Attachment_A_Revised_Eyeglass_Price_Schedule.xlsx

XLSX spreadsheet 78 KB Posted

Attached to
Prescription Eyeglasses for the Billings Area Indian Health Service (BAIHS) Locations.
Solicitation number
75H709-BAIHS25Q-012
Issued by

About this file

This is a comprehensive Excel-based Price Schedule for a Prescription Eyeglasses contract for the Billings Area Indian Health Service (BAIHS) in Montana. The solicitation (RFQ 75H709-BAIHS25Q-012) seeks a Blanket Purchase Agreement for a base 12-month period with four additional 12-month option years. The pricing schedule covers an extensive range of eyewear products including frames (budget, mid-range, premium, and designer), various lens types (single vision, bifocal, trifocal, progressive), lens materials (glass, plastic, polycarbonate), and additional lens treatments like transitions, anti-reflective coatings, tints, and prism adjustments.

The estimated annual quantities are substantial, with 10,500 total frames projected across different categories and approximately 10,500 lens units for various vision correction needs. Frames range from budget ($0) to designer/specialty styles, with lens options including single vision, bifocal, trifocal, and progressive lenses in multiple materials and treatments. The contract allows for precise customization, with options for oversized lenses, special coatings, and complex lens modifications. The procurement will be conducted under Simplified Acquisition procedures, with Purchase Referred Care Offices authorizing eyewear purchases using IHS-T-843-1A Purchase-Delivery Orders, and pricing expected to be at or below the contractor's usual customary fees.

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Base Year

BILLINGS AREA EYEGLASS CONTRACTBase Year
Unit of
Item/DescriptionEst.QuantityIssueUnit PriceTotal Amount
1. *Frames – A minimum of 100
different frame types in various10,500
styles, sizes and colors.
Budget frame4,000EA$________$________
Mid-range frame5,000EA$________$________
Premium frame1,000EA$________$________
Designer Frame/Speciality Frame500EA$________$________
2. Lenses, basic, per pair, in clear$________$________
glass or CR-39, unless otherwise
noted, not oversized
*a. Single glass vision lenses270EA$________$________
*b. Single vision plastic lenses2028EA$________$________
with scratch and UV coat
*c. Polycarbonate single vision10500EA$________$________
lenses, scratch coated,
polished edges
*d. High index (1.60 & 1.67)350EA$________$________
*e. Thin & Light w/AR Coating (1.74)200EA$________$________
*f. Transition Lenses
1. Standard transitions (Level 1)340EA$________$________
2. Upgraded Transitions (Level 2)40EA$________$________
3. Other _____________75EA$________$________
3. All lined bifocal (R-22, FT-25,
FT-28, FT-35 or executive) lenses
*a. Glass280EA$________$________
*b. Plastic1850EA$________$________
with scratch and UV Coat
*c. Polycarb942EA$________$________
*d. High index28EA$________$________
*e. Transitions318EA$________$________
4. All FT-25 or FT-28 Trifocals
* a. Glass5EA$________$________
* b. Plastic40EA$________$________
with scratch and UV coat
*c.Polycarb10EA$________$________
*d. High index5EA$________$________

*5. Progressive Multi-focal

*a. Progressive 1, specify___________
1. polycarb750EA$________$________
2. plastic45EA$________$________
3. high index100EA$________$________
4. transitions poly200EA$________$________
5. transitions plastic80EA$________$________
*b. Progressive 2, specify___________
1. polycarb500EA$________$________
2. plastic35EA$________$________
3. high index75EA$________$________
4. transitions poly100EA$________$________
5. transitions plastic60EA$________$________
*c. Progressive 3, specify___________
1. polycarb250EA$________$________
2. plastic22EA$________$________
3. high index65EA$________$________
4. transitions poly40EA$________$________
5. transitions plastic40EA$________$________
*d. Progressive 4, specify___________
1. polycarb150EA$________$________
2. plastic15EA$________$________
3. high index45EA$________$________
4. transitions poly30EA$________$________
5. transitions plastic20EA$________$________
*e. Glass Multi-focal
1. Clear20EA$________$________
2. Photochromatic20EA$________$________
*f. Other, specify _______________150EA$________$________
*g. Other, specify _______________150EA$________$________
*h. Other, specify _______________150EA$________$________
6. Glass Lens, extra charge, per pair
*a. Oversized single vision15EA$________$________
(specify eye size) ________
*b. Oversized bifocal13EA$________$________
(specify eye size)_________
*c. UV and Polaroid coatings75EA$________$________
*d. Color coating
1. Solid40EA$________$________
2. Gradient40EA$________$________
3. Other, specify_________40EA$________$________
e. Edge coating20EA$________$________
f. Mirror coating20EA$________$________
1. Standard15EA$________$________
2. Other, specify__________5EA$________$________
*g. Antireflectant coating
1. Standard AR coating50EA$________$________
2. Other specify _____________50EA$________$________
*h. Horizontal Prism (per diopter/per lens)15EA$________$________
*i. Vertical Prism (per diopter/per lens)5EA$________$________
*j. Prism over_______ diopters (fill in blank)5EA$________$________
*k. Slab-off10EA$________$________
*l. Anti-fog5EA$________$________
*m. Other glass Lens, extra charge, per pair, specify ___________10EA$________$________

