Attachment B - Price Cost Schedule.docx
DOCX document 23 KB Posted
- Attached to
- V225--Lebanon Ambulance Services
- Solicitation number
- 36C24420Q0381
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Other files
| File | Type | Posted |
|---|---|---|
| 36C24420Q0381 0001.docx | DOCX document | |
| Attachment F - PAST PERFORMANCE QUESTIONNAIRE.docx | DOCX document | |
| Attachment E - Wage Determination.docx | DOCX document | |
| Attachment A - Performance Work Statement.docx | DOCX document | |
| Attachment C - Quality Assurance Surveillance Plan.docx | DOCX document | |
| S02 36C24420Q0381 - Combined Synopsis-Solicitation.docx | DOCX document | |
| Attachment D - Business Associate Agreement.docx | DOCX document | |
| SF 1449 - 36C24420Q0381.pdf |
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Text version
Contractor shall furnish 24-hour, paramedic and ambulance services for the beneficiaries of the Lebanon VA Medical Center (LVAMC), Lebanon, PA 10742, and associated CBOCS for the performance period of five (5) years.
ESTIMATED REQUIREMENTS FOR TRANSPORTING VA BENEFICIARIES VIA AMBULANCE ARE BASED ON PREVIOUS USAGE. THE QUANTITIES CITED ARE YEARLY ESTIMATED REQUIREMENTS FOR THE LEBANON VA MEDICAL CENTER.
Period of Performance: 10/1/2020 – 9/30/2025
Place of Performance: Lebanon VA Medical Center, 1700 S Lincoln Ave., Lebanon, PA 17042
Pricing Instructions:
The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments, VA Directive 1663 Appendix B.
Ordering Procedures:
For the purpose of this contract, the Contractor will be notified that services are required via the Lebanon VAMC Travel Office or the Officer of the Day. The mode of transport shall be discussed and cooperatively determined by the Contractor and VA clinician providing the level of care. Once the Contractor is notified of the need, they shall transport per contract requirements, Contractor policies and standard industry practices.
Note: The Government shall order the below specified minimum contract value of services and may order up to and including the below specified maximum contract value of services through task orders under this basic IDIQ contract throughout the duration of the contract. The maximum amount under this contract is not guaranteed.
IDIQ contract Minimum $300,000.00
IDIQ contract Maximum $6,500,000.00
ITEM INFORMATION
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
Not Priced
| __________________ |
| __________________ |
Ambulance Services - Year 1 Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021
0001AA
| 325.00 |
| EA |
| __________________ |
| __________________ |
Advanced Life Support (ALS) -Emergency Ambulance Transport
0001AB
| 625.00 |
| EA |
| __________________ |
| __________________ |
Basic Life Support (BLS) - Emergency Ambulance Transport
0001AC
| 4,650.00 |
| EA |
| __________________ |
| __________________ |
Wheelchair Transport
0001AD
| 42,500.00 |
| EA |
| __________________ |
| __________________ |
Mileage (per mile after first 20 miles)
0001AE
| 50.00 |
| EA |
| __________________ |
| __________________ |
Oxygen Administration
0001AF
| 150.00 |
| EA |
| __________________ |
| __________________ |
Wait time (15 minutes increments; 1ea = 15 minutes)
Not Priced
| __________________ |
| __________________ |
Ambulance Services - Year 2
POP Begin: 10-01-2021 POP End: 09-30-2022
0002AA
| 325.00 |
| EA |
| __________________ |
| __________________ |
Advanced Life Support (ALS) -Emergency Ambulance Transport
0002AB
| 625.00 |
| EA |
| __________________ |
| __________________ |
Basic Life Support (BLS) - Emergency Ambulance Transport
0002AC
| 4,650.00 |
| EA |
| __________________ |
| __________________ |
Wheelchair Transport
0002AD
| 42,500.00 |
| EA |
| __________________ |
| __________________ |
Mileage (per mile after first 20 miles)
0002AE
| 50.00 |
| EA |
| __________________ |
| __________________ |
Oxygen Administration
0002AF
| 150.00 |
| EA |
| __________________ |
| __________________ |
Wait time (15 minutes increments; 1ea = 15 minutes)
Not Priced
| __________________ |
| __________________ |
Ambulance Services - Year 3
POP Begin: 10-01-2022 POP End: 09-30-2023
0003AA
| 325.00 |
| EA |
| __________________ |
| __________________ |
Advanced Life Support (ALS) -Emergency Ambulance Transport
0003AB
| 625.00 |
| EA |
| __________________ |
| __________________ |
Basic Life Support (BLS) - Emergency Ambulance Transport
0003AC
| 4,650.00 |
| EA |
| __________________ |
| __________________ |
Wheelchair Transport
0003AD
| 42,500.00 |
| EA |
| __________________ |
| __________________ |
Mileage (per mile after first 20 miles)
0003AE
| 50.00 |
| EA |
| __________________ |
| __________________ |
Oxygen Administration
0003AF
| 150.00 |
| EA |
| __________________ |
| __________________ |
Wait time (15 minutes increments; 1ea = 15 minutes)
Not Priced
| __________________ |
| __________________ |
Ambulance Services - Year 4
POP Begin: 10-01-2023 POP End: 09-30-2024
0004AA
| 325.00 |
| EA |
| __________________ |
| __________________ |
Advanced Life Support (ALS) -Emergency Ambulance Transport
0004AB
| 625.00 |
| EA |
| __________________ |
| __________________ |
Basic Life Support (BLS) - Emergency Ambulance Transport
0004AC
| 4,650.00 |
| EA |
| __________________ |
| __________________ |
Wheelchair Transport
0004AD
| 42,500.00 |
| EA |
| __________________ |
| __________________ |
Mileage (per mile after first 20 miles)
0004AE
| 50.00 |
| EA |
| __________________ |
| __________________ |
Oxygen Administration
0004AF
| 150.00 |
| EA |
| __________________ |
| __________________ |
Wait time (15 minutes increments; 1ea = 15 minutes)
Not Priced
| __________________ |
| __________________ |
Ambulance Services - Year 5
POP Begin: 10-01-2024 POP End: 09-30-2025
0005AA
| 325.00 |
| EA |
| __________________ |
| __________________ |
Advanced Life Support (ALS) -Emergency Ambulance Transport
0005AB
| 625.00 |
| EA |
| __________________ |
| __________________ |
Basic Life Support (BLS) - Emergency Ambulance Transport
0005AC
| 4,650.00 |
| EA |
| __________________ |
| __________________ |
Wheelchair Transport
0005AD
| 42,500.00 |
| EA |
| __________________ |
| __________________ |
Mileage (per mile after first 20 miles)
0005AE
| 50.00 |
| EA |
| __________________ |
| __________________ |
Oxygen Administration
0005AF
| 150.00 |
| EA |
| __________________ |
| __________________ |
Wait time (15 minutes increments; 1ea = 15 minutes)
GRAND TOTAL
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