15BCTS23Q00000026.pdf

15BCTS23Q00000026 Page 1 of 64

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30

1. REQUISITION NUMBER PAGE 1 OF

5. SOLICITATION NUMBER

15BCTS23Q00000026

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

12/20/2022

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

Paul Clark p5clark@bop.gov

b. TELEPHONE NUMBER (No collect calls)

(202) 353-0382

8. OFFER DUE DATE / LOCAL

TIME

01/13/2023 14:00

CODE BCTS

Federal Bureau of Prisons Acquisitions Branch/Community Treatment Svcs Contractng 320 First Street NW Room 901-5 Washington, DC 20534

9. ISSUED BY UNRESTRICTED OR X SET ASIDE:100.00 % FOR

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS: 621420

SIZE STANDARD: $16,500,000

10. THE ACQUISITION IS

SEE

SCHEDULE

11. DELIVERY FOR FOB DESTINATION

UNLESS BLOCK IS MARKED

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER DPAS

(15 CFR 700)

13b. RATING

X RFQ IFB RFP

14. METHOD OF SOLICITATION

15B500CODE15. DELIVER TO

Federal Bureau of Prisons South Central Regional Office 344 Marine Forces Drive Grand Prairie, TX 75051

BOP-RSD-CRBCTS-BILL-DAL

CODE 15BCTS16. ADMINISTERED BY

Federal Bureau of Prisons Community Treatment Svcs Contractng 320 First Street NW Room 901-5 Washington, DC 20534

Paul Clark

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

FACILITY

CODE

CODE

TELEPHONE NO.

17a. CONTRACTOR/

OFFEROR

15B500CODE18a. PAYMENT WILL BE MADE BY

Federal Bureau of Prisons South Central Regional Office 344 Marine Forces Drive Grand Prairie, TX 75051

Michael Nichols BOP-RSDCRBCTS-BILL-DAL@bop.gov

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER SEE ADDENDUM

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS

CHECKED

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Substance Use, Mental Health, Medical Assisted and Sex Offender Treatment Services in LA Cruses, NM.

Firm Fixed Price

See Continuation Sheet(s) (Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE X ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

X 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1 COPIES TO

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE

TERMS AND CONDITIONS SPECIFIED.

29. AWARD OF CONTRACT: REF. _____________________________ OFFER

DATED _________________ . YOUR OFFER ON SOLICITATION (BLOCK 5)

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN,

IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (TYPE OR PRINT)

Paul Clark

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

028 - 2023

X

15BCTS23Q00000026 Page 2 of 64

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: _________________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

PARTIAL FINAL

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

COMPLETE PARTIAL FINAL

36. PAYMENT 37. CHECK NUMBER

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

15BCTS23Q00000026 Page 3 of 64

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

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

2004) DJAR-PGD-15-03 Security of Department Information and Systems 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 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) 52.216-18 Ordering (Oct 1995) 52.216-19 Order Limitations (Oct 1995) 52.216-21 Requirements (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.232-18 Availability Of Funds (Apr 1984) 52.232-19 Availability Of Funds For The Next Fiscal Year (Apr 1984) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997)

BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR

2011) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (June 2016) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services (Oct 2022) 52.212-5 Contract Terms and Conditions Required To Implement Statutes or Executive Orders- Commercial Products and Commercial Services (Oct 2022) DOJ-01 Whistleblower Information Distribution (Oct 2021) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021); (Alt. I) -- Classified Information -- Cleared Contractors 52.216-22 Indefinite Quantity (Oct 1995) DOJ-08 Continuing Contract Performance During a Pandemic Influenza or other National Emergency

(OCT 2007)

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) 52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Dec 2019) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Dec 2019) 52.204-16 Commercial and Government Entity Code Reporting (Jul 2016) 52.204-22 Alternative Line Item Proposal (Jan 2017) 52.204-7 System for Award Management (Oct 2018) 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (Nov 2021) 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)

15BCTS23Q00000026 Page 4 of 64

Section 2 - Commodity or Services Schedule

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0001 Substance Use Intake Screening (2005) 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0002 Substance Use Individual Counseling (2010) 100 Units Guaranteed Minimum; 1600 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0003 Substance Use Intake Assessment & Report (2011) 5 Units Guaranteed Minimum; 35 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0004 Dual Diagnosis Intake Assessment & Report (2012) 3 Units Guaranteed Minimum; 25 Units Estimated Maximum Base Period:

Date of award - 12 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0005 Substance Use Group Counseling (2020) 144 Units Guaranteed Minimum; 2400 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

144 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0006 Substance Use Family Counseling (2030) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

15BCTS23Q00000026 Page 5 of 64

0007 Buprenorphine Follow-Up and Report - MAT (4002) 1 Unit Guaranteed Minimum; 30 Units Estimated Maximum Base Period:

Date of Award to 12 Months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0008 Naltrexone Follow-Up and Report - MAT (4003) 1 Unit Guaranteed Minimum; 24 Units Estimated Maximum Base Period: Date of Award to 12 Months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0009 Psychiatric Evaluation & Report - MAT (4050) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Base Period: Date of Award to 12 Months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0010 Mental Health Intake (5005) 2 Units Guaranteed Minimum; 25 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0011 Mental Health Intake Assessment & Report (5011) 4 Units Guaranteed Minimum; 50 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0012 Psychiatric Evaluation & Report (5030) 2 Units Guaranteed Minimum; 45 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

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

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0014 Mental Health Individual Counseling (6010) 40 Units Guaranteed Minimum; 800 Units Estimated Maximum Base Period: Date of award - 12 months

40 EA $________ $_________________

15BCTS23Q00000026 Page 6 of 64

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0015 Mental Health Group Counseling (6020) 32 Units Guaranteed Minimum; 400 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

32 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0016 Mental Health Family Counseling (6031) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0017 Medication Monitoring and Report (6051) 5 Units Guaranteed Minimum; 150 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0018 Sex Offender Specific Intake Assessment & Report (5012) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0019 Sex Offender Intake Screening (6005) 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0020 Sex Offender Individual Counseling (6012) 20 Units Guaranteed Minimum; 400 Units Estimated Maximum Base Period: Date of award - 12 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0021 Sex Offender Group Counseling (6022) 24 Units Guaranteed Minimum; 580 Units Estimated Maximum Base Period: Date of award - 12 months

24 EA $________ $_________________

15BCTS23Q00000026 Page 7 of 64

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0022 Substance Use Intake Screening (2005) 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0023 Substance Use Individual Counseling (2010) 100 Units Guaranteed Minimum; 1600 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0024 Substance Use Intake Assessment & Report (2011) 5 Units Guaranteed Minimum; 35 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0025 Dual Diagnosis Intake Assessment & Report (2012) 3 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0026 Substance Use Group Counseling (2020) 144 Units Guaranteed Minimum; 2400 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

144 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0027 Substance Use Family Counseling (2030) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0028 Buprenorphine Follow-Up and Report - MAT (4002) 1 Unit Guaranteed Minimum; 30 Units Estimated Maximum Option Year 1: 13 months through 24 months

1 EA $________ $_________________

15BCTS23Q00000026 Page 8 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0029 Naltrexone Follow-Up and Report - MAT (4003) 1 Unit Guaranteed Minimum; 24 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0030 Psychiatric Evaluation & Report - MAT (4050) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0031 Mental Health Intake (5005) 2 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0032 Mental Health Intake Assessment & Report (5011) 4 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0033 Psychiatric Evaluation & Report (5030) 2 Units Guaranteed Minimum; 45 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0034 Crisis Intervention (6000) 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0035 Mental Health Individual Counseling (6010) 40 Units Guaranteed Minimum; 800 Units Estimated Maximum Option Year 1: 13 months through 24 months

15BCTS23Q00000026 Page 9 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0036 Mental Health Group Counseling (6020) 32 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

32 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0037 Mental Health Family Counseling (6031) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0038 Medication Monitoring and Report (6051) 5 Units Guaranteed Minimum; 150 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0039 Sex Offender Specific Intake Assessment & Report (5012) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0040 Sex Offender Intake Screening (6005) 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0041 Sex Offender Individual Counseling (6012) 20 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 1: 13 months through 24 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0042 Sex Offender Group Counseling (6022) 24 Units Guaranteed Minimum; 580 Units Estimated Maximum Option Year 1: 13 months through 24 months

15BCTS23Q00000026 Page 10 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0043 Substance Use Intake Screening (2005) 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0044 Substance Use Individual Counseling (2010) 100 Units Guaranteed Minimum; 1600 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0045 Substance Use Intake Assessment & Report (2011) 5 Units Guaranteed Minimum; 35 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0046 Dual Diagnosis Intake Assessment & Report (2012) 3 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0047 Substance Use Group Counseling (2020) 144 Units Guaranteed Minimum; 2400 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

144 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0048 Substance Use Family Counseling (2030) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0049 Buprenorphine Follow-Up and Report - MAT (4002) 1 Unit Guaranteed Minimum; 30 Units Estimated Maximum Option Year 2: 25 months through 36 months

15BCTS23Q00000026 Page 11 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0050 Naltrexone Follow-Up and Report - MAT (4003) 1 Unit Guaranteed Minimum; 24 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0051 Psychiatric Evaluation & Report - MAT (4050) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0052 Mental Health Intake (5005) 2 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0053 Mental Health Intake Assessment & Report (5011) 4 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0054 Psychiatric Evaluation & Report (5030) 2 Units Guaranteed Minimum; 45 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0055 Crisis Intervention (6000) 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0056 Mental Health Individual Counseling (6010) 40 Units Guaranteed Minimum; 800 Units Estimated Maximum Option Year 2: 25 months through 36 months

15BCTS23Q00000026 Page 12 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0057 Mental Health Group Counseling (6020) 32 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

32 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0058 Mental Health Family Counseling (6031) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0059 Medication Monitoring and Report (6051) 5 Units Guaranteed Minimum; 150 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0060 Sex Offender Specific Intake Assessment & Report (5012) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0061 Sex Offender Intake Screening (6005) 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0062 Sex Offender Individual Counseling (6012) 20 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 2: 25 months through 36 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0063 Sex Offender Group Counseling (6022) 24 Units Guaranteed Minimum; 580 Units Estimated Maximum Option Year 2: 25 months through 36 months

15BCTS23Q00000026 Page 13 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0064 Substance Use Intake Screening (2005) 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0065 Substance Use Individual Counseling (2010) 100 Units Guaranteed Minimum; 1600 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0066 Substance Use Intake Assessment & Report (2011) 5 Units Guaranteed Minimum; 35 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0067 Dual Diagnosis Intake Assessment & Report (2012) 3 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0068 Substance Use Group Counseling (2020) 144 Units Guaranteed Minimum; 2400 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

144 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0069 Substance Use Family Counseling (2030) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0070 Buprenorphine Follow-Up and Report - MAT (4002) 1 Unit Guaranteed Minimum; 30 Units Estimated Maximum Option Year 3: 37 months through 48 months

15BCTS23Q00000026 Page 14 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0071 Naltrexone Follow-Up and Report - MAT (4003) 1 Unit Guaranteed Minimum; 24 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0072 Psychiatric Evaluation & Report - MAT (4050) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0073 Mental Health Intake (5005) 2 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0074 Mental Health Intake Assessment & Report (5011) 4 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0075 Psychiatric Evaluation & Report (5030) 2 Units Guaranteed Minimum; 45 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0076 Crisis Intervention (6000) 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0077 Mental Health Individual Counseling (6010) 40 Units Guaranteed Minimum; 800 Units Estimated Maximum Option Year 3: 37 months through 48 months

15BCTS23Q00000026 Page 15 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0078 Mental Health Group Counseling (6020) 32 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

32 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0079 Mental Health Family Counseling (6031) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0080 Medication Monitoring and Report (6051) 5 Units Guaranteed Minimum; 150 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0081 Sex Offender Specific Intake Assessment & Report (5012) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0082 Sex Offender Intake Screening (6005) 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0083 Sex Offender Individual Counseling (6012) 20 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 3: 37 months through 48 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0084 Sex Offender Group Counseling (6022) 24 Units Guaranteed Minimum; 580 Units Estimated Maximum Option Year 3: 37 months through 48 months

15BCTS23Q00000026 Page 16 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0085 Substance Use Intake Screening (2005) 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0086 Substance Use Individual Counseling (2010) 100 Units Guaranteed Minimum; 1600 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0087 Substance Use Intake Assessment & Report (2011) 5 Units Guaranteed Minimum; 35 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0088 Dual Diagnosis Intake Assessment & Report (2012) 3 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0089 Substance Use Group Counseling (2020) 144 Units Guaranteed Minimum; 2400 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

144 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0090 Substance Use Family Counseling (2030) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0091 Buprenorphine Follow-Up and Report - MAT (4002) 1 Unit Guaranteed Minimum; 30 Units Estimated Maximum Option Year 4: 49 months through 60 months

