Attachment 2 - Price Schedule Template - Medical Screening.xlsx
XLSX spreadsheet 25 KB Posted
- Attached to
- Medical Screening
- Solicitation number
- 134100-26-0013
About this file
This is a price schedule template for medical screening services to be provided to the Department of Commerce (DOC) and its bureaus and offices. The template is designed for submission as part of the RFQ 134100-26-0013, which seeks to establish a single award firm fixed unit price Blanket Purchase Agreement (BPA) for medical screening services. The BPA will have a 12-month base period followed by four optional 12-month renewal periods, for a potential total contract duration of five years.
The template itself is a spreadsheet designed to capture pricing data but does not contain specific performance requirements, service level details, or other substantive contract terms. Contractors responding to this solicitation are expected to complete this price schedule template to submit their unit pricing for the medical screening services. The template serves as the primary vehicle for price evaluation and will determine the cost basis for the firm fixed unit price structure of the resulting BPA with the Department of Commerce.
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Other files
| File | Type | Posted |
|---|---|---|
| QA Medical Screening RESPONSES.xlsx | XLSX spreadsheet | |
| Attachment 1 - PWS BIS Medical Exam.pdf | ||
| Request For Quote - Medical Screening_vF.pdf |
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| Price Matrix - Medical Screening | ||||
| Task Name | Medical Clearance and Surveillance Examinations Task Order | |||
| *Estimated quantities are provided for planning and evaluation purposes only and do not represent a guarantee of future orders. Actual quantities may vary, and individual call orders may exceed the estimated quantities identified | ||||
| Base Year | ||||
| Items Required | Fixed Unit Price | *Estimated Quantity | ||
| CLIN 0001 Audiometry | $ | 25 | ERROR:#VALUE! | |
| CLIN 0002 Electrocardiogram | $ | 25 | ERROR:#VALUE! | |
| CLIN 0003 Comprehensive Vision | $ | 25 | ERROR:#VALUE! | |
| CLIN 0004 Vital Signs/Body Ht and Wt (no charge with exam) | $ | 25 | ERROR:#VALUE! | |
| CLIN 0005 Tuberculosis Skin Test (subject to availability) | $ | 25 | ERROR:#VALUE! | |
| CLIN 0006 Comprehensive Exam (Moderate Complexity) | $ | 70 | ERROR:#VALUE! | |
| CLIN 0007 Missed Work-up or missed procedure | $ | 25 | ERROR:#VALUE! | |
| CLIN 0008 Missed Exam | $ | 25 | ERROR:#VALUE! | |
| CLIN 0009 Physician - Occupational Medicine Consultant (Case Review) | $ | 70 | ERROR:#VALUE! | |
| CLIN 0010 Lead, industrial whole blood | $ | 70 | ERROR:#VALUE! | |
| CLIN 0011 ZPP, Blood Protoporphyrins, zinc | $ | 70 | ERROR:#VALUE! | |
| CLIN 0015 Project Office Management - FFP | $ | 1 | ERROR:#VALUE! |
| TOTAL COSTS | ERROR:#VALUE! | |||
| Year 1 | ||||
| Items Required | Fixed Unit Price | *Estimated Quantity | ||
| CLIN 1001 Audiometry | $ | 25 | ERROR:#VALUE! | |
| CLIN 1002 Electrocardiogram | $ | 25 | ERROR:#VALUE! | |
| CLIN 1003 Comprehensive Vision | $ | 25 | ERROR:#VALUE! | |
| CLIN 1004 Vital Signs/Body Ht and Wt (no charge with exam) | $ | 25 | ERROR:#VALUE! | |
| CLIN 1005 Tuberculosis Skin Test (subject to availability) | $ | 25 | ERROR:#VALUE! | |
| CLIN 1006 Comprehensive Exam (Moderate Complexity) | $ | 70 | ERROR:#VALUE! | |
| CLIN 1007 Missed Work-up or missed procedure | $ | 25 | ERROR:#VALUE! | |
