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1. NTE Profit Percentages
PRICING TABLE 1- VIRTUAL MEDICAL SPECIALIST CONSULTATIONS
| | Proposed Not-to-Exceed (NTE) Profit Percentages | | | |
| Base Period | Option Period 1 | Option Period 2 | Option Period 3 | Option Period 4 | Six-Month Option to Extend |
| 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Notes |
| 1) Offerors shall propose one profit percentage per contract year. |
| 2) The proposed profit percentages shall not exceed two decimal places. |
| 3) Offerors shall not alter the Excel sheet in any way other than to fill out the yellow-highlighted areas. |
| 4) Offerors shall populate each cell highlighted in yellow. |
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2. Contract Pricing
| PRICING TABLE 2- VIRTUAL MEDICAL SPECIALIST CONSULTATIONS | | | | | | |
| Base Period | | | | | | Notes: |
| CLIN # | CLIN Type | CLIN Description | Est. Number of Consultations | Fixed-Unit Price | Extended Price | 1) Offerors shall populate each cell highlighted in yellow. Do not populate an extended price for CLIN X001; those cells will automatically populate based on calculated extended price for each Sub-CLIN X001A-X001C. |
| | | | | | 2) For CLIN X002, Offerors shall use absolute values and not round up. |
| | | | | | 3) Offerors shall propose one not-to-exceed (NTE) firm-fixed-unit price (FFUP) per contract period for each Sub-CLIN X001A- X001C. The FFUP shall include the cost for accessing the Offeror's telehealth platform. |
| 0001 | FFUP | Medical Specialist Consultations | | | $0.00 | 4) Offerors shall not alter the Excel sheet in any way other than to fill out the yellow-highlighted areas. |
| | Sub-CLIN 0001A: Type 1- Provider-Specialist | 250 | | $0.00 | 5) A NTE amount of $10,000 is pre-populated for CLIN X003 for each contract period, with the exception of the six-month extension, whose NTE amount is $5,000. |
| | Sub-CLIN 0001B: Type 4- MED Washington-Specialist | 250 | | $0.00 | 6) The total for each contract period reads $10,000 ($5,000 for the six-month extension) due to the formula to add the relevant CLINs, but the total will update as Offerors populate each yellow cell. The same is true for the Grand Total cell. |
| | Sub-CLIN 0001C: Type 5- UME-Specialist | 100 | | $0.00 | |
| 0002 | FFP | Program Management | | | | |
| 0003 | M | Other Direct Costs | | | $10,000.00 | |
| Base Period Total: | | | | | $10,000.00 | |
| Option Period 1 | | | | | |
| CLIN # | CLIN Type | CLIN Description | Est. Number of Consultations | Fixed-Unit Price | Extended Price |
| 1001 | FFUP | Medical Specialist Consultations | | $0.00 |
| | Sub-CLIN 1001A: Type 1- Provider-Specialist | 250 | $0.00 |
| | Sub-CLIN 1001B: Type 4- MED Washington-Specialist | 250 | $0.00 |
| | Sub-CLIN 1001C: Type 5- UME-Specialist | 100 | $0.00 |
| 1002 | FFP | Program Management | | |
| 1003 | M | Other Direct Costs | | $10,000.00 |
| Option Period 1 Total: | | | | $10,000.00 |
| Option Period 2 | | | | | |
| CLIN # | CLIN Type | CLIN Description | Est. Number of Consultations | Fixed-Unit Price | Extended Price |
| 2001 | FFUP | Medical Specialist Consultations | | $0.00 |
| | Sub-CLIN 2001A: Type 1- Provider-Specialist | 500 | $0.00 |
| | Sub-CLIN 2001B: Type 4- MED Washington-Specialist | 500 | $0.00 |
| | Sub-CLIN 2001C: Type 5- UME-Specialist | 100 | $0.00 |
| 2002 | FFP | Program Management | | |
| 2003 | M | Other Direct Costs | | $10,000.00 |
| Option Period 2 Total: | | | | $10,000.00 |
| Option Period 3 | | | | | |
| CLIN # | CLIN Type | CLIN Description | Est. Number of Consultations | Fixed-Unit Price | Extended Price |
| 3001 | FFUP | Medical Specialist Consultations | | $0.00 |
| | Sub-CLIN 3001A: Type 1- Provider-Specialist | 500 | $0.00 |
| | Sub-CLIN 3001B: Type 4- MED Washington-Specialist | 500 | $0.00 |
| | Sub-CLIN 3001C: Type 5- UME-Specialist | 100 | $0.00 |
| 3002 | FFP | Program Management | | |
| 3003 | M | Other Direct Costs | | $10,000.00 |
| Option Period 3 Total: | | | | $10,000.00 |
| Option Period 4 | | | | | |
| CLIN # | CLIN Type | CLIN Description | Est. Number of Consultations | Fixed-Unit Price | Extended Price |
| 4001 | FFUP | Medical Specialist Consultations | | $0.00 |
| | Sub-CLIN 4001A: Type 1- Provider-Specialist | 500 | $0.00 |
| | Sub-CLIN 4001B: Type 4- MED Washington-Specialist | 500 | $0.00 |
| | Sub-CLIN 4001C: Type 5- UME-Specialist | 100 | $0.00 |
| 4002 | FFP | Program Management | | |
| 4003 | M | Other Direct Costs | | $10,000.00 |
| Option Period 4 Total: | | | | $10,000.00 |
| Six-Month Extension (FAR 52.217-8) | | | | | |
| CLIN # | CLIN Type | CLIN Description | Est. Number of Consultations | Fixed-Unit Price | Extended Price |
| 5001 | FFUP | Medical Specialist Consultations | | $0.00 |
| | Sub-CLIN 5001A: Type 1- Provider-Specialist | 250 | $0.00 |
| | Sub-CLIN 5001B: Type 4- MED Washington-Specialist | 250 | $0.00 |
| | Sub-CLIN 5001C: Type 5- UME-Specialist | 50 | $0.00 |
| 5002 | FFP | Program Management | | |
| 5003 | M | Other Direct Costs | | $5,000.00 |
| Six-Month Extension Total: | | | | $5,000.00 |
Grand Total: $55,000.00
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