15BCTS21Q00000019.pdf
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15BCTS21Q00000019 Page 1 of 76
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30
1. REQUISITION NUMBER
5. SOLICITATION NUMBER
15BCTS21Q00000019
2. CONTRACT NO. 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
11/24/2020
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
Shuwona Jones Sjones2@bop.gov
b. TELEPHONE NUMBER (No collect calls)
202-616-9758
8. OFFER DUE DATE / LOCAL
TIME
12/15/2020 12:00 ET
CODE 15BCTS
Federal Bureau of Prisons Community Treatment Services Contracting 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: 621420
SIZE STANDARD: $16,500,000
10. THE ACQUISITION IS
SEE
SCHEDULE
11. DELIVERY FOR FOB DESTINATION
UNLESS BLOCK IS MARKED
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
15B200CODE15. DELIVER TO
Federal Bureau of Prisons Kansas Office
400 STATE AVENUE
SUITE 800
KANSAS CITY, KS 66101
CODE 15BCTS16. ADMINISTERED BY
Federal Bureau of Prisons Community Treatment Services Contracting 320 First Street NW Room 901-5 Washington, DC 20534
Shuwona Jones
(O) 202-616-9758 sjones2@bop.gov
FACILITY
CODE
CODE
TELEPHONE NO.
17a. CONTRACTOR/
OFFEROR
15B200CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons Kansas Office
400 STATE AVENUE
SUITE 800
KANSAS CITY, KS 66101
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
Substance Use, Mental Health, and Sex Offender Treatment Services in Great Falls, MT.
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
X 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1 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) 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
02/01/2021
019-21
15BCTS21Q00000019 Page 2 of 76
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
15BCTS21Q00000019 Page 3 of 76
Table of Contents
Section Description Page Number
1 Solicitation/Contract Form 2 Commodity or Services Schedule 3 Contract Clauses
52.21-603-70 Contracting Officer's Representative (COR) (June 2012)
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) DJAR-PGD-15-03 Security of Department Information and Systems 52.216-18 Ordering (Aug 2020) 52.216-19 Order Limitations (Oct 1995) 52.216-21 Requirements (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 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)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR
2011) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (June 2016) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders- Commercial Items (Nov 2020)
4 List of Attachments 5 Solicitation Provisions
52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct 2020) 52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.212-3 Offeror Representations and Certifications-Commercial Items (Nov 2020) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998)
52.27-103-71 FAITH-BASED AND COMMUNITY-BASED ORGANIZATIONS (AUG 2005)
52.216-1 Type of Contract (Apr 1984) 52.217-5 Evaluation of Options (July 1990)
15BCTS21Q00000019 Page 4 of 76
Section 2 - Commodity or Services Schedule
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0001 Intake - Substance Use (2005) (one per inmate) for Estimated 30 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 30 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 45 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
2,160 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 45 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
3,240 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 45 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,080 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
15BCTS21Q00000019 Page 5 of 76
0006 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 30 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 Methadone Follow-Up and Report- MAT (4001) Estimated 6 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
42 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
42 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
42 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 Administration of Methadone - MAT (4010) Estimated 168 Units per Inmate; Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,176 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 Methadone and Administration - MAT(4011) Estimated 168 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,176 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
1,176 SS $________ $_________________
15BCTS21Q00000019 Page 6 of 76
Firm Fixed Price
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,176 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Administration of Buprenorphine Injection- MAT (4030) Estimated 6 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
42 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 Buprenorphine and Administration of Injection- MAT (4031) Estimated 6 Units per Inmate; Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
42 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
42 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 7 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
42 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 5 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
5 SS $________ $_________________
15BCTS21Q00000019 Page 7 of 76
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Intake - Mental Health (5005) (one per inmate) for Estimated 15 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 15 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
15 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Transportation, Round Trip (1202) Estimated 8 Units per Inmate; Estimated 45 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
360 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 21 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
1,008 SS $________ $_________________
15BCTS21Q00000019 Page 8 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 21 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
1,008 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Case Management Services (6030) Estimated 24 Units per Inmate; Estimated 10 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 21 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
504 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 21 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
126 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0029 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 21 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
105 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 6 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
6 EA $________ $_________________
15BCTS21Q00000019 Page 9 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 6 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
6 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 6 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
288 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 6 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
432 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 6 Inmates Base Period: Date of award - 12 months
Firm Fixed Price
PSC: G004
144 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Intake - Substance Use (2005) (one per inmate) for Estimated 30 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 30 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
30 EA $________ $_________________
15BCTS21Q00000019 Page 10 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 30 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
1,440 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 30 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
