26RS0002_-_Quote_Rate_Sheet.xlsx
XLSX spreadsheet 17 KB Posted
- Attached to
- 26RS0002 - *SB only *Oral Surgery Services
- Solicitation number
- 0000037899
- Issued by
- Shasta County, Shasta CDP, Shasta Lake City, Mount Shasta City, California
About this file
This is a bid rate sheet for the California Department of Veterans Affairs solicitation 26RS0002 for oral surgery services at the Veterans Home of California at Redding. The solicitation requests rates for a comprehensive range of oral surgical procedures including tooth extractions (simple and complex), impacted tooth removal, biopsies, lesion excisions, cyst and tumor removals, and abscess drainage. Estimated service quantities range from one to twenty procedures across multiple procedure codes, with panoramic X-rays estimated at twenty units and specialty consultations at five units. The rate sheet requires bidders to enter unit costs for each procedure, with all amounts becoming binding for the full contract term including any extensions through formal amendment. The state makes no guarantee regarding actual service volumes, which remain subject to change based on facility needs.
Pricing must be submitted as all-inclusive rates for each listed procedure, with any blank entries or zero dollar amounts potentially resulting in bid rejection or commitment to provide services at no cost, respectively. Bidders must complete the mandatory rate sheet with dollar amounts in the yellow-highlighted sections and submit it in accordance with solicitation instructions. For any authorized procedures not listed on the rate sheet, compensation will be calculated using the contractor's published usual and customary fee schedule reduced by ten percent, which must be provided by the awarded contractor upon contract execution. The basis of award is the lowest responsible bid, with the completed rate sheet becoming part of the agreement as Exhibit B-1.
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Other files
| File | Type | Posted |
|---|---|---|
| 26RS0002-_STD_213_Sample.pdf | ||
| 26RS0002_-_All_Attachments_(SFQ).pdf | ||
| 26RS0002_-_SFQ_SB.pdf | ||
| 26RS0002_-_All_Exhibits.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
&"Arial,Regular"&10Page &P of &N
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