Amendment 2 15BCTS21Q00000027.pdf
PDF 302 KB Posted
- Solicitation number
- 15BCTS21Q00000027
View the file
Other files
Show all 12
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
15BCTS21Q00000027/0002 Page 1 of 59
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
1. CONTRACT ID CODE PAGE OF PAGES
1 59
2. AMENDMENT/MODIFICATION NUMBER
3. EFFECTIVE DATE
12/07/2021
4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)
BCTSCODE
320 First Street NW Room 901-5 Washington, DC 20534
Federal Bureau of Prisons Acquisitions Branch/Community Treatment Services kacannon@bop.gov
6. ISSUED BY CODE7. ADMINISTERED BY (If other than Item 6)
9A. AMENDMENT OF SOLICITATION NUMBER
15BCTS21Q00000027
CODE FACILITY CODE
8. NAME AND ADDRESS OF CONTRACTOR (Number, street, country, state and ZIP Code) (X)
X 9B. DATED (SEE ITEM 11)
04/27/2021
10A. MODIFICATION OF CONTRACT/ORDER
NUMBER
10B. DATED (SEE ITEM 13)
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
X XThe above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing items 8 and 15, and returning __1__copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12. ACCOUNTING AND APPROPRIATION DATA (If required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.
IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.
CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT
ORDER NUMBER IN ITEM 10A.
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor is not, is required to sign this document and return _______ copies to the issuing office.
14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
Amendment 2 is hereby issued to:
1. Remove Contract Line Item Numbers (CLINs) 4010, 4021, 4030, 4031, 4041, 4050, 5012, 6005, 6012, 6022, and 6032 from the solicitation.
2. Update Section 2.1 Continuation of SF1449, the Decisional Rule Criteria (DRC), and the Technical Quotation Information Packet.
3. Reopen the solicitation until January 5, 2022 at 2:00 p.m. EST.
Please note that we are aware that the Contract Line Item Numbers in Amendment 2 are not in sequential order. This is a system error and it will be corrected once the contract is awarded.
THIS AMENDMENT EXTENDS THE SOLICITATION CLOSING DATE/TIME TO: 01/05/2022 - 14:00 ET US/Eastern Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15A. NAME AND TITLE OF SIGNER (Type or print) 16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)
Kathaleen Cannon
(Signature of person authorized to sign)
15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED
By (Signature of Contracting Officer)
16B. UNITED STATES OF AMERICA 16C. DATE SIGNED
12/07/2021 Previous edition unusable STANDARD FORM 30 (REV. 11/2016)
Prescribed by GSA FAR (48 CFR) 53.243
Kathaleen Cannon
(202) 305-9853
15BCTS21Q00000027/0002 Page 2 of 59
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) DJAR-PGD-15-03 Security of Department Information and Systems 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) 52.203-3 Gratuities (Apr 1984) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Dec 2013) 52.253-1 Computer Generated Forms (Jan 1991) 52.212-4 Contract Terms and Conditions-Commercial Items (Oct 2018) 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) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-2 Privacy Act (Apr 1984) 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) 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)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR
2011)
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) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct 2020) 52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.212-3 Offeror Representations and Certifications-Commercial Items (Feb 2021) 52.216-1 Type of Contract (Apr 1984)
15BCTS21Q00000027/0002 Page 3 of 59
Section 2 - Commodity or Services Schedule
Substance Use, Mental Health, and Medication Assisted Treatment Services in Topeka, KS
Firm Fixed Price
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0001 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 20
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 22 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
1,152
Change:
-96
Current :
1,056
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
15BCTS21Q00000027/0002 Page 4 of 59
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 22 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
1,728
Change:
-144
Current :
1,584
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0006 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 22 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change:
-48
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
EA $________ $_________________
15BCTS21Q00000027/0002 Page 5 of 59
Current :
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 10 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 10 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
15BCTS21Q00000027/0002 Page 6 of 59
0020 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 10 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 13 inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 96
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 13 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 96
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 13 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 48
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 13 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 48
Current :
15BCTS21Q00000027/0002 Page 7 of 59
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Administration of Medication (6050) (6 visits per inmate) for Estimated 13 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 12
Current : 78
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Medication Monitoring and Report (6051) (five per inmate) for Estimated 13 Inmates
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 10
Current : 65
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 20
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 8 of 59
0035 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
1,440
Change: 0
Current :
1,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 9 of 59
0041 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
15BCTS21Q00000027/0002 Page 10 of 59
Current : 10
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 1: 13 months through 24 months
Previous :
15BCTS21Q00000027/0002 Page 11 of 59
PSC: G004 Current :
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 60
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 50
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 20
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 20
15BCTS21Q00000027/0002 Page 12 of 59
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
1,440
Change: 0
Current :
1,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 30
15BCTS21Q00000027/0002 Page 13 of 59
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0080 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 14 of 59
0081 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 15 of 59
0086 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 60
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 50
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 20
