15BCTS24Q00000016 Syracuse NY.pdf
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- Attached to
- 15BCTS24Q00000016 - SU/MH in Syracuse, NY Federal contract opportunity
- Solicitation number
- 15BCTS24Q00000016
About this file
This is a Request for Quote (RFQ) solicitation document from the Federal Bureau of Prisons (BOP) seeking community-based outpatient substance use disorder and mental health treatment services for male and female Adults in Custody in Syracuse, NY. The services must be provided by licensed clinicians within a 5-mile radius of Syracuse City Hall and within 1/2 mile of public transportation.
The contract will have a one-year base period beginning March 1, 2025, with four one-year option periods through February 28, 2030, plus a potential 6-month extension. This is a firm-fixed price IDIQ contract set aside for small businesses. The RFQ will be available around December 6, 2024 through SAM.gov, with quotes due December 27, 2024 at 12:00 PM EST. Services include substance use disorder treatment planning, intake screening, individual and group counseling, mental health assessments, psychiatric evaluations, crisis intervention, and medication management, with specified minimum guaranteed quantities and maximum estimated quantities for each service type across all periods. All clinicians must be licensed to practice independently in New York state without supervision.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Question2 15BCTS24Q00000016 Syracuse NY.pdf | ||
| Questions 15BCTS24Q00000016 Syracuse NY.pdf | ||
| 2 - SECTION 2.1, CONTINUATION OF SF-1449, BLOCK 20.pdf | ||
| 5 - Business Quotation Information Packet.pdf | ||
| 6 - Whistleblower Information.pdf | ||
| 3 - 2022 Statement of Work (SOW).pdf | ||
| 8 - Attachment Quotation Form.xlsx | XLSX spreadsheet | |
| 4 - Technical Quotation Information Packet Syracuse NY.docx | DOCX document | |
| 7 - Subcontracting Plan 01-2024.pdf | ||
| 1 - Cover letter FBO 018-24 sign.pdf |
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15BCTS24Q00000016 Page 1 of 70
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
15BCTS24Q00000016
2. CONTRACT NUMBER 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
12/05/2024
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
12/27/2024 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 SET ASIDE:______% FOR
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
15B200CODE15. DELIVER TO
Federal Bureau of Prisons Northeast Regional Office
US CUSTOM HOUSE, 7TH FLOOR
2ND & CHESTNUT
Philadelphia, PA 19106
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
15B200CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons Northeast Regional Office
US CUSTOM HOUSE, 7TH FLOOR
2ND & CHESTNUT
Philadelphia, PA 19106
BOP-RSD-CRBCTS-BILL-PHL-
S@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: 03/01/2025
Substance Use and Mental Health Treatment Services in
Syracuse, NY
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 (Jan) 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
018-24
Firm Fixed Price
X
15BCTS24Q00000016 Page 2 of 70
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
15BCTS24Q00000016 Page 3 of 70
Table of Contents
Section Description Page Number
Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses
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) 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023) 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) 52.237-7 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) 52.203-17 Contractor Employee Whistleblower Rights (Nov 2023) 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
52.217-5 Evaluation of Options (July 1990) 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) 52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation (Jan 2017) 52.216-1 Type of Contract (Apr 1984) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) 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) 52.204-29 Federal Acquisition Supply Chain Security Act Orders-Representation and Disclosures (Dec 2023)
3.1 INSTRUCTIONS TO OFFERORS - COMMERCIAL SERVICES
15BCTS24Q00000016 Page 4 of 70
52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services (May 2024)
15BCTS24Q00000016 Page 5 of 70
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: 5 Estimated Maximum Quantity: 50
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 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 Estimated 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: 40 Estimated Maximum Quantity: 1200
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 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: 50
50 EA $________ $_________________
15BCTS24Q00000016 Page 6 of 70
Base Period: 1 month through 12 months
Use the Estimated 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: 180 Estimated Maximum Quantity: 2400
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,400 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 Estimated 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: 5 Estimated Maximum Quantity: 50
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 40
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Base Period: 1 month through 12 months
15BCTS24Q00000016 Page 7 of 70
Use the Estimated 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: 5 Estimated Maximum Quantity: 50
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 20 Estimated Maximum Quantity: 800
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 MH - Administration of Medication (6050)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
20 EA $________ $_________________
15BCTS24Q00000016 Page 8 of 70
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Base Period: 1 month through 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 40 Estimated Maximum Quantity: 1200
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 9 of 70
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 180 Estimated Maximum Quantity: 2400
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,400 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 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 Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 40
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
40 EA $________ $_________________
15BCTS24Q00000016 Page 10 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0029 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 20 Estimated Maximum Quantity: 800
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 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 Estimated Maximum Quantity when developing the total amount.
