6100066109 Attachment A - Cost Submittal.xlsx

XLSX spreadsheet 64 KB Posted

Attached to
Mobile Diagnostic Imaging Services
Solicitation number
6100066109
Issued by
Adams County, Jefferson County, Luzerne County, Montgomery County, Philadelphia County, Lower Burrell City, Pennsylvania

About this file

This is a Cost Submittal spreadsheet for an Invitation for Bid (IFB #6100066109) issued by the Department of Human Services (DHS), Bureau of Procurement & Contract Management, for Mobile Diagnostic Imaging Services across five facilities of the Bureau of Juvenile Justice Services in Pennsylvania. The solicitation is structured as five separate lots, each corresponding to a specific facility: Loysville Complex (LYDC), Northeast Secure Treatment Unit (NESTU), South Mountain Secure Treatment Unit (SMSTU), Southeast Youth Development Center (SYDC), and Youth Forestry Camp #3 (YDC#3). Contractors may submit bids for one or multiple lots but must complete all pricing lines for any lot submitted. Services include routine and STAT mobile x-rays, ultrasound studies, electrocardiography (EKG), Holter monitors, echocardiography, pulmonary function studies, and mammograms. Each facility lot includes an estimated quantity of 2,030 service units annually across 70 different diagnostic imaging service line items, with unit prices to be provided by vendors on a per-service basis.

All pricing must be inclusive of travel and administrative expenses, with vendors required to input unit prices only in designated yellow-highlighted cells on the spreadsheet. Contractors must complete and sign the Cost Submittal Spreadsheet as a mandatory condition of bid submission; failure to do so will result in bid rejection. The completed cost submittal sheet submitted by the vendor is considered final. All submissions must be submitted electronically. The solicitation permits vendors to bid competitively on individual facility locations, allowing for multiple contract awards across the five DHS facilities with mobile diagnostic imaging services to be performed on-site at each facility location.

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Instructions

DHS Bureau of Procurement & Contract Management

IFB Facility Mobile Diagnostic Imaging Services

The selected Contractor shall complete and sign the Cost Submittal Spreadsheet.
Instructions:
This solicitation is divided into five Lots for each DHS Bureau of Juvenile Justice Services facility. Contractors may choose to submit a signed bid for one Lot or multiple Lots but must complete all lines for any lot they are submitting a bid. Contractors must sign their submitted bid.

Failure to complete and submit this Cost Submittal Spreadsheet with your bid submissiong, as instructed, will result in the rejection of the contractor’s bid. Please indicate the locations (Lots) that you are submitting a bid for by marking an X to the left of your Lot selection.

(For Example: _X_Lot 1 Loysville Complex)

____Lot 1 Loysville Complex ("LYDC") 8 Opportunity Drive Loysville, PA 17047

____Lot 2 Northeast Secure Treatment Unit (“NESTU”) 701 Sathers Drive Pittston, PA 18640

____Lot 3 South Mountain Secure Treatment Unit ("SMSTU") 10056 South Mountain Road South Mountain, PA. 17261

____Lot 4 Southeast Youth Development Center (“SYDC”) 1212 Mokychic Drive, Bld. 12 Schwenksville, PA. 19473

____Lot 5 Youth Forestry Camp #3 (“YDC#3”) 4534 Tar Kiln Road James Creek, PA 16657

*Supplier will only need to input responses in the yellow highlighted areas. Other fields will populate.
**All rates must be inclusive of all travel and administrative expenses.
*** The completed Cost Submittal Sheet attached to the vendor's submission is considered final.
****All submissions must be submitted electronically.

Facility Cost Submittal IFB #6100066109 Facility Mobile Diagnostic Imaging Services

CONTACT INFORMATION

First Name: Last Name:

Street Address:

City:

State: Zip Code:

Phone Number: E-mail Address:

Vendor Name:

Vendor Number: Contract No.:

LotDescriptionEstimated Quantity
(Service Location)Unit of Measure (EA = Lot)Facility Service Location/Lot TotalAnnual Total
1Loysville Complex1EA$0.00
2Northeast Secure Treatment Unit (NSTU)1EA$0.00
3South Mountain Secure Treatment Unit (SMSTU)1EA$0.00
4Southeast Youth Development Center1EA$0.00
5Youth Forestry Camp #31EA$0.00
Total Annual Cost$0.00
Signature of Vendor:
*Supplier will only need to input responses in the yellow highlighted areas. Other fields will populate.
**All rates must be inclusive of all travel and administrative expenses.
*** The completed Cost Submittal Sheet attached to the vendor's submission is considered final.
****All submissions must be submitted electronically.

