Exhibit B-1 Bid Form.Mobile XRay.BPM053986.xlsx
XLSX spreadsheet 22 KB Posted
- Solicitation number
- BPM053986
- Issued by
- Maryland
About this file
This is a bid form for Mobile X-Ray Services at Clifton T. Perkins Hospital Center in Maryland. The solicitation seeks a contractor to provide mobile radiography and ultrasound services for a three-year contract period. The scope of work includes 13 types of radiography tests (ranging from finger X-rays to rib imaging) and 8 categories of ultrasound services (including obstetric, breast, prostate, thyroid, vascular doppler, venous, and echocardiogram services). Year One estimated testing volumes total 115 radiography tests and 68 ultrasound tests. Year Two and Year Three utilize identical estimated volumes for evaluation purposes. Bidders must submit pricing on the provided bid form with unit prices and extended prices for each test type across all three contract years, with tests noted as estimates only and not representative of actual volumes that may be ordered during contract performance.
All bid prices must be all-inclusive, fully-loaded prices encompassing labor, profit, overhead, administrative costs, fuel surcharges, travel, and technician rates. Bidders must complete every tab and line item on the bid form without alterations, amendments, or blank entries; any corrections must be initialed and dated. The bid form calculates total annual costs for each year, with the overall contract award not to exceed $50,000 across the three-year period. Bidders must sign the bid form and provide authorized representative information, company details, FEIN, eMMA number, and any applicable small business certifications (CSB, MBE, or VSB status). Unit prices must be entered clearly in dollars and cents with distinct decimal points, calculations rounded to the nearest cent, and all entries must accurately reflect the bidder's true proposed pricing with no contingencies or conditions attached.
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Text version
Instructions
| Bid Instructions |
| In order to assist each Bidder in the preparation of its Bid and to comply with the requirements of this solicitation, Bid Instructions and a Bid Form have been prepared. Each Bidder shall submit its Bid on the Bid Form in accordance with the instructions on the Bid Form and as specified herein. Do not alter the Bid Form or the Bid may be determined to be not responsive. The Bid Form is to be signed and dated, where requested, by an individual who is authorized to bind the Bidder to the prices entered on the Bid Form. This is identified on Tab: Total Bid Price |
| The Bid Form is used to calculate the Bidder’s TOTAL BID PRICE. Follow these instructions carefully when completing your Bid Form: there are several tabs to review. Please complete every tab. |
| A) All Unit and Extended Prices must be clearly entered in dollars and cents, e.g., $24.15. Make your decimal points clear and distinct. |
B) All Unit Prices must be the actual price per unit the State will pay for the specific item or service identified in this RFB and may not be contingent on any other factor or condition in any manner.
C) All calculations shall be rounded to the nearest cent, e.g., .344 shall be .34 and .345 shall be .35.
D) Any goods or services required through this RFB and proposed by the vendor at No Cost to the State must be clearly entered in the Unit Price, if appropriate, and Extended Price with $0.00.
E) Every blank in every Bid Form shall be filled in. Any changes or corrections made to the Bid Form by the Bidder prior to submission shall be initialed and dated.
F) Except as instructed on the Bid Form, nothing shall be entered on or attached to the Bid Form that alters or proposes conditions or contingencies on the prices. Alterations and/or conditions may render the Bid not responsive.
G) It is imperative that the prices included on the Bid Form have been entered correctly and calculated accurately by the Bidder and that the respective total prices agree with the entries on the Bid Form. Any incorrect entries or inaccurate calculations by the Bidder will be treated as provided in COMAR 21.05.02.12 and may cause the Bid to be rejected.
H) If option years are included, Bidders must submit pricing for each option year. Any option to renew will be exercised at the sole discretion of the State and comply with all terms and conditions in force at the time the option is exercised. If exercised, the option period shall be for a period identified in the RFB at the prices entered in the Bid Form. (NOT APPLICABLE)
I) All Bid prices entered below are to be fully loaded prices that include all costs/expenses associated with the provision of services as required by the RFB. The Bid price shall include, but is not limited to, all: labor, profit/overhead, general operating, administrative, and all other expenses and costs necessary to perform the work set forth in the solicitation. No other amounts will be paid to the Contractor. If labor rates are requested, those amounts shall be fully loaded rates; no overtime amounts will be paid.