7. Plastic/Polycarb Lens/high index, extra charge, per pair

*a. Oversized single vision600EA$________$________
(specify eye size)__________
*b. Oversized bifocal280EA$________$________
(specify eye size)___________
*c. Antireflectant coating
1. Standard AR coating1500EA$________$________
2. Other specify _____________700EA$________$________
*d. Mirror Coating
1. Standard35EA$________$________
2. Other specify _____________20EA$________$________

*e. Anti-fog 25 EA $________ $________

*f. Horiz. Prism (per diopter/per lens)125EA$________$________
*g. Vert. Prism (per diopter/per lens)25EA$________$________
*h. Prism over ______ diopters (fill in blank)10EA$________$________

*i. Slab-off 10 EA $________ $________

*j. Lens faceting15EA$________$________
*k. Grooving & mounting for170EA$________$________
semi-rimless
*l. 4-Hole Drilled225EA$________$________
*m. Edge polishing10EA$________$________
*n. Solid tint800EA$________$________
*o. Gradient tint800EA$________$________
*p. Double gradient tint65EA$________$________
*q. Tint removal15EA$________$________
*r. Other Plastic/Polycarb Lens/high index, extra charge, per pair, specify _________25EA$________$________
8. High Power
*a. Spheres (+)or(-) _______________ per lens (please specify diopter range)500EA$________$________
1. Spheres over_________diopters (fill in blank)100EA$________$________
*b. Cylinder (+)or(-) ________________per lens (please specify diopter range)300EA$________$________
1. Cylinders over ______ diopters (fill in blank)50EA$________$________

9. Repairs, per pair

a. Replace nosepads

1. Hard jumbo pads10EA$________$________
2. Soft jumbo pads10EA$________$________
3. Silicone pads75EA$________$________

*b. Install adjustable arms & pads 10 EA $________ $________

*c. Repair hinge (plastic frame) 10 EA $________ $________

*d. Solder hinge, pad arm, bridge7EA$________$________
or eyewire on metal frame

Opt Yr 1

BILLINGS AREA EYEGLASS CONTRACTOption Year One
Unit of
Item/DescriptionEst.QuantityIssueUnit PriceTotal Amount
1. *Frames – A minimum of 100
different frame types in various10,500
styles, sizes and colors.
Budget frame4,000EA$________$________
Mid-range frame5,000EA$________$________
Premium frame1,000EA$________$________
Designer Frame/Speciality Frame500EA$________$________
2. Lenses, basic, per pair, in clear$________$________
glass or CR-39, unless otherwise
noted, not oversized
*a. Single glass vision lenses270EA$________$________
*b. Single vision plastic lenses2028EA$________$________
with scratch and UV coat
*c. Polycarbonate single vision10500EA$________$________
lenses, scratch coated,
polished edges
*d. High index (1.60 & 1.67)350EA$________$________
*e. Thin & Light w/AR Coating (1.74)200EA$________$________
*f. Transition Lenses
1. Standard transitions (Level 1)340EA$________$________
2. Upgraded Transitions (Level 2)40EA$________$________
3. Other _____________75EA$________$________
3. All lined bifocal (R-22, FT-25,
FT-28, FT-35 or executive) lenses
*a. Glass280EA$________$________
*b. Plastic1850EA$________$________
with scratch and UV Coat
*c. Polycarb942EA$________$________
*d. High index28EA$________$________
*e. Transitions318EA$________$________
4. All FT-25 or FT-28 Trifocals
* a. Glass5EA$________$________
* b. Plastic40EA$________$________
with scratch and UV coat
*c.Polycarb10EA$________$________
*d. High index5EA$________$________