LOT 1 LYDC

Loysville Complex - Price List
DescriptionQuantityUOMUnit PriceTotal
Abdomen 1 - View30Each$0.00
Abdomen 2 - View30Each$0.00
Abdomen 3 - View30Each$0.00
Ankle (AP & Oblique, Lateral)30Each$0.00
Bone Density Study15Each$0.00
Set-up fee for Bone Density Study15Each$0.00
Calcaneus30Each$0.00
Cervical Spine (AP & Lateral)30Each$0.00
Chest (AP)30Each$0.00
Chest (AP & Lateral)30Each$0.00
Clavicle (AP, AP Angle 15 degrees)30Each$0.00
Dorsal Spine30Each$0.00
Echocardiogram30Each$0.00
Electrocardiogram (EKG) with Interpretation30Each$0.00
EKG Set-up Fee30Each$0.00
Elbow (AP & Oblique, Lateral)30Each$0.00
Elbow Complete30Each$0.00
Facial Bones (water, lateral arches)30Each$0.00
Femur (AP & Lateral)30Each$0.00
Finger30Each$0.00
Foot Complete 3V30Each$0.00
Foot (AP & Lateral)30Each$0.00
Forearm (AP & Lateral)30Each$0.00
Hand (AP & Oblique, Lateral)30Each$0.00
Hand 3 Views30Each$0.00
Hip Unilateral30Each$0.00
Hip Bilateral Pelvis30Each$0.00
Holter/Print out/RPT interpretation30Each$0.00
Humerus (AP & Lateral)30Each$0.00
Knee (AP & Lateral)30Each$0.00
Knee 3 Views30Each$0.00
Lower Leg (AP & Lateral)30Each$0.00
Lumbar Spine (AP & Lateral)30Each$0.00
Mammogram (bilateral)30Each$0.00
Mammogram (unilateral)30Each$0.00
Mammogram Set-up fee/Site Visit30Each$0.00
Mandiblie30Each$0.00
Nasal Bones (waters, both laterals)30Each$0.00
Orbit30Each$0.00
Pelvis30Each$0.00
Ribs (bilateral)30Each$0.00
Ribs (unilateral)30Each$0.00
Sacrum/Coccyx MIN V230Each$0.00
Scapula Complete30Each$0.00
Shoulder (Internal & External)30Each$0.00
Sinuses (waters PA lateral)30Each$0.00
Skull (AP, townes, both laterals)30Each$0.00
Tibia/Fibula30Each$0.00
Toe30Each$0.00
Thoracic Spine (AP & Lateral)30Each$0.00
Ultrasound - Breast30Each$0.00
Ultrasound - Abdomen Complete30Each$0.00
Ultrasound - Renal Retroperitone30Each$0.00
Ultrasound - Pelvis Complete30Each$0.00
Ultrasound - Pelvis Limited30Each$0.00
Ultrasound - Extremity30Each$0.00
Ultrasound - Thyoid30Each$0.00
Ultrasound - Gall Bladder US30Each$0.00
Ultrasound - Scrotum30Each$0.00
Vascular Studies30Each$0.00
Wrist (AP, Oblique & Lateral)30Each$0.00
Wrist Complete30Each$0.00
X-ray Set-up Fees50Each$0.00
Arteries Dopler-Cartoid30Each$0.00
Artierial Bilateral30Each$0.00
Arterial Duplex Scan30Each$0.00
Ven Doppler Extremity/Limited30Each$0.00
Pulmonary Function Test30Each$0.00
Total QTY2030EachAnnual Total$0.00

