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ATTACHMENT 1 – PRICE SCHEDULE
| Description of Service |
| 12-Month Estimated Quantity |
| Unit |
| Unit Price |
| Estimated Total Amount |
(Estimated Maximum)
| CLIN |
| CONTRACT PERIOD OF PERFORMANCE 3/1/2025-2/28/2026 |
| 0001 |
| (A0428) Basic Life Support, Non-Emergency Transport, (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 0002 |
| (A0429) Basic Life Support, Emergency transport (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 0003 |
| (A0426) Non-Emergent Advance Life Support Transport, Level 1 (ALS 1) ((base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 0004 |
| (A0422) Advanced Life Support, Emergency Transport, Level 1 (ALS 1) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 0005 |
| (A0434) Critical Care Transport (Upper-Level Care) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 0006 |
| (A0380) Mileage Trip (Outside the Base Rate) |
| 1 |
| Mile |
| 0007 |
| (A0435) Waiting Time (more than 30 minutes shall be paid in 30-minute increments). |
| 1 |
| Each 30-minute interval |
| 0008 |
| Wheelchair Van Transportation Service - (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
TOTAL BASE
| Description of Service |
| 12-Month Estimated Quantity |
| Unit |
| Unit Price |
| Estimated Total Amount |
(Estimated Maximum)
CONTRACT PERIOD OF PERFORMANCE 3/1/2026-2/28/2027
| 1001 |
| (A0428) Basic Life Support, Non-Emergency Transport, (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 1002 |
| (A0429) Basic Life Support, Emergency transport (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 1003 |
| (A0426) Non-Emergent Advance Life Support Transport, Level 1 (ALS 1) ((base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 1004 |
| (A0422) Advanced Life Support, Emergency Transport, Level 1 (ALS 1) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 1005 |
| (A0434) Critical Care Transport (Upper-Level Care) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 1006 |
| (A0380) Mileage Trip (Outside the Base Rate) |
| 1 |
| Mile |
| 1007 |
| (A0435) Waiting Time (more than 30 minutes shall be paid in 30-minute increments). |
| 1 |
| Each 30-minute interval |
| 1008 |
| Wheelchair Van Transportation Service - (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
TOTAL OY 1
| Description of Service |
| 12-Month Estimated Quantity |
| Unit |
| Unit Price |
| Estimated Total Amount |
(Estimated Maximum)
CONTRACT PERIOD OF PERFORMANCE 3/1/2027-2/29/2028
| 2001 |
| (A0428) Basic Life Support, Non-Emergency Transport, (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 2002 |
| (A0429) Basic Life Support, Emergency transport (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 2003 |
| (A0426) Non-Emergent Advance Life Support Transport, Level 1 (ALS 1) ((base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 2004 |
| (A0422) Advanced Life Support, Emergency Transport, Level 1 (ALS 1) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 2005 |
| (A0434) Critical Care Transport (Upper-Level Care) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 2006 |
| (A0380) Mileage Trip (Outside the Base Rate) |
| 1 |
| Mile |
| 2007 |
| (A0435) Waiting Time (more than 30 minutes shall be paid in 30-minute increments). |
| 1 |
| Each 30-minute interval |
| 2008 |
| Wheelchair Van Transportation Service - (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
TOTAL OY 2
| Description of Service |
| 12-Month Estimated Quantity |
| Unit |
| Unit Price |
| Estimated Total Amount |
(Estimated Maximum)
CONTRACT PERIOD OF PERFORMANCE 3/1/2028-2/28/2029
| 3001 |
| (A0428) Basic Life Support, Non-Emergency Transport, (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 3002 |
| (A0429) Basic Life Support, Emergency transport (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 3003 |
| (A0426) Non-Emergent Advance Life Support Transport, Level 1 (ALS 1) ((base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 3004 |
| (A0422) Advanced Life Support, Emergency Transport, Level 1 (ALS 1) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 3005 |
| (A0434) Critical Care Transport (Upper-Level Care) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 3006 |
| (A0380) Mileage Trip (Outside the Base Rate) |
| 1 |
| Mile |
| 3007 |
| (A0435) Waiting Time (more than 30 minutes shall be paid in 30-minute increments). |
| 1 |
| Each 30-minute interval |
| 3008 |
| Wheelchair Van Transportation Service - (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
TOTAL OY 3
| Description of Service |
| 12-Month Estimated Quantity |
| Unit |
| Unit Price |
| Estimated Total Amount |
(Estimated Maximum)
OY4 PERIOD OF PERFORMANCE 3/1/2029-2/28/2030
| 4001 |
| (A0428) Basic Life Support, Non-Emergency Transport, (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 4002 |
| (A0429) Basic Life Support, Emergency transport (base rate, to include first 15 miles) One-Way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 4003 |
| (A0426) Non-Emergent Advance Life Support Transport, Level 1 (ALS 1) ((base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 4004 |
| (A0422) Advanced Life Support, Emergency Transport, Level 1 (ALS 1) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 4005 |
| (A0434) Critical Care Transport (Upper-Level Care) (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
| 4006 |
| (A0380) Mileage Trip (Outside the Base Rate) |
| 1 |
| Mile |
| 4007 |
| (A0435) Waiting Time (more than 30 minutes shall be paid in 30-minute increments). |
| 1 |
| Each 30-minute interval |
| 4008 |
| Wheelchair Van Transportation Service - (base rate to include first 15 miles) One-way trip is equivalent to one each for the unit of issue |
| 1 |
| One-Way Trip |
TOTAL OY 4
ESTIMATED GRAND TOTAL
IDIQ contract Minimum $ One (1) One-Way Trip of CLIN 001 or 0008 first utilized.
IDIQ contract Maximum $ ____________________________________________
