0 - SF1449.pdf
PDF 310 KB Posted
- Attached to
- CTS Services in Florence, AZ Federal contract opportunity
- Solicitation number
- 15BCTS24Q00000004
About this file
This document is a solicitation for Substance Use Disorder, Mental Health, and Sex Offender Treatment Services in Florence, AZ. The Federal Bureau of Prisons is seeking quotes for a firm-fixed price contract to provide these services within a 15-mile radius of Florence Town Hall. The contract will have a one-year base period starting December 1, 2024, with four one-year option periods, for a total potential performance period of 5 years. The required services are detailed in the attached schedule and include treatment planning, screening, assessments, individual and group counseling, case management, medication management, and other related services. This requirement will be set aside for small businesses, and all responsible business concerns may submit a quote. The solicitation will be available on the SAM.gov website, with an estimated closing date around October 5, 2024.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 5 - Section 2.1 Continuation of SF-1449.pdf | ||
| 4 - Whistleblower Info.pdf | ||
| 6 - Quotation Attachment Form.pdf | ||
| 3 - Technical Information Document.docx | DOCX document | |
| 1 - SOW 2022.pdf | ||
| 2 - Business Quotation Information March 2019.pdf | ||
| 0 - Cover Letter.docx | DOCX document |
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15BCTS24Q00000004 Page 1 of 84
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES
NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 AND 30.
1. REQUISITION NUMBER PAGE 1 OF
5. SOLICITATION NUMBER
15BCTS24Q00000004
2. CONTRACT NUMBER 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
10/21/2024
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
Stephen A. Deffenbaugh sadeffenbaugh@bop.gov
b. TELEPHONE NUMBER (No collect calls)
202-598-3483
8. OFFER DUE DATE / LOCAL
TIME
11/12/2024 02:00 ET
CODE 15BCTS
Federal Bureau of Prisons
Community Treatment Services Contracting
320 First Street NW
Suite 901-5
Washington, DC 20534
9. ISSUED BY UNRESTRICTED OR X SET ASIDE:100.00 % FOR
X SMALL BUSINESS
HUBZONE SMALL
BUSINESS
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
(SDVOSB)
WOMEN-OWNED SMALL
BUSINESS (WOSB)
ECONOMICALLY DISADVANTAGED
WOMEN-OWNED SMALL BUSINESS
(EDWOSB)
8(A)
NORTH AMERICAN
INDUSTRY CLASSIFICATION
STANDARD (NAICS):
621420
SIZE STANDARD:
$19,000,000
10. THE ACQUISITION IS
SEE SCHEDULE
11. DELIVERY FOR FREE ON BOARD
(FOB) DESTINATION UNLESS
BLOCK IS MARKED
12. DISCOUNT TERMS
13a. THIS CONTRACT IS A
RATED ORDER UNDER THE
DEFENSE PRIORITIES AND
ALLOCATIONS SYSTEM -
DPAS (15 CFR 700)
13b. RATING
X REQUEST
FOR QUOTE
(RFQ)
INVITATION
FOR BID
(IFB)
REQUEST
FOR
PROPOSAL
(RFP)
14. METHOD OF SOLICITATION
15B600CODE15. DELIVER TO
Federal Bureau of Prisons Western Regional Office
7338 SHORELINE DRIVE
STOCKTON, CA 95219
CODE 15BCTS16. ADMINISTERED BY
Federal Bureau of Prisons Community Treatment Services Contracting 320 First Street NW Suite 901-5 Washington, DC 20534
Stephen A. Deffenbaugh
(O) 202-598-3483 sadeffenbaugh@bop.gov
FACILITY
CODE
CODE
TELEPHONE NUMBER
17a. CONTRACTOR/
OFFEROR
15B100CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons Western Regional Office
7338 SHORELINE DRIVE
STOCKTON, CA 95219
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 NUMBER
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
Delivery Date: 12/01/2024
Substance Use, Mental Health, and Sex Offender Treatment Services in Florence, AZ.
Use the Estimated Maximum Quantity when developing the total amount.
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 Government Use Only)
X 27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) 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: REFERENCE _____________________________
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)
Stephen Deffenbaugh
31c. DATE SIGNED
10/21/2024
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STANDARD FORM 1449 (REV. 11/2021)
Prescribed by GSA - FAR (48 CFR) 53.212
004-24
15BCTS24Q00000004 Page 2 of 84
19.
ITEM NUMBER
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. 11/2021) BACK
15BCTS24Q00000004 Page 3 of 84
Table of Contents
Section Description Page Number
Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses
52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020) 52.204-12 Unique Entity Identifier Maintenance (Oct 2016) 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-2 Privacy Act (Apr 1984) 52.242-13 Bankruptcy (July 1995) 52.253-1 Computer Generated Forms (Jan 1991) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Mar 2023) 52.203-3 Gratuities (Apr 1984) 52.242-15 Stop-Work Order (Aug 1989) 52.204-13 System for Award Management Maintenance (Oct 2018) 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (Nov 2021)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS
(APR 2011)
DOJ-01 Whistleblower Information Distribution (Oct 2021) DOJ-02 Contractor Privacy Requirements (JAN 2022) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021) 52.216-18 Ordering (Aug 2020) 52.216-19 Order Limitations (Oct 1995) 52.216-22 Indefinite Quantity (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 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) DOJ-05 Security of Department Information and Systems DOJ-05 (OCT 2023) DOJ-08 Continuing Contract Performance During a Pandemic Influenza or other National Emergency (OCT 2007) 52.203-17 Contractor Employee Whistleblower Rights (Nov 2023) 52.226-8 Encouraging Contractor Policies To Ban Text Messaging While Driving (May 2024) 52.252-6 Authorized Deviations in Clauses (Nov 2020) 52.212-5 Contract Terms and Conditions Required To Implement Statutes or Executive Orders-Commercial Products and Commercial Services (May 2024)
3 List of Attachments 4 Solicitation Provisions
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 (Sep 2023) 52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation (Jan 2017) 52.204-16 Commercial and Government Entity Code Reporting (Aug 2020) 52.217-5 Evaluation of Options (July 1990) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) 52.216-1 Type of Contract (Apr 1984) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (NOV 2020) 52.209-7 Information Regarding Responsibility Matters (Oct 2018)
15BCTS24Q00000004 Page 4 of 84
52.204-29 Federal Acquisition Supply Chain Security Act Orders-Representation and Disclosures (Dec 2023) 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services (May 2024)
15BCTS24Q00000004 Page 5 of 84
Section 1 - Commodity or Services Schedule
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0001 Substance Use Disorder Treatment Planning and Follow-up (2001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Substance Use Disorder Individual Counseling (2010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Substance Use Disorder Intake Assessment & Report (2011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0006 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 1320 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
1,320 EA $________ $_________________
15BCTS24Q00000004 Page 6 of 84
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 MAT - Follow-up & Report (4004)
1 Unit Guaranteed Minimum; 120 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 MAT - Intake Screening (4005)
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 MAT - Administration of Medication (4045)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 MAT - Psychiatric Evaluation & Report (4050)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Mental Health Treatment Planning and Follow-up (5001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Mental Health Intake Screening (5005) 40 EA $________ $_________________
15BCTS24Q00000004 Page 7 of 84
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Mental Health Intake Assessment & Report (5011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 Psychiatric Evaluation & Report (5030)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 10 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Mental Health Individual Counseling (6010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Mental Health Group Counseling (6020)
12 Units Guaranteed Minimum; 600 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Case Management Services (6029)
4 Units Guaranteed Minimum; 250 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
250 EA $________ $_________________
15BCTS24Q00000004 Page 8 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 MH - Administration of Medication (6050)
1 Unit Guaranteed Minimum; 50 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 MH - Medication Monitoring & Report (6051)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
150 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Units Guaranteed Minimum; 25 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Sex Offender Intake Screening (6005)
1 Units Guaranteed Minimum; 40 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
15BCTS24Q00000004 Page 9 of 84
0026 Sex Offender Individual Counseling (6012)
8 Units Guaranteed Minimum; 600 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Sex Offender Group Counseling (6022)
10 Units Guaranteed Minimum; 480 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Sex Offender Relationship and Parenting Counseling (6032)
2 Units Guaranteed Minimum; 48 Units Estimated Maximum
Base Year - 12/1/2024-11/30/2025
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0029 Substance Use Disorder Treatment Planning and Follow-up (2001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Substance Use Disorder Individual Counseling (2010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 Substance Use Disorder Intake Assessment & Report (2011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
50 EA $________ $_________________
15BCTS24Q00000004 Page 10 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 1320 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
1,320 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 MAT - Follow-up & Report (4004)
1 Unit Guaranteed Minimum; 120 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 MAT - Intake Screening (4005)
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 MAT - Administration of Medication (4045)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
0039 MAT - Psychiatric Evaluation & Report (4050) 25 EA $________ $_________________
15BCTS24Q00000004 Page 11 of 84
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Mental Health Treatment Planning and Follow-up (5001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Mental Health Intake Assessment & Report (5011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Psychiatric Evaluation & Report (5030)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 10 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Mental Health Individual Counseling (6010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
1,200 EA $________ $_________________
15BCTS24Q00000004 Page 12 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 Mental Health Group Counseling (6020)
12 Units Guaranteed Minimum; 600 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 Case Management Services (6029)
4 Units Guaranteed Minimum; 250 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
250 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 MH - Administration of Medication (6050)
