15BCTS24Q00000005.pdf
PDF 429 KB Posted
- Attached to
- SU/MH/SOT in Sacramento, CA Federal contract opportunity
- Solicitation number
- 15BCTS24Q00000005
About this file
This document is a solicitation (Solicitation No. 15BCTS24Q00000005) issued by the Federal Bureau of Prisons (BOP) Community Treatment Services (CTS) Contracting Office for community-based outpatient substance use disorder, mental health treatment, sex offender treatment, and medication assisted treatment services for male and female inmates in Sacramento, California.
The services are required for a one-year base period estimated to begin on June 1, 2024, with four one-year option periods and a potential six-month extension, for a total potential performance period of up to 60 months. The solicitation is set aside for small businesses and requires that all treatment services be provided by clinicians who currently hold a professional license to practice independently in California. The location where services are to be provided must be within a 10-mile radius of Sacramento City Hall and within 1/2 mile of public transportation. The solicitation includes detailed line items for the various treatment services, with guaranteed minimum and estimated maximum quantities for each. Offers are due by April 18, 2024 at 12:00 pm ET.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Questions 3 15BCTS24Q00000005 Sacramento CA.pdf | ||
| 15BCTS24Q00000005 Amendment 1.pdf | ||
| Questions 2 15BCTS24Q00000005 Sacramento CA.pdf | ||
| Questions 15BCTS24Q00000005 CTS in Sacramento CA..pdf | ||
| 2 - Section 2.1, Continuation SF-1449.pdf | ||
| 6 - Whistleblower Information.pdf | ||
| 3 - 2022 Statement of Work (SOW).pdf | ||
| 5 - Business Quotation Information Packet.pdf | ||
| 7 - Clause 52.212-5.pdf | ||
| 8 - Attachment Quotation Form.xlsx | XLSX spreadsheet | |
| 1 - Cover Letter.pdf | ||
| 4 - Technical Quotation Information Packet.docx | DOCX document |
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Text version
15BCTS24Q00000005 Page 1 of 67
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
15BCTS24Q00000005
2. CONTRACT NUMBER 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
03/29/2024
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
Joo Walker j15walker@bop.gov
b. TELEPHONE NUMBER (No collect calls)
(202) 451-7924
8. OFFER DUE DATE / LOCAL
TIME
04/18/2024 12:00 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
BWROCODE15. DELIVER TO
Federal Bureau of Prisons Western Region - CTS Office 1299 Seaside Avenue San Pedro, CA 90731
CODE 15BCTS16. ADMINISTERED BY
Federal Bureau of Prisons Community Treatment Services Contracting 320 First Street NW Suite 901-5 Washington, DC 20534
Joo Walker
(O) 202-451-7924 j15walker@bop.gov
FACILITY
CODE
CODE
TELEPHONE NUMBER
17a. CONTRACTOR/
OFFEROR
BWROCODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons Western Region - CTS Office 1299 Seaside Avenue San Pedro, CA 90731
BOP-RSD-CRBCTS-BILL-LA@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 NUMBER
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
Delivery Date: 06/01/2024
Substance Use, Mental Health and Sex Offender Treatment Services in Sacramento, CA.
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)
Joo Walker
31c. DATE SIGNED
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STANDARD FORM 1449 (REV. 11/2021)
Prescribed by GSA - FAR (48 CFR) 53.212
005-24
15BCTS24Q00000005 Page 2 of 67
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
15BCTS24Q00000005 Page 3 of 67
Table of Contents
Section Description Page Number
Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses
52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023) 52.242-15 Stop-Work Order (Aug 1989) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-2 Privacy Act (Apr 1984) 52.253-1 Computer Generated Forms (Jan 1991) 52.203-3 Gratuities (Apr 1984) 52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020) 52.204-12 Unique Entity Identifier Maintenance (Oct 2016) 52.242-13 Bankruptcy (July 1995) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Mar 2023) 52.204-13 System for Award Management Maintenance (Oct 2018) 52.216-19 Order Limitations (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)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS
(APR 2011)
52.204-21 Basic Safeguarding of Covered Contractor Information Systems (Nov 2021) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021) DOJ-01 Whistleblower Information Distribution (Oct 2021) 52.204-18 Commercial and Government Entity Code Maintenance (Aug 2020) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997) 52.216-22 Indefinite Quantity (Oct 1995) 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) 52.216-18 Ordering (Aug 2020) DOJ-02 Contractor Privacy Requirements (JAN 2022) DOJ-08 Continuing Contract Performance During a Pandemic Influenza or other National Emergency (OCT 2007) DOJ-05 Security of Department Information and Systems DOJ-05 (OCT 2023)
3 List of Attachments 4 Solicitation Provisions
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) 52.204-22 Alternative Line Item Proposal (Jan 2017) 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (Sep 2023) 52.204-7 System for Award Management (Oct 2018) 52.216-1 Type of Contract (Apr 1984) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (NOV 2020)
3.1 INSTRUCTIONS TO OFFERORS - COMMERCIAL SERVICES
15BCTS24Q00000005 Page 4 of 67
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)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 600
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 20
20 EA $________ $_________________
15BCTS24Q00000005 Page 5 of 67
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0006 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 800
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Base Period: 1 month through 12 months
30 EA $________ $_________________
15BCTS24Q00000005 Page 6 of 67
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 10
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 32 Estimated Maximum Quantity: 600
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Case Management Services (6029)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 500
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
500 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
100 EA $________ $_________________
15BCTS24Q00000005 Page 7 of 67
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 60
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Sex Offender Intake Assessment & Report (5012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Sex Offender Intake Screening (6005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 15
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Sex Offender Individual Counseling (6012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 600
Base Period: 1 month through 12 months
Use the Guaranteed Maximum Quantity when developing the total amount.
