site listed in 1a. The diagram must identify all rooms that will be used as counseling space, i.e., individual, group, or psychiatric treatment rooms, as well as any areas used for a waiting, lobby or reception area. The location of the restroom facilities should also be identified. [SOW 7.1.1]
* Specify on the office diagram the number of people each group room can comfortably accommodate.
Therapeutic group rooms must be primarily dedicated to treatment or reserved for outpatient community treatment services.
1. Complete and submit the attached Americans with Disabilities Act (ADA) Checklist for each proposed performance site listed in 1a. [SOW 7.1.1]
2. Complete and submit the attached Local Areas of Concern document for each proposed performance site listed in 1a. This document must identify the following areas of concern that are within: 500 feet This must include the same space and/or same building, of each proposed performance site, and include a plan to mitigate risk to children and other vulnerable populations:
* Schools, day-care centers, playgrounds, developed or improved parks, athletic fields, churches, school bus stops, and any facilities/businesses that primarily care for/educate/entertain minors or other vulnerable populations. [SOW 7.2.1]
1. Facility Requirement – Facility License: The facility must be appropriately licensed and/or certified to provide all required services on, or by, the contract effective date by the state authority where services will be rendered. [SOW 7.4]
2. Submit the required state facility license and/or certification to provide all treatment services at the proposed performance site(s) listed in 1a.
* If in the process of obtaining a valid license, submit the completed application, provisional license, official email correspondence, and/or other official documentation as proof. Documentation must show that the Quoter may begin services on, or by, the contract effective date.
1. Staffing Requirement: The Quoter must have key personnel to meet the solicitation requirements. The Quoter must ensure all personnel providing clinical services to Bureau inmates meet the experiential, educational, and appropriate licensure/certification as required by the state authority where the services will be rendered. [SOW 5.1]
2. Submit the Technical Personnel document that identifies the position and responsibility of all personnel proposed to meet or exceed the minimum staffing requirements of key personnel in table 3a below. All key personnel must be identified on this document. [SOW 5.2]
3. Submit copies of current and valid professional licenses for clinical staff. Clinical licenses submitted must be listed in table 3b below and must correspond to the respective clinical duties performed. [SOW 5.4]
* If unable to produce an original license, provide a license verification sheet with a copy of a government-issued photo identification card for the staff member.
* If submitting a non-medical license that is not listed on the table below, complete the Mental Health/Behavioral Health Professionals Scope of Practice Summary. Any licenses other than those listed below will be reviewed on a case-by-case basis.
15BCTS22Q00000001 Page 22 of 60
1. Psychiatric/Medication Monitoring: Submit a Drug Enforcement Agency Controlled Substance Registration Certificate for a qualified practitioner with prescriptive authority who meets the standards of practice established by the state’s professional regulatory board to provide psychiatric evaluations and medication monitoring. [SOW 5.4.5]
2. MAT Services: Submit certified practitioner's DATA 2000 waiver identification number (X-number) to prescribe and administer buprenorphine.
3. Operational Requirement – Cognitive Behavioral Therapy (CBT): The Quoter must demonstrate adherence to the CBT model of treatment or other evidence-based programming compatible with CBT. [SOW 2.2]
4. Submit two cognitive behavioral methods or techniques that will be used with Bureau inmates in the delivery of Community Treatment Services (CTS). Limit response to listing the methods or techniques that will be used; do not provide explanations or descriptions of the methods or techniques, unless not a widely known form of treatment.
[SOW 2.2.1]
5. Operational Requirement – Crisis Interventions: The Quoter must provide emergency crisis intervention assessments, when necessary. The Quoter must have the ability to complete a Crisis Intervention Evaluation and Report, contract line item number (CLIN) 6000, within 24 hours of the request made by CTS staff. [SOW 4.3.9]
6. Identify on the Technical Personnel document key personnel able to conduct a comprehensive diagnostic interview and submit a written report within 24 hours of referral for emergency crisis interventions.
3a. Minimum Staffing Requirements of Key Personnel Identify the following on the Technical Personnel Document:
Authorized Negotiator Key Personnel for Substance Use Disorder Services Key Personnel for Mental Health Services Key Personnel for Crisis Intervention Services Key Personnel for Psychiatric Services Key Personnel for MAT Services
3b. Professional Licensing Requirements for Clinical Staff All clinicians must be licensed or certified in the state of Ohio and must be able to practice independently, without supervision, in the state of Ohio.
Mental Health/Sex Offender/Substance Use MAT Licensed Independent Social Worker Licensed Independent Social Worker - S Licensed Professional Clinical Counselor Licensed Professional Clinical Counselor – S Psychologist Psychiatrist
APN
Psychiatrist
APN
PRICING
Pricing will be evaluated for price reasonableness and cost realism. Prices quoted to the Government shall be as low as or lower than those charges to the supplier’s most favored customer for comparable quantities under similar terms and conditions, in addition to any discounts offered for prompt payment.
Please complete the chart below with total quoted price for the base period and each option year.
Year Total Base Period $ Option Year 1 $ Option Year 2 $ Option Year 3 $ Option Year 4 $ Six Month Extension $ Total of All Years $
DELIVERIES
15BCTS22Q00000001 Page 23 of 60
In accordance with Federal Acquisition Regulation (FAR) 16.505, and the clause located in FAR 52.216-18, Ordering, states that any supplies or services to be furnished under this contract shall be ordered by issuance of task orders by a warranted Contracting Officer in the CTS Contracting Office.
BILLING INFORMATION
The Government will make payment on a monthly basis via Electronic Fund Transfer. Invoices with the contract number should be submitted electronically to BOP-RSD-CRBTS-BILL-PHL@bop.gov. Contractors that are classified as a small business are required to indicate their small business size status on each invoice submitted for payment.
AWARD…
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .