15BCTS25Q00000017.pdf

15BCTS25Q00000017 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

15BCTS25Q00000017

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

08/06/2026

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

Shuwona Jones sjones2@bop.gov

b. TELEPHONE NUMBER (No collect calls)

202-598-6128

8. OFFER DUE DATE / LOCAL

TIME

09/09/2026 14:00 ET

CODE 15BCTS

Federal Bureau of Prisons

Community Treatment Services Contracting 320 First Street NW

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 Washington, DC 20534

Shuwona Jones

(O) 202-598-6128 sjones2@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

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: 10/01/2026

Substance Use and Mental Health Treatment Services in Cedar Rapids, IA.

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)

Shuwona Jones

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

Federal Bureau of Prisons North Central Regional Office

400 STATE AVENUE

SUITE 800

Kansas City, KS 66101

15BCTS25Q00000017 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

15BCTS25Q00000017 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 DEC 2025)

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) 52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020) 52.204-13 Alt I (DEV) System for Award Management-Maintenance (Oct 2018) - Alternate I

(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) 52.224-1 Privacy Act Notification (Apr 1984)

15BCTS25Q00000017 Page 4 of 53

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) 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)

15BCTS25Q00000017 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; 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

0002 Substance Use Disorder Intake Screening (2005)

5 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

0003 Substance Use Disorder Individual Counseling (2010)

160 Units Guaranteed Minimum; 800 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

800 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0004 Substance Use Disorder Intake Assessment & Report (2011)

10 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

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 $________ $_________________

15BCTS25Q00000017 Page 6 of 53

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0006 Substance Use Disorder Group Counseling (2020)

240 Units Guaranteed Minimum; 750 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

750 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0007 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0008 Mental Health Treatment Planning and Follow-up (5001)

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

0009 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 55 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

55 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0010 Mental Health Intake Assessment & Report (5011)

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

75 EA $________ $_________________

15BCTS25Q00000017 Page 7 of 53

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0011 Psychiatric Evaluation & Report (5030)

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

0012 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0013 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 900 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

900 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0014 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0015 MH- Medication Monitoring & Reporting (6051)

10 Units Guaranteed Minimum; 300 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Base Period: 1 month through 12 months

PSC: G004

300 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

15BCTS25Q00000017 Page 8 of 53

0016 Substance Use Disorder Treatment Planning and Follow-up (2001)

10 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

0017 Substance Use Disorder Intake Screening (2005)

5 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

0018 Substance Use Disorder Individual Counseling (2010)

160 Units Guaranteed Minimum; 800 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

800 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0019 Substance Use Disorder Intake Assessment & Report (2011)

10 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

0020 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

0021 Substance Use Disorder Group Counseling (2020)

240 Units Guaranteed Minimum; 750 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

750 EA $________ $_________________

15BCTS25Q00000017 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 Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0023 Mental Health Treatment Planning and Follow-up (5001)

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

0024 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 55 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

55 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0025 Mental Health Intake Assessment & Report (5011)

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

0026 Psychiatric Evaluation & Report (5030)

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

15BCTS25Q00000017 Page 10 of 53

QUANTITY

UNIT UNIT PRICE AMOUNT

0027 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0028 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 900 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

900 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0029 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0030 MH- Medication Monitoring & Reporting (6051)

10 Units Guaranteed Minimum; 300 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 1: 13 months through 24 months

PSC: G004

300 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0031 Substance Use Disorder Treatment Planning and Follow-up (2001)

10 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.