*5. Progressive Multi-focal

*a. Progressive 1, specify___________
1. polycarb750EA$________$________
2. plastic45EA$________$________
3. high index100EA$________$________
4. transitions poly200EA$________$________
5. transitions plastic80EA$________$________
*b. Progressive 2, specify___________
1. polycarb500EA$________$________
2. plastic35EA$________$________
3. high index75EA$________$________
4. transitions poly100EA$________$________
5. transitions plastic60EA$________$________
*c. Progressive 3, specify___________
1. polycarb250EA$________$________
2. plastic22EA$________$________
3. high index65EA$________$________
4. transitions poly40EA$________$________
5. transitions plastic40EA$________$________
*d. Progressive 4, specify___________
1. polycarb150EA$________$________
2. plastic15EA$________$________
3. high index45EA$________$________
4. transitions poly30EA$________$________
5. transitions plastic20EA$________$________
*e. Glass Multi-focal
1. Clear20EA$________$________
2. Photochromatic20EA$________$________
*f. Other, specify _______________150EA$________$________
*g. Other, specify _______________150EA$________$________
*h. Other, specify _______________150EA$________$________
6. Glass Lens, extra charge, per pair
*a. Oversized single vision15EA$________$________
(specify eye size) ________
*b. Oversized bifocal13EA$________$________
(specify eye size)_________
*c. UV and Polaroid coatings75EA$________$________
*d. Color coating
1. Solid40EA$________$________
2. Gradient40EA$________$________
3. Other, specify_________40EA$________$________
e. Edge coating20EA$________$________
f. Mirror coating20EA$________$________
1. Standard15EA$________$________
2. Other, specify__________5EA$________$________
*g. Antireflectant coating
1. Standard AR coating50EA$________$________
2. Other specify _____________50EA$________$________
*h. Horizontal Prism (per diopter/per lens)15EA$________$________
*i. Vertical Prism (per diopter/per lens)5EA$________$________
*j. Prism over_______ diopters (fill in blank)5EA$________$________
*k. Slab-off10EA$________$________
*l. Anti-fog5EA$________$________
*m. Other glass Lens, extra charge, per pair, specify ___________10EA$________$________

7. Plastic/Polycarb Lens/high index, extra charge, per pair

*a. Oversized single vision600EA$________$________
(specify eye size)__________
*b. Oversized bifocal280EA$________$________
(specify eye size)___________
*c. Antireflectant coating
1. Standard AR coating1500EA$________$________
2. Other specify _____________700EA$________$________
*d. Mirror Coating
1. Standard35EA$________$________
2. Other specify _____________20EA$________$________

*e. Anti-fog 25 EA $________ $________

*f. Horiz. Prism (per diopter/per lens)125EA$________$________
*g. Vert. Prism (per diopter/per lens)25EA$________$________
*h. Prism over ______ diopters (fill in blank)10EA$________$________

*i. Slab-off 10 EA $________ $________

*j. Lens faceting15EA$________$________
*k. Grooving & mounting for170EA$________$________
semi-rimless
*l. 4-Hole Drilled225EA$________$________
*m. Edge polishing10EA$________$________
*n. Solid tint800EA$________$________
*o. Gradient tint800EA$________$________
*p. Double gradient tint65EA$________$________
*q. Tint removal15EA$________$________
*r. Other Plastic/Polycarb Lens/high index, extra charge, per pair, specify _________25EA$________$________
8. High Power
*a. Spheres (+)or(-) _______________ per lens (please specify diopter range)500EA$________$________
1. Spheres over_________diopters (fill in blank)100EA$________$________
*b. Cylinder (+)or(-) ________________per lens (please specify diopter range)300EA$________$________
1. Cylinders over ______ diopters (fill in blank)50EA$________$________