100 EA $________ $_________________
15BCTS24Q00000016 Page 11 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 MH - Administration of Medication (6050)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 1: 13 months through 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 40 Estimated Maximum Quantity: 1200
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
1,200 EA $________ $_________________
15BCTS24Q00000016 Page 12 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 180 Estimated Maximum Quantity: 2400
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,400 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 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 Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 13 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 40
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 20 Estimated Maximum Quantity: 800
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
800 EA $________ $_________________
15BCTS24Q00000016 Page 14 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 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 Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 MH - Administration of Medication (6050)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 2: 25 months through 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
25 EA $________ $_________________
15BCTS24Q00000016 Page 15 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 40 Estimated Maximum Quantity: 1200
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 180 Estimated Maximum Quantity: 2400
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,400 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 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 Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 16 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 40
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0058 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
20 EA $________ $_________________
15BCTS24Q00000016 Page 17 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 20 Estimated Maximum Quantity: 800
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 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 Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 MH - Administration of Medication (6050)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 3: 37 months through 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 18 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 25
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 40 Estimated Maximum Quantity: 1200
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 180 Estimated Maximum Quantity: 2400
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
2,400 EA $________ $_________________
15BCTS24Q00000016 Page 19 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 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 Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 40
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 20 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 20 Estimated Maximum Quantity: 800
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 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 Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 MH - Administration of Medication (6050)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0080 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 4: 49 months through 60 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 21 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 Substance Use Disorder Treatment Planning and Follow-up (2001)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 25
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 13
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum Quantity: 20 Estimated Maximum Quantity: 600
Potential 6 Month Extension
Use the Estimated 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: 3 Estimated Maximum Quantity: 25
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 22 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 90 Estimated Maximum Quantity: 1200
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 50
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 25
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 20
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 25
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 23 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 25
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
25 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
Potential 6 Month Extension
Use the Estimated 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: 10 Estimated Maximum Quantity: 400
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
400 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 50
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 MH - Administration of Medication (6050)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 10
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
10 EA $________ $_________________
15BCTS24Q00000016 Page 24 of 70
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 50
Potential 6 Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS24Q00000016 Page 25 of 70
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 contract as an addendum to FAR clause 52.212-4.
Clauses By Reference
52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)
This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): www.acquisition.gov
Clause Title Fill-ins (if applicable)
52.242-15 Stop-Work Order (Aug 1989)
52.224-1 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)
52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023)
Clauses By Full Text
15BCTS24Q00000016 Page 26 of 70
52.216-19 Order Limitations (Oct 1995)
(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than one [insert dollar figure or quantity], the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.
(b) Maximum order. The Contractor is not obligated to honor--
(1) Any order for a single item in excess of the estimated quantities identified on the SF-1449 (BLOCK-21.OUANTITY) within the current contract performance period [insert dollar figure or quantity];
(2) Any order for a combination of items in excess of the estimated quantities identified on the SF-1449 (BLOCK-21.OUANTITY) within the current contract performance period [insert dollar figure or quantity]; or
(3) A series of orders from the same ordering office within 30 days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.
(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.
(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 7 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.
(End of clause)
52.217-8 Option to Extend Services (Nov 1999)
The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within the current performance period [insert the period of time within which the Contracting Officer may exercise the option].
(End of clause)
52.232-18 Availability of Funds (Apr 1984)
Funds are not presently available for this contract. The Government's obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer.
(End of clause)
52.232-19 Availability of Funds for the Next Fiscal Year (Apr 1984)
Funds are not presently available for performance under this contract beyond September 30th of the base year or any option year exercised. The Government's obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise for performance under this contract beyond September 30th of the base year or any option year exercised, until funds are made available to the Contracting Officer for performance and until the Contractor receives notice of availability, to be confirmed in writing by the Contracting Officer.
(End of clause)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR 2011)
15BCTS24Q00000016 Page 27 of 70
The services, although not directly supervised, shall be reviewed by Federal Bureau of Prisons (BOP) staff to ensure contract compliance. The contractor's performance will be evaluated in accordance with FAR 42.15. Contract monitoring reports will be prepared by the Contacting Officer's Representative (COR) and maintained in the contract file.
