2.2.1.1- ATTACHMENT 4_PRICING TEMPLATE_70B06C26R00000017 A0002_29Apr2026.xlsx

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Medical Support Services for CBP (including medical exams, fitness for duty, drug testing, and related services)
Solicitation number
70B06C26R00000017
Issued by

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Written by GovTribe AI ·

This is a Pricing Template for an Indefinite Delivery/Indefinite Quantity (IDIQ) firm fixed unit price contract for Medical Support Services with the U.S. Customs and Border Protection (CBP). The contract spans five 12-month ordering periods with a Total Estimated Contract Value (TECV) of $600,000, comprised of $520,000 in Ordering Period 1 (Base) and $20,000 in each subsequent ordering period. The contract number is 70B06C26R00000017 A0002, and the incumbent contractor is Comprehensive Health Services, LLC.

The pricing template requires offerors to provide unit pricing for over 115 numbered Contract Line Items (CLINs) across five service categories: Medical Examinations (including independent medical examinations, psychiatric evaluations, and no-show fees); Non-Psychiatric Consultations (tiered by document page count); Psychiatric Specialist Consultations (tiered by complexity and document length); Fitness Test Services (pre-employment fitness testing for various CBP positions including Border Patrol Agents, Customs and Border Protection Officers, and Agricultural Specialists); and Drug Program Services (blind samples, MRO meetings, pre-employment and post-employment drug testing, and expert testimony). Additional Medical Tests CLINs cover diagnostic services such as X-rays, EKGs, audiometry, and various laboratory panels. Two travel CLINs include Not-To-Exceed (NTE) amounts of $10,000 each for Medical Services Travel and MRO/Laboratory Travel, which offerors are prohibited from modifying. Development of Medical Standards and Clinical Policy Consultation CLINs are also included with an NTE hourly rate of $300 per hour for up to four hours. As an IDIQ contract, quantities provided are estimates only for evaluation purposes; actual orders will be placed at fixed unit prices with no guaranteed minimums, and offerors must be prepared to fulfill orders for any combination of CLINs as needed by the Government.

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Summary - TECV

DO NOT fill in values on this worksheet
70B06C26R00000017 SummaryTEV
Ordering Period 1$ 520,000.00
Ordering Period 2$ 20,000.00
Ordering Period 3$ 20,000.00
Ordering Period 4$ 20,000.00
Ordering Period 5$ 20,000.00
Total Estimated Contract Value [TECV]$ 600,000.00
Instructions for Completing the Pricing Schedule

ON the other worksheets, offerors must provide unit pricing for numbered CLINs listed. All unit prices should be entered in the designated column for each CLIN.

Travel Reimbursement: Travel costs will be reimbursed in accordance with Federal Travel Regulations. The values for travel are “Not-To-Exceed” (NTE) amounts and have already been entered in the pricing schedule. Offerors shall not modify these NTE values.

IDIQ Contract Structure: This solicitation is for an Indefinite Delivery/Indefinite Quantity (IDIQ) contract. The quantities provided in the pricing schedule are estimates only and are for evaluation purposes.

Actual orders will be placed using fixed unit price line items of funding for any combination of CLINs, based on the Government’s needs.

Order Placement: Orders may be placed for any CLIN(s) listed in the schedule, in any quantity, at the fixed unit price proposed.

Offerors are not guaranteed any minimum quantity and should be prepared to fulfill orders as required.

General Notes: Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors must incorporate such costs into their unit pricing.

Comprehensive Health Services, LLC U.S. Customs and Border Protection Solicitation: 70B06C20R00000044 Medical Services

Use or disclosure of data contained on this sheet is subject to the restrictions on the title page of this proposal.

OP1 (Base)

Ordering Period 170B06C26R00000017 A0002- Base [Ordering Period 1]
Instructions for Completing the Pricing Schedule

On the other worksheets, offerors must provide unit pricing for numbered CLINs listed. All unit prices should be entered in the designated column for each CLIN.

Travel Reimbursement: Travel costs will be reimbursed in accordance with Federal Travel Regulations. The values for travel are “Not-To-Exceed” (NTE) amounts and have already been entered in the pricing schedule. Offerors shall not modify these NTE values. Vendors shall offer unit pricing for all highlighted cells.

IDIQ Contract Structure: This solicitation is for an Indefinite Delivery/Indefinite Quantity (IDIQ) contract. The quantities provided in the pricing schedule are estimates only and are for evaluation purposes.

Actual orders will be placed using fixed unit price line items of funding for any combination of CLINs, based on the Government’s needs.

Order Placement: Orders may be placed for any CLIN(s) listed in the schedule, in any quantity, at the fixed unit price proposed.

Offerors are not guaranteed any minimum quantity and should be prepared to fulfill orders as required.

General Notes: Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors must incorporate such costs into their unit pricing. Units of Measure: “Each” refers to a single item or service; “Lot” refers to a group or package of items/services. "Hour" refers to the cost for one hour of labor/ service. Transition-In CLIN 1000: plug-in provided $500,000. Offerors shall not adjust this value unless awarded a contract.