9. Repairs, per pair

a. Replace nosepads

1. Hard jumbo pads10EA$________$________
2. Soft jumbo pads10EA$________$________
3. Silicone pads75EA$________$________

*b. Install adjustable arms & pads 10 EA $________ $________

*c. Repair hinge (plastic frame) 10 EA $________ $________

*d. Solder hinge, pad arm, bridge7EA$________$________
or eyewire on metal frame

Opt Yr 2

BILLINGS AREA EYEGLASS CONTRACTOption Year Two
Unit of
Item/DescriptionEst.QuantityIssueUnit PriceTotal Amount
1. *Frames – A minimum of 100
different frame types in various10,500
styles, sizes and colors.
Budget frame4,000EA$________$________
Mid-range frame5,000EA$________$________
Premium frame1,000EA$________$________
Designer Frame/Speciality Frame500EA$________$________
2. Lenses, basic, per pair, in clear$________$________
glass or CR-39, unless otherwise
noted, not oversized
*a. Single glass vision lenses270EA$________$________
*b. Single vision plastic lenses2028EA$________$________
with scratch and UV coat
*c. Polycarbonate single vision10500EA$________$________
lenses, scratch coated,
polished edges
*d. High index (1.60 & 1.67)350EA$________$________
*e. Thin & Light w/AR Coating (1.74)200EA$________$________
*f. Transition Lenses
1. Standard transitions (Level 1)340EA$________$________
2. Upgraded Transitions (Level 2)40EA$________$________
3. Other _____________75EA$________$________
3. All lined bifocal (R-22, FT-25,
FT-28, FT-35 or executive) lenses
*a. Glass280EA$________$________
*b. Plastic1850EA$________$________
with scratch and UV Coat
*c. Polycarb942EA$________$________
*d. High index28EA$________$________
*e. Transitions318EA$________$________
4. All FT-25 or FT-28 Trifocals
* a. Glass5EA$________$________
* b. Plastic40EA$________$________
with scratch and UV coat
*c.Polycarb10EA$________$________
*d. High index5EA$________$________

*5. Progressive Multi-focal

*a. Progressive 1, specify___________
1. polycarb750EA$________$________
2. plastic45EA$________$________
3. high index100EA$________$________
4. transitions poly200EA$________$________
5. transitions plastic80EA$________$________
*b. Progressive 2, specify___________
1. polycarb500EA$________$________
2. plastic35EA$________$________
3. high index75EA$________$________
4. transitions poly100EA$________$________
5. transitions plastic60EA$________$________
*c. Progressive 3, specify___________
1. polycarb250EA$________$________
2. plastic22EA$________$________
3. high index65EA$________$________
4. transitions poly40EA$________$________
5. transitions plastic40EA$________$________
*d. Progressive 4, specify___________
1. polycarb150EA$________$________
2. plastic15EA$________$________
3. high index45EA$________$________
4. transitions poly30EA$________$________
5. transitions plastic20EA$________$________
*e. Glass Multi-focal
1. Clear20EA$________$________
2. Photochromatic20EA$________$________
*f. Other, specify _______________150EA$________$________
*g. Other, specify _______________150EA$________$________
*h. Other, specify _______________150EA$________$________
6. Glass Lens, extra charge, per pair
*a. Oversized single vision15EA$________$________
(specify eye size) ________
*b. Oversized bifocal13EA$________$________
(specify eye size)_________
*c. UV and Polaroid coatings75EA$________$________
*d. Color coating
1. Solid40EA$________$________
2. Gradient40EA$________$________
3. Other, specify_________40EA$________$________
e. Edge coating20EA$________$________
f. Mirror coating20EA$________$________
1. Standard15EA$________$________
2. Other, specify__________5EA$________$________
*g. Antireflectant coating
1. Standard AR coating50EA$________$________
2. Other specify _____________50EA$________$________
*h. Horizontal Prism (per diopter/per lens)15EA$________$________
*i. Vertical Prism (per diopter/per lens)5EA$________$________
*j. Prism over_______ diopters (fill in blank)5EA$________$________
*k. Slab-off10EA$________$________
*l. Anti-fog5EA$________$________
*m. Other glass Lens, extra charge, per pair, specify ___________10EA$________$________

7. Plastic/Polycarb Lens/high index, extra charge, per pair

*a. Oversized single vision600EA$________$________
(specify eye size)__________
*b. Oversized bifocal280EA$________$________
(specify eye size)___________
*c. Antireflectant coating
1. Standard AR coating1500EA$________$________
2. Other specify _____________700EA$________$________
*d. Mirror Coating
1. Standard35EA$________$________
2. Other specify _____________20EA$________$________

