Schedule__BW.docx
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- Solicitation number
- CSOSA16Q0033
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Schedule BW
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| Revised_SOW_Psych_Eval_ _Sup_Servs.docx | DOCX document | |
| Revised_SF1449_Sec_A.doc | DOC document | |
| Revised_Sec_J.3_QUESTIONNAIRE.docx | DOCX document | |
| SF1449_Sec_A.doc | DOC document | |
| SECTION_J_LIST_OF_ATTACHMENTS.docx | DOCX document | |
| 1_solicitation_combined_Final.docx | DOCX document | |
| Schedule__BY.docx | DOCX document | |
| Final_SOW_Psych_Test_and_Assess.docx | DOCX document | |
| Sec_J.2_QUESTIONNAIRE.docx | DOCX document | |
| SECTION_M.docx | DOCX document | |
| Final_SOW_Psych_Eval_ _Sup_Servs.docx | DOCX document |
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Text version
STANDARD FORM 1449 (REV. 2/2012) BACK
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
Base Year – Psychologists for psychological evaluation, case consultation, individual therapy, and supervision of interns
Task 1: Psychological Evaluation and Report Writing
Task 2: Case Consultation-Interdisciplinary Determination Team Meeting (IDT)
Task 3: Individual Therapy
Task 4: Clinical Supervision
60 hours per week
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
Option Year One– Psychologists for psychological evaluation, case consultation, individual therapy, and supervision of interns
Task 2: Case Consultation-Interdisciplinary Determination Team Meeting (IDT)
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
Option Year Two– Psychologists for psychological evaluation, case consultation, individual therapy, and supervision of interns
Task 2: Case Consultation-Interdisciplinary Determination Team Meeting (IDT)
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
Option Year Three– Psychologists for psychological evaluation, case consultation, individual therapy, and supervision of interns
Task2: Case Consultation-Interdisciplinary Determination Team Meeting (IDT)
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
Option Year Four – Psychologists for psychological evaluation, case consultation, individual therapy, and supervision of interns
Task2: Case Consultation-Interdisciplinary Determination Team Meeting (IDT)
32a QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:
| 32b SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE |
| 32c DATE |
| 32d PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE |
| 32e MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE |
| 32f TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE |
32g E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
| 33. SHIP NUMBER |
| 34. VOUCHER NUMBER |
| 35. AMOUNT VERIFIED CORRECT FOR |
| 36. PAYMENT |
| 37. CHECK NUMBER |
PARTIAL FINAL
COMPLETE PARTIAL FINAL
| 38. S/R ACCOUNT NO. |
| 39. S/R VOUCHER NUMBER |
| 40. PAID BY |
| 41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT |
| 42a. RECEIVED BY (Print) |
| 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER |
| 41c. DATE |
42b RECEIVED AT (Location)
| 42c DATE REC'D (YY/MM/DD) |
| 42d TOTAL CONTAINERS |
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