15BCTS25Q00000017 Page 11 of 53

0032 Substance Use Disorder Intake Screening (2005)

5 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

0033 Substance Use Disorder Individual Counseling (2010)

160 Units Guaranteed Minimum; 800 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

800 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0034 Substance Use Disorder Intake Assessment & Report (2011)

10 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

0035 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

0036 Substance Use Disorder Group Counseling (2020)

240 Units Guaranteed Minimum; 750 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

750 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0037 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

100 EA $________ $_________________

15BCTS25Q00000017 Page 12 of 53

Option Year 2: 25 months through 36 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0038 Mental Health Treatment Planning and Follow-up (5001)

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

0039 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 55 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

55 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0040 Mental Health Intake Assessment & Report (5011)

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

0041 Psychiatric Evaluation & Report (5030)

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 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

10 EA $________ $_________________

15BCTS25Q00000017 Page 13 of 53

QUANTITY

UNIT UNIT PRICE AMOUNT

0043 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 900 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

900 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0044 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0045 MH- Medication Monitoring & Reporting (6051)

10 Units Guaranteed Minimum; 300 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 2: 25 months through 36 months

PSC: G004

300 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0046 Substance Use Disorder Treatment Planning and Follow-up (2001)

10 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

0047 Substance Use Disorder Intake Screening (2005)

5 Units Guaranteed Minimum; 40 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

40 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS25Q00000017 Page 14 of 53

0048 Substance Use Disorder Individual Counseling (2010)

160 Units Guaranteed Minimum; 800 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

800 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0049 Substance Use Disorder Intake Assessment & Report (2011)

10 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

0050 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

0051 Substance Use Disorder Group Counseling (2020)

240 Units Guaranteed Minimum; 750 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

750 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0052 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0053 Mental Health Treatment Planning and Follow-up (5001)

10 Units Guaranteed Minimum; 75 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

15BCTS25Q00000017 Page 15 of 53

Option Year 3: 37 months through 48 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0054 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 55 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

55 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0055 Mental Health Intake Assessment & Report (5011)

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

0056 Psychiatric Evaluation & Report (5030)

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

0057 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0058 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 900 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

900 EA $________ $_________________

15BCTS25Q00000017 Page 16 of 53

QUANTITY

UNIT UNIT PRICE AMOUNT

0059 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0060 MH- Medication Monitoring & Reporting (6051)

10 Units Guaranteed Minimum; 300 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 3: 37 months through 48 months

PSC: G004

300 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; 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

0062 Substance Use Disorder Intake Screening (2005)

5 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

0063 Substance Use Disorder Individual Counseling (2010)

160 Units Guaranteed Minimum; 800 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

800 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS25Q00000017 Page 17 of 53

0064 Substance Use Disorder Intake Assessment & Report (2011)

10 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

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 4: 49 months through 60 months

PSC: G004

35 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0066 Substance Use Disorder Group Counseling (2020)

240 Units Guaranteed Minimum; 750 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

750 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0067 Substance Use Disorder Relationship and Parenting Counseling (2030)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

100 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0068 Mental Health Treatment Planning and Follow-up (5001)

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

0069 Mental Health Intake Screening (5005)

5 Units Guaranteed Minimum; 55 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

55 EA $________ $_________________

15BCTS25Q00000017 Page 18 of 53

Option Year 4: 49 months through 60 months

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0070 Mental Health Intake Assessment & Report (5011)

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

0071 Psychiatric Evaluation & Report (5030)

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

0072 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 10 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

10 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0073 Mental Health Individual Counseling (6010)

240 Units Guaranteed Minimum; 900 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

900 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0074 Mental Health Relationship and Parenting Counseling (6031)

2 Units Guaranteed Minimum; 100 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

100 EA $________ $_________________

15BCTS25Q00000017 Page 19 of 53

QUANTITY

UNIT UNIT PRICE AMOUNT

0075 MH- Medication Monitoring & Reporting (6051)

10 Units Guaranteed Minimum; 300 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Option Year 4: 49 months through 60 months

PSC: G004

300 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0076 Substance Use Disorder Treatment Planning and Follow-up (2001)

5 Units Guaranteed Minimum; 25 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

25 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0077 Substance Use Disorder Intake Screening (2005)

3 Units Guaranteed Minimum; 20 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

20 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0078 Substance Use Disorder Individual Counseling (2010)

80 Units Guaranteed Minimum; 400 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

400 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0079 Substance Use Disorder Intake Assessment & Report (2011)

