Exhibit C_Bid Price.docx

This is a bid price exhibit (Exhibit C) for RFQQ 2025 0131 from the Washington State Department of Transportation (WSDOT) requesting medical invoice review services. The document presents three sample medical cases for vendors to demonstrate their invoice savings capabilities: a physical therapy case from South Whidbey Physical Therapy ($175 charge), a chiropractic services case from Allied Chiropractic Pain and Injury Center ($125 charge), and an MRI case from Evergreen Radia and Imaging ($1,350 charge).

For each sample case, vendors must indicate the amount reduced, percentage of savings on the original invoice, vendor's fee based on savings, and calculate the net cost to WSDOT. The evaluation will be based on the total net cost to WSDOT across all three samples. Vendors must complete all calculations, sign the document, and include their company name and authorized representative information. All unsigned quotes submitted in response to RFQQ 2025 0131 will not be accepted by WSDOT.