Program CategoryDescription_UnitExtended Value
Est QTYUnit price
CLIN
1000Transition- In [*This value is for proposal evaluation only and does not reflect the final negotiated amount, which may be adjusted upon/ post-award based on the actual transition plan.] $500,000 is set as the value for purposes of this solicitation. Transition-In may include but is not limited to onboarding staff, credentialing, training, IT/data migration/setup, initial reporting, and project management.$500,000
Medical Services
Medical Examinations (IME: Cost includes evaluation, physician review, cancellation, and all administrative fees.)
1001PREIME (including physician review)1$ - 0each$ - 0
1002PRENo show fee IME (day of appointment)1$ - 0each$ - 0
1003PREPsychiatric IME (including physician review)1$ - 0each$ - 0
1004PREPre-employment medical exam - all positions115,000$ - 0each$ - 0
1005PREPre-employment medical exam/drug test combination1$ - 0each$ - 0
1006PREPre-employment fitness test/drug test combination1$ - 0each$ - 0
1007PREPre-employment medical exam/fitness test combination1$ - 0each$ - 0
1008PREPre-employment medical exam/fitness test/drug test combination1$ - 0each$ - 0
1009PREPre-employment Overseas Medical Examination1$ - 0each$ - 0
1010POSTEmployee medical examination (including physician review)130$ - 0each$ - 0
1011POSTNo show fee for employee medical examination8$ - 0each$ - 0
1012POSTIME (including physician review)75$ - 0each$ - 0
1013POSTNo show fee (day of appointment)10$ - 0Lot$ - 0
1014POSTPsychiatric IME75$ - 0each$ - 0
1015POSTMedical Hardship/Medical Reassignment I100$ - 0each$ - 0
1016POSTMedical Hardship/Medical Reassignment II100$ - 0each$ - 0
Non-Psychiatric Consultation
1017PRENon-Psychiatric Consultation Level I5,000$ - 0each$ - 0
1018PRENon-Psychiatric Consultation Level 2-1 (100 pages or less)50$ - 0each$ - 0
1019PRENon-Psychiatric Consultation Level 2-2 (101-200 pages)100$ - 0each$ - 0
1020PRENon-Psychiatric Consultation Level 2-3 (201-300 pages)100$ - 0each$ - 0
1021PRENon-Psychiatric Consultation Level 2-4 (301-400 pages)100$ - 0each$ - 0
1022PRENon-Psychiatric Consultation Level 2-5 (401-500 pages)100$ - 0each$ - 0
1023PRENon-Psychiatric Consultation Level 2-6 (501-600 pages)40$ - 0each$ - 0
1024PRENon-Psychiatric Consultation Level 2-7 (601-700 pages)40$ - 0each$ - 0
1025PRENon-Psychiatric Consultation Level 2-8 (701-800 pages)40$ - 0each$ - 0
1026PRENon-Psychiatric Consultation Level 2-9 (801-900 pages)5$ - 0each$ - 0
1027PRENon-Psychiatric Consultation Level 2-10 (901-1000 pages)5$ - 0each$ - 0
1028PRENon-Psychiatric Level III Specialist Consultation350$ - 0each$ - 0
1029PREVision Consultation8,000$ - 0each$ - 0
1030POSTNon-Psychiatric Level I Consultation (1-15 pages)40$ - 0each$ - 0
1031POSTNon-Psychiatric Level II Consultation (16-30 pages)40$ - 0each$ - 0
1032POSTNon-Psychiatric Level III Consultation (31 and over pages)40$ - 0each$ - 0
Psychiatric Specialist Consultation
1033PREPhysician legal consult/testimony1$ - 0hour$ - 0
1034PREIME physician legal consult/testimony1$ - 0each$ - 0
1035PREMental Health Screening Consultation10,000$ - 0each$ - 0
1036PREPsychiatric Level I Consultation100$ - 0each$ - 0
1037PREPsychiatric Level II Consultation5$ - 0each$ - 0
1038PREPsychiatric Level III Consultation5$ - 0each$ - 0
1039PREPsychiatric Level IV Consultation5$ - 0each$ - 0
1040POSTPsychiatric Level I Consultation (1 - 50 pages)25$ - 0each$ - 0
1041POSTPsychiatric Level II Consultation (51 - 100 pages)25$ - 0each$ - 0
1042POSTPsychiatric Level III Consultation (101 - 300 pages)25$ - 0each$ - 0
1043POSTPsychiatric Level IV Consultation (301 - 500 pages)7$ - 0each$ - 0
1044POSTPsychiatric Level V Consultation (501 - 700 pages)3$ - 0each$ - 0
1045POSTPsychiatric Level VI Consultation (701 - 900 pages)3$ - 0each$ - 0
1046POSTPsychiatric Level VII Consultation (901 - 1100 pages)3$ - 0each$ - 0
1047POSTPsychiatric Level VIII Consultation (1101 - 1300 pages)3$ - 0each$ - 0
1048POSTPsychiatric Level IX Consultation (1301 - 1400 pages)3$ - 0each$ - 0
1049POSTPsychiatric Level X Consultation (1401 to 1500 pages)3$ - 0each$ - 0
1050POSTPhysician legal consult/testimony10$ - 0each$ - 0
1051POSTIME physician legal consult/testimony (per physican / case)5$ - 0each$ - 0
Fitness Test Services
1052PREPre-employment Fitness Test - BPA55,000$ - 0each$ - 0
1053PREPre-employment Fitness Test - CBPO55,000$ - 0each$ - 0
1054PREPre-employment Fitness Test - AMO5,000$ - 0each$ - 0
1055PREPre-employment Fitness Test Overseas - BPA1$ - 0each$ - 0
1056PREPre-employment Fitness Test Overseas - CBPO1$ - 0each$ - 0
1057PREPre-employment Fitness Test Overseas - AMO1$ - 0each$ - 0
Drug Program Services [Employee Drug Testing, Collection staff and HHS clinics, collection kits and shipping, Laboratory, and MRO services]
NOTE: All costs associated with Drug Testing will be rolled into CLINs under the circumstances for Random, Reasonable Suspicion, Post Accident and Return-to Duty /follow up. Specimen Testing Services include: Scheduling, Collection Supplies, On and Off-site specimen collection, Quality Control and Training, Data, Monthly Statistical Reports, Corrective Action Report, Status Briefings, Next Day Delivery Service (One Way), and Courier Services, Laboratory, MRO services and split specimen transfers .
1058PREBlind Sample (Collection and shipping supplies, Lab and MRO)180$ - 0each$ - 0
1059PREMRO Meeting and Consultations1$ - 0hour$ - 0
1060PREMRO Expert Testimony1$ - 0hour$ - 0
1061PRELaboratory Director Expert Testimony1$ - 0hour$ - 0
1062PREPre-employment Drug Test - all positions115,000$ - 0each$ - 0
1063PREPre-employment Onsite - all positions1$ - 0each$ - 0
1064PREPre-employment Modified Onsites - all positions1$ - 0each$ - 0
1065PREPre-employment Overseas Drug Test - all positions1$ - 0each$ - 0
1066PREPre-Employment Positive (without Litigation package)1,000$ - 0each$ - 0
1067PRESplit Specimen TX to the HHS Labs (TX, GC/MS, MRO)1,000$ - 0each$ - 0
1068PRELitigation Package1$ - 0each$ - 0
1069POSTFFD Negative drug test10$ - 0each$ - 0
1070POSTFFD Positive drug test3$ - 0each$ - 0
1071POSTEmployee Random Drug Test (20% of Drug Testing Positions12,200$ - 0each$ - 0
1072POSTReasonable Suspicion35$ - 0each$ - 0
1073POSTPost Accident (unsafe practice)20$ - 0each$ - 0
1074POSTReturn-to-duty/follow-up20$ - 0each$ - 0
1075POSTPositive Drug Test Results (Includes Litigation package)40$ - 0each$ - 0
1076POSTSplit Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)30$ - 0each$ - 0
1077POSTBlind Sample (Collection and shipping supplies, Lab and MRO)300$ - 0each$ - 0
1078POSTMRO Meeting and Consultations15$ - 0Hours$ - 0
1079POSTMRO Expert Testimony36$ - 0Hours$ - 0
1080POSTLaboratory Director Expert Testimony10$ - 0Hours$ - 0
Additional Medical tests
1081POSTChest X-Ray (single view)5$ - 0each$ - 0
1082POSTChest X-Ray (PA and Lateral)5$ - 0each$ - 0
1083POSTX-Ray (general)10$ - 0each$ - 0
1084POSTTB Skin Test (with chest x-ray if indicated)5$ - 0each$ - 0
1085POSTAudiometry5$ - 0each$ - 0
1086POSTLab Profile: CBC with differential, CHEM profile, Urinalysis5$ - 0each$ - 0
1087POSTResting EKG with interpretation15$ - 0each$ - 0
1088POSTVisual Acuity (Corrected and uncorrected, near and distance)15$ - 0each$ - 0
1089POSTVital Signs5$ - 0each$ - 0
1090POSTThyroid Stimulating Hormone (TSH) w/Reflex Free T460$ - 0each$ - 0
1091POSTHemoglobin A1C (HgBA1C)30$ - 0each$ - 0
1092POSTBlood Glucose30$ - 0each$ - 0
1093POSTBlood Lead Level5$ - 0each$ - 0
1094POSTCardiac Risk Profile/Lipid Panel30$ - 0each$ - 0
1095POSTColor Vision Assessment5$ - 0each$ - 0
1096POSTMaximal Stress EKG with MD interpretation5$ - 0each$ - 0
1097POSTPeripheral Vision and Visual Depth Perception5$ - 0each$ - 0
1098POSTProtoporphyrin, Zinc (ZPP) Blood Test5$ - 0each$ - 0
1099POSTResting 12 Lead EKG with MD Interpretation5$ - 0each$ - 0
1100POSTSpirometry (FVC%, FEV1, FEV1/FVC%)5$ - 0each$ - 0
1101POSTBlood Alcohol Test5$ - 0each$ - 0
1102POSTExercise Stress Echo5$ - 0each$ - 0
1103POSTEchocardiogram5$ - 0each$ - 0
1104POSTSleep study5$ - 0each$ - 0
1105POSTFunctional capacity Evaluation (FCE) with report10$ - 0each$ - 0
1106POSTFolate5$ - 0each$ - 0
1107POSTVitamin B-125$ - 0each$ - 0
1108POSTProthrombin Time with INR5$ - 0each$ - 0
1109POSTPartial Thromboplastin Time, Activated5$ - 0each$ - 0
1110POSTMiscellaneous IME Tests20$ - 0each$ - 0
Travel
1111POST/PREMedical Services Travel (i.e. Meetings)1$ 10,000.00each$ 10,000.00
1112POST/PREMRO and Laboratory Travel1$ 10,000.00each$ 10,000.00
Development of Medical Standards and Clinical Policy Consultation
1113POSTDevelopment of Vision Standards (CBPO, AMO Positions)2$ - 0each$ - 0
1114POSTDevelopment of Hearing Standards (CBPO, AMO Positions)2$ - 0each$ - 0
1115POSTClinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures). Hourly rate = NTE $300/hr. for 4 hours Varies by Clinical Specialty and nature of inquiry4$ - 0each$ - 0
Ordering Period 1 Total Extended Value$520,000

