Attach 1 - Price Schedule.xlsx

XLSX spreadsheet 32 KB Posted Jul 8, 2022

Attached to: V225--Ground Ambulance Service 1. Questions and Answers 2. Updated PWS 3. Quote due date extended to 12 Aug 2022 Federal contract opportunity
Solicitation number: 36C26122Q0486
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21

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Other files for this federal contract opportunity

Other files attached to V225--Ground Ambulance Service 1. Questions and Answers 2. Updated PWS 3. Quote due date extended to 12 Aug 2022, newest first.
File	Type	Posted
P09 - PWS - Updated 2 Aug 2022.docx	DOCX document	Aug 2, 2022
36C26122Q0486_4.docx	DOCX document	Aug 2, 2022
Questions - Ground Ambulance Palo Alto - UPDATED 2 AUGUST.docx	DOCX document	Aug 2, 2022
Attach 4 - Past Performance Survey.docx	DOCX document	Jul 8, 2022
Attach 3 - QASP.docx	DOCX document	Jul 8, 2022
Attach 2 - P07 - Wages - Combined.pdf	PDF	Jul 8, 2022
36C26122Q0486_3.docx	DOCX document	Jul 8, 2022
S02 - 36C26122Q0486.docx	DOCX document	Jul 8, 2022
36C26122Q0486_2.docx	DOCX document	Jul 8, 2022

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VA Palo Alto

Caller/Location Code	Name	Address
VAPAL	VAPAHCS	3801 Miranda Ave, Palo Alto, CA 94304
HVCC/CAPCL/HSCV	VA Capitola Clinic	1350 N 41st St, STE 102, Capitola, CA 95010
VACSJ	VA San Jose Clinic	5855 Silver Creek Valley Pl, San Jose, CA 95138
HMPV	VA Menlo Park Division	795 Willow Rd, Menlo Park, CA 94025
P6302	VA Livermore Division	4951 Arroyo Rd, Livermore, CA 94550
P1512	VA Fremont Clinic	39199 Liberty St. Bldg B., Fremont, CA 94538
CVAM/VACL	VA Modesto Clinic	1225 Oakdale Rd. Modesto, CA 95355
6301	VA Stockton Clinic	500 W Hospital Rd. French Camp, CA 95231
CVASNN/P5467	VA Sonora Clinic	13663 Mono Wy. Sonora, CA 95370
WGVA	VA Montery Clinic	201 9th St. Marina, CA 93933

	getting clarification from AMR CAT on loc codes
Service Areas:
Type of Service:
All TOS

Lot 4

640-23-1-425-0002 Ground Ambulance Services	Contract code 1800
Lot 4 - San Joaquin, Stanislaus	VA Palo Alto
VAPAHCS		7/1/2018-6/30/2019

Base Period 10/1/22-9/30/23 Option Year #1 10/1/23-9/30/24 Option Year #2 10/1/24-9/30/25 Option Year #3 10/1/25-9/30/26 Option Year #4

10/1/26-9/30/27 PO# 640-C19200

Base Period

10/1/22-9/30/27					Medicare
NRT	Avg Charged Miles	Medicare vs VA mileage	Mileage $ Adj	Medicare NRT adusted for VA Mileage	Medicare % to VA
		CLIN	Description	Est. Qty	Unit Price	Total Price	Unit	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price
		0001	Base Rate - BLS ground ambulance service for pre-authorized Veterans	5	$ - 0	$ - 0	Trip	$ - 0	$ - 0	0.00	$ - 0	0.00	$ - 0	0.00	$ - 0	458.96	$ 269.06	10.81	ERROR:#REF!	ERROR:#REF!	ERROR:#REF!	ERROR:#REF!
		0002	Base Rate - ALS ground ambulance service for pre-authorized Veterans	2	$ - 0	$ - 0	Trip	$ - 0	$ - 0	0.00	$ - 0	0.00	$ - 0	0.00	$ - 0	540.79	$ 476.33	26.06	ERROR:#REF!	ERROR:#REF!	ERROR:#REF!	ERROR:#REF!
		0003	Base Rate - CCT ground ambulance service for pre-authorized Veterans	1	$ - 0	$ - 0	Trip	$ - 0	$ - 0	0.00	$ - 0	0.00	$ - 0	0.00	$ - 0	3719.38
		0004	Mileage Rate	1,500	0.00	$0.00	Trip	$ - 0	$ - 0	0.00	$ - 0	0.00	$ - 0	0.00	$ - 0	10.35	$ 7.40
		0005	Oxygen		0.00	$0.00	Trip	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
			Dry Runs at 1/2 of base rate		0.00	$0.00	Trip	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
						$ - 0			$ - 0		$ - 0		$ - 0		$ - 0

The VAPAHCS has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 0001-0004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 0005.

