CSP011856_DOH054_REV_Contract.pdf

Index No.: DOH054

Eff. Date: 01/01/23

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

MANDATORY USE CONTRACT FOR: DATA COLLECTION FOR OHIO BEHAVIORAL RISK FACTOR SURVEILLANCE

SYSTEM (BRFSS)

CONTRACT NUMBER: CSP011856 EFFECTIVE DATES: 01/01/23 TO 12/31/25

The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.

SRC0000005650 that opened on 10/19/22. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.

This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.

This Requirements Contract is available to the Department of Health as applicable.

The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.

This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:

https://procure.ohio.gov/

Eff. Date: 01/01/23

MUTUALLY AGREED TO CLARIFICATIONS / MODIFICATIONS TO THE RFP

1. Clarification Letter – Dated 11/18/22

2. Best and Final Offer Letter – 11/28/22

Eff. Date: 03/17/23

COST SUMMARY FORM

DATA COLLECTION FOR OHIO BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)

UNSPSC CATEGORY CODE: 93141600

Description Cost Per Interview Offeror’s costs to provide work and deliverables for the Ohio Department of Health (ODH) for

Data Collection for Ohio Behavioral Risk Factor Surveillance System (BRFSS) project as outlined in the Scope of Work, Attachment One, Part One.

1. 20 – 25 minutes completed landline BRFSS interviews. $122.00 / ea.

2. 20 – 25 minutes completed cell phone BRFSS interviews. $158.75 / ea.

* 3. 25 – 30 minutes completed landline BRFSS interviews.

(Only for interviews conducted during 03/01/23 – 12/31/23) $134.20 / ea.

* 4. 25 - 30 minutes completed cell phone BRFSS interviews.

(Only for interviews conducted during 03/01/23 – 12/31/23) $174.63 / ea.

5. 15 minutes completed Asthma Call-Back interviews. $57.05 / ea.

6. Weighting e.g., particular population (non-CDC supported) $225.00 / ea.

All costs must be in U.S. Dollars.

The State will not be responsible for any costs not identified.

There will be no additional reimbursement for travel or other related expenses.

CONTRACTOR INDEX

CONTRACTOR AND TERMS: CONTRACT NO.: CSP011856

0000084551 ICF Incorporated, LLC DELIVERY: As Specified 9300 Lee Highway Fairfax, VA 22031 TERMS: Net 30

CONTRACTOR CONTACT:

Deborah Moser PHONE: (703) 225-5737 EMAIL: deborah.moser@icf.com

* To update the cost summary form to include 25 – 30 minute completed landline and cell phone interview services to the contract.

mailto:deborah.moser@icf.com

Eff. Date: 03/17/23

SUMMARY OF AMENDMENTS

Amendment Number

Effective Date Description

1 03/17/23 This amendment is issued to update the cost summary form to include 25 – 30 minute completed landline and cell phone interview services to the contract. Also, the addition of the Summary of Amendments page.