*e. Anti-fog 25 EA $________ $________

*f. Horiz. Prism (per diopter/per lens)125EA$________$________
*g. Vert. Prism (per diopter/per lens)25EA$________$________
*h. Prism over ______ diopters (fill in blank)10EA$________$________

*i. Slab-off 10 EA $________ $________

*j. Lens faceting15EA$________$________
*k. Grooving & mounting for170EA$________$________
semi-rimless
*l. 4-Hole Drilled225EA$________$________
*m. Edge polishing10EA$________$________
*n. Solid tint800EA$________$________
*o. Gradient tint800EA$________$________
*p. Double gradient tint65EA$________$________
*q. Tint removal15EA$________$________
*r. Other Plastic/Polycarb Lens/high index, extra charge, per pair, specify _________25EA$________$________
8. High Power
*a. Spheres (+)or(-) _______________ per lens (please specify diopter range)500EA$________$________
1. Spheres over_________diopters (fill in blank)100EA$________$________
*b. Cylinder (+)or(-) ________________per lens (please specify diopter range)300EA$________$________
1. Cylinders over ______ diopters (fill in blank)50EA$________$________

9. Repairs, per pair

a. Replace nosepads

1. Hard jumbo pads10EA$________$________
2. Soft jumbo pads10EA$________$________
3. Silicone pads75EA$________$________

*b. Install adjustable arms & pads 10 EA $________ $________

*c. Repair hinge (plastic frame) 10 EA $________ $________

*d. Solder hinge, pad arm, bridge7EA$________$________
or eyewire on metal frame

Opt Yr 3

BILLINGS AREA EYEGLASS CONTRACTOption Year Three
Unit of
Item/DescriptionEst.QuantityIssueUnit PriceTotal Amount
1. *Frames – A minimum of 100
different frame types in various10,500
styles, sizes and colors.
Budget frame4,000EA$________$________
Mid-range frame5,000EA$________$________
Premium frame1,000EA$________$________
Designer Frame/Speciality Frame500EA$________$________
2. Lenses, basic, per pair, in clear$________$________
glass or CR-39, unless otherwise
noted, not oversized
*a. Single glass vision lenses270EA$________$________
*b. Single vision plastic lenses2028EA$________$________
with scratch and UV coat
*c. Polycarbonate single vision10500EA$________$________
lenses, scratch coated,
polished edges
*d. High index (1.60 & 1.67)350EA$________$________
*e. Thin & Light w/AR Coating (1.74)200EA$________$________
*f. Transition Lenses
1. Standard transitions (Level 1)340EA$________$________
2. Upgraded Transitions (Level 2)40EA$________$________
3. Other _____________75EA$________$________
3. All lined bifocal (R-22, FT-25,
FT-28, FT-35 or executive) lenses
*a. Glass280EA$________$________
*b. Plastic1850EA$________$________
with scratch and UV Coat
*c. Polycarb942EA$________$________
*d. High index28EA$________$________
*e. Transitions318EA$________$________
4. All FT-25 or FT-28 Trifocals
* a. Glass5EA$________$________
* b. Plastic40EA$________$________
with scratch and UV coat
*c.Polycarb10EA$________$________
*d. High index5EA$________$________

*5. Progressive Multi-focal

*a. Progressive 1, specify___________
1. polycarb750EA$________$________
2. plastic45EA$________$________
3. high index100EA$________$________
4. transitions poly200EA$________$________
5. transitions plastic80EA$________$________
*b. Progressive 2, specify___________
1. polycarb500EA$________$________
2. plastic35EA$________$________
3. high index75EA$________$________
4. transitions poly100EA$________$________
5. transitions plastic60EA$________$________
*c. Progressive 3, specify___________
1. polycarb250EA$________$________
2. plastic22EA$________$________
3. high index65EA$________$________
4. transitions poly40EA$________$________
5. transitions plastic40EA$________$________
*d. Progressive 4, specify___________
1. polycarb150EA$________$________
2. plastic15EA$________$________
3. high index45EA$________$________
4. transitions poly30EA$________$________
5. transitions plastic20EA$________$________
*e. Glass Multi-focal
1. Clear20EA$________$________
2. Photochromatic20EA$________$________
*f. Other, specify _______________150EA$________$________
*g. Other, specify _______________150EA$________$________
*h. Other, specify _______________150EA$________$________
6. Glass Lens, extra charge, per pair
*a. Oversized single vision15EA$________$________
(specify eye size) ________
*b. Oversized bifocal13EA$________$________
(specify eye size)_________
*c. UV and Polaroid coatings75EA$________$________
*d. Color coating
1. Solid40EA$________$________
2. Gradient40EA$________$________
3. Other, specify_________40EA$________$________
e. Edge coating20EA$________$________
f. Mirror coating20EA$________$________
1. Standard15EA$________$________
2. Other, specify__________5EA$________$________
*g. Antireflectant coating
1. Standard AR coating50EA$________$________
2. Other specify _____________50EA$________$________
*h. Horizontal Prism (per diopter/per lens)15EA$________$________
*i. Vertical Prism (per diopter/per lens)5EA$________$________
*j. Prism over_______ diopters (fill in blank)5EA$________$________
*k. Slab-off10EA$________$________
*l. Anti-fog5EA$________$________
*m. Other glass Lens, extra charge, per pair, specify ___________10EA$________$________

