Attachment 003 Bid Schedule OMSP College Station TX Excel Document.xlsx

XLSX spreadsheet 23 KB Posted

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Occupational Medical Surveillance Program - College Station TX - Base + 4 Option Periods
Solicitation number
12805B21Q0292
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Summary

Attachment 003 Bid Schedule Occupational Medical Surveillance Program College Station TX
Offeror
Quote Number
Date of Quote

Summary Cost Section

BASE PERIOD $0.00

OPTION PERIOD 1 $0.00

OPTION PERIOD 2 $0.00

OPTION PERIOD 3 $0.00

OPTION PERIOD 4 $0.00

Total (This is your Quote total) $0.00

Instructions: Please complete the yellow highlighted fields. The total will compute automatically on the total line when all Option Periods are complete.

BASE Period

BASE PERIOD - CONTRACT AWARD DATE THROUGH OCTOBER 31, 2021, SERVICE TO BE COMPLETED BY SEPTEMBER 30, 2021 *Note less than 1 year
Occupational Medical Services to be provided for Agricultural Research Service at College Station, Texas in accordance with Attachment 001 Statement of Work
Item No.ItemEstimated QuantityUnit PriceTotal
1Physical Examination30$0.00$ - 0
2General Lab Tests
(Blood chemistry, hematology, and Urinalysis)30$0.00$ - 0
3Chest X-ray (one view)6$0.00$ - 0
4Spironmetry (Lung Function)10$0.00$ - 0
5Cholinesterase Determination10$0.00$ - 0
6Specific Cancer Tests
A) Sputum cytology1$0.00$ - 0
B) Urinary sediment cytology1$0.00$ - 0
7Audiometric examination8$0.00$ - 0
8Thyroid2$0.00$ - 0
9Sodium2$0.00$ - 0
10Potassium2$0.00$ - 0
11Histoplasma2$0.00$ - 0
12Additional Testsas approved
13Ergonomics & Evaluation2$0.00$ - 0
14Vaccination: Tetanus Shot2$0.00$ - 0
15Respirator Evaluation4$0.00$ - 0
16Administrative Services6$0.00$ - 0
17Consultation for chemical exposure response1$0.00$ - 0
Total for Option Period Noted above$ - 0

Instructions: Please complete the yellow highlighted fields. The total will compute automatically in the bottom line and copy to the summary page.

OMSP Cost Estimation

Option Period 1

OPTION PERIOD 1 - 11/1/2021 THROUGH 10/31/2022. SERVICE TO BE COMPLETED BY SEPTEMBER 30, 2022
Occupational Medical Services to be provided for Agricultural Research Service at College Station, Texas in accordance with Attachment 001 Statement of Work
Item No.ItemEstimated QuantityUnit PriceTotal
1Physical Examination28$0.00$ - 0
2General Lab Tests
(Blood chemistry, hematology, and Urinalysis)28$0.00$ - 0
3Chest X-ray (one view)6$0.00$ - 0
4Spironmetry (Lung Function)9$0.00$ - 0
5Cholinesterase Determination10$0.00$ - 0
6Specific Cancer Tests
A) Sputum cytology1$0.00$ - 0
B) Urinary sediment cytology1$0.00$ - 0
7Audiometric examination8$0.00$ - 0
8Thyroid2$0.00$ - 0
9Sodium2$0.00$ - 0
10Potassium2$0.00$ - 0
11Histoplasma2$0.00$ - 0
12Additional Testsas approved
13Ergonomics & Evaluation2$0.00$ - 0
14Vaccination: Tetanus Shot2$0.00$ - 0
15Respirator Evaluation4$0.00$ - 0
16Administrative Services6$0.00$ - 0
17Consultation for chemical exposure response1$0.00$ - 0
Total for Option Period Noted above$ - 0

Instructions: Please complete the yellow highlighted fields. The total will compute automatically in the bottom line and copy to the summary page.

