Cost Proposal Sheet - DOCJT Medical Services Occupational Medicine.docx
DOCX document 22 KB Posted
- Attached to
- DOCJT Medical Services Occupational Medicine
- Solicitation number
- RFP 525 2600000408 1
- Issued by
- Johnson County, Kentucky
About this file
This is a Cost Proposal Submittal Form for the Department of Criminal Justice Training (DOCJT) Request for Proposal 525 2600000408 for Medical Services Occupational Medicine. The RFP requests pricing for occupational medicine services including pre-employment physical exams, blood tests, vision tests, and fit-for-duty exams. Additionally, the proposal solicits pricing for vaccine services, specifically seasonal influenza vaccines, Hepatitis A/B vaccines, and other vaccines available. The cost proposal also requires pricing for on-the-job injury evaluations. Offerors must submit the cost proposal under separate cover from any technical proposal submission, with failure to do so resulting in a non-responsive submittal designation.
The cost proposal component is valued at 400 points out of a total of 1,150 points in the evaluation criteria. Offerors must provide independent pricing for each service category listed and certify that the cost proposal was developed independently without collusion, consultation, communication, or agreement regarding pricing with any other offeror or competitor, and without any conflict of interest. The certification must be signed by an authorized representative of the offeror with the company name clearly identified on the form.
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Other files
| File | Type | Posted |
|---|---|---|
| Final_RFP_525_2600000408_1_SO_FORM.PDF |
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Text version
COST PROPOSAL SUBMITTAL FORM
OFFEROR MUST SUBMIT UNDER SEPARATE COVER
DO NOT SUBMIT COST PROPOSAL WITH TECHNICAL PROPOSAL OR SUBMITTAL SHALL BE DEEMED NON-RESPONSIVE
DEPARTMENT OF CRIMINAL JUSTICE TRAINING
REQUEST FOR PROPOSAL TITLE: DOCJT Medical Services Occupational Medicine
RFP 525 2600000408
COST PROPOSAL EVALUATION CRITERIA POINTS VALUE: 400 POINTS out of 1150 TOTAL POINTS
NAME OF OFFEROR:
This Cost Proposal provides necessary costs associated with the above name RFP.
COST PROPOSAL:
Offeror should include the price for each of the following, as per section 3.00 Cost Proposal Evaluation:
Pre-employment Physical Exam $________________
Blood Test $________________
Vision Test $________________
Fit For Duty Exam $________________
Vaccines Seasonal Influenza Vaccine $________________
Hepatitis A/B Vaccine $________________
Other Vaccines Available $________________
On the Job Injury Evaluations $________________
I, ____________________________, certify that this Cost Proposal was arrived at independently (print name) without collusion, consultation, communication, or agreement as to any matter relating to prices with any other offeror or with any competitor and without any conflict of interest.
Signature of Offeror:
File details come from the government source that posted it. Updated .