DRAFT Attachment V Proposed Pricing Worksheet.xlsx
XLSX spreadsheet 18 KB Posted
- Solicitation number
- 26RA003
- Issued by
-
Department of the Army
About this file
This document is a draft Attachment V Proposed Pricing Worksheet for a Basic Life Support (BLS) Emergency Medical Services (EMS) contract (Solicitation W51AA1-25-R-A003) at Tobyhanna Army Depot. The pricing worksheet covers a base year and four option years, with three distinct Contract Line Item Numbers (CLINs) for each year: a Firm Fixed Price (FFP) for core BLS-EMS services, a Time and Materials (T&M) rate for treatment and transport services, and a T&M rate for standby coverage for special events.
The contract requires one BLS EMS ground ambulance, two PA DOH certified EMTs, emergency and non-emergency responses, and support for Public Access Defibrillation (PAD) and Stop the Bleed (STB) programs. Services will be provided onsite during regular duty hours (Monday-Friday, 7 a.m. to 5 p.m.), with additional 24/7 emergency coverage. The worksheet includes a six-month option to extend services and requires offerors to submit detailed rates for various medical service levels, including BLS and ALS transport and treatment rates. A pre-solicitation meeting is scheduled for December 16, 2025, to address potential offeror questions about the upcoming Request for Proposals.
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Pricing Worksheet
| ATTACHMENT V |
| PROPOSED PRICING WORKSHEET (04-DEC-2025) |
| Solicitation W51AA1-25-R-A003 |
| Basic Life Support (BMS) - Emergency Medical Services (EMS) |
| INSTRUCTIONS | |||||||||
| *This attachment shall be submitted as part of the offeror's proposal.* | |||||||||
| Entries are required in the green shaded cells ONLY. | |||||||||
| FULL COMPANY NAME: | |||||||||
| CAGE CODE: | |||||||||
| UEI: | |||||||||
| Firm Fixed Price (FFP) - Enter a Firm Fixed Price for the Base Year (CLIN 0001); Option Year 1 (CLIN 1001); Option Year 2 (CLIN 2001); Option Year 3 (CLIN 3001); and Option Year 4 (CLIN 4001) for Core Basic Life Support - Emergency Medical Services, in accordance with Attachment I, Performance Work Statement (PWS). The quantity/unit of issue on the subsequent contract will be 12 LOTS. These prices shall also be included on the submitted SF1449. All firm fixed prices proposed by the offeror shall be binding for the entire life of the contract. | |||||||||
| Time and Materials (T&M) - Enter the fully burdened rate for each hour of labor utilized to provide treatment and transport services in accordance with Attachment I, Performance Work Statement (PWS) for the Base Year (CLIN 0002); Option Year 1 (CLIN 1002); Option Year 2 (CLIN 2002); Option Year 3 (CLIN 3002); Option Year 4 (CLIN 4002). These prices shall also be included on the submitted SF1449. The hours estimated for treatment and transport services are strictly for use in evaluating offers and will not obligate the Government to a specific number of hours in any way. The quantity/unit of issue on the subsequent contract will be 12 LOTS since request for payment shall be submitted monthly. | |||||||||
| Time and Materials (T&M) - Enter the fully burdened rate for each hour of labor utilized to provide standby coverage for special events in accordance with Attachment I, Performance Work statement for the Base Year (CLIN 0003); Option Year 1 (CLIN 1003); Option Year 2 (CLIN 2003); Option Year 3 (CLIN 3003); Option Year 4 (CLIN 4003). These prices shall also be included on the submitted SF1449. The hours estimated for standby coverage for special events are strictly for use in evaluating offers and will not obligate the Government to a specific number of hours in any way. The quantity/unit of issue on the subsequent contract will be 12 LOTS since requests for payment shall be submitted monthly. | |||||||||
| REMINDER: Service Contract Labor Standards. FAR 37.107 and 41 USC Chapter 67, Service Contract Labor Standards, provides for minimum wages and fringe benefits as well as other conditions of work under certain types of service contracts. Service Contract Labor Standards are applicable to this acquisition and can be located on https://sam.gov. | |||||||||
| Contract Line | |||||||||
| Item Numbers (CLINs) | Description | Quantity | Unit | Unit Price | Total Price | ||||