2,160 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 30 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
720 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 30 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Methadone Follow-Up and Report- MAT (4001) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
15BCTS21Q00000019 Page 11 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Administration of Methadone - MAT (4010) Estimated 168 Units per Inmate; Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
840 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Methadone and Administration - MAT(4011) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
840 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 Administration of Buprenorphine Injection- MAT (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
15BCTS21Q00000019 Page 12 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 Buprenorphine and Administration of Injection- MAT (4031) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
30 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
30 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 5 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
5 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Intake - Mental Health (5005) (one per inmate) for Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
15 EA $________ $_________________
15BCTS21Q00000019 Page 13 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
15 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Transportation, Round Trip (1202) Estimated 8 Units per Inmate; Estimated 30 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
240 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0058 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
720 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Case Management Services (6030) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
360 EA $________ $_________________
15BCTS21Q00000019 Page 14 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
90 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
75 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 6 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 6 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
6 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 6 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
288 EA $________ $_________________
15BCTS21Q00000019 Page 15 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 6 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
432 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 6 Inmates Option Year 1- 13 months through 24 months
Firm Fixed Price
PSC: G004
144 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Intake - Substance Use (2005) (one per inmate) for Estimated 30 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 30 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 30 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
1,440 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 30 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
2,160 SS $________ $_________________
15BCTS21Q00000019 Page 16 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 30 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
720 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 30 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 Methadone Follow-Up and Report- MAT (4001) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 Administration of Methadone - MAT (4010) Estimated 168 Units per Inmate; Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
840 SS $________ $_________________
15BCTS21Q00000019 Page 17 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Methadone and Administration - MAT(4011) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0080 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
840 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Administration of Buprenorphine Injection- MAT (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Buprenorphine and Administration of Injection- MAT (4031) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
15BCTS21Q00000019 Page 18 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
30 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 5 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
5 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Intake - Mental Health (5005) (one per inmate) for Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
15 SS $________ $_________________
15BCTS21Q00000019 Page 19 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 Transportation, Round Trip (1202) Estimated 8 Units per Inmate; Estimated 30 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
240 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0092 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
720 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Case Management Services (6030) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
90 EA $________ $_________________
15BCTS21Q00000019 Page 20 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
75 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0098 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 6 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0099 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 6 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
6 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 6 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
288 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 6 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
PSC: G004
432 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0102 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 6 Inmates Option Year 2- 25 months through 36 months
Firm Fixed Price
144 EA $________ $_________________
15BCTS21Q00000019 Page 21 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 Intake - Substance Use (2005) (one per inmate) for Estimated 30 Inmates Option Year 3- 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0104 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 30 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0105 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 30 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
1,440 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0106 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 30 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
2,160 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 30 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0108 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 30 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
30 SS $________ $_________________
15BCTS21Q00000019 Page 22 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 Methadone Follow-Up and Report- MAT (4001) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0111 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0112 Administration of Methadone - MAT (4010) Estimated 168 Units per Inmate; Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0113 Methadone and Administration - MAT(4011) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
840 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0114 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
840 SS $________ $_________________
15BCTS21Q00000019 Page 23 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0115 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
840 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0116 Administration of Buprenorphine Injection- MAT (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Buprenorphine and Administration of Injection- MAT (4031) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