LOT 2 NESTU

Northeast Secure Treatment Unit - Price List
DescriptionQuantityUOMUnit PriceTotal
Abdomen 1 - View30Each$0.00
Abdomen 2 - View30Each$0.00
Abdomen 3 - View30Each$0.00
Ankle (AP & Oblique, Lateral)30Each$0.00
Bone Density Study15Each$0.00
Set-up fee for Bone Density Study15Each$0.00
Calcaneus30Each$0.00
Cervical Spine (AP & Lateral)30Each$0.00
Chest (AP)30Each$0.00
Chest (AP & Lateral)30Each$0.00
Clavicle (AP, AP Angle 15 degrees)30Each$0.00
Dorsal Spine30Each$0.00
Echocardiogram30Each$0.00
Electrocardiogram (EKG) with Interpretation30Each$0.00
EKG Set-up Fee30Each$0.00
Elbow (AP & Oblique, Lateral)30Each$0.00
Elbow Complete30Each$0.00
Facial Bones (water, lateral arches)30Each$0.00
Femur (AP & Lateral)30Each$0.00
Finger30Each$0.00
Foot Complete 3V30Each$0.00
Foot (AP & Lateral)30Each$0.00
Forearm (AP & Lateral)30Each$0.00
Hand (AP & Oblique, Lateral)30Each$0.00
Hand 3 Views30Each$0.00
Hip Unilateral30Each$0.00
Hip Bilateral Pelvis30Each$0.00
Holter/Print out/RPT interpretation30Each$0.00
Humerus (AP & Lateral)30Each$0.00
Knee (AP & Lateral)30Each$0.00
Knee 3 Views30Each$0.00
Lower Leg (AP & Lateral)30Each$0.00
Lumbar Spine (AP & Lateral)30Each$0.00
Mammogram (bilateral)30Each$0.00
Mammogram (unilateral)30Each$0.00
Mammogram Set-up fee/Site Visit30Each$0.00
Mandiblie30Each$0.00
Nasal Bones (waters, both laterals)30Each$0.00
Orbit30Each$0.00
Pelvis30Each$0.00
Ribs (bilateral)30Each$0.00
Ribs (unilateral)30Each$0.00
Sacrum/Coccyx MIN V230Each$0.00
Scapula Complete30Each$0.00
Shoulder (Internal & External)30Each$0.00
Sinuses (waters PA lateral)30Each$0.00
Skull (AP, townes, both laterals)30Each$0.00
Tibia/Fibula30Each$0.00
Toe30Each$0.00
Thoracic Spine (AP & Lateral)30Each$0.00
Ultrasound - Breast30Each$0.00
Ultrasound - Abdomen Complete30Each$0.00
Ultrasound - Renal Retroperitone30Each$0.00
Ultrasound - Pelvis Complete30Each$0.00
Ultrasound - Pelvis Limited30Each$0.00
Ultrasound - Extremity30Each$0.00
Ultrasound - Thyoid30Each$0.00
Ultrasound - Gall Bladder US30Each$0.00
Ultrasound - Scrotum30Each$0.00
Vascular Studies30Each$0.00
Wrist (AP, Oblique & Lateral)30Each$0.00
Wrist Complete30Each$0.00
X-ray Set-up Fees50Each$0.00
Arteries Dopler-Cartoid30Each$0.00
Artierial Bilateral30Each$0.00
Arterial Duplex Scan30Each$0.00
Ven Doppler Extremity/Limited30Each$0.00
Pulmonary Function Test30Each$0.00
Total QTY2030EachAnnual Total$0.00