| CLIN 0001 | Base Year | FFP | Core Basic Life Support - Emergency Medical Services | 12 | Lots | $0.00 | Enter a firm fixed price for core BLS-EMS services, onsite at TYAD, during regular duty hours, Monday through Friday, 7 a.m. to 5 p.m., excluding federal holidays, to be performed in accordance with Attachment I, Performance Work Statement (PWS). Services include one (1) BLS EMS ground ambulance, two (2) PA DOH certified PA EMTs; stand-by BLS-EMS coverage as needed; emergency and non-emergency responses; and Public Access Defibrillation (PAD) and Stop the Bleed (STB) program assistance. | ||
| CLIN 0002 | Base Year | T&M | Treatment and Transport Services | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide treatment and transport services, as required, 24 hours a day, 365 days a year, in accordance with Attachment I, Performance Work Statement (PWS). The contractor will manage mutual aid agreements with third-party agencies, for these services, as needed. Labor rates proposed will be the labor rate authorized to be charged against this CLIN. | ||
| CLIN 0003 | Base Year | T&M | Standby Coverage for Special Events | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide standby coverage, which includes a second BLS EMS ground ambulance for transport services and two additional BLS EMS personnel for special events during regular duty hours, after-hours, weekends or federal holidays in accordance with Attachment I, Performance Work Statement (PWS). Labor rates proposed will be the labor rate authorized to be charged against this CLIN. | ||
| Total Evaluated Price for the Base Year | $0.00 |
| CLIN 1001 | Option Year 1 | FFP | Core Basic Life Support - Emergency Medical Services | 12 | Lot | $0.00 | Enter a firm fixed price for core BLS-EMS services, onsite at TYAD, during regular duty hours, Monday through Friday, 7 a.m. to 5 p.m., excluding federal holidays, to be performed in accordance with Attachment I, Performance Work Statement (PWS). Services include one (1) BLS EMS ground ambulance, two (2) PA DOH certified PA EMTs; stand-by BLS-EMS coverage as needed; emergency and non-emergency responses; and Public Access Defibrillation (PAD) and Stop the Bleed (STB) program assistance. |
| CLIN 1002 | Option Year 1 | T&M | Treatment and Transport Services | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide treatment and transport services, as required, 24 hours a day, 365 days a year, in accordance with Attachment I, Performance Work Statement (PWS). The contractor will manage mutual aid agreements with third-party agencies, for these services, as needed. Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| CLIN 1003 | Option Year 1 | T&M | Standby Coverage for Special Events | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide standby coverage, which includes a second BLS EMS ground ambulance for transport services and two additional BLS EMS personnel for special events during regular duty hours, after-hours, weekends or federal holidays in accordance with Attachment I, Performance Work Statement (PWS). Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| Total Evaluated Price for Option Year 1 | $0.00 |
| CLIN 2001 | Option Year 2 | FFP | Core Basic Life Support - Emergency Medical Services | 12 | Lot | $0.00 | Enter a firm fixed price for core BLS-EMS services, onsite at TYAD, during regular duty hours, Monday through Friday, 7 a.m. to 5 p.m., excluding federal holidays, to be performed in accordance with Attachment I, Performance Work Statement (PWS). Services include one (1) BLS EMS ground ambulance, two (2) PA DOH certified PA EMTs; stand-by BLS-EMS coverage as needed; emergency and non-emergency responses; and Public Access Defibrillation (PAD) and Stop the Bleed (STB) program assistance. |
| CLIN 2002 | Option Year 2 | T&M | Treatment and Transport Services | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide treatment and transport services, as required, 24 hours a day, 365 days a year, in accordance with Attachment I, Performance Work Statement (PWS). The contractor will manage mutual aid agreements with third-party agencies, for these services, as needed. Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| CLIN 2003 | Option Year 2 | T&M | Standby Coverage for Special Events | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide standby coverage, which includes a second BLS EMS ground ambulance for transport services and two additional BLS EMS personnel for special events during regular duty hours, after-hours, weekends or federal holidays in accordance with Attachment I, Performance Work Statement (PWS). Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| Total Evaluated Price for Option Year 2 | $0.00 |