Option Period 2

OPTION PERIOD 2 - 11/1/2022 THROUGH 10/31/2023. SERVICE TO BE COMPLETED BY SEPTEMBER 30, 2023
Occupational Medical Services to be provided for Agricultural Research Service at College Station, Texas in accordance with Attachment 001 Statement of Work
Item No.ItemEstimated QuantityUnit PriceTotal
1Physical Examination28$0.00$ - 0
2General Lab Tests
(Blood chemistry, hematology, and Urinalysis)28$0.00$ - 0
3Chest X-ray (one view)6$0.00$ - 0
4Spironmetry (Lung Function)9$0.00$ - 0
5Cholinesterase Determination10$0.00$ - 0
6Specific Cancer Tests
A) Sputum cytology1$0.00$ - 0
B) Urinary sediment cytology1$0.00$ - 0
7Audiometric examination8$0.00$ - 0
8Thyroid2$0.00$ - 0
9Sodium2$0.00$ - 0
10Potassium2$0.00$ - 0
11Histoplasma2$0.00$ - 0
12Additional Testsas approved
13Ergonomics & Evaluation2$0.00$ - 0
14Vaccination: Tetanus Shot2$0.00$ - 0
15Respirator Evaluation4$0.00$ - 0
16Administrative Services6$0.00$ - 0
17Consultation for chemical exposure response1$0.00$ - 0
Total for Option Period Noted above$ - 0

Instructions: Please complete the yellow highlighted fields. The total will compute automatically in the bottom line and copy to the summary page.

Option Period 3

OPTION PERIOD 3 - 11/1/2023 THROUGH 10/31/2024. SERVICE TO BE COMPLETED BY SEPTEMBER 30, 2024
Occupational Medical Services to be provided for Agricultural Research Service at College Station, Texas in accordance with Attachment 001 Statement of Work
Item No.ItemEstimated QuantityUnit PriceTotal
1Physical Examination28$0.00$ - 0
2General Lab Tests
(Blood chemistry, hematology, and Urinalysis)28$0.00$ - 0
3Chest X-ray (one view)6$0.00$ - 0
4Spironmetry (Lung Function)9$0.00$ - 0
5Cholinesterase Determination10$0.00$ - 0
6Specific Cancer Tests
A) Sputum cytology1$0.00$ - 0
B) Urinary sediment cytology1$0.00$ - 0
7Audiometric examination8$0.00$ - 0
8Thyroid2$0.00$ - 0
9Sodium2$0.00$ - 0
10Potassium2$0.00$ - 0
11Histoplasma2$0.00$ - 0
12Additional Testsas approved
13Ergonomics & Evaluation2$0.00$ - 0
14Vaccination: Tetanus Shot2$0.00$ - 0
15Respirator Evaluation4$0.00$ - 0
16Administrative Services6$0.00$ - 0
17Consultation for chemical exposure response1$0.00$ - 0
Total for Option Period Noted above$ - 0

Instructions: Please complete the yellow highlighted fields. The total will compute automatically in the bottom line and copy to the summary page.

Option Period 4

OPTION PERIOD 4 - 11/1/2024 THROUGH 10/31/2025. SERVICE TO BE COMPLETED BY SEPTEMBER 30, 2025
Occupational Medical Services to be provided for Agricultural Research Service at College Station, Texas in accordance with Attachment 001 Statement of Work
Item No.ItemEstimated QuantityUnit PriceTotal
1Physical Examination28$0.00$ - 0
2General Lab Tests
(Blood chemistry, hematology, and Urinalysis)28$0.00$ - 0
3Chest X-ray (one view)6$0.00$ - 0
4Spironmetry (Lung Function)9$0.00$ - 0
5Cholinesterase Determination10$0.00$ - 0
6Specific Cancer Tests
A) Sputum cytology1$0.00$ - 0
B) Urinary sediment cytology1$0.00$ - 0
7Audiometric examination8$0.00$ - 0
8Thyroid2$0.00$ - 0
9Sodium2$0.00$ - 0
10Potassium2$0.00$ - 0
11Histoplasma2$0.00$ - 0
12Additional Testsas approved
13Ergonomics & Evaluation2$0.00$ - 0
14Vaccination: Tetanus Shot2$0.00$ - 0
15Respirator Evaluation4$0.00$ - 0
16Administrative Services6$0.00$ - 0
17Consultation for chemical exposure response1$0.00$ - 0
Total for Option Period Noted above$ - 0

Instructions: Please complete the yellow highlighted fields. The total will compute automatically in the bottom line and copy to the summary page.

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