B09_SA_0003_EXHIBIT_D_Price_Schedule_Final_03Oct24_0003.xlsx
XLSX spreadsheet 134 KB Posted
- Solicitation number
- 140D0424R0071
About this file
This document is an Exhibit D Price Schedule Amendment 0003 for a federal contract opportunity related to the Office of Wildland Fire Medical Qualification IDIQ contract. It outlines the estimated quantities, unit prices, and subtotals for various medical services and examinations across a 5-year period (FY25-29) for contract 140L0620D0002. The services include basic, comprehensive, and periodic medical exams, vaccinations, laboratory testing, medical reviews and qualifications, and other related services. The document also includes a separate price schedule for mobile medical events, with pricing for personnel, lab analysis, testing, shipping, and travel. Pricing is presented on a per unit or per event basis, to be negotiated and awarded as firm fixed price line items. The referenced federal contract opportunity is solicitation number 140D0424R0071, for the Department of the Interior Departmental Offices Interior Business Center.
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Text version
FY25-29
| 140D0424R0071 - EXHIBIT D PRICE SCHEDULE - AMDT 0003 | YEAR 1 | YEAR 2 | YEAR 3 | YEAR 4 | YEAR 5 | |||||||||||||||
| Service Title | Est. Qty. | Unit | Unit Price | SUBTOTAL | Est. Qty. | Unit | Unit Price | SUBTOTAL | Est. Qty. | Unit | Unit Price | SUBTOTAL | Est. Qty. | Unit | Unit Price | SUBTOTAL | Est. Qty. | Unit | Unit Price | SUBTOTAL |
| Phase-In | 1 | EA | $0 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |||||
| Basic Exam | 250 | EA | $0 | 250 | EA | $0 | 250 | EA | $0 | 250 | EA | $0 | 250 | EA | $0 | |||||
| Comprehensive Exam | 2500 | EA | $0 | 2500 | EA | $0 | 2500 | EA | $0 | 2500 | EA | $0 | 2500 | EA | $0 | |||||
| Periodic Exam | 2400 | EA | $0 | 2400 | EA | $0 | 2400 | EA | $0 | 2400 | EA | $0 | 2400 | EA | $0 | |||||
| Tetanus Vaccine - Td or Tdap | 1400 | EA | $0 | 1400 | EA | $0 | 1400 | EA | $0 | 1400 | EA | $0 | 1400 | EA | $0 | |||||
| Tuberculosis Skin Test (PPD) | 490 | EA | $0 | 490 | EA | $0 | 490 | EA | $0 | 490 | EA | $0 | 490 | EA | $0 | |||||
| Missed Appointment | 300 | EA | $0 | 300 | EA | $0 | 300 | EA | $0 | 300 | EA | $0 | 300 | EA | $0 | |||||
| Medical Review/ Qualification Determination | 4450 | EA | $0 | 4450 | EA | $0 | 4450 | EA | $0 | 4450 | EA | $0 | 4450 | EA | $0 | |||||
| Medical Review/ Qualification Determination - NPS LE, 90 Days | 700 | EA | $0 | 700 | EA | $0 | 700 | EA | $0 | 700 | EA | $0 | 700 | EA | $0 | |||||
| Diver Qualification Determination | 90 | EA | $0 | 90 | EA | $0 | 90 | EA | $0 | 90 | EA | $0 | 90 | EA | $0 | |||||
| Limited Medical Review / Qualification Determination | 1000 | EA | $0 | 1000 | EA | $0 | 1000 | EA | $0 | 1000 | EA | $0 | 1000 | EA | $0 | |||||
| Self-Certification / Pre-Fitness Medical Review | 1500 | EA | $0 | 1500 | EA | $0 | 1500 | EA | $0 | 1500 | EA | $0 | 1500 | EA | $0 | |||||
| RMO Field Orientation - Daily Rate, Includes Travel | 60 | EA | $0 | 36 | EA | $0 | 36 | EA | $0 | 36 | EA | $0 | 36 | EA | $0 | |||||
| Medical Consultation | 100 | HR | $0 | 100 | HR | $0 | 100 | HR | $0 | 100 | HR | $0 | 100 | HR | $0 | |||||
| Audiogram | 26 | EA | $0 | 26 | EA | $0 | 26 | EA | $0 | 26 | EA | $0 | 26 | EA | $0 | |||||
| OSHA Respiratory Questionnaire | 100 | EA | $0 | 100 | EA | $0 | 100 | EA | $0 | 100 | EA | $0 | 100 | EA | $0 | |||||
| Color Vision - (Ishihara or Farnsworth) | 200 | EA | $0 | 200 | EA | 200 | EA | 200 | EA | 200 | EA | |||||||||
| Laboratory Urinalysis | 100 | EA | $0 | 100 | EA | $0 | 100 | EA | $0 | 100 | EA | $0 | 100 | EA | $0 | |||||
| Chest X-Ray (PA View) | 80 | EA | $0 | 80 | EA | $0 | 80 | EA | $0 | 80 | EA | $0 | 80 | EA | $0 | |||||
| Lead, industrial whole blood and ZPP - In Conjunction With Periodic Exam | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | |||||
| Lead, industrial whole blood and ZPP - Without Exam | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | |||||
