Attachment B - PRICE SCHEDULE - Mod.docx

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V225--Non-Emergent Ambulance Transportation | Wilkes-Barre |
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36C24421Q0645
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36C24421Q0645 - Combo-Solicitation.docx DOCX document
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Attachment H - VA Information Custodial Language.docx DOCX document
Attachment G - NARA RM CONTRACT LANGUAGE CLAUSE-2020.docx DOCX document
Attachment B - PRICE SCHEDULE.docx DOCX document
Attachment D - Wage Determination - Wilkes-Barre PA.pdf PDF
36C24421Q0645.docx DOCX document
Attachment C - 36C24421Q0645 - SF1449.docx DOCX document
Attachment A - PWS Wilkes-Barre.docx DOCX document
Attachment F - CONTRACTOR PERSONNEL SECURITY REQUIREMENTS 042721.docx DOCX document
Attachment E - Past Performance Questionnair_Non-Emergent Amublance Trans.docx DOCX document
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PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM NUMBER
DESCRIPTION OF SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
200.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip

POP: 06/01/2021 - 05/31/2022

115.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip for services beyond 20 miles

100.00
MI
__________________
__________________

ALS Ambulance Mileage Rate in Excess of 30 Miles

1,020.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip

100.00
MI
__________________
__________________

BLS Ambulance Mileage Rate in Excess of 30 Miles:

725.00
EA
__________________
__________________

WheelChair Van: Rate for 20 miles or less/Trip

1,000.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip for services beyond 20 miles

6,000.00
EA
__________________
__________________

WheelChair Van: Rate for 21 miles or more/Trip

300.00
MI
__________________
__________________

Wheelchair Van Mileage Rate in Excess of Thirty Miles: Rate / Mile

5,000.00
EA
__________________
__________________

ALS / BLS / Wheelchair Van Wait Time per 15 minutes beyond the initial scheduled time: Rate / 15 Mins.

220.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip

POP: 06/01/2022 - 05/31/2023

127.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip for services beyond 20 miles

110.00
MI
__________________
__________________

ALS Ambulance Mileage Rate in Excess of 30 Miles

1,122.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip

110.00
MI
__________________
__________________

BLS Ambulance Mileage Rate in Excess of 30 Miles:

798.00
EA
__________________
__________________

WheelChair Van: Rate for 20 miles or less/Trip

1,100.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip for services beyond 20 miles

6,600.00
EA
__________________
__________________

WheelChair Van: Rate for 21 miles or more/Trip

330.00
MI
__________________
__________________

Wheelchair Van Mileage Rate in Excess of Thirty Miles: Rate / Mile

5,500.00
EA
__________________
__________________

ALS / BLS / Wheelchair Van Wait Time per 15 minutes beyond the initial scheduled time: Rate / 15 Mins.

242.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip

POP: 06/01/2023 - 05/31/2024

139.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip for services beyond 20 miles

121.00
MI
__________________
__________________

ALS Ambulance Mileage Rate in Excess of 30 Miles

1,234.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip

121.00
MI
__________________
__________________

BLS Ambulance Mileage Rate in Excess of 30 Miles:

877.00
EA
__________________
__________________

WheelChair Van: Rate for 20 miles or less/Trip

1,210.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip for services beyond 20 miles

7,260.00
EA
__________________
__________________

WheelChair Van: Rate for 21 miles or more/Trip

363.00
MI
__________________
__________________

Wheelchair Van Mileage Rate in Excess of Thirty Miles: Rate / Mile

6,050.00
EA
__________________
__________________

ALS / BLS / Wheelchair Van Wait Time per 15 minutes beyond the initial scheduled time: Rate / 15 Mins.

254.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip

POP: 06/01/2024 - 05/31/2025

146.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip for services beyond 20 miles

127.00
MI
__________________
__________________

ALS Ambulance Mileage Rate in Excess of 30 Miles

1,296.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip

127.00
MI
__________________
__________________

BLS Ambulance Mileage Rate in Excess of 30 Miles:

921.00
EA
__________________
__________________

WheelChair Van: Rate for 20 miles or less/Trip

1,271.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip for services beyond 20 miles

7,623.00
EA
__________________
__________________

WheelChair Van: Rate for 21 miles or more/Trip

381.00
MI
__________________
__________________

Wheelchair Van Mileage Rate in Excess of Thirty Miles: Rate / Mile

6,353.00
EA
__________________
__________________

ALS / BLS / Wheelchair Van Wait Time per 15 minutes beyond the initial scheduled time: Rate / 15 Mins.

267.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip

POP: 06/01/2025 - 05/31/2026

153.00
EA
__________________
__________________

ALS Ambulance: Rate / Trip for services beyond 20 miles

133.00
MI
__________________
__________________

ALS Ambulance Mileage Rate in Excess of 30 Miles

1,361.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip

133.00
MI
__________________
__________________

BLS Ambulance Mileage Rate in Excess of 30 Miles:

967.00
EA
__________________
__________________

WheelChair Van: Rate for 20 miles or less/Trip

1,334.00
EA
__________________
__________________

BLS Ambulance: Rate / Trip for services beyond 20 miles

8,004.00
EA
__________________
__________________

WheelChair Van: Rate for 21 miles or more/Trip

400.00
MI
__________________
__________________

Wheelchair Van Mileage Rate in Excess of Thirty Miles: Rate / Mile

6,670.00
EA
__________________
__________________

ALS / BLS / Wheelchair Van Wait Time per 15 minutes beyond the initial scheduled time: Rate / 15 Mins.

GRAND TOTAL
__________________

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