30 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0120 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 5 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
5 SS $________ $_________________
15BCTS21Q00000019 Page 24 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0121 Intake - Mental Health (5005) (one per inmate) for Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0122 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
15 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0123 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0124 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0125 Transportation, Round Trip (1202) Estimated 8 Units per Inmate; Estimated 30 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
240 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0126 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
720 EA $________ $_________________
15BCTS21Q00000019 Page 25 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0127 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
720 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0128 Case Management Services (6030) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0129 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0130 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
90 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0131 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0132 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 6 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
6 SS $________ $_________________
15BCTS21Q00000019 Page 26 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0133 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 6 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
6 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0134 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 6 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
288 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0135 Sex Offender Group Counseling (6022) 30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 6 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
432 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0136 Sex Offender Family Counseling (6032) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 6 Inmates Option Year 3 - 37 months through 48 months
Firm Fixed Price
PSC: G004
144 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0137 Intake - Substance Use (2005) (one per inmate) for Estimated 30 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0138 Assessment & Report - Substance Use (2011) (one per inmate) for Estimated 30 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
15BCTS21Q00000019 Page 27 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0139 Individual Counseling - Substance Use (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 30 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
1,440 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0140 Group Counseling - Substance Use (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 30 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
2,160 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0141 Family Counseling - Substance Use (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 30 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
720 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0142 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 30 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0143 Methadone Follow-Up and Report- MAT (4001) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0144 Buprenorphine Follow-Up and Report- MAT (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
15BCTS21Q00000019 Page 28 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0145 Naltrexone Follow-Up and Report- MAT (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0146 Administration of Methadone - MAT (4010) Estimated 168 Units per Inmate; Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
840 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0147 Methadone and Administration - MAT(4011) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0148 Administration of Buprenorphine - MAT (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
840 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0149 Buprenorphine and Administration - MAT (4021) Estimated 168 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
840 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0150 Administration of Buprenorphine Injection- MAT (4030) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
15BCTS21Q00000019 Page 29 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0151 Buprenorphine and Administration of Injection- MAT (4031) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
30 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0152 Administration of Naltrexone- MAT (4040) Estimated 6 Units per Inmate for Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0153 Naltrexone and Administration- MAT (4041) Estimated 6 Units per Inmate; Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
30 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0154 Psychiatric Evaluation & Report- MAT (4050) Estimated 1 Units per Inmate; Estimated 5 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
5 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0155 Intake - Mental Health (5005) (one per inmate) for Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0156 Assessment & Report - Mental Health (5011) (one per inmate) for Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
15 EA $________ $_________________
15BCTS21Q00000019 Page 30 of 76
QUANTITY
UNIT UNIT PRICE AMOUNT
0157 Psychiatric Evaluation & Report - Mental Health (5030) (one per inmate) for Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0158 Crisis Intervention - Mental Health (6000) (one per inmate) for Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
15 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0159 Transportation, Round Trip (1202) Estimated 8 Units per Inmate; Estimated 30 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
240 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0160 Individual Counseling - Mental Health (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
720 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0161 Group Counseling - Mental Health (6020) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
720 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0162 Case Management Services (6030) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
360 EA $________ $_________________
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QUANTITY
UNIT UNIT PRICE AMOUNT
0163 Family Counseling - Mental Health (6031) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0164 Administration of Medication (6050) Estimated 6 Units per Inmate; Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
90 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0165 Medication Monitoring - Mental Health (6051) (5 visits per inmate) for Estimated 15 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
75 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0166 Sex Offender-specific Evaluation and Report (5012) (one per inmate) for Estimated 6 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0167 Intake Screening- Sex Offender (6005) (one per inmate) for Estimated 6 Inmates Option Year 4 - 49 months through 60 months
Firm Fixed Price
PSC: G004
6 SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0168 Sex Offender Individual Counseling (6012) (30 Minutes = 1 Unit) Estimated 48…
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