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 16 of 59
0096 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0098 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
1,440
Change: 0
Current :
1,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0099 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 17 of 59
0101 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0111 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
15BCTS21Q00000027/0002 Page 18 of 59
Current : 10
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0112 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0113 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0114 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0115 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0116 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
15BCTS21Q00000027/0002 Page 19 of 59
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 60
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 50
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0125 Substance Use Intake Screening (2005) (one per inmate) for Estimated 20 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 20
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0126 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 20 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
15BCTS21Q00000027/0002 Page 20 of 59
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0127 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 20 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0128 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 20 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 20
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0129 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 20 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
1,440
Change: 0
Current :
1,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0130 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 20 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0131 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
15BCTS21Q00000027/0002 Page 21 of 59
Current : 30
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0132 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0134 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0138 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 5 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0140 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 5 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0141 Mental Health Intake (5005) (one per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 22 of 59
0142 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0143 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0144 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0145 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0146 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 23 of 59
0147 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0148 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0149 Administration of Medication (6050) (6 visits per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 60
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0150 Medication Monitoring and Report (6051) (five per inmate) for Estimated 10 Inmates
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 50
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0156 Substance Use Intake Screening (2005) (one per inmate) for Estimated 10 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 10
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 24 of 59
0157 Substance Use Individual Counseling (2010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 10 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0158 Substance Use Intake Assessment & Report (2011) (one per inmate) for Estimated 10 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 10
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0159 Dual Diagnosis Intake Assessment & Report (2012) (one per inmate) for Estimated 10 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 10
SS $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0160 Substance Use Group Counseling (2020) (30 Minutes = 1 Unit) Estimated 72 Units per Inmate; Estimated 10 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0161 Substance Use Family Counseling (2030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 10 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 25 of 59
0162 MAT- Buprenorphine Follow-Up and Report (4002) Estimated 6 Units per Inmate for Estimated 3 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 18
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0163 MAT - Naltrexone Follow-Up and Report (4003) Estimated 6 Units per Inmate for Estimated 3 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 18
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0165 MAT - Administration of Buprenorphine (4020) Estimated 168 Units per Inmate for Estimated 3 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0169 MAT – Administration of Naltrexone (4040) Estimated 6 Units per Inmate; Estimated 3 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 18
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0171 MAT - Psychiatric Evaluation & Report (4050) (one per inmate) for Estimated 3 Inmates
6 Month Extension
PSC: G004
Previous : 3
Change: 0
Current : 3
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0172 Mental Health Intake (5005) (one per inmate) for Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous : 5
Change: 0
Current : 5
15BCTS21Q00000027/0002 Page 26 of 59
QUANTITY
UNIT UNIT PRICE AMOUNT
0173 Mental Health Intake Assessment & Report (5011) (one per inmate) for Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0174 Psychiatric Evaluation & Report (5030) (one per inmate) for Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0175 Crisis Intervention (6000) Estimated 1 Unit per Inmate; Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous : 5
Change: 0
Current : 5
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0176 Mental Health Individual Counseling (6010) (30 Minutes = 1 Unit) Estimated 48 Units per Inmate; Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0177 Mental Health Group Counseling (6020) (30 minutes = 1 unit) Estimated 48 Units per Inmate; Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS21Q00000027/0002 Page 27 of 59
0178 Case Management Services (6030) (30 Minutes = 1 Unit) Estimated 24 Units per Inmate; Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0179 Mental Health Family Counseling (6031) (30 minutes = 1 unit) Estimated 24 Units per Inmate; Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0180 Administration of Medication (6050) (6 visits per inmate) for Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0181 Medication Monitoring and Report (6051) (five per inmate) for Estimated 5 Inmates
6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 25
Section 3 - Contract Clauses
A.1 ADDENDUM TO FAR 52.212-4, Contract Terms and Conditions-Commercial Items (Oct 2018)
The terms and conditions for the following clauses are hereby incorporated into this solicitation and resulting contract as an addendum to FAR clause 52.212-4.
