12.1.25_RFP_195237_Cost_Sheet.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Pre-Employment Medical Services
- Solicitation number
- RFP195237
- Issued by
- Santa Clara County, California
About this file
This is a cost sheet for RFP 195237 issued by the City of Palo Alto, California, for Pre-Employment Medical Services on a three-year term. The City seeks a qualified medical services provider to perform pre-employment, post-offer, and ongoing occupational health examinations and related services for its workforce of approximately 1,000 full-time employees across multiple departments including police, fire, utilities, public works, community services, and administrative functions. The services must comply with OSHA Standards, FMLA, HIPAA, DOT Regulations 49 CFR Part 40, EEOC Guidance, ADA, and applicable state and local health codes. The cost sheet outlines thirteen standardized exam types plus employer-directed and optional exams, including Full Medical & Occupational Health History (Exam Type 1), Non-DOT Medical (Exam Type 2), DOT Medical (Exam Type 3), Firefighter Preplacement (Exam Type 4), Police Physical (Exam Type 5), DMV Physical (Exam Type 6), OSHA Respirator Medical (Exam Type 7), Fitness for Duty (Exam Type 8), Drug & Alcohol Testing (Exam Type 9), TB Testing (Exam Type 10), Vaccinations (Exam Type 11), Laboratory Only (Exam Type 12), and Hazmat Baseline/Annual/Periodic (Exam Type 13).
The cost sheet requires bidders to provide unit costs for each exam type across all three contract years, with separate columns for Year 1, Year 2, and Year 3 pricing. Each exam type itemizes specific components such as medical history reviews, pulmonary function testing, titers, imaging, drug screening, and various medical assessments. Additionally, bidders must provide pricing for implementation costs including project planning and administrative fees, design and customization, training and documentation, and customer support services, as well as any ongoing maintenance fees. The sheet includes a separate section for employer or clinically indicated one-time exams and optional exams with individual pricing for services such as vaccinations, lab work, physician consultations, and breath alcohol testing. Bidders may indicate "N/A" or "0" for services not offered.
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Text version
Sheet1
| RFP 195237 Costing Sheet – Pre-Employment Medical Services (3-Year Term) | ||||
| Exam Type 1 – Full Medical & Occupational Health History | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Full medical and occupational health history review | ||||
| OSHA Respirator Medical Evaluation Questionnaire review | ||||
| Pulmonary Function Testing baseline (includes forced vital capacity testing/evaluation) | ||||
| Visual acuity assessment | ||||
| Audiometric baseline assessment | ||||
| Mobility, use, and functionality of extremities | ||||
| TOTAL | ||||
| Exam Type 2 – Non-DOT | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Full medical and occupational health history review | ||||
| OSHA Respirator Medical Evaluation Questionnaire review | ||||
| Pulmonary Function Testing baseline (includes FVC testing/evaluation) | ||||
| Titer: MMR, Tdap, Hepatitis A, Hepatitis B, Varicella | ||||
| Visual acuity assessment | ||||
| Audiometric baseline assessment | ||||
| Mobility, use, and functionality of extremities | ||||
| Urine drug screen handling and collection (Non-DOT; includes active cannabis test) | ||||
| TOTAL | ||||
| Exam Type 3 – DOT | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Full medical and occupational health history review | ||||
| OSHA Respirator Medical Evaluation Questionnaire review | ||||
| Pulmonary Function Testing baseline (includes FVC testing/evaluation) | ||||
| Titer: MMR, Tdap, Hepatitis A, Hepatitis B, Varicella | ||||
| Visual acuity assessment | ||||
| Audiometric baseline assessment | ||||
| Mobility, use, and functionality of extremities | ||||
| Urine drug screen handling and collection per DOT | ||||
| DMV exam (DL-51 Medical Examination Report) | ||||
| TOTAL | ||||
| Exam Type 4 – Firefighter Preplacement Exam (FFPP) | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Firefighter Physical Exam | ||||
| Full medical and occupational health history review | ||||
| Cardiac stress test with Treadmill | ||||
| Visual & Audio assessments | ||||
| Spirometry | ||||
| EKG | ||||
| Chest X-Rays (2 views, PA & Lateral) | ||||
| Sleep apnea review | ||||
| Drug and alcohol screening | ||||
| Physical fitness assessment | ||||
| Titer: Hepatitis B Surface Antibody (HBsAb) | ||||
| Titer: Hepatitis C Antibody Screen | ||||
