S02 D.3 Fillable Schedule of Services - Locum GI Physician Services - 05-28-2026.xlsx

XLSX spreadsheet 20 KB Posted

Attached to
Q505--Locum Gastroenterology (GI) Physician Services MSO-2026-COM-0017
Solicitation number
36C25726Q0159
Issued by

About this file

This is a Fillable Schedule of Services pricing template for locum gastroenterology (GI) physician services under RFQ 36C25726Q0159 for the South Texas Veterans Health Care System. The contract covers a base year (08-01-2026 to 07-31-2027) with four optional renewal years extending through 07-31-2031.

The schedule includes three service line items for each contract period: (1) On-site Board Certified/Board Eligible GI Physicians services to be performed on-site at the South Texas Veterans Health Care System, with an estimated 9,181 hours annually; (2) On-Call GI Physician coverage defined as availability for urgent needs with response requirements per the Performance Work Statement, estimated at 3,868 hours annually; and (3) Call-Back GI Physician services occurring when on-call providers are contacted during on-call hours to report on-site, estimated at 180 hours annually. All services are priced on an hourly basis, with pricing to be filled in by the offeror. The template shows zero dollar amounts as placeholders and provides estimated annual totals and a grand total across all five contract years for calculation purposes.

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Other files

File Type Posted
36C25726Q0159 0004.docx DOCX document
S02 36C25726Q0159 - Locum GI Physician Services - Unrestricted Insufficient Small Businesses.docx DOCX document
36C25726Q0159 0003.docx DOCX document
S02 D.8 VHA Bookable Hour and Appointment Length Standards Memorandum - 05-28-2026.pdf PDF
S02 D.5 Contractor Rules of Behavior - 05-28-2026.docx DOCX document
S02 D.6 Contractor Certification - Immigration and Nationality Act - 05-28-2026.docx DOCX document
S02 D.7 Organizational Conflicts of Interest - 05-28-2026.docx DOCX document
S02 D.4 Past Performance Questionnaire Worksheet - Locum GI Physician Services - 05-28-2026.docx DOCX document
S02 D.1 Quality Assurance Surveillance Plan - Locum GI Physician Services - 05-28-2026.docx DOCX document
36C25726Q0159 0002.docx DOCX document
36C25726Q0159 0001.docx DOCX document
S02 D.5 Contractor Rules of Behavior.docx DOCX document
S02 D.8 VHA Bookable Hour and Appointment Length Standards Memorandum.pdf PDF
S02 D.4 Past Performance Questionnaire Worksheet - Locum GI Physician Services.docx DOCX document
S02 D.7 Organizational Conflicts of Interest.docx DOCX document
S02 D.1 Quality Assurance Surveillance Plan - Locum GI Physician Services.docx DOCX document
36C25726Q0159_1.docx DOCX document
S02 D.3 Fillable Schedule of Services - Locum GI Physician Services.xlsx XLSX spreadsheet
S02 D.6 Contractor Certification - Immigration and Nationality Act.docx DOCX document
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Base Year D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159

Base Year - 08-01-2026 to 07-31-2027
LIN No.SLIN No.Description of ServicesEstimated QuantityUnitUnit PriceEstimated Total Annual Price
0001NoneOn-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS.9181Hour (HR)$ - 0$ - 0
LIN 0001 Total$ - 0
0002NoneOn-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call-back coverage shall be paid at providers hourly rate included in LIN 0003.3868HR$ - 0$ - 0
LIN 0002 Total$ - 0
0003NoneCall-Back Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 0$ - 0
LIN 0003 Total$ - 0
Estimated Base Year Total$ - 0

Option Year One D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159

Option Year One - 08-01-2027 to 07-31-2028
LIN No.SLIN No.Description of ServicesEstimated QuantityUnitUnit PriceEstimated Total Annual Price
1001NoneOn-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS.9181Hour (HR)$ - 0$ - 0
LIN 1001 Total$ - 0
1002NoneOn-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003.3868HR$ - 0$ - 0
LIN 1002 Total$ - 0
1003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 0$ - 0
LIN 1003 Total$ - 0
Estimated Option Year One Total$ - 0

Option Year Two D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159

Option Year Two - 08-01-2028 to 07-31-2029
LIN No.SLIN No.Description of ServicesEstimated QuantityUnitUnit PriceEstimated Total Annual Price
2001NoneOn-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS.9181Hour (HR)$ - 0$ - 0
LIN 2001 Total$ - 0
2002NoneOn-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003.3868HR$ - 0$ - 0
LIN 2002 Total$ - 0
2003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 0$ - 0
LIN 2003 Total$ - 0
Estimated Option Year Two Total$ - 0

Option Year Three D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159

Option Year Three - 08-01-2029 to 07-31-2030
LIN No.SLIN No.Description of ServicesEstimated QuantityUnitUnit PriceEstimated Total Annual Price
3001NoneOn-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS.9181Hour (HR)$ - 0$ - 0
LIN 3001 Total$ - 0
3002NoneOn-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003.3868HR$ - 0$ - 0
LIN 3002 Total$ - 0
3003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 0$ - 0
LIN 3003 Total$ - 0
Estimated Option Year Three Total$ - 0

Option Year Four D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159

Option Year Four - 08-01-2030 to 07-31-2031
LIN No.SLIN No.Description of ServicesEstimated QuantityUnitUnit PriceEstimated Total Annual Price
4001NoneOn-site Board Certified/Board Eligible Gastroenterology (GI) Physicians: GI Physicians services as identified and must be accomplished on-site at the South Texas Veterans Health Care System in accordance with the PWS.9181Hour (HR)$ - 0$ - 0
LIN 4001 Total$ - 0
4002NoneOn-Call Gastroenterology (GI) Physician; On-Call coverage is defined as on-call availability. An on-call provider is one that is available to the VA in case of urgent need and shall respond to the VA point of contact as required in the performance work statement, and if clinically necessary, be available for call-back to provide onsite services. Call-back occurs when the provider is contacted during on-call hours and asked to report on-site to provide on-site services (see PWS paragraph 3.1.3.). Call back coverage shall be paid at providers hourly rate included in LIN 0003.3868HR$ - 0$ - 0
LIN 4002 Total$ - 0
4003NoneCallBack Gastroenterology (GI) Physician; Occurs when the provider is contacted during on-call availability to report on-site to provide services.180HR$ - 0$ - 0
LIN 4003 Total$ - 0
Estimated Option Year Four Total$ - 0

Estimated Grand Total

D.3 Fillable Schedule of Services - Locum GI Physician Services - RFQ 36C25726Q0159
Base Year$ - 0
Option Year One$ - 0
Option Year Two$ - 0
Option Year Three$ - 0
Option Year Four$ - 0
Estimated Grand Total$ - 0

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