15BCTS25Q00000018.pdf
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- Attached to
- SU MH in Little Rock, AR Federal contract opportunity
- Solicitation number
- 15BCTS25Q00000018
About this file
This is a Request for Quote (RFQ) from the Federal Bureau of Prisons (BOP) for Outpatient Substance Use Disorder (SU) and Mental Health (MH) Services in Little Rock, Arkansas. The solicitation (Number 15BCTS25Q00000018) is set aside 100% for small businesses and will be an Indefinite Delivery, Indefinite Quantity (IDIQ) contract with firm-fixed unit prices. The base period is one year from award date, with four additional one-year option periods, potentially extending the contract to five years total.
The contract includes a comprehensive range of behavioral health services with specific line items for various treatments, including substance use disorder and mental health screenings, intake assessments, individual and group counseling, treatment planning, psychiatric evaluations, crisis interventions, and medication monitoring. Estimated maximum quantities vary by service type, ranging from 4-6,000 units per service category across the contract periods. The solicitation was issued on September 2, 2025, with quotes due by October 2, 2025, at 12:00 ET. Quotes should be submitted electronically to Shuwona Jones at sjones2@bop.gov, with the contract to be administered by the BOP's Community Treatment Services Contracting office in Washington, DC.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment 1-Signed.pdf | ||
| Cover letter Updated.pdf | ||
| Amendment 1-Signed.pdf | ||
| SOW 2022.pdf | ||
| Amendment 1-Signed.pdf | ||
| Technical Quotation Information.docx | DOCX document | |
| Whistleblower Info.pdf | ||
| Business Quotation Information Packet.pdf | ||
| Cover letter..pdf | ||
| Quotation Attachment Form.xlsx | XLSX spreadsheet | |
| Section 2.1, Continuation of SF-1449.pdf | ||
| SOW2022.pdf | ||
| FAR Clause 52.212-5 (JAN 2025) (DEVIATION FEB 2025).pdf |
Show all 13
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Text version
15BCTS25Q00000018 Page 1 of 62
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
15BCTS25Q00000018
2. CONTRACT NUMBER 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
09/02/2025
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
10/02/2025 12:00 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
15B500CODE18a. PAYMENT WILL BE MADE BY
Federal Bureau of Prisons South Central Regional Office 344 Marine Forces Drive Grand Prairie, TX 75051
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: 1/01/2026 Outpatient Substance Use Disorder (SU) and Mental Health (MH) Services in Little Rock, AR.
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
RCA 028-25
Federal Bureau of Prisons South Central Regional Office 344 Marine Forces Drive Grand Prairie, TX 75051
15BCTS25Q00000018 Page 2 of 62
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
15BCTS25Q00000018 Page 3 of 62
Table of Contents
Section Description Page Number
Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses
52.203-3 Gratuities (Apr 1984) 52.203-12 Limitation On Payments to Influence Certain Federal Transactions (Jun 2020) 52.204-13 System for Award Management Maintenance (Oct 2018) 52.204-18 Commercial and Government Entity Code Maintenance (Aug 2020) 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-2 Privacy Act (Apr 1984) 52.242-13 Bankruptcy (July 1995) 52.242-15 Stop-Work Order (Aug 1989) 52.252-6 Authorized Deviations in Clauses (Nov 2020) 52.253-1 Computer Generated Forms (Jan 1991) 52.204-12 Unique Entity Identifier Maintenance (Oct 2016) 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) 52.216-18 Ordering (Aug 2020) 52.216-19 Order Limitations (Oct 1995) 52.216-22 Indefinite Quantity (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.232-18 Availability of Funds (Apr 1984) 52.232-19 Availability of Funds for the Next Fiscal Year (Apr 1984) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997)
BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS
(APR 2011)
DOJ-01 Whistleblower Information Distribution (Oct 2021) DOJ-02 Contractor Privacy Requirements (JAN 2022) DOJ-03 Personnel Security Requirements For Contractor Employees (Nov 2021) DOJ-08 Continuing Contract Performance During a Pandemic Influenza or other National Emergency (OCT 2007) 52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services (May 2024) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (Nov 2021)...
