Attachment_3_-_Cost_Sheet.xlsx
XLSX spreadsheet 16 KB Posted
- Solicitation number
- 0000039129
- Issued by
- California
About this file
This is a cost sheet for a state and local contract opportunity involving occupational health examination services. The contract covers required medical examinations and related services spanning three fiscal years: 2026/27, 2027/28, and 2028/29. The scope of services includes comprehensive physical examinations, specialized testing such as hearing assessments, visual screening, laboratory work (complete blood count, urinalysis, blood chemistry), occupational exposure testing (blood lead, cholinesterase), pulmonary function testing (spirometry), chest x-rays, cardiology services (resting EKG and consultation), hernia and prostate examinations, and vaccination services (Hepatitis B and Twinrix). Additional optional tests requested by the Department of Toxic Substances Control (DTSC) include elemental and organic mercury testing, cadmium and inorganic compound testing, and chromium testing. The contract also includes consultation or retainer fees, DTSC Automated External Defibrillator (AED) medical director services, and packet labor for processing medical examination records.
Bidders must provide pricing for each examination and service for all three fiscal years, with prices then averaged across the three-year period and weighted according to specified weighting factors ranging from 0.001 to 1.0 depending on the service. The bid total is calculated by summing the weighted averages for selected items and will be used solely to determine the lowest bidder. The cost sheet requires complete and comprehensive pricing with no blank fields, and incomplete submissions may result in bid rejection. All columns for three-year averages, weighting factors, and weighted averages are for bidding evaluation purposes only and will not appear in the final executed contract.
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Other files
| File | Type | Posted |
|---|---|---|
| IFB_I-2526-02_Solicitation_Package.pdf |
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Text version
Attachment 3 - Cost Sheet Contract Reference I.D. in Exhibit A, Section IV Required Examinations 2026/27 PRICE 2027/28 PRICE 2028/29 PRICE 3 Year Avg. Weighting Factor Weighted Avg.
| Each field in the Bidder Cost Sheet must be completed, leaving no blanks. NOTE: Bids may be rejected if the Bidder Cost Sheet is not completed in its entirety. | |||||||||
| 1 | C.6.a.i - C.6.a.xiii | Complete Physical Examination | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 2 | C.6.a.xiv | Hearing (Audiometry) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 3 | C.6.a.xv | Visual screening | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 4 | C.6.a.xvi | Complete blood count | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 5 | C.6.a.xvii | Complete urinalysis | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 6 | C.6.a.xviii | Blood Chemistry | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 7 | C.6.a.xix.1 | Blood Lead | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 9 | C.6.a.xix.2 | Cholinesterase (RBC and plasma, or comparable such as serum) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 10 | C.6.a.xx | Spirometry | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 11 | C.6.a.xxi | Chest x-ray – baseline, exit and when medically necessary | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.1 | $ - 0 | |
| 12 | C.6.a.xxii | Cardiology (Resting EKG) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| 13 | C.6.a.xxiii | Cardiology Consultation | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.1 | $ - 0 | |
| 14 | C.6.a.xxiv | Hernia and Prostate examination. | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.5 | $ - 0 | |
| 15 | C.6.a.xxiv | PSA Lab Test | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.5 | $ - 0 | |
| 16 | C.6.a.xxv | a. Hepatitis B Vaccination - For each vaccination in the series (price per vaccination) – 3 Vaccination Series | $ - 0 | $ - 0 | $ - 0 | ||||
| b. Twinrix – For each vaccination in the series (price per vaccination) – 2 Vaccination Series | $ - 0 | $ - 0 | $ - 0 | ||||||
| c. Bid Amount: divide the sum of lines 16a and 16b by two (2) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |||
| 17 | C.6.a.xxvi | Optional tests as requested by DTSC | |||||||
| a. Mercury, elemental | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.01 | $ - 0 | |||
| b. Mercury, organic | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.01 | $ - 0 | |||
| c. Cadmium and inorganic compounds | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.01 | $ - 0 | |||
| d. Chromium (IV, water soluble fume) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.01 | $ - 0 | |||
| 18 | C.7.i | Consultation or Retainer Fee (hourly rate) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.001 | $ - 0 | |
| C.7.ii | DTSC Audomated External Defibrillator (AED) Medical Director (hourly rate) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.001 | $ - 0 | ||
| C.7.iii | DTSC AED Medical Director review of AED incidences (per incident) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 0.001 | $ - 0 | ||
| 19 | C.2.b | Packet labor (fixed rate per full medical exam record) | $ - 0 | $ - 0 | $ - 0 | $ - 0 | 1 | $ - 0 | |
| BID TOTAL | |||||||||
| Instructions – Enter the price for each item for each Fiscal Year. Then average the costs over all 3 years for each item and enter the result in the 3 Year Average column. Multiply the 3 Year Avg column by the Weighting Factor for each item. The BID TOTAL is the sum of the Weighted Average for Items 1 - 15, 16c, and 17 - 19. | $ - 0 |
Note: The columns for 3 Year Average, Weighting Factor, and Weighted Average are for bidding purposes only, and will not appear in the final contract. Additionally, the Bid Total will be used only for determining the lowest bidder and will not appear in the final contract.
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