26RS0002_-_Bid_Rate_Sheet.xlsx
XLSX spreadsheet 17 KB Posted
- Attached to
- 26RS0002 - Oral Surgery Services
- Solicitation number
- 0000038935
- Issued by
- Shasta County, Shasta CDP, Shasta Lake City, Mount Shasta City, California
About this file
This is a Bid Rate Sheet for solicitation 26RS0002 issued by the California Department of Veterans Affairs for Oral Surgery Services at the Veterans Home of California at Redding. The solicitation requests pricing for a comprehensive range of oral surgery procedures including tooth extractions, impacted tooth removal, biopsies, lesion excisions, cyst and tumor removals, and abscess drainage. Estimated service quantities range from 1 to 20 procedures per code, with 20 panorex x-rays representing the highest volume estimate. Bidders are required to submit pricing for all listed procedure codes using the provided rate sheet, which will become Exhibit B-1 of the resulting agreement upon award. The submission of this bid rate sheet is mandatory for consideration.
Pricing must be submitted on an all-inclusive, per-unit basis for each procedure code listed, with all yellow-highlighted sections completed. Failure to provide a dollar amount for any item may result in bid rejection, and any items listed at zero cost will be interpreted as the contractor providing those services at no charge. The basis of award will be the lowest responsible bid. Rates quoted by the successful bidder are binding for the entire contract term, including any extensions through formal amendment, regardless of actual service volume. For any authorized procedures not specifically listed on the rate sheet, compensation will be provided at the contractor's published usual and customary fee schedule less ten percent, which the contractor must submit with the signed contract upon award. The State makes no guarantee regarding the actual volume of services required.
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Other files
| File | Type | Posted |
|---|---|---|
| S25DLSE016-RFP_KAD_Addendum_1.pdf | ||
| 26RS0002_-_IFB.pdf | ||
| 26RS0002_-_All_Exhibits.pdf | ||
| 26RS0002_-_All_documents_(IFB).pdf |
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Text version
Sheet1
| California Department of Veterans Affairs | Solicitation Number 26RS0002 | |
| Bid Rate Sheet | TBD | |
| Oral Surgery Services |
Submission of this attachment is MANDATORY. Upon award, the bid below will become part of the Agreement in Exhibit B-1, Rate Sheet. The Bidder shall enter the rates in the yellow-highlighted section below. An all-inclusive rate is required for each item listed below. Failure to indicate a dollar amount in any item may be grounds to reject the entire bid. A zero dollar ($0.00) amount listed for any and all items will be understood by the State that the bidder will perform any such services at no cost.
The Basis of Award shall be used to determine the lowest responsible bid. 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 the needs of the Home. However, the rates quoted by Bidder shall be binding for the term of the Agreement, including any extension of the term through a formal amendment.
| Enter the bid in the yellow-highlighted area. | ||||||
| Procedure Code | Description of Service | Estimated # of Services | x | Unit Cost | = | Totals |
| D7140 | Extraction, erupted tooth or exposed root | 5 | x | = | $0.00 | |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning tooth, and including elevation of mucoperiosteal flap | 5 | x | = | $0.00 | |
| D7220 | Removal of impacted tooth-soft tissue | 5 | x | = | $0.00 | |
| D7230 | Removal of impacted tooth – partially bony | 10 | x | = | $0.00 | |
| D7240 | Removal of impacted tooth – complete bony | 10 | x | = | $0.00 | |
| D7241 | Removal of impacted tooth- completely bony with unusual surgical complications | 5 | x | = | $0.00 | |
| D7250 | Removal of residual roots(cutting procedure) | 5 | x | = | $0.00 | |
| D725 | Coronectomy-intentional partial tooth removal | |||||
| 1 | x | = | $0.00 | |||
| D7260 | Oroantral fistula closure | 1 | x | = | $0.00 | |
| D7261 | Primary closure of Sinus Perforation | 1 | x | = | $0.00 | |
| D7285 | Incisional Biopsy of oral tissue – hard (bone, tooth) | |||||
| 3 | x | = | $0.00 | |||
| D7286 | Incisional Biopsy of oral tissue –soft | |||||
| 5 | x | = | $0.00 | |||
| D7287 | Exfoliative cytological sample collection | 5 | x | = | $0.00 | |
| D7288 | Brush biopsy | 5 | x | = | $0.00 | |
| D7311 | Alveoplasty in conjunction with extraction- one to three teeth or tooth spaces per quadrant | 1 | x | = | $0.00 | |
| D7310 | Alveoplasty in conjunction with extraction – four or more teeth or tooth spaces, per quadrant | 1 | x | = | $0.00 | |
| D7410 | Excision of benign lesion up to 1.25 cm | |||||
| 5 | x | = | $0.00 | |||
| D7411 | Excision of benign lesion greater than 1.25 cm | 3 | x | = | $0.00 | |
| D7450 | Removal of benign odontogenic cyst or tumor – lesion diameter up to 1.25 cm | 1 | x | = | $0.00 | |
| D7451 | Removal of benign odontogenic cyst or tumor – lesion diameter greater than 1.25cm | 1 | x | = | $0.00 | |
| D7460 | Removal of benign non-odontogenic tumor or cyst – lesion diameter up to 1.25cm | |||||
| 1 | x | = | $0.00 | |||
| D7461 | Removal of benign non-odontogenic tumor or cyst – lesion diameter greater than 1.25 am | 1 | x | = | $0.00 | |
| D7510 | Incision and drainage of abscess – intraoral soft tissue | 2 | x | = | $0.00 | |
| D7511 | Incision and drainage of abscess –intraoral soft tissue – complicated (includes drainage of multiple fascial spaces) | 2 | x | = | $0.00 | |
| 70355 | Panorex X-ray | 20 | x | = | $0.00 | |
| D0220 | Intraoral Periapical Film | 5 | x | = | $0.00 | |
| D9310 | Specialty Consultation | 5 | x | = | $0.00 | |
| MISC. | Authorized Procedures | 5 | x | = | $0.00 | |
| Total | $0.00 | |||||
| Basis of Award | ||||||
| Contractor’s Usual and Customary Rates |
Any services provided under this contract without a rate listed shall be paid at the Contractor’s Published Usual and Customary Fee Schedule, as specified in Exhibit B-2, less ten percent (10%). Contractor shall provide the Contractor’s Published Usual and Customary Fee Schedule along with the signed contract upon award.
| This Rate Sheet Must be signed and returned. |
| The bid must be transmitted in accordance with the solicitation instructions |
Printed Name and Title
Signature and Date
Company Name
Address
City, State, and ZIP
Telephone and Fax Number
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