10. Base SF-1449.pdf
PDF 306 KB Posted
- Attached to
- 15BCTS25Q00000014 - SU/MH/SOT in Wichita, KS
- Solicitation number
- 15BCTS25Q00000014
About this file
This is a federal Request for Quote (RFQ) for mental health and substance use disorder treatment services to be provided at a location in Wichita, Kansas for the Federal Bureau of Prisons (BOP).
The solicitation seeks comprehensive behavioral health services including substance use disorder treatment planning and follow-up, intake screening and assessments, individual and group counseling, relationship and parenting counseling, mental health services (treatment planning, intake screening, assessments, psychiatric evaluations, individual counseling, medication monitoring), and sex offender treatment services. Services are priced on a per-unit basis with a guaranteed minimum and estimated maximum quantity for each service line. The contract is a Firm Fixed Price, Indefinite Delivery Indefinite Quantity (IDIQ) arrangement with a base period of 12 months, four one-year option periods, and a potential six-month extension, for a total contract duration not to exceed five years. The estimated maximum quantities for the base period and option periods vary by service type, ranging from 12 to 2,700 units depending on the specific service. The solicitation is set aside 100 percent for small business and is a commercial services acquisition under NAICS code 621420 with a small business size standard of $19,000,000. The solicitation issue date is September 11, 2026, with an offer due date of October 11, 2026 at 2:00 p.m. Central Time. Delivery is required by December 1, 2026. Offerors must submit completed SF-1449 forms, business and technical quotation packets, pricing charts, proof of active SAM registration, professional liability insurance documentation, and completed vendor attestation forms via email in PDF format to the Contracting Officer.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 11. Additional Questions.docx | DOCX document | |
| 1. SF1449.pdf | ||
| 9. Combined Solicitation - Wichita, KS.pdf | ||
| 0. Solicitation Cover Letter (Wichita, KS).pdf | ||
| 1a. Combined Solicitation - Wichita, KS.pdf | ||
| 1. SF 1449.pdf | ||
| 3. Technical Quotation Information Request.docx | DOCX document | |
| 7. Statement of Work (2022).pdf | ||
| 8. Whistleblower Information.pdf | ||
| 0. Solicitation Cover Letter (Wichita, KS).pdf | ||
| 1. Wichita Solicitation (SF-1449).pdf | ||
| 2. Attachment Quotation Form.xlsx | XLSX spreadsheet | |
| 3. Technical Quotation Information Request.docx | DOCX document | |
| 4. Business Quotation Information Packet.pdf | ||
| 6. ATU Vendor Attestation.pdf | ||
| 5. Pricing Chart.docx | DOCX document |
Show all 16
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15BCTS25Q00000014 Page 1 of 53
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
15BCTS25Q00000014
2. CONTRACT NUMBER 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
09/11/2026
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
Roderick D. Bryant rbryant1@bop.gov
b. TELEPHONE NUMBER (No collect calls)
202-598-6128
8. OFFER DUE DATE / LOCAL
TIME
10/11/2026 14:00 CT
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
CODE15. DELIVER TO CODE 15BCTS16. ADMINISTERED BY
Federal Bureau of Prisons Community Treatment Services Contracting 320 First Street NW Suite 901-5 Washington, DC 20534
Roderick D. Bryant
(O) 202-598-6128 rbryant1@bop.gov
FACILITY
CODE
CODE
TELEPHONE NUMBER
17a. CONTRACTOR/
OFFEROR
15B400CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons North Central Regional Office
400 STATE AVENUE
SUITE 800
Kansas City, KS 66101
CTS-KC-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: 12/01/2026
MH/SU/SOT in Wichita, KS 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)
Roderick D Bryant
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
024/25
15BCTS25Q00000014 Page 2 of 53
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
15BCTS25Q00000014 Page 3 of 53
Table of Contents
Section Description Page Number
Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses
52.203-6 Alt I Restrictions on Subcontractor Sales to the Government (Jun 2020) - Alternate I (Nov 2021) 52.204-13 (DEV) System for Award Management-Maintenance (Oct 2018) (DEVIATION NOV 2025) 52.204-19 Incorporation by Reference of Representations and Certifications (Dec 2014) 52.204-91 (DEV) Contractor Identification (DEVIATION NOV 2025) 52.209-6 (DEV) Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded (Jan 2025)
(DEVIATION NOV 2025)
52.212-4 (DEV) Terms and Conditions-Commercial Products and Commercial Services (Nov
2023) (DEVIATION NOV 2025)
52.219-8 (DEV) Utilization of Small Business Concerns (Jan 2025) (DEVIATION DEC 2025) 52.219-28 (DEV) Postaward Small Business Program Rerepresentation (Jan 2025)
(DEVIATION DEC 2025)
52.222-3 (DEV) Convict Labor (June 2003) (DEVIATION DEC 2025) 52.222-19 (DEV) Child Labor-Cooperation with Authorities and Remedies (Jan 2025)
(DEVIATION MAR 2026)
52.222-35 (DEV) Equal Opportunity for Veterans (Jun 2020) (DEVIATION DEC 2025) 52.222-36 (DEV) Equal Opportunity for Workers with Disabilities (Jun 2020) (DEVIATION
DEC 2025)
52.222-37 (DEV) Employment Reports on Veterans (Jun 2020) (DEVIATION DEC 2025) 52.222-41 (DEV) Service Contract Labor Standards (Aug 2018) (DEVIATION DEC 2025) 52.222-50 (DEV) Combating Trafficking in Persons (Oct 2025) (DEVIATION DEC 2025) 52.222-54 (DEV) Employment Eligibility Verification (Jan 2025) (DEVIATION DEC 2025) 52.224-3 Privacy Training (Jan 2017) 52.232-33 Payment by Electronic Funds Transfer-System for Award Management (Oct 2018) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Mar 2023) 52.233-3 (DEV) Protest after Award (Aug 1996) (DEVIATION NOV 2025) 52.233-4 (DEV) Applicable Law for Breach of Contract Claim (Oct 2004) (DEVIATION NOV 2025) 52.240-91 (DEV) Security Prohibitions and Exclusions (DEVIATION NOV 2025) 52.242-13 Bankruptcy (July 1995) 52.242-15 Stop-Work Order (Aug 1989) 52.252-6 Authorized Deviations in Clauses (Nov 2020) 52.253-1 (DEV) Computer Generated Forms (Jan 1991) (DEVIATION NOV 2025) 52.209-9 (DEV) Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) (DEVIATION NOV 2025) 52.209-10 (DEV) Prohibition on Contracting With Inverted Domestic Corporations (Nov 2015)
