Attachment D Proposal Price Template REV.2 03.31.26.xlsx
XLSX spreadsheet 31 KB Posted
- Attached to
- TELERADIOLOGY PHYSICIAN SERVICES
- Solicitation number
- 36C10G26R0015_0003
About this file
This is a Proposal Price Template for the Veterans Health Administration (VHA) National Teleradiology Program (NTP) Teleradiology Physician Services contract opportunity (Solicitation Number 36C10G26R0015). The template provides a uniform format for offerors to submit fully burdened, proposed unit pricing across five ordering periods, with each period spanning multiple Contract Line Item Numbers (CLINs).
The pricing structure covers four primary teleradiology modalities: Digital X-Rays (DX), CT Scans, MR Scans, and Ultrasound (US) Scans, with estimated annual quantities ranging from 5,000 to approximately 86,301 units per modality across the five ordering periods. Offerors must provide unit prices (limited to two decimal places) for all CLINs across all five ordering periods, with quantities escalating progressively through each period, and each period including a 3% Service Level Agreement (SLA) fee. Pricing submissions must be completed only in yellow-highlighted cells, with all other cells locked to prevent modification of the spreadsheet structure, quantities, or formulas. The total proposed price is automatically calculated by the template. Submissions must be in the original Excel format with the naming convention "Name_Price Schedule_Date," and any blank entries or submissions in non-editable formats may result in proposal rejection. This template was revised as of March 31, 2026, and is part of a solicitation modification that also included updated Performance Work Statement and Questions and Answers documents.
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Instructions
| Veterans Health Administration (VHA) |
| National Teleradiology Program (NTP) |
| Teleradiology Physician Services |
| Price Proposal |
| Quoter Name: | |
| Instructions: | |
| 1. The purpose of this Price Schedule is to provide a uniform format for Offerors to submit proposed pricing for [Requirement Name/Solicitation Number]. |
| 2, This schedule is organized by Ordering period. Offerors must provide pricing for all five (5) ordering periods as follows: | |
| Ordering Period 1: CLINs 0001-0004 | |
| Ordering Period 2: CLINs 1001-1004 | |
| Ordering Period 3: CLINs 2001-2004 | |
| Ordering Period 4: CLINs 3001-3004 | |
| Ordering Period 5: CLINs 4001-4004 |
| 3. Formatting and Input | |
| Offerors shall enter their fully burdened, proposed unit prices only in the cells highlighted in Yellow. | |
| All other cells (CLINs, Descriptions, Estimated Quantities and Formulas) are locked. Offerors shall not attempt to modify the structure, quantities or formulas of this spreadsheet. | |
| Unit prices must be limited to two (2) decimal places. | |
| Offerors must provide a price for every CLIN. A blank entry may be considered a failure to propose on the entire requirement and may result in the proposal being excluded from further consideration. | |
| 4. The Total Proposed Price is automatically calculated located at the bottom of the schedule. This will consist of the sum of all proposed prices for Ordering Periods 1 through 5. | |
| 5. Offerors shall submit this Price Schedule in its original Excel format. Submissions in PDF or other non-editable formats may be rejected. The Excel file should be formatted as "Name_Price Schedule_Date" |
Price Schedule Offeror Name: 0
| Ordering Period 1 | ||||||
| CLIN | Modality | Description | Quantity | Unit | Unit Cost | Total CLIN Price |
| 0001 | DX | Digital X-Rays | 71,000 | EA | $ - 0 | |
| 0002 | CT | CT Scans | 51,000 | EA | $ - 0 | |
| 0003 | MR | MR Scans | 5,000 | EA | $ - 0 | |
| 0004 | US | US Scans | 11,000 | EA | $ - 0 | |
| 0005 | SLA FEE 3% | 1 | LT | $ - 0 | ||
| Total OP Price: | $ - 0 |
| Ordering Period 2 | ||||||
| CLIN | Modality | Description | Quantity | Unit | Unit Cost | Total CLIN Price |
| 1001 | DX | Digital X-Rays | 74,550 | EA | $ - 0 | |
| 1002 | CT | CT Scans | 53,550 | EA | $ - 0 | |
| 1003 | MR | MR Scans | 5,250 | EA | $ - 0 | |
| 1004 | US | US Scans | 11,550 | EA | $ - 0 | |
| 1005 | SLA FEE 3% | 1 | LT | $ - 0 | ||
| Total OP Price: | $ - 0 |
| Ordering Period 3 | ||||||
| CLIN | Modality | Description | Quantity | Unit | Unit Cost | Total CLIN Price |
| 2001 | DX | Digital X-Rays | 78,278 | EA | $ - 0 | |
| 2002 | CT | CT Scans | 56,228 | EA | $ - 0 | |
| 2003 | MR | MR Scans | 5,513 | EA | $ - 0 | |
| 2004 | US | US Scans | 12,128 | EA | $ - 0 | |
| 2005 | SLA FEE 3% | 1 | LT | $ - 0 | ||
| Total OP Price: | $ - 0 |
| Ordering Period 4 | ||||||
| CLIN | Modality | Description | Quantity | Unit | Unit Cost | Total CLIN Price |
| 3001 | DX | Digital X-Rays | 82,191 | EA | $ - 0 | |
| 3002 | CT | CT Scans | 59,039 | EA | $ - 0 | |
| 3003 | MR | MR Scans | 5,788 | EA | $ - 0 | |
| 3004 | US | US Scans | 12,734 | EA | $ - 0 | |
| 3005 | SLA FEE 3% | 1 | LT | $ - 0 | ||
| Total OP Price: | $ - 0 |
| Ordering Period 5 | ||||||
| CLIN | Modality | Description | Quantity | Unit | Unit Cost | Total CLIN Price |
| 4001 | DX | Digital X-Rays | 86,301 | EA | $ - 0 | |
| 4002 | CT | CT Scans | 61,991 | EA | $ - 0 | |
| 4003 | MR | MR Scans | 6,078 | EA | $ - 0 | |
| 4004 | US | US Scans | 13,371 | EA | $ - 0 | |
| 4005 | SLA FEE 3% | 1 | LT | $ - 0 | ||
| Total OP Price: | $ - 0 |
Total Proposed Price $ - 0
National Teleradiology Program (NTP) Teleradiology Physician Services Attachment C - Price Model Solicitation Number # 36C10G26R0015
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