1 Unit Guaranteed Minimum; 50 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 MH - Medication Monitoring & Report (6051)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
150 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
25 EA $________ $_________________
15BCTS24Q00000004 Page 13 of 84
1 Units Guaranteed Minimum; 25 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Sex Offender Intake Screening (6005)
1 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Sex Offender Individual Counseling (6012)
8 Units Guaranteed Minimum; 600 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Sex Offender Group Counseling (6022)
10 Units Guaranteed Minimum; 480 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Sex Offender Relationship and Parenting Counseling (6032)
2 Units Guaranteed Minimum; 48 Units Estimated Maximum
Option Year One - 12/1/2025-11/30/2026
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Substance Use Disorder Treatment Planning and Follow-up (2001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0058 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
40 EA $________ $_________________
15BCTS24Q00000004 Page 14 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Substance Use Disorder Individual Counseling (2010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Substance Use Disorder Intake Assessment & Report (2011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 1320 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
1,320 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 MAT - Follow-up & Report (4004)
1 Unit Guaranteed Minimum; 120 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
0065 MAT - Intake Screening (4005) 20 EA $________ $_________________
15BCTS24Q00000004 Page 15 of 84
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 MAT - Administration of Medication (4045)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 MAT - Psychiatric Evaluation & Report (4050)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Mental Health Treatment Planning and Follow-up (5001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 Mental Health Intake Assessment & Report (5011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 Psychiatric Evaluation & Report (5030)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
50 EA $________ $_________________
15BCTS24Q00000004 Page 16 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 10 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Mental Health Individual Counseling (6010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Mental Health Group Counseling (6020)
12 Units Guaranteed Minimum; 600 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 Case Management Services (6029)
4 Units Guaranteed Minimum; 250 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
250 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 MH - Administration of Medication (6050)
1 Unit Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 MH - Medication Monitoring & Report (6051)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
150 EA $________ $_________________
15BCTS24Q00000004 Page 17 of 84
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0080 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Units Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 Sex Offender Intake Screening (6005)
1 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Sex Offender Individual Counseling (6012)
8 Units Guaranteed Minimum; 600 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Sex Offender Group Counseling (6022)
10 Units Guaranteed Minimum; 480 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Sex Offender Relationship and Parenting Counseling (6032)
2 Units Guaranteed Minimum; 48 Units Estimated Maximum
Option Year Two - 12/1/2026-11/30/2027
48 EA $________ $_________________
15BCTS24Q00000004 Page 18 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Substance Use Disorder Treatment Planning and Follow-up (2001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Substance Use Disorder Individual Counseling (2010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Substance Use Disorder Intake Assessment & Report (2011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 1320 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
1,320 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 Substance Use Disorder Relationship and Parenting Counseling (2030)
100 EA $________ $_________________
15BCTS24Q00000004 Page 19 of 84
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0092 MAT - Follow-up & Report (4004)
1 Unit Guaranteed Minimum; 120 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 MAT - Intake Screening (4005)
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 MAT - Administration of Medication (4045)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 MAT - Psychiatric Evaluation & Report (4050)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 Mental Health Treatment Planning and Follow-up (5001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
40 EA $________ $_________________
15BCTS24Q00000004 Page 20 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0098 Mental Health Intake Assessment & Report (5011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0099 Psychiatric Evaluation & Report (5030)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 10 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 Mental Health Individual Counseling (6010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0102 Mental Health Group Counseling (6020)
12 Units Guaranteed Minimum; 600 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 Case Management Services (6029)
4 Units Guaranteed Minimum; 250 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
250 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0104 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
100 EA $________ $_________________
15BCTS24Q00000004 Page 21 of 84
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0105 MH - Administration of Medication (6050)
1 Unit Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0106 MH - Medication Monitoring & Report (6051)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
150 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0108 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Units Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 Sex Offender Intake Screening (6005)
1 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Sex Offender Individual Counseling (6012)
8 Units Guaranteed Minimum; 600 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
600 EA $________ $_________________
15BCTS24Q00000004 Page 22 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0111 Sex Offender Group Counseling (6022)
10 Units Guaranteed Minimum; 480 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0112 Sex Offender Relationship and Parenting Counseling (6032)
2 Units Guaranteed Minimum; 48 Units Estimated Maximum
Option Year Three - 12/1/2027-11/30/2028
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0113 Substance Use Disorder Treatment Planning and Follow-up (2001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0114 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0115 Substance Use Disorder Individual Counseling (2010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0116 Substance Use Disorder Intake Assessment & Report (2011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