In accordance with FAR 42.1502 and 42.1503, agencies shall prepare an evaluation of contractor performance and submit it to the Past Performance Information Retrieval System (PPIRS). The BOP utilizes the Department of Defense (DOD) web-based Contractor Performance Assessment Reporting System (CPARS) to provide contractor performance evaluations. The contractor shall provide and maintain a current e-mail address throughout the life of the contract. The contractor will receive an e-mail from the Focal Point thru the following website address webptsmh@navy.milwhen the contract is registered in CPARS. The e-mail will contain a "user ID" and temporary password to register in the CPARS system. The contractor must be registered to access and review its evaluation and/or provide a response. If assistance is required when registering, please contact the Contracting Staff/Focal Point.
(End of Clause)
52.204-21 Basic Safeguarding of Covered Contractor Information Systems (Nov 2021)
(a) Definitions. As used in this clause--
"Covered contractor information system" means an information system that is owned or operated by a contractor that processes, stores, or transmits Federal contract information.
"Federal contract information" means information, not intended for public release, that is provided by or generated for the Government under a contract to develop or deliver a product or service to the Government, but not including information provided by the Government to the public (such as on public Web sites) or simple transactional information, such as necessary to process payments.
"Information" means any communication or representation of knowledge such as facts, data, or opinions, in any medium or form, including textual, numerical, graphic, cartographic, narrative, or audiovisual (Committee on National Security Systems Instruction (CNSSI) 4009).
"Information system" means a discrete set of information resources organized for the collection, processing, maintenance, use, sharing, dissemination, or disposition of information (44 U.S.C. 3502).
"Safeguarding" means measures or controls that are prescribed to protect information systems.
(b) Safeguarding requirements and procedures.
(1) The Contractor shall apply the following basic safeguarding requirements and procedures to protect covered contractor information systems. Requirements and procedures for basic safeguarding of covered contractor information systems shall include, at a minimum, the following security controls:
(i) Limit information system access to authorized users, processes acting on behalf of authorized users, or devices (including other information systems).
(ii) Limit information system access to the types of transactions and functions that authorized users are permitted to execute.
(iii) Verify and control/limit connections to and use of external information systems.
(iv) Control information posted or processed on publicly accessible information systems.
(v) Identify information system users, processes acting on behalf of users, or devices.
(vi) Authenticate (or verify) the identities of those users, processes, or devices, as a prerequisite to allowing access to organizational information systems.
15BCTS24Q00000016 Page 28 of 70
(vii) Sanitize or destroy information system media containing Federal Contract Information before disposal or release for reuse.
(viii) Limit physical access to organizational information systems, equipment, and the respective operating environments to authorized individuals.
(ix) Escort visitors and monitor visitor activity; maintain audit logs of physical access; and control and manage physical access devices.
(x) Monitor, control, and protect organizational communications (i.e., information transmitted or received by organizational information systems) at the external boundaries and key internal boundaries of the information systems.
(xi) Implement subnetworks for publicly accessible system components that are physically or logically separated from internal networks.
(xii) Identify, report, and correct information and information system flaws in a timely manner.
(xiii) Provide protection from malicious code at appropriate locations within organizational information systems.
(xiv) Update malicious code protection mechanisms when new releases are available.
(xv) Perform periodic scans of the information system and real-time scans of files from external sources as files are downloaded, opened, or executed.
(2) Other requirements. This clause does not relieve the Contractor of any other specific safeguarding requirements specified by Federal agencies and departments relating to covered contractor information systems generally or other Federal safeguarding requirements for controlled unclassified information (CUI) as established by Executive Order 13556.
(c) Subcontracts. The Contractor shall include the substance of this clause, including this paragraph (c), in subcontracts under this contract (including subcontracts for the acquisition of commercial products or commercial services, other than commercially available off-the-shelf items), in which the subcontractor may have Federal contract information residing in or transiting through its information system.
(End of clause)
52.217-9 Option to Extend the Term of the Contract (Mar 2000)
(a) The Government may extend the term of this contract by written notice to the Contractor within the current performance period [insert the period of time within which the Contracting Officer may exercise the option]; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days [60 days unless a different number of days is inserted] before the contract expires. The preliminary notice does not commit the Government to an extension.
(b) If…
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