52.217-9 Option to Extend the Term of the Contract (Mar 2000)
3 List of Attachments 4 Solicitation Provisions
52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation (Jan 2017) 52.204-7 System for Award Management (Nov 2024) 52.204-16 Commercial and Government Entity Code Reporting (Aug 2020) 52.204-22 Alternative Line Item Proposal (Jan 2017) 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (Sep 2023) 52.217-5 Evaluation of Options (July 1990) 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021) 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) 52.204-29 Federal Acquisition Supply Chain Security Act Orders-Representation and Disclosures (Dec 2023) 52.209-7 Information Regarding Responsibility Matters (Oct 2018) 52.216-1 Type of Contract (Apr 1984) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (NOV 2020)
15BCTS25Q00000018 Page 4 of 62
Section 1 - Commodity or Services Schedule
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0001 (2001) Substance Use Disorder Treatment Planning and Follow-up
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum; Quantity: 100 Estimated Maximum Quantity: 4800
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
4,800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
50 EA $________ $_________________
15BCTS25Q00000018 Page 5 of 62
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0006 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 360 Estimated Maximum Quantity: 6000
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
6,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0007 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0009 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity:10 Estimated Maximum Quantity: 100
Base Period: Date of award - 12 months
100 EA $________ $_________________
15BCTS25Q00000018 Page 6 of 62
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 8
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
8 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 240 Estimated Maximum Quantity: 2000
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Mental Health Group Counseling (6020)
Guaranteed Minimum Quantity: 12 Estimated Maximum Quantity: 600
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 7 of 62
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 30 Estimated Maximum Quantity: 300
Base Period: Date of award - 12 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 (2001) Substance Use Disorder Treatment Planning and Follow-up
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum; Quantity: 100 Estimated Maximum Quantity: 4800
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
4,800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 8 of 62
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 360 Estimated Maximum Quantity: 6000
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
6,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
75 EA $________ $_________________
15BCTS25Q00000018 Page 9 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity:10 Estimated Maximum Quantity: 100
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0028 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 8
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
8 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0029 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 240 Estimated Maximum Quantity: 2000
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 Mental Health Group Counseling (6020)
Guaranteed Minimum Quantity: 12 Estimated Maximum Quantity: 600
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
600 EA $________ $_________________
15BCTS25Q00000018 Page 10 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 30 Estimated Maximum Quantity: 300
Option Year 1: 13 - 24 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 (2001) Substance Use Disorder Treatment Planning and Follow-up
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum; Quantity: 100 Estimated Maximum Quantity: 4800
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
4,800 EA $________ $_________________
15BCTS25Q00000018 Page 11 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 360 Estimated Maximum Quantity: 6000
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
6,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 12 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity:10 Estimated Maximum Quantity: 100
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 8
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
8 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 240 Estimated Maximum Quantity: 2000
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
2,000 EA $________ $_________________
15BCTS25Q00000018 Page 13 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 Mental Health Group Counseling (6020)
Guaranteed Minimum Quantity: 12 Estimated Maximum Quantity: 600
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0047 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 30 Estimated Maximum Quantity: 300
Option Year 2: 25 - 36 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 (2001) Substance Use Disorder Treatment Planning and Follow-up
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
75 EA $________ $_________________
15BCTS25Q00000018 Page 14 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum; Quantity: 100 Estimated Maximum Quantity: 4800
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
4,800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 360 Estimated Maximum Quantity: 6000
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
6,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 15 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0058 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity:10 Estimated Maximum Quantity: 100
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 8
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
8 EA $________ $_________________
15BCTS25Q00000018 Page 16 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 240 Estimated Maximum Quantity: 2000
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Mental Health Group Counseling (6020)
Guaranteed Minimum Quantity: 12 Estimated Maximum Quantity: 600
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 30 Estimated Maximum Quantity: 300
Option Year 3: 37 - 48 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 (2001) Substance Use Disorder Treatment Planning and Follow-up
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 17 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0066 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum; Quantity: 100 Estimated Maximum Quantity: 4800
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
4,800 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 50
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 360 Estimated Maximum Quantity: 6000
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
6,000 EA $________ $_________________
15BCTS25Q00000018 Page 18 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 10 Estimated Maximum Quantity: 100
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 75
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
75 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity:10 Estimated Maximum Quantity: 100
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 100
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 19 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 8
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
8 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 240 Estimated Maximum Quantity: 2000
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 Mental Health Group Counseling (6020)
Guaranteed Minimum Quantity: 12 Estimated Maximum Quantity: 600
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
600 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 2 Estimated Maximum Quantity: 100
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
100 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0080 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 30 Estimated Maximum Quantity: 300
Option Year 4: 49 - 60 months
Use the Estimated Maximum Quantity when developing the total amount.