Contract Code Base Period 10/1/22-9/30/23 Option Year #1 10/1/23-9/30/24 Option Year #2 10/1/24-9/30/25 Option Year #3 10/1/25-9/30/26 Option Year #4

10/1/26-9/30/27 PO# 640-C19200

Base Period 10/1/23-9/30/28

		CLIN	Description	Est. Qty	Unit Price	Total Price	Unit	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price
	180R	0006	BLS ground ambulance service for pre-authorized Veterans
Stockton, CA VA to VAPAHCS (75 miles)	5	$0.00	$0.00	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	1056.07	$8,448.56
	180R	0007	ALS ground ambulance service for pre-authorized Veterans
Stockton, CA VA to VAPAHCS (75 miles)	3	$0.00	$0.00	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	1126.02	$3,378.06
	180S	0008	BLS ground ambulance service for pre-authorized Veterans

Stockton, CA VA to San Joaquin Community Hospital

(226 miles)	5	$0.00	$0.00	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	2392.42	$19,139.36
	180S	0009	ALS ground ambulance service for pre-authorized Veterans

Stockton, CA VA to San Joaquin Community Hospital

(226 miles)	3	$0.00	$0.00	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	2462.37	$7,387.11
	180S	0010	CCT ground ambulance service for pre-authorized Veterans

Stockton, CA VA to San Joaquin Community Hospital

2	$0.00	$0.00	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	3179.34	$6,358.68
180V	0011	BLS Roundtrip ambulance service for pre-authorized Veteran

Dialysis Treatment from residence to Satellite Dialysis Modesto, CA (distance is .3 miles one-way)

86	$0.00	$0.00	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	802.34	$64,989.54
		TOTAL PRICE/YEAR:	104	$0.00	$0.00		0	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
			104	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$11,018.56	$109,701.31

Lot 4
Total Price Base Period:	$0.00	0
Total Price OY1:	$0.00	28507.358
Total Price OY2:	$0.00	$0.00
Total Price OY3:	$0.00
Total Price OY4:	$0.00
TOTAL PRICE Base+OY1+OY2+OY3+OY4	$0.00

Lot 5

640-23-1-425-0002 Ground Ambulance Services	Contract code 1805
Lot 5 - Tuolumne	VA Palo Alto
VAPAHCS

Base Period 10/1/22-9/30/23 Optional Year #1 10/1/23-9/30/24 Optional Year #2 10/1/24-9/30/25 Optional Year #3 10/1/25-9/30/26 Optional Year Period 10/1/26-9/30/27

CLIN	Description	Est. Qty	Unit	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price
0001	Base Rate - BLS ground ambulance service for pre-authorized Veterans	1	Trip	$0.00	$ - 0	$ - 0	$ - 0	0.00	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
0002	Base Rate - ALS ground ambulance service for pre-authorized Veterans	1	Trip	$0.00	$ - 0	0.00	$ - 0	0.00	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
0003	Base Rate - CCT ground ambulance service for pre-authorized Veterans	1	Trip	$0.00	$ - 0	0.00	$ - 0	0.00	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
0004	Mileage Rate	250		$ - 0	$ - 0	0.00	$ - 0	0.00	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
0005	Oxygen			0.00		0		0.00		0.00		0.00
	Dry Runs at 1/2 of base rate
				$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
The VAPAHCS has certain destinations that passengers are repeatedly transported to and from. The price for the destinations below shall constitute final one-way transport price. Trips other than these listed below, will be billed in accordance with CLINS 0001-0004 above. The destinations below are interchangeable (for example, X to Y and may also be Y to X). If oxygen is required, it will be charged in accordance with CLIN 0005.

Contract Code

10/1/22-9/30/23 Option Year #1 10/1/22-9/30/24 Option Year #2 10/1/22-9/30/25 Option Year #3 10/1/22-9/30/26 Option Year #4 10/1/22-9/30/27

		CLIN	Description	Est. Qty	Unit	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price
	180T	0006	BLS ground ambulance service for pre-authorized Veterans
Sonora VA clinic to Sonora Regional Medical Center (1.6 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180T	0007	ALS ground ambulance service for pre-authorized Veterans
Sonora VA clinic to Sonora Regional Medical Center (1.6 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180X	0008	BLS ground ambulance service for pre-authorized Veterans
Sonora VA clinic or Sonora Regional Medical Center to the VAPAHCS 130 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180X	0009	ALS ground ambulance service for pre-authorized Veterans
Sonora VA clinic or Sonora Regional Medical Center to the VAPAHCS 130 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
			TOTAL PRICE/YEAR:	4		$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
			Lot 5
			Total Price Base Period:	$ - 0
			Total Price OY1:	$0.00
			Total Price OY2:	$ - 0
			Total Price OY3:	$ - 0
			Total Price OY4:	$ - 0
			TOTAL PRICE Base+OY1+OY2+OY3+OY4	$ - 0

Lot 6 PAD

640-23-1-425-0002 Ground Ambulance Services	Contract code 1800
Lot 6 - Santa Clara, Alameda, San Benito, San Mateo, Santa Cruz, Monterey	VA Palo Alto
VAPAHCS and VANCHCS (Alameda)		7/1/2018-6/30/2019

Base Period 10/1/22-9/30/23 Option Year #1 10/1/23-9/30/24 Option Year #2 10/1/24-9/30/25 Option Year #3