LOT 3 SMSTU

South Mountain Secure Treatment Unit - Price List
DescriptionQuantityUOMUnit PriceTotal
Abdomen 1 - View30Each$0.00
Abdomen 2 - View30Each$0.00
Abdomen 3 - View30Each$0.00
Ankle (AP & Oblique, Lateral)30Each$0.00
Bone Density Study15Each$0.00
Set-up fee for Bone Density Study15Each$0.00
Calcaneus30Each$0.00
Cervical Spine (AP & Lateral)30Each$0.00
Chest (AP)30Each$0.00
Chest (AP & Lateral)30Each$0.00
Clavicle (AP, AP Angle 15 degrees)30Each$0.00
Dorsal Spine30Each$0.00
Echocardiogram30Each$0.00
Electrocardiogram (EKG) with Interpretation30Each$0.00
EKG Set-up Fee30Each$0.00
Elbow (AP & Oblique, Lateral)30Each$0.00
Elbow Complete30Each$0.00
Facial Bones (water, lateral arches)30Each$0.00
Femur (AP & Lateral)30Each$0.00
Finger30Each$0.00
Foot Complete 3V30Each$0.00
Foot (AP & Lateral)30Each$0.00
Forearm (AP & Lateral)30Each$0.00
Hand (AP & Oblique, Lateral)30Each$0.00
Hand 3 Views30Each$0.00
Hip Unilateral30Each$0.00
Hip Bilateral Pelvis30Each$0.00
Holter/Print out/RPT interpretation30Each$0.00
Humerus (AP & Lateral)30Each$0.00
Knee (AP & Lateral)30Each$0.00
Knee 3 Views30Each$0.00
Lower Leg (AP & Lateral)30Each$0.00
Lumbar Spine (AP & Lateral)30Each$0.00
Mammogram (bilateral)30Each$0.00
Mammogram (unilateral)30Each$0.00
Mammogram Set-up fee/Site Visit30Each$0.00
Mandiblie30Each$0.00
Nasal Bones (waters, both laterals)30Each$0.00
Orbit30Each$0.00
Pelvis30Each$0.00
Ribs (bilateral)30Each$0.00
Ribs (unilateral)30Each$0.00
Sacrum/Coccyx MIN V230Each$0.00
Scapula Complete30Each$0.00
Shoulder (Internal & External)30Each$0.00
Sinuses (waters PA lateral)30Each$0.00
Skull (AP, townes, both laterals)30Each$0.00
Tibia/Fibula30Each$0.00
Toe30Each$0.00
Thoracic Spine (AP & Lateral)30Each$0.00
Ultrasound - Breast30Each$0.00
Ultrasound - Abdomen Complete30Each$0.00
Ultrasound - Renal Retroperitone30Each$0.00
Ultrasound - Pelvis Complete30Each$0.00
Ultrasound - Pelvis Limited30Each$0.00
Ultrasound - Extremity30Each$0.00
Ultrasound - Thyoid30Each$0.00
Ultrasound - Gall Bladder US30Each$0.00
Ultrasound - Scrotum30Each$0.00
Vascular Studies30Each$0.00
Wrist (AP, Oblique & Lateral)30Each$0.00
Wrist Complete30Each$0.00
X-ray Set-up Fees50Each$0.00
Arteries Dopler-Cartoid30Each$0.00
Artierial Bilateral30Each$0.00
Arterial Duplex Scan30Each$0.00
Ven Doppler Extremity/Limited30Each$0.00
Pulmonary Function Test30Each$0.00
Total QTY2030EachAnnual Total$0.00

LOT 4 SYDC

Southeast Youth Development Center - Price List
DescriptionQuantityUOMUnit PriceTotal
Abdomen 1 - View30Each$0.00
Abdomen 2 - View30Each$0.00
Abdomen 3 - View30Each$0.00
Ankle (AP & Oblique, Lateral)30Each$0.00
Bone Density Study15Each$0.00
Set-up fee for Bone Density Study15Each$0.00
Calcaneus30Each$0.00
Cervical Spine (AP & Lateral)30Each$0.00
Chest (AP)30Each$0.00
Chest (AP & Lateral)30Each$0.00
Clavicle (AP, AP Angle 15 degrees)30Each$0.00
Dorsal Spine30Each$0.00
Echocardiogram30Each$0.00
Electrocardiogram (EKG) with Interpretation30Each$0.00
EKG Set-up Fee30Each$0.00
Elbow (AP & Oblique, Lateral)30Each$0.00
Elbow Complete30Each$0.00
Facial Bones (water, lateral arches)30Each$0.00
Femur (AP & Lateral)30Each$0.00
Finger30Each$0.00
Foot Complete 3V30Each$0.00
Foot (AP & Lateral)30Each$0.00
Forearm (AP & Lateral)30Each$0.00
Hand (AP & Oblique, Lateral)30Each$0.00
Hand 3 Views30Each$0.00
Hip Unilateral30Each$0.00
Hip Bilateral Pelvis30Each$0.00
Holter/Print out/RPT interpretation30Each$0.00
Humerus (AP & Lateral)30Each$0.00
Knee (AP & Lateral)30Each$0.00
Knee 3 Views30Each$0.00
Lower Leg (AP & Lateral)30Each$0.00
Lumbar Spine (AP & Lateral)30Each$0.00
Mammogram (bilateral)30Each$0.00
Mammogram (unilateral)30Each$0.00
Mammogram Set-up fee/Site Visit30Each$0.00
Mandiblie30Each$0.00
Nasal Bones (waters, both laterals)30Each$0.00
Orbit30Each$0.00
Pelvis30Each$0.00
Ribs (bilateral)30Each$0.00
Ribs (unilateral)30Each$0.00
Sacrum/Coccyx MIN V230Each$0.00
Scapula Complete30Each$0.00
Shoulder (Internal & External)30Each$0.00
Sinuses (waters PA lateral)30Each$0.00
Skull (AP, townes, both laterals)30Each$0.00
Tibia/Fibula30Each$0.00
Toe30Each$0.00
Thoracic Spine (AP & Lateral)30Each$0.00
Ultrasound - Breast30Each$0.00
Ultrasound - Abdomen Complete30Each$0.00
Ultrasound - Renal Retroperitone30Each$0.00
Ultrasound - Pelvis Complete30Each$0.00
Ultrasound - Pelvis Limited30Each$0.00
Ultrasound - Extremity30Each$0.00
Ultrasound - Thyoid30Each$0.00
Ultrasound - Gall Bladder US30Each$0.00
Ultrasound - Scrotum30Each$0.00
Vascular Studies30Each$0.00
Wrist (AP, Oblique & Lateral)30Each$0.00
Wrist Complete30Each$0.00
X-ray Set-up Fees50Each$0.00
Arteries Dopler-Cartoid30Each$0.00
Artierial Bilateral30Each$0.00
Arterial Duplex Scan30Each$0.00
Ven Doppler Extremity/Limited30Each$0.00
Pulmonary Function Test30Each$0.00
Total QTY2030EachAnnual Total$0.00

