Attachment 2 - Dental Lab Fees Quote Form 8012022.xlsx

XLSX spreadsheet 14 KB Posted

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Dental Laboratory Services - Cass Lake Indian Health Service Hospital
Solicitation number
75H70522R00010
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Attachment 4 - Amendment 1 pros_delivered_2022_.pdf PDF
Attachment 3 - IHS IEE Representation Form_Jan 2022_508 Compliant.pdf PDF
Combined Synposis Solicitation 75H70522R00010.pdf PDF
Attachment 1 - SOW Dental Laboratory.pdf PDF

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Quoted Prices Lab Name: ________________________________ Lab Phone Number: __________________ Date: __________

LIST LAB FEES
(flat rate that includes shipping & handling costs, custom trays, material fees, infection control fees, etc.)Premium Denture2Economy DenturePremium Partial2Economy PartialInterim Partial (2 clasps, 1-8 teeth)Interim Partial
(no clasps, 1-3 teeth)Premium Flexible Partial2Economy Flexible Partial
Denture RelineAcrylic Repair (Denture / Partial)Add / Replace Tooth2 (Denture / Partial)Repair Frameworks / Clasps
Gold CrownLithium Disilicate CrownZirconia CrownEsthetic Zirconia CrownLithium Disilicate fused to Zirconia CrownPFM CrownBi-Lat. Space Maint. (Max. or Mand.)TPA Space Maint.Bruxism SplintResin Based Partial w/ 2 Clasps2 (Transitional
Denture)Gasket Retention Partial (Transitional Denture)

2Denture teeth must be equivalent to IPN (w/ lifetime warranty)

*Please ensure each product for which a lab fee is quoted meets the technical requirements as laid out in the Statement of Work!

Brand Name List

LIST BRANDS USED FOR QUOTED RATES
Economy Denture Teeth:
Premium Denture Teeth:
PFM alloy:
PFM ceramic:
Gold Crowns:
% Au
Lithium Disilicate:
Esthetic Zirconia:
Lithium Disilicate Fused to Zirconia:
Bruxism Splints:
Flexible Partial:
Gasket Retention Partial:
Partial Frameworks:

Warranties

LIST WARRANTIES FOR QUOTED SERVICES
Economy Dentures:
Premium Dentures:
Economy Partials:
Premium Partials:
Interim Partials:
Flexible Partial:
Acrylic Repairs / Adding Teeth:
Framework Repairs:
PFM Crowns:
Gold Crowns:
Lithium Disilicate:
Esthetic Zirconia:
Lithium Disilicate Fused to Zirconia:
Space Maintainers:
Bruxism Splints:
Resin Based Partials:
Gasket Retention Partial:

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