Comprehensive Health Services, LLC U.S. Customs and Border Protection

Use or disclosure of data contained on this sheet is subject to the restrictions on the title page of this proposal.

OP2

Ordering Period 270B06C26R00000017 A0002- Ordering Period 2
Instructions for Completing the Pricing Schedule

On the other worksheets, offerors must provide unit pricing for numbered CLINs listed. All unit prices should be entered in the designated column for each CLIN.

Travel Reimbursement: Travel costs will be reimbursed in accordance with Federal Travel Regulations. The values for travel are “Not-To-Exceed” (NTE) amounts and have already been entered in the pricing schedule. Offerors shall not modify these NTE values. Vendors shall offer unit pricing for all highlighted cells.

IDIQ Contract Structure: This solicitation is for an Indefinite Delivery/Indefinite Quantity (IDIQ) contract. The quantities provided in the pricing schedule are estimates only and are for evaluation purposes.

Actual orders will be placed using fixed unit price line items of funding for any combination of CLINs, based on the Government’s needs.

Order Placement: Orders may be placed for any CLIN(s) listed in the schedule, in any quantity, at the fixed unit price proposed.

Offerors are not guaranteed any minimum quantity and should be prepared to fulfill orders as required.

General Notes: Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors must incorporate such costs into their unit pricing. Units of Measure: “Each” refers to a single item or service; “Lot” refers to a group or package of items/services. "Hour" refers to the cost for one hour of labor/ service.

