Attachment 1 Pricing Form Amendment 3.xlsx

XLSX spreadsheet 40 KB Posted

Attached to
Final Request for Quote for Occupational Health Support Services III (OHSS III)
Solicitation number
80LARC25Q7001
Issued by

About this file

The file is a Pricing Form (Attachment 1) for NASA Langley Research Center's Occupational Health Support Services III (OHSS III) solicitation. The pricing template requires offerors to complete detailed labor rate information across a 5-year contract period, including a base period and three 1-year option periods. The document includes worksheets for baseline services, labor rate buildups, and mandatory fee-for-service items, with spaces for 15 different labor categories and multiple cost components such as direct labor rates, markup, and bill rates.

The pricing form covers cost details for various occupational health services, including medical examinations (pre-placement, surveillance, job certification), vaccination services, employee assistance program counseling, and health maintenance examinations. The total estimated Other Direct Costs (ODC) for the contract period is $98,838, with government-provided yellow highlighted numbers that should not be altered. The solicitation is an 8(a) set-aside competition with a NAICS code of 621999, small business size standard of $20.5M, and anticipated contract award date of July 31, 2025, with a contract effective date of September 1, 2025.

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Other files

File Type Posted
OHSS III SF 1449 Amendment 4.pdf PDF
Exhibit E Wage Determination Amendment 4.pdf PDF
EXHIBIT D - Position Descriptions Amendment 4.pdf PDF
80LARC25Q7001 Amendment 4.pdf PDF
Exhibit A - PWS Amendment 4.pdf PDF
EXHIBIT D - Position Descriptions Amendment 3.pdf PDF
80LARC25Q7001 Amendment 3.pdf PDF
Exhibit C Installation-Accountable Government Property Amendment 3.xlsx XLSX spreadsheet
OHSS III SF 1449 Amendment 3.pdf PDF
OHSS III Sections A - E Amendment 3.pdf PDF
Exhibit A - PWS Amendment 3.pdf PDF
OHSS III Sections A - E Amendment 2.pdf PDF
Exhibit C Installation-Accountable Government Property.xlsx XLSX spreadsheet
OHSS III Question and Answers Amendment 2.pdf PDF
80LARC25Q7001 Amendment 2.pdf PDF
Attachment 8 - Building 1216 LaRC Clinic Layout.pdf PDF
Attachment 5 Historical Current Data Amendment 2.pdf PDF
Exhibit A - PWS Amendment 2.pdf PDF
EXHIBIT D - Position Descriptions Amendment 2.pdf PDF
OHSS III SF 1449 Amendment 1.pdf PDF
Attachment 1 Pricing Form Amendment 1.xlsx XLSX spreadsheet
OHSS3 Pre-Quote Conference Final.pdf PDF
OHSS III Sections A - E Amendment 1.pdf PDF
OHSS III Question and Answers Amendment 1.pdf PDF
80LARC25Q7001 Amendment 1.pdf PDF
Pre-Quote Conference Sign-in Sheet.pdf PDF
Final RFQ 80LARC25Q7001 SF 1449 and Section A-E.pdf PDF
OHSS III Final Request for Quote Cover Letter.pdf PDF
Attachments.zip ZIP file
Exhibits.zip ZIP file
OHSS III Question and Answers.pdf PDF
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Instructions

Cost Template Instructions
1Please Read instructions in solicitation.
2The following worksheets are formula driven requiring no input except for adding offeror name:
CLIN Summary
Baseline Services
Sub Baseline Services
3Quoter to provide payrates and markup by labor category on following worksheets:
Baseline Labor Rate Buildup
4Quoter's Sub to provide payrates and markup by labor category on following worksheets:
Sub Baseline Labor Rate Buildup
NOTE: Add additional worksheets for additional Subs as necessary and adjust other worksheets to accommodate changes.
6Quoter to provide the prices for all the mandatory fee for service items and include any additional fee for service items that will be offered along with the price
Mandatory FFS
NOTE: They may be sample data on worksheets that needs to be removed.

CLIN Summary

CLIN SUMMARY
OHSS III
CLIN Summary
CLINDescriptionBase PeriodOption Period 1Option Period 2Option Period 3Total
CLIN 0001Baseline Services$ - 0$ - 0$ - 0$ - 0$ - 0
CLIN 0002Other Direct costs (ODC) CR no fee$ 38,051$ 19,749$ 20,256$ 20,782$ 98,838
Total$ 38,051$ 19,749$ 20,256$ 20,782$ 98,838
All data flows from other worksheets. Confirm accuracy of formulas.
Yellow Highlighted numbers are government provided, do not change.