| CLIN 1008 Missed Exam | $ | 25 | ERROR:#VALUE! | |
| CLIN 1009 Physician - Occupational Medicine Consultant (Case Review) | $ | 70 | ERROR:#VALUE! | |
| CLIN 1010 Lead, industrial whole blood | $ | 70 | ERROR:#VALUE! | |
| CLIN 1011 ZPP, Blood Protoporphyrins, zinc | $ | 70 | ERROR:#VALUE! | |
| CLIN 1015 Project Office Management - FFP | $ | 1 | ERROR:#VALUE! |
| TOTAL COSTS | ERROR:#VALUE! | |||
| Year 2 | ||||
| Items Required | Fixed Unit Price | *Estimated Quantity | ||
| CLIN 2001 Audiometry | $ | 25 | ERROR:#VALUE! | |
| CLIN 2002 Electrocardiogram | $ | 25 | ERROR:#VALUE! | |
| CLIN 2003 Comprehensive Vision | $ | 25 | ERROR:#VALUE! | |
| CLIN 2004 Vital Signs/Body Ht and Wt (no charge with exam) | $ | 25 | ERROR:#VALUE! | |
| CLIN 2005 Tuberculosis Skin Test (subject to availability) | $ | 25 | ERROR:#VALUE! | |
| CLIN 2006 Comprehensive Exam (Moderate Complexity) | $ | 70 | ERROR:#VALUE! | |
| CLIN 2007 Missed Work-up or missed procedure | $ | 25 | ERROR:#VALUE! | |
| CLIN 2008 Missed Exam | $ | 25 | ERROR:#VALUE! | |
| CLIN 2009 Physician - Occupational Medicine Consultant (Case Review) | $ | 70 | ERROR:#VALUE! | |
| CLIN 2010 Lead, industrial whole blood | $ | 70 | ERROR:#VALUE! | |
| CLIN 2011 ZPP, Blood Protoporphyrins, zinc | $ | 70 | ERROR:#VALUE! | |
| CLIN 2015 Project Office Management - FFP | $ | 1 | ERROR:#VALUE! | |
| TOTAL COSTS | ERROR:#VALUE! | |||
| Year 3 | ||||
| Items Required | Fixed Unit Price | *Estimated Quantity | ||
| CLIN 3001 Audiometry | $ | 25 | ERROR:#VALUE! | |
| CLIN 3002 Electrocardiogram | $ | 25 | ERROR:#VALUE! | |
| CLIN 3003 Comprehensive Vision | $ | 25 | ERROR:#VALUE! | |
| CLIN 3004 Vital Signs/Body Ht and Wt (no charge with exam) | $ | 25 | ERROR:#VALUE! | |
| CLIN 3005 Tuberculosis Skin Test (subject to availability) | $ | 25 | ERROR:#VALUE! | |
| CLIN 3006 Comprehensive Exam (Moderate Complexity) | $ | 70 | ERROR:#VALUE! | |
| CLIN 3007 Missed Work-up or missed procedure | $ | 25 | ERROR:#VALUE! | |
| CLIN 3008 Missed Exam | $ | 25 | ERROR:#VALUE! | |
| CLIN 3009 Physician - Occupational Medicine Consultant (Case Review) | $ | 70 | ERROR:#VALUE! | |
| CLIN 3010 Lead, industrial whole blood | $ | 70 | ERROR:#VALUE! | |
| CLIN 3011 ZPP, Blood Protoporphyrins, zinc | $ | 70 | ERROR:#VALUE! | |
| CLIN 3015 Project Office Management - FFP | $ | 1 | ERROR:#VALUE! | |
| TOTAL COSTS | ERROR:#VALUE! | |||
| Year 4 | ||||
| Items Required | Fixed Unit Price | *Estimated Quantity | ||
| CLIN 4001 Audiometry | $ | 25 | ERROR:#VALUE! | |
| CLIN 4002 Electrocardiogram | $ | 25 | ERROR:#VALUE! | |
| CLIN 4003 Comprehensive Vision | $ | 25 | ERROR:#VALUE! | |
| CLIN 4004 Vital Signs/Body Ht and Wt (no charge with exam) | $ | 25 | ERROR:#VALUE! | |
| CLIN 4005 Tuberculosis Skin Test (subject to availability) | $ | 25 | ERROR:#VALUE! | |
| CLIN 4006 Comprehensive Exam (Moderate Complexity) | $ | 70 | ERROR:#VALUE! | |
| CLIN 4007 Missed Work-up or missed procedure | $ | 25 | ERROR:#VALUE! | |
| CLIN 4008 Missed Exam | $ | 25 | ERROR:#VALUE! | |
| CLIN 4009 Physician - Occupational Medicine Consultant (Case Review) | $ | 70 | ERROR:#VALUE! | |
| CLIN 4010 Lead, industrial whole blood | $ | 70 | ERROR:#VALUE! | |
| CLIN 4011 ZPP, Blood Protoporphyrins, zinc | $ | 70 | ERROR:#VALUE! | |
| CLIN 4015 Project Office Management - FFP | $ | 1 | ERROR:#VALUE! | |
| TOTAL COSTS | ERROR:#VALUE! |
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