Program CategoryDescription_UnitExtended Value
Est QTYUnit Price
CLINMedical Services
Medical Examinations (IME: Cost includes evaluation, physician review, cancellation, and all administrative fees.)
2001PREIME (including physician review)1$ - 0each$ - 0
2002PRENo show fee IME (day of appointment)1$ - 0each$ - 0
2003PREPsychiatric IME (including physician review)1$ - 0each$ - 0
2004PREPre-employment medical exam - all positions115,000$ - 0each$ - 0
2005PREPre-employment medical exam/drug test combination1$ - 0each$ - 0
2006PREPre-employment fitness test/drug test combination1$ - 0each$ - 0
2007PREPre-employment medical exam/fitness test combination1$ - 0each$ - 0
2008PREPre-employment medical exam/fitness test/drug test combination1$ - 0each$ - 0
2009PREPre-employment Overseas Medical Examination1$ - 0each$ - 0
2010POSTEmployee medical examination (including physician review)130$ - 0each$ - 0
2011POSTNo show fee for employee medical examination8$ - 0each$ - 0
2012POSTIME (including physician review)75$ - 0each$ - 0
2013POSTNo show fee (day of appointment)10$ - 0Lot$ - 0
2014POSTPsychiatric IME75$ - 0each$ - 0
2015POSTMedical Hardship/Medical Reassignment I100$ - 0each$ - 0
2016POSTMedical Hardship/Medical Reassignment II100$ - 0each$ - 0
Non-Psychiatric Consultation
2017PRENon-Psychiatric Consultation Level I5,000$ - 0each$ - 0
2018PRENon-Psychiatric Consultation Level 2-1 (100 pages or less)50$ - 0each$ - 0
2019PRENon-Psychiatric Consultation Level 2-2 (101-200 pages)100$ - 0each$ - 0
2020PRENon-Psychiatric Consultation Level 2-3 (201-300 pages)100$ - 0each$ - 0
2021PRENon-Psychiatric Consultation Level 2-4 (301-400 pages)100$ - 0each$ - 0
2022PRENon-Psychiatric Consultation Level 2-5 (401-500 pages)100$ - 0each$ - 0
2023PRENon-Psychiatric Consultation Level 2-6 (501-600 pages)40$ - 0each$ - 0
2024PRENon-Psychiatric Consultation Level 2-7 (601-700 pages)40$ - 0each$ - 0
2025PRENon-Psychiatric Consultation Level 2-8 (701-800 pages)40$ - 0each$ - 0
2026PRENon-Psychiatric Consultation Level 2-9 (801-900 pages)5$ - 0each$ - 0
2027PRENon-Psychiatric Consultation Level 2-10 (901-1000 pages)5$ - 0each$ - 0
2028PRENon-Psychiatric Level III Specialist Consultation350$ - 0each$ - 0
2029PREVision Consultation8,000$ - 0each$ - 0
2030POSTNon-Psychiatric Level I Consultation (1-15 pages)40$ - 0each$ - 0
2031POSTNon-Psychiatric Level II Consultation (16-30 pages)40$ - 0each$ - 0
2032POSTNon-Psychiatric Level III Consultation (31 and over pages)40$ - 0each$ - 0
Psychiatric Specialist Consultation
2033PREPhysician legal consult/testimony1$ - 0hour$ - 0
2034PREIME physician legal consult/testimony1$ - 0each$ - 0
2035PREMental Health Screening Consultation10,000$ - 0each$ - 0
2036PREPsychiatric Level I Consultation100$ - 0each$ - 0
2037PREPsychiatric Level II Consultation5$ - 0each$ - 0
2038PREPsychiatric Level III Consultation5$ - 0each$ - 0
2039PREPsychiatric Level IV Consultation5$ - 0each$ - 0
2040POSTPsychiatric Level I Consultation (1 - 50 pages)25$ - 0each$ - 0
2041POSTPsychiatric Level II Consultation (51 - 100 pages)25$ - 0each$ - 0
2042POSTPsychiatric Level III Consultation (101 - 300 pages)25$ - 0each$ - 0
2043POSTPsychiatric Level IV Consultation (301 - 500 pages)7$ - 0each$ - 0
2044POSTPsychiatric Level V Consultation (501 - 700 pages)3$ - 0each$ - 0
2045POSTPsychiatric Level VI Consultation (701 - 900 pages)3$ - 0each$ - 0
2046POSTPsychiatric Level VII Consultation (901 - 1100 pages)3$ - 0each$ - 0
2047POSTPsychiatric Level VIII Consultation (1101 - 1300 pages)3$ - 0each$ - 0
2048POSTPsychiatric Level IX Consultation (1301 - 1400 pages)3$ - 0each$ - 0
2049POSTPsychiatric Level X Consultation (1401 to 1500 pages)3$ - 0each$ - 0
2050POSTPhysician legal consult/testimony10$ - 0each$ - 0
2051POSTIME physician legal consult/testimony (per physican / case)5$ - 0each$ - 0
Fitness Test Services
2052PREPre-employment Fitness Test - BPA55,000$ - 0each$ - 0
2053PREPre-employment Fitness Test - CBPO55,000$ - 0each$ - 0
2054PREPre-employment Fitness Test - AMO5,000$ - 0each$ - 0
2055PREPre-employment Fitness Test Overseas - BPA1$ - 0each$ - 0
2056PREPre-employment Fitness Test Overseas - CBPO1$ - 0each$ - 0
2057PREPre-employment Fitness Test Overseas - AMO1$ - 0each$ - 0
Drug Program Services [Employee Drug Testing, Collection staff and HHS clinics, collection kits and shipping, Laboratory, and MRO services]
NOTE: All costs associated with Drug Testing will be rolled into CLINs under the circumstances for Random, Reasonable Suspicion, Post Accident and Return-to Duty /follow up. Specimen Testing Services include: Scheduling, Collection Supplies, On and Off-site specimen collection, Quality Control and Training, Data, Monthly Statistical Reports, Corrective Action Report, Status Briefings, Next Day Delivery Service (One Way), and Courier Services, Laboratory, MRO services and split specimen transfers .
2058PREBlind Sample (Collection and shipping supplies, Lab and MRO)180$ - 0each$ - 0
2059PREMRO Meeting and Consultations1$ - 0hour$ - 0
2060PREMRO Expert Testimony1$ - 0hour$ - 0
2061PRELaboratory Director Expert Testimony1$ - 0hour$ - 0
2062PREPre-employment Drug Test - all positions115,000$ - 0each$ - 0
2063PREPre-employment Onsite - all positions1$ - 0each$ - 0
2064PREPre-employment Modified Onsites - all positions1$ - 0each$ - 0
2065PREPre-employment Overseas Drug Test - all positions1$ - 0each$ - 0
2066PREPre-Employment Positive (without Litigation package)1,000$ - 0each$ - 0
2067PRESplit Specimen TX to the HHS Labs (TX, GC/MS, MRO)1,000$ - 0each$ - 0
2068PRELitigation Package1$ - 0each$ - 0
2069POSTFFD Negative drug test10$ - 0each$ - 0
2070POSTFFD Positive drug test3$ - 0each$ - 0
2071POSTEmployee Random Drug Test (20% of Drug Testing Positions12,200$ - 0each$ - 0
2072POSTReasonable Suspicion35$ - 0each$ - 0
2073POSTPost Accident (unsafe practice)20$ - 0each$ - 0
2074POSTReturn-to-duty/follow-up20$ - 0each$ - 0
2075POSTPositive Drug Test Results (Includes Litigation package)40$ - 0each$ - 0
2076POSTSplit Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)30$ - 0each$ - 0
2077POSTBlind Sample (Collection and shipping supplies, Lab and MRO)300$ - 0each$ - 0
2078POSTMRO Meeting and Consultations15$ - 0Hours$ - 0
2079POSTMRO Expert Testimony36$ - 0Hours$ - 0
2080POSTLaboratory Director Expert Testimony10$ - 0Hours$ - 0
Additional Medical tests
2081POSTChest X-Ray (single view)5$ - 0each$ - 0
2082POSTChest X-Ray (PA and Lateral)5$ - 0each$ - 0
2083POSTX-Ray (general)10$ - 0each$ - 0
2084POSTTB Skin Test (with chest x-ray if indicated)5$ - 0each$ - 0
2085POSTAudiometry5$ - 0each$ - 0
2086POSTLab Profile: CBC with differential, CHEM profile, Urinalysis5$ - 0each$ - 0
2087POSTResting EKG with interpretation15$ - 0each$ - 0
2088POSTVisual Acuity (Corrected and uncorrected, near and distance)15$ - 0each$ - 0
2089POSTVital Signs5$ - 0each$ - 0
2090POSTThyroid Stimulating Hormone (TSH) w/Reflex Free T460$ - 0each$ - 0
2091POSTHemoglobin A1C (HgBA1C)30$ - 0each$ - 0
2092POSTBlood Glucose30$ - 0each$ - 0
2093POSTBlood Lead Level5$ - 0each$ - 0
2094POSTCardiac Risk Profile/Lipid Panel30$ - 0each$ - 0
2095POSTColor Vision Assessment5$ - 0each$ - 0
2096POSTMaximal Stress EKG with MD interpretation5$ - 0each$ - 0
2097POSTPeripheral Vision and Visual Depth Perception5$ - 0each$ - 0
2098POSTProtoporphyrin, Zinc (ZPP) Blood Test5$ - 0each$ - 0
2099POSTResting 12 Lead EKG with MD Interpretation5$ - 0each$ - 0
2100POSTSpirometry (FVC%, FEV1, FEV1/FVC%)5$ - 0each$ - 0
2101POSTBlood Alcohol Test5$ - 0each$ - 0
2102POSTExercise Stress Echo5$ - 0each$ - 0
2103POSTEchocardiogram5$ - 0each$ - 0
2104POSTSleep study5$ - 0each$ - 0
2105POSTFunctional capacity Evaluation (FCE) with report10$ - 0each$ - 0
2106POSTFolate5$ - 0each$ - 0
2107POSTVitamin B-125$ - 0each$ - 0
2108POSTProthrombin Time with INR5$ - 0each$ - 0
2109POSTPartial Thromboplastin Time, Activated5$ - 0each$ - 0
2110POSTMiscellaneous IME Tests20$ - 0each$ - 0
Travel
2111POST/PREMedical Services Travel (i.e. Meetings)1$ 10,000.00each$ 10,000.00
2112POST/PREMRO and Laboratory Travel1$ 10,000.00each$ 10,000.00
Development of Medical Standards and Clinical Policy Consultation
2113POSTDevelopment of Vision Standards (CBPO, AMO Positions)2$ - 0each$ - 0
2114POSTDevelopment of Hearing Standards (CBPO, AMO Positions)2$ - 0each$ - 0
2115POSTClinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures). Hourly rate = NTE $300/hr. for 4 hours Varies by Clinical Specialty and nature of inquiry4$ - 0each$ - 0
Ordering Period 2 Total Extended Value$ 20,000.00

Comprehensive Health Services, LLC U.S. Customs and Border Protection

Use or disclosure of data contained on this sheet is subject to the restrictions on the title page of this proposal.