5 Units Guaranteed Minimum; 25 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

25 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

15BCTS25Q00000017 Page 20 of 53

0080 Co-occurring Intake Assessment & Report (2012)

1 Unit Guaranteed Minimum; 18 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

18 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0081 Substance Use Disorder Group Counseling (2020)

120 Units Guaranteed Minimum; 375 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

375 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0082 Substance Use Disorder Relationship and Parenting Counseling (2030)

1 Unit Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0083 Mental Health Treatment Planning and Follow-up (5001)

5 Units Guaranteed Minimum; 38 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

38 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0084 Mental Health Intake Screening (5005)

3 Units Guaranteed Minimum; 28 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

28 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0085 Mental Health Intake Assessment & Report (5011)

5 Units Guaranteed Minimum; 38 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total

38 EA $________ $_________________

15BCTS25Q00000017 Page 21 of 53

Potential 6 Month Extension

PSC: G004

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0086 Psychiatric Evaluation & Report (5030)

5 Units Guaranteed Minimum; 38 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

38 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0087 Crisis Intervention Evaluation & Report (6000)

1 Unit Guaranteed Minimum; 5 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

5 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0088 Mental Health Individual Counseling (6010)

120 Units Guaranteed Minimum; 450 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

450 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0089 Mental Health Relationship and Parenting Counseling (6031)

1 Unit Guaranteed Minimum; 50 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

PSC: G004

50 EA $________ $_________________

ITEM NO. SUPPLIES/SERVICES EST.

QUANTITY

UNIT UNIT PRICE AMOUNT

0090 MH- Medication Monitoring & Reporting (6051)

5 Units Guaranteed Minimum; 150 Units Estimated Maximum

Use the Estimated Maximum Quantity when developing the total amount.

Potential 6 Month Extension

150 EA $________ $_________________

15BCTS25Q00000017 Page 22 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)

15BCTS25Q00000017 Page 23 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) (DEVIATION DEC 2025)

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)

15BCTS25Q00000017 Page 24 of 53

Clauses By Full Text

52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020)

(a) Definitions. As used in this clause--

"Agency" means "executive agency" as defined in Federal Acquisition Regulation (FAR) 2.101.

"Covered Federal action" means any of the following actions:

(1) Awarding any Federal contract.

(2) Making any Federal grant.

(3) Making any Federal loan.

(4) Entering into any cooperative agreement.

(5) Extending, continuing, renewing, amending, or modifying any Federal contract, grant, loan, or cooperative agreement.

"Indian tribe" and "tribal organization" have the meaning provided in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b) and include Alaskan Natives.

"Influencing or attempting to influence" means making, with the intent to influence, any communication to or appearance before an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with any covered Federal action.

"Local government" means a unit of government in a State and, if chartered, established, or otherwise recognized by a State for the performance of a governmental duty, including a local public authority, a special district, an intrastate district, a council of governments, a sponsor group representative organization, and any other instrumentality of a local government.

"Officer or employee of an agency" includes the following individuals who are employed by an agency:

(1) An individual who is appointed to a position in the Government under Title 5, United States Code, including a position under a temporary appointment.

(2) A member of the uniformed services, as defined in subsection 101(3), Title 37, United States Code.

(3) A special Government employee, as defined in section 202, Title 18, United States Code.

(4) An individual who is a member of a Federal advisory committee, as defined by the Federal Advisory Committee Act, Title 5, United States Code, appendix 2.

"Person" means an individual, corporation, company, association, authority, firm, partnership, society, State, and local government, regardless of whether such entity is operated for profit, or not for profit. This term excludes an Indian tribe, tribal organization, or any other Indian organization eligible to receive Federal contracts, grants, cooperative agreements, or loans from an agency, but only with respect to expenditures by such tribe or organization that are made for purposes specified in paragraph (b) of this clause and are permitted by other Federal law.

"Reasonable compensation" means, with respect to a regularly employed officer or employee of any person, compensation that is consistent with the normal compensation for such officer or employee for work that is not furnished to, not funded by, or not furnished in cooperation with the Federal Government.

"Reasonable payment" means, with respect to professional and other technical services, a payment in an amount that is consistent with the amount normally paid for such services in the private sector.

