Amendment 2 - 15BCTS25R00000005 - signed.pdf
PDF 313 KB Posted
- Attached to
- SU/MH/SOT in Washington, D. C.
- Solicitation number
- 15BCTS25R00000005
About this file
This is a Standard Form 30 (Amendment of Solicitation/Modification of Contract) issued by the Federal Bureau of Prisons, Community Treatment Services Contracting on August 26, 2026, with an effective date of 8/26/2026. The amendment cancels solicitation 15BCTS25R00000005 in its entirety. The contracting officer is Kia Warner, and the document was signed by authorized representatives of both the contracting office and the Federal Bureau of Prisons.
The original solicitation covered Substance Use, Mental Health, and Sex Offender Treatment Services in Washington, D.C., on a firm fixed-price basis with a base period of 12 months and four option years (13, 12, 12, and 12 months respectively), plus a potential 6-month extension. The services schedule included 126 line items across three service categories: substance use disorder treatment (including treatment planning, intake screening, individual and group counseling, assessments, and relationship counseling); mental health services (including treatment planning, intake screening, assessments, psychiatric evaluations, crisis interventions, individual counseling, case management, medication monitoring, and relationship counseling); and sex offender treatment services (including intake assessments, treatment planning, intake screening, individual counseling, and group counseling). Estimated quantities ranged from 2 to 7,440 units per service item across the contract period. The cancellation eliminates all procurement activity under this solicitation, and no contractor was selected.
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment 1 - signed.pdf | ||
| Questions for 15BCTS25R00000005.pdf | ||
| 15BCTS25R00000005.pdf | ||
| Attachment Proposal Form.xlsx | XLSX spreadsheet | |
| CTS Statement of Work 2022.pdf | ||
| Whistleblower Information.pdf | ||
| FBOP ATU Vendor Attestation .docx | DOCX document | |
| Technical Proposal Information Packet.docx | DOCX document | |
| Cover Letter Washington DC.pdf | ||
| Section 2.1, Continuation SF1449 Washington, DC.pdf | ||
| Business Proposal Information Packet.pdf | ||
| FAR Clause 52.212-5 (JAN 2025) (DEVIATION FEB 2025).pdf |
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Text version
15BCTS25R00000005/0002 Page 1 of 30
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
1. CONTRACT ID CODE PAGE OF PAGES
1 30
2. AMENDMENT/MODIFICATION NUMBER
3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)
15BCTSCODE
Federal Bureau of Prisons Community Treatment Services Contracting 320 First Street NW Suite 901-5 Washington, DC 20534
Kia Warner
(O) 205-598-6139 k1warner@bop.gov
6. ISSUED BY CODE7. ADMINISTERED BY (If other than Item 6)
9A. AMENDMENT OF SOLICITATION NUMBER
15BCTS25R00000005
CODE FACILITY CODE
8. NAME AND ADDRESS OF CONTRACTOR (Number, street, country, state and ZIP Code) (X)
X 9B. DATED (SEE ITEM 11)
09/01/2025
10A. MODIFICATION OF CONTRACT/ORDER
NUMBER
10B. DATED (SEE ITEM 13)
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
XThe above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing items 8 and 15, and returning ____copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12. ACCOUNTING AND APPROPRIATION DATA (If required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.
IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.
CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT
ORDER NUMBER IN ITEM 10A.
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor is not, is required to sign this document and return _______ copies to the issuing office.
14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
This amendment is hereby issued to cancel the solicitation in its entirety.
Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15A. NAME AND TITLE OF SIGNER (Type or print) 16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)
Kia Warner Contracting Officer
(Signature of person authorized to sign)
15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED
By (Signature of Contracting Officer)
16B. UNITED STATES OF AMERICA 16C. DATE SIGNED
Previous edition unusable STANDARD FORM 30 (REV. 11/2016) Prescribed by GSA FAR (48 CFR) 53.243
8/26/2026
8/26/2026
15BCTS25R00000005/0002 Page 2 of 30
Table of Contents
Section Description Page Number
Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses 3 List of Attachments 4 Solicitation Provisions
15BCTS25R00000005/0002 Page 3 of 30
Section 1 - Commodity or Services Schedule
Substance Use, Mental Health, and Sex Offender Treatment Services in Washington, D.C.
Firm Fixed Price
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; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0002 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0003 Substance Use Disorder Individual Counseling (2010)
40 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0004 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
EA $________ $_________________
15BCTS25R00000005/0002 Page 4 of 30
Current :
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0005 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 125 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0006 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 7440 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
7,440
Change: 0
Current :
7,440
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: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0008 Mental Health Treatment Planning and Follow-up (5001)
10 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
15BCTS25R00000005/0002 Page 5 of 30
0009 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0010 Mental Health Intake Assessment & Report (5011)
10 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0011 Psychiatric Evaluation & Report (5030)
10 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount. .