LOT 5 YDC3

Youth Forestry Camp #3 - Price List
DescriptionQuantityUOMUnit PriceTotal
Abdomen 1 - View30Each$0.00
Abdomen 2 - View30Each$0.00
Abdomen 3 - View30Each$0.00
Ankle (AP & Oblique, Lateral)30Each$0.00
Bone Density Study15Each$0.00
Set-up fee for Bone Density Study15Each$0.00
Calcaneus30Each$0.00
Cervical Spine (AP & Lateral)30Each$0.00
Chest (AP)30Each$0.00
Chest (AP & Lateral)30Each$0.00
Clavicle (AP, AP Angle 15 degrees)30Each$0.00
Dorsal Spine30Each$0.00
Echocardiogram30Each$0.00
Electrocardiogram (EKG) with Interpretation30Each$0.00
EKG Set-up Fee30Each$0.00
Elbow (AP & Oblique, Lateral)30Each$0.00
Elbow Complete30Each$0.00
Facial Bones (water, lateral arches)30Each$0.00
Femur (AP & Lateral)30Each$0.00
Finger30Each$0.00
Foot Complete 3V30Each$0.00
Foot (AP & Lateral)30Each$0.00
Forearm (AP & Lateral)30Each$0.00
Hand (AP & Oblique, Lateral)30Each$0.00
Hand 3 Views30Each$0.00
Hip Unilateral30Each$0.00
Hip Bilateral Pelvis30Each$0.00
Holter/Print out/RPT interpretation30Each$0.00
Humerus (AP & Lateral)30Each$0.00
Knee (AP & Lateral)30Each$0.00
Knee 3 Views30Each$0.00
Lower Leg (AP & Lateral)30Each$0.00
Lumbar Spine (AP & Lateral)30Each$0.00
Mammogram (bilateral)30Each$0.00
Mammogram (unilateral)30Each$0.00
Mammogram Set-up fee/Site Visit30Each$0.00
Mandiblie30Each$0.00
Nasal Bones (waters, both laterals)30Each$0.00
Orbit30Each$0.00
Pelvis30Each$0.00
Ribs (bilateral)30Each$0.00
Ribs (unilateral)30Each$0.00
Sacrum/Coccyx MIN V230Each$0.00
Scapula Complete30Each$0.00
Shoulder (Internal & External)30Each$0.00
Sinuses (waters PA lateral)30Each$0.00
Skull (AP, townes, both laterals)30Each$0.00
Tibia/Fibula30Each$0.00
Toe30Each$0.00
Thoracic Spine (AP & Lateral)30Each$0.00
Ultrasound - Breast30Each$0.00
Ultrasound - Abdomen Complete30Each$0.00
Ultrasound - Renal Retroperitone30Each$0.00
Ultrasound - Pelvis Complete30Each$0.00
Ultrasound - Pelvis Limited30Each$0.00
Ultrasound - Extremity30Each$0.00
Ultrasound - Thyoid30Each$0.00
Ultrasound - Gall Bladder US30Each$0.00
Ultrasound - Scrotum30Each$0.00
Vascular Studies30Each$0.00
Wrist (AP, Oblique & Lateral)30Each$0.00
Wrist Complete30Each$0.00
X-ray Set-up Fees50Each$0.00
Arteries Dopler-Cartoid30Each$0.00
Artierial Bilateral30Each$0.00
Arterial Duplex Scan30Each$0.00
Ven Doppler Extremity/Limited30Each$0.00
Pulmonary Function Test30Each$0.00
Total QTY2030EachAnnual Total$0.00

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