10/1/25-9/30/26		Option Year #4
10/1/26-9/30/27				VA Avg Miles Charged	VA NRT with Mileage		Medicare
NRT	Avg Charged Miles	Medicare vs VA mileage	Mileage $ Adj	Medicare NRT adusted for VA Mileage
		CLIN	Description	Est. Qty	Unit	Unit Cost	Estimated Total Cost	Unit Price	Estimated Total Cost	Unit Price	Estimated Total Cost	Unit Price	Estimated Total Cost	Unit Price	Estimated Total Cost
		0001	Base Rate - BLS ground ambulance service for pre-authorized Veterans	75	Trip	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	31	$ - 0	$ 271.57	7.29	23.71	$ 175.45	$ 447.02
		0002	Base Rate - ALS ground ambulance service for pre-authorized Veterans	60	Trip	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	65	$ - 0	$ 411.98	23.06	41.94	$ 310.36	$ 722.34
		0003	Base Rate - CCT ground ambulance service for pre-authorized Veterans	5	Trip	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	39	$ - 0
		0004	Mileage Rate	5,000	MILE	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00			$ 7.40
		0005	Oxygen (included in the base rate)		EA	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00
			Dry Runs at 1/2 of base rate			0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00	0.00	$0.00
			TOTAL PRICE/YEAR:				$0.00		$0.00		$0.00		$0.00		$0.00

Contract Code

10/1/22-9/30/23 Option Year #1 10/1/23-9/30/24 Option Year #2 10/1/2024-9/30/25 Option Year #3 10/1/25-9/30/26 Option Year #4 10/1/26-9/30/27

		CLIN	Description	Est. Qty	Unit	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price	Unit Price	Total Price
	180A	0006	BLS ground ambulance service for pre-authorized Veterans
VA Menlo Park Division (MPD) to VAPAHCS (7 miles one-way)	100	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180A	0007	ALS ground ambulance service for pre-authorized Veterans
VA Menlo Park Division (MPD) to VAPAHCS (7 miles one-way)	40	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180A	0008	CCT ground ambulance service for pre-authorized Veterans
VA Menlo Park Division (MPD) to VAPAHCS (7 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180B	0009	BLS ground ambulance service for pre-authorized Veterans
Stanford to VAPAHCS (2.5 miles one-way)	30	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180B	0010	ALS ground ambulance service for pre-authorized Veterans
Stanford to VAPAHCS (2.5 miles one-way)	30	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180B	0011	CCT ground ambulance service for pre-authorized Veterans
Stanford to VAPAHCS (2.5 miles one-way)	3	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180C	0012	BLS ground ambulance service for pre-authorized Veterans
Monterey VA Clinic to CHOMP (9.2 miles one-way)	5	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180C	0013	ALS ground ambulance service for pre-authorized Veterans
Monterey VA Clinic to CHOMP (9.2 miles one-way)	40	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180C	0014	CCT ground ambulance service for pre-authorized Veterans
Monterey VA Clinic to CHOMP (9.2 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180D	0015	BLS ground ambulance service for pre-authorized Veterans
Monterey VA Clinic to VAPAHCS (76 miles one-way)	5	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180D	0016	ALS ground ambulance service for pre-authorized Veterans
Monterey VA Clinic to VAPAHCS (76 miles one-way)	15	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180D	0017	CCT ground ambulance service for pre-authorized Veterans
Monterey VA Clinic to VAPAHCS (76 miles one-way)	2	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180F	0018	BLS ground ambulance service for pre-authorized Veterans
San Jose VA Clinic to VAPAHCS (29 miles one-way)	25	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180F	0019	ALS ground ambulance service for pre-authorized Veterans
San Jose VA Clinic to VAPAHCS (29 miles one-way)	12	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180F	0020	CCT ground ambulance service for pre-authorized Veterans
San Jose VA Clinic to VAPAHCS (29 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180G	0021	BLS ground ambulance service for pre-authorized Veterans
Livermore VA Clinic to VAPAHCS) (38 miles one-way)	60	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180G	0022	ALS ground ambulance service for pre-authorized Veterans
Livermore VA Clinic to VAPAHCS (38 miles one-way)	20	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
	180G	0023	CCT ground ambulance service for pre-authorized Veterans
Livermore VA Clinic to VAPAHCS (38 miles one-way)	1	Trip	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0	$ - 0
			TOTAL PRICE/YEAR:	391		$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	0	$0.00	$0.00	$0.00
							$0.00
			Lot 4, Lot 5 & Lot 6
			Total Price Base Period:	$0.00
			Total Price OY1:	$0.00
			Total Price OY2:	$0.00
			Total Price OY3:	$0.00
			Total Price OY4:	$0.00
			TOTAL PRICE Base+OY1+OY2+OY3+OY4	$0.00
			Lot 6
			Total Price Base Period:	$0.00
			Total Price OY1:	$0.00
			Total Price OY2:	$0.00
			Total Price OY3:	$0.00
			Total Price OY4:	$0.00
			TOTAL PRICE Base+OY1+OY2+OY3+OY4	$0.00

File details come from the government source that posted it. Updated Jul 8, 2022.