15BCTS23Q00000026 Page 17 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0092 Naltrexone Follow-Up and Report - MAT (4003) 1 Unit Guaranteed Minimum; 24 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0093 Psychiatric Evaluation & Report - MAT (4050) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0094 Mental Health Intake (5005) 2 Units Guaranteed Minimum; 25 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0095 Mental Health Intake Assessment & Report (5011) 4 Units Guaranteed Minimum; 50 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0096 Psychiatric Evaluation & Report (5030) 2 Units Guaranteed Minimum; 45 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0097 Crisis Intervention (6000) 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0098 Mental Health Individual Counseling (6010) 40 Units Guaranteed Minimum; 800 Units Estimated Maximum Option Year 4: 49 months through 60 months

15BCTS23Q00000026 Page 18 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0099 Mental Health Group Counseling (6020) 32 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

32 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0100 Mental Health Family Counseling (6031) 4 Units Guaranteed Minimum; 40 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

4 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0101 Medication Monitoring and Report (6051) 5 Units Guaranteed Minimum; 150 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0102 Sex Offender Specific Intake Assessment & Report (5012) 2 Units Guaranteed Minimum; 12 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0103 Sex Offender Intake Screening (6005) 2 Units Guaranteed Minimum; 10 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0104 Sex Offender Individual Counseling (6012) 20 Units Guaranteed Minimum; 400 Units Estimated Maximum Option Year 4: 49 months through 60 months

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0105 Sex Offender Group Counseling (6022) 24 Units Guaranteed Minimum; 580 Units Estimated Maximum Option Year 4: 49 months through 60 months

15BCTS23Q00000026 Page 19 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0106 Substance Use Intake Screening (2005) 1 Unit Guaranteed Minimum; 10 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0107 Substance Use Individual Counseling (2010) 50 Units Guaranteed Minimum; 800 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0108 Substance Use Intake Assessment & Report (2011) 3 Units Guaranteed Minimum; 18 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0109 Dual Diagnosis Intake Assessment & Report (2012) 2 Units Guaranteed Minimum; 13 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0110 Substance Use Group Counseling (2020) 72 Units Guaranteed Minimum; 1200 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

72 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0111 Substance Use Family Counseling (2030) 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0112 Buprenorphine Follow-Up and Report - MAT (4002) 1 Unit Guaranteed Minimum; 15 Units Estimated Maximum Potential 6 Month Extension

15BCTS23Q00000026 Page 20 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0113 Naltrexone Follow-Up and Report - MAT (4003) 1 Unit Guaranteed Minimum; 12 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0114 Psychiatric Evaluation & Report - MAT (4050) 1 Unit Guaranteed Minimum; 6 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0115 Mental Health Intake (5005) 1 Unit Guaranteed Minimum; 13 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0116 Mental Health Intake Assessment & Report (5011) 2 Units Guaranteed Minimum; 25 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0117 Psychiatric Evaluation & Report (5030) 1 Unit Guaranteed Minimum; 23 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0118 Crisis Intervention (6000) 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0119 Mental Health Individual Counseling (6010) 20 Units Guaranteed Minimum; 400 Units Estimated Maximum Potential 6 Month Extension

20 EA $________ $_________________

15BCTS23Q00000026 Page 21 of 64

QUANTITY

UNIT UNIT PRICE AMOUNT

0120 Mental Health Group Counseling (6020) 16 Units Guaranteed Minimum; 200 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

16 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0121 Mental Health Family Counseling (6031) 2 Units Guaranteed Minimum; 20 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

2 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0122 Medication Monitoring and Report (6051) 3 Units Guaranteed Minimum; 75 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

3 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0123 Sex Offender Specific Intake Assessment & Report (5012) 1 Unit Guaranteed Minimum; 6 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0124 Sex Offender Intake Screening (6005) 1 Unit Guaranteed Minimum; 5 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

1 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0125 Sex Offender Individual Counseling (6012) 10 Units Guaranteed Minimum; 200 Units Estimated Maximum Potential 6 Month Extension

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0126 Sex Offender Group Counseling (6022) 12 Units Guaranteed Minimum; 290 Units Estimated Maximum Potential 6 Month Extension

12 EA $________ $_________________

15BCTS23Q00000026 Page 22 of 64

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

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 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)

15BCTS23Q00000026 Page 23 of 64

(a)Michael Nichols SCTC 972-730-8940; Crystal Lotterbery CTC 202-353-6897; Lantia Bridges CTOS 972-730-8941; Nicole Briscoe CTOS 972-730-8946; Keith Goodjoint CTOS 972-730-8835; Ian Jansz CTOS 202-451-7278; Shelia Jones CTOS 972-730-9845; Bettina Suarez-Cromley CTOS 972-730-8944; Nikki Kinnick MA 972-730-8947 ,_______________________ , _Dallas Field Office________________________,______________________________, 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.