J) Unless indicated elsewhere in the RFB, sample amounts used for calculations on the Bid Form are typically estimates for evaluation purposes only. Unless stated otherwise in the RFB, the Department does not guarantee a minimum or maximum number of units or usage in the performance of the Contract.
| K) Failure to adhere to any of these instructions may result in the Bid being determined not responsive. |
| ***PLEASE FILL IN EVERY TAB. IF YOU ENCOUNTER A PROBLEM THEN CONTACT THE PROCUREMENT OFFICER. |
Bid Form Yr1
| Exhibit B.1 – BID FORM |
| Mobile X-Ray Services at Clifton T. Perkins Hospital Center |
| BPM053986 |
| The Bid Form shall contain an all inclusive price and information in the format specified on these pages including all surcharges (ex: fuel, travel, technician rate etc.) as well as all administrative costs. Complete the Bid Form only as provided in the Bid Instructions. Do not amend, alter or leave blank any items on the Bid Form. Tests are an estimate only and not representative of the amounts that may be ordered during the course of each year. The pricing is used to evaluate estimated annual costs. Failure to adhere to any of these instructions may result in the Bid being determined not responsive. | |||
| The total Contract award shall not exceed $50,000. | |||
| YEAR ONE | |||
| Group 1. Radiography Tests | Estimated Number of Tests | Price Per Test | Total Price |
| a. Finger | 1 | $ - 0 | $ - 0 |
| b. Hand or Wrist | 4 | $ - 0 | $ - 0 |
| c. Knee | 12 | $ - 0 | $ - 0 |
| d. Foot or Ankle | 20 | $ - 0 | $ - 0 |
| e. Leg (thigh or calf) | 4 | $ - 0 | $ - 0 |
| f. Hip | 1 | $ - 0 | $ - 0 |
| g. Chest | 32 | $ - 0 | $ - 0 |
| h. Skull or Head | 4 | $ - 0 | $ - 0 |
| i. Thoracic Spine | 4 | $ - 0 | $ - 0 |
| j. LumoSacral (LS) Spine | 16 | $ - 0 | $ - 0 |
| k. Abdomen | 12 | $ - 0 | $ - 0 |
| l. Pelvis | 1 | $ - 0 | $ - 0 |
| m. Ribs | 4 | $ - 0 | $ - 0 |
| TOTAL GROUP 1 | $ - 0 |
| Group 2. Ultrasound | Estimated Number of Tests | Price Per Test | Total Price |
| a. Obstetric - Pelvis | 4 | $ - 0 | $ - 0 |
| b. Obstetric - Abdomen | 1 | $ - 0 | $ - 0 |
| c. Breast | 1 | $ - 0 | $ - 0 |
| d. Prostate | 1 | $ - 0 | $ - 0 |
| e. Thyroid | 4 | $ - 0 | $ - 0 |
| f. Vascular Doppler | 10 | $ - 0 | $ - 0 |
| g. Venous (Extremities) | 5 | $ - 0 | $ - 0 |
| h. Echocardiogram | 42 | $ - 0 | $ - 0 |
| TOTAL GROUP 2 | $ - 0 |
YEAR ONE - TOTAL GROUP 1 + TOTAL GROUP 2 = $ - 0
Bid Form Yr2
| Exhibit B.1 – BID FORM | |||
| Mobile X-Ray Services at Clifton T. Perkins Hospital Center | |||
| BPM053986 | |||
| The Bid Form shall contain an all inclusive price and information in the format specified on these pages including all surcharges (ex: fuel, travel, technician rate etc.) as well as all administrative costs. Complete the Bid Form only as provided in the Bid Instructions. Do not amend, alter or leave blank any items on the Bid Form. Tests are an estimate only and not representative of the amounts that may be ordered during the course of each year. The pricing is used to evaluate estimated annual costs. Failure to adhere to any of these instructions may result in the Bid being determined not responsive. | |||
| The total Contract award shall not exceed $50,000. | |||
| YEAR TWO | |||
| Group 1. Radiography Tests | Estimated Number of Tests | Price Per Test | Total Price |
| a. Finger | 1 | $ - 0 | $ - 0 |
| b. Hand or Wrist | 4 | $ - 0 | $ - 0 |
| c. Knee | 12 | $ - 0 | $ - 0 |
| d. Foot or Ankle | 20 | $ - 0 | $ - 0 |
| e. Leg (thigh or calf) | 4 | $ - 0 | $ - 0 |
| f. Hip | 1 | $ - 0 | $ - 0 |
| g. Chest | 32 | $ - 0 | $ - 0 |
| h. Skull or Head | 4 | $ - 0 | $ - 0 |
| i. Thoracic Spine | 4 | $ - 0 | $ - 0 |
| j. LumoSacral (LS) Spine | 16 | $ - 0 | $ - 0 |
| k. Abdomen | 12 | $ - 0 | $ - 0 |