OP3

Ordering Period 370B06C26R00000017 A0002- Ordering Period 3
Instructions for Completing the Pricing Schedule

On the other worksheets, offerors must provide unit pricing for numbered CLINs listed. All unit prices should be entered in the designated column for each CLIN.

Travel Reimbursement: Travel costs will be reimbursed in accordance with Federal Travel Regulations. The values for travel are “Not-To-Exceed” (NTE) amounts and have already been entered in the pricing schedule. Offerors shall not modify these NTE values. Vendors shall offer unit pricing for all highlighted cells.

IDIQ Contract Structure: This solicitation is for an Indefinite Delivery/Indefinite Quantity (IDIQ) contract. The quantities provided in the pricing schedule are estimates only and are for evaluation purposes.

Actual orders will be placed using fixed unit price line items of funding for any combination of CLINs, based on the Government’s needs.

Order Placement: Orders may be placed for any CLIN(s) listed in the schedule, in any quantity, at the fixed unit price proposed.

Offerors are not guaranteed any minimum quantity and should be prepared to fulfill orders as required.

General Notes: Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors must incorporate such costs into their unit pricing. Units of Measure: “Each” refers to a single item or service; “Lot” refers to a group or package of items/services. "Hour" refers to the cost for one hour of labor/ service.

Program CategoryDescription_UnitExtended Value
Est QTYUnit price
CLINMedical Services
Medical Examinations (IME: Cost includes evaluation, physician review, cancellation, and all administrative fees.)
3001PREIME (including physician review)1$ - 0each$ - 0
3002PRENo show fee IME (day of appointment)1$ - 0each$ - 0
3003PREPsychiatric IME (including physician review)1$ - 0each$ - 0
3004PREPre-employment medical exam - all positions115,000$ - 0each$ - 0
3005PREPre-employment medical exam/drug test combination1$ - 0each$ - 0
3006PREPre-employment fitness test/drug test combination1$ - 0each$ - 0
3007PREPre-employment medical exam/fitness test combination1$ - 0each$ - 0
3008PREPre-employment medical exam/fitness test/drug test combination1$ - 0each$ - 0
3009PREPre-employment Overseas Medical Examination1$ - 0each$ - 0
3010POSTEmployee medical examination (including physician review)130$ - 0each$ - 0
3011POSTNo show fee for employee medical examination8$ - 0each$ - 0
3012POSTIME (including physician review)75$ - 0each$ - 0
3013POSTNo show fee (day of appointment)10$ - 0Lot$ - 0
3014POSTPsychiatric IME75$ - 0each$ - 0
3015POSTMedical Hardship/Medical Reassignment I100$ - 0each$ - 0
3016POSTMedical Hardship/Medical Reassignment II100$ - 0each$ - 0
Non-Psychiatric Consultation
3017PRENon-Psychiatric Consultation Level I5,000$ - 0each$ - 0
3018PRENon-Psychiatric Consultation Level 2-1 (100 pages or less)50$ - 0each$ - 0
3019PRENon-Psychiatric Consultation Level 2-2 (101-200 pages)100$ - 0each$ - 0
3020PRENon-Psychiatric Consultation Level 2-3 (201-300 pages)100$ - 0each$ - 0
3021PRENon-Psychiatric Consultation Level 2-4 (301-400 pages)100$ - 0each$ - 0
3022PRENon-Psychiatric Consultation Level 2-5 (401-500 pages)100$ - 0each$ - 0
3023PRENon-Psychiatric Consultation Level 2-6 (501-600 pages)40$ - 0each$ - 0
3024PRENon-Psychiatric Consultation Level 2-7 (601-700 pages)40$ - 0each$ - 0
3025PRENon-Psychiatric Consultation Level 2-8 (701-800 pages)40$ - 0each$ - 0
3026PRENon-Psychiatric Consultation Level 2-9 (801-900 pages)5$ - 0each$ - 0
3027PRENon-Psychiatric Consultation Level 2-10 (901-1000 pages)5$ - 0each$ - 0
3028PRENon-Psychiatric Level III Specialist Consultation350$ - 0each$ - 0
3029PREVision Consultation8,000$ - 0each$ - 0
3030POSTNon-Psychiatric Level I Consultation (1-15 pages)40$ - 0each$ - 0
3031POSTNon-Psychiatric Level II Consultation (16-30 pages)40$ - 0each$ - 0
3032POSTNon-Psychiatric Level III Consultation (31 and over pages)40$ - 0each$ - 0
Psychiatric Specialist Consultation
3033PREPhysician legal consult/testimony1$ - 0hour$ - 0
3034PREIME physician legal consult/testimony1$ - 0each$ - 0
3035PREMental Health Screening Consultation10,000$ - 0each$ - 0
3036PREPsychiatric Level I Consultation100$ - 0each$ - 0
3037PREPsychiatric Level II Consultation5$ - 0each$ - 0
3038PREPsychiatric Level III Consultation5$ - 0each$ - 0
3039PREPsychiatric Level IV Consultation5$ - 0each$ - 0
3040POSTPsychiatric Level I Consultation (1 - 50 pages)25$ - 0each$ - 0
3041POSTPsychiatric Level II Consultation (51 - 100 pages)25$ - 0each$ - 0
3042POSTPsychiatric Level III Consultation (101 - 300 pages)25$ - 0each$ - 0
3043POSTPsychiatric Level IV Consultation (301 - 500 pages)7$ - 0each$ - 0
3044POSTPsychiatric Level V Consultation (501 - 700 pages)3$ - 0each$ - 0
3045POSTPsychiatric Level VI Consultation (701 - 900 pages)3$ - 0each$ - 0
3046POSTPsychiatric Level VII Consultation (901 - 1100 pages)3$ - 0each$ - 0
3047POSTPsychiatric Level VIII Consultation (1101 - 1300 pages)3$ - 0each$ - 0
3048POSTPsychiatric Level IX Consultation (1301 - 1400 pages)3$ - 0each$ - 0
3049POSTPsychiatric Level X Consultation (1401 to 1500 pages)3$ - 0each$ - 0
3050POSTPhysician legal consult/testimony10$ - 0each$ - 0
3051POSTIME physician legal consult/testimony (per physican / case)5$ - 0each$ - 0
Fitness Test Services
3052PREPre-employment Fitness Test - BPA55,000$ - 0each$ - 0
3053PREPre-employment Fitness Test - CBPO55,000$ - 0each$ - 0
3054PREPre-employment Fitness Test - AMO5,000$ - 0each$ - 0
3055PREPre-employment Fitness Test Overseas - BPA1$ - 0each$ - 0
3056PREPre-employment Fitness Test Overseas - CBPO1$ - 0each$ - 0
3057PREPre-employment Fitness Test Overseas - AMO1$ - 0each$ - 0
Drug Program Services [Employee Drug Testing, Collection staff and HHS clinics, collection kits and shipping, Laboratory, and MRO services]
NOTE: All costs associated with Drug Testing will be rolled into CLINs under the circumstances for Random, Reasonable Suspicion, Post Accident and Return-to Duty /follow up. Specimen Testing Services include: Scheduling, Collection Supplies, On and Off-site specimen collection, Quality Control and Training, Data, Monthly Statistical Reports, Corrective Action Report, Status Briefings, Next Day Delivery Service (One Way), and Courier Services, Laboratory, MRO services and split specimen transfers .
3058PREBlind Sample (Collection and shipping supplies, Lab and MRO)180$ - 0each$ - 0
3059PREMRO Meeting and Consultations1$ - 0hour$ - 0
3060PREMRO Expert Testimony1$ - 0hour$ - 0
3061PRELaboratory Director Expert Testimony1$ - 0hour$ - 0
3062PREPre-employment Drug Test - all positions115,000$ - 0each$ - 0
3063PREPre-employment Onsite - all positions1$ - 0each$ - 0
3064PREPre-employment Modified Onsites - all positions1$ - 0each$ - 0
3065PREPre-employment Overseas Drug Test - all positions1$ - 0each$ - 0
3066PREPre-Employment Positive (without Litigation package)1,000$ - 0each$ - 0
3067PRESplit Specimen TX to the HHS Labs (TX, GC/MS, MRO)1,000$ - 0each$ - 0
3068PRELitigation Package1$ - 0each$ - 0
3069POSTFFD Negative drug test10$ - 0each$ - 0
3070POSTFFD Positive drug test3$ - 0each$ - 0
3071POSTEmployee Random Drug Test (20% of Drug Testing Positions12,200$ - 0each$ - 0
3072POSTReasonable Suspicion35$ - 0each$ - 0
3073POSTPost Accident (unsafe practice)20$ - 0each$ - 0
3074POSTReturn-to-duty/follow-up20$ - 0each$ - 0
3075POSTPositive Drug Test Results (Includes Litigation package)40$ - 0each$ - 0
3076POSTSplit Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)30$ - 0each$ - 0
3077POSTBlind Sample (Collection and shipping supplies, Lab and MRO)300$ - 0each$ - 0
3078POSTMRO Meeting and Consultations15$ - 0Hours$ - 0
3079POSTMRO Expert Testimony36$ - 0Hours$ - 0
3080POSTLaboratory Director Expert Testimony10$ - 0Hours$ - 0
Additional Medical tests
3081POSTChest X-Ray (single view)5$ - 0each$ - 0
3082POSTChest X-Ray (PA and Lateral)5$ - 0each$ - 0
3083POSTX-Ray (general)10$ - 0each$ - 0
3084POSTTB Skin Test (with chest x-ray if indicated)5$ - 0each$ - 0
3085POSTAudiometry5$ - 0each$ - 0
3086POSTLab Profile: CBC with differential, CHEM profile, Urinalysis5$ - 0each$ - 0
3087POSTResting EKG with interpretation15$ - 0each$ - 0
3088POSTVisual Acuity (Corrected and uncorrected, near and distance)15$ - 0each$ - 0
3089POSTVital Signs5$ - 0each$ - 0
3090POSTThyroid Stimulating Hormone (TSH) w/Reflex Free T460$ - 0each$ - 0
3091POSTHemoglobin A1C (HgBA1C)30$ - 0each$ - 0
3092POSTBlood Glucose30$ - 0each$ - 0
3093POSTBlood Lead Level5$ - 0each$ - 0
3094POSTCardiac Risk Profile/Lipid Panel30$ - 0each$ - 0
3095POSTColor Vision Assessment5$ - 0each$ - 0
3096POSTMaximal Stress EKG with MD interpretation5$ - 0each$ - 0
3097POSTPeripheral Vision and Visual Depth Perception5$ - 0each$ - 0
3098POSTProtoporphyrin, Zinc (ZPP) Blood Test5$ - 0each$ - 0
3099POSTResting 12 Lead EKG with MD Interpretation5$ - 0each$ - 0
3100POSTSpirometry (FVC%, FEV1, FEV1/FVC%)5$ - 0each$ - 0
3101POSTBlood Alcohol Test5$ - 0each$ - 0
3102POSTExercise Stress Echo5$ - 0each$ - 0
3103POSTEchocardiogram5$ - 0each$ - 0
3104POSTSleep study5$ - 0each$ - 0
3105POSTFunctional capacity Evaluation (FCE) with report10$ - 0each$ - 0
3106POSTFolate5$ - 0each$ - 0
3107POSTVitamin B-125$ - 0each$ - 0
3108POSTProthrombin Time with INR5$ - 0each$ - 0
3109POSTPartial Thromboplastin Time, Activated5$ - 0each$ - 0
3110POSTMiscellaneous IME Tests20$ - 0each$ - 0
Travel
3111POST/PREMedical Services Travel (i.e. Meetings)1$ 10,000.00each$ 10,000.00
3112POST/PREMRO and Laboratory Travel1$ 10,000.00each$ 10,000.00
Development of Medical Standards and Clinical Policy Consultation
3113POSTDevelopment of Vision Standards (CBPO, AMO Positions)2$ - 0each$ - 0
3114POSTDevelopment of Hearing Standards (CBPO, AMO Positions)2$ - 0each$ - 0
3115POSTClinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures). Hourly rate = NTE $300/hr. for 4 hours Varies by Clinical Specialty and nature of inquiry4$ - 0each$ - 0
Ordering Period 3 Total Extended Value$ 20,000.00