Clauses By Reference
15BCTS21Q00000027/0002 Page 28 of 59
52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)
This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): www.acquisition.gov
Clause Title Fill-ins (if applicable)
52.242-15 Stop-Work Order (Aug 1989)
52.203-3 Gratuities (Apr 1984)
52.232-40 Providing Accelerated Payments to Small Business Subcontractors
(Dec 2013)
52.253-1 Computer Generated Forms (Jan 1991)
52.212-4 Contract Terms and Conditions-Commercial Items (Oct 2018)
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)
52.224-1 Privacy Act Notification (Apr 1984)
52.224-2 Privacy Act (Apr 1984)
Clauses By Full Text
52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE 2004) (DEVIATION)
For three of the five years immediately prior to submission of an offer/bid/quote, or prior to performance under a contract or commitment, individuals or contractor employees providing services must have:
1. Legally resided in the United States (U.S.);
2. worked for the U.S. overseas in a Federal or military capacity; or
3. been a dependent of a Federal or military employee serving overseas.
If the individual is not a U.S. citizen, they must be from a country allied with the U.S. The following website provides current information regarding allied countries: http://www.state.gov/s/l/treaty/collectivedefense By signing this contract or commitment document, or by commencing performance, the contractor agrees to this restriction.
[End of Clause]
52.218-000 CONTINUING CONTRACT PERFORMANCE DURING A PANDEMIC INFLUENZA OR OTHER NATIONAL EMERGENCY (May 2008)
During a Pandemic or other emergency we understand that our contractor workforce will experience the same high levels of absenteeism as our federal employees. Although the Excusable Delays and Termination for Default clauses used in Government contracts list epidemics and quarantine restrictions among the reasons to excuse delays in contract performance, we expect our contractors to make a reasonable effort to keep performance at an acceptable level during emergency periods.
The Office of Personnel Management (OPM) has provided guidance to federal managers and employees on the kinds of actions to be taken to ensure the continuity of operations during emergency periods. This guidance is also applicable to our contract workforce.
15BCTS21Q00000027/0002 Page 29 of 59
Contractors are expected to have reasonable policies in place for continuing work performance, particularly those performing mission critical services, during a pandemic influenza or other emergency situation.
The types of actions a federal contractor should reasonably take to help ensure performance are:
* Encourage employees to get inoculations or follow other preventive measures as advised by the public health service.
* Cross-train workers as backup for all positions performing critical services. This is particularly important for work such as guard services where telework is not an option.
* Implement telework to the greatest extent possible in the workgroup so systems are in place to support successful remote work in an emergency.
* Communicate expectations to all employees regarding their roles and responsibilities in relation to remote work in the event of a pandemic health crisis or other emergency.
* Establish communication processes to notify employees of activation of this plan.
* Integrate pandemic health crisis response expectations into telework agreements.
* With the employee, assess requirements for working at home (supplies and equipment needed for an extended telework period). Security concerns should be considered in making equipment choices; agencies or contractors may wish to avoid use of employees' personal computers and provide them with PCs or laptops as appropriate.
* Determine how all employees who may telework will communicate with one another and with management to accomplish work.
* Practice telework regularly to ensure effectiveness.