| l. Pelvis | 1 | $ - 0 | $ - 0 |
| m. Ribs | 4 | $ - 0 | $ - 0 |
| TOTAL GROUP 1 | $ - 0 |
| Group 2. Ultrasound | Estimated Number of Tests | Price Per Test | Total Price |
| a. Obstetric - Pelvis | 4 | $ - 0 | $ - 0 |
| b. Obstetric - Abdomen | 1 | $ - 0 | $ - 0 |
| c. Breast | 1 | $ - 0 | $ - 0 |
| d. Prostate | 1 | $ - 0 | $ - 0 |
| e. Thyroid | 4 | $ - 0 | $ - 0 |
| f. Vascular Doppler | 10 | $ - 0 | $ - 0 |
| g. Venous (Extremities) | 5 | $ - 0 | $ - 0 |
| h. Echocardiogram | 42 | $ - 0 | $ - 0 |
| TOTAL GROUP 2 | $ - 0 |
YEAR TWO - TOTAL GROUP 1 + TOTAL GROUP 2 = $ - 0
Bid Form Yr3
| Exhibit B.1 – BID FORM |
| MobileX-Ray Services at Clifton T. Perkins Hospital Center |
| BPM053986 |
| The Bid Form shall contain an all inclusive price and information in the format specified on these pages including all surcharges (ex: fuel, travel, technician rate etc.) as well as all administrative costs. Complete the Bid Form only as provided in the Bid Instructions. Do not amend, alter or leave blank any items on the Bid Form. Tests are an estimate only and not representative of the amounts that may be ordered during the course of each year. The pricing is used to evaluate estimated annual costs. Failure to adhere to any of these instructions may result in the Bid being determined not responsive. |
| The total Contract award shall not exceed $50,000. |
| Group 1. Radiography Tests | Estimated Number of Tests | Price Per Test | Total Price |
| a. Finger | 1 | $ - 0 | $ - 0 |
| b. Hand or Wrist | 4 | $ - 0 | $ - 0 |
| c. Knee | 12 | $ - 0 | $ - 0 |
| d. Foot or Ankle | 20 | $ - 0 | $ - 0 |
| e. Leg (thigh or calf) | 4 | $ - 0 | $ - 0 |
| f. Hip | 1 | $ - 0 | $ - 0 |
| g. Chest | 32 | $ - 0 | $ - 0 |
| h. Skull or Head | 4 | $ - 0 | $ - 0 |
| i. Thoracic Spine | 4 | $ - 0 | $ - 0 |
| j. LumoSacral (LS) Spine | 16 | $ - 0 | $ - 0 |
| k. Abdomen | 12 | $ - 0 | $ - 0 |
| l. Pelvis | 1 | $ - 0 | $ - 0 |
| m. Ribs | 4 | $ - 0 | $ - 0 |
| TOTAL GROUP 1 | $ - 0 |
| Group 2. Ultrasound | Estimated Number of Tests | Price Per Test | Total Price |
| a. Obstetric - Pelvis | 4 | $ - 0 | $ - 0 |
| b. Obstetric - Abdomen | 1 | $ - 0 | $ - 0 |
| c. Breast | 1 | $ - 0 | $ - 0 |
| d. Prostate | 1 | $ - 0 | $ - 0 |
| e. Thyroid | 4 | $ - 0 | $ - 0 |
| f. Vascular Doppler | 10 | $ - 0 | $ - 0 |
| g. Venous (Extremities) | 5 | $ - 0 | $ - 0 |
| h. Echocardiogram | 42 | $ - 0 | $ - 0 |
| TOTAL GROUP 2 | $ - 0 |
YEAR THREE - TOTAL GROUP 1 + TOTAL GROUP 2 = $ - 0
Total Bid Price
| Exhibit B.1 – BID FORM |
| Mobile X-Ray Services at Clifton T. Perkins Hospital Center |
| BPM053986 |
| The Bid Form shall contain an all inclusive price and information in the format specified on these pages including all surcharges (ex: fuel, travel, technician rate etc.) as well as all administrative costs. Complete the Bid Form only as provided in the Bid Instructions. Do not amend, alter or leave blank any items on the Bid Form. Tests are an estimate only and not representative of the amounts that may be ordered during the course of each year. The pricing is used to evaluate estimated annual costs. Failure to adhere to any of these instructions may result in the Bid being determined not responsive. |
| The total Contract award shall not exceed $50,000. |
| TOTAL PRICE YEAR ONE = | $ - 0 |
| TOTAL PRICE YEAR TWO = | $ - 0 |
| TOTAL PRICE YEAR THREE = | $ - 0 |
| TOTAL BID PRICE (YEAR ONE + YEAR TWO + YEAR THREE) = | $ - 0 |
| Signature of Authorized Representative: |
| Printed Name and Title: |
| Telephone: |
| Email address: |
| Bidder Company Name: |
| Bidder Company Address: |
| City/State: |
| Date: |
| FEIN: |
| eMMA #: |
| CSB#/MBE#VSB#: |
File details come from the government source that posted it. Updated .