7. Plastic/Polycarb Lens/high index, extra charge, per pair

*a. Oversized single vision600EA$________$________
(specify eye size)__________
*b. Oversized bifocal280EA$________$________
(specify eye size)___________
*c. Antireflectant coating
1. Standard AR coating1500EA$________$________
2. Other specify _____________700EA$________$________
*d. Mirror Coating
1. Standard35EA$________$________
2. Other specify _____________20EA$________$________

*e. Anti-fog 25 EA $________ $________

*f. Horiz. Prism (per diopter/per lens)125EA$________$________
*g. Vert. Prism (per diopter/per lens)25EA$________$________
*h. Prism over ______ diopters (fill in blank)10EA$________$________

*i. Slab-off 10 EA $________ $________

*j. Lens faceting15EA$________$________
*k. Grooving & mounting for170EA$________$________
semi-rimless
*l. 4-Hole Drilled225EA$________$________
*m. Edge polishing10EA$________$________
*n. Solid tint800EA$________$________
*o. Gradient tint800EA$________$________
*p. Double gradient tint65EA$________$________
*q. Tint removal15EA$________$________
*r. Other Plastic/Polycarb Lens/high index, extra charge, per pair, specify _________25EA$________$________
8. High Power
*a. Spheres (+)or(-) _______________ per lens (please specify diopter range)500EA$________$________
1. Spheres over_________diopters (fill in blank)100EA$________$________
*b. Cylinder (+)or(-) ________________per lens (please specify diopter range)300EA$________$________
1. Cylinders over ______ diopters (fill in blank)50EA$________$________

9. Repairs, per pair

a. Replace nosepads

1. Hard jumbo pads10EA$________$________
2. Soft jumbo pads10EA$________$________
3. Silicone pads75EA$________$________

*b. Install adjustable arms & pads 10 EA $________ $________

*c. Repair hinge (plastic frame) 10 EA $________ $________

*d. Solder hinge, pad arm, bridge7EA$________$________
or eyewire on metal frame

Opt Yr 4

BILLINGS AREA EYEGLASS CONTRACTOption Year Four
Unit of
Item/DescriptionEst.QuantityIssueUnit PriceTotal Amount
1. *Frames – A minimum of 100
different frame types in various10,500
styles, sizes and colors.
Budget frame4,000EA$________$________
Mid-range frame5,000EA$________$________
Premium frame1,000EA$________$________
Designer Frame/Speciality Frame500EA$________$________
2. Lenses, basic, per pair, in clear$________$________
glass or CR-39, unless otherwise
noted, not oversized
*a. Single glass vision lenses270EA$________$________
*b. Single vision plastic lenses2028EA$________$________
with scratch and UV coat
*c. Polycarbonate single vision10500EA$________$________
lenses, scratch coated,
polished edges
*d. High index (1.60 & 1.67)350EA$________$________
*e. Thin & Light w/AR Coating (1.74)200EA$________$________
*f. Transition Lenses
1. Standard transitions (Level 1)340EA$________$________
2. Upgraded Transitions (Level 2)40EA$________$________
3. Other _____________75EA$________$________
3. All lined bifocal (R-22, FT-25,
FT-28, FT-35 or executive) lenses
*a. Glass280EA$________$________
*b. Plastic1850EA$________$________
with scratch and UV Coat
*c. Polycarb942EA$________$________
*d. High index28EA$________$________
*e. Transitions318EA$________$________
4. All FT-25 or FT-28 Trifocals
* a. Glass5EA$________$________
* b. Plastic40EA$________$________
with scratch and UV coat
*c.Polycarb10EA$________$________
*d. High index5EA$________$________

