15BCTS23Q00000004 Amend 1.pdf

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15BCTS23Q00000004 SU, MH, SO and MA Treatment Services in Tucson, AZ
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15BCTS23Q00000004/0001 Page 1 of 69

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE PAGE OF PAGES

1 69

2. AMENDMENT/MODIFICATION NUMBER

3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

15BCTSCODE

Federal Bureau of Prisons Community Treatment Services 320 First Street NW Suite 901-5 Washington, DC 20534

Paul Clark

(O) 202-353-0382 p5clark@bop.gov

6. ISSUED BY CODE7. ADMINISTERED BY (If other than Item 6)

9A. AMENDMENT OF SOLICITATION NUMBER

15BCTS23Q00000004

CODE FACILITY CODE

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, country, state and ZIP Code) (X)

X 9B. DATED (SEE ITEM 11)

05/18/2022

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.)

This amendment 1 is issued to extend the closing date to July 8, 2022, 2:00 pm ET.

THIS AMENDMENT EXTENDS THE SOLICITATION CLOSING DATE/TIME TO: 07/08/2022 - 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)

Paul Clark Contracting Officer

(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

Previous edition unusable STANDARD FORM 30 (REV. 11/2016) Prescribed by GSA FAR (48 CFR) 53.243

6/15/2022

15BCTS23Q00000004/0001 Page 2 of 69

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 (Nov 2021) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services (Nov 2021) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders- Commercial Products and Commercial Services (Jan 2022) 52.203-17 Contractor Employee Whistleblower Rights and Requirement To Inform Employees of Whistleblower Rights (Jun 2020) DOJ-01 Whistleblower Information Distribution (Oct 2021) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021); (Alt. I) -- Classified Information -- Cleared Contractors

4 List of Attachments 5 Solicitation Provisions

52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998) 52.216-1 Type of Contract (Apr 1984) 52.217-5 Evaluation of Options (July 1990)

15BCTS23Q00000004/0001 Page 3 of 69

Section 2 - Commodity or Services Schedule

Substance Use, Mental Health, Sex Offender and Medication Assisted Treatment Services in Tucson, AZ.

Firm Fixed Price

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0001 2005 Substance Use Intake Screening - 2 Units Guaranteed Minimum; 15 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0002 2010 Substance Use Individual Counseling - 300 Units Guaranteed Minimum; 2200 Units Estimated Maximum.

Base Period: Date of award - 12 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0003 2011 Substance Use Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum 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

0004 2012 Dual Diagnosis Intake Assessment and Report - 10 Units Guaranteed Minimum; 25 Units Estimated Maximum 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

15BCTS23Q00000004/0001 Page 4 of 69

0005 2020 Substance Use Group Counseling - 480 Units Guaranteed Minimum; 1800 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0006 2030 Substance Use Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0007 4002 MAT – Buprenorphine Follow-up and Report - 6 Units Guaranteed Minimum; 60 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 6

Change: 0

Current : 6

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0008 4003 MAT – Naltrexone Follow-up and Report - 3 Units Guaranteed Minimum; 20 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 3

Change: 0

Current : 3

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0009 4050 MAT – Psychiatric Evaluation and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0010 5005 Mental Health Intake Screening - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS23Q00000004/0001 Page 5 of 69

0011 5011 Mental Health Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum 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

0012 5030 Psychiatric Evaluation & Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum 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

0013 6000 Crisis Intervention - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0014 6010 Mental Health Individual Counseling - 300 Units Guaranteed Minimum; 2000 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0015 6020 Mental Health Group Counseling - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum 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

0016 6030 Case Management Services - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

15BCTS23Q00000004/0001 Page 6 of 69

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0017 6031 Mental Health Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0018 6050 Administration of Medication - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0019 6051 Mental Health Medication Monitoring - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum 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

0020 5012 Sex Offender Intake Assessment and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0021 6005 Sex Offender Intake Screening - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0022 6012 Sex Offender Individual Counseling - 32 Units Guaranteed Minimum; 240 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous :

Change: 0

Current : 32

15BCTS23Q00000004/0001 Page 7 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0023 6022 Sex Offender Group Counseling - 24 Units Guaranteed Minimum; 360 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous :

Change: 0

Current : 24

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0024 6032 Sex Offender Family Counseling - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0025 2005 Substance Use Intake Screening - 2 Units Guaranteed Minimum; 15 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0026 2010 Substance Use Individual Counseling - 300 Units Guaranteed Minimum; 2200 Units Estimated Maximum.

Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0027 2011 Substance Use Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0028 2012 Dual Diagnosis Intake Assessment and Report - 10 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 1: 13 - 24 months

Previous :

15BCTS23Q00000004/0001 Page 8 of 69

PSC: G004 Change: 0

Current : 10

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0029 2020 Substance Use Group Counseling - 480 Units Guaranteed Minimum; 1800 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0030 2030 Substance Use Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0031 4002 MAT – Buprenorphine Follow-up and Report - 6 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 6

Change: 0

Current : 6

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0032 4003 MAT – Naltrexone Follow-up and Report - 3 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 3

Change: 0

Current : 3

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0033 4050 MAT – Psychiatric Evaluation and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0034 5005 Mental Health Intake Screening - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 1: 13 - 24 months

Previous : 2

Change: 0

15BCTS23Q00000004/0001 Page 9 of 69

PSC: G004 Current : 2

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0035 5011 Mental Health Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0036 5030 Psychiatric Evaluation & Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0037 6000 Crisis Intervention - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0038 6010 Mental Health Individual Counseling - 300 Units Guaranteed Minimum; 2000 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0039 6020 Mental Health Group Counseling - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current : 20

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS23Q00000004/0001 Page 10 of 69

0040 6030 Case Management Services - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0041 6031 Mental Health Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0042 6050 Administration of Medication - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0043 6051 Mental Health Medication Monitoring - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current : 20

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0044 5012 Sex Offender Intake Assessment and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0045 6005 Sex Offender Intake Screening - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0046 6012 Sex Offender Individual Counseling - 32 Units Guaranteed Minimum; 240 Units Estimated Maximum Option Year 1: 13 - 24 months

Previous :

15BCTS23Q00000004/0001 Page 11 of 69

Current : 32

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0047 6022 Sex Offender Group Counseling - 24 Units Guaranteed Minimum; 360 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous :

Change: 0

Current : 24

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0048 6032 Sex Offender Family Counseling - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 1: 13 - 24 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0049 2005 Substance Use Intake Screening - 2 Units Guaranteed Minimum; 15 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0050 2010 Substance Use Individual Counseling - 300 Units Guaranteed Minimum; 2200 Units Estimated Maximum.

Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0051 2011 Substance Use Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS23Q00000004/0001 Page 12 of 69

0052 2012 Dual Diagnosis Intake Assessment and Report - 10 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0053 2020 Substance Use Group Counseling - 480 Units Guaranteed Minimum; 1800 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0054 2030 Substance Use Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0055 4002 MAT – Buprenorphine Follow-up and Report - 6 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 6

Change: 0

Current : 6

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0056 4003 MAT – Naltrexone Follow-up and Report - 3 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 3

Change: 0

Current : 3

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0057 4050 MAT – Psychiatric Evaluation and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS23Q00000004/0001 Page 13 of 69

0058 5005 Mental Health Intake Screening - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0059 5011 Mental Health Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0060 5030 Psychiatric Evaluation & Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0061 6000 Crisis Intervention - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0062 6010 Mental Health Individual Counseling - 300 Units Guaranteed Minimum; 2000 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0063 6020 Mental Health Group Counseling - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 20

15BCTS23Q00000004/0001 Page 14 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0064 6030 Case Management Services - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0065 6031 Mental Health Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0066 6050 Administration of Medication - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0067 6051 Mental Health Medication Monitoring - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 20

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0068 5012 Sex Offender Intake Assessment and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0069 6005 Sex Offender Intake Screening - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS23Q00000004/0001 Page 15 of 69

0070 6012 Sex Offender Individual Counseling - 32 Units Guaranteed Minimum; 240 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 32

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0071 6022 Sex Offender Group Counseling - 24 Units Guaranteed Minimum; 360 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous :

Change: 0

Current : 24

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0072 6032 Sex Offender Family Counseling - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 2: 25 - 36 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0073 2005 Substance Use Intake Screening - 2 Units Guaranteed Minimum; 15 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0074 2010 Substance Use Individual Counseling - 300 Units Guaranteed Minimum; 2200 Units Estimated Maximum.

Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0075 2011 Substance Use Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current : 10

15BCTS23Q00000004/0001 Page 16 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0076 2012 Dual Diagnosis Intake Assessment and Report - 10 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0077 2020 Substance Use Group Counseling - 480 Units Guaranteed Minimum; 1800 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0078 2030 Substance Use Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0079 4002 MAT – Buprenorphine Follow-up and Report - 6 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 6

Change: 0

Current : 6

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0080 4003 MAT – Naltrexone Follow-up and Report - 3 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 3

Change: 0

Current : 3

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0081 4050 MAT – Psychiatric Evaluation and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 2

Change: 0

Current : 2

15BCTS23Q00000004/0001 Page 17 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0082 5005 Mental Health Intake Screening - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0083 5011 Mental Health Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0084 5030 Psychiatric Evaluation & Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0085 6000 Crisis Intervention - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0086 6010 Mental Health Individual Counseling - 300 Units Guaranteed Minimum; 2000 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0087 6020 Mental Health Group Counseling - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 3: 37 - 48 months

Previous :

15BCTS23Q00000004/0001 Page 18 of 69

Current : 20

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0088 6030 Case Management Services - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0089 6031 Mental Health Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0090 6050 Administration of Medication - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0091 6051 Mental Health Medication Monitoring - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current : 20

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0092 5012 Sex Offender Intake Assessment and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0093 6005 Sex Offender Intake Screening - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 1

Change: 0

15BCTS23Q00000004/0001 Page 19 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0094 6012 Sex Offender Individual Counseling - 32 Units Guaranteed Minimum; 240 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current : 32

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0095 6022 Sex Offender Group Counseling - 24 Units Guaranteed Minimum; 360 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous :

Change: 0

Current : 24

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0096 6032 Sex Offender Family Counseling - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 3: 37 - 48 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0097 2005 Substance Use Intake Screening - 2 Units Guaranteed Minimum; 15 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0098 2010 Substance Use Individual Counseling - 300 Units Guaranteed Minimum; 2200 Units Estimated Maximum.

Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0099 2011 Substance Use Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 4: 49 - 60 months

Previous :

15BCTS23Q00000004/0001 Page 20 of 69

Current : 10

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0100 2012 Dual Diagnosis Intake Assessment and Report - 10 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0101 2020 Substance Use Group Counseling - 480 Units Guaranteed Minimum; 1800 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0102 2030 Substance Use Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0103 4002 MAT – Buprenorphine Follow-up and Report - 6 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 6

Change: 0

Current : 6

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0104 4003 MAT – Naltrexone Follow-up and Report - 3 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 3

Change: 0

Current : 3

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS23Q00000004/0001 Page 21 of 69

0105 4050 MAT – Psychiatric Evaluation and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0106 5005 Mental Health Intake Screening - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0107 5011 Mental Health Intake Assessment and Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0108 5030 Psychiatric Evaluation & Report - 10 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0109 6000 Crisis Intervention - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0110 6010 Mental Health Individual Counseling - 300 Units Guaranteed Minimum; 2000 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current :

15BCTS23Q00000004/0001 Page 22 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0111 6020 Mental Health Group Counseling - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current : 20

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0112 6030 Case Management Services - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0113 6031 Mental Health Family Counseling - 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0114 6050 Administration of Medication - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0115 6051 Mental Health Medication Monitoring - 20 Units Guaranteed Minimum; 60 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current : 20

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0116 5012 Sex Offender Intake Assessment and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 2

Change: 0

Current : 2

15BCTS23Q00000004/0001 Page 23 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0117 6005 Sex Offender Intake Screening - 1 Unit Guaranteed Minimum;

10 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0118 6012 Sex Offender Individual Counseling - 32 Units Guaranteed Minimum; 240 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current : 32

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0119 6022 Sex Offender Group Counseling - 24 Units Guaranteed Minimum; 360 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous :

Change: 0

Current : 24

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0120 6032 Sex Offender Family Counseling - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 4: 49 - 60 months

PSC: G004

Previous : 2

Change: 0

Current : 2

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0121 2005 Substance Use Intake Screening - 1 Unit Guaranteed Minimum; 8 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0122 2010 Substance Use Individual Counseling - 150 Units Guaranteed Minimum; 1100 Units Estimated Maximum.