(DEVIATION NOV 2025)
52.216-18 Ordering (Aug 2020) 52.216-19 Order Limitations (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.222-90 Addressing DEI Discrimination by Federal Contractors (APR 2026) 52.237-7 (DEV) Indemnification and Medical Liability Insurance (Jan 1997) (DEVIATION NOV 2025) 52.240-93 (DEV) Basic Safeguarding of Covered Contractor Information Systems
(DEVIATION NOV 2025)
BOP 2852.201-71 Contracting Officer's Representative (COR) (June 2012)
15BCTS25Q00000014 Page 4 of 53
BOP DOJ-05 DEVIATION BOP-05 Security of Department Information and Systems (January 2025) DOJ-01 Whistleblower Information Distribution (Oct 2021) DOJ-02 Contractor Privacy Requirements (JAN 2022) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021) DOJ-08 Continuing Contract Performance During a Pandemic Influenza or other National Emergency (OCT 2007)
3 List of Attachments 4 Solicitation Provisions
52.203-11 Certification And Disclosure Regarding Payments to Influence Certain Federal Transactions (Sept 2024) 52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation (Jan 2017) 52.204-7 (DEV) System for Award Management-Registration (Nov 2024) (DEVIATION NOV 2025) 52.212-1 (DEV) Instructions to Offerors-Commercial Products and Commercial Services (Sep
2023) (DEVIATION NOV 2025)
52.212-2 (DEV) Evaluation-Commercial Products and Commercial Services (Nov 2021)
(DEVIATION NOV 2025)
52.217-5 (DEV) Evaluation of Options (July 1990) (DEVIATION AUG 2025) 52.219-4 (DEV) Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Oct 2022) (DEVIATION DEC 2025) 52.229-11 (DEV) Tax on Certain Foreign Procurements--Notice and Representation (Jun
2020) (DEVIATION AUG 2025)
52.216-1 (DEV) Type of Contract (Apr 1984) (DEVIATION DEC 2025) 52.240-90 (DEV) Security Prohibitions and Exclusions Representations and Certifications
(DEVIATION NOV 2025)
2852.233-70 Protests Filed Directly with the Department of Justice (NOV 2020)
15BCTS25Q00000014 Page 5 of 53
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)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Substance Use Disorder Intake Screening (2005)
3 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Substance Use Disorder Individual Counseling (2010)
120 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 35 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
35 EA $________ $_________________
15BCTS25Q00000014 Page 6 of 53
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0006 Substance Use Disorder Group Counseling (2020)
90 Units Guaranteed Minimum; 2700 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
2,700 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 Mental Health Treatment Planning and Follow-up (5001)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 Mental Health Intake Screening (5005)
3 Units Guaranteed Minimum; 40 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 Mental Health Intake Assessment & Report (5011)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
50 EA $________ $_________________
15BCTS25Q00000014 Page 7 of 53
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 Psychiatric Evaluation & Report (5030)
5 Units Guaranteed Minimum; 65 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
65 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Mental Health Individual Counseling (6010)
40 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 MH- Medication Monitoring & Reporting (6051)
5 Units Guaranteed Minimum; 120 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
15BCTS25Q00000014 Page 8 of 53
0016 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 15 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Sex Offender Individual Counseling (6012)
2 Units Guaranteed Minimum; 360 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Sex Offender Group Counseling (6022)
2 Units Guaranteed Minimum; 240 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: 1 month through 12 months
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
75 EA $________ $_________________
15BCTS25Q00000014 Page 9 of 53
Option Year 1: 13 months through 24 months
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Substance Use Disorder Intake Screening (2005)
3 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Substance Use Disorder Individual Counseling (2010)
120 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 35 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
35 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Substance Use Disorder Group Counseling (2020)
90 Units Guaranteed Minimum; 2700 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
2,700 EA $________ $_________________
15BCTS25Q00000014 Page 10 of 53
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Mental Health Treatment Planning and Follow-up (5001)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0029 Mental Health Intake Screening (5005)
3 Units Guaranteed Minimum; 40 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 Mental Health Intake Assessment & Report (5011)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Psychiatric Evaluation & Report (5030)
5 Units Guaranteed Minimum; 65 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
65 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25Q00000014 Page 11 of 53
0032 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Mental Health Individual Counseling (6010)
40 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 MH- Medication Monitoring & Reporting (6051)
5 Units Guaranteed Minimum; 120 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total
25 EA $________ $_________________
15BCTS25Q00000014 Page 12 of 53
Option Year 1: 13 months through 24 months