Baseline Services

Quoter: _________________________________________________

Year 1Year 2Base PeriodOption Period 1 -Year 3Option Period 2 -Year 4Option Period 3 -Year 5Total
Labor categoryHoursRateCostHoursRateCostHoursRateCostHoursRateCostHoursRateCostHoursCost
labor cat 10$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 20$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 30$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 40$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 50$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 60$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 70$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 80$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 90$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 100$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 110$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 120$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 130$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 140$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 150$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
Subtotal Labor0$ - 00$ - 00$ - 00$ - 00$ - 00$ - 00$ - 0
Sub0$ - 00$ - 00$ - 00$ - 00$ - 00$ - 00$ - 0
Total0$ - 0$ - 00$ - 00$ - 00$ - 00$ - 00$ - 0
travel/training

All data flows from other worksheets

All data flows from other worksheets. Confirm accuracy of formulas.

Baseline Labor Rate Buildup

Quoter: _________________________________________________
Year 1
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 2
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 3
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 4
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 5
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00

Sub Baseline Services

Quoter: _________________________________________________

Year 1Year 2Base PeriodOption Period 1 -Year 3Option Period 2 -Year 4Option Period 3 -Year 5Total
Labor categoryHoursRateCostHoursRateCostHoursRateCostHoursRateCostHoursRateCostHoursCost
labor cat 10$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 20$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 30$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 40$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 50$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 60$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 70$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 80$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 90$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 100$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 110$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 120$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 130$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 140$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
labor cat 150$0.00$ - 00$0.00$ - 0- 0$ - 00$0.00$ - 00$0.00$ - 00$0.00$ - 00$ - 0
Total Sub0$ - 00$ - 00$ - 00$ - 00$ - 00$ - 00$ - 0
All data flows from other worksheets

All data flows from other worksheets. Confirm accuracy of formulas.

Sub Baseline Labor Rate Buildup

Quoter: _________________________________________________
Year 1
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 2
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 3
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 4
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00
Year 5
Labor CategoryHours Per Labor CategoryDirect Labor RateMarkupBill Rate Includes FeeWD or ExemptSource for Pay Rate
labor cat 10$0.00$0.00$0.00
labor cat 20$0.00$0.00$0.00
labor cat 30$0.00$0.00$0.00
labor cat 40$0.00$0.00$0.00
labor cat 50$0.00$0.00$0.00
labor cat 60$0.00$0.00$0.00
labor cat 70$0.00$0.00$0.00
labor cat 80$0.00$0.00$0.00
labor cat 90$0.00$0.00$0.00
labor cat 100$0.00$0.00$0.00
labor cat 110$0.00$0.00$0.00
labor cat 120$0.00$0.00$0.00
labor cat 130$0.00$0.00$0.00
labor cat 140$0.00$0.00$0.00
labor cat 150$0.00$0.00$0.00

Mandatory FFS Mandatory Fee-for-Services for LaRC Contractors and Civil Servant Retirees (*Note: the PWS paragraph references below are to describe the services to be offered. Although the PWS paragraphs may say “at no cost to employee,” that is only referring to Civil Servants and LaRC Exchange Personnel.

Contract Year 1 Price (each)Contract Year 2 Price (each)Contract Year 3 Price (each)Contract Year 4 Price (each)Contract Year 5 Price (each)
Occupation-Related Examination: Pre-Placement (PWS Section 1.6.4)
Occupation-Related Examination: Surveillance (PWS Section 1.6.4)
Occupation-Related Examination: Job Certification/ Special Purpose (PWS Section 1.6.4)
Occupation-Related Examination: Job Separation/ Retirement (PWS Section 1.6.4)
Occupation-Related Examination: Flight Physical Examinations IAW NASA Aviation Medical Certification Standards (PWS Section 1.6.4)
Optician Services (PWS Section 1.6.9)
International Travel: Pre‐travel physical assessment, counseling, required immunizations, travel kits (PWS Section 1.6.4)
Hepatitis A and B Vaccination (PWS Section 1.7.1)
Tetanus Vaccination (PWS Section 1.7.1)
TDAP Vaccination (PWS Section 1.7.1)
Mandatory Fee-for-Services for All Employees - This includes LaRC Civil Service employees, LaRC Exchange employees, LaRC Contractors, and LaRC Civil Service Retirees
Non-Work-Related Injury/Illness Office Visit (PWS Section 1.6.3)
Administration of Medicines and Treatment (PWS Section 1)
EAP Counseling Session per Hour* (PWS Section 2.0)

* As noted in PWS 2.0, LaRC Civil Service employees, LaRC Exchange employees, and their families incur no cost for up to 5 sessions per concern. This FFS pricing listed here only applies to LaRC Civil Service employees, Exchange employees and their families for any sessions beyond the first 5 sessions per concern. For LaRC contractors the counseling session per hour price applies to initial and all other sessions.

Head-to-Toe Complete Health Maintenance Examination (PWS Section 8)
Partial Health Maintenance Examination (PWS Section 8)

File details come from the government source that posted it. Updated .