300 EA $________ $_________________
15BCTS25Q00000018 Page 20 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 (2001) Substance Use Disorder Treatment Planning and Follow-up
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Substance Use Disorder Intake Screening (2005)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 38
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
38 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Substance Use Disorder Individual Counseling (2010)
Guaranteed Minimum; Quantity: 50 Estimated Maximum Quantity: 2400
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
2,400 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Substance Use Disorder Intake Assessment & Report (2011)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0085 Co-occurring Intake Assessment & Report (2012)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 25
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
25 EA $________ $_________________
15BCTS25Q00000018 Page 21 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Substance Use Disorder Group Counseling (2020)
Guaranteed Minimum Quantity: 180 Estimated Maximum Quantity: 3000
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
3,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Substance Use Disorder Relationship and Parenting Counseling (2030)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 50
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Mental Health Treatment Planning and Follow-up (5001)
Guaranteed Minimum Quantity: 5 Estimated Maximum Quantity: 50
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Mental Health Intake Screening (5005)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 38
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
38 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Mental Health Intake Assessment & Report (5011)
Guaranteed Minimum Quantity:5 Estimated Maximum Quantity: 50
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 22 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 Psychiatric Evaluation & Report (5030)
Guaranteed Minimum Quantity: 3 Estimated Maximum Quantity: 50
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
50 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0092 Crisis Intervention Evaluation & Report (6000)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 4
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
4 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 Mental Health Individual Counseling (6010)
Guaranteed Minimum Quantity: 120 Estimated Maximum Quantity: 1000
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
1,000 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Mental Health Group Counseling (6020)
Guaranteed Minimum Quantity: 6 Estimated Maximum Quantity: 300
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
PSC: G004
300 EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 Mental Health Relationship and Parenting Counseling (6031)
Guaranteed Minimum Quantity: 1 Estimated Maximum Quantity: 50
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
15BCTS25Q00000018 Page 23 of 62
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 MH - Medication Monitoring & Report (6051)
Guaranteed Minimum Quantity: 15 Estimated Maximum Quantity: 150
Potential Six-Month Extension
Use the Estimated Maximum Quantity when developing the total amount.
150 EA $________ $_________________
15BCTS25Q00000018 Page 24 of 62
Section 2 - Contract Clauses
A.1 ADDENDUM TO FAR 52.212-4, Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023)
The terms and conditions for the following clauses are hereby incorporated into this solicitation and resulting contract as an addendum to FAR clause 52.212-4.
Clauses By Reference
52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)
This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): www.acquisition.gov
Clause Title Fill-ins (if applicable)
52.203-3 Gratuities (Apr 1984)
52.203-12 Limitation On Payments to Influence Certain Federal
Transactions (Jun 2020)
52.204-13 System for Award Management Maintenance (Oct 2018)
52.204-18 Commercial and Government Entity Code Maintenance
(Aug 2020)
52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (Nov 2023)
52.224-1 Privacy Act Notification (Apr 1984)
52.224-2 Privacy Act (Apr 1984)
52.242-13 Bankruptcy (July 1995)
52.242-15 Stop-Work Order (Aug 1989)
52.252-6 Authorized Deviations in Clauses (Nov 2020)
52.253-1 Computer Generated Forms (Jan 1991)
52.204-12 Unique Entity Identifier Maintenance (Oct 2016)
Clauses By Full Text
15BCTS25Q00000018 Page 25 of 62
52.21-603-70 Contracting Officer's Representative (COR) (June 2012)
(a)Nicole Foster (Acting SCTC), Nicole Briscoe, Keith Goodjoint, Ian Jansz ,and Nikki Kinnick , [Location],202-598-9740,202-532-5210,202-532-3903,202-451-7278 and 202-598-9176, is hereby designated as the Contracting Officer's Representative (COR) under this contract.