| Titer: Hepatitis A IgG Antibody (HAAb) | ||||
| QuantiFERON | ||||
| TOTAL |
| Exam Type 5 – Police (POSTPP) | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| POST Physical Exam | ||||
| Full medical and occupational health history review | ||||
| Visual & Audio assessments | ||||
| Spirometry | ||||
| EKG, resting | ||||
| Cardiac Stress Test with Treadmill | ||||
| Drug and alcohol screening | ||||
| Physical fitness assessment | ||||
| Titer: Hepatitis B Surface Antibody (HBsAb) | ||||
| Titer: Hepatitis C Antibody Screen | ||||
| Titer: Hepatitis A IgG Antibody (HAAb) | ||||
| QuantiFERON | ||||
| TOTAL |
| Exam Type 6 – DMV Physical | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Full medical review | ||||
| Vision test | ||||
| Hearing test | ||||
| Physical fitness/coordination test | ||||
| TOTAL |
| Exam Type 7 – OSHA Respirator Medical | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| OSHA Respirator Questionnaire review | ||||
| Pulmonary function testing | ||||
| TOTAL |
| Exam Type 8 – Fitness for Duty | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Full medical review | ||||
| Vision and hearing assessment | ||||
| Physical strength/flexibility assessment | ||||
| Drug/alcohol screening | ||||
| TOTAL |
| Exam Type 9 – Drug & Alcohol Testing | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Drug/alcohol screening (DOT & Non-DOT) | ||||
| Other confirmatory testing | ||||
| TOTAL |
| Exam Type 10 – TB Testing | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| TB Skin Test (PPD) | ||||
| QuantiFERON (if needed) | ||||
| Chest X-Ray (if indicated) | ||||
| TOTAL |
| Exam Type 11 – Vaccinations | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| MMR | ||||
| Tdap | ||||
| Hepatitis A/B | ||||
| Varicella | ||||
| Rabies Vaccine, series of 3 injections | ||||
| TOTAL |
| Exam Type 12 – Laboratory Only | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| History/Review of Tests/Brief Screen - No Physical Exam | ||||
| Venipuncture | ||||
| Titer: Hepatitis B Surface Antibody (HBsAb) | ||||
| Titer: Hepatitis A IgG Antibody (HAAb) | ||||
| Titer: Mumps Antibody Screen | ||||
| Titer: Rubella Antibody Screen (German Measles) | ||||
| Titer: Rubeola Antibody Screen (Measles) | ||||
| Titer: Varicella (Varicella or Chickenpox) Antibody Screen | ||||
| Titer: Rabies Antibody Testing | ||||
| TOTAL |
| Exam Type 13 –Hazmant Baseline/Annual/Periodic | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Hazardous Worker Exam | ||||
| Audiogram, screening | ||||
| Spirometry | ||||
| Chem Comprehensive Panel | ||||
| TOTAL |
| Employer or Clinically Indicated One-Time or Other Exams | ||||
| Description | Unit Cost ($) Year 1 | Unit Cost ($) Year 2 | Unit Cost ($) Year 3 | Notes |
| Preplacement Physical Exam | ||||
| PPD, 1 step, placement and reading | ||||
| Chest X-Ray, 1 view | ||||
| Chest X-Ray, 2 views | ||||
| Spirometry | ||||
| EKG, resting | ||||
| Cardiac Stress Test with Treadmill | ||||
| Venipuncture | ||||
| Titer: Hepatitis B Surface Antibody (HBsAb) | ||||
| Collection for Drug Screen-Preferred Alliance | ||||
| Vaccine: Hepatitis B, may need series of 3 injections | ||||
| Vaccine: Hepatitis A, may need series of 2 injections | ||||
| Vaccine: Twinrix (Hep B and Hep A combo), series of 3 injections | ||||
| Vaccine: Measles Mumps Rubella (MMR), may need series of 2 injections | ||||
| Vaccine: Varivax (Varicella or Chickenpox), may need series of 2 injections | ||||
| Vaccine: Tdap | ||||
| Vaccine: Influenza (when seasonally available) | ||||
| Titer: Mumps Antibody Screen | ||||
| Titer: Rubella Antibody Screen (German Measles) | ||||
| Titer: Rubeola Antibody Screen (Measles) | ||||
| Titer: Varicella (Varicella or Chickenpox) Antibody Screen | ||||
| Urinalysis with microscopy | ||||
| Physician Consultation, each 15 minutes | ||||
| Collection for Drug Screen-Preferred Alliance | ||||
| Breath Alcohol Testing (BAT) – Preferred Alliance | ||||
| Breath Alcohol Testing (BAT), Confirmatory – Preferred Alliance | ||||
| Optional or Other Exams | ||||
| Note: If exam is already included in one of the exam types you may leave this blank (if price is the same) | ||||
| Implementation (Include the one-time cost associated with your proposed services) | ||||
| Project Planning & Administrative Fees | ||||
| Implementation | ||||
| Design and Customization (if services offered are different) | ||||
| Training and Documentation | ||||
| Customer Support Services | ||||
| Ongoing Maintenance Fees (if any) | ||||
| Note: If services is not available or offered please indicate "N/A" or "0" |
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