Comprehensive Health Services, LLC U.S. Customs and Border Protection

Use or disclosure of data contained on this sheet is subject to the restrictions on the title page of this proposal.

OP4

Ordering Period 470B06C26R00000017 A0002- Ordering Period 4
Instructions for Completing the Pricing Schedule

On the other worksheets, offerors must provide unit pricing for numbered CLINs listed. All unit prices should be entered in the designated column for each CLIN.

Travel Reimbursement: Travel costs will be reimbursed in accordance with Federal Travel Regulations. The values for travel are “Not-To-Exceed” (NTE) amounts and have already been entered in the pricing schedule. Offerors shall not modify these NTE values. Vendors shall offer unit pricing for all highlighted cells.

IDIQ Contract Structure: This solicitation is for an Indefinite Delivery/Indefinite Quantity (IDIQ) contract. The quantities provided in the pricing schedule are estimates only and are for evaluation purposes.

Actual orders will be placed using fixed unit price line items of funding for any combination of CLINs, based on the Government’s needs.

Order Placement: Orders may be placed for any CLIN(s) listed in the schedule, in any quantity, at the fixed unit price proposed.

Offerors are not guaranteed any minimum quantity and should be prepared to fulfill orders as required.

General Notes: Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors must incorporate such costs into their unit pricing. Units of Measure: “Each” refers to a single item or service; “Lot” refers to a group or package of items/services. "Hour" refers to the cost for one hour of labor/ service.

