25LS0017_-_Rate_Sheet.xlsx
XLSX spreadsheet 21 KB Posted
- Solicitation number
- 0000037392
- Issued by
- California
About this file
This is a Rate Sheet for Pre-Employment/Annual Physicals Services submitted by the California Department of Veterans Affairs for Agreement Number 25LS0017. The services will be provided at the Veterans Home of California - Lancaster located at 45221 30th Street West, Lancaster, CA 93536. The contract encompasses nine service line items including basic physicals with employee forms, tuberculosis skin tests (two-step process), chest X-rays, and five vaccine types (Hepatitis B, Influenza, MMR, Tdap, and Varicella). The estimated quantities over the contract term are: 450 basic physicals, 300 TB skin tests (Step 1), 75 TB skin tests (Step 2), 75 chest X-rays, and 150 doses each of the five vaccines.
Proposers must submit complete rate quotes for each service line item in the spaces provided; failure to indicate a dollar amount for any item will be interpreted as the proposer offering that service at no cost. The total of all line items (Lines A through I) becomes the basis for award and represents the total contract amount, though the State makes no guarantee on actual service volumes required and reserves the right to adjust based on facility needs. All quoted rates are binding for the term of the agreement. Submission of the completed Rate Sheet is mandatory, must be signed in blue ink by the company representative, and must be transmitted via email in accordance with solicitation instructions.
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Other files
| File | Type | Posted |
|---|---|---|
| 25LS0017_-_IFB_12.2.25.pdf | ||
| 25LS0017_-_All_Exhibits.pdf | ||
| 25LS0017_-_STD_213_SAMPLE.pdf | ||
| 25LS0017_-_All_Attachments.pdf |
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Text version
Sheet1
| PRE-EMPLOYMENT/ANNUAL PHYSICALS SERVICES |
| RATE SHEET |
Submission of this attachment is MANDATORY. Upon award, quotes below will become part of the Agreement in Exhibit B, Attachment 1 Rate Sheet. The Proposer shall set forth the rates in the space provided. Failure to indicate a dollar amount for any item will be understood by the State that the Proposer will provide the item at no cost.
The undersigned Contractor hereby proposes to furnish all labor, licenses, permits, supplies, materials, parts, equipment, and any other item of expense to perform Pre-Employment/Annual Physicals Services at the Veterans Home of California – Lancaster located at 45221 30th Street West, Lancaster, CA 93536 in accordance with the specifications and provisions stated in the SFQ package.
| Description of Service | Number of Services for Contract Term | Rate | Totals | |||
| A. | Basic Physical with Employee Form (LIC 503) | 450 | x | = | $ - 0 | |
| B. | TB Skin Test- Step 1 | 300 | x | = | $ - 0 | |
| C. | TB Skin Test- Step 2 | 75 | x | = | $ - 0 | |
| D. | Chest X-Ray 1 View | 75 | x | = | $ - 0 | |
| E. | Vaccine-Hepatitis B | 150 | x | = | $ - 0 | |
| F. | Vaccine-Influenza | 150 | x | = | $ - 0 | |
| G. | Vaccine-MMR (measles, mumps, and rubella) | 150 | x | = | $ - 0 | |
| H. | Vaccine-Tdap (tetanus, diphtheria, and pertussis) | 150 | x | = | $ - 0 | |
| I. | Vaccine-Varicella | 150 | x | = | $ - 0 | |
| J. | Total Lines A - I | $ - 0 | ||||
| K. | Total (Basis of Award and Total Contract Amount): | $ - 0 |
The Basis of Award shall be used to determine the lowest responsible quote. The State makes no guarantee, expressed or implied, on the actual amount of services that shall be required for this Agreement and is subject to change based on needs of the Home. However, the rates quoted by proposer shall be binding for the term of the Agreement.
This Rate Sheet MUST be signed and returned (please use Blue ink when signing). The quote must be transmitted via email in accordance with solicitation instructions.
| Company Name: |
| Company Representative's Name (Printed): |
| Company Representative's Signature: |
| Date: |
&"Arial,Regular"California Department of Veterans Affairs Rate Sheet &"Arial,Regular"Agreement Number: 25LS0017
TBD
Sheet2
Sheet3
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