Amend 0004 Att A Pricing Sheet.xls
XLS spreadsheet 40 KB Posted
- Attached to
- AFRH Dental Services
- Solicitation number
- 20342326Q00004
About this file
This document is a Pricing Sheet for Request for Quote (RFQ) 20342326Q00004 for AFRH Dental Services, covering a base period from 01/01/2026 through 09/30/2026. The comprehensive pricing template details a wide range of dental procedures across diagnostic, preventive, restorative, dentures, partials, oral surgery, endodontics, prosthodontics, and miscellaneous categories, with estimated quantities for each procedure type. The solicitation is set aside exclusively for small businesses, with the Department of the Treasury Bureau of the Fiscal Service procuring dental services for the Armed Forces Retirement Home in Washington, D.C.
The procurement involves a firm fixed price contract with one 9-month base period, requiring offerors to have an unexpired SAM.gov registration and Unique Entity Identifier. The quotation submission deadline has been extended to 10:00 AM on Tuesday, November 04, 2025, with electronic submissions to be sent to purchasing@fiscal.treasury.gov and brittany.coffman@fiscal.treasury.gov. While the pricing sheet shows a comprehensive list of dental procedures, all unit prices are currently marked as zero, indicating that actual pricing will be provided by the offerors in their competitive quotes.
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Other files
| File | Type | Posted |
|---|---|---|
| Amend 0003 RFQ 20342326Q00004.pdf | ||
| Amend 0003 Att A Pricing Sheet.xls | XLS spreadsheet | |
| RFQ 20342326Q00004 QAComplete.xlsx | XLSX spreadsheet | |
| Attachment B- Historical Procedures.pdf | ||
| RFQ 20342326Q00004.pdf | ||
| Attachment A Pricing Sheet.xls | XLS spreadsheet |
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Text version
Base Period
| Pricing Sheet | ||||
| RFQ 20342326Q00004 AFRH Dental Services | ||||
| Base Period: POP: 01/01/2026 through 09/30/2026 | ||||
| Type- Item/Procedure | Description- Item/Procedure | Unit Price | Estimated Qty Base Period | Extended Total |
| DIAGNOSTIC | Oral Exam (Periodic/Comp./Limited) | $ - 0 | 120 | $ - 0 |
| Intraoral comprehensive series | $ - 0 | 12 | $ - 0 | |
| Intraoral periapical x-ray (1) | $ - 0 | 72 | $ - 0 | |
| Intraoral periapical (additional) | $ - 0 | 32 | $ - 0 | |
| Bitewing-1 film | $ - 0 | 12 | $ - 0 | |
| Bitewing-2 films | $ - 0 | 20 | $ - 0 | |
| Bitewing-3 films | $ - 0 | 10 | $ - 0 | |
| Bitewing-4 films | $ - 0 | 24 | $ - 0 | |
| PREVENTIVE | Adult Prophylaxis | $ - 0 | 104 | $ - 0 |
| Fluoride Treatment (Adult) | $ - 0 | 103 | $ - 0 | |
| Scaling/Full Mouth Debridement | $ - 0 | 32 | $ - 0 | |
| Scaling & Root Planning (Per Quad) | $ - 0 | 28 | $ - 0 | |
| RESTORATIVE | Composite-1 surface | $ - 0 | 20 | $ - 0 |
| Composite-2 surface | $ - 0 | 16 | $ - 0 | |
| Composite-3 surface | $ - 0 | 16 | $ - 0 | |
| Composite-4 surface | $ - 0 | 12 | $ - 0 | |
| Composite-1 surface (P) | $ - 0 | 6 | $ - 0 | |
| Composite-2 surface (P) | $ - 0 | 6 | $ - 0 | |
| Composite-3 surface (P) | $ - 0 | 10 | $ - 0 | |
| Composite-4 surface (P) | $ - 0 | 10 | $ - 0 | |
| Amalgam-1 surface | $ - 0 | 13 | $ - 0 | |
| Amalgam-2 surface | $ - 0 | 19 | $ - 0 | |
| Amalgam-3 surface | $ - 0 | 16 | $ - 0 | |
| Amalgam-4 surface | $ - 0 | 6 | $ - 0 | |
| Pin | $ - 0 | 10 | $ - 0 | |
| Core Buildup | $ - 0 | 10 | $ - 0 | |
| Post & Core | $ - 0 | 16 | $ - 0 | |
