36C24818R0023-00001001.pdf

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Attached to
ALS/BLS Ground Transportation (non-emergency) Federal contract opportunity
Solicitation number
36C24818R0023
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8

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36C24818R0023 00001 B4 Schedule Svc _ Pricing Revised 4-02-2018.pdf

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B.4 SCHEDULE OF SERVICES AND PRICING (revised 04/02/2018)

All prices and rates shall be for loaded (patient onboard) services and mileage only. But for exceptions (dry-runs or cancellations) indicated in Section B.5, PWS Paragraph 9.F., the Government shall not pay for unloaded (no patient) services or mileage.

Orders shall be placed in accordance with Section B.5, PWS Paragraph 4. The default method of payment shall be electronic funds transfer submitted into Tungsten, unless the Contracting Officer specifies otherwise. The Contractor is required to maintain an awareness of available order quantities as they are depleted during performance. Services rendered which exceed order quantities issued by the Contracting Officer shall be the risk of the Contractor and any cost thereof may be borne by the Contractor.

The quantities are estimated quantities only and shall be considered nonbinding.

The guaranteed minimum for the fiscal year in which the contract was awarded shall be $2,000.00.

The total maximum amount of services acquired under this contract shall not exceed $15,000,000.00.

Base Period: Date of Award through September 30, 2018

CONTRACT LINE

ITEM NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

Orange County Basic Life Support (BLS) Ambulance Transportation (A0428) orders

$__________ per order

Orange County Advanced Life Support 1 (ALS1) Ambulance Transportation (A0426)

Orange County Advanced Life Support 2 (ALS2) Ambulance Transportation (A0433)

Volusia County Basic Life Support (BLS) Ambulance Transportation (A0428)

Volusia County Advanced Life Support 1 (ALS1) Ambulance Transportation (A0426)

Volusia County Advanced Life Support 2 (ALS2) Ambulance Transportation (A0433)

Seminole County Basic Life Support (BLS) Ambulance Transportation (A0428)

Seminole County Advanced Life Support 1 (ALS1) Ambulance Transportation (A0426)

CONTRACT LINE

ITEM NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

Seminole County Advanced Life Support 2 (ALS2) Ambulance Transportation (A0433)

Brevard County Basic Life Support (BLS) Ambulance Transportation (A0428)

Brevard County Advanced Life Support 1 (ALS1) Ambulance Transportation (A0426)

Brevard County Advanced Life Support 2 (ALS2) Ambulance Transportation (A0433)

Osceola County Basic Life Support (BLS) Ambulance Transportation (A0428)

Osceola County Advanced Life Support 1 (ALS1) Ambulance Transportation (A0426)

Osceola County Advanced Life Support 2 (ALS2) Ambulance Transportation (A0433) orders

$__________ per order

Lake County Basic Life Support (BLS) Ambulance Transportation (A0428)

Lake County Advanced Life Support 1 (ALS1) Ambulance Transportation (A0426)

Lake County Advanced Life Support 2 (ALS2) Ambulance Transportation (A0433)

Mileage Rate – per County (A0425)

0019AA Mileage Rate – Orange County 7,700 miles

$__________ per mile

0019AB Mileage Rate – Orange County 3,292 miles

$__________ per mile

0019AC Mileage Rate – Orange County miles $__________ per mile

0019AD Mileage Rate – Orange County 3,148 miles

$__________ per mile

0019AE Mileage Rate – Osceola County 3,204 miles

$__________ per mile

0019AF Mileage Rate – Lake County 1,288 Miles

$__________ per mile

CONTRACT LINE

ITEM NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

Wait Time (in excess of initial 15 minutes) by County

0020AA Wait Time – Orange County orders $__________ per order

0020AB Wait Time – Orange County orders $__________ per order

0020AC Wait Time – Orange County orders $__________ per order

0020AD Wait Time – Orange County orders $__________ per order

0020AE Wait Time – Osceola County orders $__________ per order

0020AF Wait Time – Lake County

Option Year 1: October 1, 2018 through September 30, 2019

CONTRACT

LINE ITEM

NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

Orange County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Orange County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Orange County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Volusia County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Volusia County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Volusia County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Seminole County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Seminole County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

LINE ITEM

NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

Seminole County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Brevard County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Brevard County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Brevard County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Osceola County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Osceola County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Osceola County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433) orders

$__________ per order

Lake County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Lake County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Lake County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

1019 Mileage Rate – per County (A0425)

1019AA Mileage Rate – Orange County 23,100 miles

$__________ per mile

1019AB Mileage Rate – Orange County 9,576 miles

$__________ per mile

1019AC Mileage Rate – Orange County 2,756 miles

$__________ per mile

1019AD Mileage Rate – Orange County 9,444 miles

$__________ per mile

1019AE Mileage Rate – Osceola County 6,312 miles

$__________ per mile

1019AF Mileage Rate – Lake County 3,864 miles

NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

1020AA Wait Time – Orange County orders $__________ per order

1020AB Wait Time – Orange County orders $__________ per order

1020AC Wait Time – Orange County orders $__________ per order

1020AD Wait Time – Orange County orders $__________ per order

1020AE Wait Time – Osceola County orders $__________ per order

1020AF Wait Time – Lake County

Option Year 2: October 1, 2019 through September 30, 2020

LINE ITEM

NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

Orange County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Orange County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Orange County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Volusia County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Volusia County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Volusia County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Seminole County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Seminole County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