Potential Six Month Extension

PSC: G004

Previous :

15BCTS23Q00000004/0001 Page 24 of 69

Current :

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0123 2011 Substance Use Intake Assessment and Report - 5 Units Guaranteed Minimum; 25 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 5

Change: 0

Current : 5

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0124 2012 Dual Diagnosis Intake Assessment and Report - 5 Units Guaranteed Minimum; 13 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 5

Change: 0

Current : 5

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0125 2020 Substance Use Group Counseling - 240 Units Guaranteed Minimum; 900 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous :

Change: 0

Current :

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0126 2030 Substance Use Family Counseling - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0127 4002 MAT – Buprenorphine Follow-up and Report - 3 Units Guaranteed Minimum; 30 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 3

Change: 0

Current : 3

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0128 4003 MAT – Naltrexone Follow-up and Report - 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Potential Six Month Extension

Previous : 2

15BCTS23Q00000004/0001 Page 25 of 69

PSC: G004 Current : 2

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0129 4050 MAT – Psychiatric Evaluation and Report - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0130 5005 Mental Health Intake Screening - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0131 5011 Mental Health Intake Assessment and Report - 5 Units Guaranteed Minimum; 25 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 5

Change: 0

Current : 5

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0132 5030 Psychiatric Evaluation & Report - 5 Units Guaranteed Minimum; 25 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 5

Change: 0

Current : 5

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0133 6000 Crisis Intervention - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0134 6010 Mental Health Individual Counseling - 150 Units Guaranteed Minimum; 1000 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous :

Change: 0

Current :

15BCTS23Q00000004/0001 Page 26 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0135 6020 Mental Health Group Counseling - 10 Units Guaranteed Minimum; 30 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0136 6030 Case Management Services - 1 Unit Guaranteed Minimum; 3 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0137 6031 Mental Health Family Counseling - 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0138 6050 Administration of Medication - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0139 6051 Mental Health Medication Monitoring - 10 Units Guaranteed Minimum; 30 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous :

Change: 0

Current : 10

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0140 5012 Sex Offender Intake Assessment and Report - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

15BCTS23Q00000004/0001 Page 27 of 69

QUANTITY

UNIT UNIT PRICE AMOUNT

0141 6005 Sex Offender Intake Screening - 1 Unit Guaranteed Minimum;

5 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Current : 1

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0142 6012 Sex Offender Individual Counseling - 16 Units Guaranteed Minimum; 120 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous :

Change: 0

Current : 16

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0143 6022 Sex Offender Group Counseling - 12 Units Guaranteed Minimum; 180 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous :

Change: 0

Current : 12

EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0144 6032 Sex Offender Family Counseling - 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Potential Six Month Extension

PSC: G004

Previous : 1

Change: 0

Section 3 - Contract Clauses

A.1 ADDENDUM TO FAR 52.212-4, Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2021)

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

15BCTS23Q00000004/0001 Page 28 of 69

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

(Nov 2021)

52.253-1 Computer Generated Forms (Jan 1991)

52.212-4 Contract Terms and Conditions-Commercial Products and Commercial

Services (Nov 2021)

52.203-12 Limitation On Payments To Influence Certain Federal Transactions

(Oct 2010)

52.242-13 Bankruptcy (July 1995)

52.224-1 Privacy Act Notification (Apr 1984)

52.224-2 Privacy Act (Apr 1984)

52.204-12 Unique Entity Identifier Maintenance (Oct 2016)

Clauses By Full Text

52.21-603-70 Contracting Officer's Representative (COR) (June 2012)

(a)Tiffany Olivi SCTC Lead COR, Shannon Hart, Shalini Haylock, Fidencio Lamas, Daniel Reeser, Miriam Guzman and Lei Zhang ,Los Angeles Field Office , 1299 Seaside Avenue, San Pedro, CA 90731,(215) 521-7474, (310) 732-5191, (310) 732-5138, (310)732-5175, (310)732-5526, (310)732-5226, is hereby designated as the Contracting Officer's Representative (COR) under this contract.

(b) The COR is responsible, as applicable, for: receiving all deliverables, inspecting and accepting the supplies or services provide hereunder in accordance with the terms and conditions of this contract; providing direction to the contractor which clarifies the contractor effort, fills in details or otherwise serves to accomplish the contractual Scope of Work; evaluating performance; and certifying all invoices/vouchers for acceptance of the supplies or services furnished for payment.

(c) The COR does not have the authority to alter the contractor's obligations under the contract, and/or modify any of the expressed terms, conditions, specifications, or cost of the agreement. If as a result of technical discussions it is desirable to alter/change contractual obligations or the Scope of Work, the Contracting Officer shall issue such changes.

15BCTS23Q00000004/0001 Page 29 of 69

52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE 2004)

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.opm.gov/employ/html/citizen.htm 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.

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 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 .