(b) The COR is responsible, as applicable, for: receiving all deliverables, inspecting and accepting the supplies or services provide hereunder in accordance with the terms and conditions of this contract; providing direction to the contractor which clarifies the contractor effort, fills in details or otherwise serves to accomplish the contractual Scope of Work; evaluating performance; and certifying all invoices/vouchers for acceptance of the supplies or services furnished for payment.
(c) The COR does not have the authority to alter the contractor's obligations under the contract, and/or modify any of the expressed terms, conditions, specifications, or cost of the agreement. If as a result of technical discussions it is desirable to alter/change contractual obligations or the Scope of Work, the Contracting Officer shall issue such changes.
52.216-18 Ordering (Aug 2020)
(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from first day of the contract's effective period through he last day of the contract's effective period [insert dates].
(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.
(c) A delivery order or task order is considered "issued" when--
(1) If sent by mail (includes transmittal by U.S. mail or private delivery service), the Government deposits the order in the mail;
(2) If sent by fax, the Government transmits the order to the Contractor's fax number; or
(3) If sent electronically, the Government either--
(i) Posts a copy of the delivery order or task order to a Government document access system, and notice is sent to the Contractor; or
(ii) Distributes the delivery order or task order via email to the Contractor's email address.
(d) Orders may be issued by methods other than those enumerated in this clause only if authorized in the contract.
(End of clause)
52.216-19 Order Limitations (Oct 1995)
(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than one [insert dollar figure or quantity], the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.
(b) Maximum order. The Contractor is not obligated to honor--
(1) Any order for a single item in excess of the estimated quantities identified on the SF-1449 (Block 21, Quantity) within the current contract performance period [insert dollar figure or quantity];
15BCTS25Q00000018 Page 26 of 62
(2) Any order for a combination of items in excess of the estimated quantities identified on the SF-1449 (Block 21, Quantity) within the current contract performance period [insert dollar figure or quantity]; or
(3) A series of orders from the same ordering office within 30 days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.
(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.
(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 7 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.
(End of clause)
52.216-22 Indefinite Quantity (Oct 1995)
(a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract.
(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause.
The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the "maximum." The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum."
(c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.
(d) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after the last day of the contract's effective period [insert date].
(End of clause)
52.217-8 Option to Extend Services (Nov 1999)
The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within the current performance period [insert the period of time within which the Contracting Officer may exercise the option].
(End of clause)
52.232-18 Availability of Funds (Apr 1984)
Funds are not presently available for this contract. The Government's obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer.
(End of clause)
15BCTS25Q00000018 Page 27 of 62
52.232-19 Availability of Funds for the Next Fiscal Year (Apr 1984)
Funds are not presently available for performance under this contract beyond September 30 of the Base Year or any option year exercised. The Government's obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise for performance under this contract beyond September 30 of the Base Year or any option year exercised, until funds are made available to the Contracting Officer for performance and until the Contractor receives notice of availability, to be confirmed in writing by the Contracting Officer.
(End of clause)
52.237-7 Indemnification and Medical Liability Insurance (Jan 1997)
(a) It is expressly agreed and understood that this is a nonpersonal services contract, as defined in Federal Acquisition Regulation (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over professional aspects of the services rendered, including by example, the Contractor's professional medical judgment, diagnosis, or specific medical treatments. The Contractor shall be solely liable for and expressly agrees to indemnify the Government with respect to any liability producing acts or omissions by it or by its employees or agents. The Contractor shall maintain during the term of this contract liability insurance issued by a responsible insurance carrier of not less than the following amount(s) per specialty per occurrence: *1 million.
(b) An apparently successful offeror, upon request by the Contracting Officer, shall furnish prior to contract award evidence of its insurability concerning the medical liability insurance required by paragraph (a) of this clause.
(c) Liability insurance may be on either an occurrences basis or on a claims-made basis. If the policy is on a claims-made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided.
(d) Evidence of insurance documenting the required coverage for each health care provider who will perform under this contract shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on a claims-made basis and evidence of an extended reporting endorsement is not provided prior to the commencement of services, evidence of such endorsement shall be provided to the Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended reporting endorsement is provided to the Contracting Officer.
(e) The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the Government's interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If, during the performance period of the contract the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause, for the entire period of the contract, either under the new policy, or a combination of old and new policies.
(f) The Contractor shall insert the substance of this clause, including this paragraph (f), in all subcontracts under this contract for health care services and shall require such…
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