Seminole County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Brevard County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Brevard County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Brevard County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Osceola County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Osceola County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Osceola County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433) orders

$__________ per order

Lake County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Lake County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Lake County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

2019 Mileage Rate – per County (A0425)

2019AA Mileage Rate – Orange County 23,100 miles

$__________ per mile

2019AB Mileage Rate – Orange County 9,576 miles

$__________ per mile

2019AC Mileage Rate – Orange County 2,756 miles

$__________ per mile

2019AD Mileage Rate – Orange County 9,444 miles

$__________ per mile

2019AE Mileage Rate – Osceola County 6,312 miles

$__________ per mile

2019AF Mileage Rate – Lake County

NUMBER

(CLIN)

DESCRIPTION OF SERVICES

ESTIMATED

QUANTITIES

UNIT PRICE

2020AA Wait Time – Orange County orders $__________ per order

2020AB Wait Time – Orange County orders $__________ per order

2020AC Wait Time – Orange County orders $__________ per order

2020AD Wait Time – Orange County orders $__________ per order

2020AE Wait Time – Osceola County orders $__________ per order

2020AF Wait Time – Lake County

Option Year 3: October 1, 2020 through September 30, 2021

LINE ITEM

NUMBER

(CLIN)

DESCRIPTION OF SERVICES ESTIMATED

QUANTITIES UNIT PRICE

Orange County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Orange County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Orange County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Volusia County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Volusia County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Volusia County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Seminole County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Seminole County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

NUMBER

(CLIN)

DESCRIPTION OF SERVICES ESTIMATED

QUANTITIES UNIT PRICE

Seminole County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Brevard County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Brevard County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Brevard County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Osceola County Basic Life Support (BLS) Ambulance Transportation (A0428)

Osceola County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Osceola County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433) orders

$__________ per order

Lake County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Lake County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Lake County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

3019 Mileage Rate – per County (A0425)

3019AA Mileage Rate – Orange County 23,100 miles

$__________ per mile

3019AB Mileage Rate – Orange County 9,576 miles

$__________ per mile

3019AC Mileage Rate – Orange County 2,756 miles

$__________ per mile

3019AD Mileage Rate – Orange County 9,444 miles

$__________ per mile

3019AE Mileage Rate – Osceola County 6,312 miles

$__________ per mile

3019AF Mileage Rate – Lake County

NUMBER

(CLIN)

DESCRIPTION OF SERVICES ESTIMATED

QUANTITIES UNIT PRICE

3020AA Wait Time – Orange County orders $__________ per order

3020AB Wait Time – Orange County orders $__________ per order

3020AC Wait Time – Orange County orders $__________ per order

3020AD Wait Time – Orange County orders $__________ per order

3020AE Wait Time – Osceola County orders $__________ per order

3020AF Wait Time – Lake County

Option Year 4: October 1, 2021 through September 30, 2022

LINE ITEM

NUMBER

(CLIN)

DESCRIPTION OF SERVICES ESTIMATED

QUANTITIES UNIT PRICE

Orange County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Orange County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Orange County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Volusia County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Volusia County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Volusia County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Seminole County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Seminole County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

NUMBER

(CLIN)

DESCRIPTION OF SERVICES ESTIMATED

QUANTITIES UNIT PRICE

Seminole County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Brevard County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Brevard County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Brevard County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Osceola County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Osceola County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Osceola County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433) orders

$__________ per order

Lake County Basic Life Support (BLS) Ambulance Transportation Rate (A0428)

Lake County Advanced Life Support 1 (ALS1) Ambulance Transportation Rate (A0426)

Lake County Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

4019 Mileage Rate – per County (A0425)

4019AA Mileage Rate – Orange County 23,100 miles

$__________ per mile

4019AB Mileage Rate – Orange County 9,576 miles

$__________ per mile

4019AC Mileage Rate – Orange County 2,756 miles

$__________ per mile

4019AD Mileage Rate – Orange County 9,444 miles

$__________ per mile

4019AE Mileage Rate – Osceola County 6,312 miles

$__________ per mile

4019AF Mileage Rate – Lake County 3,864

NUMBER

(CLIN)

DESCRIPTION OF SERVICES ESTIMATED

QUANTITIES UNIT PRICE

4020AA Wait Time – Orange County orders $__________ per order

4020AB Wait Time – Orange County orders $__________ per order

4020AC Wait Time – Orange County orders $__________ per order

4020AD Wait Time – Orange County orders $__________ per order

4020AE Wait Time – Osceola County orders $__________ per order

4020AF Wait Time – Lake County

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