*5. Progressive Multi-focal

*a. Progressive 1, specify___________
1. polycarb750EA$________$________
2. plastic45EA$________$________
3. high index100EA$________$________
4. transitions poly200EA$________$________
5. transitions plastic80EA$________$________
*b. Progressive 2, specify___________
1. polycarb500EA$________$________
2. plastic35EA$________$________
3. high index75EA$________$________
4. transitions poly100EA$________$________
5. transitions plastic60EA$________$________
*c. Progressive 3, specify___________
1. polycarb250EA$________$________
2. plastic22EA$________$________
3. high index65EA$________$________
4. transitions poly40EA$________$________
5. transitions plastic40EA$________$________
*d. Progressive 4, specify___________
1. polycarb150EA$________$________
2. plastic15EA$________$________
3. high index45EA$________$________
4. transitions poly30EA$________$________
5. transitions plastic20EA$________$________
*e. Glass Multi-focal
1. Clear20EA$________$________
2. Photochromatic20EA$________$________
*f. Other, specify _______________150EA$________$________
*g. Other, specify _______________150EA$________$________
*h. Other, specify _______________150EA$________$________
6. Glass Lens, extra charge, per pair
*a. Oversized single vision15EA$________$________
(specify eye size) ________
*b. Oversized bifocal13EA$________$________
(specify eye size)_________
*c. UV and Polaroid coatings75EA$________$________
*d. Color coating
1. Solid40EA$________$________
2. Gradient40EA$________$________
3. Other, specify_________40EA$________$________
e. Edge coating20EA$________$________
f. Mirror coating20EA$________$________
1. Standard15EA$________$________
2. Other, specify__________5EA$________$________
*g. Antireflectant coating
1. Standard AR coating50EA$________$________
2. Other specify _____________50EA$________$________
*h. Horizontal Prism (per diopter/per lens)15EA$________$________
*i. Vertical Prism (per diopter/per lens)5EA$________$________
*j. Prism over_______ diopters (fill in blank)5EA$________$________
*k. Slab-off10EA$________$________
*l. Anti-fog5EA$________$________
*m. Other glass Lens, extra charge, per pair, specify ___________10EA$________$________

7. Plastic/Polycarb Lens/high index, extra charge, per pair

*a. Oversized single vision600EA$________$________
(specify eye size)__________
*b. Oversized bifocal280EA$________$________
(specify eye size)___________
*c. Antireflectant coating
1. Standard AR coating1500EA$________$________
2. Other specify _____________700EA$________$________
*d. Mirror Coating
1. Standard35EA$________$________
2. Other specify _____________20EA$________$________

*e. Anti-fog 25 EA $________ $________

*f. Horiz. Prism (per diopter/per lens)125EA$________$________
*g. Vert. Prism (per diopter/per lens)25EA$________$________
*h. Prism over ______ diopters (fill in blank)10EA$________$________

*i. Slab-off 10 EA $________ $________

*j. Lens faceting15EA$________$________
*k. Grooving & mounting for170EA$________$________
semi-rimless
*l. 4-Hole Drilled225EA$________$________
*m. Edge polishing10EA$________$________
*n. Solid tint800EA$________$________
*o. Gradient tint800EA$________$________
*p. Double gradient tint65EA$________$________
*q. Tint removal15EA$________$________
*r. Other Plastic/Polycarb Lens/high index, extra charge, per pair, specify _________25EA$________$________
8. High Power
*a. Spheres (+)or(-) _______________ per lens (please specify diopter range)500EA$________$________
1. Spheres over_________diopters (fill in blank)100EA$________$________
*b. Cylinder (+)or(-) ________________per lens (please specify diopter range)300EA$________$________
1. Cylinders over ______ diopters (fill in blank)50EA$________$________

9. Repairs, per pair

a. Replace nosepads

1. Hard jumbo pads10EA$________$________
2. Soft jumbo pads10EA$________$________
3. Silicone pads75EA$________$________

*b. Install adjustable arms & pads 10 EA $________ $________

*c. Repair hinge (plastic frame) 10 EA $________ $________

*d. Solder hinge, pad arm, bridge7EA$________$________
or eyewire on metal frame

File details come from the government source that posted it. Updated .