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0012 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 12
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0013 Mental Health Individual Counseling (6010)
20 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
15BCTS25R00000005/0002 Page 6 of 30
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0014 Case Management Services (6029)
2 Units Guaranteed Minimum; 800 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0015 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: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0016 MH - Medication Monitoring & Report (6051)
10 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0017 Sex Offender Intake Assessment & Report (5012)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0018 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
Previous :
Change: 0
Current : 45
15BCTS25R00000005/0002 Page 7 of 30
PSC: G004
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0019 Sex Offender Intake Screening (6005)
2 Units Guaranteed Minimum; 30 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0020 Sex Offender Individual Counseling (6012)
20 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0021 Sex Offender Group Counseling (6022)
4 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Base Period: Date of award - 12 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0022 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0023 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Previous :
15BCTS25R00000005/0002 Page 8 of 30
Option Year 1: 13 months through 24 months
PSC: G004
Current :
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0024 Substance Use Disorder Individual Counseling (2010)
40 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0025 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0026 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 125 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0027 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 7440 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
7,440
Change: 0
Current :
7,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 9 of 30
0028 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0029 Mental Health Treatment Planning and Follow-up (5001)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0030 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0031 Mental Health Intake Assessment & Report (5011)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0032 Psychiatric Evaluation & Report (5030)
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
Previous :
Change: 0
Current :
15BCTS25R00000005/0002 Page 10 of 30
QUANTITY
UNIT UNIT PRICE AMOUNT
0033 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 12
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0034 Mental Health Individual Counseling (6010)
20 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0035 Case Management Services (6029)
2 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0036 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0037 MH - Medication Monitoring & Report (6051)
10 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
15BCTS25R00000005/0002 Page 11 of 30
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0038 Sex Offender Intake Assessment & Report (5012)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0039 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0040 Sex Offender Intake Screening (6005)
2 Units Guaranteed Minimum; 30 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0041 Sex Offender Individual Counseling (6012)
20 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0042 Sex Offender Group Counseling (6022)
4 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 1: 13 months through 24 months
Previous :
15BCTS25R00000005/0002 Page 12 of 30
PSC: G004 Current :
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0043 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0044 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0045 Substance Use Disorder Individual Counseling (2010)
40 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0046 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 13 of 30
0047 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 125 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0048 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 7440 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
7,440
Change: 0
Current :
7,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0049 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 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0050 Mental Health Treatment Planning and Follow-up (5001)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0051 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
15BCTS25R00000005/0002 Page 14 of 30
QUANTITY
UNIT UNIT PRICE AMOUNT
0052 Mental Health Intake Assessment & Report (5011)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0053 Psychiatric Evaluation & Report (5030)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0054 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 12
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0055 Mental Health Individual Counseling (6010)
20 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0056 Case Management Services (6029)
2 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
Previous :
15BCTS25R00000005/0002 Page 15 of 30
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0057 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0058 MH - Medication Monitoring & Report (6051)
10 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0059 Sex Offender Intake Assessment & Report (5012)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0060 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0061 Sex Offender Intake Screening (6005)
2 Units Guaranteed Minimum; 30 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Previous :
15BCTS25R00000005/0002 Page 16 of 30
Option Year 2: 25 months through 36 months
PSC: G004
Change: 0
Current : 30
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0062 Sex Offender Individual Counseling (6012)
20 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0063 Sex Offender Group Counseling (6022)
4 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 2: 25 months through 36 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0064 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0065 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 17 of 30
0066 Substance Use Disorder Individual Counseling (2010)
40 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0067 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0068 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 125 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0069 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 7440 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
7,440
Change: 0
Current :
7,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0070 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
Previous :
Change: 0
Current :
15BCTS25R00000005/0002 Page 18 of 30
QUANTITY
UNIT UNIT PRICE AMOUNT
0071 Mental Health Treatment Planning and Follow-up (5001)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0072 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0073 Mental Health Intake Assessment & Report (5011)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0074 Psychiatric Evaluation & Report (5030)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0075 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Previous :
15BCTS25R00000005/0002 Page 19 of 30
Option Year 3: 37 months through 48 months
PSC: G004
Current : 12
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0076 Mental Health Individual Counseling (6010)
20 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0077 Case Management Services (6029)
2 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0078 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0079 MH - Medication Monitoring & Report (6051)