600 EA $________ $_________________
15BCTS24Q00000005 Page 8 of 67
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 600
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 20
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 9 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 800
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0029 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 10 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 10
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 32 Estimated Maximum Quantity: 600
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Case Management Services (6029)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 500
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
500 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 11 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 60
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Sex Offender Intake Assessment & Report (5012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 Sex Offender Intake Screening (6005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 15
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Sex Offender Individual Counseling (6012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 600
Option Year 1: 13 months through 24 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 12 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 600
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 20
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 13 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 800
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 14 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 10
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 32 Estimated Maximum Quantity: 600
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Case Management Services (6029)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 500
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
500 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 15 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 60
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Sex Offender Intake Assessment & Report (5012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0058 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Sex Offender Intake Screening (6005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 15
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Sex Offender Individual Counseling (6012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 600
Option Year 2: 25 months through 36 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 16 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 600
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 20
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 17 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 800
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 18 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 10
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 32 Estimated Maximum Quantity: 600
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Case Management Services (6029)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 500
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
500 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 19 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 60
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 Sex Offender Intake Assessment & Report (5012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Sex Offender Intake Screening (6005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 15
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0080 Sex Offender Individual Counseling (6012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 600
Option Year 3: 37 months through 48 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 20 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 600
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 30
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 20
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 21 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 60 Estimated Maximum Quantity: 800
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 22 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 4 Estimated Maximum Quantity: 30
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0092 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 10
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
10 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 32 Estimated Maximum Quantity: 600
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Case Management Services (6029)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 500
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
500 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 23 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 60
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Sex Offender Intake Assessment & Report (5012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0098 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0099 Sex Offender Intake Screening (6005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 15
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 Sex Offender Individual Counseling (6012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 600
Option Year 4: 49 months through 60 months
Use the Guaranteed Maximum Quantity when developing the total amount.
15BCTS24Q00000005 Page 24 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 15
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0102 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 13
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 30 Estimated Maximum Quantity: 300
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0104 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 15
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0105 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 10
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
10 EA $________ $_________________
15BCTS24Q00000005 Page 25 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0106 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 30 Estimated Maximum Quantity: 400
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
400 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 50
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0108 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 15
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 13
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 15
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
15 EA $________ $_________________
15BCTS24Q00000005 Page 26 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0111 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 15
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0112 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 5
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
5 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0113 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 16 Estimated Maximum Quantity: 300
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0114 Case Management Services (6029)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 250
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
250 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0115 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 50
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
50 EA $________ $_________________
15BCTS24Q00000005 Page 27 of 67
QUANTITY
UNIT UNIT PRICE AMOUNT
0116 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 30
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
30 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Sex Offender Intake Assessment & Report (5012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 13
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 13
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Sex Offender Intake Screening (6005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 8
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
PSC: G004
8 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0120 Sex Offender Individual Counseling (6012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 300
Potential 6 Month Extension
Use the Guaranteed Maximum Quantity when developing the total amount.
300 EA $________ $_________________
15BCTS24Q00000005 Page 28 of 67
Page Left Blank Intentionally
15BCTS24Q00000005 Page 29 of 67
Section 2 - Contract Clauses
52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023)
(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights--
(1) Within a reasonable time after the defect was discovered or should have been discovered; and
(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.
(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.
(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.
(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.
(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.
(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.
(g) Invoice.
(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include--
(i) Name and address of the Contractor;
(ii) Invoice date and number;
(iii) Contract number, line item number and, if applicable, the order number;
(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;
(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;
(vi) Terms of any discount for prompt payment offered;
15BCTS24Q00000005 Page 30 of 67
(vii) Name and address of official to whom payment is to be sent;
(viii) Name, title, and phone number of person to notify in event of defective invoice; and
(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.
(x)…
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