Program CategoryDescription_UnitExtended Value
Est QTYUnit price
CLINMedical Services
Medical Examinations (IME: Cost includes evaluation, physician review, cancellation, and all administrative fees.)
4001PREIME (including physician review)1$ - 0each$ - 0
4002PRENo show fee IME (day of appointment)1$ - 0each$ - 0
4003PREPsychiatric IME (including physician review)1$ - 0each$ - 0
4004PREPre-employment medical exam - all positions115,000$ - 0each$ - 0
4005PREPre-employment medical exam/drug test combination1$ - 0each$ - 0
4006PREPre-employment fitness test/drug test combination1$ - 0each$ - 0
4007PREPre-employment medical exam/fitness test combination1$ - 0each$ - 0
4008PREPre-employment medical exam/fitness test/drug test combination1$ - 0each$ - 0
4009PREPre-employment Overseas Medical Examination1$ - 0each$ - 0
4010POSTEmployee medical examination (including physician review)130$ - 0each$ - 0
4011POSTNo show fee for employee medical examination8$ - 0each$ - 0
4012POSTIME (including physician review)75$ - 0each$ - 0
4013POSTNo show fee (day of appointment)10$ - 0Lot$ - 0
4014POSTPsychiatric IME75$ - 0each$ - 0
4015POSTMedical Hardship/Medical Reassignment I100$ - 0each$ - 0
4016POSTMedical Hardship/Medical Reassignment II100$ - 0each$ - 0
Non-Psychiatric Consultation
4017PRENon-Psychiatric Consultation Level I5,000$ - 0each$ - 0
4018PRENon-Psychiatric Consultation Level 2-1 (100 pages or less)50$ - 0each$ - 0
4019PRENon-Psychiatric Consultation Level 2-2 (101-200 pages)100$ - 0each$ - 0
4020PRENon-Psychiatric Consultation Level 2-3 (201-300 pages)100$ - 0each$ - 0
4021PRENon-Psychiatric Consultation Level 2-4 (301-400 pages)100$ - 0each$ - 0
4022PRENon-Psychiatric Consultation Level 2-5 (401-500 pages)100$ - 0each$ - 0
4023PRENon-Psychiatric Consultation Level 2-6 (501-600 pages)40$ - 0each$ - 0
4024PRENon-Psychiatric Consultation Level 2-7 (601-700 pages)40$ - 0each$ - 0
4025PRENon-Psychiatric Consultation Level 2-8 (701-800 pages)40$ - 0each$ - 0
4026PRENon-Psychiatric Consultation Level 2-9 (801-900 pages)5$ - 0each$ - 0
4027PRENon-Psychiatric Consultation Level 2-10 (901-1000 pages)5$ - 0each$ - 0
4028PRENon-Psychiatric Level III Specialist Consultation350$ - 0each$ - 0
4029PREVision Consultation8,000$ - 0each$ - 0
4030POSTNon-Psychiatric Level I Consultation (1-15 pages)40$ - 0each$ - 0
4031POSTNon-Psychiatric Level II Consultation (16-30 pages)40$ - 0each$ - 0
4032POSTNon-Psychiatric Level III Consultation (31 and over pages)40$ - 0each$ - 0
Psychiatric Specialist Consultation
4033PREPhysician legal consult/testimony1$ - 0hour$ - 0
4034PREIME physician legal consult/testimony1$ - 0each$ - 0
4035PREMental Health Screening Consultation10,000$ - 0each$ - 0
4036PREPsychiatric Level I Consultation100$ - 0each$ - 0
4037PREPsychiatric Level II Consultation5$ - 0each$ - 0
4038PREPsychiatric Level III Consultation5$ - 0each$ - 0
4039PREPsychiatric Level IV Consultation5$ - 0each$ - 0
4040POSTPsychiatric Level I Consultation (1 - 50 pages)25$ - 0each$ - 0
4041POSTPsychiatric Level II Consultation (51 - 100 pages)25$ - 0each$ - 0
4042POSTPsychiatric Level III Consultation (101 - 300 pages)25$ - 0each$ - 0
4043POSTPsychiatric Level IV Consultation (301 - 500 pages)7$ - 0each$ - 0
4044POSTPsychiatric Level V Consultation (501 - 700 pages)3$ - 0each$ - 0
4045POSTPsychiatric Level VI Consultation (701 - 900 pages)3$ - 0each$ - 0
4046POSTPsychiatric Level VII Consultation (901 - 1100 pages)3$ - 0each$ - 0
4047POSTPsychiatric Level VIII Consultation (1101 - 1300 pages)3$ - 0each$ - 0
4048POSTPsychiatric Level IX Consultation (1301 - 1400 pages)3$ - 0each$ - 0
4049POSTPsychiatric Level X Consultation (1401 to 1500 pages)3$ - 0each$ - 0
4050POSTPhysician legal consult/testimony10$ - 0each$ - 0
4051POSTIME physician legal consult/testimony (per physican / case)5$ - 0each$ - 0
Fitness Test Services
4052PREPre-employment Fitness Test - BPA55,000$ - 0each$ - 0
4053PREPre-employment Fitness Test - CBPO55,000$ - 0each$ - 0
4054PREPre-employment Fitness Test - AMO5,000$ - 0each$ - 0
4055PREPre-employment Fitness Test Overseas - BPA1$ - 0each$ - 0
4056PREPre-employment Fitness Test Overseas - CBPO1$ - 0each$ - 0
4057PREPre-employment Fitness Test Overseas - AMO1$ - 0each$ - 0
Drug Program Services [Employee Drug Testing, Collection staff and HHS clinics, collection kits and shipping, Laboratory, and MRO services]
NOTE: All costs associated with Drug Testing will be rolled into CLINs under the circumstances for Random, Reasonable Suspicion, Post Accident and Return-to Duty /follow up. Specimen Testing Services include: Scheduling, Collection Supplies, On and Off-site specimen collection, Quality Control and Training, Data, Monthly Statistical Reports, Corrective Action Report, Status Briefings, Next Day Delivery Service (One Way), and Courier Services, Laboratory, MRO services and split specimen transfers .
4058PREBlind Sample (Collection and shipping supplies, Lab and MRO)180$ - 0each$ - 0
4059PREMRO Meeting and Consultations1$ - 0hour$ - 0
4060PREMRO Expert Testimony1$ - 0hour$ - 0
4061PRELaboratory Director Expert Testimony1$ - 0hour$ - 0
4062PREPre-employment Drug Test - all positions115,000$ - 0each$ - 0
4063PREPre-employment Onsite - all positions1$ - 0each$ - 0
4064PREPre-employment Modified Onsites - all positions1$ - 0each$ - 0
4065PREPre-employment Overseas Drug Test - all positions1$ - 0each$ - 0
4066PREPre-Employment Positive (without Litigation package)1,000$ - 0each$ - 0
4067PRESplit Specimen TX to the HHS Labs (TX, GC/MS, MRO)1,000$ - 0each$ - 0
4068PRELitigation Package1$ - 0each$ - 0
4069POSTFFD Negative drug test10$ - 0each$ - 0
4070POSTFFD Positive drug test3$ - 0each$ - 0
4071POSTEmployee Random Drug Test (20% of Drug Testing Positions12,200$ - 0each$ - 0
4072POSTReasonable Suspicion35$ - 0each$ - 0
4073POSTPost Accident (unsafe practice)20$ - 0each$ - 0
4074POSTReturn-to-duty/follow-up20$ - 0each$ - 0
4075POSTPositive Drug Test Results (Includes Litigation package)40$ - 0each$ - 0
4076POSTSplit Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)30$ - 0each$ - 0
4077POSTBlind Sample (Collection and shipping supplies, Lab and MRO)300$ - 0each$ - 0
4078POSTMRO Meeting and Consultations15$ - 0Hours$ - 0
4079POSTMRO Expert Testimony36$ - 0Hours$ - 0
4080POSTLaboratory Director Expert Testimony10$ - 0Hours$ - 0
Additional Medical tests
4081POSTChest X-Ray (single view)5$ - 0each$ - 0
4082POSTChest X-Ray (PA and Lateral)5$ - 0each$ - 0
4083POSTX-Ray (general)10$ - 0each$ - 0
4084POSTTB Skin Test (with chest x-ray if indicated)5$ - 0each$ - 0
4085POSTAudiometry5$ - 0each$ - 0
4086POSTLab Profile: CBC with differential, CHEM profile, Urinalysis5$ - 0each$ - 0
4087POSTResting EKG with interpretation15$ - 0each$ - 0
4088POSTVisual Acuity (Corrected and uncorrected, near and distance)15$ - 0each$ - 0
4089POSTVital Signs5$ - 0each$ - 0
4090POSTThyroid Stimulating Hormone (TSH) w/Reflex Free T460$ - 0each$ - 0
4091POSTHemoglobin A1C (HgBA1C)30$ - 0each$ - 0
4092POSTBlood Glucose30$ - 0each$ - 0
4093POSTBlood Lead Level5$ - 0each$ - 0
4094POSTCardiac Risk Profile/Lipid Panel30$ - 0each$ - 0
4095POSTColor Vision Assessment5$ - 0each$ - 0
4096POSTMaximal Stress EKG with MD interpretation5$ - 0each$ - 0
4097POSTPeripheral Vision and Visual Depth Perception5$ - 0each$ - 0
4098POSTProtoporphyrin, Zinc (ZPP) Blood Test5$ - 0each$ - 0
4099POSTResting 12 Lead EKG with MD Interpretation5$ - 0each$ - 0
4100POSTSpirometry (FVC%, FEV1, FEV1/FVC%)5$ - 0each$ - 0
4101POSTBlood Alcohol Test5$ - 0each$ - 0
4102POSTExercise Stress Echo5$ - 0each$ - 0
4103POSTEchocardiogram5$ - 0each$ - 0
4104POSTSleep study5$ - 0each$ - 0
4105POSTFunctional capacity Evaluation (FCE) with report10$ - 0each$ - 0
4106POSTFolate5$ - 0each$ - 0
4107POSTVitamin B-125$ - 0each$ - 0
4108POSTProthrombin Time with INR5$ - 0each$ - 0
4109POSTPartial Thromboplastin Time, Activated5$ - 0each$ - 0
4110POSTMiscellaneous IME Tests20$ - 0each$ - 0
Travel
4111POST/PREMedical Services Travel (i.e. Meetings)1$ 10,000.00each$ 10,000.00
4112POST/PREMRO and Laboratory Travel1$ 10,000.00each$ 10,000.00
Development of Medical Standards and Clinical Policy Consultation
4113POSTDevelopment of Vision Standards (CBPO, AMO Positions)2$ - 0each$ - 0
4114POSTDevelopment of Hearing Standards (CBPO, AMO Positions)2$ - 0each$ - 0
4115POSTClinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures). Hourly rate = NTE $300/hr. for 4 hours Varies by Clinical Specialty and nature of inquiry4$ - 0each$ - 0
Ordering Period 4 Total Extended Value$ 20,000.00