10 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 20 of 30
0080 Sex Offender Intake Assessment & Report (5012)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0081 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0082 Sex Offender Intake Screening (6005)
2 Units Guaranteed Minimum; 30 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0083 Sex Offender Individual Counseling (6012)
20 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0084 Sex Offender Group Counseling (6022)
4 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 3: 37 months through 48 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 21 of 30
0085 Substance Use Disorder Treatment Planning and Follow-up (2001)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0086 Substance Use Disorder Intake Screening (2005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0087 Substance Use Disorder Individual Counseling (2010)
40 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0088 Substance Use Disorder Intake Assessment & Report (2011)
10 Units Guaranteed Minimum; 250 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0089 Co-occurring Intake Assessment & Report (2012)
2 Units Guaranteed Minimum; 125 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
15BCTS25R00000005/0002 Page 22 of 30
QUANTITY
UNIT UNIT PRICE AMOUNT
0090 Substance Use Disorder Group Counseling (2020)
60 Units Guaranteed Minimum; 7440 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
7,440
Change: 0
Current :
7,440
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0091 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0092 Mental Health Treatment Planning and Follow-up (5001)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0093 Mental Health Intake Screening (5005)
2 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0094 Mental Health Intake Assessment & Report (5011)
10 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Previous :
15BCTS25R00000005/0002 Page 23 of 30
Option Year 4: 49 months through 60 months
PSC: G004
Current :
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0095 Psychiatric Evaluation & Report (5030)
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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0096 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 12 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 12
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0097 Mental Health Individual Counseling (6010)
20 Units Guaranteed Minimum; 2400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
2,400
Change: 0
Current :
2,400
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0098 Case Management Services (6029)
2 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
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 24 of 30
0099 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
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0100 MH - Medication Monitoring & Report (6051)
10 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0101 Sex Offender Intake Assessment & Report (5012)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0102 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
2 Units Guaranteed Minimum; 45 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 45
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0103 Sex Offender Intake Screening (6005)
2 Units Guaranteed Minimum; 30 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current : 30
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 25 of 30
0104 Sex Offender Individual Counseling (6012)
20 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0105 Sex Offender Group Counseling (6022)
4 Units Guaranteed Minimum; 600 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0106 Substance Use Disorder Treatment Planning and Follow-up (2001)
5 Units Guaranteed Minimum; 125 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0107 Substance Use Disorder Intake Screening (2005)
1 Unit Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 75
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0108 Substance Use Disorder Individual Counseling (2010)
20 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
1,200
Change: 0
Current :
1,200
15BCTS25R00000005/0002 Page 26 of 30
QUANTITY
UNIT UNIT PRICE AMOUNT
0109 Substance Use Disorder Intake Assessment & Report (2011)
5 Units Guaranteed Minimum; 125 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Option Year 4: 49 months through 60 months
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0110 Co-occurring Intake Assessment & Report (2012)
1 Unit Guaranteed Minimum; 63 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 63
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0111 Substance Use Disorder Group Counseling (2020)
30 Units Guaranteed Minimum; 3720 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
3,720
Change: 0
Current :
3,720
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0112 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
Previous :
Change: 0
Current : 50
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0113 Mental Health Treatment Planning and Follow-up (5001)
5 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
15BCTS25R00000005/0002 Page 27 of 30
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0114 Mental Health Intake Screening (5005)
1 Unit Guaranteed Minimum; 75 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 75
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0115 Mental Health Intake Assessment & Report (5011)
5 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0116 Psychiatric Evaluation & Report (5030)
5 Units Guaranteed Minimum; 150 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount. .
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0117 Crisis Intervention Evaluation & Report (6000)
1 Unit Guaranteed Minimum; 6 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous : 6
Change: 0
Current : 6
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0118 Mental Health Individual Counseling (6010)
10 Units Guaranteed Minimum; 1200 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Previous :
1,200
15BCTS25R00000005/0002 Page 28 of 30
Potential 6 Month Extension
PSC: G004
Change: 0
Current :
1,200
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0119 Case Management Services (6029)
1 Unit Guaranteed Minimum; 400 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0120 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
Previous :
Change: 0
Current : 50
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0121 MH - Medication Monitoring & Report (6051)
5 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0122 Sex Offender Intake Assessment & Report (5012)
1 Unit Guaranteed Minimum; 23 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 23
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
15BCTS25R00000005/0002 Page 29 of 30
0123 Sex Offender Treatment Disorder Treatment Planning and Follow-up (6001)
1 Unit Guaranteed Minimum; 23 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 23
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0124 Sex Offender Intake Screening (6005)
1 Unit Guaranteed Minimum; 15 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current : 15
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0125 Sex Offender Individual Counseling (6012)
10 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
ITEM NO. SUPPLIES/SERVICES EST.
QUANTITY
UNIT UNIT PRICE AMOUNT
0126 Sex Offender Group Counseling (6022)
2 Units Guaranteed Minimum; 300 Units Estimated Maximum
Use the Estimated Maximum Quantity when developing the total amount.
Potential 6 Month Extension
PSC: G004
Previous :
Change: 0
Current :
EA $________ $_________________
Section 2 - Contract Clauses
No Clauses
Section 3 - List of Attachments
No Clauses
15BCTS25R00000005/0002 Page 30 of 30
No Attachments
Section 4 - Solicitation Provisions
No Clauses
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