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/1/treaty/collectivedefense.

By signing this contract or commitment document, or by commencing performance, the contractor agrees to this restriction.

[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 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

15BCTS23Q00000026 Page 24 of 64 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 nor release to any third-party at any time, including during or at expiration or termination of the contract without the prior written permission of the CO.

C. Any DOJ information made available to Contractor under this contract shall be used only for the purpose of performance of this contract and shall not be divulged or made known in any manner to any persons except as may be necessary in the performance of this contract. In performance of this contract, Contractor assumes responsibility for the protection of the confidentiality of any and all DOJ Information processed, stored, or transmitted by the Contractor. When requested by the CO (typically no more than annually), Contractor shall provide a report to the CO identifying, to the best of Contractor’s knowledge and belief, the type, amount, and level of sensitivity of the DOJ Information processed, stored, or transmitted under the Contract, including an estimate of the number of individuals for whom PII has been processed, stored or transmitted under the Contract and whether such information includes social security numbers (in whole or in part).

IV. Compliance with Information Technology Security Policies, Procedures and Requirements

A. For all Covered Information Systems, Contractor shall comply with all security requirements, including but not limited to the regulations and guidance found in the Federal Information Security Management Act of 2014 (“FISMA”), Privacy Act of 1974, E- Government Act of 2002, National Institute of Standards and Technology (“NIST”) Special Publications (“SP”), including NIST SP 800-37, 800-53, and 800-60 Volumes I and II, Federal Information Processing Standards (“FIPS”) Publications 140-2, 199, and 200, OMB Memoranda, Federal Risk and Authorization Management Program (“FedRAMP”), DOJ IT Security Standards, including DOJ Order 2640.2, as amended. These requirements include but are not limited to:

1. Limiting access to DOJ Information and Covered Information Systems to authorized users and to transactions and functions that authorized users are permitted to exercise;

2. Providing security awareness training including, but not limited to, recognizing and reporting potential indicators of insider threats to users and managers of DOJ Information and Covered Information Systems;

3. Creating, protecting, and retaining Covered Information System audit records, reports, and supporting documentation to enable reviewing, monitoring, analysis, investigation, reconstruction, and reporting of unlawful, unauthorized, or inappropriate activity related to such Covered Information Systems and/or DOJ Information;

4. Maintaining authorizations to operate any Covered Information System;

5. Performing continuous monitoring on all Covered Information Systems;

6. Establishing and maintaining baseline configurations and inventories of Covered Information Systems, including hardware, software, firmware, and documentation, throughout the Information System Development Lifecycle, and establishing and enforcing security configuration settings for IT products employed in Information Systems;

7. Ensuring appropriate contingency planning has been performed, including DOJ Information and Covered Information System backups;

15BCTS23Q00000026 Page 25 of 64

8. Identifying Covered Information System users, processes acting on behalf of users, or devices, and authenticating and verifying the identities of such users, processes, or devices, using multifactor authentication or HSPD-12 compliant authentication methods where required;

9. Establishing an operational incident handling capability for Covered Information Systems that includes adequate preparation, detection, analysis, containment, recovery, and user response activities, and tracking, documenting, and reporting incidents to appropriate officials and authorities within Contractor’s organization and the DOJ;

10. Performing periodic and timely maintenance on Covered Information Systems, and providing effective controls on tools, techniques, mechanisms, and personnel used to conduct such maintenance;

12. Protecting Covered Information System media containing DOJ Information, including paper, digital and electronic media;

limiting access to DOJ Information to authorized users; and sanitizing or destroying Covered Information System media containing DOJ Information before disposal, release or reuse of such media;

13. Limiting physical access to Covered Information Systems, equipment, and physical facilities housing such Covered Information Systems to authorized U.S. citizens unless a waiver has been granted by the Contracting Officer (“CO”), and protecting the physical facilities and support infrastructure for such Information Systems;

14. Screening individuals prior to authorizing access to Covered Information Systems to ensure compliance with DOJ Security standards;

15. Assessing the risk to DOJ Information in Covered Information Systems periodically, including scanning…