Comprehensive Health Services, LLC U.S. Customs and Border Protection

Use or disclosure of data contained on this sheet is subject to the restrictions on the title page of this proposal.

OP5

Ordering Period 570B06C26R00000017 A0002- Ordering Period 5
Instructions for Completing the Pricing Schedule

On the other worksheets, offerors must provide unit pricing for numbered CLINs listed. All unit prices should be entered in the designated column for each CLIN.

Travel Reimbursement: Travel costs will be reimbursed in accordance with Federal Travel Regulations. The values for travel are “Not-To-Exceed” (NTE) amounts and have already been entered in the pricing schedule. Offerors shall not modify these NTE values. Vendors shall offer unit pricing for all highlighted cells.

IDIQ Contract Structure: This solicitation is for an Indefinite Delivery/Indefinite Quantity (IDIQ) contract. The quantities provided in the pricing schedule are estimates only and are for evaluation purposes.

Actual orders will be placed using fixed unit price line items of funding for any combination of CLINs, based on the Government’s needs.

Order Placement: Orders may be placed for any CLIN(s) listed in the schedule, in any quantity, at the fixed unit price proposed.

Offerors are not guaranteed any minimum quantity and should be prepared to fulfill orders as required.

General Notes: Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors must incorporate such costs into their unit pricing. Units of Measure: “Each” refers to a single item or service; “Lot” refers to a group or package of items/services. "Hour" refers to the cost for one hour of labor/ service.

Program CategoryDescription_UnitExtended Value
Est QTYUnit Price
CLINMedical Services
Medical Examinations (IME: Cost includes evaluation, physician review, cancellation, and all administrative fees.)
5001PREIME (including physician review)1$ - 0each$ - 0
5002PRENo show fee IME (day of appointment)1$ - 0each$ - 0
5003PREPsychiatric IME (including physician review)1$ - 0each$ - 0
5004PREPre-employment medical exam - all positions115,000$ - 0each$ - 0
5005PREPre-employment medical exam/drug test combination1$ - 0each$ - 0
5006PREPre-employment fitness test/drug test combination1$ - 0each$ - 0
5007PREPre-employment medical exam/fitness test combination1$ - 0each$ - 0
5008PREPre-employment medical exam/fitness test/drug test combination1$ - 0each$ - 0
5009PREPre-employment Overseas Medical Examination1$ - 0each$ - 0
5010POSTEmployee medical examination (including physician review)130$ - 0each$ - 0
5011POSTNo show fee for employee medical examination8$ - 0each$ - 0
5012POSTIME (including physician review)75$ - 0each$ - 0
5013POSTNo show fee (day of appointment)10$ - 0Lot$ - 0
5014POSTPsychiatric IME75$ - 0each$ - 0
5015POSTMedical Hardship/Medical Reassignment I100$ - 0each$ - 0
5016POSTMedical Hardship/Medical Reassignment II100$ - 0each$ - 0
Non-Psychiatric Consultation
5017PRENon-Psychiatric Consultation Level I5,000$ - 0each$ - 0
5018PRENon-Psychiatric Consultation Level 2-1 (100 pages or less)50$ - 0each$ - 0
5019PRENon-Psychiatric Consultation Level 2-2 (101-200 pages)100$ - 0each$ - 0
5020PRENon-Psychiatric Consultation Level 2-3 (201-300 pages)100$ - 0each$ - 0
5021PRENon-Psychiatric Consultation Level 2-4 (301-400 pages)100$ - 0each$ - 0
5022PRENon-Psychiatric Consultation Level 2-5 (401-500 pages)100$ - 0each$ - 0
5023PRENon-Psychiatric Consultation Level 2-6 (501-600 pages)40$ - 0each$ - 0
5024PRENon-Psychiatric Consultation Level 2-7 (601-700 pages)40$ - 0each$ - 0
5025PRENon-Psychiatric Consultation Level 2-8 (701-800 pages)40$ - 0each$ - 0
5026PRENon-Psychiatric Consultation Level 2-9 (801-900 pages)5$ - 0each$ - 0
5027PRENon-Psychiatric Consultation Level 2-10 (901-1000 pages)5$ - 0each$ - 0
5028PRENon-Psychiatric Level III Specialist Consultation350$ - 0each$ - 0
5029PREVision Consultation8,000$ - 0each$ - 0

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