| CLIN 3001 | Option Year 3 | FFP | Core Basic Life Support - Emergency Medical Services | 12 | Lot | $0.00 | Enter a firm fixed price for core BLS-EMS services, onsite at TYAD, during regular duty hours, Monday through Friday, 7 a.m. to 5 p.m., excluding federal holidays, to be performed in accordance with Attachment I, Performance Work Statement (PWS). Services include one (1) BLS EMS ground ambulance, two (2) PA DOH certified PA EMTs; stand-by BLS-EMS coverage as needed; emergency and non-emergency responses; and Public Access Defibrillation (PAD) and Stop the Bleed (STB) program assistance. |
| CLIN 3002 | Option Year 3 | T&M | Treatment and Transport Services | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide treatment and transport services, as required, 24 hours a day, 365 days a year, in accordance with Attachment I, Performance Work Statement (PWS). The contractor will manage mutual aid agreements with third-party agencies, for these services, as needed. Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| CLIN 3003 | Option Year 3 | T&M | Standby Coverage for Special Events | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide standby coverage, which includes a second BLS EMS ground ambulance for transport services and two additional BLS EMS personnel for special events during regular duty hours, after-hours, weekends or federal holidays in accordance with Attachment I, Performance Work Statement (PWS). Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| Total Evaluated Price for Option Year 3 | $0.00 |
| CLIN 4001 | Option Year 4 | FFP | Core Basic Life Support - Emergency Medical Services | 12 | Lot | $0.00 | Enter a firm fixed price for core BLS-EMS services, onsite at TYAD, during regular duty hours, Monday through Friday, 7 a.m. to 5 p.m., excluding federal holidays, to be performed in accordance with Attachment I, Performance Work Statement (PWS). Services include one (1) BLS EMS ground ambulance, two (2) PA DOH certified PA EMTs; stand-by BLS-EMS coverage as needed; emergency and non-emergency responses; and Public Access Defibrillation (PAD) and Stop the Bleed (STB) program assistance. |
| CLIN 4002 | Option Year 4 | T&M | Treatment and Transport Services | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide treatment and transport services, as required, 24 hours a day, 365 days a year, in accordance with Attachment I, Performance Work Statement (PWS). The contractor will manage mutual aid agreements with third-party agencies, for these services, as needed. Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| CLIN 4003 | Option Year 4 | T&M | Standby Coverage for Special Events | 1 | Hour | $0.00 | Enter the fully burdened rate for each hour of labor, including mileage, hourly rates, vehicle costs, supplies/equipment, insurance costs, and overhead costs to provide standby coverage, which includes a second BLS EMS ground ambulance for transport services and two additional BLS EMS personnel for special events during regular duty hours, after-hours, weekends or federal holidays in accordance with Attachment I, Performance Work Statement (PWS). Labor rates proposed will be the labor rate authorized to be charged against this CLIN. |
| Total Evaluated Price for Option Year 4 | $0.00 |
| Option to Extend Services (FAR 52.217-8) | FFP | Six (6) Month Option to Extend Services | ||||
| 1 | Lot | $0.00 | The six (6) month option to extend services does not require pricing. It will be calculated in the pricing worksheet as one-half (1/2) of option year four (4) per FAR 52.217-8 and will be calculated based on the offeror's proposed option year four (4) prices. | |||
| TOTAL EVALUATED PRICE >>>>>>>>>>>>>>>> | $0.00 | Price evaluation will be based on this total. | ||||
| TOTAL EVALUATED PRICE - This price will be used for "EVALUATION PURPOSES ONLY" since it includes an estimate for treatment and transport services and standby coverage. |
| BLS treat, no transport rate (patient refusal) | Enter an all-inclusive, fixed rate. | |
| BLS transport rate | Enter an all-inclusive, fixed rate. | |
| ALS treat, no transport rate (patient refusal) | Enter an all-inclusive, fixed rate. | |
| ALS transport rate Level 1 | Enter an all-inclusive, fixed rate. | |
| ALS transport rate Level 2 | Enter an all-inclusive, fixed rate. | |
| NOTE - Offerors shall submit with their technical proposals a detailed description of the interventions performed at ALS transport rate Level 1 and ALS transport level 2 (if applicable) service. |
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