15BCTS24Q00000004 Page 23 of 84
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 1320 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
1,320 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0120 MAT - Follow-up & Report (4004)
1 Unit Guaranteed Minimum; 120 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0121 MAT - Intake Screening (4005)
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0122 MAT - Administration of Medication (4045)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0123 MAT - Psychiatric Evaluation & Report (4050)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
15BCTS24Q00000004 Page 24 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0124 Mental Health Treatment Planning and Follow-up (5001)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0125 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0126 Mental Health Intake Assessment & Report (5011)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0127 Psychiatric Evaluation & Report (5030)
4 Units Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0128 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 10 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0129 Mental Health Individual Counseling (6010)
32 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0130 Mental Health Group Counseling (6020)
12 Units Guaranteed Minimum; 600 Units Estimated Maximum
15BCTS24Q00000004 Page 25 of 84
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0131 Case Management Services (6029)
4 Units Guaranteed Minimum; 250 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
250 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0132 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 100 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0133 MH - Administration of Medication (6050)
1 Unit Guaranteed Minimum; 50 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0134 MH - Medication Monitoring & Report (6051)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
150 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0135 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0136 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Units Guaranteed Minimum; 25 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
15BCTS24Q00000004 Page 26 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0137 Sex Offender Intake Screening (6005)
1 Units Guaranteed Minimum; 40 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0138 Sex Offender Individual Counseling (6012)
8 Units Guaranteed Minimum; 600 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0139 Sex Offender Group Counseling (6022)
10 Units Guaranteed Minimum; 480 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
480 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0140 Sex Offender Relationship and Parenting Counseling (6032)
2 Units Guaranteed Minimum; 48 Units Estimated Maximum
Option Year Four - 12/1/2028-11/30/2029
PSC: G004
48 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0141 Substance Use Disorder Treatment Planning and Follow-up (2001)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0142 Substance Use Disorder Intake Screening (2005)
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0143 Substance Use Disorder Individual Counseling (2010)
16 Units Guaranteed Minimum; 600 Units Estimated Maximum
15BCTS24Q00000004 Page 27 of 84
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0144 Substance Use Disorder Intake Assessment & Report (2011)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0145 Co-occurring Intake Assessment & Report (2012)
1 Units Guaranteed Minimum; 13 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0146 Substance Use Disorder Group Counseling (2020)
30 Units Guaranteed Minimum; 660 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
660 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0147 Substance Use Disorder Relationship and Parenting Counseling (2030)
1 Unit Guaranteed Minimum; 50 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0148 MAT - Follow-up & Report (4004)
1 Unit Guaranteed Minimum; 60 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0149 MAT - Intake Screening (4005)
1 Unit Guaranteed Minimum; 10 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
10 EA $________ $_________________
15BCTS24Q00000004 Page 28 of 84
QUANTITY
UNIT UNIT PRICE AMOUNT
0150 MAT - Administration of Medication (4045)
1 Unit Guaranteed Minimum; 13 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0151 MAT - Psychiatric Evaluation & Report (4050)
1 Unit Guaranteed Minimum; 13 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0152 Mental Health Treatment Planning and Follow-up (5001)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0153 Mental Health Intake Screening (5005)
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0154 Mental Health Intake Assessment & Report (5011)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0155 Psychiatric Evaluation & Report (5030)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0156 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 5 Units Estimated Maximum
5 EA $________ $_________________
15BCTS24Q00000004 Page 29 of 84
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0157 Mental Health Individual Counseling (6010)
16 Units Guaranteed Minimum; 600 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0158 Mental Health Group Counseling (6020)
6 Units Guaranteed Minimum; 300 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0159 Case Management Services (6029)
2 Units Guaranteed Minimum; 125 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
125 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0160 Mental Health Relationship and Parenting Counseling (6031)
1 Units Guaranteed Minimum; 50 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0161 MH - Administration of Medication (6050)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0162 MH - Medication Monitoring & Report (6051)
1 Unit Guaranteed Minimum; 75 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
150 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
15BCTS24Q00000004 Page 30 of 84
0163 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 13 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0164 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Units Guaranteed Minimum; 13 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0165 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 20 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0166 Sex Offender Individual Counseling (6012)
4 Units Guaranteed Minimum; 300 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0167 Sex Offender Group Counseling (6022)
5 Units Guaranteed Minimum; 240 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0168 Sex Offender Relationship and Parenting Counseling (6032)
1 Unit Guaranteed Minimum; 24 Units Estimated Maximum
Potential 6-month Extension - 12/1/2029-5/31/2030
24 EA $________ $_________________
15BCTS24Q00000004 Page 31 of 84
Section 2 - Contract Clauses
A.1 ADDENDUM TO FAR 52.212-4, Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023)
The terms and conditions for the following clauses are hereby incorporated into this solicitation and resulting…
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