Attachment 1 - Schedule of Items.pdf

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Intent to Sole Source Robotic Prescription Dispensing System Lease and Support for Portland Area Indian Health Services
Solicitation number
75H71326Q00020
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This is a Schedule of Items pricing template for the Indian Health Service Portland Area solicitation for a Robotic Prescription Dispensing System Lease and Support contract. Offerors must provide separate U.S. dollar pricing for each Contract Line Item Number (CLIN), with all pricing inclusive of labor, materials, travel, shipping, software licenses, maintenance, support, and other incidentals necessary to satisfy the statement of work.

The contract structure includes a base year (April 1, 2026 through March 31, 2027) comprising five CLINs: CLIN 0001 for a one-time WIN 11 & Server 2019 Upgrade, and CLINs 0002-0005 for 12-month recurring leases and support services for the Workflow Platform Server and Robotic Prescription Dispensing System. Four option years (April 1, 2027 through March 31, 2031) contain recurring monthly CLINs only, with each option year including lease and support services for both the Workflow Platform Server and Robotic Prescription Dispensing System. Offerors must calculate extended prices for each CLIN and provide Base Year Total, Option Year totals, and a Grand Total for the entire contract period. Vendors must complete the vendor information block identifying company name, UEI, contract number if pricing is based on a Federal Supply Schedule or other contract vehicle, point of contact, phone, email, authorized signature, and date. The government may evaluate pricing for the base year and all option years combined.

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Indian Health Service - Portland Area Page 1

Schedule of Items Robotic Prescription Dispensing System Lease and Support

Instructions to Offerors: Enter separate pricing for each CLIN in U.S. dollars. Pricing shall include all labor, materials, travel, shipping, software/licenses, maintenance, support, and other incidentals necessary to satisfy the statement of work. Option-year prices shall be stated separately. If any quoted pricing is based on a Federal Supply Schedule or other contract vehicle, identify that contract number in the vendor information block below.

CLIN Description Period of Performance Unit Qty Unit Price Extended Price

WIN 11 & Server 2019 Upgrade

04/01/2026 - 03/31/2027 Lot 1 $ _____________ $ _____________

0002 Workflow Platform Server Lease 04/01/2026 - 03/31/2027 Month 12 $ _____________ $ _____________

Workflow Platform Server Support

04/01/2026 - 03/31/2027 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Lease

04/01/2026 - 03/31/2027 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Support

04/01/2026 - 03/31/2027 Month 12 $ _____________ $ _____________

Base Year Total $ _____________

1001 Workflow Platform Server Lease 04/01/2027 - 03/31/2028 Month 12 $ _____________ $ _____________

Workflow Platform Server Support

04/01/2027 - 03/31/2028 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Lease

04/01/2027 - 03/31/2028 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Support

04/01/2027 - 03/31/2028 Month 12 $ _____________ $ _____________

Option Year 1 Total $ _____________

2001 Workflow Platform Server Lease 04/01/2028 - 03/31/2029 Month 12 $ _____________ $ _____________

Workflow Platform Server Support

04/01/2028 - 03/31/2029 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Lease

04/01/2028 - 03/31/2029 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Support

04/01/2028 - 03/31/2029 Month 12 $ _____________ $ _____________

Option Year 2 Total $ _____________

Indian Health Service - Portland Area Page 2

CLIN Description Period of Performance Unit Qty Unit Price Extended Price

3001 Workflow Platform Server Lease 04/01/2029 - 03/31/2030 Month 12 $ _____________ $ _____________

Workflow Platform Server Support

04/01/2029 - 03/31/2030 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Lease

04/01/2029 - 03/31/2030 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Support

04/01/2029 - 03/31/2030 Month 12 $ _____________ $ _____________

Option Year 3 Total $ _____________

4001 Workflow Platform Server Lease 04/01/2030 - 03/31/2031 Month 12 $ _____________ $ _____________

Workflow Platform Server Support

04/01/2030 - 03/31/2031 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Lease

04/01/2030 - 03/31/2031 Month 12 $ _____________ $ _____________

Robotic Prescription Dispensing System Support

04/01/2030 - 03/31/2031 Month 12 $ _____________ $ _____________

Option Year 4 Total $ _____________

Grand Total (Base + 4 Option Years) $ _____________

Notes: (1) Base Year includes one-time CLIN 0001 plus recurring monthly CLINs 0002-0005. (2) Option Years 1-4 include recurring monthly CLINs only. (3) The Government may evaluate the total price for the base year and all option years. (4) Offerors may attach additional pricing assumptions, but the schedule above shall govern for evaluation purposes.

Vendor Name: ______________________________________________ UEI: ____________________________

Contract Number / Schedule (if applicable): ____________________________ Phone: ____________________________

Point of Contact: _____________________________________________ Email: ____________________________

Authorized Signature: _______________________________________ Date: ____________________________

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Indian Health Service Portland Area:
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Vendor Name:
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Contract Number Schedule if applicable:
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Date:
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