| PFM/Porcelain Crown | $ - 0 | 20 | $ - 0 | |
| Insert PFM/Porcelain Crown | $ - 0 | 24 | $ - 0 | |
| Gold Crown | $ - 0 | 9 | $ - 0 | |
| Insert Gold Crown | $ - 0 | 13 | $ - 0 | |
| Sedative Filling | $ - 0 | 16 | $ - 0 | |
| DENTURES | Complete Upper Denture | $ - 0 | 16 | $ - 0 |
| Preliminary Impression | $ - 0 | 13 | $ - 0 | |
| Final Impression | $ - 0 | 10 | $ - 0 | |
| Bite Block | $ - 0 | 13 | $ - 0 | |
| Wax Tryin | $ - 0 | 16 | $ - 0 | |
| Deliver Denture | $ - 0 | 16 | $ - 0 | |
| Complete Lower Denture | $ - 0 | 0 | $ - 0 | |
| Preliminary Impression | $ - 0 | 10 | $ - 0 | |
| Final Impression | $ - 0 | 7 | $ - 0 | |
| Bite Block | $ - 0 | 10 | $ - 0 | |
| Wax Tryin | $ - 0 | 10 | $ - 0 | |
| Deliver Denture | $ - 0 | 10 | $ - 0 | |
| Immediate Upper Denture | $ - 0 | 0 | $ - 0 | |
| Preliminary Impression | $ - 0 | 10 | $ - 0 | |
| Final Impression | $ - 0 | 7 | $ - 0 | |
| Bite Block | $ - 0 | 10 | $ - 0 | |
| Wax Tryin | $ - 0 | 10 | $ - 0 | |
| Deliver Denture | $ - 0 | 10 | $ - 0 | |
| Immediate Lower Denture | $ - 0 | 10 | $ - 0 | |
| Preliminary Impression | $ - 0 | 10 | $ - 0 | |
| Final Impression | $ - 0 | 7 | $ - 0 | |
| Bite Block | $ - 0 | 10 | $ - 0 | |
| Wax Tryin | $ - 0 | 10 | $ - 0 | |
| Deliver Denture | $ - 0 | 10 | $ - 0 | |
| PARTIALS | Upper Partial | $ - 0 | 10 | $ - 0 |
| Preliminary Impression | $ - 0 | 10 | $ - 0 | |
| Final Impression | $ - 0 | 7 | $ - 0 | |
| Bite Block | $ - 0 | 10 | $ - 0 | |
| Wax Tryin | $ - 0 | 10 | $ - 0 | |
| Deliver Partial | $ - 0 | 1 | $ - 0 | |
| Lower Partial | $ - 0 | 0 | $ - 0 | |
| Preliminary Impression | $ - 0 | 6 | $ - 0 | |
| Final Impression | $ - 0 | 6 | $ - 0 | |
| Bite Block | $ - 0 | 6 | $ - 0 | |
| Wax Tryin | $ - 0 | 6 | $ - 0 | |
| Deliver Partial | $ - 0 | 6 | $ - 0 | |
| Repair/Add Clasp | $ - 0 | 6 | $ - 0 | |
| Interim Partial/Flipper-Max. | $ - 0 | 6 | $ - 0 | |
| Interim Partial/Flipper-Mand. | $ - 0 | 6 | $ - 0 | |
| Reline Upper Denture | $ - 0 | 6 | $ - 0 | |
| Reline Lower Denture | $ - 0 | 6 | $ - 0 | |
| Reline Upper Partial | $ - 0 | 6 | $ - 0 | |
| Reline Lower Partial | $ - 0 | 6 | $ - 0 | |
| Add Tooth to Partial | $ - 0 | 7 | $ - 0 | |
| Add Tooth to Denture | $ - 0 | 7 | $ - 0 | |
| Denture/Partial Repair | $ - 0 | 7 | $ - 0 | |
| ORAL SURGERY | Extraction/Single Tooth | $ - 0 | 7 | $ - 0 |
| Extraction Add'l Tooth | $ - 0 | 7 | $ - 0 | |
| Root Removal | $ - 0 | 7 | $ - 0 | |
| Surgical Extraction | $ - 0 | 7 | $ - 0 | |
| Surgical Root Removal | $ - 0 | 5 | $ - 0 | |
| ENDODONTICS | Root Canal Anterior | $ - 0 | 5 | $ - 0 |
| Root Canal Bicuspid | $ - 0 | 5 | $ - 0 | |
| Root Canal Molar | $ - 0 | 5 | $ - 0 | |
| RCT Re-Treat (Anterior) | $ - 0 | 5 | $ - 0 | |
| RCT Re-Treat (Bicuspid) | $ - 0 | 5 | $ - 0 | |
| RCT Re-Treat (Molar) | $ - 0 | 5 | $ - 0 | |
| FIXED | Bridge Abutment | $ - 0 | 5 | $ - 0 |
| PROSTHODONTICS | Bridge Pontic | $ - 0 | 5 | $ - 0 |
| Deliver Bridge Per Unit | $ - 0 | 5 | $ - 0 | |
| Recement Bridge | $ - 0 | 5 | $ - 0 | |
| Recement Crown | $ - 0 | 6 | $ - 0 | |
| MISCELLANEOUS | Consultation | $ - 0 | 10 | $ - 0 |
| Palliative | $ - 0 | 10 | $ - 0 | |
| OTHER | Nightguard | $ - 0 | 5 | $ - 0 |
| Broken Appointment Fee | $ - 0 | 10 | $ - 0 | |
| Panoramic | $ - 0 | 8 | $ - 0 | |
| Local Admin. Antibiotic Per Site | $ - 0 | 5 | $ - 0 | |
| Base Period Total: | $0.00 |
&LAttachment A
RFQ 20342326Q00004
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