* Make it clear that in emergency situations, employees must perform all duties assigned by management, even if they are outside usual or customary duties.
* Identify how time and attendance will be maintained.
It is the contractor's responsibility to advise the Government Contracting Officer if they anticipate not being able to perform and to work with the Department to fill gaps as necessary. This means direct communication with the Contracting Officer or in his/her absence, another responsible person in the contracting office via telephone or email messages acknowledging the contractor's notification. The incumbent contractor is responsible for assisting the Department in estimating the adverse impacts of nonperformance and to work diligently with the Department to develop a strategy for maintaining the continuity of operations.
The Department does reserve the right in such emergency situations to use Federal employees, employees of other agencies, contract support from other existing contractors, or to enter into new contracts for critical support services. Any new contracting efforts would be acquired following the guidance in the Office of federal Procurement Policy issuance "Emergency Acquisitions", May, 2007 and Subpart 18.2. Emergency Acquisition Flexibilities, of the Federal Acquisition Regulations.
[End of Clause]
DJAR-PGD-15-03 Security of Department Information and Systems
I. Applicability to Contractors and Subcontractors
This clause applies to all contractors and subcontractors, including cloud service providers (“CSPs”), and personnel of contractors, subcontractors, and CSPs (hereinafter collectively, “Contractor”) that may access, collect, store, process, maintain, use, share, retrieve, disseminate, transmit, or dispose of DOJ Information. It establishes and implements specific DOJ requirements applicable to this Contract. The requirements established herein are in addition to those required by the Federal Acquisition Regulation (“FAR”), including FAR 11.002(g) and 52.239-1, the Privacy Act of 1974, and any other applicable laws, mandates, Procurement Guidance Documents, and Executive Orders pertaining to the development and operation of Information Systems and the protection of Government Information. This clause does not alter or diminish any existing rights, obligation or liability under any other civil and/or criminal law, rule, regulation or mandate.
II. General Definitions
The following general definitions apply to this clause. Specific definitions also apply as set forth in other paragraphs.
A. Information means any communication or representation of knowledge such as facts, data, or opinions, in any form or medium, including textual, numerical, graphic, cartographic, narrative, or audiovisual. Information includes information in an electronic format that allows it be stored, retrieved or transmitted, also referred to as “data,” and “personally identifiable information” (“PII”), regardless of form.
B. Personally Identifiable Information (or PII) means any information about an individual maintained by an agency, including, but not limited to, information related to education, financial transactions, medical history, and criminal or employment
15BCTS21Q00000027/0002 Page 30 of 59 history and information, which can be used to distinguish or trace an individual's identity, such as his or her name, social security number, date and place of birth, mother's maiden name, biometric records, etc., including any other personal information which is linked or linkable to an individual.
C. DOJ Information means any Information that is owned, produced, controlled, protected by, or otherwise within the custody or responsibility of the DOJ, including, without limitation, Information related to DOJ programs or personnel. It includes, without limitation, Information (1) provided by or generated for the DOJ, (2) managed or acquired by Contractor for the DOJ in connection with the performance of the contract, and/or (3) acquired in order to perform the contract.
D. Information System means any resources, or set of resources organized for accessing, collecting, storing, processing, maintaining, using, sharing, retrieving, disseminating, transmitting, or disposing of (hereinafter collectively, “processing, storing, or transmitting”) Information.
E. Covered Information System means any information system used for, involved with, or allowing, the processing, storing, or transmitting of DOJ Information.
III. Confidentiality and Non-disclosure of DOJ Information
A. Preliminary and final deliverables and all associated working papers and material generated by Contractor containing DOJ Information are the property of the U.S. Government and must be submitted to the Contracting Officer (“CO”) or the CO’s Representative (“COR”) at the conclusion of the contract. The U.S. Government has unlimited data rights to all such deliverables and associated working papers and materials in accordance with FAR 52.227-14.
B. All documents produced in the performance of this contract containing DOJ Information are the property of the U.S.
Government and Contractor shall neither reproduce…
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 .