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 15 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 Sex Offender Individual Counseling (6012)
2 Units Guaranteed Minimum; 360 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Sex Offender Group Counseling (6022)
2 Units Guaranteed Minimum; 240 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Substance Use Disorder Intake Screening (2005)
3 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
15BCTS25Q00000014 Page 13 of 53
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Substance Use Disorder Individual Counseling (2010)
120 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 35 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
35 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 Substance Use Disorder Group Counseling (2020)
90 Units Guaranteed Minimum; 2700 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
2,700 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25Q00000014 Page 14 of 53
0048 Mental Health Treatment Planning and Follow-up (5001)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 Mental Health Intake Screening (5005)
3 Units Guaranteed Minimum; 40 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Mental Health Intake Assessment & Report (5011)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Psychiatric Evaluation & Report (5030)
5 Units Guaranteed Minimum; 65 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
65 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Mental Health Individual Counseling (6010)
40 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total
600 EA $________ $_________________
15BCTS25Q00000014 Page 15 of 53
Option Year 2: 25 months through 36 months
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 MH- Medication Monitoring & Reporting (6051)
5 Units Guaranteed Minimum; 120 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0058 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 15 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
15 EA $________ $_________________
15BCTS25Q00000014 Page 16 of 53
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Sex Offender Individual Counseling (6012)
2 Units Guaranteed Minimum; 360 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Sex Offender Group Counseling (6022)
2 Units Guaranteed Minimum; 240 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Substance Use Disorder Intake Screening (2005)
3 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Substance Use Disorder Individual Counseling (2010)
120 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25Q00000014 Page 17 of 53
0064 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 35 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
35 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Substance Use Disorder Group Counseling (2020)
90 Units Guaranteed Minimum; 2700 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
2,700 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Mental Health Treatment Planning and Follow-up (5001)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Mental Health Intake Screening (5005)
3 Units Guaranteed Minimum; 40 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total
40 EA $________ $_________________
15BCTS25Q00000014 Page 18 of 53
Option Year 2: 25 months through 36 months
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 Mental Health Intake Assessment & Report (5011)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 Psychiatric Evaluation & Report (5030)
5 Units Guaranteed Minimum; 65 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
65 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Mental Health Individual Counseling (6010)
40 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
36 EA $________ $_________________
15BCTS25Q00000014 Page 19 of 53
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 MH- Medication Monitoring & Reporting (6051)
5 Units Guaranteed Minimum; 120 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 15 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Sex Offender Individual Counseling (6012)
2 Units Guaranteed Minimum; 360 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25Q00000014 Page 20 of 53
0080 Sex Offender Group Counseling (6022)
2 Units Guaranteed Minimum; 240 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Substance Use Disorder Intake Screening (2005)
3 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Substance Use Disorder Individual Counseling (2010)
120 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
1,200 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 35 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total
35 EA $________ $_________________
15BCTS25Q00000014 Page 21 of 53
Option Year 4: 49 months through 60 months
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Substance Use Disorder Group Counseling (2020)
90 Units Guaranteed Minimum; 2700 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
2,700 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Substance Use Disorder Relationship and Parenting Counseling (2030)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Mental Health Treatment Planning and Follow-up (5001)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Mental Health Intake Screening (5005)
3 Units Guaranteed Minimum; 40 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
40 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Mental Health Intake Assessment & Report (5011)
5 Units Guaranteed Minimum; 50 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
15BCTS25Q00000014 Page 22 of 53
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 Psychiatric Evaluation & Report (5030)
5 Units Guaranteed Minimum; 65 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
65 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0092 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
12 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 Mental Health Individual Counseling (6010)