"Recipient" includes the Contractor and all subcontractors. This term excludes an Indian tribe, tribal organization, or any other Indian organization eligible to receive Federal contracts, grants, cooperative agreements, or loans from an agency, 15BCTS25Q00000017 Page 25 of 53 but only with respect to expenditures by such tribe or organization that are made for purposes specified in paragraph (b) of this clause and are permitted by other Federal law.

"Regularly employed" means, with respect to an officer or employee of a person requesting or receiving a Federal contract, an officer or employee who is employed by such person for at least 130 working days within 1 year immediately preceding the date of the submission that initiates agency consideration of such person for receipt of such contract. An officer or employee who is employed by such person for less than 130 working days within 1 year immediately preceding the date of the submission that initiates agency consideration of such person shall be considered to be regularly employed as soon as he or she is employed by such person for 130 working days.

"State" means a State of the United States, the District of Columbia, or an outlying area of the United States, an agency or instrumentality of a State, and multi-State, regional, or interstate entity having governmental duties and powers.

(b) Prohibition. 31 U.S.C. 1352 prohibits a recipient of a Federal contract, grant, loan, or cooperative agreement from using appropriated funds to pay any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with any covered Federal actions. In accordance with 31 U.S.C. 1352 the Contractor shall not use appropriated funds to pay any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the award of this contractor the extension, continuation, renewal, amendment, or modification of this contract.

(1) The term appropriated funds does not include profit or fee from a covered Federal action.

(2) To the extent the Contractor can demonstrate that the Contractor has sufficient monies, other than Federal appropriated funds, the Government will assume that these other monies were spent for any influencing activities that would be unallowable if paid for with Federal appropriated funds.

(c) Exceptions. The prohibition in paragraph (b) of this clause does not apply under the following conditions:

(1) Agency and legislative liaison by Contractor employees. (i) Payment of reasonable compensation made to an officer or employee of the Contractor if the payment is for agency and legislative liaison activities not directly related to this contract.

For purposes of this paragraph, providing any information specifically requested by an agency or Congress is permitted at any time.

(ii) Participating with an agency in discussions that are not related to a specific solicitation for any covered Federal action, but that concern--

(A) The qualities and characteristics (including individual demonstrations) of the person's products or services, conditions or terms of sale, and service capabilities; or

(B) The application or adaptation of the person's products or services for an agency's use.

(iii) Providing prior to formal solicitation of any covered Federal action any information not specifically requested but necessary for an agency to make an informed decision about initiation of a covered Federal action;

(iv) Participating in technical discussions regarding the preparation of an unsolicited proposal prior to its official submission; and

(v) Making capability presentations prior to formal solicitation of any covered Federal action by persons seeking awards from an agency pursuant to the provisions of the Small Business Act, as amended by Pub. L. 95-507, and subsequent amendments.

(2) Professional and technical services. (i) A payment of reasonable compensation made to an officer or employee of a person requesting or receiving a covered Federal action or an extension, continuation, renewal, amendment, or modification of a covered Federal action, if payment is for professional or technical services rendered directly in the preparation, submission, or negotiation of any bid, proposal, or application for that Federal action or for meeting requirements imposed by or pursuant to law as a condition for receiving that Federal action.

(ii) Any reasonable payment to a person, other than an officer or employee of a person requesting or receiving a covered Federal action or an extension, continuation, renewal, amendment, or modification of a covered Federal action if the

15BCTS25Q00000017 Page 26 of 53 payment is for professional or technical services rendered directly in the preparation, submission, or negotiation of any bid, proposal, or application for that Federal action or for meeting requirements imposed by or pursuant to law as a condition for receiving that Federal action. Persons other than officers or employees of a person requesting or receiving a covered Federal action include consultants and trade associations.

(iii) As used in paragraph (c)(2) of this clause, "professional and technical services" are limited to advice and analysis directly applying any professional or technical discipline (for examples, see FAR 3.803(a)(2)(iii)).

(iv) Requirements imposed by or pursuant to law as a condition for receiving a covered Federal award include those required by law or regulation…