| Lead, industrial whole blood, ZPP and audiogram - Without Exam | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | |||||
| Cholinesterase Baseline | 80 | EA | $0 | 80 | EA | $0 | 80 | EA | $0 | 80 | EA | $0 | 80 | EA | $0 | |||||
| EKG | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | 50 | EA | $0 | |||||
| Fitness for Duty - Adult Specialty Medicine | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | |||||
| Fitness for Duty - Mental Health Specialist | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | |||||
| Fitness for Duty - Vision/Hearing Specialist | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | 5 | EA | $0 | |||||
| Mobile Medical Events - See Separate Tab | ||||||||||||||||||||
| Grand Total - Annual | $0 | $0 | $0 | $0 | $0 |
Contract No. 140L0620D0002 ATTACHMENT B &A
Mobile Event Price Schedule
| EXHIBIT D PRICE SCHEDULE - AMDT 0003 | ||||||||||||||||||||
| YEAR 01 | YEAR 02 | YEAR 03 | YEAR 04 | YEAR 05 | ||||||||||||||||
| PERSONNEL* | Unit | QTY | Rate | Amount | Unit | QTY | Rate | Amount | Unit | QTY | Rate | Amount | Unit | QTY | Rate | Amount | Unit | QTY | Rate | Amount |
| Program Manager | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | |||||
| Event/Logistics Coordinator | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | |||||
| On-site Lead | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | |||||
| PA/NP | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | |||||
| RN | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | |||||
| Medical Interpreter | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | |||||
| Medical Tech | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | Hour | 1 | $ - 0 | |||||
| 1 | 1 | 1 | 1 | 1 | ||||||||||||||||
| PER EXAM/EVENT ITEMS*** | 1 | 1 | 1 | 1 | 1 | |||||||||||||||
| Lab Analysis | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | |||||
| TB Testing | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | |||||
| Tetanus | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | Exam | 1 | $ - 0 | |||||
| Shipping of On-site Materials++ | Event | 1 | $ - 0 | Event | 1 | $ - 0 | $ - 0 | Event | 1 | $ - 0 | $ - 0 | Event | 1 | $ - 0 | $ - 0 | Event | 1 | $ - 0 | ||
| Supplies++ | Event | 1 | $ - 0 | Event | 1 | $ - 0 | $ - 0 | Event | 1 | $ - 0 | $ - 0 | Event | 1 | $ - 0 | $ - 0 | Event | 1 | $ - 0 | ||
| 1 | 1 | 1 | 1 | 1 | ||||||||||||||||
| TRAVEL** |
tc={D3D45690-303A-4359-A51D-59E3BF144DB2}: [Threaded comment]
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Comment:
| Possibly delete the line items here since these will be negotiated at TO level. | 1 | 1 | 1 | 1 | 1 | |||||||||||
| Flight / Baggage | Each | 1 | $ - 0 | Each | 1 | $ - 0 | Each | 1 | $ - 0 | Each | 1 | $ - 0 | Each | 1 | $ - 0 | |
| Per Diem | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | |
| Lodging | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | |
| Vehicle Rental(s) | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | Day | 1 | $ - 0 | |
| Mileage | Mile | 1 | $ - 0 | Mile | 1 | $ - 0 | Mile | 1 | $ - 0 | Mile | 1 | $ - 0 | Mile | 1 | $ - 0 | |
| Tolls / Fuel / Parking | Event | 1 | $ - 0 | Event | 1 | $ - 0 | Event | 1 | $ - 0 | Event | 1 | $ - 0 | Event | 1 | $ - 0 | |
| *Personnel will be negotiated and awarded as a firm fixed price line item based upon rates established in price schedule and reasonable staffing to meet event needs. | ||||||||||||||||
| **Travel - will be negotiated and awarded as a firm fixed price line item based upon available commercial pricing and federal per diem rates. | ||||||||||||||||
| ++Supplies and shipping of materials will be negotiated and awarded as a firm fixed price line item. Quotes will be provided based upon location, quantities, and scheduling needs for each event. | ||||||||||||||||
| ***Per exam and event items will be invoiced as incurred at fixed price established in the price schedule. |
Contract No. 140L0620D0002 ATTACHMENT B &A image1.png
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