40 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Mental Health Relationship and Parenting Counseling (6031)
2 Units Guaranteed Minimum; 36 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 MH- Medication Monitoring & Reporting (6051)
5 Units Guaranteed Minimum; 120 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
120 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25Q00000014 Page 23 of 53
0096 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Unit Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0098 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 15 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
15 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0099 Sex Offender Individual Counseling (6012)
2 Units Guaranteed Minimum; 360 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
360 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 Sex Offender Group Counseling (6022)
2 Units Guaranteed Minimum; 240 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
240 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 Substance Use Disorder Treatment Planning and Follow-up (2001)
5 Units Guaranteed Minimum; 38 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total
38 EA $________ $_________________
15BCTS25Q00000014 Page 24 of 53
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0102 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 Substance Use Disorder Individual Counseling (2010)
60 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0104 Substance Use Disorder Intake Assessment & Report (2011)
5 Units Guaranteed Minimum; 38 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
38 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0105 Co-occurring Intake Assessment & Report (2012)
1 Units Guaranteed Minimum; 18 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0106 Substance Use Disorder Group Counseling (2020)
45 Units Guaranteed Minimum; 1350 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
1,350 EA $________ $_________________
15BCTS25Q00000014 Page 25 of 53
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 Substance Use Disorder Relationship and Parenting Counseling (2030)
1 Units Guaranteed Minimum; 18 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL 6 MONTH EXTENSION (EXT): 61 months thru 66 months
PSC: G004
18 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0108 Mental Health Treatment Planning and Follow-up (5001)
3 Units Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
25 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 20 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
20 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Mental Health Intake Assessment & Report (5011)
3 Units Guaranteed Minimum; 25 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0111 Psychiatric Evaluation & Report (5030)
3 Units Guaranteed Minimum; 33 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
33 EA $________ $_________________
15BCTS25Q00000014 Page 26 of 53
QUANTITY
UNIT UNIT PRICE AMOUNT
0112 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 6 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
6 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0113 Mental Health Individual Counseling (6010)
20 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0114 Mental Health Relationship and Parenting Counseling (6031)
1 Units Guaranteed Minimum; 18 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
36 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0115 MH- Medication Monitoring & Reporting (6051)
3 Units Guaranteed Minimum; 60 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
60 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0116 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 13 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
13 EA $________ $_________________
15BCTS25Q00000014 Page 27 of 53
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Unit Guaranteed Minimum; 13 Units Estimated Maximum Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL 6 MONTH EXTENSION (EXT): 61 mths through 66 mths
PSC: G004
13 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 8 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
8 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Sex Offender Individual Counseling (6012)
1 Units Guaranteed Minimum; 180 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
180 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0120 Sex Offender Group Counseling (6022)
1 Units Guaranteed Minimum; 120 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
POTENTIAL SIX MONTH EXTENSION (EXT): 61 months through 66 months
PSC: G004
120 EA $________ $_________________
MH/SU/SOT in Wichita, KS
15BCTS25Q00000014 Page 28 of 53
Section 2 - Contract Clauses
A.1 ADDENDUM TO FAR 52.212-4, Terms and Conditions-Commercial Products and Commercial Services (Nov
2023) (DEVIATION NOV 2025)
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)
52.203-6 Alt I Restrictions on Subcontractor Sales to the Government
(Jun 2020) - Alternate I (Nov 2021)
52.204-13 (DEV) System for Award Management-Maintenance (Oct 2018)
(DEVIATION NOV 2025)
52.204-19 Incorporation by Reference of Representations and
Certifications (Dec 2014)
52.204-91 (DEV) Contractor Identification (DEVIATION NOV 2025)
52.209-6 (DEV) Protecting the Government's Interest When
Subcontracting with Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded (Jan
2025) (DEVIATION NOV 2025)
52.212-4 (DEV) Terms and Conditions-Commercial Products and
Commercial Services (Nov 2023) (DEVIATION NOV
2025)
52.219-8 (DEV) Utilization of Small Business Concerns (Jan 2025)
(DEVIATION DEC 2025)
52.219-28 (DEV) Postaward Small Business Program Rerepresentation
(Jan 2025) (DEVIATION DEC 2025)
15BCTS25Q00000014 Page 29 of 53
Clause Title Fill-ins (if applicable)
52.222-3 (DEV) Convict Labor (June 2003) (DEVIATION DEC 2025)
52.222-19 (DEV) Child Labor-Cooperation with Authorities and Remedies
(Jan 2025)…
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